ascorbic-acid and Gingival-Diseases

Scurvy, the disease resulting from vitamin C deficiency, is perceived as being rare and occurring predominantly in the past. However, scurvy continues to exist and may be encountered in children with medical/developmental conditions and/or restricted diet. Diagnosis can be challenging given the perceived rarity of the condition and nonspecific symptoms, including gingival disease.. We present a series of two cases of scurvy in which the affected children presented to medical attention with dental complaints. Additional cases of scurvy are described, based on the literature review of case reports/series published in the last 10 years.. Literature review yielded 77 relevant case reports published in the English language since 2009. Most affected children had a previous diagnosis of a medical or developmental condition (especially autism spectrum disorder). Intraoral features (gingival swelling, pain, and bleeding) were noted in most of the identified cases of scurvy. Improvement in the oral features of scurvy occurred within days of vitamin C therapy initiation.. Recognizing classic signs and symptoms of scurvy enables prompt diagnosis and avoids invasive investigations. Dentists may be in a unique position to facilitate prompt and accurate diagnosis of a condition that is relatively easy and safe to treat once identified.

Topics: Ascorbic Acid; Autism Spectrum Disorder; Child; Developmental Disabilities; Gingival Diseases; Humans; Scurvy

Topics: Animals; Ascorbic Acid; Child; Female; Gingival Diseases; Hemorrhage; Humans; Infant; Joint Diseases; Nutritional Requirements; Scurvy

Physiologic gingival hyperpigmentation is a common esthetic concern that affects individuals of various ethnicities, and can have a significant impact on individual's self-confidence and overall quality of life. Thus, this study aimed to clinically assess the effectiveness of intra-mucosal injection of vitamin C versus 980 nm diode laser for the management of physiologic gingival hyperpigmentation.. Twenty-six healthy non-smoker individuals with physiologic gingival hyperpigmentation were randomly assigned to two groups. Group I received intra-mucosal injection of vitamin C (L-Ascorbic acid 1000 mg/5 ml), and group II was managed using diode laser (980 nm, 1.5 W, continuous wave mode). Clinical evaluation of pigmentation intensity and distribution was performed preoperatively, and at 1, 2 and 3 months postoperatively using two different color assessment indices; Dummett-Gupta Oral Pigmentation Index (DOPI), and Gingival Pigmentation Index (GPI). Additionally, the study assessed pain intensity and patients' satisfaction.. Pigmentation scores decreased significantly between pre-operative visit and different follow-up visits for both treatment modalities (p < 0.0001*). When compared to the vitamin C mesotherapy group, the laser group demonstrated significantly lower gingival pigmentation scores (p < 0.0001*). However, both treatment modalities were equally satisfying for the patients.. Vitamin C mesotherapy and diode laser are both effective in the management of physiologic gingival hyperpigmentation. While diode laser yields better and earlier results, vitamin C mesotherapy offers a cost-effective, safe and minimally invasive approach that is equally satisfying for the patients seeking esthetic enhancements.. The study was registered on ClinicalTrials.gov (NCT05608057) on (01/11/2022).

Topics: Ascorbic Acid; Esthetics, Dental; Gingival Diseases; Humans; Hyperpigmentation; Lasers, Semiconductor; Lasers, Solid-State; Mesotherapy; Quality of Life

Vitamin C/Ascorbic acid inhibits tyrosinase enzyme causing melanin biosynthesis suppression. This study aimed to compare the efficacy of intra-mucosal injection (mesotherapy) with topical gel as non-surgical methods for managing gingival hyperpigmentation.. Twenty healthy non-smokers with mild to severe hyperpigmented gingiva were randomly assigned for Mesotherapy (G1); intra-mucosal injection of ascorbic acid (1/week/3 weeks); or Gel (G2), topical ascorbic acid gel (1/day/3 months). Pigmentation index (DOPI), patient satisfaction, as well as histological analysis for Fontana-Masson-stained specimens were performed at baseline and after 6 months. Comparison between groups and changes by time were analyzed using Mann-Whitney and Friedman's tests, respectively.. The median DOPI significantly decreased after 1 month in G1 (P value < 0.001, r = 0.9) compared with non-significant change in G2. No pain experienced during or after treatment in both groups. G1 patients showed significantly higher satisfaction with treatment than G2. Mean area fraction of melanin forming cells was significantly reduced in both groups after 6 months, but the effect size was higher in G1 (r = 0.886) than in G2 (r = 0.797).. Vitamin C mesotherapy showed better and early effect than topical gel, and both techniques were not painful and esthetically satisfying in managing gingival hyperpigmentation.. Gingival melanin pigmentation causes esthetic concerns for significant number of patients. Investigating non-surgical depigmentation techniques to decrease postoperative complications and patient discomfort, pain and long healing period associated with surgical methods would be clinically significant.

