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Natural extracts supplement use as anti-inflammatory modulator in periodontitis and oral surgery: a randomized controlled trial
Università degli studi di Chieti
Department of Medical, Oral and Biotechnological Sciences University of Chieti “G. d’Annunzio” 31, Via dei Vestini – 66013 Chieti, Italy
Prof. Marco Dolci; Dr Silvia D’Agostino; Dr Davide Salvatore
Prof. Marco Dolci; Dr Silvia D’Agostino; Dr Davide Salvatore
English; Italian; Spanish
Type of Research Project
- Clinical Project without Laboratory work
What is the background of the project?
Inflammation is an innate defense mechanism that activates our body to react to harmful stimuli, such as an infection. The purpose of inflammation is to eliminate the initial cause of cell or tissue damage and start a reparative process. The inflammatory reaction includes various clinical factors such as: local swelling, redness, increased body temperature and pain. Gingivitis is an inflammatory condition affecting the soft tissues surrounding the tooth; it is a direct immune response, in reaction to the microbial plaque present on the tooth surface. It is a reversible condition, unlike periodontitis. Typical clinical parameters which are evaluated in gingival inflammation are: FMPS: full mouth plaque score FMBS: full mouth bleeding score PPD: probing pocket depth Several enzymatic compounds (bromelain, papain and nattokinase) and phytotherapic compounds (curcumin, myrrh) have been individually investigated as natural anti-inflammatories.
What is the aim of the project?
The aim of the project is to observe the effects of a natural supplement in post-surgical management and in gingivitis/periodontitis.
What techniques and methods are used?
Patients over 18 years affected by periodontal diseases or post-surgical phlogoses will be considered. Exclusion parameters are: - subjects below 18 years of age; - pregnancy and breastfeeding; - patients with liver disease; - patients with coagulopathies (treated with antiplatelet agents, anticoagulants drugs and NOA, new oral anticoagulants). After completing the individual medical history folder and after accepting the specific informed consent, non-invasive parameters relating to gingival health will be detected. These parameters include: Full mouth bleeding score, FMBS, Periodontal probing depth reduction (PPD), Full Mouth plaque score (FMPS), Visual analog scale (VAS) for pain, Post-surgical edema (extraoral measurement with sartorial cm), Trismus (intraoral measurement with a caliber). At t0 the patients eligible for the first visit will be divided into 3 groups according to the randomization technique with the use of an online software for the management of random numbers and will undergo a professional oral hygiene session or oral surgery (extractions, dental implant placements). GROUP 1: Suitable patients will be encouraged to follow the normal post-treatment oral hygiene practices and will be advised to take the supplement 2 tablets a day for 7 days after the treatment. The intake should take place between meals (45 minutes before or an hour and a half after eating). The supplement will be provided to them free. GROUP 2: Suitable patients will be encouraged to follow the normal post-treatment oral hygiene practices and will be advised to use a mouthwash with Chlorhexidine 0.2%, twice a day, with rinses of 60s each, over 7 days following treatment. They will not have to dilute the mouthwash with water, and they will not have to eat, drink or smoke for the next hour. It will be provided to them free. GROUP 3: Eligible patients will be encouraged to follow the normal post-treatment oral hygiene practices: using a soft-bristle toothbrush at least 3 times a day for at least 2 minutes, performing the "Bass technique" (explained to patients during chair-based motivation). The use of interdental devices is also recommended. The 3 groups will be reviewed at t1 = 48h after treatment, and at t2 = 7 days after treatment, with the recording of all the parameters mentioned above. The data obtained will be inserted in the patient's personal medical records, so that they can always access it. Microsoft Excel e ImageJ softwares will be used to analyze data.
What is the role of the student?
- The student will mainly observe
- The tasks will be done under supervision
What are the tasks expected to be accomplished by the student?
Every day the tutors will show to the student the planning of the day. The student will follow them into the Dental Clinic, once there, he can prepare tools for the dental unit. The tutors will introduce the student and his role to the patients, he will attend during the medical examination and during the treatment plan elaboration, he can ask questions to physicians and dental hygienists. The student will rearrange the dental unit and he will be educated on the principles of disinfections of surfaces and tools, so he can do it himself. The student will write down the values recorded for the study (FMPS; FMBS; PPD; VAS;) and he can complete tables about these values for each patient. The student will assist the data processing for the statistical analysis, and he/she can learn how to use Microsoft Excel and ImageJ.
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
Prof. Marco Dolci and Dr. Silvia D’Agostino will provide at least 2 seminars, 2 hours per seminar.
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- The student will prepare a scientific report
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
Good English, curiosity, desire to learn, compliance. Subjects passed: Anatomy; General Pathology.
Are there any legal limitations in the student’s involvement
Type of students accepted
This project accepts: - Medical students - Pre-Medical students from the American-British system
- Chen; H.; McGowan E.M.; Ren; N.; Lal; S.; Nassif; N.; Shad-Kaneez; F.; Qu; X. & Lin; Y. Nattokinase: A Promising Alternative in Prevention and Treatment of Cardiovascular Diseases. A short review. Biomarker Insights: SAGE Journals. (2018)
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