ascorbic-acid and Periodontitis

Periodontitis is a common disorder affecting the bone and soft tissues of the periodontal complex. When untreated, it may lead to severe mobility or even loss of teeth. The pathogenesis of periodontitis is complex, with crucial factors being chronic inflammation in gingival and periodontal tissues and oral microbiome alterations. However, recent studies highlight the alleged role of vitamins, such as vitamin C (VitC) and vitamin D (VitD), in the development of the disease. VitC regulates numerous biochemical reactions, but foremost, it is involved in synthesizing collagen. It was reported that VitC deficiency could lead to damage to the periodontal ligaments. VitC supplementation improves postoperative outcomes in patients with periodontitis. VitD is a steroid derivative that can be produced in the skin under ultraviolet radiation and later transformed into an active form in other tissues, such as the kidneys. VitD was established to decrease the expression of proinflammatory cytokines in gingiva and regulate the proper mineral density of teeth. Moreover, the supplementation of VitD was associated with better results in the nonsurgical treatment of periodontitis. In this review, we summarize recent knowledge on the role of vitamins C and D in the pathogenesis and treatment of periodontitis.

Topics: Ascorbic Acid; Humans; Periodontitis; Ultraviolet Rays; Vitamin D; Vitamins

The antioxidant potential of vitamin C is useful in reducing oxidative stress, free radicals, and reactive oxygen species, which may assist in the improved outcomes of periodontal therapy. This systematic review was aimed to evaluate the effectiveness of vitamin C supplementation as an adjunct to non-surgical periodontal therapy, in the management of periodontitis.. PubMed, EMBASE, Cochrane Library, and Web of Science.. Randomized controlled trials published between January 1990 and March 2020.. People 18 years and older with periodontitis.. The Critical Appraisal Skills Programme (CASP) quality appraisal tool.. The initial search yielded 441 articles out of which six studies fulfilled the inclusion criteria. Vitamin C supplementation helped improve bleeding indices in gingivitis but did not significantly lead to reduction of probing depths or clinical attachment gain for periodontitis.. Administration of vitamin C as an adjunct to non-surgical periodontal therapy did not result in clinically significant improvements in pocket probing depths at 3 months in periodontitis patients. With the limited evidence available, no recommendation can be made for supplementation of vitamin C in conjunction with initial periodontal therapy for subjects with periodontitis to improve primary treatment outcome measures.

Topics: Ascorbic Acid; Dietary Supplements; Humans; Periodontitis; Vitamins

Periodontitis results from the loss of a delicate balance between microbial virulence factors and a proportionate host response. Nutritional factors have been implicated in several chronic inflammatory diseases that are associated with periodontitis. This manuscript reviews the evidence for nutritional exposures in the etiology and therapeutic management of periodontitis, and makes recommendations for daily nutritional intake for vitamin C (ascorbic acid), vitamin D, calcium, and antioxidants.. Periodontitis is associated with low serum/plasma micronutrient levels, which may result from dietary and/or life-style factors as well as nutrigenetic characteristics. Early evidence suggests beneficial outcomes from nutritional interventions; supporting the contention that daily intake of certain nutrients should be at the higher end of recommended daily allowances. For prevention and treatment of periodontitis daily nutrition should include sufficient antioxidants, vitamin D, and calcium. Inadequate antioxidant levels may be managed by higher intake of vegetables, berries, and fruits (e.g. kiwi fruit), or by phytonutrient supplementation. Current evidence is insufficient to support recommendations of mono-antioxidant vitamin supplements and randomised controlled double-blind intervention studies are needed to provide evidence to underpin future recommendations. Inadequate supply of vitamin D and calcium may be addressed by implementing changes in diet/life style or by supplements.

Topics: Antioxidants; Ascorbic Acid; Calcium, Dietary; Diet; Dietary Supplements; Fatty Acids, Unsaturated; Humans; Micronutrients; Nutrigenomics; Periodontitis; Vitamin D; Vitamins

Although gingival bleeding is a manifestation of both scurvy and inflammatory periodontal disease, the two conditions are distinctly separate entities. The defective collagen synthesis associated with scurvy also manifests many of the same symptoms as deficient vitamin C physiology, but neither condition is associated with periodontal disease. Unlike scurvy, the various periodontal diseases are caused by oral plaque microorganisms. The body's reaction to these microorganisms is strongly influenced by the compromised functioning of leucocytes and monocytes. Although certain infections and systemic diseases cause gingival bleeding, avitaminosis-C does not cause commonly encountered periodontitis. Vitamin C should not be used for the prophylaxis or cure of periodontal disease in otherwise healthy, well-nourished individuals. A patient with bleeding gingivae warrants referral to a periodontist, oral medicine specialist, or appropriately qualified dentist for examination and treatment.

Topics: Ascorbic Acid; Ascorbic Acid Deficiency; Collagen; Dental Plaque; Diagnosis, Differential; Gingival Hemorrhage; Humans; Leukocytes; Monocytes; Mouth Diseases; Periodontal Diseases; Periodontitis; Scurvy

Scurvy and periodontitis both manifest gingival bleeding but constitute separate entities. Defective collagen in scurvy reflects many symptoms emanating from deficient vitamin C physiology. The various periodontal diseases are caused by oral plaque micro-organisms, the body's reaction to which is strongly influenced by inadequate functioning of leucocytes and monocytes. Although certain infections and systemic diseases cause gingival bleeding, avitaminosis C does not cause commonly encountered periodontal disease, but will aggravate established periodontitis. Vitamin C should not be used for prophylaxis or cure of periodontitis in healthy well-nourished individuals. A patient with bleeding gingivae warrants referral to oral medicine and periodontics specialists for examination and treatment.

Topics: Adult; Ascorbic Acid; Ascorbic Acid Deficiency; Chronic Disease; Humans; Male; Periodontal Diseases; Periodontitis; Scurvy

Topics: Animals; Ascorbic Acid; Ascorbic Acid Deficiency; Humans; Nutrition Disorders; Periodontitis; Proteins; Vitamins

Deficient ascorbic acid levels (AALs) and Type 2 diabetes mellitus (T2DM) are associated with periodontal disease. This study evaluated the relationship between plasma AAL and periodontitis in systemically healthy and T2DM subjects, which to the best of our knowledge is being reported for the first time.. One hundred twenty subjects were categorized into four groups of 30 each as group 1: without periodontal disease; group 2: chronic gingivitis; group 3: chronic periodontitis, and group 4: chronic periodontitis and freshly diagnosed T2DM. Plaque index (PlI), sulcus bleeding index (SBI), and probing pocket depths (PPDs) were evaluated. Venous blood was evaluated for plasma AAL spectrophotometrically. Randomized subjects were subgrouped within groups 2-4, to receive either scaling and root planing (SRP) with dietary supplementation (450 mg) of ascorbic acid (AA) for two weeks or only SRP. After two weeks, the clinical parameters were reassessed. Tukey's multiple post hoc procedures and paired t test were used with the level of statistical significance adjusted to p ≤ .05.. AAL plasma levels were significantly greater in group 1 than in group 2 (p = .0007) and in group 4 (p = .0003). A significant reduction in the SBI was seen in the subgroups that received dietary supplementation of vitamin C within group 2 (p = .0012) and group 4 (p = .036).. Plasma AAL is below the normal range in systemically healthy subjects with gingivitis and diabetics with periodontitis. Dietary AA supplementation with SRP improves the SBI in subjects with gingivitis and diabetics with periodontitis.

