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Impact of dietary augmentation with dried whole fruit, vegetable and berry juice concentrates upon outcomes of periodontal therapy: a randomized controlled trial

Milward M. M. et al., Clin Nutr Suppl 2010; 5, Suppl.1: 11

Den Einfluss von Juice Plus+ Obst-, Gemüse- und Beerenauslese auf die nicht-chirurgische periodontale Therapie untersuchten Milward und Mitarbeiter von der Periodontal Research Group am College of Medical and Dental Sciences der Universität Birmingham. In der placebokontrollierten, randomisierten Doppelblindstudie bei 48 Nichtrauchern wurden die Studienteilnehmer in drei Gruppen aufgeteilt: Obst- und Gemüseauslese (FV), Obst-, Gemüse- und Beerenauslese (FVB) und Placebo. Sowohl bei der parodontalen Taschentiefenmessung wie auch bei der Messung der Zunahme des konnektiven Bindegewebes zeigte sich nach drei Monaten zusätzlich zu den positiven Resultaten der nicht-chirurgischen Standardtherapie ein weiterer Vorteil sowohl in der FV- als auch in der FVB-Gruppe.

Damit wurde zum ersten Mal in einer kontrollierten Studie objektiviert, was aus Erfahrungsberichten von Zahnärzten bereits längere Zeit bekannt war.
M.M. Milward1, N. Ling-Mountford1, P. Weston1, G.E. Dallal2, J.B. Matthews1, S. De-Spirt3, W. Stahl3, I.L.C. Chapple1
1 Periodontal Research Group, College of Medical and Dental Sciences, The University of Birmingham, UK
2 Biostatistics Unit, USDA HNRC at Tufts University, Boston, MA, USA
3 Institut fuer Biochemie und Molekularbiologie I Heinrich-Heine-Universitaet, Duesseldorf, Germany

Abstract (engl.)

Chronic periodontitis is the most prevalent chronic inflammatory disease of humans [1], a major cause of tooth loss [2] and an independent risk factor for systemic inflammatory diseases, such as atherogenic vascular disease [3], type-2 diabetes [4] and rheumatoid arthritis [5]. It is caused by a dysregulated inflammatory response to the microbial plaque biofilm, characterised by oxidative stress [6], and which fails to remove causative pathogens, creating a non-resolving inflammation that destroys the attachment of the teeth to jaw bone. Large epidemiological studies have demonstrated an inverse association between serum antioxidant micronutrient levels and periodontitis prevalence [7]. Therefore, the aim of this placebo-controlled randomized, double blind trial, was to assess whether additional benefit could be obtained by use of dietary augmentation with dried whole fruit, vegetable and berry extracts (Juice Plus+), employed during and after non-surgical periodontal therapy. Primary outcome measures were reductions in periodontal pocket depth (PPD) and gain in connective tissue attachment level (CAL) to teeth, 2-months following standard therapy. Test interventions were fruit/vegetable (FV, n = 16) and FV/berry (FVB, n = 15) verses placebo (PL, n = 17). Statistical analysis employed 2-tailed ANCOVA (baseline PPD and CAL as covariates) and interim data on 48 never smokers are reported. Plasma beta-carotene concentrations increased over the study period in FV and FVV groups (p < 0.0001), but not the PL group (p > 0.05), and were higher at 2-months in FV and FVV than PL (p < 0.006). Non-surgical therapy produced statistically significant improvements in PPD (FV = 0.86 ± 0.4 mm; FVB = 0.88 ± 0.4 mm; PL = 0.81 ± 0.5 mm) and for CAL (p < 0.0001). Despite such large improvements, additional benefit was seen for PPD with FV (p < 0.03) and FVB (p < 0.04) supplementation versus PL, and a trend towards additional gains in CAL with FV (p = 0.07). Thus, adjunctive antioxidant micronutrients (Juice Plus+) may offer additional therapeutic benefit to standard non-surgical periodontal therapy. 
Support: NSA (TN, USA).