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Fawzy El-Sayed KM, Cosgarea R, Sculean A, Doerfer C. Can vitamins improve periodontal wound healing/regeneration? Periodontol 2000 2024; 94:539-602. [PMID: 37592831 DOI: 10.1111/prd.12513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/13/2023] [Accepted: 07/19/2023] [Indexed: 08/19/2023]
Abstract
Periodontitis is a complex inflammatory disorder of the tooth supporting structures, associated with microbial dysbiosis, and linked to a number if systemic conditions. Untreated it can result in an irreversible damage to the periodontal structures and eventually teeth loss. Regeneration of the lost periodontium requires an orchestration of a number of biological events on cellular and molecular level. In this context, a set of vitamins have been advocated, relying their beneficial physiological effects, to endorse the biological regenerative events of the periodontium on cellular and molecular levels. The aim of the present article is to elaborate on the question whether or not vitamins improve wound healing/regeneration, summarizing the current evidence from in vitro, animal and clinical studies, thereby shedding light on the knowledge gap in this field and highlighting future research needs. Although the present review demonstrates the current heterogeneity in the available evidence and knowledge gaps, findings suggest that vitamins, especially A, B, E, and CoQ10, as well as vitamin combinations, could exert positive attributes on the periodontal outcomes in adjunct to surgical or nonsurgical periodontal therapy.
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Affiliation(s)
- Karim M Fawzy El-Sayed
- Oral Medicine and Periodontology Department, Faculty of Oral and Dental Medicine, Cairo University, Giza, Egypt
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts University, Kiel, Germany
| | - Raluca Cosgarea
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
- Department of Periodontology and Peri-implant Diseases, Philips University Marburg, Marburg, Germany
- Clinic for Prosthetic Dentistry, University Iuliu-Hatieganu, Cluj-Napoca, Romania
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Christof Doerfer
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts University, Kiel, Germany
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Saha S, Mahilkar S, Abraham DV, S S, Bhat N, Srivastava DS. A Comparative Analysis of Three Antioxidants in Addition to Scaling and Root Planing in Stage Three Grade B Periodontitis. Cureus 2024; 16:e51916. [PMID: 38333482 PMCID: PMC10850926 DOI: 10.7759/cureus.51916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 01/08/2024] [Indexed: 02/10/2024] Open
Abstract
INTRODUCTION The main feature of periodontitis is the development of periodontal pockets as a secondary consequence, which is mainly caused by an excessive immune response to the dental biofilm. The prime factor in the pathogenesis of periodontitis is an increase in oxidative stress. Numerous clinical studies have demonstrated that antioxidant supplementation can reduce endogenous antioxidant depletion and the oxidative damage that goes along with it. Hence, antioxidant therapy in the treatment of periodontal disease may prove to be a promising tool. OBJECTIVE The objective of the study is to compare the efficiency of three different antioxidants as oral supplements. MATERIALS AND METHODS Eighty patients with chronic periodontitis were randomly split into four groups. The control group received scaling and root planning (SRP), and the test group received oral supplements for 30 days with SRP. Pocket depth (PD), clinical attachment level (CAL), oral hygiene index-simplified (OHI-S), and sulcus bleeding index (SBI) were evaluated at baseline and 30 days. The analysis of the data was done with ANOVA, Kruskal-Wallis, and post hoc tests. The significance level was set at p<0.05 and p<0.001. RESULTS All groups resulted in a statistically significant reduction in all parameters from baseline to one month. The treatment groups revealed a statistically significant reduction in PD and CAL (p<0.00) but no reduction in OHI-S and SBI (p>0.05) scores. A highly statistically significant reduction was observed in PD with green coffee bean extract when compared with other groups. CONCLUSION Green coffee bean extract oral supplements may prove to be a promising appendage in therapeutic and prophylactic fashion, along with SRP, in the treatment of stage III grade B periodontitis patients.
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Affiliation(s)
- Sagorika Saha
- Department of Periodontology, Chhattisgarh Dental College and Research Institute, Rajnandgaon, IND
| | - Sonal Mahilkar
- Department of Dentistry, Government Medical College, Mahasamund, IND
| | - Dennis V Abraham
- Department of Periodontics, Maitri College of Dentistry and Research Center, Durg, IND
| | - Sreejith S
- Department of Oral Pathology and Microbiology, Dent Inn Dental Clinic, Thiruvananthapuram, IND
| | - Nagesh Bhat
- Department of Preventive Dental Sciences, Al Baha University, Al Baha, SAU
| | - Dr Shilpi Srivastava
- Department of Oral Medicine and Radiology, Teerthanker Mahaveer Dental College, Moradabad, IND
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Gegout PY, Stutz C, Huck O. Gels as adjuvant to non-surgical periodontal therapy: A systematic review and meta-analysis. Heliyon 2023; 9:e17789. [PMID: 37455970 PMCID: PMC10345361 DOI: 10.1016/j.heliyon.2023.e17789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 06/14/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023] Open
Abstract
Objective This systematic review and meta-analysis evaluated the effect of the use of available drugs loaded gels used as adjunct to non-surgical periodontal therapy. Methods Systematic research on PubMed/MEDLINE, Cochrane Central register of Controlled Trials, and Embase databases up to December 2021 was performed. Randomized clinical trials (RCT) which compared the outcomes of scaling and root planing (SRP) + local adjuvant administration (gel) versus SRP + placebo or SRP alone in Humans were included. The primary outcome measures were PPD and CAL changes at 3 months. Results After articles screening, 77 articles were included and assessed for quality. Then, a meta-analysis was conducted in studies with at least 3 months of follow-up. Clinical improvements were found to be significant for tetracyclines (-0.51 [-0.71;-0.31] p < 0.001), macrolides (-0.71 [-1.04;-0.38] p < 0.001), statins (-0.84 [-0.98;-0.70] p < 0.001), metformin (-1.47 [-1.66;-1.29] p < 0.001) and hyaluronan (-1.61 [-2.28;-0.94] p < 0.001) loaded gels, but non-significant for chlorhexidine (-0.48 [-1.10; 0.14] p = 0.13), metronidazole (-0.50 [-1.20; 0.20] p = 0.16) and bisphosphonates (-0.42 [-1.39; 0.54] p = 0.539) gels. Conclusion Adjunctive use of drugs loaded gels to non-surgical periodondal treatment could improve PPD reduction at 3 months. However, huge disparities remain when comparing the outcomes of the differents drugs used. Future comparative studies should be considered to determine precisely short and long term benefits of such treatments.
