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Trial registered on ANZCTR
Registration number
ACTRN12623000893606
Ethics application status
Approved
Date submitted
7/08/2023
Date registered
21/08/2023
Date last updated
20/09/2024
Date data sharing statement initially provided
21/08/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
Evaluation of the Prebiotic Effect of New Dentifrice Formulations In Healthy Adults
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Scientific title
Effect of a Toothpaste containing Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) and Stannous Fluoride on Supragingival Plaque Composition and Gingivitis in Healthy Adults
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Secondary ID [1]
310321
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Oral Health
331040
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Condition category
Condition code
Oral and Gastrointestinal
327836
327836
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0
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Normal oral and gastrointestinal development and function
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants will brush their teeth with the allocated toothpaste (i.e., one of the test products) three times per day for 21 consecutive days at the following times: after breakfast, after dinner and before retiring. Participants will use an amount of toothpaste to completely cover the bristles on their toothbrush. The participants will then brush their teeth for two minutes ensuring they brush all tooth surfaces. After toothbrushing the participants will not eat or drink for 30 minutes.
A diary will be provided for each participant to record the times of administration of intervention treatment (i.e., toothbrushing with their allocated toothpaste) each day during the treatment period and returned at the completion of the study.
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Intervention code [1]
326699
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Treatment: Other
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Comparator / control treatment
Marketed Control: Colgate Total SF toothpaste containing stannous fluoride (1100 ppm F).
Participants will brush their teeth for two minutes with Colgate Total SF toothpaste three times a day after breakfast, after dinner and before bed, with no other oral hygiene procedures over 21 days.
A diary will be provided for each participant to record their interventions and compliance during the treatment period and returned at the completion of the study.
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Control group
Active
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Outcomes
Primary outcome [1]
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Change in gingivitis.
Tools/tests to be used for assessment:
Clinical examination will be performed at the start and finish of the treatment period by a trained dentist.
Gingivitis will be measured using the Modified Gingival Index (MGI – Lobene et al., 1986). This index is a modification of the Löe and Silness (1963) Gingival Index and allows greater discrimination for mild and moderate gingivitis. In this study, gingival inflammation on a scale from 0 to 4 will be scored for gingival tissues associated with four sites (buccal, lingual, mesial and distal) of all teeth (excluding third molars).
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Assessment method [1]
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Timepoint [1]
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Baseline before intervention, and 21 days post-intervention commencement.
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Secondary outcome [1]
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Change in bleeding on probing.
Tools/tests to be used for assessment:
Clinical examination will be performed at the start and finish of the treatment period by a trained dentist.
Bleeding on probing will be scored using the Sulcus Bleeding Index (SBI – Muhlemann and Son, 1971).
Four gingival units are scored systematically for each tooth: the labial and lingual marginal gingival (M units) and the mesial and distal papillary gingival (P units). Scores for these units are added and divided by four. Adding the scores of the undivided teeth and dividing them by the number of teeth can determine the sulcus bleeding index.
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Assessment method [1]
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Timepoint [1]
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Baseline before intervention, and 21 days post-intervention commencement.
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Secondary outcome [2]
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Development of supragingival plaque.
Tools/tests to be used for assessment:
Clinical examination will be performed at the start and finish of the treatment period by a trained dentist..Supragingival plaque will be collected from the buccal surfaces of the maxillary molars
Supragingival plaque will be assessed using the Turesky modification of the Quigley-Hein Index (TPI – Turesky et al., 1970). This index is recognized as a reliable estimate of the tooth area covered by plaque and is frequently used for evaluating anti-plaque agents. Plaque scores associated with unrestored labial, buccal and lingual surfaces of all teeth, except third molars will be assessed. Each surface will be assigned a score from 0 to 5.
The plaque index is obtained by adding the scores for each tooth and dividing by the number of surfaces examined.
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Assessment method [2]
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Timepoint [2]
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Baseline before intervention, and 21 days post-intervention commencement.
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Secondary outcome [3]
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Shift in microbial composition of the supragingival plaque formed on the maxillary molars.
Tools/tests to be used for assessment:
Clinical examination will be performed at the start and finish of the treatment period by a trained dentist. Supragingival plaque will be collected from the buccal surfaces of the maxillary molars. Genomic DNA will be extracted from the supragingival plaque using a combination of mechanical disruption of the cells via a Precellys homogeniser and the chemical extraction and purification of the genomic DNA via the PowerLyzer PowerSoil DNA Isolation Kit (MoBio). Quantitation of the extracted DNA will be achieved using a Qubit dsDNA High Sensitivity Assay kit (ThermoFisher), before 5 ng DNA is used as template in a PCR reaction that amplifies the V1-V3 variable region of the 16S ribosomal RNA gene and individually barcodes the PCR product from each sample. The barcoded DNA will then be sequenced using an Ion Torrent Personal Genome machine and Torrent Suiteâ„¢ Software (ThermoFisher).
