The effect of periodontal therapy on oxidative stress biomarkers: A systematic review

J Clin Periodontol. 2018 Oct;45(10):1222-1237. doi: 10.1111/jcpe.12993. Epub 2018 Aug 28.


Aim: To systematically review the literature about the effect of periodontal treatment on oxidative stress (OxS) biomarkers.

Material and methods: Three databases (PubMed, EMBASE, and Scopus) were searched up to February 2018. Clinical trials with a follow-up of at least 6 weeks after mechanical periodontal treatment were included. Due to the high heterogeneity among the units and indices of measurements used in the studies, a meta-analysis was not performed.

Results: Overall, 3,199 studies were retrieved, of which 20 were included. Four studies were randomized clinical trials (RCT), and 16 studies were non-RCTs. The most common OxS biomarkers used were 8-hydroxydeoxiguanosine (8-OHdG), total oxidant status (TOS), and total antioxidant status (TAS). After treatment, most of the studies reported a decrease in 8-OHdG concentration in the gingival crevicular fluid (GCF) and saliva. In addition, the salivary concentration of this biomarker was similar to periodontally healthy patients. Periodontal therapy was effective in reducing TOS in GCF, saliva, and serum in most studies. TAS, however, responded inconsistently to the periodontal intervention.

Conclusion: Periodontal therapy reduces the levels of OxS biomarkers, even to values similar to those found in periodontally healthy individuals. Additional RCTs are warranted, as the information is mainly based on nonrandomized studies.

Keywords: antioxidants; free radicals; oxidative stress; periodontal diseases; reactive oxygen species.

Publication types

  • Systematic Review

MeSH terms

  • Biomarkers
  • Chronic Periodontitis*
  • Gingival Crevicular Fluid
  • Humans
  • Oxidative Stress
  • Periodontal Attachment Loss
  • Periodontal Index
  • Saliva


  • Biomarkers