The Impact of Oxidative Damage on Periodontal Tissues: Addressing Implications for Periodontitis Progression and Systemic Health- A Narrative Review
The Impact of Oxidative Damage on Periodontal Tissues and Systemic Health
Keywords:
oxidative stress, periodontitis, reactive oxygen species, systemic diseases, inflammation, oral microbiota.
Abstract
Oxidative stress, resulting from the overproduction of reactive oxygen species (ROS), plays a significant role in the pathogenesis of periodontitis and its systemic implications. Periodontitis is a chronic inflammatory disease affecting periodontal tissues, potentially leading to tooth loss and contributing to systemic diseases such as cardiovascular disease, diabetes, chronic kidney disease, and adverse pregnancy outcomes. This review discusses the intricate relationship between oxidative stress and periodontitis, examining how ROS contribute to periodontal tissue destruction by impairing the host immune response and promoting pro-inflammatory cytokine production. Additionally, the two-way relationship between periodontitis and systemic diseases is explored, highlighting the exacerbating effect of oxidative stress on both local periodontal and systemic conditions. A deeper understanding of the role of oxidative stress in periodontal and systemic diseases can offer insights into potential therapeutic approaches and management strategies for mitigating these interconnected health issues.
References
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2. Eriksson K, Fei G, Lundmark A, Benchimol D, Lee L, Hu YO, Kats A, Saevarsdottir S, Catrina AI, Klinge B, Andersson AF. Periodontal health and oral microbiota in patients with rheumatoid arthritis. Journal of clinical medicine. 2019 May 8;8(5):630.
3. Blasco-Baque V, Garidou L, Pomié C, Escoula Q, Loubieres P, Le Gall-David S, Lemaitre M, Nicolas S, Klopp P, Waget A, Azalbert V. Periodontitis induced by Porphyromonas gingivalis drives periodontal microbiota dysbiosis and insulin resistance via an impaired adaptive immune response. Gut. 2017 May 1;66(5):872-85.
4. Rotariu D, Babes EE, Tit DM, Moisi M, Bustea C, Stoicescu M, Radu AF, Vesa CM, Behl T, Bungau AF, Bungau SG. Oxidative stress–Complex pathological issues concerning the hallmark of cardiovascular and metabolic disorders. Biomedicine & Pharmacotherapy. 2022 Aug 1;152:113238.
5. Heinkele FJ, Lou B, Erben V, Bennewitz K, Poschet G, Sticht C, Kroll J. Metabolic and transcriptional adaptations improve physical performance of zebrafish. Antioxidants. 2021 Oct 7;10(10):1581.
6. Chapple IL. Potential mechanisms underpinning the nutritional modulation of periodontal inflammation. The Journal of the American Dental Association. 2009 Feb 1;140(2):178-84.
7. Chapple IL, Matthews JB. The role of reactive oxygen and antioxidant species in periodontal tissue destruction. Periodontology 2000. 2007 Feb 1;43(1).
8. Corrêa MG, Pires PR, Ribeiro FV, Pimentel SZ, Casarin RC, Cirano FR, Tenenbaum HT, Casati MZ. Systemic treatment with resveratrol and/or curcumin reduces the progression of experimental periodontitis in rats. Journal of periodontal research. 2017 Apr;52(2):201-9.
9. Ikeda E, Ikeda Y, Wang Y, Fine N, Sheikh Z, Viniegra A, Barzilay O, Ganss B, Tenenbaum HC, Glogauer M. Resveratrol derivative‐rich melinjo seed extract induces healing in a murine model of established periodontitis. Journal of Periodontology. 2018 May;89(5):586-95.
10. Wilcox ME, Charbonney E, d’Empaire PP, Duggal A, Pinto R, Javid A, Dos Santos C, Rubenfeld GD, Sutherland S, Liles WC, Glogauer M. Oral neutrophils are an independent marker of the systemic inflammatory response after cardiac bypass. Journal of Inflammation. 2014 Dec;11:1-1.
11. Fernandez-Solari J, Barrionuevo P, Mastronardi CA. Periodontal disease and its systemic associated diseases. Mediators of inflammation. 2015;2015.
12. Fine N, Hassanpour S, Borenstein A, Sima C, Oveisi M, Scholey J, Cherney D, Glogauer M. Distinct oral neutrophil subsets define health and periodontal disease states. Journal of dental research. 2016 Jul;95(8):931-8.
13. Almerich-Silla, J. M., Montiel-Company, J. M., Pastor, S., Serrano, F., Puig-Silla, M., and Dasí, F. (2015). Oxidative stress parameters in saliva and its association with periodontal disease and types of bacteria. Dis. Markers 2015, 653537–7. doi:10.1155/2015/653537
14. Buczko P, Zalewska A, Szarmach I. Saliva and oxidative stress in oral cavity and in some systemic disorders. J Physiol Pharmacol. 2015;66(1):3-9.
15. Johnstone AM, Koh A, Goldberg MB, Glogauer M. A hyperactive neutrophil phenotype in patients with refractory periodontitis. Journal of Periodontology. 2007 Sep;78(9):1788-94.
