Abstract
AimA double-blind randomized controlled trial to determine whether dietary supplementation with fruit/vegetable/berry juice powder concentrates, simultaneously with non-surgical periodontal therapy, improved 2-month treatment outcomes.MethodsVolunteers with chronic periodontitis were randomly assigned to one of three groups: fruit/vegetable (FV), fruit/vegetable/berry (FVB) or placebo. Supplements were taken daily during non-surgical debridement and maintenance and outcomes assessed at 2, 5 and 8 months after completion. Primary outcomes were mean probing pocket depth (PPD), clinical attachment gain, % sites bleeding on probing (% BOP) at 2 months. Adherence and plasma β-carotene were determined.ResultsSixty-one nutritionally replete (by serum biochemistry) volunteers enrolled and 60 (n = 20 per arm) completed the 2-month review. Clinical outcomes improved in all groups at 2 months, with additional improvement in PPD versus placebo for FV (p < 0.03). Gingival crevicular fluid volumes diminished more in supplement groups than placebo (FVB; p < 0.05) at 2 months, but not at later times. The % BOP (5 months) and cumulative plaque scores (8 months) were lowered more in the FV group (p < 0.05).ConclusionsAdjunctive juice powder concentrates appear to improve initial pocket depth reductions in nutritionally replete patients, where plasma micronutrient bioavailability is attainable. Definitive multicentre studies in untreated and treated patients are required to ascertain the clinical significance of such changes.
Highlights
The following exclusion criteria were applied: patients with aggressive disease, patients with physical or mental disability, pregnant women, patients whose medical history may place them at risk of complications from periodontal therapy, patients taking long-term antimicrobial or anti-inflammatory drugs, patients unable to swallow capsules, patients unable to provide informed consent, current smokers, patients taking regular vitamin supplementation
Using the primary outcome measure of reduction in probing pocket depth (PPD) and assuming a mean additional PPD reduction in the supplement groups of 0.4 mm over non-surgical therapy alone, 17 volunteers per treatment group were needed to complete the study for a two-sided test of equality of means at the 0.05 level of significance with 80% power
The current study is the first to report the impact of providing periodontitis patients with an adjunctive phytonutrient supplement during standard mechanical non-surgical periodontal therapy
Summary
This was an investigator-led, threearm, placebo-controlled, doubleblind randomized intervention study (NCT00952536) and was approved by South Birmingham Local Research Ethics Committee (05/Q2707/252), and research governance was overseen by South Birmingham Primary Care Trust Research Management and Governance (Project Number – SouthDent116/742). The study was conducted in accordance with international Good Clinical Practice standards
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