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I) Patients:
the present study will be carried on periodontitis patients. The patients will be informed about the treatment steps. This includes the possible effects or risks, and other treatment options according to the rules of the ethical committee of Faculty of dentistry, Mansoura University.
Groups:
Group I (negative control): 15 periodontally healthy subjects . Group II (positive control): 15 patients will be treated with mechanical debridement only.
Group III (study group A): 15 patients will be treated with mechanical debridement followed by delivery of spirulina gel extracted by phosphate buffered saline (PBS).
Group IV (study group B): 15 patients will be treated with mechanical debridement followed by delivery of spirulina gel exracted by 1.5% calcium chloride (CaCl2) aqueous solution.
Group V (study group C): 15 patients will be treated with mechanical debridement followed by delivery of spirulina gel exracted by ethanol.
In group III, IV and V extract of spirulina algae powder (Emtenan Health Shop,2019 © Egypt,TEL 16246)
Periodontal evaluation will be performed for all patients at baseline and after three months including the following parameters:
Immunological analysis of TNF-α in GCF
I) Patients:
The patient will be selected from Out Patient Clinic, Department of Oral Medicine, Periodontology, Diagnosis and Oral Radiology, Faculty of Dentistry, Mansoura University. The patients will be informed about the treatment steps. This includes the possible effects or risks, and other treatment options according to the rules of the ethical committee of Faculty of dentistry, Mansoura University. The patients must be legally competent to provide written consent before performing any required steps.
A)Inclusion Criteria
1. Systemic diseases / drugs which could influence the outcome of the therapy (According to Cornell Medical Index-Health Questionnaire).
2. Receiving periodontal therapy in past 6 month. 3. Pregnant and lactating females. 4. Vulnerable groups of patients (e.g handicapped patients and decisionally impaired individuals).
5. Smoking.
D) Groups:
Group I (negative control): 15 periodontally healthy subjects . Group II (positive control): 15 patients will be treated with mechanical debridement only.
Group III (study group A): 15 patients will be treated with mechanical debridement followed by delivery of spirulina gel extracted by phosphate buffered saline (PBS).
Group IV (study group B): 15 patients will be treated with mechanical debridement followed by delivery of spirulina gel exracted by 1.5% calcium chloride (CaCl2) aqueous solution.
Group V (study group C): 15 patients will be treated with mechanical debridement followed by delivery of spirulina gel exracted by ethanol.
In group III, IV and V extract of spirulina algae powder (Emtenan Health Shop,2019 © Egypt,TEL 16246)
II) Clinical Procedures:
A) Periodontal assessment:
Periodontal evaluation will be performed for all patients at baseline and after three months including the following parameters:
III) Laboratory procedures
A) Pharmaceutics Section: Formulation development:
Based on the oil formulation, various gels will be developed with a focus on creating formulations suitable for clinical application.
B) Immunological analysis of TNF-α in GCF Assessment of crevicular fluid TNF-α will be performed using enzyme-linked immunosorbent assay technique.
C)Sterilization and Disinfection Protocol for Laboratory Procedures To maintain aseptic conditions and prevent contamination during the laboratory phase, all work surfaces will be disinfected before and after procedures using 70% ethanol or a commercial disinfectant. Personnel will adhere to strict hygiene measures, including wearing disposable gloves, lab coats, and face masks. Glassware and metal instruments will be autoclaved before and after use, while plastic consumables will be pre-sterilized and discarded after single use. The active constituent formulation will be conducted under sterile conditions in a biosafety cabinet, with filtration through 0.22 µm or 0.45 µm Millipore filters to ensure sterility before gel incorporation. The final gel formulations will be packaged in sterile, sealed containers and stored under controlled conditions. Microbiological safety checks, including sterility testing on nutrient agar plates incubated at 37°C for 24-48 hours, will be performed alongside physicochemical assessments (pH and viscosity) to confirm formulation stability. Biohazardous waste will be autoclaved before disposal, and all sharp or glass waste will be discarded in designated biohazard containers following institutional guidelines. These sterilization measures will ensure product integrity, compliance with laboratory safety protocols, and the reliability of experimental results.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| negative control periodontally healthy subjects | No Intervention | periodontally healthy subjects no intervention | |