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Affiliation(s)
- Pierre-Yves Gegout
- Université de Strasbourg, Faculté de Chirurgie Dentaire, Periodontology, Strasbourg, France
- Hôpitaux Universitaires de Strasbourg, Pôle de Médecine et Chirurgie Bucco-dentaires, Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Céline Stutz
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Olivier Huck
- Université de Strasbourg, Faculté de Chirurgie Dentaire, Periodontology, Strasbourg, France
- Hôpitaux Universitaires de Strasbourg, Pôle de Médecine et Chirurgie Bucco-dentaires, Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
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Bengi V. U, Saygun I, Bal V, Ozcan E, Kose Ozkan C, Torun D, Avcu F, Kantarcı A. Effect of antioxidant lycopene on human osteoblasts. Clin Oral Investig 2022; 27:1637-1643. [PMID: 36416948 DOI: 10.1007/s00784-022-04789-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 11/11/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The aim of this in vitro study is to evaluate the effect of antioxidant lycopene on human osteoblasts. MATERIAL AND METHOD The human osteoblast cell line (CRL-11372) was obtained from the American Type Culture Collection (ATCC Manassas, Va) and grown in Dulbecco's Modified Eagle's medium (DMEM) supplemented with 10% fetal calf serum (FCS), penicillin (100 U/ml), and streptomycin (100 mg/ ml) at 37 °C in a humidified atmosphere of 5% CO2 and 95% air. The effective dose of lycopene was determined by MTT assay and a real-time cell analysis (RTCA) system. Proliferative effects were analyzed by in vitro wound healing model. Gene expressions of type 1 collagen (COL1A1), osteocalcin (OCN), and growth differentiation factor-5 (GDF-5) were measured by quantitative real-time polymerase chain reaction (qRT-PCR) at 72 h. Statistical differences between test groups were analyzed with a one-way ANOVA test. RESULTS MTT assay showed that the doses between 10-5 and 1 µmol of lycopene had dose-dependent proliferative effects. The doses between 10-5 and 10-1 µmol were most effective at 72 h. Lycopene accelerates the healing rate by increasing osteoblast proliferation. CONCLUSION Results suggested that lycopene had proliferative effects on human osteoblasts, which may help to increase bone regeneration, and thus, it can be useful in tissue engineering procedures. CLINICAL RELEVANCE By the help of antioxidants like lycopene capacity, velocity and quality of new bone forming may be increased in periodontal and dental implant treatments.
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Astaxanthin Enhances Gingival Wound Healing following High Glucose-Induced Oxidative Stress. BIOMED RESEARCH INTERNATIONAL 2022; 2022:4043105. [PMID: 35392260 PMCID: PMC8983170 DOI: 10.1155/2022/4043105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/21/2022] [Indexed: 12/24/2022]
Abstract
Fibroblasts of the gingiva play a key role in oral wound healing in diabetes. In this study, effects of astaxanthin (ASTX), a xanthophyll carotenoid, were tested on gingival fibroblasts in a wound healing assay in vitro. The aim of this study was to determine whether ASTX can recover delayed wound healing or not when oxidative stress is elevated by high glucose exposure. For this purpose, human gingival fibroblasts were incubated with or without ASTX following exposure to systemic doses of low glucose (LG) and high glucose (HG) in culture media (5- and 25-, 50 mM D-glucose in DMEM Ham's F12) following 24 hours of incubation. Levels of ROS (Reactive oxygen species) were determined for each experimental group by confocal microscopy. Cell proliferation and viability were assessed by an automated cell counter with trypan blue assay. Wound healing assay was designed in 60 mm petri dishes. Cells were exposed to 5-, 25-, and 50 mM glucose for 24 hours, and a straight line free of cells was created upon full confluency. 100 μM ASTX was added to the recovery group, simultaneously. Cells were monitored with JuLIⓇ-Br Cell History Recorder. ROS levels were significantly increased with increasing glucose levels, while cell proliferation and viability demonstrated a negative correlation with increasing oxidative stress. ROS levels significantly decreased in the 100 μM ASTX-treated group compared to the gingival fibroblasts treated with 50 mM HG medium-only, as well as growth rate and viability. Wound healing was delayed in a dose-dependent manner following high glucose exposure, while ASTX treatment recovered wounded area by 1.16-fold in the 50 mM HG group. Our results demonstrated that ASTX enhances gingival wound healing through its antioxidative properties following high glucose induced oxidative stress. Therefore, ASTX can be suggested as a promising candidate to maintain oral health in chronic wounds of the oral tissues related to diabetes.
