# Clinical and Biochemical Effects of Antioxidant Gel as a Local Drug Delivery Agent in Stage II Grade A Periodontitis Patients: A Prospective Clinical Study

## TL;DR

This study shows that using an antioxidant gel with a standard treatment improves periodontal health and reduces oxidative stress in patients with stage II grade A periodontitis.

## Contribution

The study evaluates the effectiveness of an antioxidant gel as a local drug delivery adjunct to SRP in periodontitis management.

## Key findings

- Both groups showed significant improvement in clinical and biochemical parameters after three months.
- The antioxidant gel group showed better improvement in most parameters compared to the control group.
- Oxidative stress markers were significantly reduced in the antioxidant gel group.

## Abstract

Background

Periodontal tissue breakdown is mainly due to pathogenic bacteria and dysregulated immune response resulting in the production of reactive oxygen species/reactive nitrogen species (ROS/RNS) causing tissue degradation. Scaling and root planing (SRP) is usually done for the management of periodontitis. However, it has been reported that adjuncts like antibiotics, antiseptics, and antioxidants in the form of local drug delivery enhance the outcome of SRP.

Aim

The present clinical study aims to examine the efficacy of an antioxidant oral gel (Bluem®) as a local drug delivery agent adjunct to SRP in the management of stage II grade A periodontitis in terms of clinical and biochemical parameters.

Materials and methods

The prospective clinical study was conducted among 40 stage II grade A periodontitis patients. The participants were then divided into two groups: Group 1 (Control)-SRP alone (n=20) and Group 2 (Test)-antioxidant gel (Bluem®) with SRP (n=20). Clinical variables including plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) were recorded. Saliva (unstimulated) specimens were collected to measure total oxidant status (TOS), total antioxidant capacity (TAOC), and oxidative stress index (OSI). Specimen collection and assessment of clinical variables were done before intervention (baseline) and after three months. SPSS Software (Version 20.0, Armonk, NY, USA: IBM Corp) was used for statistical analysis. Intragroup and intergroup comparisons were done by paired t-test and independent t-test, respectively. A p-value <0.05 indicated that the result was statistically significant.

Results

On intragroup analysis, both the groups at three months revealed statistically significant improvement of PI, GI, PD, CAL, TOS, TAOC, and OSI (p<0.05) from baseline. Intergroup comparison in the third month showed a statistically significant improvement in favor of Group 2 in terms of all the clinical and biochemical parameters (p<0.05) except for PI (p>0.05).

Conclusion

The locally delivered antioxidant gel as an adjunct to SRP seems to be effective in reducing oxidative stress and improving the periodontal parameters among stage II grade A periodontitis patients.