1
|
Pappe CL, Peters B, Pivovarova-Ramich O, Schremmer R, Adam A, Vach K, Dommisch H, Woelber JP. Effects of a 4-week free-sugar avoidance during periodontal therapy: An explorative randomized controlled clinical trial. J Periodontol 2024. [PMID: 39185702 DOI: 10.1002/jper.24-0208] [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: 04/30/2024] [Revised: 07/01/2024] [Accepted: 07/03/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND This study investigated the effect of a 4-week free-sugar avoidance on periodontal parameters during periodontal therapy. METHODS Twenty-one patients with untreated periodontitis and daily free-sugar intake were allocated to a sugar avoidance group (SAG) and a control group (CG). The SAG received a 45-min dietary consultation and was instructed to avoid free sugars during the following 4 weeks after subgingival instrumentation, while the CG continued with their regular diet. Bleeding on probing (BOP), plaque control record, body weight (BW), visceral fat (FATv), and a food frequency questionnaire (FFQ) were collected at baseline (T1), 4 weeks (T2), and 8 weeks (T3) after subgingival instrumentation. RESULTS The main outcome parameter BOP was significantly reduced at T2 by 40.3% ± 15.54 in the SAG and 34% ± 12.47 in the CG (intra-p value both <0.001, inter-p value 0.361). A linear regression analysis of changes at patient level adjusted for age and FATv revealed a significant group difference for BOP (regression coefficient = -6.8; p = 0.019). Significant reductions were observed in BW, FATv and mean daily intake of free sugars (-14.4 g/day), and a significant increase of vitamin C derived from fruits (75.89 mg/day) at T2 in the SAG only. CONCLUSION This study may indicate additional beneficial effects of a sugar avoidance on periodontal and metabolic parameters, and nutritional intake during periodontal therapy. German Clinical Trials Register (DRKS00026699). PLAIN LANGUAGE SUMMARY The current widespread free-sugar consumption is linked to an increasing incidence of chronic non-communicable diseases. Data indicate a relationship between sugar intake and a higher prevalence of periodontitis and increased gingival inflammation. This study showed that free-sugar avoidance after periodontal therapy had additional beneficial effects on periodontal and metabolic parameters in 10 test and 11 control patients. After 4 weeks of avoiding free sugars like sweets, processed white flour, juice, and so forth, periodontal bleeding was significantly reduced in both groups (-40.3% test group, -34% control group). Further regression analysis revealed a significant difference between groups favoring the intervention. Additionally, body weight and visceral fat were significantly reduced in the intervention group, only. To avoid sugar, patients were allowed to replace it with whole fruit, which led to increased levels of micronutrients such as vitamin C. Therefore, free-sugar avoidance may be of therapeutic benefit in addition to periodontal therapy. Further research is needed to investigate this effect in larger cohorts.
Collapse
Affiliation(s)
- Christina L Pappe
- Department of Periodontology, Oral Medicine, and Oral, Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Beeke Peters
- Research Group Molecular Nutritional Medicine and Department of Human Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München, Germany
| | - Olga Pivovarova-Ramich
- Research Group Molecular Nutritional Medicine and Department of Human Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München, Germany
- Department of Endocrinology and Metabolism, Corporate Member of Freie Universität Berlin, and Humboldt-Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Robert Schremmer
- Department of Periodontology, Oral Medicine, and Oral, Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Aysegül Adam
- Department of Periodontology, Oral Medicine, and Oral, Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Kirstin Vach
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, Hannover, Germany
- Department of Operative Dentistry and Periodontology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Henrik Dommisch
- Department of Periodontology, Oral Medicine, and Oral, Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Johan P Woelber
- Policlinic of Operative Dentistry, Periodontology, and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| |
Collapse
|
2
|
Nisha S, Bettahalli Shivamallu A, Prashant A, Shashikumar P, Ganganna A, Das D. Effect of non surgical periodontal therapy and vitamin C supplementation on total antioxidant capacity in patients with chronic generalised periodontitis - A randomised controlled trial. J Oral Biol Craniofac Res 2023; 13:511-516. [PMID: 37396691 PMCID: PMC10310911 DOI: 10.1016/j.jobcr.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/10/2023] [Accepted: 05/04/2023] [Indexed: 07/04/2023] Open
Abstract
Background Periodontal inflammation are inflammation of supporting tissues of periodontium. The microbial factor can cause infection which is polymicrobial in origin and causes dysbiosis and shift in oxidative stress with compromised antioxidant capacity. This study focused at determination of the effect of nonsurgical periodontal therapy (NSPT) and vitamin C supplementation on total antioxidant capacity (TAOC) in chronic periodontitis patients (ChP). Material & method A total of 70 ChPand 35 periodontally healthy subjects (control) were recruited in this study. Further, ChP group was subdivided into ChP1 group (n = 35) which received NSPT only and ChP 2 group (n = 35) which received NSPT with vitamin C 500 mg once daily for 3 months. Serum and saliva samples were taken at baseline and at 3 months postNSPT for measurement of TAOC. Clinical parameters measured were measured at 1-, 3-, 6- and 12-month interval. Results Lower levels of serum and salivary TAOC levels were observed in ChP patients than healthy subjects (p < 0.05). Improvement in Clinical parameters was observed in both the groups ChP1 and ChP 2 group post therapy (p < 0.05). The periodontal treatment showed insignificant changes in serum and salivary TAOC levels (p > 0.05). The supplemental dose of vitamin C didn't have any additional benefits (p > 0.05). Conclusion There lies an association of oxidative stress with periodontitis, low serum and salivary TAOC levels were seen in chronic periodontitis patients. NSPT improved the periodontal inflammatory status. However, benefits of vitamin C as an adjunct to NSPT remains inconclusive and needs to be further explored by multicentre longitudinal studies.
Collapse
Affiliation(s)
- Swet Nisha
- Department of Periodontology, J.S.S Dental College & Hospital, JSS Academy of Higher Education & Research, Mysuru, Karnataka, 570015, India
| | - Avinash Bettahalli Shivamallu
- Department of Periodontology, J.S.S Dental College & Hospital, JSS Academy of Higher Education & Research, Mysuru, Karnataka, 570015, India
| | - Akila Prashant
- Department of Biochemistry, J.S.S Medical College & Hospital, JSS Academy of Higher Education & Research, Mysuru, Karnataka, 570015, India
| | - Pratibha Shashikumar
- Department of Periodontology, J.S.S Dental College & Hospital, JSS Academy of Higher Education & Research, Mysuru, Karnataka, 570015, India
| | - Aruna Ganganna
- Department of Periodontology, J.S.S Dental College & Hospital, JSS Academy of Higher Education & Research, Mysuru, Karnataka, 570015, India
| | - Debanjan Das
- Department of Conservative Dentistry and Endodontics, Haldia Institute of Dental Sciences and Research, Haldia
| |
Collapse
|
3
|
Woelber JP, Reichenbächer K, Groß T, Vach K, Ratka-Krüger P, Bartha V. Dietary and Nutraceutical Interventions as an Adjunct to Non-Surgical Periodontal Therapy-A Systematic Review. Nutrients 2023; 15:nu15061538. [PMID: 36986267 PMCID: PMC10052653 DOI: 10.3390/nu15061538] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
The aim of this study was to conduct a systematic literature review on the influence of dietary and nutraceutical interventions as an adjunct to non-surgical periodontal therapy (NSPT). A literature search for randomized, controlled clinical trials (RCTs) was performed in PubMed, the Cochrane Library, and the Web of Science. Trial inclusion criteria included the application of a defined nutritional intervention (food, beverages, or supplements) adjunctive to NSPT compared to NSPT alone with at least one measured periodontal parameter (pocket probing depths (PPD) or clinical attachment level (CAL)). Of 462 search results, 20 clinical trials relating to periodontitis and nutritional interventions were identified, of which, in total, 14 studies could be included. Eleven studies examined supplements containing lycopene, folate, chicory extract, juice powder, micronutrients and plant extracts, omega-3 fatty acids, vitamin E, or vitamin D. Three studies examined food-based interventions (kiwifruit, green or oolong tea). Due to limited information on within-group differences in the studies, results were descriptively analyzed. A significant positive effect on periodontal parameters (PPD, bleeding on probing) was found for vitamin E, chicory extract, juice powder, green tea, and oolong tea. Heterogeneous effects were found for lycopene, folate, omega-3 fatty acids, and vitamin D. No effects on PPD were found for adjunct kiwifruit (in combination with NSPT). Risk of bias via RoB2 revealed a low risk of bias with some concerns. There was a high heterogeneity in the type of nutritional interventions. The adjunctive use of various supplements and green/oolong tea led to positive and significant effects of the nutritional interventions on clinical periodontal outcome parameters. In the context of non-surgical periodontal therapy, an adjunctive intake of micronutrients, omega-3 fatty acids, green/oolong tea, and polyphenols and flavonoids could be beneficial. Long-term clinical studies with full data reports (especially within-group differences) are needed for conducting a meta-analysis.