16. Bartold PM, Marshall RI, Haynes DR. Periodontitis and rheumatoid arthritis: a review. Journal of periodontology. 2005 Nov;76:2066-74.
17. Boyce BF, Xing L. Biology of RANK, RANKL, and osteoprotegerin. Arthritis research & therapy. 2007 Jun;9:1-7.
18. Belibasakis GN, Bostanci N. The RANKL‐OPG system in clinical periodontology. Journal of clinical periodontology. 2012 Mar;39(3):239-48.
19. Baltacıoğlu E, Yuva P, Aydın G, Alver A, Kahraman C, Karabulut E, Akalın FA. Lipid peroxidation levels and total oxidant/antioxidant status in serum and saliva from patients with chronic and aggressive periodontitis. Oxidative stress index: a new biomarker for periodontal disease?. Journal of periodontology. 2014 Oct;85(10):1432-41.
20. Chiu AV, Saigh MA, McCulloch CA, Glogauer M. The role of NrF2 in the regulation of periodontal health and disease. Journal of dental research. 2017 Aug;96(9):975-83.
21. Johnstone AM, Koh A, Goldberg MB, Glogauer M. A hyperactive neutrophil phenotype in patients with refractory periodontitis. Journal of Periodontology. 2007 Sep;78(9):1788-94.
22. Wruck CJ, Fragoulis A, Gurzynski A, Brandenburg LO, Kan YW, Chan K, Hassenpflug J, Freitag-Wolf S, Varoga D, Lippross S, Pufe T. Role of oxidative stress in rheumatoid arthritis: insights from the Nrf2-knockout mice. Annals of the rheumatic diseases. 2011 May 1;70(5):844-50.
23. Aboodi GM, Goldberg MB, Glogauer M. Refractory periodontitis population characterized by a hyperactive oral neutrophil phenotype. Journal of periodontology. 2011 May;82(5):726-33.
24. Lakschevitz FS, Aboodi GM, Glogauer M. Oral neutrophil transcriptome changes result in a pro-survival phenotype in periodontal diseases. PloS one. 2013 Jul 11;8(7):e68983.
25. Reynolds JJ. Collagenases and tissue inhibitors of metalloproteinases: a functional balance in tissue degradation. Oral diseases. 1996 Mar;2(1):70-6.
26. Guan SM, Shu L, Fu SM, Liu B, Xu XL, Wu JZ. Prevotella intermedia upregulates MMP-1 and MMP-8 expression in human periodontal ligament cells. FEMS microbiology letters. 2009 Oct 1;299(2):214-22.
27. Kaur S, White S, Bartold PM. Periodontal disease and rheumatoid arthritis: a systematic review. Journal of dental research. 2013 May;92(5):399-408.
28. Hienz SA, Paliwal S, Ivanovski S. Mechanisms of bone resorption in periodontitis. Journal of immunology research. 2015;2015(1):615486.
29. Graves D. Cytokines that promote periodontal tissue destruction. Journal of periodontology. 2008 Aug;79:1585-91.
30. Ling MR, Chapple IL, Matthews JB. Peripheral blood neutrophil cytokine hyper-reactivity in chronic periodontitis. Innate immunity. 2015 Oct;21(7):714-25.
31. Hatanaka E, Monteagudo PT, Marrocos MS, Campa A. Neutrophils and monocytes as potentially important sources of proinflammatory cytokines in diabetes. Clinical & Experimental Immunology. 2006 Dec;146(3):443-7.
32. Almerich-Silla JM, Montiel-Company JM, Pastor S, Serrano F, Puig-Silla M, Dasí F. Oxidative stress parameters in saliva and its association with periodontal disease and types of bacteria. Disease markers. 2015;2015(1):653537.
33. Sui L, Wang J, Xiao Z, Yang Y, Yang Z, Ai K. ROS-scavenging nanomaterials to treat periodontitis. Frontiers in chemistry. 2020 Nov 4;8:595530.
34. Tottoli, E. M., Dorati, R., Genta, I., Chiesa, E., Pisani, S., and Conti, B. (2020). Skin wound healing process and new emerging technologies for skin wound care and regeneration. Pharmaceutics 12, 735. doi:10.3390/pharmaceutics12080735
35. Cordani, M., Resines-Urien, E., Gamonal, A., Milan-Rois, P., Salmon, L., Bousseksou, A., et al. (2021). Water soluble iron-based coordination trimers as synergistic adjuvants for pancreatic cancer. Antioxidants (Basel) 10, 66. doi:10. 3390/antiox10010066
36. Han, Y., Huang, Y., Gao, P., Yang, Q., Jia, L., Zheng, Y., et al. (2022). Leptin aggravates periodontitis by promoting M1 polarization via NLRP3. J. Dent. Res. 101, 675–685. doi:10.1177/00220345211059418
37. Liu Y, Duan D, Ma R, Ding Y, Xu Y, Zhou X, Zhao L, Xu X. The combined use of salivary biomarkers and clinical parameters to predict the outcome of scaling and root planing: A cohort study. Journal of clinical periodontology. 2020 Nov;47(11):1379-90.