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Olszewska-Czyz I, Kralik K, Tota M, Prpic J. The Influence of Hyaluronic Acid Adjunctive Therapy of Periodontitis on Salivary Markers of Oxidative Stress: Randomized, Controlled Clinical Trial. Antioxidants (Basel) 2022; 11:antiox11010135. [PMID: 35052639 PMCID: PMC8773125 DOI: 10.3390/antiox11010135] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 02/04/2023] Open
Abstract
Periodontitis is a common oral disease affecting the tooth-supporting tissues. Bacteria have been long viewed as the main causative factor in its development; however, many investigations have proved that aberrant immune and inflammatory response and the resulting misbalance between the damage caused by reactive oxygen species and the antioxidant capacity of tissues may be an underlying factor in disease progression that reduces healing potential. The objective of the current trial is to assess the outcomes of the addition of hyaluronic acid (HA) to standard non-surgical periodontal therapy (NST) on some major oxidative stress markers in saliva. HA-based gel designed for dental application was used and the measurements were taken after 3 months. HA adjunctive therapy had a significantly greater increase in markers with antioxidant properties as well as total antioxidant capacity compared to standard NST alone. Furthermore, clinically measured levels of gingival inflammation (bleeding on probing-BOP) and periodontal destruction (clinical attachment loss-CAL) were significantly correlated with these markers, and the correlation was negative. This investigation demonstrates that HA may indeed express antioxidant properties and improve the antioxidant capacity of periodontal tissues, thus improving the prognosis for the teeth and the results of periodontal therapy. Further investigations will be necessary to determine the duration of these effects over time.
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Affiliation(s)
- Iwona Olszewska-Czyz
- Department of Periodontology, Prophylaxis and Oral Pathology, Dental Institute, Medical Faculty, Jagiellonian University, 31155 Krakow, Poland
- Correspondence:
| | - Kristina Kralik
- Department of Medical Statistics and Medical Informatics, Medical Faculty Osijek, University Josip Juraj Strossmayer of Osijek, 31000 Osijek, Croatia;
| | - Marin Tota
- Department of Medical Chemistry, Biochemistry and Clinical Chemistry, Medical Faculty, University of Rijeka, 51000 Rijeka, Croatia;
| | - Jelena Prpic
- Department of Oral Medicine and Periodontology, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia;
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Molavi N, Rasouli-Azad M, Mirzaei H, Matini AH, Banafshe HR, Valiollahzadeh M, Hassanzadeh M, Saghazade AR, Abbaszadeh-Mashkani S, Mamsharifi P, Ghaderi A. The Effects of Probiotic Supplementation on Opioid-Related Disorder in Patients under Methadone Maintenance Treatment Programs. Int J Clin Pract 2022; 2022:1206914. [PMID: 35685534 PMCID: PMC9159114 DOI: 10.1155/2022/1206914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 03/11/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Patients under methadone maintenance treatment programs (MMTPs) are susceptible to numerous complications (e.g., mental and metabolic disorders). This study evaluated the effects of probiotics on clinical symptoms, biomarkers of oxidative stress, inflammation, insulin resistance, and serum lipid content in patients receiving MMTPs. MATERIALS AND METHODS A randomized, double-blind, placebo-controlled trial was conducted among 70 patients receiving MMTPs to receive either 1.8 × 109 CFU/day probiotics (n = 35) or placebo (n = 35) for 12 weeks. Clinical symptoms and metabolic profiles were measured before and after the intervention in patients receiving MMTPs. RESULTS Compared with the placebo group, probiotic supplementation resulted in a significant improvement in the severity of depression (P < 0.05). In addition, probiotic administration significantly decreased fasting plasma glucose (FPG), total cholesterol, and low-density lipoprotein cholesterol (LDL cholesterol) (P < 0.05). Furthermore, probiotics resulted in a significant reduction in high-sensitivity C-reactive protein (hs-CRP) and a significant elevation in total antioxidant capacity (TAC) and total glutathione (GSH) levels (P < 0.05). CONCLUSION Treatment with probiotics for 12 weeks to patients receiving MMTPs had beneficial effects on symptoms of depression, as well as several metabolic profiles. Clinical Trial Registration: this study was registered in the Iranian website (https://www.irct.ir) for clinical trials registration (https://fa.irct.ir/trial/46363/IRCT20170420033551N9). The registration date is March 22, 2020.