Topics: Adult; Ascorbic Acid; Ascorbic Acid Deficiency; Dental Plaque Index; Dental Scaling; Diabetes Mellitus, Type 2; Dietary Supplements; Double-Blind Method; Gingival Pocket; Gingivitis; Humans; India; Middle Aged; Periodontal Index; Periodontitis; Root Planing

The use of chlorhexidine (CHX) has been recommended for a number of clinical applications including plaque control in the post-operative period. However, the use of CHX is burdened by some side effects that could affect the compliance of the patient. The aim of this clinical trial was to evaluate the side effects, the staining in particular, the patient acceptance, and the efficacy of a 0.2% CHX mouthwash containing an anti discoloration system (ADS) compared with a 0.2% CHX alone, after periodontal flap surgery.. This single-centre, cross-over, triple-blind randomized clinical trial was carried out on 48 consecutive patients. After periodontal flap surgery, the patients were prescribed to rinse two times per day for 1 min for 1 week with 10 ml of test or control CHX, contained in anonymous bottles coded K or M and assigned randomly. No brushing and interdental cleaning of the surgical area was allowed. At week 1, after suture removal, patients received full-mouth prophylaxis and were given a second anonymous bottle, reversing the products, with the same instructions as at baseline. Patients resumed tooth-brushing but not interdental cleaning. At the end of week 2, prophylaxis was repeated, mouth rinsing was discontinued and patients resumed normal oral hygiene. At weeks 1 and 2, the following variables were recorded: presence of pigmentation, gingival parameters at the surgically treated sites (gingival inflammation, tissue inflammation around the sutures, gingival swelling and presence of granulation tissue), patient perception and acceptance of the 2 mouthwashes.. Forty-seven patients completed the study. The difference between treatments related to gingival variables was not statistically significant. The test CHX caused consistently less pigmentations than the control CHX in all the evaluated areas of the dental surfaces (odds ratio (OR)=0.083 p<0.0001 in the incisal area, OR=0.036 p<0.0001 in the approximal area and OR=0.065 p<0.0001 in the gingival area). The CHX ADS was found to be more tolerated by patients than the control mouthwash and to cause less food alteration, less alterations to the perception of salt and to be less irritant for the oral tissues.. (1) CHX ADS caused less pigmentation, was burdened by less side effects and was more agreeable than the control CHX; (2) CHX ADS was as effective as CHX without ADS in reducing gingival signs of inflammation in the post-surgical early healing phase; (3) the use of CHX ADS could be of value in treatment protocols in which the patient compliance with a CHX mouthwash prescription is relevant.

Topics: Adult; Aged; Anti-Infective Agents, Local; Ascorbic Acid; Chlorhexidine; Cross-Over Studies; Dental Plaque; Double-Blind Method; Female; Gingiva; Humans; Linear Models; Male; Middle Aged; Mouthwashes; Patient Compliance; Periodontitis; Sulfites; Surgical Flaps; Taste; Tooth Discoloration; Treatment Outcome; Wound Healing

Previous studies demonstrate a relationship between a lack of vitamin C and increased risk of periodontal disease. In the present study we examine the vitamin C plasma levels and inflammatory measures in periodontitis patients before and after the consumption of grapefruit.. Fifty-eight patients with chronic periodontitis were assigned to the test group (non-smokers n=21, smokers n=17) and a diseased control group (non-smokers n=11, smokers n=9). Furthermore, 22 healthy subjects were recruited to compare vitamin C plasma levels between periodontally diseased and healthy subjects. Clinical evaluations, including plaque index (PI), sulcus bleeding index (SBI), probing pocket depths (PPD) and plasma vitamin C levels, were performed at baseline, and after two weeks of grapefruit consumption.. At baseline, we observed significantly reduced plasma vitamin C levels in the test group and diseased controls in comparison with the healthy controls. On principle, smokers showed lower levels of vitamin C (mean 0.39 +/- 0.17 mg dl(-1)) than non-smokers (mean 0.56+/-0.29 mg dl(-1)). After grapefruit consumption, the mean plasma vitamin C levels rose significantly in the test group compared to the diseased controls (non-smokers: 0.87+/-0.39 mg dl(-1), smokers: 0.74+/-0.30 mg dl(-1)). Furthermore the SBI was reduced in the test group (non-smokers: from 1.68+/-0.6 to 1.05+/-0.6, p<0.001), whereas PI and PPD were unaffected.. The present results show that periodontitis patients are characterised by plasma vitamin C levels below the normal range, especially in smokers. The intake of grapefruit leads to an increase in plasma vitamin C levels and improves sulcus bleeding scores. Longer term studies are necessary to determine whether other periodontal outcomes improve with such supplementation especially in smokers.

Topics: Adult; Aged; Ascorbic Acid; Citrus paradisi; Epidemiologic Methods; Female; Humans; Male; Middle Aged; Periodontitis; Smoking

In an attempt to determine the optimal daily ascorbic acid requirement, the effect of different levels of ascorbic acid intake on collagen synthesis was studied in a double-blind experimental design. By use of electron microscopy, interproximal gingival tissue sections in subjects consuming between 20 to 35 mg of ascorbic acid daily were examined before and after the administration of tablets containing 70 mg of ascorbic acid. The results showed that practically all subjects were affected by progressive periodontitis with marked changes in the connective tissue of the gingival lamina propria. After six weeks of supplementation with ascorbic acid, differences in the shape and activity of fibroblasts in the regenerative tissue of lamina propria were observed. This has resulted in the increased number of collagen bundles in fibroblasts' periphery, increased tonofibril content and an enlarged number of desmosomes between adjacent cells. It is concluded that the obtained results, though suggesting that the optimal daily ascorbic acid intake should be set above the presently recommended 30-50 mg, have to be quantified by a more objective analytical method.