Collapse
Affiliation(s)
- Johan Peter Woelber
- Department for Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Str. 75, 79106 Freiburg, Germany
| | - Katharina Reichenbächer
- Department for Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Str. 75, 79106 Freiburg, Germany
| | - Tara Groß
- Department for Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Str. 75, 79106 Freiburg, Germany
| | - Kirstin Vach
- Institute of Medical Biometry and Statistics, Faculty of Medicine, University of Freiburg, Zinkmattenstr. 6A, 79108 Freiburg, Germany
| | - Petra Ratka-Krüger
- Department for Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Hugstetter Str. 75, 79106 Freiburg, Germany
| | - Valentin Bartha
- Department for Conservative Dentistry, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| |
Collapse
|
4
|
Effect of Coffee on Lipopolysaccharide-Induced Immortalized Human Oral Keratinocytes. Foods 2022; 11:foods11152199. [PMID: 35892784 PMCID: PMC9330743 DOI: 10.3390/foods11152199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/18/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022] Open
Abstract
Periodontitis is a common inflammatory disease that is strongly influenced by dietary habits. Coffee is one of the most common dietary components; however, current research on the relationship between coffee consumption and periodontitis, as well as its underlying mechanisms, is limited. Based on a previous report, caffeine (CA) and chlorogenic acid (CGA) were formulated into artificial coffee (AC) for this experiment. Cell viability, prostaglandin E2 release, Western blotting, cellular reactive oxygen species (ROS) production, and NF-E2-related factor 2 (Nrf2) translocation analyses were performed to explore the effects of AC on lipopolysaccharide (LPS)-induced immortalized human oral keratinocytes (IHOKs) and elucidate their underlying mechanisms. AC pretreatment attenuated LPS-induced inflammatory mediator release, ROS production, and nuclear factor kappa B translocation in IHOKs. CA and CGA promoted AMP-activated protein kinase phosphorylation and down-regulated the nuclear factor-κB pathways to exert anti-inflammatory effects. Additionally, CGA promoted Nrf2 translocation and heme oxygenase-1 expression and showed anti-oxidative effects. Furthermore, AC, CA, and CGA components showed synergistic effects. Thus, we predict that coffee consumption may be beneficial for alleviating periodontitis. Moreover, the main coffee components CA and CGA seem to play a synergistic role in periodontitis.
Collapse
|
5
|
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.
Collapse
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;
| |
Collapse
|
6
|
Eberhard J, Ruiz K, Tan J, Jayasinghe TN, Khan S, Eroglu E, Adler C, Simpson SJ, Le Couteur DG, Raubenheimer D, Macia L, Gosby AK, Ribeiro RV. A randomised clinical trial to investigate the effect of dietary protein sources on periodontal health. J Clin Periodontol 2021; 49:388-400. [PMID: 34935176 DOI: 10.1111/jcpe.13587] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 10/26/2021] [Accepted: 11/24/2021] [Indexed: 11/28/2022]
Abstract
AIM The aim was to assess two macronutrient interventions in a 2x2 factorial dietary design to determine their effects on oral health. MATERIALS AND METHODS Participants (65-75 years old) with a BMI between 20-35 kg/m2 of a larger RCT who consented to an oral health assessment were recruited. They had ad libitum access to one of four experimental diets (omnivorous higher fat or higher carbohydrate, semi-vegetarian higher fat or higher carbohydrate) for 4 weeks. Periodontal examination included periodontal probing depth (PPD), clinical attachment level (CAL) and bleeding on probing. Oral plaque and gingival crevicular fluid (GCF) were collected before and after the intervention. RESULTS Between baseline and follow up the number of sites with a CAL <5 mm (mean difference (MD) -5.11±9.68, P=0.039) increased and the GCF amount (MD -23.42±39.42 Periotron Units (PU), P=0.050) decreased for the semi-vegetarian high fat diet. For the mean proportion of sites with PPD reduction >1 mm and CAL gain >1 mm significant differences were calculated between the diets investigated. The clinical parameters were not associated with changes of the oral microbiota. CONCLUSION The results of this study provided evidence that a semi-vegetarian higher fat diet provides benefits to clinical parameters of periodontal health. ACTRN12616001606471. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Joerg Eberhard
- Charles Perkins Centre, University of Sydney, NSW, Australia.,The University of Sydney School of Dentistry, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Kate Ruiz
- The University of Sydney School of Dentistry, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Jian Tan
- Charles Perkins Centre, University of Sydney, NSW, Australia
| | - Thilini N Jayasinghe
- Charles Perkins Centre, University of Sydney, NSW, Australia.,The University of Sydney School of Dentistry, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Shahrukh Khan
- Charles Perkins Centre, University of Sydney, NSW, Australia
| | - Elif Eroglu
- Charles Perkins Centre, University of Sydney, NSW, Australia
| | - Christina Adler
- Charles Perkins Centre, University of Sydney, NSW, Australia.,The University of Sydney School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | | | - David G Le Couteur
- Charles Perkins Centre, University of Sydney, NSW, Australia.,Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, University of Sydney, NSW, Australia.,ANZAC Research Institute, University of Sydney, Concord Hospital, NSW, Australia
| | - David Raubenheimer
- Charles Perkins Centre, University of Sydney, NSW, Australia.,School of Life and Environmental Sciences, University of Sydney, NSW, Australia
| | - Laurence Macia
- Charles Perkins Centre, University of Sydney, NSW, Australia
| | - Alison K Gosby
- Charles Perkins Centre, University of Sydney, NSW, Australia.,School of Life and Environmental Sciences, University of Sydney, NSW, Australia.,Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, NSW, Australia
| | - Rosilene V Ribeiro
- Charles Perkins Centre, University of Sydney, NSW, Australia.,Centre for Education and Research on Ageing and Alzheimer's Institute, Concord Hospital, University of Sydney, NSW, Australia.,School of Life and Environmental Sciences, University of Sydney, NSW, Australia
| |
Collapse
|
7
|
The potential of salivary biomarkers of nutritional status and dietary intake: A Systematic Review. J Dent 2021; 115:103840. [PMID: 34624418 DOI: 10.1016/j.jdent.2021.103840] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/24/2021] [Accepted: 09/29/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES To explore whether nutritional salivary biomarkers could be used to aid nutritional status assessment and/or support traditional dietary assessment methods for patients. DATA AND SOURCES Searches were performed using four electronic databases; MEDLINE, EMBASE, Scopus and Web of Science. Trial registers (i.e. Cochrane), grey literature and reference lists were searched. STUDY SELECTION Studies which measured nutritional salivary biomarkers related to nutritional status and/or dietary intake outcome were included. No restrictions on participants' age, study design, publication date, setting or health status. Animal studies, non-English language studies, commentaries, and conference abstracts were excluded. RESULTS Study titles and abstracts were screened (n = 7982), full-texts assessed (n = 176) and 85 studies were included in a narrative synthesis. The most promising salivary biomarkers for nutritional status included: glucose, where saliva and serum levels were positively correlated in those with type 2 diabetes (T2D), higher salivary calcium levels in post-menopausal women in general and specifically those with lower bone mineral density (BMD), and salivary vitamin D to assess vitamin D status in healthy volunteers. Higher salivary total antioxidant capacity (TAC), nitrate/nitrite and fluoride were observed with increased antioxidant, nitrate/nitrite and fluoride dietary intake, respectively. A meta-analysis found significantly higher mean salivary glucose (n = 12) in T2D compared with healthy controls, but there was substantial heterogeneity (I2=94%) and evidence of publication bias. CONCLUSIONS The most promising salivary biomarkers identified in this systematic review were, glucose, vitamin D, calcium, TAC, nitrate/nitrite and fluoride. However, this was based on a small number of studies of varying quality, with many lacking a salivary assay performance assessment. CLINICAL SIGNIFICANCE At present, nutritional salivary biomarkers cannot be used alone to assess nutritional status or dietary intake. Further research into the most promising nutritional salivary biomarkers is required.
Collapse
|
8
|
Rajaram SS, Nisha S, Ali NM, Shashikumar P, Karmakar S, Pandey V. Influence of a Low-Carbohydrate and Rich in Omega-3 Fatty Acids, Ascorbic Acid, Antioxidants, and Fiber Diet on Clinical Outcomes in Patients with Chronic Gingivitis: A Randomized Controlled Trial. J Int Soc Prev Community Dent 2021; 11:58-67. [PMID: 33688474 PMCID: PMC7934824 DOI: 10.4103/jispcd.jispcd_365_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 09/01/2020] [Accepted: 12/28/2020] [Indexed: 01/12/2023] Open
Abstract
Background Nutrition has a significant impact on the pathophysiology of periodontal disease. Both micro- and macronutrients have an impact on periodontal health. This study aimed at the evaluation of the effects of a diet low in carbohydrate and rich in omega-3 fatty acids, ascorbic acid, antioxidants, and fiber on clinical outcomes in patients with gingival inflammation for four weeks. Materials and Methods Overall, 54 systemically healthy subjects were enrolled in this study. The clinical trial consisted of two groups: Group A (test group) (n = 27) was instructed to consume a diet comprising low carbohydrates, rich in omega-3 fatty acids, ascorbic acid, antioxidants, and fibers for the next four weeks; in Group B (control group) (n = 27), no alteration in dietary behavior was done, and these subjects were instructed to have their daily routine diet. Clinical parameters measured were plaque index (PI), gingival bleeding index (GI), probing depths (PD), clinical attachment level (CAL), and bleeding on probing (BOP) at one week without any dietary changes (baseline) for both the groups, followed by a one-week adaptation period; then, the parameters were checked on a weekly basis for the next four weeks. Results Primary clinical outcome BOP and secondary outcome GI showed significant changes in the test group compared with the control group (P < 0.05). However, no significant changes were seen in the plaque scores in the test group (P > 0.05). The degree of diet compliance on the clinical parameters (PI, GI, and BOP) was assessed by using regression analysis. Conclusion Dietary recommendations can be beneficial in managing gingival and periodontal inflammation. Nutritional interventional studies as monotherapy are required to evaluate the clinical significance of diet in periodontal therapy.
