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Fawzy El-Sayed KM, Cosgarea R, Sculean A, Doerfer C. Can vitamins improve periodontal wound healing/regeneration? Periodontol 2000 2024; 94:539-602. [PMID: 37592831 DOI: 10.1111/prd.12513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/13/2023] [Accepted: 07/19/2023] [Indexed: 08/19/2023]
Abstract
Periodontitis is a complex inflammatory disorder of the tooth supporting structures, associated with microbial dysbiosis, and linked to a number if systemic conditions. Untreated it can result in an irreversible damage to the periodontal structures and eventually teeth loss. Regeneration of the lost periodontium requires an orchestration of a number of biological events on cellular and molecular level. In this context, a set of vitamins have been advocated, relying their beneficial physiological effects, to endorse the biological regenerative events of the periodontium on cellular and molecular levels. The aim of the present article is to elaborate on the question whether or not vitamins improve wound healing/regeneration, summarizing the current evidence from in vitro, animal and clinical studies, thereby shedding light on the knowledge gap in this field and highlighting future research needs. Although the present review demonstrates the current heterogeneity in the available evidence and knowledge gaps, findings suggest that vitamins, especially A, B, E, and CoQ10, as well as vitamin combinations, could exert positive attributes on the periodontal outcomes in adjunct to surgical or nonsurgical periodontal therapy.
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Affiliation(s)
- Karim M Fawzy El-Sayed
- Oral Medicine and Periodontology Department, Faculty of Oral and Dental Medicine, Cairo University, Giza, Egypt
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts University, Kiel, Germany
| | - Raluca Cosgarea
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
- Department of Periodontology and Peri-implant Diseases, Philips University Marburg, Marburg, Germany
- Clinic for Prosthetic Dentistry, University Iuliu-Hatieganu, Cluj-Napoca, Romania
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Christof Doerfer
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts University, Kiel, Germany
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Merle CL, Lenzen C, Schmalz G, Ziebolz D. Systematic Review on Protocols of Coenzyme Q10 Supplementation in Non-Surgical Periodontitis Therapy. Nutrients 2023; 15:nu15071585. [PMID: 37049426 PMCID: PMC10096526 DOI: 10.3390/nu15071585] [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: 01/31/2023] [Revised: 03/01/2023] [Accepted: 03/10/2023] [Indexed: 04/14/2023] Open
Abstract
This systematic review focuses on the different study protocols on CoQ10 as an adjunct in non-surgical periodontitis therapy. The study protocol was developed following PRISMA guidelines and was registered in PROSPERO (CRD42021156887). A sensitive search up to January 2022 considered MEDLINE via PubMed and Web of Science, Embase, Web of Science Core Collection via Web of Science, Google Scholar, Cochrane CENTRAL, WHO (ICTRP), ClinicalTrials.gov, and grey literature. Randomized controlled (SRP with/without placebo) clinical trials (RCTs) on all types of CoQ10 administration were included. The primary outcome was probing pocket depth (PPD). Secondary outcomes were bleeding on probing, clinical attachment loss, and gingival and plaque indices. Twelve RCTs with local and five with systemic CoQ10 administration were included. The study protocols were heterogeneous. Local CoQ10 administration was performed once or several times in a period up to 15 days. Systemic CoQ10 was applied twice or three times daily for six weeks up to four months. The reporting quality was low, including missing information about CoQ10 doses. Risk of bias was high or unclear. About half of the studies reported significant group differences for PPD. Until now, no statement on the effectiveness of CoQ10 in non-surgical periodontitis therapy is possible. Further high-quality RCTs are necessary and should consider the protocol recommendations of this review.