Topics: Ascorbic Acid; Esthetics, Dental; Gingival Diseases; Humans; Hyperpigmentation; Melanins; Mesotherapy

Gingival melanin pigmentation may cause esthetic concerns, even if no serious medical problem is present. As an inhibitor of melanin formation, ascorbic acid is often used to treat skin melanin pigmentation. Thus, the present study investigated the effects of ascorbic acid on gingival melanin pigmentation in vitro and in vivo.. The effects of ascorbic acid on melanin formation were evaluated in vitro in B16 mouse melanoma cells and three-dimensional human skin models. In addition, a clinical trial was performed to investigate the inhibitory effects of a gel containing ascorbic acid 2-glucoside (AS-G gel) on gingival melanin pigmentation. This study used a double-masked, split-mouth design on 73 subjects with symmetric gingival melanin pigmentation. AS-G gel was applied to one side of the gingiva for 12 weeks, whereas placebo gel was applied to the other side as a control. Luminance (L*)-value, which describes the lightness of gingiva, was determined by spectrophotometry to obtain an objective measure of melanin pigmentation every 4 weeks.. Ascorbic acid significantly inhibited tyrosinase activity and melanin formation in B16 mouse melanoma cells (P <0.01 and P <0.05, respectively). The inhibitory effects of ascorbic acid on melanin formation were also significant in three-dimensional human skin models (P <0.01). Moreover, in the clinical trial, a significant relative change in pigmentation was seen after 4 weeks with the application of AS-G gel compared to placebo (L*-value ratio).. Ascorbic acid (AS-G) has potential for the treatment of gingival melanin pigmentation.

Topics: Adult; Animals; Antioxidants; Ascorbic Acid; Cell Line, Tumor; Double-Blind Method; Female; Gels; Gingival Diseases; Humans; Male; Melanins; Melanosis; Mice; Monophenol Monooxygenase; Skin Pigmentation; Spectrophotometry

204 children between the ages of 1.5 and 6.5 years living in a West African village where the incidence of gingivitis and bleeding gums is about 40% of the population at the end of the rainy season, were given vitamin C or a placebo for 69 days, followed by a multivitamin supplement or placebo for 47 days. The condition of their gums was continuously monitored by trained field workers and by a paediatrician during the supplementation period, and was also assessed in greater detail by the paediatrician at the beginning and end of each treatment period. No benefit of either type of supplement could be detected, either on incidence of bleeding, or on over-all severity of gingivitis, although there was a clear-cut seasonal trend towards lower incidence of bleeding in both groups as the study progressed.

Topics: Ascorbic Acid; Child; Child, Preschool; Female; Gambia; Gingival Diseases; Gingival Hemorrhage; Gingivitis; Humans; Infant; Male; Seasons; Vitamins