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Assessment method [3]
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Timepoint [3]
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Baseline before intervention, and 21 days post-intervention commencement.
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Eligibility
Key inclusion criteria
Inclusion Criteria:
To be eligible to participate in this study, an individual must meet all of the following criteria:
1. Ability to understand, and willingness and ability to read and sign, the informed consent form.
2. Age range: 18 to 75 years old.
3. Good general health.
4. Minimum of 20 natural teeth.
5. A gum-stimulated whole salivary flow rate greater than or equal to 1.0 ml/minute and unstimulated whole salivary flow rate greater than or equal to 0.2 ml/minute.
6. A baseline mean whole-mouth modified gingival index greater than or equal to 1.2.
7. A baseline mean whole-mouth plaque index greater than or equal to 1.5.
8. Willingness to comply with all study procedures and be available for the duration of the study.
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Minimum age
18
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Exclusion Criteria:
Individuals who manifest ANY of the following exclusion criteria at the time of randomization will NOT be eligible for the study:
1. Allergy to milk protein, tin or other ingredients in toothpaste products.
2. Orthodontic appliances or removable prostheses.
3. Veneers, or more than one incisor with a prosthetic crown.
4. Gross oral pathology (including periodontal disease {Community Periodontal Index of Treatment Needs [CPITN] greater than or equal to 3} and tumours of the soft or hard oral tissues).
5. Chronic disease with concomitant oral manifestations (e.g., diabetes [irrespective of level of control], human immunodeficiency virus infection or acquired immunodeficiency syndrome, use of medications associated with gingival hyperplasia).
6. Unrestored dentinal caries.
7. Treatment with antibiotics or anti-inflammatory medication in the month prior to starting the study.
8. Concomitant pharmacotherapy with drugs that may interact with test drug.
9. History of conditions requiring antibiotic coverage prior to invasive dental procedures.
10. Pregnancy/lactation.
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
4/09/2023
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Actual
10/10/2023
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Date of last participant enrolment
Anticipated
31/12/2024
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Actual
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Date of last data collection
Anticipated
31/03/2025
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Actual
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Sample size
Target
40
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Accrual to date
10
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment postcode(s) [1]
41054
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3010 - University Of Melbourne
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Centre of Oral Health Research
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Address [1]
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Centre of Oral Health Research, Melbourne Dental School
The University of Melbourne
720 Swanston Street
Melbourne, Victoria 3010
Australia
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Country [1]
314527
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Australia
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Primary sponsor type
University
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Name
The University of Melbourne
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Address
The University of Melbourne
Melbourne, Victoria 3010
Australia
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
316484
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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University of Melbourne Central Human Research Ethics Committee
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Ethics committee address [1]
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Office of Research Ethics and Integrity | Research, Innovation & Commercialisation Level 5, Alan Gilbert Building, 161 Barry Street, Carlton The University of Melbourne, Victoria 3010, Australia
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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16/08/2023
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Approval date [1]
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22/09/2023
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Ethics approval number [1]
313569
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Summary
Brief summary
This examiner-blinded, randomized controlled clinical trial will use a two-treatment, parallel design to assess the effects of the treatments on the severity of gingivitis, accumulation of supragingival plaque and changes in the microbial composition of supragingival plaque. Participants will be randomly assigned to one of two treatments with each treatment comprising 21 days. The two treatments will be as follows: A. Tooth brushing with GC MI Paste One Perio containing 10% CPP-ACP and stannous fluoride (1100 ppm F) three times a day (after breakfast, after dinner and before bed), with no other oral hygiene procedures over 21 days. B. Tooth brushing with Colgate Total SF containing stannous fluoride (1100 ppm F) three times a day (after breakfast, after dinner and before bed), with no other oral hygiene procedures over 21 days. During the treatment period, all participants will be requested not to brush with any other toothpaste and not to consume any antibiotics or antimicrobials including antimicrobial mints, lozenges, films and chewing gums.
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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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Prof Eric Reynolds
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Address
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Melbourne Dental School
The University of Melbourne
720 Swanston Street
Melbourne, Victoria 3010
Australia
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Country
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Australia
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Phone
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+61 3 9341 1547
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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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Eric Reynolds
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Address
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Melbourne Dental School
The University of Melbourne
720 Swanston Street
Melbourne, Victoria 3010
Australia
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Country
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Australia
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Phone
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+61 3 9341 1547
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Eric Reynolds
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Address
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Melbourne Dental School
The University of Melbourne
720 Swanston Street
Melbourne, Victoria 3010
Australia
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Country
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Australia
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Phone
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+61 3 9341 1547
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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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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