Topics: Adult; Ascorbic Acid; Clinical Trials as Topic; Double-Blind Method; Epithelium; Female; Gingiva; Humans; Male; Microscopy, Electron; Periodontitis

Topics: Administration, Oral; Administration, Topical; Ascorbic Acid; Clinical Trials as Topic; Humans; Periodontitis

This Mendelian randomization (MR) study was performed to explore the causal relationship among circulating vitamin C and D levels, dental caries, and periodontitis.. MR analyses were conducted with the inverse variance weighted (IVW) method, weighted median, MR-Egger approaches, and MR-robust adjusted profile score method to assess the causal relationships between circulating vitamin C and D concentrations and dental caries, the number of remaining natural permanent teeth in the mouth (N teeth), and periodontitis.. We found potential causal association of circulating vitamin D concentrations with N teeth (β = 0.085; 95% confidence interval: 0.019 to 0.150; p = .012) based on the IVW method. No significant causal relationship between circulating vitamin D levels and dental caries and periodontitis was observed. Similarly, no evidence supported a causal relationship between circulating vitamin C concentrations and the risk of dental caries, N teeth, and periodontitis.. There is no obvious evidence suggesting a causal relationship among circulating vitamin D, dental caries, and periodontitis, drawing into question the mechanism for any association with N teeth. Additionally, there is insufficient power to detect small effects in vitamin C levels and caries and periodontitis.

Topics: Ascorbic Acid; Dental Caries; Genome-Wide Association Study; Humans; Mendelian Randomization Analysis; Periodontitis; Polymorphism, Single Nucleotide; Vitamin D

Vitamins and omega-3 fatty acids (Ω3FA) modulate periodontitis-associated inflammatory processes. The aim of the current investigation was to evaluate associations of oral nutrient intake and corresponding serum metabolites with clinical severity of human periodontitis. Within the Food Chain Plus cohort, 373 periodontitis patients—245 without (POL) and 128 with tooth loss (PWL)—were matched to 373 controls based on sex, smoking habit, age and body mass index in a nested case-control design. The amount of oral intake of vitamins and Ω3FAs was assessed from nutritional data using a Food Frequency Questionnaire. Oral intake and circulatory bioavailability of vitamins and Ω3FA serum metabolomics were compared, using ultra-high-resolution mass spectrometry. Periodontitis patients exhibited a significantly higher oral intake of vitamin C and Ω3FA Docosapentaenoic acid (p < 0.05) compared to controls. Nutritional intake of vitamin C was higher in PWL, while the intake of Docosapentaenoic acid was increased in POL (p < 0.05) compared to controls. In accordance, serum levels of Docosapentaenoic acid were also increased in POL (p < 0.01) compared to controls. Vitamin C and the Ω3FA Docosapentaenoic acid might play a role in the pathophysiology of human periodontitis. Further studies on individualized nutritional intake and periodontitis progression and therapy are necessary.

Topics: Ascorbic Acid; Case-Control Studies; Fatty Acids, Omega-3; Humans; Periodontitis; Vitamins

The association between micronutrient intake and the risk of periodontitis has received much attention in recent years. However, most studies focused on the linear relationship between them. This study aimed to explore the dose-response association between micronutrient intake and periodontitis. A total of 8959 participants who underwent a periodontal examination, and reported their micronutrient intake levels were derived from the US National Health and Nutrition Examination Survey (NHANES, 2009-2014) database. Logistic regression was performed to evaluate associations between micronutrient intake and periodontitis after propensity score matching (PSM), and restricted cubic splines (RCS) analysis was conducted to explore the dose-response associations. Following PSM, 5530 participants were included in the RCS analysis. The risk of periodontitis was reduced with sufficient intake of the following micronutrients: vitamin A, vitamin B1, vitamin B2, and vitamin E. In addition, the risk of periodontitis was increased with excessive intake of the following micronutrients: vitamin B1 (1.8 mg/day, males; 1.3 mg/day, females), vitamin C (90 mg/day, males), and copper (1.1 mg/day, combined). In conclusion, a linear association was found between vitamin A, vitamin B2, vitamin C, and copper and periodontitis-namely, a sufficient intake of vitamin A and vitamin B2 might help reduce the prevalence of periodontitis; by contrast, a high intake of vitamin C and copper increased the risk. In addition, a nonlinear dose-response association was found for the incidence of periodontitis with vitamin B1 and vitamin E. When within reasonable limits, supplemental intake helped reduce the prevalence of periodontitis, while excessive intake did not help significantly and might even increase the risk. However, confounding factors, such as health awareness, should still be considered.

Topics: Ascorbic Acid; Copper; Eating; Female; Humans; Male; Micronutrients; Nutrition Surveys; Periodontitis; Riboflavin; Thiamine; Vitamin A; Vitamin E; Vitamins

The purpose of this study was to investigate whether periodontitis is associated with dietary vitamin C intake, using data from The National Health and Nutrition Examination Survey (NHANES) 2009-2014.. The study included 5145 adults (age ≥ 30 years) with periodontitis as a dichotomous variable and daily intake of vitamin C as a continuous variable. Multiple sets of covariates, such as age, sex, number of flossing, etc., were selected. Using EmpowerStats version 3.0, multivariate logistic regression analysis and hierarchical analysis were performed on the data, and curve fitting graphs were made.. There were no statistically significant differences (P > 0.05) between the four dietary vitamin C intake groups (quartiles, Q1-Q4) and covariates (drinking alcohol and hypertension). The low VC intake group (Q1) was more prone to periodontitis than Q2, Q3, and Q4 (all OR < 1.00). A threshold nonlinear association was found between vitamin C (mg) log10 transformation and periodontitis in a generalized additive model (GAM) (P = 0.01).. The relationship between dietary vitamin C intake and the likelihood of periodontitis was non-linear. The smallest periodontitis index occurred when dietary vitamin C intake was 158.49 mg. Too little or too much vitamin C intake increases periodontitis.