Collapse
Affiliation(s)
- Savan Sunari Rajaram
- Department of Periodontology, Haldia Institute of Dental Sciences & Research, Haldia, West Bengal
| | - Swet Nisha
- Department of Periodontology, Haldia Institute of Dental Sciences & Research, Haldia, West Bengal
| | | | - Pratibha Shashikumar
- Department of Periodontology, J.S.S. Dental College & Hospital, JSS Academy of Higher Education & Research, Mysore, Karnataka, India
| | - Shaswata Karmakar
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vijayendra Pandey
- Department of Periodontology, Vananchal Dental College and Hospital, Garhwa, Jharkhand, India
| |
Collapse
|
9
|
West N, Chapple I, Claydon N, D'Aiuto F, Donos N, Ide M, Needleman I, Kebschull M. BSP implementation of European S3 - level evidence-based treatment guidelines for stage I-III periodontitis in UK clinical practice. J Dent 2021; 106:103562. [PMID: 33573801 DOI: 10.1016/j.jdent.2020.103562] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/16/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To adapt the supranational European Federation for Periodontology (EFP) S3-Level Clinical Practice Guideline for treatment of periodontitis (stage I-III) to a UK healthcare environment, taking into account the views of a broad range of stakeholders, and patients. SOURCES This UK version is based on the supranational EFP guideline (Sanz et al., 2020) published in the Journal of Clinical Periodontology. The source guideline was developed using the S3-level methodology, which combined the assessment of formal evidence from 15 systematic reviews with a moderated consensus process of a representative group of stakeholders, and accounts for health equality, environmental factors and clinical effectiveness. It encompasses 62 clinical recommendations for the treatment of stage I-III periodontitis, based on a step-wise process mapped to the 2017 classification system. METHODOLOGY The UK version was developed from the source guideline using a formal process called the GRADE ADOLOPMENT framework. This framework allows for the adoption (unmodified acceptance), adaptation (acceptance with modifications) and the de novo development of clinical recommendations. Using this framework and following the S3-process, the underlying systematic reviews were updated and a representative guideline group of 75 delegates from 17 stakeholder organisations was assembled into three working groups. Following the formal S3-process, all clinical recommendations were formally assessed for their applicability to the UK and adoloped accordingly. RESULTS AND CONCLUSION Using the ADOLOPMENT protocol, a UK version of the EFP S3-level clinical practice guideline was developed. This guideline delivers evidence- and consensus-based clinical recommendations of direct relevance to the dental community in the UK. CLINICAL SIGNIFICANCE The aim of S3-level guidelines is to combine the evaluation of formal evidence, grading and synthesis with the clinical expertise of a broad range of stakeholders to form clinical recommendations. Herein, the first major international S3-level guideline in dentistry, the EFP guideline, was implemented for direct clinical applicability in the UK healthcare system.
Collapse
Affiliation(s)
- Nicola West
- Periodontology, Bristol Dental School, University of Bristol, Lower Maudlin Street, Bristol, BS1 2LY, UK.
| | - Iain Chapple
- Periodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK; Birmingham Community Healthcare NHS Trust, Birmingham, UK.
| | - Nick Claydon
- Periodontology, Bristol Dental School, University of Bristol, Lower Maudlin Street, Bristol, BS1 2LY, UK.
| | - Francesco D'Aiuto
- Periodontology, University College London, Gower Street, London, WC1E 6BT, UK.
| | - Nikos Donos
- Periodontology, Institute of Dentistry, Barts and The London School of Medicine & Dentistry, Queen Mary University, Turner Street, London E1 2AD, UK.
| | - Mark Ide
- Periodontology, Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, Kings College London, London SE1 9RT, UK.
| | - Ian Needleman
- Periodontology, University College London, Gower Street, London, WC1E 6BT, UK.
| | - Moritz Kebschull
- Periodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK; Birmingham Community Healthcare NHS Trust, Birmingham, UK; Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, USA.
| |
Collapse
|
10
|
Ramseier CA, Woelber JP, Kitzmann J, Detzen L, Carra MC, Bouchard P. Impact of risk factor control interventions for smoking cessation and promotion of healthy lifestyles in patients with periodontitis: A systematic review. J Clin Periodontol 2020; 47 Suppl 22:90-106. [DOI: 10.1111/jcpe.13240] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Christoph A. Ramseier
- Department of Periodontology School of Dental Medicine University of Bern Bern Switzerland
| | - Johan P. Woelber
- Department of Operative Dentistry and Periodontology Faculty of Medicine University of Freiburg Freiburg Germany
| | - Julia Kitzmann
- Department of Operative Dentistry and Periodontology Faculty of Medicine University of Freiburg Freiburg Germany
- Private Practice Hamburg Germany
| | - Laurent Detzen
- Service of Odontology Department of Periodontology Rothschild Hospital AP‐HP Université de Paris U.F.R. of Odontology Paris France
| | - Maria Clotilde Carra
- Service of Odontology Department of Periodontology Rothschild Hospital AP‐HP Université de Paris U.F.R. of Odontology Paris France
- Population‐based Epidemiologic Cohorts Unit INSERM UMS 011 Villejuif France
| | - Philippe Bouchard
- Service of Odontology Department of Periodontology Rothschild Hospital AP‐HP Université de Paris U.F.R. of Odontology Paris France
- EA 2496 Université de Paris U.F.R. of Odontology Paris France
| |
Collapse
|
11
|
Sanz M, Herrera D, Kebschull M, Chapple I, Jepsen S, Berglundh T, Sculean A, Tonetti MS. Treatment of stage I-III periodontitis-The EFP S3 level clinical practice guideline. J Clin Periodontol 2020; 47 Suppl 22:4-60. [PMID: 32383274 PMCID: PMC7891343 DOI: 10.1111/jcpe.13290] [Citation(s) in RCA: 651] [Impact Index Per Article: 162.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 04/03/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND The recently introduced 2017 World Workshop on the classification of periodontitis, incorporating stages and grades of disease, aims to link disease classification with approaches to prevention and treatment, as it describes not only disease severity and extent but also the degree of complexity and an individual's risk. There is, therefore, a need for evidence-based clinical guidelines providing recommendations to treat periodontitis. AIM The objective of the current project was to develop a S3 Level Clinical Practice Guideline (CPG) for the treatment of Stage I-III periodontitis. MATERIAL AND METHODS This S3 CPG was developed under the auspices of the European Federation of Periodontology (EFP), following the methodological guidance of the Association of Scientific Medical Societies in Germany and the Grading of Recommendations Assessment, Development and Evaluation (GRADE). The rigorous and transparent process included synthesis of relevant research in 15 specifically commissioned systematic reviews, evaluation of the quality and strength of evidence, the formulation of specific recommendations and consensus, on those recommendations, by leading experts and a broad base of stakeholders. RESULTS The S3 CPG approaches the treatment of periodontitis (stages I, II and III) using a pre-established stepwise approach to therapy that, depending on the disease stage, should be incremental, each including different interventions. Consensus was achieved on recommendations covering different interventions, aimed at (a) behavioural changes, supragingival biofilm, gingival inflammation and risk factor control; (b) supra- and sub-gingival instrumentation, with and without adjunctive therapies; (c) different types of periodontal surgical interventions; and (d) the necessary supportive periodontal care to extend benefits over time. CONCLUSION This S3 guideline informs clinical practice, health systems, policymakers and, indirectly, the public on the available and most effective modalities to treat periodontitis and to maintain a healthy dentition for a lifetime, according to the available evidence at the time of publication.
Collapse
Affiliation(s)
- Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri‐implant Diseases) Research GroupUniversity Complutense of MadridMadridSpain
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri‐implant Diseases) Research GroupUniversity Complutense of MadridMadridSpain
| | - Moritz Kebschull
- Periodontal Research GroupInstitute of Clinical SciencesCollege of Medical and Dental SciencesThe University of BirminghamBirminghamUK
- Birmingham Community Healthcare NHS TrustBirminghamUK
- Division of PeriodonticsSection of Oral, Diagnostic and Rehabilitation SciencesCollege of Dental MedicineColumbia UniversityNew YorkNYUSA
| | - Iain Chapple
- Periodontal Research GroupInstitute of Clinical SciencesCollege of Medical and Dental SciencesThe University of BirminghamBirminghamUK
- Birmingham Community Healthcare NHS TrustBirminghamUK
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive DentistryUniversity Hospital BonnBonnGermany
| | - Tord Berglundh
- Department of PeriodontologyInstitute of OdontologyThe Sahlgrenska AcademyUniversity of GothenburgGöteborgSweden
| | - Anton Sculean
- Department of PeriodontologySchool of Dental MedicineUniversity of BernBernSwitzerland
| | - Maurizio S. Tonetti
- Division of Periodontology and Implant DentistryFaculty of DentistryThe University of Hong KongHong KongHong Kong
- Department of Oral and Maxillo‐facial ImplantologyShanghai Key Laboratory of StomatologyNational Clinical Research Centre for StomatologyShanghai Ninth People HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghaiChina
| |
Collapse
|
12
|
Using ginger supplement in adjunct with non-surgical periodontal therapy improves metabolic and periodontal parameters in patients with type 2 diabetes mellitus and chronic periodontitis: A double-blind, placebo-controlled trial. J Herb Med 2020. [DOI: 10.1016/j.hermed.2019.100315] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
13
|
Abdulkareem AA, Al Marah ZA, Abdulbaqi HR, Alshaeli AJ, Milward MR. A randomized double-blind clinical trial to evaluate the efficacy of chlorhexidine, antioxidant, and hyaluronic acid mouthwashes in the management of biofilm-induced gingivitis. Int J Dent Hyg 2020; 18:268-277. [PMID: 32100933 DOI: 10.1111/idh.12432] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 01/14/2020] [Accepted: 02/24/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To investigate the antiplaque and antigingivitis efficacy in addition to evaluating side effects and subjects' perceptions of three commercially available mouthwashes. METHODS This study was a double-blind, parallel, and short-term trial. A total of 75 dental students with biofilm-induced gingivitis were included in the final analysis of the current study. Clinical parameters (plaque index and bleeding on probing) and the staining effect were measured at baseline and after 7 days. In addition, a VAS-based assessment questionnaire was completed by the participants. RESULTS All interventions significantly reduced plaque scores, but chlorhexidine (CHX) had a significantly higher effect than the hyaluronic acid (HA) and antioxidant mouthwashes. However, all mouthwashes significantly reduced the total bleeding scores to <10% in 53% of the patients, compared to the baseline record. Additionally, teeth underwent shade changes in association with all interventions by the end of the study. Analysis of feedback about the mouthwashes showed that the participants seemed to prefer the HA mouthwash over the other mouthwashes. CONCLUSIONS CHX remains the most effective antiplaque mouthwash although HA and antioxidants are as effective as CHX in reducing bleeding. In addition, based on its better acceptance by the participants, HA is potentially a good alternative to CHX.