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Affiliation(s)
- Nader Molavi
- Department of Addiction Studies, School of Medical, Kashan University of Medical Sciences, Kashan, Iran
| | - Morad Rasouli-Azad
- International Center for Comparative Criminology, University of Montreal, Montreal, Canada
| | - Hamed Mirzaei
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Amir Hassan Matini
- Department of Clinical Pathology, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamid Reza Banafshe
- Department of Addiction Studies, School of Medical, Kashan University of Medical Sciences, Kashan, Iran
- Physiology Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Majid Hassanzadeh
- Department of Addiction Studies, School of Medical, Kashan University of Medical Sciences, Kashan, Iran
| | - Ahmad Reza Saghazade
- Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samira Abbaszadeh-Mashkani
- Trauma Nursing Research Center, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | - Peyman Mamsharifi
- Department of Psychology, Allameh Tabataba'i University, Tehran, Iran
| | - Amir Ghaderi
- Department of Addiction Studies, School of Medical, Kashan University of Medical Sciences, Kashan, Iran
- Clinical Research Development Unit-Matini/Kargarnejad Hospital, Kashan University of Medical Sciences, Kashan, Iran
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Iviglia G, Torre E, Cassinelli C, Morra M. Functionalization with a Polyphenol-Rich Pomace Extract Empowers a Ceramic Bone Filler with In Vitro Antioxidant, Anti-Inflammatory, and Pro-Osteogenic Properties. J Funct Biomater 2021; 12:jfb12020031. [PMID: 34063147 PMCID: PMC8167574 DOI: 10.3390/jfb12020031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/21/2021] [Accepted: 04/27/2021] [Indexed: 02/06/2023] Open
Abstract
Oral diseases and periodontitis in particular are a major health burden worldwide, because of their association with various systemic diseases and with conditions such as peri-implantitis. Attempts have been made over the years to reverse bone loss due to the host disproportionate inflammatory response and to prevent failure of dental implants. To this end, the use of biomaterials functionalized with molecules characterized by anti-inflammatory and antioxidant properties could represent a new frontier for regenerating functional periodontal tissues. In this study, a new ceramic granulated biomaterial, named Synergoss Red (SR), functionalized with a polyphenolic mixture extracted from pomace of the Croatina grape variety, is introduced. Following a preliminary in-depth characterization of the extract by HPLC analysis and of the biomaterial surface and composition, we performed evaluations of cytocompatibility and a biological response through in vitro assays. The anti-inflammatory and antioxidant properties of the identified phenolic molecules contained in SR were shown to downregulate inflammation in macrophages, to stimulate in osteoblast-like cells the expression of genes involved in deposition of the early bone matrix, and to mitigate bone remodeling by decreasing the RANKL/OPG ratio. Thanks to its cytocompatibility and assorted beneficial effects on bone regeneration, SR could be considered an innovative regenerative approach in periodontal therapy.
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Ali A, Saliem S, Abdulkareem A, Radhi H, Gul S. Evaluation of the efficacy of lycopene gel compared with minocycline hydrochloride microspheres as an adjunct to nonsurgical periodontal treatment: A randomised clinical trial. J Dent Sci 2020; 16:691-699. [PMID: 33854720 PMCID: PMC8025195 DOI: 10.1016/j.jds.2020.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/15/2020] [Indexed: 11/28/2022] Open
Abstract
Background/purpose The prescription of antibiotics as an adjunct to mechanical periodontal therapy in patients with severe periodontitis is recommended; however, the side effects of antibiotics are a major concern. The aim of this study was to evaluate the efficacy of lycopene (Lyc) antioxidant gel versus minocycline hydrochloride microspheres (ARISTIN) as an adjunct to the nonsurgical treatment of periodontitis. Materials and methods Three identical periodontal pockets/patient received root surface debridement followed by the random application of either ARISTIN, Lyc, or placebo gel (control, Ctrl). Clinical parameters, plaque index, bleeding on probing, probing pocket depth, and clinical attachment loss, were recorded at the baseline and after 30 days. Additionally, the levels of interleukin-8 (IL-8), matrix metallopeptidase 9, and tissue inhibitor of metalloproteinases 1 (TIMP1) in gingival crevicular fluid samples were assessed at the same time points. Results Twenty-three patients with periodontitis completed the study. Both ARISTIN and Lyc treatments showed significantly greater gains in attachment (1.94 ± 1.33 and 1.72 ± 0.88, respectively) than the Ctrl treatment (1.04 ± 0.96). Compared with those in the Ctrl, only ARISTIN showed a significant reduction in IL-8 level, whereas TIMP1 levels were significantly upregulated in the Lyc gel and ARISTIN sites. The effect size estimation indicated that Lyc gel exhibited considerably greater efficacy than the Ctrl gel. Conclusion Lyc gel and ARISTIN offer almost equal improvement in both clinical and biochemical parameters of periodontitis.
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Affiliation(s)
- Aya Ali
- College of Dentistry, Mustansiriya University, Baghdad, Iraq
| | - Saif Saliem
- College of Dentistry, University of Baghdad, Baghdad, Iraq
| | | | - Hani Radhi
- College of Dentistry, Mustansiriya University, Baghdad, Iraq
| | - Sarhang Gul
- College of Dentistry, University of Sulaimani, Sulaymaniyah, Iraq
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Salivary Redox Biomarkers in the Course of Caries and Periodontal Disease. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10186240] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Caries are a pathological process of extracorporeal nature, characterized by demineralization of inorganic substances as well as proteolysis triggered by acids produced by bacteria present in dental plaque, as a result of metabolism of sugars of both external and internal origin. Periodontal disease, on the other hand, is a multifactorial degenerative disease associated with inflammation, involving a group of tissues that surround the dental cervix and root of the tooth. It is believed that one of the mechanisms in the etiopathogenesis of caries and periodontitis are disorders of local and/or general oxidative stress (OS) parameters. Numerous clinical studies have confirmed the relationship between oxidative stress markers and oral diseases. In most analyzed studies, technical and biological variability was so high that none of the markers so far has proven suitable for routine clinical use. The aim of systematic reviews of the literature is to present the existing studies on OS parameters, mainly concerning the activity of antioxidant enzymes in saliva of patients with caries and periodontitis.