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Affiliation(s)
- Cordula Leonie Merle
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93053 Regensburg, Germany
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany
| | - Carina Lenzen
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany
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Coenzyme Q10 Metabolism: A Review of Unresolved Issues. Int J Mol Sci 2023; 24:ijms24032585. [PMID: 36768907 PMCID: PMC9916783 DOI: 10.3390/ijms24032585] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 01/12/2023] [Accepted: 01/21/2023] [Indexed: 01/31/2023] Open
Abstract
The variable success in the outcome of randomised controlled trials supplementing coenzyme Q10 (CoQ10) may in turn be associated with a number of currently unresolved issues relating to CoQ10 metabolism. In this article, we have reviewed what is currently known about these factors and where gaps in knowledge exist that need to be further elucidated. Issues addressed include (i) whether the bioavailability of CoQ10 could be improved; (ii) whether CoQ10 could be administered intravenously; (iii) whether CoQ10 could be administered via alternative routes; (iv) whether CoQ10 can cross the blood-brain barrier; (v) how CoQ10 is transported into and within target cells; (vi) why some clinical trials supplementing CoQ10 may have been unsuccessful; and (vii) which is the most appropriate tissue for the clinical assessment of CoQ10 status.
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THE EFFECT OF COENZYME Q10 ON PERIODONTITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF CLINICAL TRIALS. J Evid Based Dent Pract 2022; 22:101710. [PMID: 35718433 DOI: 10.1016/j.jebdp.2022.101710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 11/30/2022]
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Shaheen MA, Elmeadawy SH, Bazeed FB, Anees MM, Saleh NM. Innovative coenzyme Q 10-loaded nanoformulation as an adjunct approach for the management of moderate periodontitis: preparation, evaluation, and clinical study. Drug Deliv Transl Res 2020; 10:548-564. [PMID: 31953677 DOI: 10.1007/s13346-019-00698-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Periodontal diseases are worldwide chronic inflammatory conditions that are associated with heavy production of reactive oxygen species followed by damage of the tooth-supporting tissues. Although the mechanical approach of scaling and root planing (SRP) for removing of plaque is considered as the key element for controlling periodontitis, the anatomical complexity of the teeth hinders accessibility to deeper points. The aim of this study was to design a micellar nanocarrier of coenzyme Q10 (Q10) to support the management of moderate periodontitis. Q10 was formulated in nanomicelles (NMQ10) and evaluated regarding encapsulation efficiency, loading efficiency, percent yield, hydrodynamic size (Dh), polydispersity index (PDI), and zeta potential (ζ potential). NMQ10 was incorporated to in situ gelling systems and the in vitro release of Q10 was studied. A clinical study including evaluation of periodontal parameters and biochemical assay of total antioxidant capacity (T-AOC) and lipid peroxide was achieved. Results revealed that Q10 was efficiently entrapped in spherical-shaped stable NMQ10 with Dh, PDI, and ζ potential of 154.0 nm, 0.108, and - 31.67 mV, respectively. The clinical study revealed that SRP only exhibited improvement of the periodontal parameters. Also, assay of T-AOC and lipid peroxide revealed that their values diminished by 21.5 and 23.8%, respectively. On the other hand, SRP combined with local application of NMQ10 resulted in a significant management of the periodontal parameters, and likewise, the assayed biomarkers proved enhanced antioxidant activity over SRP alone. In conclusion, NMQ10 can be suggested as a promising nanosystem as an approach to support the management of chronic periodontitis. Such results could be used to conduct larger clinical studies. Graphical abstrac.
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Affiliation(s)
| | - Samah H Elmeadawy
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Fagr B Bazeed
- Department of Medical Biochemistry, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohamed M Anees
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Noha M Saleh
- Department of Pharmaceutics, Faculty of Pharmacy, Mansoura University, Gomhoreyah St., Mansoura, 35516, Egypt.