Collapse
Affiliation(s)
| | - Zaid A Al Marah
- Faculty of Dentistry, Dijlah University College, Baghdad, Iraq
| | | | - Ali J Alshaeli
- College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Mike R Milward
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| |
Collapse
|
14
|
Bazyar H, Maghsoumi-Norouzabad L, Yarahmadi M, Gholinezhad H, Moradi L, Salehi P, Haghighi-zadeh MH, Zare Javid A. The Impacts of Synbiotic Supplementation on Periodontal Indices and Biomarkers of Oxidative Stress in Type 2 Diabetes Mellitus Patients with Chronic Periodontitis Under Non-Surgical Periodontal Therapy. A Double-Blind, Placebo-Controlled Trial. Diabetes Metab Syndr Obes 2020; 13:19-29. [PMID: 32021348 PMCID: PMC6954633 DOI: 10.2147/dmso.s230060] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 12/10/2019] [Indexed: 12/19/2022] Open
Abstract
AIM The aim of the current study was to investigate that combination of the synbiotic supplementation in adjunct with non-surgical periodontal therapy (NSPT) is useful in treating periodontitis and biomarkers of oxidative stress in type 2 diabetes mellitus (T2DM) patients. METHODS In this study, 47 patients suffering from DM and CP were recruited and randomly assigned to two groups. The intervention (n= 23) and control (n=24) groups received either multispecies probiotic supplement plus 100 mg fructo-oligosaccharide (500 mg in each capsule) or placebo capsule containing 500 mg wheat flour, respectively, every day for 8 weeks. All subjects were treated with NSPT during the intervention period. Serum levels of interleukin-1β (IL-1β), malondialdehyde (MDA), total antioxidant capacity (TAC), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and periodontal indices including clinical attachment loss (CAL), pocket depth (PD) (main outcome), BOP, and plaque index were measured before and after the intervention. RESULTS Supplementation with the synbiotic with NSPT led to a significant decrease in the levels of IL-1β, MDA, plaque index, PD, and CAL in the intervention group post-intervention (p < 0.05). The serum levels of TAC, SOD, and GPx were significantly increased in the intervention group compared with the baseline (p < 0.05). Consumption of synbiotic with NSPT, compared to the control, resulted in a significant decrease in the mean changes of IL-1β, MDA, and CAL (p < 0.05). Also, the mean changes of TAC and GPx were significantly higher in the intervention group compared with the control group (p < 0.05). Also, in the intervention group was seen a significant reduction in plaque index (p = 0.035) and BOP (p = 0.04) compared with the control group. CONCLUSION It was observed that synbiotic supplementation with NSPT may be beneficial in improving inflammatory, antioxidant, and periodontal status in T2DM patients with CP.
Collapse
Affiliation(s)
- Hadi Bazyar
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Leila Maghsoumi-Norouzabad
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohsen Yarahmadi
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hassan Gholinezhad
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Leila Moradi
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parvin Salehi
- Department of Periodontology, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Ahmad Zare Javid
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Correspondence: Ahmad Zare Javid Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranTel +98 914 317 6237 Email
| |
Collapse
|
15
|
Né YGS, Martins BV, Castro MML, Alvarenga MOP, Fagundes NCF, Magno MB, Maia LC, Lima RR. Is nutritional intervention an improvement factor in the management of periodontitis? A systematic review. Clin Nutr 2019; 39:2639-2646. [PMID: 31928861 DOI: 10.1016/j.clnu.2019.12.016] [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: 04/17/2019] [Revised: 11/26/2019] [Accepted: 12/15/2019] [Indexed: 01/29/2023]
Abstract
AIMS This systematic review aimed to evaluate the effect of nutritional intervention in the management of periodontitis. METHODS This study was registered on the Prospective International Registry of Systematic Reviews-PROSPERO, under the registration number CRD42017076674. The database searching was performed on: Pubmed, Scopus, Web of Science, Clinical Trials and Lilacs. The OpenGrey and Google Scholar were also assessed for searching the grey literature. The PICO framework was carried out, in which the participants (P) were humans with periodontitis receiving conventional periodontal therapy simultaneously with dietary supplements (I), compared (C) with those managed with conventional therapy only, having as an outcome (O) the influence-or not influence-of nutritional intervention in the management of periodontitis. After the searching, duplicates were removed and articles were first assessed by title and abstract, following the inclusion and exclusion criteria; then, the full text of the remaining articles were reviewed. All steps within the review process were performed independently by two reviewers and checked by a third-party disagreement evaluator. For quality/risk of bias assessment of the study selection, The Cochrane Collaboration's tool for randomized studies and Robins-TOOL for non-randomized studies (ROBINS-I) were performed. The Grading of recommendations, assessment, development and evaluation (GRADE) was used for assessing the level of evidence. RESULTS A total of 2574 citations were recorded, but only four were considered eligible. The included studies reported different nutritional interventions such as fruit concentrate, vegetables and fruit juice powders, multivitamins, fish oil, and a customized dietary advice. The three studies using nutritional supplements showed improvements in at least one clinical parameter of periodontitis -reduction of probing depths, attachment gain, crevicular fluid decreased, reduced bleeding values on probing-after 2-6 months. Although, only two articles presented a moderate risk of bias, a very low level of evidence was found among the four studies taken together. CONCLUSIONS Despite the results suggested that nutritional intervention is beneficial for periodontal therapy, the evidence in general, is inconsistent and imprecise. More interventional studies with longer periods of follow-up and the assessment of a specific nutritional intervention must be conducted.
Collapse
Affiliation(s)
- Yago Gecy Sousa Né
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém, Brazil
| | - Beatriz Voss Martins
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém, Brazil
| | - Micaele Maria Lopes Castro
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém, Brazil
| | - María Olimpia Paz Alvarenga
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém, Brazil
| | | | - Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Rodrigues Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém, Brazil.
| |
Collapse
|
16
|
Abbass MM, Rady D, Radwan IA, El Moshy S, AbuBakr N, Ramadan M, Yussif N, Al Jawaldeh A. The occurrence of periodontal diseases and its correlation with different risk factors among a convenient sample of adult Egyptian population: a cross-sectional study. F1000Res 2019; 8:1740. [PMID: 32494356 PMCID: PMC7236581 DOI: 10.12688/f1000research.20310.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/11/2020] [Indexed: 02/13/2024] Open
Abstract
Background: Even though extensive studies on the prevalence of periodontal diseases in various populations worldwide have been carried out, data for the Egyptian population is limited. The present study was carried out to evaluate the occurrence and the severity of periodontal disease and its correlation with different risk factors. Methods: Periodontal examination was performed on 343 adults attending the outpatient clinics of the Faculty of Dentistry, Cairo University, as well as three private clinics. Socio-demographic data, brushing frequency, body mass index (BMI) and dietary habits were recorded using a questionnaire. Results: It was found that 58.9% of participants had calculus deposits. The occurrence of periodontitis was 89.8%, where 70.8% of participants had stage I and 15.2% had stage II, while only 4.4% and 2.05% suffered from stage III and stage IV, respectively. Calculus was positively correlated with age, grains, and sugar in drinks and negatively correlated with socioeconomic status, education level, brushing frequency and milk. Calculus was not correlated with gender and BMI. Periodontitis was positively correlated with age, carbohydrates other than bread, grains, and crackers, as well as caffeinated drinks, while negatively correlated with gender, socioeconomic status, brushing frequency. Periodontitis was not correlated with BMI or education level. Conclusion: The present study clarifies that age, brushing frequency, carbohydrates and caffeinated drinks consumption are significant factors influencing the occurrence and the severity of periodontal diseases.