38. Corredor, Z., Suarez-Molina, A., Fong, C., Cifuentes, C. L., and Guauque-Olarte, S. (2022). Presence of periodontal pathogenic bacteria in blood of patients with coronary artery disease. Sci. Rep. 12, 1241. doi:10.1038/s41598-022-05337-1
39. Galea J, Armstrong J, Gadsdon P, Holden H, Francis SE, Holt CM. Interleukin-1 beta in coronary arteries of patients with ischemic heart disease. Arterioscler Thromb Vasc Biol. 1996 Aug;16(8):1000-6. doi: 10.1161/01.atv.16.8.1000. PMID: 8696938.
40. Peter Barath, Michael C. Fishbein, Jin Cao, James Berenson, Richard H. Helfant, James S. Forrester, Detection and localization of tumor necrosis factor in human atheroma, The American Journal of Cardiology, Volume 65, Issue 5,1990, Pages 297-302, ISSN 0002-9149,https://doi.org/10.1016/0002-9149(90)90291-8.
41. Haraszthy, V.I., Zambon, J.J., Trevisan, M., Zeid, M. and Genco, R.J. (2000), Identification of Periodontal Pathogens in Atheromatous Plaques. Journal of Periodontology, 71: 1554-1560. https://doi.org/10.1902/jop.2000.71.10.1554
42. Fiehn, N.-E., Larsen, T., Christiansen, N., Holmstrup, P. and Schroeder, T.V. (2005), Identification of Periodontal Pathogens in Atherosclerotic Vessels. Journal of Periodontology, 76: 731-736. https://doi.org/10.1902/jop.2005.76.5.731
43. Lalla E, Park DB, Papapanou PN, Lamster IB. Oral disease burden in Northern Manhattan patients with diabetes mellitus. Am J Public Health. 2004 May;94(5):755-8. doi: 10.2105/ajph.94.5.755. PMID: 15117696; PMCID: PMC1448333.
44. Preshaw PM, Alba AL, Herrera D, Jepsen S, Konstantinidis A, Makrilakis K, Taylor R. Periodontitis and diabetes: a two-way relationship. Diabetologia. 2012 Jan;55(1):21-31. doi: 10.1007/s00125-011-2342-y. Epub 2011 Nov 6. PMID: 22057194; PMCID: PMC3228943.
45. Santonocito, Simona, Polizzi, Alessandro, Marchetti, Enrico, Dalessandri, Domenico, Migliorati, Marco, Lupi, Saturnino Marco, Cicciù, Marco, Isola, Gaetano, Impact of Periodontitis on Glycemic Control and Metabolic Status in Diabetes Patients: Current Knowledge on Early Disease Markers and Therapeutic Perspectives, Mediators of Inflammation, 2022, 4955277, 7 pages, 2022. https://doi.org/10.1155/2022/4955277
46. Liu Y & Zhang Q. (2016) Periodontitis aggravated pancreatic beta-cell dysfunction in diabetic mice through interleukin-12 regulation on Klotho. Journal of Diabetes Investigation 7, 303-311. 104.Bullon P, Morillo JM, Ramirez-Tortosa MC, Quiles JL, Newman HN & Battino M. (2009) Metabolic syndrome and periodontitis: is oxidative stress a common link? Journal of Dental Research 88, 503-518.
47. Bullon P, Newman HN & Battino M. (2014) Obesity, diabetes mellitus, atherosclerosis and chronic periodontitis: a shared pathology via oxidative stress and mitochondrial dysfunction? Periodontology 2000 64, 139-153.
48. Bullon P, Morillo JM, Ramirez-Tortosa MC, Quiles JL, Newman HN, Battino M. Metabolic syndrome and periodontitis: is oxidative stress a common link?. Journal of Dental Research. 2009 Jun;88(6):503-18.
49. D‘Aiuto F, Nibali L, Parkar M, Patel K, Suvan J & Donos N. (2010) Oxidative stress, systemic inflammation, and severe periodontitis. Journal of Dental Research 89, 1241- 1246
50. Li Y, Teng DI, Shi X, Qin G, Qin Y, Quan H, Shi B, Sun H, Ba J, Chen B, Du J. Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study. bmj. 2020 Apr 28;369.
51. Nishikawa T, Suzuki Y, Sawada N, Kobayashi Y, Nakamura N, Miyabe M, Miyajima SI, Adachi K, Minato T, Mizutani M, Toriumi T. Therapeutic potential for insulin on type 1 diabetes‐associated periodontitis: Analysis of experimental periodontitis in streptozotocin‐induced diabetic rats. Journal of diabetes investigation. 2020 Nov;11(6):1482-9.
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Published
2025-06-28
How to Cite
Sadiqa Rehman, Afshan Bey, Zia, A., Ahmad Shoeb Hashmi, & Syed Amaan Ali. (2025). The Impact of Oxidative Damage on Periodontal Tissues: Addressing Implications for Periodontitis Progression and Systemic Health- A Narrative Review. UNIVERSITY JOURNAL OF DENTAL SCIENCES, 11(2). https://doi.org/10.21276/ujds.2025.v11.i2.14
Section
Review Article