Vitamin C (ascorbic acid) is widely used in dermatology for skin depigmentation. However, there are very few clinical studies on the efficacy of vitamin C in gingival depigmentation. This preliminary case series aims to present the clinical effectiveness, histologic changes, and patient-reported outcomes of intra-epidermal vitamin C injections (oral mesotherapy) for managing patients with gingival melanin hyperpigmentation.. Five patients were administered locally injectable vitamin C (once per week for 4 to 5 visits) in maxillary or mandibular anterior pigmented gingiva. The depigmentation effect was evaluated using the Dummett Oral Pigmentation Index (DOPI) and Gingival Pigmentation Index (GPI). Digital photographs were used to assess gingival luminescence (L*) and pigmented surface area (PSA). Parameters were recorded at baseline and at 1 and 3 months. Melanocyte histopathologic count was determined at baseline and at 3 months. Pain, gingival color change, and patient satisfaction scores were also assessed.. Median GPI, DOPI, and PSA were significantly reduced (P ≤ .05) from baseline to 1 month. There was no statistically significant change from 1 month to 3 months. L* value significantly increased from baseline to 3 months. A median pain score of 3 (scale of 0 to 10) was observed on the day of the procedure. A score of 3 (scale of 0 to 4) was reported for the gingival color and scores 3 and 4 (scale of 0 to 4) for the overall patient satisfaction.. Oral mesotherapy using locally injectable vitamin C is a nonsurgical, minimally invasive, and efficient technique for gingival depigmentation. Indian patients were satisfied with the gingival color obtained and the overall treatment experience.. As all the branches of medicine, specifically dentistry, direct to minimally invasive approaches, mesotherapy shows great importance to reduce the surgical interventions, especially when esthetic outcomes are needed. Oral mesotherapy using locally injectable vitamin C can be a useful nonsurgical technique for achieving gingival depigmentation in the esthetic zone.

Topics: Ascorbic Acid; Gingival Diseases; Humans; Hyperpigmentation; Melanins; Mesotherapy; Pain

Gingival disase and rheumatoid arthritis (RA) are linked at both the epidemiologic and pathogenesis levels. In this study, we aimed to identify environmental factors associated with RA and gingival disease and to investigate factors that protect the gingival tissue in RA patients. This retrospective study analyzed 754 RA patients with gingival disease selected from the NHANES database who completed the mobile examination center interview/examination between 1999 and 2004. Data collected included demographics, lifestyle, dietary intake, and biomarkers. The study included 173 RA patients with gingival disease. Multivariate logistic regression analysis showed that the odds of gingival disease were significantly increased with male gender. However, the odds of gingival disease was significantly decreased with increased vitamin C intake (OR = 0.996, p = 0.041), and higher serum vitamin D levels (OR = 0.979, p = 0.011). Given the significant association between the prevalence of gingival disease and RA, identification of risk factors of gingival disease will be useful as a screening tool in national health surveys to improve the management of periodontal disease in patients with RA.

Topics: Adult; Aged; Aged, 80 and over; Arthritis, Rheumatoid; Ascorbic Acid; Biomarkers; Female; Gingival Diseases; Humans; Life Style; Logistic Models; Male; Middle Aged; Nutrition Surveys; Odds Ratio; Prevalence; Retrospective Studies; Risk Factors; Sex Factors; Vitamin D

A smile expresses feelings of joy, affection and self-confidence in an individual. Melanin hyperpigmentation of the gingiva jeopardises the aesthetics of an individual significantly. In the present case, gingival depigmentation was performed with a surgical scalpel along with local applications of ascorbic acid, yielding satisfactory aesthetic results with low subjective pain levels, and no recurrence has been observed after 9 months of follow-up.

Topics: Adolescent; Ascorbic Acid; Esthetics; Esthetics, Dental; Female; Gingiva; Gingival Diseases; Gingivectomy; Humans; Hyperpigmentation; Smiling; Treatment Outcome

A 49-year-old man presented to hospital with severe orthostatic hypotension, gingival dysplasia and a purpuric rash involving his extremities. The orthostatic hypotension failed to respond to fluids and, on the basis of physical examination and dietary history, the patient was given a preliminary diagnosis of scurvy (ascorbic acid deficiency). Serum ascorbic acid levels were undetectable and the orthostasis was resolved within 24 h of ascorbic acid replacement. The pathogenesis of orthostatic hypotension in the setting of scurvy appears to involve impaired catecholamine synthesis and attenuated vasomotor response to α-adrenergic stimulation. We believe that this case describes a rare presentation of scurvy and highlights a previously under-reported connection between scurvy and vasomotor instability.

