ABSTRACT
BACKGROUND: Oxidative stress is implicated in the pathogenesis of periodontitis. The total antioxidant capacity (TAOC) of gingival crevicular fluid volume (GCF) and plasma appears compromised in periodontitis, but it is unclear whether this predisposes to, or results from the inflammatory process. AIM: To investigate longitudinal changes in GCF and plasma TAOC following reductions in periodontal inflammation with successful non-surgical therapy. MATERIALS AND METHODS: Two longitudinal studies were run in series on non-smokers with chronic periodontitis (CP). Study-1 (n=17) assessed index sites with mild disease; Study-2 (n=18) investigated deep sites. GCF sampling and clinical measures were performed at baseline and 3 months post-therapy. Plasma and GCF TAOC was determined by enhanced chemiluminescence and 32 age/sex-matched periodontally healthy controls were used. RESULTS: Therapy improved clinical outcomes consistent with the literature. There were no differences in plasma TAOC between periodontitis patients (507+/-92 microMTeq) and controls (520+/-100 microMTeq; p=0.57) at baseline, but GCF TAOC was lower (p<0.0001) in CP patients (680+/-371 microMTeq) than controls (1129+/-722 microMTeq). Successful periodontal therapy did not alter plasma TAOC (p=0.56), but GCF TAOC increased (by 449+/-722 microMTeq, p<0.001) to control subject levels (p=0.47) CONCLUSIONS: Local total antioxidant capacity in CP appears to reflect increased oxygen radical activity during periodontal inflammation and can be restored to control subject levels by successful non-surgical therapy.
Subject(s)
Antioxidants/metabolism , Gingival Crevicular Fluid/metabolism , Periodontitis/metabolism , Reactive Oxygen Species/metabolism , Adult , Case-Control Studies , Chronic Disease , Cross-Sectional Studies , Dental Care , Female , Humans , Longitudinal Studies , Male , Matched-Pair Analysis , Middle Aged , Oxidative Stress/physiology , Periodontal Index , Periodontitis/blood , Periodontitis/therapy , Reactive Oxygen Species/blood , Reference Values , Sex FactorsABSTRACT
BACKGROUND: The involvement of reactive oxygen species (ROS) in periodontal pathology is unclear but will be modulated by in vivo antioxidant defence systems. The aim of this cross-sectional study was to determine both local (saliva and gingival crevicular fluid (GCF) and peripheral (plasma and serum) antioxidant capacity in periodontal health and disease. MATERIALS AND METHODS: Twenty non-smoking volunteers with chronic periodontitis were sampled together with twenty age- and sex-matched, non-smoking controls. After overnight fasting, saliva (whole unstimulated and stimulated) and blood were collected. Total antioxidant capacity (TAOC) was determined using a previously reported enhanced chemiluminescence method. RESULTS: GCF antioxidant concentration was significantly lower (p<0.001) in periodontitis subjects compared to healthy controls. Although mean levels of peripheral and salivary TAOC were also lower in periodontitis the difference was only significant for plasma (p<0.05). Healthy subjects' GCF antioxidant concentration was significantly greater than paired serum or plasma (p<0.001). Data stratified for gender did not alter the findings and a male bias was revealed in all clinical samples except GCF. CONCLUSIONS: These findings suggest that the antioxidant capacity of GCF is both qualitatively and quantitatively distinct from that of saliva, plasma and serum. Whether changes in the GCF compartment in periodontitis reflect predisposition to or the results of ROS-mediated damage remains unclear. Reduced plasma total antioxidant defence could result from low-grade systemic inflammation induced by the host response to periodontal bacteria, or may be an innate feature of periodontitis patients.
