Abstract
Objectives: In today's super-ageing society, there is an urgent need to prevent periodontal diseases and to promote health. Periodontal diseases are the main cause of loss of teeth, which are indispensable for mastication, speaking and esthetics, and are also closely associated with diabetes mellitus and other fatal complications such as cardiovascular, brain and respiratory diseases. The present study investigated the effects of an immunomodulating diet containing hydrolyzed whey peptides (WHP) on clinical periodontal parameters, biochemical parameters including inflammatory cytokine levels in saliva and gingival crevicular fluid (GCF) from patients with periodontitis.
Material and methods: The study was approved by the Institutional Review Board of the Faculty of Dentistry, Niigata University and was conducted in the university hospital. Thirty-six generalized chronic periodontitis patients (24 males and 12 females, 66.8 y±11.7) with informed consent were recruited in this study. Subjects were grouped (examiner-blinded) into two groups: 18 WHP and 18 control-diet patients. Each patient's clinical periodontal status was recorded, including probing pocket depth (PPD), clinical attachment level (CAL), gingival index (GI), plaque control record (PCR) and bleeding on probing (BOP) before and after the four-week experimental period. At the same time, saliva was collected every five minutes for free-hemoglobin (f-Hb) examination. GCF was also collected and the TNF-α, IL-6, alanine aminotransferase (ALT) and asparagic amino transferase (AST) levels were measured. The Mann-Whitney test was used to compare the variables among the two groups, and the Wilcoxon signed-rank test was used to compare the variables within each group. Correlation between the two values was analyzed by Pearson's correlation-test. A significance level of 5% was set for all the analyses.
Results: TNF-α and IL-6 levels of the WHP group were significantly decreased at four weeks after the experiments compared to the baseline (p<0.05). In the control group no significant changes were observed. The levels of ALT, AST in GCF and f-Hb in saliva did not differ before and after the experiment period or between the groups. As to clinical parameters, GI, BOP and PCR scores of both groups tended to be improved. GI and BOP were significantly decreased only in the control group. No significant changes were observed in PPD and CAL in both groups.
Conclusion: The present study suggested that improved periodontal clinical conditions can be expected with both WHP and control diets in patients with periodontitis. Significant decreases in TNF-α and IL-6 in GCF were observed only in the WHP group, suggesting the beneficial effects of WHP on immunomodulation.