| positive control | Experimental | patients will be treated with mechanical debridement only. |
|
| study group A | Experimental | patients will be treated with mechanical debridement followed by delivery of spirulina gel extracted by phosphate buffered saline (PBS). |
|
| study group B | Experimental | patients will be treated with mechanical debridement followed by delivery of spirulina gel exracted by 1.5% calcium chloride (CaCl2) aqueous solution. |
|
| study group C | Experimental | patients will be treated with mechanical debridement followed by delivery of spirulina gel exracted by ethanol. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mechanical debridement will be performed for 15 stage II periodontitis patient | Other | Mechanical debridement will be performed for 15 stage II periodontitis patient |
|
| Measure | Description | Time Frame |
|---|---|---|
| assess the clinical effectiveness of the locally delivered spirulina gel prepared by different pharmaceutical extraction methods as an adjunctive therapy to mechanical debridement in stage II grade B periodontitis. | 1-Plaque index: Evaluates the presence of plaque in a dichotomous manner. Each buccal, lingual, mesial, and distal surface of all present teeth is recorded as positive if it presents soft accumulations at the dentogingival junction. 2-Bleeding on Probing : Recorded from all present teeth (excluding third molars) at four sites per tooth: mesial, distal, buccal, and lingual. BOP is assessed in a dichotomous manner, indicating the presence or absence of bleeding following gentle probing.3-Gingival index:score of 0 represents normal gingiva score of 1 mild inflammation score of 2 moderate inflammation score of 3 severe inflammation • 4-Probing pocket depth:It is defined as the distance, measured in millimeters, from the free gingival margin to the base of the gingival sulcus.5-• Clinical attachment level:the distance in millimeters from the cementoenamel junction to the base of the periodontal pocket. | 3months |
| Measure | Description | Time Frame |
|---|---|---|
| assess the impact of the locally delivered spirulina gel prepared by different pharmaceutical extraction methods as an adjunctive therapy to mechanical debridement on the GCF level of TNF-α in stage II grade B periodontitis. | GCF sample will be taken to measure the TNF-alpha TNF-alpha is inflammatory marker will be assessed by using the enzyme-linked immunosorbent assay technique. | 3 months |
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Inclusion Criteria:
1. Patients with Stage II Periodontitis grade B periodontitis (horizontal bone loss with maximum probing depth ≤ 5 mm and with 3-4 mm clinical attachment loss).
2. Minimum of 20 remaining teeth. 3. Age range (25 - 50) years. 4. Good compliance with the plaque control instructions following initial therapy.
5. Availability for follow up and maintenance program.
Exclusion Criteria:
Systemic diseases / drugs which could influence the outcome of the therapy (According to Cornell Medical Index-Health Questionnaire).
Receiving periodontal therapy in past 6 month.
Pregnant and lactating females.
Vulnerable groups of patients (e.g handicapped patients and decisionally impaired individuals).
Smoking.
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| Name | Affiliation | Role |
|---|---|---|
| Faisal Mohammed Alsharif, Bachelor's degree | Mansoura University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mansoura University Faculty of Dentistry | Al Mansurah | Dakahlia Governorate | 00000 | Egypt |
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this is a retrospective interventional study
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| spirulina gel extracted by phosphate buffered saline (PBS). | Drug | 15 patients will be treated with mechanical debridement followed by delivery of spirulina gel extracted by phosphate buffered saline (PBS). |
|
| spirulina gel exracted by 1.5% calcium chloride (CaCl2) aqueous solution. | Drug | 15 patients will be treated with mechanical debridement followed by delivery of spirulina gel exracted by 1.5% calcium chloride (CaCl2) aqueous solution. |
|
| spirulina gel exracted by ethanol. | Drug | 15 patients will be treated with mechanical debridement followed by delivery of spirulina gel exracted by ethanol |
|
| ID | Term |
|---|---|
| D010510 | Periodontal Diseases |
| D010518 | Periodontitis |
| ID | Term |
|---|---|
| D009059 | Mouth Diseases |
| D009057 | Stomatognathic Diseases |
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| ID | Term |
|---|---|
| D002122 | Calcium Chloride |
| ID | Term |
|---|---|
| D017610 | Calcium Compounds |
| D007287 | Inorganic Chemicals |
| D002712 | Chlorides |
| D006851 | Hydrochloric Acid |
| D017606 | Chlorine Compounds |
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