Collapse
Affiliation(s)
- Marwa M.S. Abbass
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Dina Rady
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Israa Ahmed Radwan
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Sara El Moshy
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Nermeen AbuBakr
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Mohamed Ramadan
- Specialized Dental Hospital, Armed Forces Medical Complex, Kobry El Qobba, Cairo, Egypt
| | - Nermin Yussif
- Periodontology Department, MSA University, Cairo, Egypt
| | | |
Collapse
|
17
|
Abbass MMS, Rady D, Radwan IA, El Moshy S, AbuBakr N, Ramadan M, Yussif N, Al Jawaldeh A. The occurrence of periodontal diseases and its correlation with different risk factors among a convenient sample of adult Egyptian population: a cross-sectional study. F1000Res 2019; 8:1740. [PMID: 32494356 PMCID: PMC7236581 DOI: 10.12688/f1000research.20310.2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/11/2020] [Indexed: 12/20/2022] Open
Abstract
Background: Even though extensive studies on the prevalence of periodontal diseases in various populations worldwide have been carried out, data for the Egyptian population is limited. The present study was carried out to evaluate the occurrence and the severity of periodontal disease and its correlation with different risk factors. Methods: Periodontal examination was performed on 343 adults attending the outpatient clinics of the Faculty of Dentistry, Cairo University, as well as three private clinics. Socio-demographic data, brushing frequency, body mass index (BMI) and dietary habits were recorded using a questionnaire. Results: It was found that 58.9% of participants had calculus deposits. The occurrence of periodontitis was 89.8%, where 70.8% of participants had stage I and 15.2% had stage II, while only 4.4% and 2.05% suffered from stage III and stage IV, respectively. Calculus was positively correlated with age, grains, and sugar in drinks and negatively correlated with socioeconomic status, education level, brushing frequency and milk. Calculus was not correlated with gender and BMI. Periodontitis was positively correlated with age, carbohydrates other than bread, grains, and crackers, as well as caffeinated drinks, while negatively correlated with gender, socioeconomic status, brushing frequency. Periodontitis was not correlated with BMI or education level. Conclusion: The present study clarifies that age, brushing frequency, carbohydrates and caffeinated drinks consumption are significant factors influencing the occurrence and the severity of periodontal diseases.
Collapse
Affiliation(s)
- Marwa M S Abbass
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Dina Rady
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Israa Ahmed Radwan
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Sara El Moshy
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Nermeen AbuBakr
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Mohamed Ramadan
- Specialized Dental Hospital, Armed Forces Medical Complex, Kobry El Qobba, Cairo, Egypt
| | - Nermin Yussif
- Periodontology Department, MSA University, Cairo, Egypt
| | | |
Collapse
|
18
|
Javid AZ, Hormoznejad R, Yousefimanesh HA, Haghighi-Zadeh MH, Zakerkish M. Impact of resveratrol supplementation on inflammatory, antioxidant, and periodontal markers in type 2 diabetic patients with chronic periodontitis. Diabetes Metab Syndr 2019; 13:2769-2774. [PMID: 31405706 DOI: 10.1016/j.dsx.2019.07.042] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 07/23/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Diabetes mellitus and periodontal disease are two common and chronic diseases with bidirectional relationship influence public health and quality of life. The aims of this study was to study the impact of resveratrol supplementation in adjunct with non-surgical periodontal therapy on inflammatory, antioxidant, and periodontal markers in patients with type 2 diabetes with periodontal disease. MATERIALS AND METHODS In this randomized clinical trial, 43 patients with diabetes and chronic periodontitis were randomly allocated into two intervention and control groups receiving either resveratrol supplements or placebo for 4 weeks. Serum levels of interleukin 6 (IL6), tumor necrosis factor α (TNFα), total antioxidant capacity (TAC) and clinical attachment loss (CAL) as the main index of periodontal marker were measured pre-intervention and post-intervention. RESULTS In the intervention group, the mean serum level of IL6 was reduced significantly (P = 0.039) post-intervention (2.19 ± 1.09 and 1.58 ± 1.06). No significant differences were seen in the mean levels of IL6, TNFα, TAC and CAL between two groups post-intervention. CONCLUSIONS It is suggested that daily consumption of resveratrol supplement may not change TNFα, TAC and CAL, but it would be beneficial in reducing serum levels of IL6. Therefore, further studies are suggested to investigate the effects of resveratrol supplementation along with NST on periodontal status.
Collapse
Affiliation(s)
- Ahmad Zare Javid
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Razie Hormoznejad
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Hojat Allah Yousefimanesh
- Department of Periodontology, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Mehrnoosh Zakerkish
- Health research institute, Diabetes research center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
19
|
Zare Javid A, Bazyar H, Gholinezhad H, Rahimlou M, Rashidi H, Salehi P, Haghighi-zadeh MH. The effects of ginger supplementation on inflammatory, antioxidant, and periodontal parameters in type 2 diabetes mellitus patients with chronic periodontitis under non-surgical periodontal therapy. A double-blind, placebo-controlled trial. Diabetes Metab Syndr Obes 2019; 12:1751-1761. [PMID: 32021341 PMCID: PMC6737165 DOI: 10.2147/dmso.s214333] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 08/17/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the effects of ginger supplementation on inflammatory, antioxidant, and periodontal parameters in type 2 diabetes mellitus (T2DM) patients with chronic periodontitis (CP) under non-surgical periodontal therapy (NSPT). MATERIAL AND METHODS In this double-blind clinical trial study, 46 T2DM patients with CP were randomly allocated to intervention and control groups and received either 4 tablets 500 mg (2 g) ginger or placebo twice a day for 8 weeks. All patients were treated with NSPT during the intervention period. Serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), hs-C-reactive protein (hs-CRP), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), periodontal indices including clinical attachment loss (CAL), bleeding on probing (BOP), pocket depth (PD), and plaque index were evaluated in all subjects pre- and post-intervention. RESULTS Following 8 weeks of ginger treatment with NSPT, significant reductions were observed in the mean levels of IL-6 (p=0.001), hs-CRP (p=0.03), TNF-α (p=0.007), CAL, and PD (p<0.001) in the intervention group. The mean serum levels of SOD and GPx were significantly increased in the intervention group after the intervention (p=0.001 and 0.002, respectively). At the end of the study, the mean changes of GPx were significantly higher in the intervention group compared with the control group (p=0.04). Also, after the administration of the ginger with NSPT, significant decrease occurred in the mean change of IL-6 (p=0.009), hs-CRP (p=0.049), TNF-α (p=0.049), CAL (p=0.003), and PD (p=0.04) compared with the control group. CONCLUSION It is recommended that ginger supplementation along with NSPT may be effective in the improvement of inflammation, oxidative, and periodontal status in T2DM with CP.
Collapse
Affiliation(s)
- Ahmad Zare Javid
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hadi Bazyar
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Correspondence: Hadi Bazyar Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Golestan Boulevard, Ahvaz, Iran, 78531-67465Tel +98 9136659629 Email
| | - Hasan Gholinezhad
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehran Rahimlou
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Homeira Rashidi
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parvin Salehi
- Department of Periodontology, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | |
Collapse
|
20
|
Bazyar H, Gholinezhad H, Moradi L, Salehi P, Abadi F, Ravanbakhsh M, Zare Javid A. The effects of melatonin supplementation in adjunct with non-surgical periodontal therapy on periodontal status, serum melatonin and inflammatory markers in type 2 diabetes mellitus patients with chronic periodontitis: a double-blind, placebo-controlled trial. Inflammopharmacology 2018; 27:67-76. [PMID: 30328031 DOI: 10.1007/s10787-018-0539-0] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 10/06/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Diabetes mellitus (DM) and periodontitis are two common chronic diseases with bidirectional relationship. Oxidative stress plays a key role in the pathogenesis of these two diseases. The aim of this study was to investigate the effects of melatonin supplementation in adjunct with non-surgical periodontal therapy on periodontal status, serum melatonin and inflammatory markers in type 2 DM patients with chronic periodontitis (CP). MATERIALS AND METHODS In this double-blind clinical trial study, 50 type 2 DM patients with CP were randomly allocated to the intervention and control groups. The intervention and control groups received either 6 mg melatonin or placebo (2 tablets) once a day. Serum levels of melatonin, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), hs-C-reactive protein (hs-CRP), clinical attachment loss (CAL), pocket depth (PD), bleeding on probing (BOP) and plaque index were evaluated in all subjects pre- and post-intervention. RESULTS Melatonin supplementation significantly increased the mean serum levels of melatonin after intervention. The mean changes of melatonin were significantly higher in intervention group compared with control group. IL-6 and hs-CRP levels were significantly (p = 0.008 and p = 0.017, respectively) reduced in the intervention group. The mean changes of IL-6 were significantly lower in the intervention group compared with the control group (p = 0.04). In the intervention group, PD and CAL were significantly decreased after intervention (p < 0.001). There were significant differences in the mean change of PD and CAL between the intervention and control groups after intervention (p < 0.001). CONCLUSIONS Melatonin supplementation in adjunct with non-surgical periodontal therapy might improve inflammatory and periodontal status in T2DM with CP.
