Oxidative Stress and Antioxidants in the Diagnosis and Therapy of Periodontitis

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.

SOD2 is upregulated in periodontitis to reduce further inflammation progression

“…Although increasing evidence suggests that intracellular oxidative stress contributes to inflammatory diseases including periodontitis (Tothova & Celec, ; Wang, Luan, Chen, Zhao, & Guo, ), the role of enzymatic antioxidants including SODs still remains to be elucidated. To explore the functional relevance of SOD enzymes in inflammatory conditions, we examined publicly available gene expression datasets from the study on the "transcriptome of healthy gingival tissue in aggressive periodontitis" (GEO accession: GSE79705, Taiete et al, ).…”

Effects of alpha‐lipoic acid therapy on experimentally induced apical periodontitis: a biochemical, histopathological and micro‐CT analysis

“…Oxidative stress is usually defined as a disbalance of the production of free radicals and antioxidant mechanisms (Tóthová & Celec ). Oxidative stress has since been correlated with several pathological or conditions, including type 2 diabetes mellitus, cardiovascular disease, cancer, pulmonary disease, and hepatopathies (Inchingolo et al .…”

“…Several attempts have been made to assess the therapeutic potential of different antioxidant agents in periodontal diseases (Tóthová & Celec ). Lycopene, melatonin, N‐acetylcysteine, resveratrol vitamin C, vitamin E, fruit and vegetable capsules and dietary interventions have been investigated for this purpose (Tóthová & Celec ). However, limited information is available on adjuvant antioxidant therapy in apical periodontitis.…”

The Capacity of Periodontal Gel to Occupy the Spaces Inside the Periodontal Pockets Using Computational Fluid Dynamic

“…Other important factors for the destruction of the periodontium are oxidative stress and diminished antioxidant capacity [29,30].…”