Topics: Ascorbic Acid; Gingival Diseases; Humans; Hypotension, Orthostatic; Male; Middle Aged; Purpura; Scurvy; Vitamins

Ascorbic acid (vitamin C) is necessary for the formation of collagen, reducing free radicals, and aiding in iron absorption. Scurvy, a disease of dietary ascorbic acid deficiency, is uncommon today. Indeed, implementation of dietary recommendations largely eradicated infantile scurvy in the US in the early 1900s. We present a case of an otherwise healthy 2-year-old Caucasian girl who presented with refusal to walk secondary to pain in her lower extremities, generalized irritability, sleep disturbance, and malaise. The girl's parents described feeding the patient an organic diet recommended by the Church of Scientology that included a boiled mixture of organic whole milk, barley, and corn syrup devoid of fruits and vegetables. Physical examination revealed pale, bloated skin with edematous, violaceous gums and loosening of a few of her teeth. Dermatologic findings included xerosis, multiple scattered ecchymoses of the extremities, and perifollicular hemorrhage. Laboratory and radiographic evaluation confirmed the diagnosis of scurvy. The patient showed dramatic improvement after only 3 days of treatment with oral ascorbic acid and significant dietary modification. In this case report, we revisit the old diagnosis of scurvy with a modern dietary twist secondary to religious practices. This case highlights the importance of taking a detailed dietary history when evaluating diseases involving the skin.

Topics: Administration, Oral; Ascorbic Acid; Child, Preschool; Diet; Edema; Female; Gingival Diseases; Humans; Religion; Scurvy; Tooth Mobility; Vitamins

Salivary thiobarbituric acid reacting substances (TBARS) have been previously shown to correlate with the impairment of gingival tissue. Although the details on the origin and the composition of this heterogeneous group of compounds in saliva are unknown, the potential clinical usefulness makes necessary the studies of factors influencing the salivary TBARS levels.. To observe the effects of daily dynamics, tooth-brushing and ascorbic acid administration on salivary TBARS levels. Subjects and methods. Self-collected samples were obtained from 10 young healthy men collecting samples in the morning, in the afternoon and in the evening during 2 consecutive days. Ascorbic acid (250 mg) was administered orally after the last sampling on day 1 and before every sampling on day 2. Additional sampling was performed before and after tooth-brushing. TBARS levels in saliva specimens were detected spectrofluorometrically. Sialic acid content was measured using a modified method of Warren.. Salivary TBARS levels vary significantly during a day (p < 0.001) with highest concentrations in the morning. Both, tooth-brushing (p < 0.05) and short-term antioxidative treatment with ascorbic acid (p < 0.005) decrease salivary TBARS levels. Sialic acid content of saliva is not influenced significantly by any of the investigated factors.. TBARS levels in saliva are affected by daytime of sampling, tooth-brushing and ascorbic acid pre-treatment. These results must be considered in clinical research using salivary TBARS levels. Sialic acid seems not to be a major component of TBARS in saliva. Further studies should clarify the molecular compounds of salivary TBARS and uncover the role of oral microbial factors.

Topics: Adult; Ascorbic Acid; Biomarkers; Circadian Rhythm; Gingiva; Gingival Diseases; Humans; Male; Oxidative Stress; Saliva; Thiobarbituric Acid Reactive Substances; Time Factors; Toothbrushing

Biochemical indices of AA clearly showed that the young men in this study were brought into various states of AA depletion and repletion according to their dietary AA intakes. While previous studies have postulated that supplemental intakes of AA may adversely affect body status of vitamins B6 and B12, we found no changes in the B vitamin status of the young men receiving varying AA intakes. Moderate AA supplementation (605 mg/day) showed no antagonistic effect on markers of vitamins B6 and B12. Blood markers of fat-soluble vitamins A and E and iron status were not affected by AA intakes. The propensity of the gingiva to become inflamed or bleed on probing was reduced after normal (65 mg/day) AA intakes as compared to deficient (5 mg/day) intakes and upon supplementary (605 mg/day) AA intakes as compared to normal intakes. The results suggest that AA status may influence early stages of gingival inflammation and crevicular bleeding, and warrant further study of the relationship between AA and periodontal health.