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Pranam S, Palwankar P, Pandey R, Goyal A. Evaluation of Efficacy of Coenzyme Q10 as an Adjunct to Nonsurgical Periodontal Therapy and Its Effect on Crevicular Superoxide Dismutase in Patients with Chronic Periodontitis. Eur J Dent 2020; 14:551-557. [PMID: 32961568 PMCID: PMC7535976 DOI: 10.1055/s-0040-1716596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVES To assess the efficacy of coenzyme Q10 (CoQ10) as an adjunct to nonsurgical periodontal therapy and its effect on superoxide dismutase (SOD) in gingival crevicular fluid (GCF) in patients with chronic periodontitis (CP). MATERIALS AND METHODS A total of 16 patients aged between 30 and 50 years having mild to moderate CP of both sexes having pocket depth of 5 to 7 mm in four nonadjacent interproximal sites were selected. The sites were randomized and divided into treatment and control groups. CoQ10 and a placebo gel were administered in the treatment and control sites, respectively, at baseline after scaling and root planing (SRP). GCF was collected using microcapillary method at baseline and 3 months and was assessed for SOD using enzyme-linked immunosorbent assay reader at 450 nm wavelength. Probing pocket depth, gingival index, and plaque index were assessed at baseline, 1 month, and 3 months, respectively. STATISTICAL ANALYSIS For each assessment point, data were statistically analyzed using Student's t-test and paired t-test. Level of significance was set at p < 0.05. RESULTS On intergroup comparison, there was no statistically significant difference between the clinical parameters of both the groups at all the time intervals (p > 0.05), but there was a significant increase in the level of SOD in the test group (p > 0.05) compared with the control group at 3 months. CONCLUSIONS Adjunctive use of CoQ10 with SRP can boost the antioxidant concentration, but it is not superior to SRP in the treatment of CP.
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Affiliation(s)
- Swagat Pranam
- Department of Periodontology, Manav Rachna Dental College, Haryana, India
| | - Pooja Palwankar
- Department of Periodontology, Manav Rachna Dental College, Haryana, India
| | - Ruchi Pandey
- Department of Periodontology, Manav Rachna Dental College, Haryana, India
| | - Anjana Goyal
- Department of Periodontology, Manav Rachna Dental College, Haryana, India
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Dommisch H, Kuzmanova D, Jönsson D, Grant M, Chapple I. Effect of micronutrient malnutrition on periodontal disease and periodontal therapy. Periodontol 2000 2019; 78:129-153. [PMID: 30198127 DOI: 10.1111/prd.12233] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Periodontitis is a complex chronic inflammatory noncommunicable disease, initiated by the development of a dysbiotic microbial plaque biofilm below the gingival margin. Whilst the pathogenic biofilm is a "necessary cause" of periodontitis, it is insufficient on its own to cause the disease, and a destructive immune-inflammatory response is a key to the translation of risk to destructive events. Other exposures or "component causes" include individual genetic predisposition, lifestyle (including smoking and nutrition), and environmental factors. Dietary nutrients are essential for life as they provide crucial energy sources in the form of macronutrients, as well as important cofactors in the form of micronutrients, which regulate the functionality of enzymes during the regulation of anabolic and catabolic processes in human cells. Moreover, micronutrients can regulate gene transcription factors, such as the proinflammatory nuclear factor kappa B and the anti-inflammatory nuclear factor (erythroid-derived 2)-like 2. This review focuses on the role of vitamins (vitamin A, carotenoids, the vitamin B complex, vitamins C, D, and E, and coenzyme Q10) and minerals (calcium, magnesium, iron, zinc, potassium, copper, manganese, and selenium) in human physiology and the impact of their deficiencies upon periodontal health and disease.
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Affiliation(s)
- Henrik Dommisch
- Department of Periodontology and Synoptic Dentistry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Denica Kuzmanova
- Department of Periodontology and Synoptic Dentistry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Daniel Jönsson
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Melissa Grant
- Periodontal Research Group, School of Dentistry, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Iain Chapple
- Periodontal Research Group, School of Dentistry, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK.,Birminham Community Health Foundation Trust, Birmingham, UK
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Subgingivally delivered coenzyme Q10 in the treatment of chronic periodontitis among smokers: A randomized, controlled clinical study. J Oral Biol Craniofac Res 2019; 9:204-208. [PMID: 31211037 DOI: 10.1016/j.jobcr.2018.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 05/08/2018] [Indexed: 11/22/2022] Open
Abstract
Background Coenzyme Q10 is an antioxidant whose efficacy in periodontal diseases is well known. However studies regarding its efficacy in smokers with periodontitis are few. Coenzyme Q10 serves as an endogenous antioxidant and its increased concentration in the diseased gingiva effectively suppresses advanced periodontal inflammation. Objectives The aim of this study is to evaluate the efficacy of coenzyme Q10 as an adjunct to scaling and root planing in smokers with chronic periodontitis. Methods Total of 40 patients were enrolled for the study. The subjects were divided into control (Scaling and root planing only) and test group (Coenzyme Q10 plus Scaling and root planing). Clinical parameters such as plaque index, modified sulcular bleeding index, probing pocket depth and clinical attachment level. These were assessed at baseline, at 1 month and 3 month. The results were subjected to appropriate statistical analysis. Results There was a significant improvement in all clinical parameters in the test sites seen at the end of the 1 month and 3 month period. Conclusions Coenzyme Q10 can be said to have a beneficial effect on smokers with periodontitis when used as an adjunct to scaling and root planing.
