Efficacy of Proanthocyanidins in Nonsurgical Periodontal Therapy.

2023-04
International dental journal 73(2)
- Evelina Alkimavičienė
- Rasa Pušinskaitė
- Nomeda Basevičienė
- Rasa Banienė
- Nijolė Savickienė
- Ingrida Marija Pacauskienė

PubMed: 36167610
DOI: 10.1016/j.identj.2022.08.006

Study Design

Type: Randomized Controlled Trial (RCT)
Sample size: n = 23
Population: 46 patients diagnosed with periodontitis (stage III-IV)
Methods: Randomised clinical study: minimally invasive nonsurgical therapy only (MINST) or MINST plus subgingival application of collagen hydrogels with proanthocyanidins (PACNs)
Duration: 8 weeks
Funding: Unclear

Background

The aim of this work was to evaluate the efficacy of proanthocyanidins (PACNs) as an adjunctive periodontal therapy in patients with periodontitis.

Methods

Patients with periodontitis (stage III-IV) were included in this randomised clinical study. Patients with periodontitis received 2 different treatment modalities: minimally invasive nonsurgical therapy only (MINST group) or minimally invasive nonsurgical therapy and subgingival application of collagen hydrogels with PACNs (MINST + PACNs group). Clinical periodontal parameters, that is, pocket probing depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), plaque index (PI), were evaluated before treatment and after 8 weeks. Concentrations of immunologic markers, matrix metalloproteinase-3 (MMP-3), and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in saliva were assessed at baseline and at 8-week follow-up.

Results

Forty-six patients diagnosed with periodontitis were randomised into 2 groups: 23 patients in the MINST group and 23 patients in the MINST + PACNs group received the intended treatment. PACNs combined with MINST resulted in additional statistically significant PPD reduction and CAL gain in moderate periodontal pockets by 0.5 mm (P < .05) on average compared to MINST alone. Additional use of PACNs did not result in additional statistically significant improvement of BOP or PI values. Application of PACNs showed significant reduction of MMP-3 levels in saliva after 8 weeks (P < .05).

Conclusions

Adjunctive use of PACNs in MINST resulted in better clinical outcomes for moderate pockets. Additional use of PACNs improved MMP-3 concentration in saliva more than MINST alone. Biochemical analysis revealed that MMP-3 concentration in saliva reflected the periodontal health state.

Research Insights

Red Grape→Improved Clinical Attachment
PACNs combined with MINST resulted in additional statistically significant PPD reduction and CAL gain in moderate periodontal pockets by 0.5 mm (P < .05) on average compared to MINST alone.
Effect
Beneficial
Effect size
Small
Red Grape→Improved Tissue Inhibitor of Matrix Metalloproteinase-1 Level
Concentrations of immunologic markers, matrix metalloproteinase-3 (MMP-3), and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in saliva were assessed at baseline and at 8-week follow-up.
Effect
Neutral
Effect size
Small
Red Grape→Reduced Bleeding on Probing (BOP)
Additional use of PACNs did not result in additional statistically significant improvement of BOP or PI values.
Effect
Neutral
Effect size
Small
Red Grape→Reduced Matrix Metalloproteinase-3 Level
Application of PACNs showed significant reduction of MMP-3 levels in saliva after 8 weeks (P < .05).
Effect
Beneficial
Effect size
Small
Red Grape→Reduced Plaque Index
Additional use of PACNs did not result in additional statistically significant improvement of BOP or PI values.
Effect
Neutral
Effect size
Small
Red Grape→Reduced Probing Pocket Depth
PACNs combined with MINST resulted in additional statistically significant PPD reduction and CAL gain in moderate periodontal pockets by 0.5 mm (P < .05) on average compared to MINST alone.
Effect
Beneficial
Effect size
Small