CHANGES IN SALIVARY ANTIOXIDANT CAPACITY AFTER ORAL SUPPLEMENTATION IN DENTAL IMPLANTS

Aim. Oxidative stress i. e. the unbalance between the production and elimination of reactive oxidant species by antioxidant systems plays a relevant role in the pathophysiology of many oral diseases like periodontitis as well as in tissue regeneration and osteointegration after dent implantation. On the other hand growing evidence suggests the potential usefulness of antioxidant formulas as preventive or adjunctive treatment to improve the success of implantations. The aim of the present study was to evaluate the effects of a combined local (toothpaste) and systemic (oral supplementation) antioxidant treatment on total salivary antioxidant capacity and some clinical outcomes in patients undergoing delayed dental implantations. Materials and methods. In this perspective case-control clinical trial 50 apparently healthy peoples candidates to a conventional delayed implantation were randomised to receive an antioxidant treatment (test group, TG, N=25, 13 F and 12 M, average 52 year old) or nothing (control group, CG, N=25, 10 F and 15 M, average 50 year old). The antioxidant treatment included the combination of a pomegranate-based toothpaste and a liquid oral antioxidant supplement (containing selenium, vitamin C, E and A, b-carotene, red fruits extracts, Zn, L-cysteine, coenzyme Q10, and pirydoxin). Salivary total antioxidant capacity to be intended as iron reducing capacity was measured by a photometric assay (optimal value 1,000 to 1,500 mM, using vitamin C as standard), before, after and four times during the follow-up (2nd, 3rd, 4th and 5th week). A visual analogical scale was administered to the all recruited subjects in order to evaluate the degree of oral inflammation (as rubor, calor, dolor, and tumor). Results. No statistically significant difference was found at the recruitment time between TG and CG except for the different M:F ratio. All the subjects completed the study and achieved the success of the implant (after 24 Months of treatment). Salivary total antioxidant capacity increased significantly before implantation compared to the first visit, (1530 ± 89 vs. 1270 ± 97 mM, p<0.05) only in the TG while it remained unchanged in the CC and picked in both groups immediately after intervention with the TG showing the highest increase during the follow-up period. Daily measurements up to ten days after implantation showed a faster significant decrease of all inflammation symptoms in the TG compared to the CG (p<0.05). The combined treatment of toothpaste and oral supplement was safe and well tolerated; no unwanted side effect were reported by the subject who completed all the 5-week treatment. Conclusions. The integration of dental implantation protocol with antioxidants as toothpaste and oral formula was associated to a significant increase of salivary total antioxidant capacity after one week of treatment before implantation and immediately after intervention compared to controls. Although preliminarily these findings suggest that the control of oxidative stress and local inflammation by antioxidant supplementation may optimize the efficacy of classical protocol of delayed dental implantations.