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Kaur K, Sculley D, Wallace J, Turner A, Ferraris C, Veysey M, Lucock M, Beckett EL. Micronutrients and bioactive compounds in oral inflammatory diseases. JOURNAL OF NUTRITION & INTERMEDIARY METABOLISM 2019. [DOI: 10.1016/j.jnim.2019.100105] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Dommisch H, Kuzmanova D, Jönsson D, Grant M, Chapple I. Effect of micronutrient malnutrition on periodontal disease and periodontal therapy. Periodontol 2000 2019; 78:129-153. [PMID: 30198127 DOI: 10.1111/prd.12233] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Periodontitis is a complex chronic inflammatory noncommunicable disease, initiated by the development of a dysbiotic microbial plaque biofilm below the gingival margin. Whilst the pathogenic biofilm is a "necessary cause" of periodontitis, it is insufficient on its own to cause the disease, and a destructive immune-inflammatory response is a key to the translation of risk to destructive events. Other exposures or "component causes" include individual genetic predisposition, lifestyle (including smoking and nutrition), and environmental factors. Dietary nutrients are essential for life as they provide crucial energy sources in the form of macronutrients, as well as important cofactors in the form of micronutrients, which regulate the functionality of enzymes during the regulation of anabolic and catabolic processes in human cells. Moreover, micronutrients can regulate gene transcription factors, such as the proinflammatory nuclear factor kappa B and the anti-inflammatory nuclear factor (erythroid-derived 2)-like 2. This review focuses on the role of vitamins (vitamin A, carotenoids, the vitamin B complex, vitamins C, D, and E, and coenzyme Q10) and minerals (calcium, magnesium, iron, zinc, potassium, copper, manganese, and selenium) in human physiology and the impact of their deficiencies upon periodontal health and disease.
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Affiliation(s)
- Henrik Dommisch
- Department of Periodontology and Synoptic Dentistry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Denica Kuzmanova
- Department of Periodontology and Synoptic Dentistry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Daniel Jönsson
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Melissa Grant
- Periodontal Research Group, School of Dentistry, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Iain Chapple
- Periodontal Research Group, School of Dentistry, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK.,Birminham Community Health Foundation Trust, Birmingham, UK
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Subgingivally delivered coenzyme Q10 in the treatment of chronic periodontitis among smokers: A randomized, controlled clinical study. J Oral Biol Craniofac Res 2019; 9:204-208. [PMID: 31211037 DOI: 10.1016/j.jobcr.2018.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 05/08/2018] [Indexed: 11/22/2022] Open
Abstract
Background Coenzyme Q10 is an antioxidant whose efficacy in periodontal diseases is well known. However studies regarding its efficacy in smokers with periodontitis are few. Coenzyme Q10 serves as an endogenous antioxidant and its increased concentration in the diseased gingiva effectively suppresses advanced periodontal inflammation. Objectives The aim of this study is to evaluate the efficacy of coenzyme Q10 as an adjunct to scaling and root planing in smokers with chronic periodontitis. Methods Total of 40 patients were enrolled for the study. The subjects were divided into control (Scaling and root planing only) and test group (Coenzyme Q10 plus Scaling and root planing). Clinical parameters such as plaque index, modified sulcular bleeding index, probing pocket depth and clinical attachment level. These were assessed at baseline, at 1 month and 3 month. The results were subjected to appropriate statistical analysis. Results There was a significant improvement in all clinical parameters in the test sites seen at the end of the 1 month and 3 month period. Conclusions Coenzyme Q10 can be said to have a beneficial effect on smokers with periodontitis when used as an adjunct to scaling and root planing.
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Tawfik MS, Abdel-Ghaffar KA, Gamal AY, El-Demerdash FH, Gad HA. Lycopene solid lipid microparticles with enhanced effect on gingival crevicular fluid protein carbonyl as a biomarker of oxidative stress in patients with chronic periodontitis. J Liposome Res 2019; 29:375-382. [DOI: 10.1080/08982104.2019.1566243] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Maie S. Tawfik
- Department of Periodontology, Faculty of Dental Medicine, Ain Shams University, Cairo, Egypt
| | - Khaled A. Abdel-Ghaffar
- Department of Periodontology, Faculty of Dental Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmed Y. Gamal
- Department of Periodontology, Faculty of Dental Medicine, Ain Shams University, Cairo, Egypt
| | - Fatma H. El-Demerdash
- Department of Periodontology, Faculty of Dental Medicine, Ain Shams University, Cairo, Egypt
| | - Heba A. Gad
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
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Tripathi P, Blaggana V, Upadhyay P, Jindal M, Gupta S, Nishat S. Antioxidant therapy (lycopene and green tea extract) in periodontal disease: A promising paradigm. J Indian Soc Periodontol 2019; 23:25-30. [PMID: 30692739 PMCID: PMC6334550 DOI: 10.4103/jisp.jisp_277_18] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Increased oxidative stress has emerged as one of the prime factors in the pathogenesis of periodontitis. Hence, antioxidant therapy may become a promising tool in the treatment of periodontal disease. Uric acid (UA) being a major antioxidant in saliva can be used as a marker to assess the total antioxidant capacity. Aim The aim of the study was to investigate the influence of orally administered antioxidants (lycopene and green tea extract) on periodontal health and salivary UA levels in gingivitis patients as an adjunct to scaling and root planing (SRP). Materials and Methods Thirty systemically healthy participants having generalized gingivitis were randomly distributed into two groups. Control group participants received full mouth oral prophylaxis, while test group participants received oral lycopene and green tea extract (CLIK®) for 45 days along with complete oral prophylaxis. Plaque index (PI), sulcular bleeding index (SBI), and salivary UA levels were evaluated at baseline and 45 days after SRP. Data were analyzed with t-test, using SPSS software (PASW, Windows version 18.0). Results Both treatment groups demonstrated statistically highly significant (P ≤ 0.001) reduction in plaque and SBI. After treatment, a highly significant increase (P ≤ 0.001) in the test group and significant (P ≤ 0.05) increase in the control group was observed for salivary UA levels. Posttreatment comparison between test and control group delineated statistically significant results in PI (P ≤ 0.001), SBI (P ≤ 0.001), and salivary UA levels (P ≤ 0.01). Conclusion Lycopene with green tea extract may prove to be a promising adjunctive prophylactic and therapeutic modality in the treatment of gingivitis patients. However, further studies are needed to evaluate the additive effect of antioxidants with routine oral prophylaxis therapy.