Topics: Adult; Ascorbic Acid; Diet; Humans; Nutrition Surveys; Nutritional Status; Periodontitis

Periodontitis is usually sustained from microorganism of oral cavity, like

Topics: Ascorbic Acid; Cell Differentiation; Cell Survival; Cells, Cultured; Epigenesis, Genetic; Humans; Lipopolysaccharides; Periodontal Ligament; Periodontitis; Porphyromonas gingivalis; Stem Cells

Topics: Alveolar Bone Loss; Animals; Antioxidants; Ascorbic Acid; Disease Models, Animal; Male; Periodontitis; Rats; Rats, Sprague-Dawley; Vitamins

This study evaluated the effects of local vitamin C treatment on tissue advanced glycation end products (AGE), interleukin (IL)-6, 8-hydroxy-2-deoxyguanosine (8-OHdG), and matrix metalloproteinases (MMP)-8 in tissues; serum C-terminal telopeptide fragments (CTX); and alveolar bone loss (ABL) in rats.. 35 male Sprague Dawley rats were divided equally into five groups: 1) control (C), 2) experimental periodontitis (P), 3) experimental diabetes (D), 4) experimental diabetes and experimental periodontitis (D + P), and 5) experimental diabetes-experimental periodontitis-locally applied vitamin C (D + P + LvitC). Diabetes was induced in rats with alloxan monohydrate, after which periodontitis was induced by ligature placement in the right mandibular first molar teeth for 11 days. In the treatment group, vitamin C was administered locally three times with two-days interval after ligature removal. The animals were sacrificed, and the samples were analyzed histometrically and immunohistochemically.. CTX, 8-OHdG, and AGE values significantly decreased in the treatment group compared to the D + P group. IL-6 and MMP-8 values decreased in the treatment group compared to the D + P group, but this is not significant. ABL was significantly reduced by the local delivery of vitamin C.. This study reveals that vitamin C treatment may be beneficial to reduce serum CTX and gingival MMP-8 levels, oxidative stress, inflammation, and AGE accumulation in periodontal tissue. Vitamin C may be an immunomodulator and antioxidant locally applied in the treatment of periodontitis to reduce the adverse effects of diabetes in periodontal tissues.

Topics: 8-Hydroxy-2'-Deoxyguanosine; Alveolar Bone Loss; Animals; Ascorbic Acid; Collagen Type I; Diabetes Mellitus, Experimental; Glycation End Products, Advanced; Interleukin-6; Male; Matrix Metalloproteinase 8; Oxidative Stress; Peptides; Periodontitis; Rats; Rats, Sprague-Dawley

Vitamin C and antioxidants play a crucial role in endothelial function and may be a link for the known interaction of periodontitis and ischemic heart disease (CAD). This pilot study evaluates the association of gingival health, periodontitis, CAD, or both conditions with salivary and serum vitamin C and antioxidant levels. The clinical and periodontal characteristics, serum, and saliva samples were collected from 36 patients with periodontitis, 35 patients with CAD, 36 patients with periodontitis plus CAD, and 36 healthy controls. Levels of vitamin C, antioxidants, and C-reactive protein (hs-CRP) were assessed with a commercially available kit. The median concentrations of salivary and serum vitamin C and antioxidants (α-tocopherol, β-carotene, lutein, and lycopene) were significantly lower in the CAD group (

Topics: Adult; Antioxidants; Ascorbic Acid; Case-Control Studies; Humans; Middle Aged; Myocardial Ischemia; Periodontitis; Saliva

The association of dietary vitamin C (vit C) on periodontitis requires more valid evidence from large representative samples to enable sufficient adjustments. This study aimed to evaluate the association between dietary vit C intake and periodontitis after controlling for various confounders in the representative Korean adult population.. A total of 10,930 Korean adults (≥19 years) from the fourth Korean National Health and Nutrition Examination Survey data set were included in this cross-sectional study. Periodontitis was defined as community periodontal index score of 3 or 4. Dietary vit C intake was estimated from a 24-hour dietary record, and categorized into adequate and inadequate according to the Korean Estimated Average Requirement value. Potential confounders included age, sex, income, frequency of tooth brushing, use of floss, dental visit, drinking, smoking, diabetes, hypercholesterolemia, hypertension, and obesity. A multivariable logistic regression analysis and stratified analysis were applied.. Those with inadequate dietary vit C intake were more likely by 1.16 times to have periodontitis than those with adequate dietary vit C intake (adjusted odds ratio [aOR] = 1.16, 95% confidence interval = 1.04-1.29). Lowest and middle-low quartile of dietary vit C intake, compared to highest quartile of dietary vit C intake, showed significant association (aOR = 1.28 and 1.22 respectively), which was in a biological-gradient relationship (trend-p <0.05).. Our data showed that inadequate dietary vit C intake was independently associated with periodontitis among Korean adults. Hence, adequate intake of dietary vitamin C could be substantially important on the promotion of periodontal health among Korean adults.

Topics: Adult; Aged; Alcohol Drinking; Ascorbic Acid; Cross-Sectional Studies; Diabetes Mellitus; Female; Humans; Income; Male; Middle Aged; Nutrition Surveys; Obesity; Odds Ratio; Periodontal Index; Periodontitis; Republic of Korea; Smoking; Toothbrushing; Vitamins; Young Adult

To evaluate for the first time in vivo the effects of methylene blue (MB) photosensitizer dissolved in ethanol in antimicrobial photodynamic therapy (aPDT) as adjuvant periodontal treatment, at plasmatic oxidative stress and vascular behavior in rat model.. Wistar rats were divided into negative control (NC, no periodontitis) and positive control (PC, with periodontitis, without any treatment). The other groups had periodontitis and were treated with scaling and root planing (SRP); SRP+aPDT+MB dissolved in water (aPDT I); SRP+aPDT+MB dissolved in ethanol (aPDT II). The periodontitis was induced by ligature at the mandibular right first molar. At 7/15/30days, rats were euthanized, the plasma was used to determine oxidative stress parameters and gingival tissue for histomorphometric analysis.. PC showed higher thiobarbituric acid reactive substances levels in 7/15/30days. aPDT II was able to block the lipid peroxidation, especially between 15th and 30th days. Glutathione reduced levels were consumed in PC, aPDT I and II groups throughout the experiment. aPDT II increased the vitamin C levels which were restored in this group in the 30th day. aPDT II group showed the highest number of blood vessels.. In summary, the aPDT with MB dissolved in ethanol provides better therapeutic responses in periodontitis treatment.