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Nelwan SC, Nugraha RA, Endaryanto A, Meizarini A, Tedjosasongko U, Pradopo S, Utomo H. Converging findings from linkage between periodontal pathogen with atopic and allergic immune response. Cytokine 2018; 113:89-98. [PMID: 29937409 DOI: 10.1016/j.cyto.2018.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/30/2018] [Accepted: 06/11/2018] [Indexed: 12/13/2022]
Abstract
This study aims to explore a relationship between exposures of whole-cell Porphyromonas gingivalis in various doses with atopic inflammatory responses at experimental mice. A pretest-posttest controlled group design, with 16 Wistar rats (Rattus novergicus) randomized into four groups. Group 1 was the control group. Group 2 was given low-dose (9 × 107 colony-forming unit) of P. gingivalis. Group 3 was given medium-dose (9 × 109 colony-forming unit) of P. gingivalis. Group 4 was given high-dose (9 × 1011 colony-forming unit) of P. gingivalis. Interleukin-4, Interleukin-5, Interleukin-17F, Interleukin-21, Immunoglobulin-E, Immunoglobulin-G4, and γ-Interferon were measured by direct-sandwich ELISA just before the treatments began, day-4, and day-11 after treatments. There is a sudden increase of Interleukin-4 in the group 4 (23.79 ± 0.91 pg/ml to 54.17 ± 0.79 pg/ml; p = 0.01) and slight increase of Interleukin-5 in the group 4 (207.60 ± 11.15 pg/ml to 243.40 ± 9.33 pg/ml; p = 0.03). No change was observed for Interleukin-17F in all groups. Serum concentration of Immunoglobulin-E was decreased in group 2 (-10.44 ± 8.13 pg/ml), but increased in group 4 (+1.03 ± 4.57 pg/ml). Taken together, some cytokines are up-regulated and others are down-regulated after exposure to whole-cell P. gingivalis. Moreover, study of host responses during periodontal infection may offer critical key insight that contribute to the development of atopy. CLINICAL IMPLICATIONS: We introduced and explained the potential role of periodontal pathogen Porphyromonas gingivalis in systemic immune responses, along with its virulence factor inside the oral cavity. Our results consider several changes and differences of cytokines and immunoglobulins following whole-cell Porphyromonas gingivalis exposure. However, results of the study need to be interpreted with caution due to its limitations. CAPSULE SUMMARY: Interleukin (IL)-4 and IL-5 had been found increase after exposure to the periodontal pathogens Porphyromonas gingivalis, whereas no or minimal change had been found in the level of IL-17F, Ig-G4, and IFN-γ. The various cytokines and immunoglobulins shown in this study do not prove a causal relationship, and the precise role of Porphyromonas gingivalis in the regulation of atopic immune response warrants further investigation. Nevertheless, these findings may provide some critical key insight into the host responses following Porphyromonas gingivalis infection.
