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Trial registered on ANZCTR
Registration number
ACTRN12614000227695
Ethics application status
Not yet submitted
Date submitted
20/02/2014
Date registered
4/03/2014
Date last updated
4/03/2014
Type of registration
Prospectively registered
Titles & IDs
Public title
Unique Manuka Factor (UMF) honey as a subgingival delivery device in the treatment of chronic periodontitis - a pilot study.
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Scientific title
Use of manuka honey subgingivally, as an adjunct to scaling and root planing (SRP) versus SRP alone, during treatment of chronic periodontitis in adult patients, in order to reduce probing pocket depths and gingival bleeding; a randomised single-blinded split-mouth clinical trial.
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Secondary ID [1]
284133
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nil
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Universal Trial Number (UTN)
U1111-1153-6120
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Trial acronym
MAP Pilot study
(Manuka honey for Adjunctive treatment of Periodontitis)
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Periodontitis
291214
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Condition category
Condition code
Oral and Gastrointestinal
291556
291556
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Alternative and Complementary Medicine
291557
291557
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0
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Other alternative and complementary medicine
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This pilot study will examine the ease of application of the product, the substantivity of the active manuka honey agent within the periodontal pocket, and the release profile of the proposed Unique Manuka Factor (UMF) agent during a 7-day pharmacokinetic study. Unique Manuka Factor (UMF) Honey will be applied below the gum around teeth with periodontitis, in combination with scaling and root planing (SRP). Each participant will receive full mouth SRP under local anaesthetic in two treatment sessions of one hour per session, over a 24-hour period. 0.05ml of Manuka honey will be delivered using a blunt cannula into the test site immediately after SRP, where possible after the first treatment session.
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Intervention code [1]
288827
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Treatment: Other
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Comparator / control treatment
Scaling and rootplaning alone: each participant will receive full mouth SRP under local anaesthetic in two treatment sessions of one hour per session, over a 24-hour period. Control sites receive no additional treatment.
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Control group
Active
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Outcomes
Primary outcome [1]
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Gingival crevicular fluid samples will be taken from the periodontal pockets using PerioPaper strips. The presence and activity of methylglyoxal in GCF will be quantified by using the neutralization assay of Kwakman et al. (2011). The strips will be stored at -80 degrees C until assayed, then thawed and centrifuged derivatized for 30 min at room temperature with o-phenylene-diamine to give 2-methylquinoxaline, according to the method of Chaplen et al. (1998). Derivatized samples will be partially purified by solid-phase extraction and subjected to reverse phase chromatography in an HPLC system.
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Assessment method [1]
291517
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Timepoint [1]
291517
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Baseline (prior to SRP) and 1, 3, 5 and 7 days after therapy
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Primary outcome [2]
291518
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Subgingival bacterial plaque samples will be taken from the periodontal pockets using a sterile curette. Subgingival plaque samples will be transferred without delay to labeled sterile transport tubes containing phosphate-buffered saline and frozen at-80 degrees C until analysis. A multiplex qRT-PCR assay will be used for the detection and quantification of seven microbial pathogenic species: A actinomycetemcomitans, P gingivalis, P intermedia, T forsythia, F nucleatum, T denticola and S aureus. Species-specific PCR primers and TaqMan probes will be designed and synthesised as described by Suzuki et al (2004). The microbial species will be quantified using the cycle threshold (^^Ct) method as described by Joyce (2002). Oral samples will be treated with InstaGene Matrix (Bio Rad) and small aliquots (in duplicate) will be subjected to TaqMan-based mqRT-PCR using the ABI 7500 Fast Real-Time qPCR System.
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Assessment method [2]
291518
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Timepoint [2]
291518
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Baseline (prior to SRP) and 1, 3, 5 and 7 days after therapy
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Secondary outcome [1]
306941
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Clinical indices consisting of Plaque Index (PI), Pocket Depth (PD), Clinical Attachment Level (CAL) and Bleeding on Probing (BOP) parameters will be recorded at all time intervals at both sites using a periodontal probe with Williams markings and 20g force.