Collapse
Affiliation(s)
- Hadi Bazyar
- Student Research Committee, Department of Nutrition, Faculty of Paramedical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hassan Gholinezhad
- Student Research Committee, Department of Nutrition, Faculty of Paramedical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Leila Moradi
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parvin Salehi
- Department of Periodontology, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Faezeh Abadi
- Department of Medical Surgical Nursing, Nursing and Midwifery School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Maryam Ravanbakhsh
- Student Research Committee, Department of Environmental Health Engineering, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ahmad Zare Javid
- Nutrition and Metabolic Diseases Research Center & Hyperlipidemia Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| |
Collapse
|
21
|
Babaei H, Forouzandeh F, Maghsoumi-Norouzabad L, Yousefimanesh HA, Ravanbakhsh M, Zare Javid A. Effects of Chicory Leaf Extract on Serum Oxidative Stress Markers, Lipid Profile and Periodontal Status in Patients With Chronic Periodontitis. J Am Coll Nutr 2018; 37:479-486. [PMID: 29558323 DOI: 10.1080/07315724.2018.1437371] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AIM The aim of present study was to evaluate the effects of chicory leaf extract on serum oxidative stress markers, lipid profile, and periodontal status in patients with chronic periodontitis. METHODS In this double-blind, randomized controlled clinical trial 40 patients with chronic periodontitis were allocated to intervention and control groups. The intervention group received a 1-gram chicory leaf methanolic extract capsule twice daily for 8 weeks. In the control group, participants received a placebo capsule (containing 1 gram wheat flour) twice daily for 8 weeks. All participants had nonsurgical periodontal therapy during the study. Anthropometric measurements, dietary intake, total antioxidant capacity (TAC), malondialdehyde (MDA), uric acid, lipid profile (total cholesterol [TC], triglycerides [TG], low-density lipoprotein cholesterol [LDL-C], and high-density lipoprotein cholesterol [HDL-C]), and pocket depth (PD) were assessed before and after intervention. RESULTS The results showed that mean serum TAC, uric acid, and HDL-C increased and mean serum MDA, TG, LDL-C, and TC decreased significantly in the intervention group compared to their baseline and the control group post-intervention. A significant difference was observed in mean PD between the two groups. CONCLUSION Chicory leaf extract as an adjunct nutritional approach with nonsurgical periodontal therapy may be helpful in controlling periodontal status.
Collapse
Affiliation(s)
- Hossein Babaei
- a Drug Applied Research Center , School of Pharmacy, Tabriz University of Medical Sciences , Tabriz , Iran
| | - Fahimeh Forouzandeh
- b Department of Nutrition , School of Paramedical Sciences, Arvand International Branch, Ahvaz Jundishapur University of Medical Sciences , Ahvaz , Iran
| | - Leila Maghsoumi-Norouzabad
- c Student Research Committee , Ahvaz Jundishapur University of Medical Sciences , Ahvaz , Iran
- e Nutrition and Metabolic Diseases Research Center, Hyperlipidemia Research Center , Ahvaz Jundishapur University of Medical Sciences , Ahvaz , Iran
| | - Hojat Allah Yousefimanesh
- d Department of Periodontology , School of Dentistry, Ahvaz Jundishapur University of Medical Sciences , Ahvaz , Iran
| | - Maryam Ravanbakhsh
- c Student Research Committee , Ahvaz Jundishapur University of Medical Sciences , Ahvaz , Iran
| | - Ahmad Zare Javid
- e Nutrition and Metabolic Diseases Research Center, Hyperlipidemia Research Center , Ahvaz Jundishapur University of Medical Sciences , Ahvaz , Iran
| |
Collapse
|
22
|
Woźniewicz M, Nowaczyk PM, Kurhańska-Flisykowska A, Wyganowska-Świątkowska M, Lasik-Kurdyś M, Walkowiak J, Bajerska J. Consumption of cranberry functional beverage reduces gingival index and plaque index in patients with gingivitis. Nutr Res 2018; 58:36-45. [PMID: 30340813 DOI: 10.1016/j.nutres.2018.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 06/05/2018] [Accepted: 06/28/2018] [Indexed: 10/28/2022]
Abstract
Periodontal disease is highly prevalent worldwide, and consumption of certain foods, such as fruits, seem to improve the effectiveness of periodontal therapy (PT) due to their antiadhesive, immunomodulatory, and antioxidative properties. We hypothesized that the cranberry functional beverage (CFB) consumed for eight weeks improves gingival inflammation indices via inhibition of dental plaque, and alterations in antioxidant status, and systemic inflammation in patients with gingivitis. In this two-arm randomized controlled study, fifty participants were divided into an experimental group (CFB), administered daily with 750 ml CFB, or a control group administered the same amount of water. All patients underwent nonsurgical PT prior to the intervention. Gingival (GI) and bleeding on probing (BoP) indices of inflammation, plaque (PI) and approximal plaque (API) indices of dental plaque deposition, saliva and serum total antioxidant status (TAS), serum malonylodialdehyde level (MDA), and interleukin 1-beta level (IL-1beta) were measured pre- and postintervention. A risk of caries development was determined by Streptococcus mutans (SM) and Lactobacillus spp. (LAB) counts in supragingival dental plaque. Changes in GI and PI but not BoP and API were significantly more pronounced in the CFB group compared to the control group. Serum or saliva TAS, IL-1beta, and MDA did not differ between groups. The number of SM reduced in CFB, but not in the control group. We demonstrated that the consumption of CFB improves gingival and plaque indices without posing a risk of caries development. Thus CFB can be recommended as a safe adjunct for nonsurgical PT in patients with gingivitis.
Collapse
Affiliation(s)
- Małgorzata Woźniewicz
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, Poland.
| | - Paulina M Nowaczyk
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, Poland
| | | | | | - Małgorzata Lasik-Kurdyś
- Institute of Food Technology of Plant Origin, Department of Fermentation and Biosynthesis, Poznan University of Life Sciences, Poland
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poland
| | - Joanna Bajerska
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, Poland
| |
Collapse
|
23
|
O'Toole S, Newton T, Moazzez R, Hasan A, Bartlett D. Randomised Controlled Clinical Trial Investigating The Impact of Implementation Planning on Behaviour Related to The Diet. Sci Rep 2018; 8:8024. [PMID: 29795123 PMCID: PMC5966402 DOI: 10.1038/s41598-018-26418-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 05/04/2018] [Indexed: 02/08/2023] Open
Abstract
There is a perceived gap between dietary advice given by health practitioners and adherence to the advice by patients. We investigated whether a behaviour change technique (implementation-planning) was more effective than standard-of-care diet advice at reducing dietary acid intake using quantitative erosive tooth wear progression as an objective clinical outcome. This study was a randomised controlled, double-blind, single-centre clinical trial in the UK. Participants (n = 60) with high dietary acid intake (≥2 daily), were recruited and randomly assigned (1:1) to receive either implementation-planning or standard-of-care diet advice in a single clinical session. Questionnaires and impressions were taken at baseline and 6 months later. Dental casts were scanned using laser profilometry and superimposed using surface-matching software. Data were analysed per protocol and intention-to-treat using independent t-tests and Mann-Whitney tests. The intervention group reduced their dietary acid intake between meals to 1 intake per day compared to 2 intakes per day for the controls and demonstrated reduced dental hard tissue volume loss (-0.00 mm3 (SD = 0.01)) compared to controls (-0.07 mm3 (SD 0.17)), p = 0.049. This paper supports the use of implementation planning in clinical practice and presents a non-invasive method of intervention assessment in behaviour change. Larger trials are needed to confirm the generalisability of results.
Collapse
Affiliation(s)
- S O'Toole
- Department of Prosthodontics, King's College London Dental Institute, London, UK.
| | - T Newton
- Department of Behavioural and Population Sciences, King's College London Dental Institute, London, UK
| | - R Moazzez
- Department of Mucosal and Salivary Biology, King's College London Dental Institute, London, UK
| | - A Hasan
- Department of Biostatistics, King's College London Dental Institute, London, UK
| | - D Bartlett
- Department of Prosthodontics, King's College London Dental Institute, London, UK
| |
Collapse
|
24
|
Culebras-Atienza E, Silvestre FJ, Silvestre-Rangil J. Possible association between obesity and periodontitis in patients with Down syndrome. Med Oral Patol Oral Cir Bucal 2018; 23:e335-e343. [PMID: 29680852 PMCID: PMC5945240 DOI: 10.4317/medoral.22311] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 04/07/2018] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND The present study was carried out to evaluate the possible association between obesity and periodontitis in patients with DS, and to explore which measure of obesity is most closely correlated to periodontitis. MATERIAL AND METHODS A prospective observational study was made to determine whether obesity is related to periodontal disease in patients with DS. The anthropometric variables were body height and weight, which were used to calculate BMI and stratify the patients into three categories: < 25(normal weight), 25-29.9 (overweight) and ≥ 30.0 kg/m2 (obese). Waist circumference and hip circumference in turn was recorded as the greatest circumference at the level of the buttocks, while the waist/hip ratio (WHR) was calculated. Periodontal evaluation was made of all teeth recording the plaque index (PI), pocket depth (PD), clinical attachment level (CAL) and the gingival index. We generated a multivariate linear regression model to examine the relationship between PD and the frequency of tooth brushing, gender, BMI, WHI, WHR, age and PI. RESULTS Significant positive correlations were observed among the anthropometric parameters BMI, WHR, WHI and among the periodontal parameters PI, PD, CAL and GI. The only positive correlation between the anthropometric and periodontal parameters corresponded to WHR. Upon closer examination, the distribution of WHR was seen to differ according to gender. Among the women, the correlation between WHR and the periodontal variables decreased to nonsignificant levels. In contrast, among the males the correlation remained significant and even increased. In a multivariate linear regression model, the coefficients relating PD to PI, WHR and age were positive and significant in all cases. CONCLUSIONS Our results suggest that there may indeed be an association between obesity and periodontitis in male patients with DS. Also, we found a clear correlation with WHR, which was considered to be the ideal adiposity indicator in this context.