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Affiliation(s)
- Sindy Cornelia Nelwan
- Department of Pediatric Dentistry, Faculty of Dentistry Universitas Airlangga, Surabaya, Indonesia.
| | | | - Anang Endaryanto
- Department of Child Health, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia
| | - Asti Meizarini
- Department of Dental Materials Science and Technology, Faculty of Dentistry Universitas Airlangga, Surabaya, Indonesia
| | - Udijanto Tedjosasongko
- Department of Pediatric Dentistry, Faculty of Dentistry Universitas Airlangga, Surabaya, Indonesia
| | - Seno Pradopo
- Department of Pediatric Dentistry, Faculty of Dentistry Universitas Airlangga, Surabaya, Indonesia
| | - Haryono Utomo
- Department of Forensic Dentistry, Faculty of Dentistry Universitas Airlangga, Surabaya, Indonesia
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Sharma V, Gupta R, Dahiya P, Kumar M. Comparative evaluation of coenzyme Q 10-based gel and 0.8% hyaluronic acid gel in treatment of chronic periodontitis. J Indian Soc Periodontol 2017; 20:374-380. [PMID: 28298817 PMCID: PMC5341310 DOI: 10.4103/0972-124x.183097] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The anti-inflammatory and immune enhancing effects of coenzyme Q10 (CoQ10) and hyaluronic acid are well established in medical literature. The present study was undertaken to evaluate their role in chronic periodontitis. MATERIALS AND METHODS One hundred twenty sites in 24 patients with clinically confirmed periodontitis were included in the study. A split-mouth design was used for intrasulcular application of CoQ10 as adjunct to scaling and root planing (SRP), 0.8% hyaluronic acid as adjunct to SRP and SRP alone. Clinical parameters such as plaque index (PI), gingival color change index (GCCI), Eastman interdental bleeding index (EIBI), pocket depth (PD), and clinical attachment level (CAL) were recorded. All the clinical parameters PI, EIBI, GCCI, PD, and CAL were recorded at baseline before SRP. Only PI, EIBI, and GCCI were recorded at 1st and 2nd week. Twenty-one days post 2nd week, i.e., 6th week all the clinical parameters were recorded again. RESULTS Intragroup analysis of all the clinical parameters showed clinical significant results between baseline and 6th week. However, on intergroup analysis, the results were not significant. CONCLUSION The local application of CoQ10 and hyaluronic acid gel in conjunction with SRP may have a beneficial effect on periodontal health in patients with chronic periodontitis.
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Affiliation(s)
- Varun Sharma
- Department of Periodontics and Implantology, Himachal Institute of Dental Sciences and Research, Paonta Sahib, Sirmour, Himachal Pradesh, India
| | - Rajan Gupta
- Department of Periodontics and Implantology, Himachal Institute of Dental Sciences and Research, Paonta Sahib, Sirmour, Himachal Pradesh, India
| | - Parveen Dahiya
- Department of Periodontics and Implantology, Himachal Institute of Dental Sciences and Research, Paonta Sahib, Sirmour, Himachal Pradesh, India
| | - Mukesh Kumar
- Department of Periodontics and Implantology, Himachal Institute of Dental Sciences and Research, Paonta Sahib, Sirmour, Himachal Pradesh, India
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Non-Nutrient, Naturally Occurring Phenolic Compounds with Antioxidant Activity for the Prevention and Treatment of Periodontal Diseases. Antioxidants (Basel) 2015; 4:447-81. [PMID: 26783837 PMCID: PMC4665427 DOI: 10.3390/antiox4030447] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 05/28/2015] [Accepted: 05/29/2015] [Indexed: 01/27/2023] Open
Abstract
One of the main factors able to explain the pathophysiological mechanism of inflammatory conditions that occur in periodontal disease is oxidative stress. Given the emerging understanding of this relationship, host-modulatory therapies using antioxidants could be interesting to prevent or slow the breakdown of soft and hard periodontal tissues. In this context, non-nutrient phenolic compounds of various foods and plants have received considerable attention in the last decade. Here, studies focusing on the relationship between different compounds of this type with periodontal disease have been collected. Among them, thymoquinone, coenzyme Q (CoQ), mangiferin, resveratrol, verbascoside and some flavonoids have shown to prevent or ameliorate periodontal tissues damage in animal models. However evidence regarding this effect in humans is poor and only limited to topical treatments with CoQ and catechins. Along with animal experiments, in vitro studies indicate that possible mechanisms by which these compounds might exert their protective effects include antioxidative properties, oxygen and nitrogen scavenging abilities, and also inhibitory effects on cell signaling cascades related to inflammatory processes which have an effect on RNS or ROS production as well as on antioxidant defense systems.
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