Oxidative stress in periodontitis and the application of antioxidants in treatment: a narrative review

Abstract

Periodontitis has turned into a general oral disease defined by chronic inflammation of the gums and helping tissues of the teeth. It dramatically influences both oral and systemic health and is a main trigger of tooth loss. Periodontitis is tightly linked to oxidative stress, and evidence reveals the utilization of certain antioxidants in related treatments. Our review delves into literature in periodontitis, centering on the latest therapeutic strategies and mechanistic evidences. This review starts by depicting the epidemiological features and pathogenic mechanisms of periodontitis, highlighting the vital mechanism of microbial community modefications, host immune responses, and genetic factors in disease development. Existing treatment approaches for periodontitis involve mechanical cleaning, antibiotic therapy, surgical interventions, and pharmacological treatments, with a comprehensive exploration on the strengths and limitations of each strategy and their related clinical utilizations. Besides, this review investigates emerging therapies, like anti-inflammatory treatments, immune modulation therapies, and biotechnological utilization in the control of periodontitis. It particularly stresses the protective effects of antioxidants and their mechanistic researches in periodontitis, highlighting their potential in slowing inflammatory responses and boosting tissue repair. Ultimately, our review intends to the concept of individual therapy and investigates future directions, comprising the utilization of precision medicine in periodontitis control and the individual design of treatment utilization.

Keywords: antioxidants; inflammation; oxidative stress; periodontitis; tissue repair.

FIGURE 1

The role of oxidative stress in the pathogenesis of periodontitis. This figure illustrates the biological mechanisms associated with oral inflammation. First, oxidative stress leads to the oxidation of lipids and proteins, triggering the failure of the antioxidant system and the production of pro-inflammatory cytokines. At the same time, plaque stimulates host cells to release inflammatory mediators such as IL-1β and TNF-α, activates the NF-κB signaling pathway, and then recruits inflammatory cell infiltrates, ultimately triggering an inflammatory response.

FIGURE 2

Application advances of antioxidant therapy in human studies. This figure illustrates the mechanism of action of antioxidants on periodontal tissue. This figure on the left shows inflammation around the Periodontal Pocket accompanied by gingival bleeding in the absence of antioxidant intervention. This figure on the right shows that antioxidants such as vitamin C, vitamin E and glutathione, when in their hands, can reduce inflammation in the gum area and improve the health of periodontal tissues, demonstrating the positive role of antioxidants in the maintenance of periodontal health.