Collapse
Affiliation(s)
- E Culebras-Atienza
- Dentistry and Medicine Faculty, University of Valencia, C/ Gasco Oliag n 1, Valencia 46010, SPAIN,
| | | | | |
Collapse
|
25
|
Zare Javid A, Maghsoumi-Norouzabad L, Ashrafzadeh E, Yousefimanesh HA, Zakerkish M, Ahmadi Angali K, Ravanbakhsh M, Babaei H. Impact of Cranberry Juice Enriched with Omega-3 Fatty Acids Adjunct with Nonsurgical Periodontal Treatment on Metabolic Control and Periodontal Status in Type 2 Patients with Diabetes with Periodontal Disease. J Am Coll Nutr 2017; 37:71-79. [DOI: 10.1080/07315724.2017.1357509] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Ahmad Zare Javid
- Nutrition and Metabolic Diseases Research Center & Hyperlipidemia Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Leila Maghsoumi-Norouzabad
- Nutrition and Metabolic Diseases Research Center & Hyperlipidemia Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Nutrition, School of Para Medicine, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | - Elnaz Ashrafzadeh
- Nutrition and Metabolic Diseases Research Center & Hyperlipidemia Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Nutrition, School of Para Medicine, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | - Hojat Allah Yousefimanesh
- Department of Periodontology, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehrnoosh Zakerkish
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kambiz Ahmadi Angali
- Biostatistics Division, Health Faculty, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Ravanbakhsh
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hosein Babaei
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
26
|
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: 83] [Impact Index Per Article: 11.9] [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.
Collapse
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
| |
Collapse
|
27
|
Gawron-Skarbek A, Guligowska A, Prymont-Przymińska A, Godala M, Kolmaga A, Nowak D, Szatko F, Kostka T. Dietary Vitamin C, E and β-Carotene Intake Does Not Significantly Affect Plasma or Salivary Antioxidant Indices and Salivary C-Reactive Protein in Older Subjects. Nutrients 2017; 9:nu9070729. [PMID: 28698489 PMCID: PMC5537843 DOI: 10.3390/nu9070729] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 06/29/2017] [Accepted: 07/06/2017] [Indexed: 12/19/2022] Open
Abstract
It is not clear whether habitual dietary intake influences the antioxidant or inflammatory status. The aim of the present study was to assess the impact of antioxidative vitamins C, E, and β-carotene obtained from daily food rations on plasma and salivary Total Antioxidant Capacity (TAC), uric acid and salivary C-reactive protein (CRP). The study involved 80 older subjects (66.9 ± 4.3 years), divided into two groups: group 1 (n = 43) with lower and group 2 (n = 37) with higher combined vitamins C, E and β-carotene intake. A 24-h dietary recall was obtained from each individual. TAC was assessed simultaneously with two methods in plasma (Ferric Reducing Ability of Plasma—FRAP, 2.2-diphenyl-1-picryl-hydrazyl—DPPH) and in saliva (FRAS and DPPHS test). Lower vitamin C intake corresponded to higher FRAS. There were no other correlations between vitamins C, E or β-carotene intake and antioxidant indices. Salivary CRP was not related to any antioxidant indices. FRAS was decreased in group 2 (p < 0.01) but no other group differences for salivary or for plasma antioxidant parameters and salivary CRP were found. Habitual, not extra supplemented dietary intake does not significantly affect plasma or salivary TAC and salivary CRP.
Collapse
Affiliation(s)
- Anna Gawron-Skarbek
- Department of Hygiene and Health Promotion, Medical University of Lodz, Hallera St. 1, Łódź 90-647, Poland.
| | - Agnieszka Guligowska
- Department of Geriatrics, Medical University of Lodz, Pieniny St. 30, Łódź 90-993, Poland.
| | - Anna Prymont-Przymińska
- Department of General Physiology, Medical University of Lodz, Mazowiecka St. 6/8, Łódź 92-215, Poland.
| | - Małgorzata Godala
- Department of Hygiene of Nutrition and Epidemiology, Medical University of Lodz, Hallera St. 1, Łódź 90-647, Poland.
| | - Agnieszka Kolmaga
- Department of Hygiene of Nutrition and Epidemiology, Medical University of Lodz, Hallera St. 1, Łódź 90-647, Poland.
| | - Dariusz Nowak
- Department of Clinical Physiology, Medical University of Lodz, Mazowiecka St. 6/8, Łódź 92-215, Poland.
| | - Franciszek Szatko
- Department of Hygiene and Health Promotion, Medical University of Lodz, Hallera St. 1, Łódź 90-647, Poland.
| | - Tomasz Kostka
- Department of Geriatrics, Medical University of Lodz, Pieniny St. 30, Łódź 90-993, Poland.
| |
Collapse
|
28
|
Tartaglia GM, Gagliano N, Zarbin L, Tolomeo G, Sforza C. Antioxidant capacity of human saliva and periodontal screening assessment in healthy adults. Arch Oral Biol 2017; 78:34-38. [PMID: 28189883 DOI: 10.1016/j.archoralbio.2017.02.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 02/02/2017] [Accepted: 02/03/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Saliva plays a pivotal role as an antioxidant system, and saliva antioxidant levels are reduced in patients with periodontal disease. Recently, a biochemical test able to determine saliva antioxidant levels was proposed as predictive for oral cavity diseases, but it was not clinically tested. In this preliminary study, we evaluated the relationships between Periodontal Screening and Recordings characteristics of patients and saliva antioxidant levels measures. DESIGN Thirty-nine patients (12 men, 27 women; mean age, 46 years, SD 17) attending the dental hygiene unit of a Private Clinic underwent a Periodontal Screening and Recordings examination and a saliva antioxidant levels measurement using a biochemical commercial test. The results of the clinical periodontal examination were compared to those obtained by the saliva test. RESULTS Approximately 70% of patients showed a low saliva antioxidant levels value, while the other patients had Optimal/Normal values. Thirteen patients (33%) resulted positive to Periodontal Screening and Recordings test. Using Periodontal Screening and Recordings values as gold standard, the saliva antioxidant levels test correctly classified 52.6% of patients; sensitivity was 84.6%, specificity was 36%. CONCLUSIONS The saliva antioxidant levels test had a good sensitivity when compared to the gold standard; this finding corroborates the hypothesis that alterations of the oral antioxidant levels are related to periodontal disease. The reduced specificity shows that saliva antioxidant levels test could detect alterations predisposing to periodontal disease before clinically evident aspects.
Collapse
Affiliation(s)
- Gianluca Martino Tartaglia
- Functional Anatomy Research Center (FARC), Laboratorio di Anatomia Funzionale dell'Apparato Stomatognatico, Dipartimento di Scienze Biomediche per la Salute, Facoltà di Medicina e Chirurgia, Università degli Studi di Milano, via Luigi Mangiagalli 31, 20133 Milano, Italy; Private practice, SST Dental Clinic, via Martiri della Libertà 58, 20090 Segrate, MI, Italy
| | - Nicoletta Gagliano
- Dipartimento di Scienze Biomediche per la Salute, Facoltà di Medicina e Chirurgia, Università degli Studi di Milano, via Luigi Mangiagalli 31, 20133 Milano, Italy
| | - Luca Zarbin
- Private practice, SST Dental Clinic, via Martiri della Libertà 58, 20090 Segrate, MI, Italy
| | - Giorgia Tolomeo
- Private practice, SST Dental Clinic, via Martiri della Libertà 58, 20090 Segrate, MI, Italy
| | - Chiarella Sforza
- Functional Anatomy Research Center (FARC), Laboratorio di Anatomia Funzionale dell'Apparato Stomatognatico, Dipartimento di Scienze Biomediche per la Salute, Facoltà di Medicina e Chirurgia, Università degli Studi di Milano, via Luigi Mangiagalli 31, 20133 Milano, Italy.
| |
Collapse
|
29
|
Pulido-Moran M, Bullon P, Morillo JM, Battino M, Quiles JL, Ramirez-Tortosa MC. The relationship between insulin resistance and periodontitis is not affected by Mediterranean diet in a Spanish population. Arch Oral Biol 2017; 77:62-67. [PMID: 28178586 DOI: 10.1016/j.archoralbio.2017.01.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 12/20/2016] [Accepted: 01/31/2017] [Indexed: 01/01/2023]
Abstract
OBJETIVE To examine the insulin resistance measured by surrogate indices in subjects with and without periodontitis and to find out any correlation among dietary intake with insulin resistance. DESIGN Fifty-five patients were recruited to participate in this cross-sectional study. Insulin resistance measured by the homoeostasis model assessment (HOMA-IR) and the quantitative insulin sensitivity check index moreover glycaemia, creatinine, uric acid, high density lipoproteins, low density lipoproteins, very low density lipoproteins and triglycerides among others. True periodontal disease was elucidated through the examination of probing pocket depth, clinical attachment level, recession of the gingival margin and gingival bleeding. The statistical analyses used were the student's T-test for independent variables, Kolmogorov-Smirnov if variations were homogeneous; if not, the Mann-Whitney U Test was applied instead. Correlations between variables were assessed using Pearson's correlation coefficients. True periodontal disease was confirmed through the greater values of probing pocket depth, clinical attachment level, gingival margin and gingival bleeding in the periodontitis group in comparison with non-periodontitis group. RESULTS Insulin resistance was evidenced by the greater values of HOMA-IR as well as by the lower quantitative insulin sensitivity check index values in the periodontitis group. Fasting insulin, glucose, uric acid, creatinine, low density lipoproteins, triglycerides and very low density lipoprotein levels were significant higher in periodontitis group. Pearson's correlations did not show any association among diet data and insulin resistance parameters in periodontitis patients. CONCLUSION A putative systemic relationship between insulin resistance and periodontitis exists but it does not seem conceivable any effect of diet over such relationship.
