CClinicalTrials.gg
CompletedNCT03358251Updated Sep 2, 2020Results posted

Investigation of the Safety and Efficacy of Pocket-X Gel

An interventional study of Pocket-X Gel and Scaling and root planing in Periodontal Pocket, sponsored by Tree of Life Pharma Ltd.. Completed at 2 sites in Israel. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-09-02.

Sponsored by Tree of Life Pharma Ltd. · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
34
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

This study is an open-label split-mouth study in which Pocket-X Gel, a periodontal in-situ gelling product, will be applied to periodontal pockets in one/two mouth segment(s) of participants, following scaling and root planing on the entire mouth, while the contralateral segment(s) will serve as control. The aim of the study is to investigate the safety and efficacy of Pocket-X Gel in improving the healing of the gingiva and preventing bacterial re-colonization in the periodontal pocket following scaling and root planing.

Read the detailed description

This study is an open-label split-mouth study that investigates the safety and efficacy of Pocket-X Gel, a periodontal in-situ gelling product, in improving the healing of the gingiva and preventing bacterial re-colonization in the periodontal pocket following scaling and root planing.

The study includes a single arm. All participants will undergo 1-4 sessions of scaling and root planing (SRP), which is the conventional gold-standard treatment for periodontal disease. The number of SRP sessions is dependent on the severity of the periodontal disease. Following completion of SRP, participants will undergo treatment with Pocket-X Gel, which will be inserted into periodontal pockets present in one/two of the participants mouth segments (quadrants), following scaling and root planing. The other mouth segments will not undergo further intervention. The number of segments to be treated is dependent on the clinical symmetry between the treated segment(s) and the contralateral segment(s). Participants will be followed for a total duration of 6 months. Additional application of Pocket-X Gel may occur 1 month and/or 3 months following first application, depending on the state of the participant's periodontal disease.

The rationale for the study is the hypothesis that a physical barrier inserted into periodontal pockets following scaling and root planing would assist in maintaining the pocket clean by preventing bacteria from re-entering the cleaned pocket, thus allowing the gums to properly heal and seal the pockets while preventing further inflammation.

02

Conditions studied

  • Periodontal Pocket

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03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Provision of signed and dated informed consent form
  2. Male or female, aged 18 and above
  3. Provision of up-to-date full mouth periapical x-rays
  4. Participants suffering from active moderate to severe chronic periodontitis with at least 3 sites of periodontal pockets of 5 mm or greater depth in each quadrant.
  5. Participants with a minimum of 6 teeth with periodontal pocket depth of more than 5 mm.
  6. Participants with a minimum of 20 teeth

Exclusion criteria

Exclusion Criteria:

  1. Known hypersensitivity to any of the devices components as listed on the user leaflet
  2. Pregnancy or lactation
  3. Smoking of more than 9 cigarettes per day
  4. A concurrent dental disease, except for periodontitis, or planned treatment that may interfere with the study or study intervention, such as dental surgery, teeth implantation, etc.
  5. Chronic disease such as diabetes mellitus or rheumatoid arthritis
  6. Aggressive periodontitis
  7. History of radiotherapy or chemotherapy
  8. Immunodeficiency or autoimmune disease
  9. Mental disorders
  10. Parafunctional habits such as bruxism
  11. Participant has taken antibiotics in the 6 months prior to the study
  12. Participant has undergone periodontal treatment 12 months prior to the study
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
34 participants (actual)

Study arms

  • Other
    SRP+Pocket-X Gel, split-mouth

    This arm is a split-mouth arm, i.e., participants will receive conventional treatment for periodontitis (scaling and root planing) for the entire mouth, and, in addition, will receive experimental treatment (Pocket-X Gel) for periodontal pockets present in one/two mouth segments (quadrants), while the contralateral quadrants will serve as control and will not undergo any further intervention.

    Device: Pocket-X Gel · Procedure: Scaling and root planing

Interventions

  • DevicePocket-X Gel

    Pocket-X Gel is a biodegradable in-situ gelling product that is inserted into a pre-cleaned periodontal pocket where it quickly turns into a gel that adheres to the periodontal pocket and acts as a filler and physical barrier against bacterial re-colonization at the site of application. Administration of this product typically causes no discomfort. The product naturally degrades after 1-3 weeks.

  • ProcedureScaling and root planing

    Scaling and root planing is a conventional gold-standard treatment for periodontitis. As part of this procedure, subgingival plaque and tartar are removed and root surfaces are planed.