Topics: Animals; Anti-Infective Agents; Ascorbic Acid; Blood Vessels; Dental Scaling; Gingiva; Glutathione; Light; Male; Methylene Blue; Oxidative Stress; Periodontitis; Photochemotherapy; Photosensitizing Agents; Rats; Rats, Wistar; Root Planing

To assess in a population deprived from regular dental care the relationship between alveolar bone loss (ABL) and environmental/systemic conditions.. The study population consisted of subjects from the Purbasari tea estate on West Java, Indonesia. A full set of dental radiographs was obtained of each subject and amount of ABL was assessed. In addition, the following parameters were evaluated: plasma vitamin C, vitamin D3 , HbA1c and CRP, the haptoglobin phenotype, presence of putative periodontopathic bacteria and viruses, dietary habits, smoking and anthropometrics.. In this population 45% showed vitamin C depletion/deficiency, 82% had vitamin D3 insufficiency/deficiency, 70% were in a pre-diabetic state, 6% had untreated diabetes, 21% had elevated CRP values ranging from 3.1 to 16.1 mg/l. Results of the regression analysis, including all above mentioned parameters, showed four significant predictors, explaining 19.8% of the variance of ABL. Number of Porphyromonas gingivalis cells and CRP values showed a positive relationship with ABL, whereas BMI and number of guava fruit servings were negatively related.. Results confirm previous findings that elevated levels of P. gingivalis may be indicative for periodontitis progression. A new finding is that guava fruit consumption may play a protective role in periodontitis in a malnourished population.

Topics: Adult; Alveolar Bone Loss; Ascorbic Acid; Ascorbic Acid Deficiency; Body Mass Index; C-Reactive Protein; Cholecalciferol; Diabetes Mellitus; Environment; Feeding Behavior; Female; Glycated Hemoglobin; Haptoglobins; Herpesvirus 4, Human; Humans; Indonesia; Male; Middle Aged; Periodontitis; Phenotype; Pilot Projects; Porphyromonas gingivalis; Prediabetic State; Psidium; Smoking; Vitamin D Deficiency; Vitamins

Periodontitis is a chronic inflammatory disease and a significant risk factor for tooth loss. Although a link between diet and periodontal health exists, the relation between diet and healing after periodontal therapy has yet to be investigated.. The objective was to determine whether higher intakes of fruits and vegetables or nutrients with antioxidant or anti-inflammatory activity are associated with greater healing, measured as reduced probing depth (PD), after scaling and root planing (SRP), a cost-effective treatment to manage periodontal disease and prevent tooth loss.. Patients (63 nonsmokers, 23 smokers) with chronic generalized periodontitis who were undergoing SRP participated. Healing was evaluated based on PD, assessed at baseline and 8-16 wk after SRP. Intakes of fruits, vegetables, β-carotene, vitamin C, α-tocopherol, α-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) were estimated using the Block 2005 food frequency questionnaire and a supplement questionnaire. Serum 25-hydroxyvitamin D concentrations were also measured. PD (% sites >3 mm) was modeled in multiple linear regression and analysis of covariance by tertile of intake and adjusted for age, sex, body mass index (BMI), baseline PD, examiner, gingival bleeding, and study duration.. In nonsmokers, PD was associated with fruit and vegetable, β-carotene, vitamin C, α-tocopherol, EPA, and DHA intakes (P < 0.05). PD was not significantly associated with ALA intake or serum 25-hydroxyvitamin D concentration. Significant associations that included supplements (β-carotene, vitamin C, α-tocopherol) were attenuated or lost, depending on the statistical model used. There were no significant associations within the group of smokers.. Dietary intakes of fruits and vegetables, β-carotene, vitamin C, α-tocopherol, EPA, and DHA are associated with reduced PD after SRP in nonsmokers, but not smokers, with chronic generalized periodontitis. These findings may lead to the development of dietary strategies to optimize healing after periodontal procedures. This trial was registered at clinicaltrials.gov as NCT02291835.

Topics: Adult; Aged; Aged, 80 and over; alpha-Linolenic Acid; alpha-Tocopherol; Antioxidants; Ascorbic Acid; beta Carotene; Body Mass Index; Chronic Disease; Cross-Sectional Studies; Dietary Supplements; Docosahexaenoic Acids; Eicosapentaenoic Acid; Energy Intake; Female; Fruit; Humans; Inflammation; Linear Models; Male; Middle Aged; Nutrition Assessment; Periodontitis; Risk Factors; Smoking; Surveys and Questionnaires; Vegetables; Vitamin D

Alpha lipoic acid (ALA) and vitamin C (Vit-C) are very important and powerful antioxidants that have been used for the treatment of many diseases. The present study aims to investigate the role of ALA and Vit-C substances in the treatment of alveolar bone resorption in periodontal diseases.. Thirty-six male Wistar albino rats were randomly divided into four groups as follows: 1) control rats; 2) rats with experimental periodontitis (PED); 3) rats with PED treated with ALA (ALA); and 4) rats with PED treated with ALA+Vit-C (ALA+Vit-C). PED was simulated by placing ligatures around the neck of teeth for 5 weeks. After ligature removal, the PED group was given a single intragastric dose of 1 mL saline, and the ALA and ALA+Vit-C groups were treated with an intragastric dose of 50 mg/kg ALA and ALA+Vit-C for 15 days, respectively. Levels of serum bone alkaline phosphatase (B-ALP) and myeloperoxidase (MPO) activity in gingival tissues were analyzed. To evaluate the osteoclast activation, expression of activated receptor activator nuclear factor-kappa B ligand (RANKL) and bone density index (BDI) were determined stereologically in the bone sections obtained from the mandibles of the rats.. The results showed statistically significant differences between the PED group and groups treated with antioxidant according to B-ALP, MPO, RANKL, and BDI values (P <0.05). ALA and ALA+Vit-C treatments showed beneficial effects on the mesial/distal periodontal bone support at the ligature-induced periodontitis tooth areas.. This study shows that ALA and Vit-C treatment provides therapeutic effects on inhibition of alveolar bone resorption and periodontal tissue destruction.

Topics: Alkaline Phosphatase; Alveolar Bone Loss; Animals; Antioxidants; Ascorbic Acid; Bone Density; Drug Therapy, Combination; Male; Osteoclasts; Periodontitis; Peroxidase; Radiography; RANK Ligand; Rats; Rats, Wistar; Thioctic Acid

Periodontitis, a ubiquitous chronic inflammatory disease, is associated with reduced antioxidant defences and neutrophil hyperactivity in terms of reactive oxygen species (ROS) generation. Its phenotype is thus characterized by oxidative stress. We have determined the effect of antioxidant micronutrients ascorbate and α-tocopherol on neutrophil ROS generation. Peripheral neutrophils from periodontally-healthy individuals (n = 20) were challenged with phorbol myristate acetate, IgG-opsonised Staphylococcus aureus, Fusobacterium nucleatum or PBS in the presence and absence of micronutrients (50 µM). Total and extracellular ROS were measured by luminol and isoluminol chemiluminescence respectively. Total and extracellular unstimulated, baseline ROS generation was unaffected by α-tocopherol, but inhibited by ascorbate and a combination of both micronutrients. Fcγ-receptor (Fcγ-R)-stimulated total or extracellular ROS generation was not affected by the presence of individual micronutrients. However, the combination significantly reduced extracellular FcγR-stimulated ROS release. Neither micronutrient inhibited TLR-stimulated total ROS, but the combination caused inhibition. Ascorbate and the micronutrient combination, but not α-tocopherol, inhibited extracellular ROS release by TLR-stimulated cells. Such micronutrient effects in vivo could be beneficial in reducing collateral tissue damage in chronic inflammatory diseases, such as periodontitis, while retaining immune-mediated neutrophil function.