Collapse
Affiliation(s)
- M Pulido-Moran
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology "José Mataix", Biomedical Research Center, University of Granada, Granada, Spain
| | - P Bullon
- Department of Periodontology, Dental School, University of Seville, Seville, Spain
| | - J M Morillo
- Department of Periodontology, Dental School, University of Seville, Seville, Spain
| | - M Battino
- Department of Biochemistry, Biology and Genetics, Faculty of Medicine, Marche Polytechnic University, Ancona, Italy
| | - J L Quiles
- Department of Physiology, Institute of Nutrition and Food Technology "José Mataix", Biomedical Research Center, University of Granada, Granada, Spain
| | - MCarmen Ramirez-Tortosa
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology "José Mataix", Biomedical Research Center, University of Granada, Granada, Spain.
| |
Collapse
|
30
|
Nguyen TT, Ngo LQ, Promsudthi A, Surarit R. Salivary oxidative stress biomarkers in chronic periodontitis and acute coronary syndrome. Clin Oral Investig 2016; 21:2345-2353. [PMID: 27987039 DOI: 10.1007/s00784-016-2029-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 12/06/2016] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The study aimed at assessing oxidative stress (OS) biomarker levels in the saliva of patients with chronic periodontitis (CP) and acute coronary syndrome (ACS) and establishing their correlation to periodontal parameters and markers for cardiovascular events. MATERIALS AND METHODS The present study enrolled 24 patients with ACS and CP (the ACSCP group), 24 patients with ACS only (the ACS group), 24 patients with CP only (the CP group), and 24 healthy controls. Plaque index (PI), gingival index, bleeding on probing, probing pocket depth (PPD), and clinical attachment loss were recorded. Markers for cardiovascular events included serum high sensitivity C-reactive protein (hsCRP) and plasma fibrinogen. 8-Hydroxydeoxyguanosine (8-OHdG), protein carbonyl (PC), malondialdehyde (MDA), and total antioxidant capacity (TAOC) were used as OS biomarkers. RESULTS Salivary 8-OHdG, MDA, and PC levels were significantly higher in the ACSCP, ACS, and CP groups than in healthy controls (p < 0.05). There were significant correlations between salivary PC levels and PI or PPD (p < 0.05) as well as between salivary 8-OHdG levels and all periodontal parameters (p < 0.05). TAOC levels in saliva were correlated to both serum hsCRP and plasma fibrinogen (p < 0.05). Salivary MDA levels were correlated to all periodontal parameters and biomarkers for cardiovascular events (p < 0.05). CONCLUSIONS Salivary OS biomarker levels were higher in diseased groups compared to control. They also correlated to clinical periodontal parameters and markers for cardiovascular events in ACS patients, with or without CP. CLINICAL RELEVANCE Salivary OS biomarkers could potentially serve as diagnostic tools for cardiovascular and/or periodontal diseases.
Collapse
Affiliation(s)
- Thuy T Nguyen
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, 6 Yothi Street, Ratchathewi, Bangkok, 10400, Thailand.,Department of Periodontology, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy-Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Lan Q Ngo
- Department of Dental Basic Sciences, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy-Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Ananya Promsudthi
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Rudee Surarit
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, 6 Yothi Street, Ratchathewi, Bangkok, 10400, Thailand.
| |
Collapse
|
31
|
Jauhiainen L, Suominen AL, Kanerva N, Männistö S, Knuuttila M, Ylöstalo P. Periodontal pocketing and gingival bleeding in relation to Nordic diet - results from a population-based survey. J Clin Periodontol 2016; 43:1013-1023. [DOI: 10.1111/jcpe.12631] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2016] [Indexed: 02/01/2023]
Affiliation(s)
- Leena Jauhiainen
- Institute of Dentistry; University of Eastern Finland; Kuopio Finland
- Department of Oral and Maxillofacial Surgery; North Karelia Central Hospital and Honkalampi Centre; Joensuu Finland
| | - Anna Liisa Suominen
- Institute of Dentistry; University of Eastern Finland; Kuopio Finland
- Department of Oral and Maxillofacial Surgery; Kuopio University Hospital; Kuopio Finland
- The Living Environment and Health Unit; National Institute for Health and Welfare; Kuopio Finland
- The Health Monitoring Unit; National Institute for Health and Welfare; Helsinki Finland
| | - Noora Kanerva
- Department of Health; National Institute for Health and Welfare; Helsinki Finland
| | - Satu Männistö
- Department of Health; National Institute for Health and Welfare; Helsinki Finland
| | - Matti Knuuttila
- Unit of Oral Health Sciences; Medical Research Center Oulu (MRC Oulu); Oulu University Hospital and Oulu University; Oulu Finland
| | - Pekka Ylöstalo
- Institute of Dentistry; University of Eastern Finland; Kuopio Finland
- Department of Oral and Maxillofacial Surgery; Kuopio University Hospital; Kuopio Finland
- Unit of Oral Health Sciences; Medical Research Center Oulu (MRC Oulu); Oulu University Hospital and Oulu University; Oulu Finland
- Department of Oral and Maxillofacial Surgery; Oulu University Hospital; Oulu Finland
- Institute of Dentistry; University of Oulu; Oulu Finland
| |
Collapse
|
32
|
Gerber FA, Sahrmann P, Schmidlin OA, Heumann C, Beer JH, Schmidlin PR. Influence of obesity on the outcome of non-surgical periodontal therapy - a systematic review. BMC Oral Health 2016; 16:90. [PMID: 27590050 PMCID: PMC5010690 DOI: 10.1186/s12903-016-0272-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 08/11/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Obesity and periodontitis are important chronic health problems. Obesity is associated with an increased prevalence of periodontitis. Whether obesity also affects the outcome of non-surgical periodontal therapy is to date still unclear. METHODS A systematic review of studies referenced in SCOPUS, MEDLINE, PubMed, Cochrane, CINAHL, Biosis and Web of Science was performed. Titles, abstracts and finally full texts were scrutinized for possible inclusion by two independent investigators. Quality and heterogeneity of the studies were assessed and the study designs were examined. Probing pocket depth reduction was analyzed as primary surrogate parameter for therapeutic success after non-surgical periodontal therapy. RESULTS One-hundred-and-fifty-nine potentially qualifying studies were screened. Eight studies fulfilled the inclusion criteria and were analyzed. Three of eight studies failed to show an influence of obesity on pocket depth reduction after non-surgical therapy. The remaining five studies documented a clear negative effect on the outcome of non-surgical periodontal therapy. The finally included studies did not correspond to the highest level of quality (RCTs). Due to the heterogeneity of the data a meta-analysis was not possible. CONCLUSION The literature on the effect of obesity on the treatment outcome of non-surgical periodontal therapy remains controversial. The data, however, support that obesity is not only a factor associated with poorer periodontal health but might also result in inferior response to non-surgical treatment of periodontitis.
Collapse
Affiliation(s)
- Fabienne A. Gerber
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland
| | - Philipp Sahrmann
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland
| | - Oliver A. Schmidlin
- Department of Internal Medicine, Cantonal Hospital Baden, Baden, Switzerland
| | - Christian Heumann
- Department of Statistics, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Jürg Hans Beer
- Department of Internal Medicine, Cantonal Hospital Baden, Baden, Switzerland
| | - Patrick R. Schmidlin
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland
| |
Collapse
|
33
|
Affiliation(s)
- Yishai Levy
- Department Medicine D, Rambam Health Care Campus, Technion Faculty of Medicine, POB 9602, Haifa 31096, Israel.
| |
Collapse
|
34
|
Salivary and Urinary Total Antioxidant Capacity as Biomarkers of Oxidative Stress in Humans. PATHOLOGY RESEARCH INTERNATIONAL 2016; 2016:5480267. [PMID: 26966611 PMCID: PMC4761395 DOI: 10.1155/2016/5480267] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 01/10/2016] [Indexed: 12/20/2022]
Abstract
Total Antioxidant Capacity (TAC) is a biomarker often used in order to investigate oxidative stress in many pathological conditions. Saliva and urine can be collected noninvasively and represent attractive diagnostic fluids for detecting biomarkers of various pathological conditions. The reviewed case-control and intervention studies that measured salivary or urinary TAC revealed that diseases, antioxidant foods, or supplements and age, gender, and lifestyle factors influenced salivary or urinary TAC. Salivary and urinary TAC were particularly affected by oral or renal status, respectively, as well as by infection; therefore these factors must be taken into account in both case-control and intervention studies. Furthermore, some considerations on sample collection and normalization strategies could be made. In particular, unstimulated saliva could be the better approach to measure salivary TAC, whereas 24 h or spontaneous urine collection should be chosen on the basis of the study outcome and of the creatinine clearance. Finally, the uric acid-independent TAC could be the better approach to evaluate red-ox status of body, in particular after nutritional interventions and in diseases associated with hyperuricaemia.
Collapse
|
35
|
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]
|