Efficacy of Antioxidants Therapy on Progression of Periodontal Disease – A Randomized Control Trial

Abstract

Background and Aim: 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 is a major salivary antioxidant, levels of which decrease in periodontitis. The aim of the present study was to investigate the effect of antioxidant therapy on the progression of periodontal disease. Material and Methods: This is a randomized controlled clinical trial conducted among 48 systemically healthy participants having generalized gingivitis with probing depth <3 mm, plaque index (PI) <1, and no bone and attachment loss. Participants were randomly assigned equally (n = 24) into two groups (test and control) using the lottery method. Full mouth scaling and root planing were performed in both the groups and oral hygiene instructions were given. Periodontal assessment at baseline 1 h after scaling and root planing was done with clinical parameters by a single examiner. Test group was prescribed; the commercially available anti-oxidant containing natural lycopene with green tea extract. Sample collection was done for both the groups at baseline and at the 45th day. Results: It was observed that significantly high results were obtained during intra-group comparison for both modified plaque index and sulcus bleeding index from baseline to 45 days. After treatment, a very highly significant increase (P ≤ 0.001) in the test group and significant (P ≤ 0.05) increase in the control group were observed in salivary uric acid levels. Conclusion: Oral lycopene and green tea extract supplementation is positively associated with salivary uric acid levels and plays an important role in the management of gingivitis.

Benefits of Natural Antioxidants on Oral Health

“…Notably, the test group that received antioxidant therapy showed statistically significant ( p = 0.001) and higher improvements in clinical parameters than the control group did. The authors came to the conclusion that lycopene and GT extract oral supplements have a significant role in the management of periodontal disease and advised adopting an antioxidant-rich diet [ 74 ].…”

Systematic review and meta-analysis of the antioxidant capacity of lycopene in the treatment of periodontal disease

“…Version 5.4.1; The Cochrane Collaboration, Copenhagen, Denmark; 2020), to assess the efficacy of periodontal treatment associated with lycopene on periodontal parameters. Two meta-analyses were performed: the first according to the parameters or biomarkers investigated in the selected studies; the second according to the follow-up periods: short-term, 2-and 3week follow-up (Belludi et al, 2013;Kaur et al, 2017); mid-term 6 and 8 weeks (Arora et al, 2013;Tripathi et al, 2019;Wasti et al, 2021) and long-term 12 and 24 weeks (Chandra et al, 2012;Tawfik et al, 2019). Both were based on mean difference (MD) and standard deviation (SD) to estimate effect size, with 95% confidence intervals (CI) to assess adverse outcomes.…”

“…After exclusion, 7 studies were finally selected and collected for meta-analysis (Chandra et al, 2012;Arora et al, 2013;Belludi et al, 2013;Kaur et al, 2017;Tawfik et al, 2019;Tripathi et al, 2019;Wasti et al, 2021)…”

Can vitamins improve periodontal wound healing/regeneration?

“…41,42 In addition, malnutrition has the potential to influence the prognosis of periodontal disease, through depletion of micronutrients essential for healing/regeneration, through disruption of cellular and immune functions, through a disturbance of the oral microbial ecology, as well as through altering the volume and the antimicrobial properties of saliva. 43 Currently, it is widely accepted that a higher dietary intake of nutrients with anti-inflammatory and antioxidant properties in a balanced nutrition 44 could be strongly linked to lower odds of developing periodontitis with slower disease progression. Higher, vitamin A, 33 vitamin C, 33,[45][46][47][48][49] vitamin E, 45,48 fruits and vegetables, 48 and omega-3 fatty acids (FAs) [50][51][52][53] intake were linked to populations with pronounced periodontal tissue health.…”

“…Currently, it is widely accepted that a higher dietary intake of nutrients with anti‐inflammatory and antioxidant properties in a balanced nutrition 44 could be strongly linked to lower odds of developing periodontitis with slower disease progression. Higher, vitamin A, 33 vitamin C, 33,45–49 vitamin E, 45,48 fruits and vegetables, 48 and omega‐3 fatty acids (FAs) 50–53 intake were linked to populations with pronounced periodontal tissue health 34,54 .…”