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Affiliation(s)
- Pragya Tripathi
- Department of Periodontology, Inderprastha Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Vikram Blaggana
- Department of Periodontology, Inderprastha Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Preeti Upadhyay
- Department of Periodontology, Inderprastha Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Manika Jindal
- Department of Periodontology, Inderprastha Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Shweta Gupta
- Department of Biochemistry, Inderprastha Dental College, Ghaziabad, Uttar Pradesh, India
| | - Sadaf Nishat
- Department of Periodontology, Inderprastha Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
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Tóthová L, Celec P. Oxidative Stress and Antioxidants in the Diagnosis and Therapy of Periodontitis. Front Physiol 2017; 8:1055. [PMID: 29311982 PMCID: PMC5735291 DOI: 10.3389/fphys.2017.01055] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 12/04/2017] [Indexed: 12/17/2022] Open
Abstract
Oxidative stress has been implicated in the pathogenesis of numerous diseases. However, large interventional studies with antioxidants failed to show benefits in the prevention or treatment of cardiovascular diseases, cancer, or diabetes mellitus. Numerous clinical studies have confirmed the association of oxidative stress markers and periodontitis. Technical and biological variability is high for most of the analyzed markers and none of them seems to be optimal for routine clinical use. In a research setting, analysis of a palette of oxidative stress markers is needed to cover lipid peroxidation, protein oxidation, and the antioxidant status. The source of reactive oxygen species and their role in the pathogenesis of periodontitis remains unclear. Interventional experiments indicate that oxidative stress might be more than just a simple consequence of the inflammation. Small studies have confirmed that some antioxidants could have therapeutic value at least as an addition to the standard non-surgical treatment of periodontitis. A clear evidence for the efficiency of antioxidant treatment in large patient cohorts is lacking. Potentially, because lowering of oxidative stress markers might be a secondary effect of anti-inflammatory or antibacterial agents. As the field of research of oxidative stress in periodontitis gains attraction and the number of relevant published papers is increasing a systematic overview of the conducted observational and interventional studies is needed. This review summarizes the currently available literature linking oxidative stress and periodontitis and points toward the potential of adjuvant antioxidant treatment, especially in cases where standard treatment fails to improve the periodontal status.
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Affiliation(s)
- L'ubomíra Tóthová
- Faculty of Medicine, Institute of Molecular Biomedicine, Comenius University, Bratislava, Slovakia.,Faculty of Medicine, Institute of Physiology, Comenius University, Bratislava, Slovakia
| | - Peter Celec
- Faculty of Medicine, Institute of Molecular Biomedicine, Comenius University, Bratislava, Slovakia.,Faculty of Medicine, Institute of Pathophysiology, Comenius University, Bratislava, Slovakia.,Department of Molecular Biology, Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia
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Chandra RV, Sailaja S, Reddy AA. Estimation of tissue and crevicular fluid oxidative stress marker in premenopausal, perimenopausal and postmenopausal women with chronic periodontitis. Gerodontology 2017; 34:382-389. [PMID: 28568604 DOI: 10.1111/ger.12279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2017] [Indexed: 01/27/2023]
Abstract
OBJECTIVES The aim of this study was to estimate tissue and gingival crevicular fluid (GCF) levels of the oxidative stress marker 8-hydroxy-2'-deoxyguanosine (8-OHdG) in premenopausal, perimenopausal and postmenopausal women with chronic periodontitis. BACKGROUND Oxidative stress has been implicated in the etiopathogenesis of periodontitis and menopause induces oxidative stress. MATERIALS AND METHODS According to Stages of Reproductive Aging Workshop (STRAW) criteria, women diagnosed with periodontitis were subdivided into three groups of 31 participants each 1. Premenopausal 2. Perimenopausal and 3. Postmenopausal. GCF and gingival tissue samples were collected from sites with maximum probing depth. Tissue DNA was extracted from the gingival sample and 8-OHdG in the extracted DNA, and GCF samples were measured using ELISA. RESULTS There was a highly significant difference in the overall GCF 8-OHdG levels among the three groups with the pairwise difference being highly significant between the premenopausal-postmenopausal groups and perimenopausal-postmenopausal groups. However, no overall significant differences in tissue 8-OHdG levels were found among the three groups. Pairwise, highly significant differences were found between the premenopausal-postmenopausal groups and perimenopausal-postmenopausal groups for tissue 8-OHdG levels. No significant correlations were found between various measure of periodontal disease and GCF/tissue 8-OHdG levels among all the groups. CONCLUSION Premenopausal-postmenopausal and perimenopausal-postmenopausal transition resulted in significant increase in tissue and GCF 8-OHdG levels. However, no association was found between stages of reproductive ageing and tissue levels of 8-OHdG.