Topics: Adult; Ascorbic Acid; Ascorbic Acid Deficiency; Gingival Diseases; Humans; Iron; Male; Nutritional Physiological Phenomena; Periodontal Diseases; Pyridoxine; Vitamin A; Vitamin B 12; Vitamin E

The objective of this article is to familiarize the dentist with clinical signs and laboratory methods used in diagnosing nutritional deficiencies, and to indicate which laboratory methods may be useful to the clinician in cases of suspected nutritional deficiency. It should be noted that the suggested laboratory methods were selected on the basis of their applicability for the clinical situation as well as their reliability as indicators of nutritional status. Therefore these suggested methods of choice may not in every instance be the most accurate of all indicators of nutritional status for a particular nutrient. The dentist who wishes to utilize one of the laboratory methods has a number of options. He can take the appropriate sample in his office, or refer the patient directly to a clinical laboratory for the simpler analyses, or refer his patient to a physician for appropriate metabolic testing. The first option may be more appropriate for the dentist practicing in areas where a clinical laboratory is not within reasonable distance. In this instance the dentist should contact the laboratory for specific information, such as sample volume and special instructions for taking, handling, and shipping the sample. The second option is available to the dentist practicing in an urban area where clinical laboratory facilities are readily available. Finally, the dentist should work in conjunction with a physician when complex metabolic testing is required.

Topics: Anthropometry; Ascorbic Acid; Blood Proteins; Calcium; Deficiency Diseases; Gingival Diseases; Humans; Iron; Lip Diseases; Medical History Taking; Mouth Diseases; Mouth Mucosa; Riboflavin; Thiamine; Tongue Diseases; Vitamin A; Vitamin B 12; Vitamin D; Vitamin E

Topics: Adolescent; Ascorbic Acid; Ascorbic Acid Deficiency; Aspartate Aminotransferases; Child; Child Nutritional Physiological Phenomena; Clinical Enzyme Tests; Gingival Diseases; Glutathione Reductase; Humans; Nutrition Surveys; Oral Hemorrhage; Riboflavin; Riboflavin Deficiency; Seasons; Stomatitis

Topics: Adult; Antigens; Ascorbic Acid; Blood Glucose; Blood Protein Disorders; Body Weight; Carbon Isotopes; Cholesterol; Diet Therapy; Epinephrine; Epithelium; Fatigue; Gingival Diseases; Hemorrhage; Humans; Immunization; Insulin; Joint Diseases; Keratosis; Lipids; Male; Middle Aged; Muscular Diseases; Nutritional Requirements; Pain; Plasma; Scurvy; Time Factors; Typhoid Fever; Water

Topics: Ascorbic Acid; Gingival Diseases; Gingivitis; Histocytochemistry; Humans; Mouth Mucosa; Periodontal Diseases

Topics: Ascorbic Acid; Dental Caries; Geriatrics; Gingival Diseases; Hemostatics; Humans; Periodontal Diseases; Radiography, Dental; Surgery, Oral; Thrombocytopenia; Tooth Extraction; Vitamin K

Topics: Ascorbic Acid; Dental Prophylaxis; Flavonoids; Gingival Diseases; Humans; Periodontal Diseases; Pharmacology; Tooth Mobility; Vitamins

Topics: Aggressive Periodontitis; Anti-Infective Agents; Ascorbic Acid; Drug Therapy; Gingival Diseases; Humans; Periodontal Diseases

Topics: Aggressive Periodontitis; Ascorbic Acid; Gingival Diseases; Glucuronidase; Humans; Periodontal Diseases

Topics: Alveolar Bone Loss; Ascorbic Acid; Gingival Diseases; Humans; Periodontal Diseases; Periodontal Ligament; Periodontium

Topics: Ascorbic Acid; Disease; Gingiva; Gingival Diseases; Humans; Scurvy; Vitamins

Topics: Aggressive Periodontitis; Ascorbic Acid; Ascorbic Acid Deficiency; Gingival Diseases; Guinea Pigs; Humans; Periodontal Diseases; Periodontium; Vitamins

Topics: Ascorbic Acid; Ascorbic Acid Deficiency; Disease; Gingiva; Gingival Diseases; Gingivitis; Humans

Topics: Ascorbic Acid; Ascorbic Acid Deficiency; Disease; Gingiva; Gingival Diseases; Gingivitis; Humans