Topics: Adult; alpha-Tocopherol; Ascorbic Acid; Cells, Cultured; Female; Fusobacterium nucleatum; Humans; Male; Micronutrients; Middle Aged; Neutrophils; Periodontitis; Reactive Oxygen Species; Receptors, IgG; Staphylococcus aureus; Tetradecanoylphorbol Acetate; Toll-Like Receptors; Young Adult

To test the hypothesis that vitamin C concentrations in plasma, polymorphonuclear neutrophilic leucocytes (PMNs) and peripheral blood mononuclear cells (PBMCs) are lower in periodontitis patients compared with healthy controls.. Twenty-one untreated periodontal patients and 21 healthy controls matched for age, gender, race and smoking habits were selected. Dietary vitamin C intake was assessed by a self-administered dietary record. Fasting blood samples were obtained and analysed for vitamin C concentrations in plasma, PMNs and PBMCs by means of high-pressure liquid chromatography (HPLC).. Plasma vitamin C was lower in periodontitis patients compared with controls (8.3 and 11.3 mg/l, respectively, p = 0.03). Only in the control group a positive correlation was present between vitamin C intake and plasma values. No differences could be assessed between patients and controls regarding vitamin C dietary intake and levels in PMNs and PBMCs. In the patient group, pocket depth appeared to be negatively associated with the vitamin C concentration in PMNs.. Although the relationship between low plasma vitamin C levels and periodontitis is clear, the disease cannot be explained by insufficient vitamin C storage capacity of leucocytes; the question remains through which mechanism low plasma vitamin C levels are related to periodontitis.

Topics: Adult; Ascorbic Acid; Case-Control Studies; Cell Count; Diet Records; Female; Humans; Leukocytes, Mononuclear; Male; Matched-Pair Analysis; Middle Aged; Neutrophils; Periodontal Index; Periodontal Pocket; Periodontitis; Reference Values

Increased levels of oxidative stress due to excessive production of reactive oxygen species are involved in the pathogenesis of periodontitis. Studies suggest a negative association between plasma vitamin C level and the severity of periodontitis. We hypothesized that increases in plasma vitamin C levels after vitamin C intake might clinically reduce gingival oxidative stress in a rat periodontitis model. A ligature was placed around rat mandibular molars for 4 weeks to induce periodontitis, and the rats were then given drinking water with or without 1 g/L vitamin C for 2 weeks after the ligature was removed. The periodontitis-induced rats showed a 149% increase in 8-hydroxydeoxyguanosine level and a 40% decrease in reduced:oxidized glutathione ratio in gingival tissue. Vitamin C intake induced a 175% increase in plasma vitamin C level, resulting in an improvement in the gingival 8-hydroxydeoxyguanosine level (decreased) and in the reduced:oxidized glutathione ratio (increased). Furthermore, in ligature-induced periodontitis lesions, gene expression encoding inflammation, including interleukin-1 alpha and interleukin-1 beta, was more than twofold down-regulated by vitamin C intake. The results suggest that systemic administration of vitamin C could be clinically beneficial in improving periodontitis-induced oxidative stress by down-regulating inflammatory gene expression.

Topics: 8-Hydroxy-2'-Deoxyguanosine; Animals; Ascorbic Acid; Deoxyguanosine; DNA, Mitochondrial; Gene Expression Regulation; Glutathione; Interleukin-1alpha; Interleukin-1beta; Male; Osteoclasts; Oxidative Stress; Periodontitis; Rats; Rats, Wistar; RNA

Periodontitis has been causally linked to cardiovascular disease, which is mediated through the oxidative stress induced by periodontitis. Since vitamin C has been suggested to limit oxidative damage, we hypothesized that vitamin C intake may reduce endothelial oxidative stress induced by periodontitis in the aorta. The aim of this study was to investigate the effects of vitamin C intake on the initiation of atherosclerosis in a ligature-induced rat periodontitis model.. Eighteen 8-week-old-male Wistar rats were divided into three groups of six rats and all rats received daily fresh water and powdered food through out the 6-week study. In the vitamin C and periodontitis groups, periodontitis was ligature-induced for the first 4 weeks. In the vitamin C group, rats were given distilled water containing 1 g/L vitamin C for the 2 weeks after removing the ligature.. In the periodontitis group, there was lipid deposition in the descending aorta and significant increases of serum level of hexanoyl-lysine (HEL), and aortic levels of nitrotyrosine expression, HEL expression and 8-hydroxydeoxyguanosine (8-OHdG) compared to the control group. Vitamin C intake significantly increased plasma vitamin C level and GSH:GSSG ratio (178% and 123%, respectively), and decreased level of serum HEL and aortic levels of nitrotyrosine, HEL and 8-OHdG (23%, 87%, 84%, and 38%, respectively).. These results suggest that vitamin C intake attenuates the degree of experimental atherosclerosis induced by periodontitis in the rat by decreasing oxidative stress.

Topics: 8-Hydroxy-2'-Deoxyguanosine; Animals; Antioxidants; Aorta, Thoracic; Aortic Diseases; Ascorbic Acid; Atherosclerosis; Deoxyguanosine; Endothelium, Vascular; Glutathione; Lysine; Male; Oxidative Stress; Periodontitis; Random Allocation; Rats; Rats, Wistar; Tyrosine; Vitamins

The purpose of this study was to evaluate and compare salivary concentrations of reduced, oxidized glutathione, uric acid, ascorbic acid, and total antioxidant capacity in subjects with diabetes and systemically healthy subjects with inflammatory periodontal disease.. Sixteen patients with type 1 diabetes mellitus (DM), 25 patients with type 2 DM, and 24 systemically healthy patients, all with inflammatory periodontal disease, were recruited. Whole-saliva samples were obtained, and full-mouth clinical periodontal measurements, including plaque index, probing depth, gingival recession, clinical attachment level, and bleeding on probing, were recorded at six sites per tooth. Saliva flow rate and salivary levels of reduced and oxidized glutathione, vitamin C, uric acid, and total antioxidant capacity were determined. Data were analyzed statistically by non-parametric tests.. The subjects with type 2 DM had fewer teeth and more sites with probing depths >4 mm than the patients with type 1 DM (both P <0.01). The mean salivary reduced-glutathione concentration was lower in patients with type 1 DM than in the other two groups (both P <0.05). No significant differences in the salivary concentrations of the other antioxidants measured were found among the groups (P >0.05). Oxidized glutathione levels in the patients with type 1 DM were significantly lower than in the systemically healthy group (P = 0.007). In both groups with diabetes, salivary reduced-glutathione levels correlated positively with probing depth, and total antioxidant capacity correlated with salivary flow rate (P <0.01).. The decrease in salivary reduced-glutathione levels in patients with type 1 DM may have a role in periodontal tissue destruction by predisposing tissues to oxidative stress.

