الفهرس 
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Abstract
Summary
Periodontal disease is a specialized infectious disease that involves inflammation of the gums and periodontal bone resorption and may subsequently lead to tooth loss if left untreated. During an inflammatory response, cytokines, chemokines, and other mediators stimulate lipid peroxidation, protein damage, increased apoptosis increasing the oxidative stress and production of reactive oxygen species.
Early in the progression of periodontal disease, especially in periodontitis, there is a marked oxidative process with increased levels of reactive oxygen and nitrogen species (ROS and RNS). The antioxidant defense system can inhibit and/or reduce the damage caused by deleterious action of free radicals or nonradical reactive species.
Among these antioxidants commonly used were lycopene and vitamin C are currently used in various auxiliary treatments for cardiovascular diseases, pulmonary diseases, ageing, and atherosclerosis. These conditions have physiologic links with periodontal diseases which would lead to the assumptions that a potential benefit could also be observed under these therapies.
Therefore, the aim of the present study was to evaluate the oxidative stress marker malondialdehyde (MDA) in chronic periodontitis patients following scaling and root planning (SRP) after systemic lycopene supplementation and vitamin C and to determine the release profile of lycopene and vitamin C in gingival crevicular fluid by High Performance Liquid chromatography (HPLC) as a primary outcome. Also, to evaluate the clinical outcomes by plaque index(PI), gingival index(GI), pocket depth (PD) and clinical attachment level (CAL) to assess the periodontal health before & after treatment.
This study was conducted on 42 individuals of both genders between the ages of 25 and 50 that were diagnosed with moderate to severe periodontitis who were divided into 3 groups of patients, each group consisted of 14 patients. All the 3 groups had received non-surgical periodontal treatment (SRP) in addition to lycopene supplements in the 1st group, vitamin C supplements in the 2nd group & a placebo in the third group.
The results of the present study revealed statistical significant decrease in mean MDA levels post-treatment in all groups however, there was no statistically significant difference between mean percentage decrease in MDA levels in the three groups.
As regards to HPLC, it showed higher bioavailability of vitamin c supplements in GCF of tested subjects in comparison to lycopene supplements. However, in both groups there were statistical significant decrease in HPLC levels after one week of vitamin c and lycopene cessation.
In all groups, there was a statistically significant decrease in median PI, GI, PD, CAL scores two months post-treatment. However, there was no statistical significant difference between median percent decrease in PI,GI in all groups.When comparing between the percent decrease in PD, CAL in all groups after two months, lycopene group showed higher median percent decrease in PD, CAL than vitamin c and control groups.
Demographic data represented no statistical significant difference between mean age & gender values in all groups.
Lycopene could be considered as a successful adjunct to non-surgical periodontal therapy as it improves the periodontal inflammation by improving the clinical parameters.
Conclusions
Based on the results of the present study, it could be concluded that:
1- In all groups there was a statistically significant decrease in mean MDA levels post treatment. However, there was a non statistically significant difference between mean percent decrease in MDA levels in all groups.
2- Vitamin C and lycopene were bioavailable in GCF, and this could explain their beneficial effect in the modulation of inflammatory response in periodontal disease .
3- In all groups, there was a statistically significant decrease in median PI, GI, PD, CAL scores post-treatment which could explain the improvement of inflammatory status of periodontal disease.
4- Lycopene group showed higher median percent decrease in PD , CAL after treatment than vitamin C and control group which might be attributed to the anti-inflammatory action of lycopene .
5- Lycopene could be considered as a promising adjunct to SRP treatment in improving periodontal inflammation and clinical outcomes.
Recommendations
1- More studies are recommended on the effect of antioxidants in long term follow up periods.
2- Further studies are required to evaluate the proper delivery system of these antioxidants.
3- Expanded studies using mixtures of antioxidants than single compounds to identify its possible effects on periodontal diseases.