The previous two articles in this series described the basic science of oxidative stress, antioxidants and their influence on wound healing. This article will focus on the use of antioxidants in restorative dentistry.

The use of metal in fillings, braces, implants, bridges and other prosthodontic restorations is common in practice.1 Zinc and copper released from gold alloys and nickel released from nickel-chromium alloys, can have a highly cytotoxic effect on fibroblast cell cultures.   The use of pure antioxidants can counteract the detrimental effects by increasing cell viability and DNA synthesis, as well as, decreasing reactive oxygen species. There are three times I would recommend the use of PerioSciences AO products in restorative dentistry:

  • Pre-treatment
  • During treatment
  • Post-treatment

Pre-treatment

Use of antioxidants pre-treatment assist in establishing ideal gingival health before beginning restorative treatment.

  • Brush with AO ProToothpaste two to three times per day
  • Floss daily
  • AO ProRinse mouthwash two times per day
  • Apply AO ProVantage gel to the area to be treated three times per day for four to eight weeks

I recommend this regimen to optimize periodontal health. The essential oils in the mouthwash (menthol and thymol) have an anti-plaque and anti-gingivitis effect without damage to tissue cells. The antioxidants (phloretin and ferulic acid) have beneficial effects on functional mechanisms that regulate fibroblast migration and proliferation during gingival healing or periodontic repair. Establishing ideal gingival health before beginning the restorative process will decrease gingival inflammation. This will promote a decrease in gingival bleeding while clinical restorative procedures that manipulate the tissue are being performed.

During treatment

  • Brush with AO ProToothpaste two to three times per day
  • AO ProRinse mouthwash two times per day
  • Apply AO ProVantage Blast to the tissue around the prepared and impressed teeth five times per day for one to two weeks

This regimen can help return irritated tissue to a healthy state by reducing inflammation.Chlorhexidine is often used for its antibacterial effect, but its poor taste and staining of the provisionals may decrease patient compliance. As described in my previous article, it can have a detrimental effect on cell migration and long-term cell survival, even in diluted concentrations.

Immediate Post-Treatment/Maintenance

  • Apply AO ProVantage Blast to the tissue around the cemented restorations five times per day for one to two weeks
  • Brush two to three times per day with AO ProToothpaste
  • AO ProRinse one time daily
  • AO ProVantage applied to the area around the restorations at bedtime

By following this regimen I have found significant improvement in patient oral health, making restorative procedures, which may influence oral soft tissue, more predictable.

Reference:

San Miguel, S. M., Opperman, L. A., Allen, E. P., Zielinski, J. E., & Svoboda, K. K. (2012). Antioxidant combinations protect oral fibroblasts against metal-induced toxicity. Archives of Oral Biology, 58(3), 299-310. doi:10.1016/j.archoralbio.2012.05.013


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