Topics: Adolescent; Adult; Aged; Antioxidants; Ascorbic Acid; Case-Control Studies; Dental Plaque Index; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Female; Gingival Hemorrhage; Gingival Recession; Glutathione; Glutathione Disulfide; Humans; Male; Middle Aged; Oxidative Stress; Periodontal Attachment Loss; Periodontal Pocket; Periodontitis; Saliva; Secretory Rate; Uric Acid; Young Adult

Peri-implant disease is considered to be an inflammatory disease, but many aspects of its pathogenesis remain unknown. At present, peri-implant disease is considered to be initiated and perpetuated by a small group of predominantly Gram-negative, anaerobic, or micro-aerophilic bacteria that colonize the subgingival area. Bacteria cause the observed tissue destruction directly by toxic products and indirectly by activating host defence systems, i.e. inflammation. A variety of molecular species appears in the inflamed tissues, among them are reactive species such as free radicals and reactive oxygen species (ROS). The purpose of this study was to assess levels of various antioxidants in saliva to identify differences between the saliva of patients with healthy peri-implant tissues and patients with peri-implant disease, and to examine whether the whole saliva of those with peri-implant disease conditions might have lower levels of antioxidants than that of healthy individuals.. Thirty healthy adult volunteers (14 men and 16 women) with implant-supported overdentures (Ankylos Biofunctional Implants) were selected from the group of patients from Tallinn Dental Clinic. Biochemical and clinical parameters evaluated were the following ones: the levels of urate, ascorbate, myeloperoxidase in saliva, total antioxidant status of saliva, pocket probing depth (mm), gingival index (0, 1, 2, or 3), and bleeding on probing (0 or 1).. Total antioxidant status (TAS) of saliva and concentration of uric acid and ascorbate, which are the main salivary antioxidants, are significantly decreased in patients with peri-implant disease. TAS in healthy subjects was 0.41+/-0.10 for resting saliva and 0.31+/-0.09 for stimulated saliva; in diseased subjects TAS was 0.19+/-0.07 and 0.12+/-0.03, respectively. In healthy subjects, the concentration of urate was 307.2+/-78.06 microM/l in resting saliva and 241.5+/-89.09 microM/l in stimulated saliva. In diseased patients, the concentration of urate was 120+/-36.13 and 91.60+/-39.35 microM/l, respectively. The concentration of ascorbate did not differ in resting and stimulated saliva. In healthy subjects, it was 2.79+/-0.81 mg/l and in diseased subjects, it was 1.54+/-0.30 mg/l. This may indicate that excessive ROS production in peri-implant disease is leading to the situation of excessive oxidative stress, which may be an important factor contributing the destruction of peri-implant tissues. The importance of these findings may be the better understanding of the processes involved in the pathogenesis of peri-implant disease and that the treatment of peri-implant disease may involve adjuvant anti-oxidants supplementation together with cumulative interceptive supportive therapy concept introduced by Mombelli & Lang.

Topics: Aged; Antioxidants; Ascorbic Acid; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Female; Free Radicals; Gingival Hemorrhage; Humans; Male; Middle Aged; Periodontal Index; Periodontal Pocket; Periodontitis; Peroxidase; Reactive Oxygen Species; Saliva; Uric Acid

Chronic periodontitis is an inflammatory disease that affects the supporting tissues of the teeth. It is initiated by specific bacteria within the plaque biofilm and progresses due to an abnormal inflammatory-immune response to those bacteria. Periodontitis is the major cause of tooth loss and is also significantly associated with an increased risk of stroke, type-2 diabetes and atheromatous heart disease. Oxidative stress is reported in periodontitis both locally and peripherally (serum), providing potential mechanistic links between periodontitis and systemic inflammatory diseases. It is therefore important to examine serum antioxidant concentrations in periodontal health/disease, both at an individual species and total antioxidant (TAOC) level. To determine whether serum antioxidant concentrations were associated with altered relative risk for periodontitis, we used multiple logistic regression for dual case definitions (both mild and severe disease) of periodontitis in an analysis of 11,480 NHANES III adult participants (>20 y of age). Serum concentrations of vitamin C, bilirubin, and TAOC were inversely associated with periodontitis, the association being stronger in severe disease. Vitamin C and TAOC remained protective in never-smokers. Higher serum antioxidant concentrations were associated with lower odds ratios for severe periodontitis of 0.53 (CI, 0.42,0.68) for vitamin C, 0.65 (0.49,0.93) for bilirubin, and 0.63 (0.47,0.85) for TAOC. In the subpopulation of never-smokers, the protective effect was more pronounced: 0.38 (0.26,0.63, vitamin C) and 0.55 (0.33,0.93, TAOC). Increased serum antioxidant concentrations are associated with a reduced relative risk of periodontitis even in never-smokers.

Topics: Adult; Aged; Antioxidants; Ascorbic Acid; Bilirubin; Chronic Disease; Female; Health Surveys; Humans; Logistic Models; Male; Middle Aged; Nutrition Surveys; Periodontitis; United States

To study the relationship between vitamin C and the severity of periodontitis.. The study population consisted of subjects from the Malabar/Purbasari tea estate on West Java, Indonesia. In 2002, clinical measurements were performed in 128 subjects, including evaluation of plaque, bleeding on probing, pocket depth and attachment loss. In 2005, 123 out of 128 subjects could be retrieved who were present at the examination of 2002. Blood samples were taken to measure plasma vitamin C levels. Information about the subject's dietary habit was obtained by means of a personal interview guided by a questionnaire.. Plasma levels of vitamin C ranged from 0.02 to 34.45 mg/l with a mean of 7.90 mg/l (+/-5.35). The correlation coefficient between plasma vitamin C level and periodontal attachment loss was -0.199 (p<0.05); stepwise linear regression revealed that vitamin C levels explained 3.9% of the variance in periodontal attachment loss. Subjects with vitamin C deficiency (14.7% of the study population) had more attachment loss compared with those with depletion or normal plasma vitamin C values.. The negative association between plasma vitamin C levels and periodontal attachment loss suggests that vitamin C deficiency may contribute to the severity of periodontal breakdown.