05

What researchers measure

Primary outcomes

  1. Change in Periodontal Pockets Probing Depth

    Change in the probing depth of periodontal pockets which have undergone treatment with SRP+Pocket-X Gel in comparison to periodontal pockets which have undergone SRP only.

    Time frame: 12 and 24 weeks following first Pocket-X Gel administration

Secondary outcomes

  1. Change in Clinical Attachment

    Change in the clinical attachment level of mouth segments which have undergone treatment with SRP+Pocket-X Gel in comparison to mouth segments which have undergone SRP only.

    Time frame: 12 and 24 weeks following first Pocket-X Gel administration

  2. Change in Recession Level

    Change in gingival recession level (buccal) of mouth segments which have undergone treatment with SRP+Pocket-X Gel in comparison to mouth segments which have undergone SRP only. Measured in mm.

    Time frame: 12 and 24 weeks following first Pocket-X Gel administration

  3. Change in Bleeding Index

    Change in gingival bleeding index of mouth segments which have undergone treatment with SRP+Pocket-X Gel in comparison to mouth segments which have undergone SRP only.

    Time frame: 12 and 24 weeks following first Pocket-X Gel administration

  4. Change in Mobility Grade

    Change in mobility grade of teeth present in mouth segments which have undergone treatment with SRP+Pocket-X Gel in comparison to mouth segments which have undergone SRP only. Mobility is graded clinically by applying pressure with the ends of 2 metal instruments (e.g. dental mirrors) and trying to rock a tooth gently in a bucco-lingual direction (towards the tongue and outwards again). Normal, physiologic tooth mobility of about 0.25 mm is present in health. This is because the tooth is not fused to the bones of the jaws, but is connected to the sockets by the periodontal ligament. Abnormal, pathologic tooth mobility occurs when the attachment of the periodontal ligament to the tooth is reduced (attachment loss), or if the periodontal ligament is inflamed. Tooth mobility is measured and graduated from 0-3. Grade 0: No apparent mobility Grade 1: Perceptible mobility \<1mm in buccolingual direction Grade 2: \>1mm but \<2mm Grade 3: \>2mm or depressibility in the socket

    Time frame: 12 and 24 weeks following first Pocket-X Gel administration

06

Results

Posted Sep 2, 2020

Participant flow

Participant flow — Overall Study
MilestoneSRP+Pocket-X Gel, Split-mouth
Started34
Completed34
Not completed0

Outcome measures

PrimaryChange in Periodontal Pockets Probing Depth

Change in the probing depth of periodontal pockets which have undergone treatment with SRP+Pocket-X Gel in comparison to periodontal pockets which have undergone SRP only.

Time frame:
12 and 24 weeks following first Pocket-X Gel administration
Reported as:
Mean · mm
Change in Periodontal Pockets Probing Depth
mmLower Jaw Pockets + TreatmentLower Jaw Pockets - ControlUpper Jaw Pockets + TreatmentUpper Jaw Pockets + Control
depth at baseline6.97 ± 1.496.81 ± 1.597.67 ± 1.457.72 ± 1.30
depth at 3 months5.19 ± 0.985.69 ± 1.385.53 ± 1.076.35 ± 1.10
depth at 6 months4.5 ± 0.85.53 ± 1.244.74 ± 0.827.72 ± 0.99
SecondaryChange in Clinical Attachment

Change in the clinical attachment level of mouth segments which have undergone treatment with SRP+Pocket-X Gel in comparison to mouth segments which have undergone SRP only.

Time frame:
12 and 24 weeks following first Pocket-X Gel administration
Reported as:
Mean · mm
Change in Clinical Attachment
mmLower Jaw Pockets + TreatmentLower Jaw Pockets - ControlUpper Jaw Pockets + TreatmentUpper Jaw Pockets + Control
change in CAL after 3 months2.08 ± 0.690.97 ± 0.642.62 ± 0.821.26 ± 0.68
change in CAL after 6 months3.01 ± 0.921.06 ± 0.633.61 ± 0.941.44 ± 0.83
SecondaryChange in Recession Level

Change in gingival recession level (buccal) of mouth segments which have undergone treatment with SRP+Pocket-X Gel in comparison to mouth segments which have undergone SRP only. Measured in mm.

