Impact of Treating Severe Periodontitis on Inflammatory Activity of Atheromatous Plaques in Patients With Acute Myocardial Infarction (AMI)
Assistance Publique - Hôpitaux de Paris
210 participants
Aug 2, 2019
INTERVENTIONAL
Conditions
Summary
Multicenter randomized clinical trial with two arms in patients hospitalized for an AMI nested in the Frenchie registry. Periodontal therapy is performed by periodontists in the intervention group versus treatment by dental surgeons as part of their usual practice in the control group. For the intervention group, periodontal management will be carried out for a maximum of 6 months after randomisation, prolonged by a follow-up of 6 months including a maintenance visit at M9. All patients will have an FDG-PET at M0 and M12 for evaluation of inflammation on carotid atherosclerotic plaques.
Eligibility
Inclusion Criteria5
- Patients hospitalized for an acute myocardial infarction and included in the Frenchie registry
- Score ≥ 5 on the screening questionnaire for periodontitis
- Six teeth at least (excluding wisdom teeth)
- Consent signature
- Affiliation to a French medical insurance (Sécurité Sociale)
Exclusion Criteria9
- Patients with diseases,other than cardiovascular and diabetes, known to change the periodontal state such as AIDS, rheumatoid arthritis, Chediak-Higashi syndrome, Papillon-Lefèvre
- Systemic antibiotic therapy> 48 hours in the 3 months prior to inclusion
- Acute heart failure
- Uncontrolled ventricular rhythm disorders
- Impossibility for the patient to attend follow-up visits
- Impossibility to maintain the extended position for 20 minutes
- Immunosuppressive therapy> 1 month in the 6 months prior to inclusion
- Pregnancy, breastfeeding
- Known hypersensitivity to chlorhexidine, povidone, 18-fluoro-deoxyglucose
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Interventions
Periodontal treatment can last up to 6 months depending on the periodontal state, followed by a follow-up period of at least 6 months including a visit to M9. Briefly, the intervention group includes initial therapy in 48 hours maximum which includes information on oral hygiene techniques (verbal + brochure), scaling and surfacing of dental roots with antiseptic irrigation and non-tooth extraction. retainable. This initial therapy is followed by a resumption of periodontal clinical measures after 6 weeks. Depending on the degree of improvement of the measurements, the treatment is either completed, or continues with further scaling-surfacing and / or performing one or more periodontal surgeries. Periodontal monitoring period often called "maintenance" includes repeated sessions of simple scaling whose rate does not exceed 4 per year.
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT04046237