Researchers from the School of Dentistry, Oral and Craniofacial Sciences at King’s College London have conducted the first randomized controlled trial for the treatment of class III furcation molars, an advanced and challenging clinical situation.
The researchers conducted a novel feasibility study using a SMART design (sequential, multiple allocation, randomized trial) in conjunction with a clinical trial. The results suggest that personalized medicine design (combining patient-specific efficacy measures with clinical outcomes) can be considered a feasible design for clinical research trials in periodontology.
In periodontology, furcation lesions (FI) occur when bone loss occurs in the roots of multi-rooted teeth. Furcation lesions affect tooth prognosis, with class III furcation lesions, the most severe, having the lowest long-term survival. There are currently no clear guidelines for the optimal treatment of class III furcation lesions.
“Our study is the first to demonstrate the feasibility of using a SMART trial design in periodontology and is the first randomized trial on the subject of class III FI molars,” explained Dr. Priya Bahal, Academic Clinical Research Fellow at King’s College London.
“The results show that open flap debridement can reduce probing pocket depth to a greater extent than nonsurgical treatment, and notably, it highlights the importance of combining clinical and patient-reported outcomes.”
The study also introduced the concept of patient-centered research by inviting “patient advocates” to participate as co-investigators. Patient advocates participated in multiple aspects of the study, from study planning to participation in the steering committee, data interpretation, and manuscript writing. This is the first time that patient advocates have participated as co-authors in a randomized trial in periodontology.
These results demonstrate the feasibility of the SMART design in periodontology and other fields, and lay the foundation for a more adaptive, personalized approach to future research.
The study was selected as a winner of the Jaccard Award presented at the EuroPerio Congress in late May. The team won the runner-up/second prize.
The Jaccard-EFP Prize for Research in Periodontology was established in 1995 by the European Federation of Periodontology (EFP) and the Jaccard Foundation of the University of Geneva to promote research in Europe. The award is presented every three years at the European Congress of Periodontology.
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