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Assessment method [1]
306941
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Timepoint [1]
306941
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Baseline (prior to SRP) and 1, 3, 5 and 7 days after therapy
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Eligibility
Key inclusion criteria
Adult patients with chronic periodontitis (two non-molar sites in opposite quadrants with pocket depths greater than or equal to 6mm and bleeding on periodontal probing)
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Current or recent (<6 months) antibiotic therapy, pregnancy or breastfeeding, uncontrolled diabetes, medical conditions or devices requiring antibiotic prophylaxis, current bisphosphonate therapy, immunocompromised individuals or those with a known hypersensitivity to pollen or bee products.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Study participants will be recruited from the periodontal patient population at a private specialist periodontal practice in Nelson, New Zealand). A split mouth design will be used, with treatments allocated randomly to either site; patients will not be informed which site is the test site. Allocation of sites will be determined by a second clinician (hygienist) and delivered using sealed opaque envelopes; allocation will be concealed from the primary clinician.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Two experimental sites will be randomly allocated at the split-mouth level by a computer-generated table into either the test group (SRP+UMF) or the control group (SRP alone)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Other
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Other design features
Single group, split mouth(pilot study)
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Phase
Phase 2
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Descriptive statistical analyses of the changes in the clinical and microbiological parameters will be employed using Mann-Whitney U tests (P <0.05) and one-way analysis of variance tests (ANOVA).
This is a pre-trial pilot study using six individuals; results will determine the sample size for the main trial (see separate trial registration)
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
21/03/2014
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
6
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
5844
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New Zealand
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State/province [1]
5844
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Nelson
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Funding & Sponsors
Funding source category [1]
288764
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Charities/Societies/Foundations
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Name [1]
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New Zealand Dental Association Research Foundation
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Address [1]
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PO Box 28 084, Remuera, Auckland 1541, New Zealand NZDA House, 1/195 Main Highway, Ellerslie, Auckland 1051
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Country [1]
288764
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New Zealand
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Primary sponsor type
Individual
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Name
Dr Helen English
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Address
Nelson Periodontics
2 Brougham St Nelson 7010
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Country
New Zealand
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Secondary sponsor category [1]
287461
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Individual
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Name [1]
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Associate Professor Warwick Duncan
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Address [1]
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Director, Clinical Research Group Sir John Walsh Research Institute University of Otago School of Dentistry
PO Box 647 University of Otago Dunedin 9054
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Country [1]
287461
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New Zealand
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Secondary sponsor category [2]
287462
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Individual
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Name [2]
287462
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Associate Professor Patrick Schmidlin
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Address [2]
287462
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Head of Periodontics
University of Zurich
Zentrum fur Zahnmedizin (Center for Dentistry) Plattenstrasse 11
8032 Zurich
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Country [2]
287462
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Switzerland
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
290606
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Northern A Health and Disability Ethics Committee
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Ethics committee address [1]
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Ministry of Health No 1 The Terrace PO Box 5013 Wellington 6011
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Ethics committee country [1]
290606
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New Zealand
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Date submitted for ethics approval [1]
290606
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21/02/2014
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Approval date [1]
290606
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Ethics approval number [1]
290606
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Summary
Brief summary
The unique antimicrobial properties of honey are well recognized. Although many honeys display antibacterial effects, the active ingredient thought to be responsible for the unique and superior antibacterial properties of honey obtained from the manuka shrub is methylglyoxal, measured by a Unique Manuka Factor (UMF registered trademark) rating. In recent years local delivery systems containing antibiotics have been introduced as an adjunctive therapy to traditional treatment of periodontal (gum) disease to optimize healing. However, use of a natural product utilising the superior therapeutic potential of our own readily-available New Zealand manuka honey in the treatment of periodontitis may show significant potential. The aim of this study is to compare the effects of manuka honey delivered into the periodontal pocket following scaling and root planing (SRP+UMF), with scaling and root planing alone (SRP). This study is the pilot trial to test the ease of application of the honey and its ability to stay in the pocket. The second phase for which a separate registrations has been made, will recruit 60 patients who fit the inclusion criteria from a private specialist periodontal practice and a single-blind, split-mouth, randomised clinical trial design methodology will be followed. Clinical measurements and microbiological analysis of plaque samples will be analysed for 6 months post-treatment.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Helen English
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Address
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Nelson Periodontics 2 Brougham St Nelson 7010
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Country
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New Zealand
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Phone
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6435489955
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Helen English
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Address
46399
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Nelson Periodontics 2 Brougham St Nelson 7010
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Country
46399
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New Zealand
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Phone
46399
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6435489955
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Fax
46399
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Email
46399
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[email protected]
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Contact person for scientific queries
Name
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Warwick Duncan
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Address
46400
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Faculty of Dentistry PO Box 647 University of Otago Dunedin 9054 New Zealand
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Country
46400
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New Zealand
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Phone
46400
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6434797110
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Fax
46400
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Email
46400
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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