Clinical Research Directory

Polynucleotides and Hyaluronic Acid vs Enamel Matrix Proteins in the Treatment of Intrabony Defects

The goal of this clinical trial is to compare two periodontal regenerative treatments in adults with Stage III or IV periodontitis and infrabony periodontal defects ≥3 mm. The study aims to determine whether hyaluronic acid and polynucleotides (Regenfast®) combined with bovine bone graft material (Bio-Oss®) provides similar or improved periodontal regeneration compared with enamel matrix derivative proteins (Emdogain®) combined with Bio-Oss®. Researchers will evaluate: * Periodontal healing and bone regeneration * Changes in probing depth, clinical attachment level, gingival recession, and tooth mobility * Radiographic bone fill * Survival of treated teeth after 1, 3, and 5 years Participants will: * Receive initial periodontal treatment and oral hygiene instruction * Undergo clinical and radiographic evaluation * Receive minimally invasive periodontal regenerative surgery under local anesthesia * Be randomly assigned to receive either Regenfast® + Bio-Oss® or Emdogain® + Bio-Oss® * Attend follow-up visits with periodontal examinations and radiographs over 5 years

Blood Glucose Screening in Patients With Advanced Periodontits: the Role of Specialist Periodontal Care in Identifying Hyperglycaemia and Supporting Patient Centered Treatment

Periodontitis is a chronic inflammatory disease and individuals with advanced periodontitis have an increased risk of hyperglycaemia. Bacterial plaque, smoking and elevated blood glucose levels are considered key modifiable risk factors for periodontal disease progression. Conventional periodontal care aims to remove and control bacterial deposits and to smoking cessation. Despite the bidirectional relationship, where periodontitis may also contribute to impaired glycaemic control, glycaemic status is rarely niether assessed nor adressed in dental care. The aim of this project is to implement and evaluate routine blood glucose testing as part of the periodontal examination in specialist dental care. Patients diagnosed with advanced periodontitis (Stage III or IV according to the current classification) will be offered capillary blood glucose testing during their periodontal assessment. The objectives of this study are to determine the prevalence of hyperglycaemia among patients with advanced periodontitis and to evaluate clinician-reported and patient-reported experiences of routine blood glucose testing as part of the periodontal assesment in specialist periodontal care.

Application of a Fasting-mimicking Diet in Obese Patients With Periodontitis Stage III-IV

This study will evaluate whether a fasting-mimicking diet (FMD) can improve the systemic and periodontal response to non-surgical periodontal treatment in obese adults with severe periodontitis. Periodontitis is a serious inflammatory disease that damages the tissues supporting the teeth and may also contribute to inflammation elsewhere in the body. Obesity is also associated with increased systemic inflammation, which may worsen periodontal disease and affect treatment outcomes. In this pilot randomized cross-over clinical trial, eligible participants will receive full-mouth non-surgical periodontal therapy and will be assigned either to an FMD group or to a control group continuing their usual diet. The FMD will be administered in three 5-day cycles around the periodontal treatment period. After a wash-out period, the groups will switch interventions. The study will assess whether FMD can reduce systemic inflammation, measured primarily by serum C-reactive protein (CRP), and improve periodontal healing after treatment. Additional outcomes include clinical periodontal measurements, inflammatory markers in gingival crevicular fluid, and changes in oral and gut microbiota. Findings from this study will help determine the feasibility of this dietary approach and provide preliminary data for a larger clinical trial.

Development and Validation of the Periodontal Map Derived From IOS and CBCT Registration for Diagnosis and Treatment Planning in Moderate-to-severe Periodontitis

This prospective diagnostic study aims to validate the clinical utility of a "Periodontal Panoramic Map" generated by the PerioAI V2.0 system, an artificial intelligence-based platform that integrates intraoral scans and cone-beam CT data, for preoperative diagnosis and surgical planning in patients with moderate to severe periodontitis (Stage II-IV). Current clinical standards-manual probing and two-dimensional radiography-have inherent limitations in accurately visualizing complex three-dimensional bone defect morphology, leading to potential underestimation of disease severity and suboptimal surgical outcomes. Building upon our team's previously published high-precision PerioAI V1.0 system, this study will enroll 80 patients requiring periodontal surgery. Preoperative intraoral scans and cone-beam CT images will be acquired as part of routine care, and the PerioAI V2.0 system will automatically generate a "Periodontal Panoramic Map" with intelligent outputs including probing depth, clinical attachment loss, bone defect morphology classification, furcation involvement grading, and automated measurements of key parameters such as intra-bony defect depth and width. These automated diagnostic results will be compared against the gold standard of full mouth clinical examination and intra-operative direct measurements and observations obtained during periodontal surgery under strict blinded conditions. The primary outcome measures are the accuracy of bone defect morphology classification and the agreement between automated and intra-operative linear measurements assessed by intraclass correlation coefficients and Bland-Altman analysis. Secondary outcomes include accuracy of probing depth, clinical attachment loss, periodontitis staging and grading, furcation involvement grading and treatment planning. This study will provide critical evidence supporting the paradigm shift in periodontal surgery from experience-dependent assessment to data-driven precision medicine, ultimately offering clinicians an intuitive, quantitative, and three-dimensional visualization tool for optimized surgical decision-making.

Microbiological and Clinical Effects of Pre- and Probiotics in Non-Surgical Periodontal Therapy

Periodontitis is a prevalent chronic inflammatory disease driven by a dysbiotic oral biofilm and a dysregulated host immune response. Standard non-surgical periodontal therapy (NSPT) is primarily mechanical and, in selected cases, may be accompanied by antiseptics or systemic antibiotics. Targeted modulation of the oral microbiome ("microbiome engineering") is currently not part of routine periodontal care due to limited high-quality evidence. PROPARO is a single-center, randomized, controlled pilot study designed to assess whether adjunctive oral supplementation with a probiotic containing Limosilactobacillus reuteri (commercial dietary supplement lozenge) alone or combined with vitamin B12 (commercial dietary supplement drops) is associated with changes in supragingival and subgingival oral microbiome composition during guideline-concordant NSPT compared with standard care alone. Participants with Stage III or IV periodontitis will be randomized 1:1:1 to: (1) NSPT/SPT without supplementation (control), (2) NSPT/SPT plus probiotic lozenges for 3 months, or (3) NSPT/SPT plus probiotic lozenges and vitamin B12 drops for 3 months. The primary outcome is change in oral microbiome composition and structure (supragingival and subgingival), assessed using 16S rDNA-based profiling and metagenomic sequencing approaches. Secondary outcomes include clinical periodontal parameters (e.g., probing depth, clinical attachment level, bleeding on probing), oral hygiene/gingival indices, dental status, and participant-level ecological covariates (diet quality, perceived stress, physical activity). Sampling and assessments are aligned with routine care time points from baseline through supportive periodontal therapy follow-up (up to 12 months). This pilot trial aims to generate feasibility and effect-size estimates to inform future confirmatory studies and potential translation into guideline-based periodontal care.