Time frame:
12 and 24 weeks following first Pocket-X Gel administration
Reported as:
Mean · mm
Change in Recession Level
mmLower Jaw Pockets + TreatmentLower Jaw Pockets - ControlUpper Jaw Pockets + TreatmentUpper Jaw Pockets + Control
B recession at baseline1.36 ± 1.271.21 ± 1.171.49 ± 1.221.38 ± 1.06
B recession at 3 months1.06 ± 1.061.35 ± 1.321.01 ± 0.981.49 ± 1.24
B recession at 6 months0.82 ± 0.891.43 ± 1.420.80 ± 0.881.51 ± 1.38
SecondaryChange in Bleeding Index

Change in gingival bleeding index of mouth segments which have undergone treatment with SRP+Pocket-X Gel in comparison to mouth segments which have undergone SRP only.

Time frame:
12 and 24 weeks following first Pocket-X Gel administration
Reported as:
Number · % percent of pockets bleeding
Change in Bleeding Index
% percent of pockets bleedingLower Jaw Pockets + TreatmentLower Jaw Pockets - ControlUpper Jaw Pockets + TreatmentUpper Jaw Pockets + Control
percent of pockets bleeding at baseline98.485.792.6692.66
percent of pockets bleeding after 3 months20.6336.5120.1845.87
percent of pockets bleeding after 6 months12.7028.578.3344.44
SecondaryChange in Mobility Grade

Change in mobility grade of teeth present in mouth segments which have undergone treatment with SRP+Pocket-X Gel in comparison to mouth segments which have undergone SRP only. Mobility is graded clinically by applying pressure with the ends of 2 metal instruments (e.g. dental mirrors) and trying to rock a tooth gently in a bucco-lingual direction (towards the tongue and outwards again). Normal, physiologic tooth mobility of about 0.25 mm is present in health. This is because the tooth is not fused to the bones of the jaws, but is connected to the sockets by the periodontal ligament. Abnormal, pathologic tooth mobility occurs when the attachment of the periodontal ligament to the tooth is reduced (attachment loss), or if the periodontal ligament is inflamed. Tooth mobility is measured and graduated from 0-3. Grade 0: No apparent mobility Grade 1: Perceptible mobility \<1mm in buccolingual direction Grade 2: \>1mm but \<2mm Grade 3: \>2mm or depressibility in the socket

Time frame:
12 and 24 weeks following first Pocket-X Gel administration
Reported as:
Mean · mobility grade
Change in Mobility Grade
mobility gradeLower Jaw Pockets + TreatmentLower Jaw Pockets - ControlUpper Jaw Pockets + TreatmentUpper Jaw Pockets + Control
Mobility at baseline0.19 ± 0.500.19 ± 0.530.18 ± 0.510.19 ± 0.52
Mobility after 3 months0.05 ± 0.210.14 ± 0.500.05 ± 0.230.15 ± 0.38
Mobility after 6 months0 ± 00.01 ± 0.120.01 ± 0.100.12 ± 0.35

Adverse events

Collected over until the last visit of the patient, 6 month post the first application of the treatment.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
SRP+Pocket-X Gel, Split-mouth0/34 (0%)0/34 (0%)0/34 (0%)

Baseline characteristics

Age, Continuous
Age, Continuous(years)SRP+Pocket-X Gel, Split-mouth
Mean51.3 ± 13.1
Sex: Female, Male
Sex: Female, Male(Participants)SRP+Pocket-X Gel, Split-mouth
Female13
Male21
Race and Ethnicity Not Collected
Race and Ethnicity Not Collected(Participants)SRP+Pocket-X Gel, Split-mouth
Region of Enrollment
Region of Enrollment(participants)SRP+Pocket-X Gel, Split-mouth
Israel34
07

Study locations

2 sites
  • Dr. Ariel Hirsch Periodontal Clinic
    Tel Aviv, Israel
  • Dr. Roni Kolerman Periodontal Clinic
    Tel Aviv, Israel
08

References and documents

Study documents

  • Protocol and statistical analysis plan · Jun 26, 2019

Documents are hosted by the registry — open the source record to download them.

09

Registry details

Key details

Study ID
NCT03358251
Lead sponsor
Tree of Life Pharma Ltd.
Responsible party
Sponsor
First posted
Nov 30, 2017
Start date
Mar 12, 2018
Primary completion
Dec 30, 2019
Completion
Dec 30, 2019
Results posted
Sep 2, 2020
Last update
Sep 2, 2020

Study contacts

Ariel Hirsch
principal investigator · Dr. Ariel Hirsch Periodontal Clinic
Roni Kolerman
principal investigator · Dr. Roni Kolerman Periodontal Clinic

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
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