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Affiliation(s)
- Rampalli Viswa Chandra
- Department of Periodontics, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
| | - Sistla Sailaja
- Department of Periodontics, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
| | - Aileni Amarender Reddy
- Department of Periodontics, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
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Muthuraj MSA, Janakiram S, Chithresan K, Maradi AP, Maddur PK, Rangaraju R. Effect of scaling and root planing on levels of 8-hydroxydeoxyguanosine in gingival crevicular fluid of chronic periodontitis patients with and without Type II diabetes mellitus. J Indian Soc Periodontol 2017; 21:201-206. [PMID: 29440786 PMCID: PMC5803875 DOI: 10.4103/jisp.jisp_184_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Context: Chronic periodontitis (CP) and diabetes mellitus are associated with increased oxidative damage to DNA with formation of 8-hydroxydeoxyguanosine (8-OHdG). The aim of this study was to evaluate the change in gingival crevicular fluid (GCF) levels of 8-OHdG and glycosylated hemoglobin (HbA1c) by 3 months after scaling and root planing (SRP), in CP patients with and without Type II diabetes mellitus. Settings and Design: Sixteen patients with CP, 16 patients with CP and Type II diabetes mellitus (CP-D), and 16 systemically healthy individuals with clinically healthy periodontium who served as controls were included in the study. Materials and Methods: The clinical parameters (plaque index [PI], probing depth [PD], clinical attachment level [CAL], and bleeding on probing [BOP%]), HbA1c levels, and GCF 8-OHdG levels were measured at baseline. All the patients except controls were treated with SRP followed by evaluation of the above-mentioned clinical and biochemical parameters after 3 months. Statistical Analysis Used: Statistical analysis was performed using paired t-test, independent t-test, and Mann–Whitney U-test. Results: After SRP, CP-D group showed a greater reduction in PI, PD, BOP%, and greater gain in CAL when compared to CP patients (P < 0.05). Levels of 8-OHdG and HbA1c in CP-D patients also showed a greater reduction, 3 months after SRP when compared to CP patients (P < 0.05). Conclusions: GCF 8-OHdG levels, HbA1c levels, and clinical parameters were reduced significantly in CP and CP-D patients, with maximum reduction achieved in CP-D patients 3 months after SRP.
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Affiliation(s)
| | - Srihari Janakiram
- Department of Periodontics and Implantology, Sri Ramakrishna Dental College, Coimbatore, Tamil Nadu, India
| | - Koshy Chithresan
- Department of Periodontics and Implantology, Sri Ramakrishna Dental College, Coimbatore, Tamil Nadu, India
| | - Arun Parappa Maradi
- Department of Periodontics and Implantology, Sri Ramakrishna Dental College, Coimbatore, Tamil Nadu, India
| | - Praveen Krishna Maddur
- Department of Periodontics and Implantology, Sri Ramakrishna Dental College, Coimbatore, Tamil Nadu, India
| | - Rajesh Rangaraju
- Department of Periodontics and Implantology, Sri Ramakrishna Dental College, Coimbatore, Tamil Nadu, India
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Affiliation(s)
- Yishai Levy
- Department Medicine D, Rambam Health Care Campus, Technion Faculty of Medicine, POB 9602, Haifa 31096, Israel.
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Shimabukuro Y, Nakayama Y, Ogata Y, Tamazawa K, Shimauchi H, Nishida T, Ito K, Chikazawa T, Kataoka S, Murakami S. Effects of an ascorbic acid-derivative dentifrice in patients with gingivitis: a double-masked, randomized, controlled clinical trial. J Periodontol 2016; 86:27-35. [PMID: 25277459 DOI: 10.1902/jop.2014.140138] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Reactive oxygen species might be associated with the onset and progression of gingival inflammation. The aim of this study is to investigate the effect of a dentifrice containing L-ascorbic acid 2-phosphate magnesium salt (APM), a long-acting ascorbic acid derivative with antioxidant properties, on gingival inflammation. METHODS The clinical effects of APM were investigated in a multicenter, randomized, parallel-group, controlled clinical trial comprising 300 individuals with gingivitis. Half of the participants were given an APM-containing dentifrice and half were given a control dentifrice. The primary outcome was the gingival index (GI) at 3 months. Secondary outcomes included gingival redness as an indicator of the degree of local gingival inflammation, gingival bleeding as a measure of the gingivitis severity index, and total antioxidant activity of the saliva. RESULTS Under the intent-to-treat analysis, GI did not significantly differ between the groups (P = 0.12). However, under the per-protocol analysis, GI was significantly lower in the APM group (P = 0.01) than in the control group. In the APM group, gingival redness was significantly lower, and the difference from the baseline gingivitis severity index was significantly greater (P = 0.04 and P = 0.02, respectively). The total antioxidant activity of the saliva was significantly higher in the APM group (P = 0.03). The incidence of adverse events did not significantly differ between the groups (P > 0.15). CONCLUSION These findings indicate that the regular application of an APM-containing dentifrice could reduce gingival inflammation.
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Affiliation(s)
- Yoshio Shimabukuro
- Department of Periodontology, Osaka University Graduate School of Dentistry, Suita, Japan
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Öngöz Dede F, Bozkurt Doğan Ş, Ballı U, Avcı B, Durmuşlar MC. The effect of initial periodontal treatment on plasma, gingival crevicular fluid and salivary levels of 8-hydroxy-deoxyguanosine in obesity. Arch Oral Biol 2015; 62:80-5. [PMID: 26655951 DOI: 10.1016/j.archoralbio.2015.11.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 10/09/2015] [Accepted: 11/18/2015] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Recent studies have shown adverse effects on the periodontium from the increased production of reactive oxygen species (ROS) in obesity. The purpose of this study was to investigate the effects of obesity on 8-hydroxy-deoxyguanosine (8-OHdG) levels in the bodily fluids of patients with and without periodontal disease and to evaluate changes after initial periodontal treatment. DESIGN Forty-five obese individuals and 45 normal-weight individuals were included in this study. Obese and normal-weight groups were classified into three sub-groups: chronic periodontitis (CP), gingivitis (G) and periodontally healthy controls (CTRL). Gingival crevicular fluid (GCF), plasma, saliva samples and clinical measurements were obtained at baseline and a month after initial periodontal treatment. Levels of 8-OHdG were analysed by ELISA. RESULTS While plasma 8-OHdG levels were significantly higher at baseline in the obese patients with periodontal disease than in the normal-weight individuals (P<0.05), no significant differences in GCF and saliva 8-OHdG levels were found (P ˃ 0.05). GCF and salivary 8-OHdG levels in obese patients with G and CP were significantly higher than in CTRL groups at baseline (P<0.05). After treatment, 8-OHdG levels were decreased in all groups with periodontal disease (P<0.01). Statistically significant positive correlations were observed between GCF 8-OHdG levels and GI in all the groups (P<0.001). CONCLUSIONS The significant increase of plasma 8-OHdG levels in obese patients did not correlate with saliva and GCF 8-OHdG levels when compared to normal-weight individuals. Periodontal treatment had a positive effect on the periodontal parameters and 8-OHdG levels of both obese and normal-weight individuals.