Topics: Adolescent; Adult; Ascorbic Acid; Ascorbic Acid Deficiency; Diet Surveys; Female; Humans; Indonesia; Linear Models; Male; Periodontal Attachment Loss; Periodontal Index; Periodontitis

Topics: Administration, Oral; Aged; Ascorbic Acid; Calcium; Diagnosis, Differential; Ecchymosis; Folic Acid; Follow-Up Studies; Humans; Male; Periodontitis; Scurvy; Time Factors; Treatment Outcome; Vitamin D

The objective of this cross-sectional study was to evaluate whether gingivitis susceptibility is associated with periodontitis. We analyzed data of 462 men in the VA Dental Longitudinal Study aged 47 to 92 years who had never smoked or had quit smoking 5+ years previously. Multiple logistic regression models, with tooth-level bleeding on probing at sites with attachment loss

Topics: Age Factors; Aged; Aged, 80 and over; Ascorbic Acid; Body Mass Index; Cohort Studies; Cross-Sectional Studies; Crowns; Dental Calculus; Dental Plaque; Diabetes Complications; Disease Susceptibility; Educational Status; Gingival Hemorrhage; Gingivitis; Humans; Income; Longitudinal Studies; Male; Marital Status; Middle Aged; Periodontal Attachment Loss; Periodontitis; Prospective Studies; Vitamins

To determine the relationship between serum vitamin C and periodontitis as estimated by clinical attachment loss (CAL) in community-dwelling elderly Japanese.. This analysis was confined to 413 Niigata citizens aged 70 years in whom the data for serum vitamin C and CAL were available. High-pressure liquid chromatography method was used to ascertain the serum vitamin C levels while CAL was assessed on six sites of all teeth present including third molars by means of pressure-sensitive probes. Other variables included gender, smoking, toothbrushing frequency, number of teeth present and random blood sugar levels.. Serum vitamin C concentration was inversely related to CAL (r=-0.23, p<0.00005) at bivariate level. Multiple linear regression analysis showed that CAL was 4% greater in subjects with lower serum vitamin C levels than in subjects with higher serum vitamin C levels notwithstanding smoking, diabetes, oral hygiene, gender or number of teeth present.. The findings suggested that serum vitamin C might have relatively weak but a statistically significant relationship with periodontitis in this elderly population.

Topics: Aged; Ascorbic Acid; Cross-Sectional Studies; Female; Humans; Japan; Linear Models; Male; Periodontal Attachment Loss; Periodontitis

This study aimed to clarify how concentrations of vitamin C in plasma relate to the serology of periodontitis. The random sample used comprised 431 men, 194 from Finland and 237 from Russia. The plasma vitamin C concentration was determined by o-phtaldialdehyde-fluorometry, and serum immunoglobulin G antibodies to Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis were determined by a multiserotype enzyme-linked immunosorbent assay (ELISA). The mean plasma vitamin C concentration was higher (P < 0.001) in Finnish subjects (mean +/- standard deviation, 4.5 +/- 2.8 mg/liter) than in Russian subjects (1.4 +/- 1.8 mg/liter). Mean antibody levels to both A. actinomycetemcomitans (4.7 +/- 3.6 versus 5.2 +/- 3.1 ELISA units [P = 0.05]) and P. gingivalis (5.7 +/- 2.5 versus 7.6 +/- 2.9 ELISA units [P < 0.001]) were lower in Finnish men than in Russian men. In the combined Finnish and Russian population, the antibody levels to P. gingivalis were negatively correlated with vitamin C concentrations (r = -0.22; P < 0.001); this association remained statistically significant (P = 0.010) in a linear regression model after adjustment for confounding factors. The proportion of P. gingivalis-seropositive subjects decreased with increasing vitamin C concentrations (P for trend, <0.01), but no trend was seen among A. actinomycetemcomitans-seropositive subjects. In conclusion, P. gingivalis infection is associated with low concentrations of vitamin C in plasma, which may increase colonization of P. gingivalis or disturb the healing of the infected periodontium.

Topics: Adult; Aggregatibacter actinomycetemcomitans; Antibodies, Bacterial; Ascorbic Acid; Enzyme-Linked Immunosorbent Assay; Female; Finland; Humans; Male; Middle Aged; Periodontitis; Porphyromonas gingivalis; Russia

Chitosan ascorbate, obtained by mixing chitosan with ascorbic acid and sodium ascorbate, was produced in a gel form suitable for the treatment of periodontitis according to current dental surgery. While chitosan ascorbate underwent degradation in vitro, especially in the presence of atmospheric oxygen and at pH 6.0, the protection from oxygen offered by the surgical cements and the physiological pH value permitted chitosan ascorbate to play an important biological role in vivo, where it kept a honeycomb structure, as indicated by SEM on biopsies taken on 10 patients. The proliferation and organization of the cells were thus favoured with a subsequent enhanced capability of reconstructing a histoarchitectural tissue. Chitosan was progressively reabsorbed by the host, with very satisfactory clinical recoveries of the 52 defects treated, for which tooth mobility and pocket depths were significantly reduced.

Topics: Adult; Ascorbic Acid; Biocompatible Materials; Chitin; Chitosan; Female; Humans; Male; Microscopy, Electron; Microscopy, Electron, Scanning; Middle Aged; Periodontitis; Periodontium

Topics: Adult; Ascorbic Acid; Chemotaxis, Leukocyte; Follow-Up Studies; Humans; Neutrophils; Periodontal Abscess; Periodontitis

Topics: Ascorbic Acid; Chromatography, High Pressure Liquid; Granulocytes; Humans; Periodontitis

Topics: Ascorbic Acid; Female; Humans; Immunity, Cellular; Male; Mouth Diseases; Mouth Mucosa; Neutrophils; Periodontitis; Recurrence; Stomatitis, Aphthous; Ulcer

Topics: Ascorbic Acid; Capillaries; Chronic Disease; Flavonoids; Humans; Periodontitis; Periodontium

Topics: Ascorbic Acid; Flavonoids; Gingivitis; Humans; Periodontitis

Topics: Ascorbic Acid; Chlortetracycline; Disease; Humans; Periodontal Diseases; Periodontitis; Periodontium; Tocopherols; Vitamin E; Vitamins

Topics: Ascorbic Acid; Ascorbic Acid Deficiency; Deficiency Diseases; Guinea Pigs; Humans; Inflammation; Periodontitis; Periodontium; Vitamins