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Affiliation(s)
- Figen Öngöz Dede
- Department of Periodontology, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey.
| | - Şeyma Bozkurt Doğan
- Department of Periodontology, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey
| | - Umut Ballı
- Department of Periodontology, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey
| | - Bahattin Avcı
- Department of Biochemistry, Faculty of Medicine, Ondokuzmayis University, Samsun, Turkey
| | - Muştafa Cenk Durmuşlar
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey
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22
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Muniz FWMG, Nogueira SB, Mendes FLV, Rösing CK, Moreira MMSM, de Andrade GM, Carvalho RDS. The impact of antioxidant agents complimentary to periodontal therapy on oxidative stress and periodontal outcomes: A systematic review. Arch Oral Biol 2015; 60:1203-14. [DOI: 10.1016/j.archoralbio.2015.05.007] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 05/18/2015] [Accepted: 05/19/2015] [Indexed: 11/29/2022]
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Reddy PVN, Ambati M, Koduganti R. Systemic lycopene as an adjunct to scaling and root planing in chronic periodontitis patients with type 2 diabetes mellitus. J Int Soc Prev Community Dent 2015; 5:S25-31. [PMID: 25984464 PMCID: PMC4428016 DOI: 10.4103/2231-0762.156520] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Patients with type 2 diabetes have an increased prevalence of periodontitis and, in turn, periodontitis adversely affects the diabetic status. Oxidative stress plays a key role in affecting the pathophysiology of both the diseases and adjunctive systemic antioxidant therapy may have beneficial effect on the treatment outcome. This study was planned to compare the efficacy of systemic antioxidant therapy with lycopene as an adjunct to scaling and root planing versus scaling and root planing alone in chronic periodontitis patients with type 2 diabetes mellitus. Materials and Methods: 40 diabetic subjects with periodontitis, attending the OP wing of the Department of Periodontics of a tertiary referral care hospital were randomized and equally divided into group A and group B. Diabetes status was recorded as per ADA guidelines and the periodontitis status as per American Academy of Periodontology (AAP) guidelines. Group A patients underwent scaling and root planing with administration of lycopene 8 mg and group B patients were treated with scaling and root planing alone. Clinical parameters like gingival index (GI), probing depth (PD), and clinical attachment level (CAL) were recorded. Serum markers, i.e. malondialdehyde (MDA) (TBARS assay) and C reactive protein (CRP) (ELISA), and glycated hemoglobin (HbA1c) levels were assessed at baseline and at 2 months and 6 months post-therapy. Results: Inter-group comparison showed group A giving statistically significant results in reducing mean serum MDA levels at 2 months and 6 months, and in reducing mean PD (mm) and mean HbA1c (%) levels at 2 months (P < 0.005). Conclusion: Lycopene as an adjunctive treatment was effective in reducing oxidative stress and restoring altered glycemic levels. Further longitudinal studies with a larger sample size are required to establish the role of lycopene in the management of chronic periodontitis.
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Affiliation(s)
- Panthula Veerendra Nath Reddy
- Department of Periodontology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Andhra Pradesh, India
| | - Manasa Ambati
- Department of Periodontology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Andhra Pradesh, India
| | - Rekharani Koduganti
- Department of Periodontology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Andhra Pradesh, India
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LPS from P. gingivalis and hypoxia increases oxidative stress in periodontal ligament fibroblasts and contributes to periodontitis. Mediators Inflamm 2014; 2014:986264. [PMID: 25374447 PMCID: PMC4211166 DOI: 10.1155/2014/986264] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 08/21/2014] [Indexed: 11/20/2022] Open
Abstract
Oxidative stress is characterized by an accumulation of reactive oxygen species (ROS) and plays a key role in the progression of inflammatory diseases. We hypothesize that hypoxic and inflammatory events induce oxidative stress in the periodontal ligament (PDL) by activating NOX4. Human primary PDL fibroblasts were stimulated with lipopolysaccharide from Porphyromonas gingivalis (LPS-PG), a periodontal pathogen bacterium under normoxic and hypoxic conditions. By quantitative PCR, immunoblot, immunostaining, and a specific ROS assay we determined the amount of NOX4, ROS, and several redox systems. Healthy and inflamed periodontal tissues were collected to evaluate NOX4 and redox systems by immunohistochemistry. We found significantly increased NOX4 levels after hypoxic or inflammatory stimulation in PDL cells (P < 0.001) which was even more pronounced after combination of the stimuli. This was accompanied by a significant upregulation of ROS and catalase (P < 0.001). However, prolonged incubation with both stimuli induced a reduction of catalase indicating a collapse of the protective machinery favoring ROS increase and the progression of inflammatory oral diseases. Analysis of inflamed tissues confirmed our hypothesis. In conclusion, we demonstrated that the interplay of NOX4 and redox systems is crucial for ROS formation which plays a pivotal role during oral diseases.
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