The Role and Significance of Oxidative Stress in Inflammatory Periodontal Disease and Contemporary Approaches to Antioxidant Therapy

Abstract

Periodontitis is a chronic inflammatory disease driven by dysbiotic biofilms and an exaggerated host immune response, resulting in progressive destruction of periodontal tissues and tooth loss. Increasing evidence suggests that oxidative and nitrosative stress play central roles in disease progression by amplifying inflammation, promoting tissue damage, and impairing repair mechanisms. Reactive oxygen species (ROS) and reactive nitrogen species (RNS) derived from immune cells, mitochondria, and enzymatic pathways contribute to lipid peroxidation, DNA damage, and alveolar bone resorption. These mechanisms help explain persistent inflammation and variable treatment response despite conventional periodontal therapy. This narrative review summarizes current evidence on oxidative stress in periodontitis and evaluates the potential role of antioxidant therapy as an adjunct to standard treatment. Particular emphasis is placed on selenium-containing compounds due to their involvement in glutathione peroxidase activity, thioredoxin systems, and mitochondrial protection. Although antioxidant strategies show promise in improving biochemical and clinical outcomes, current evidence remains heterogeneous. Further well-designed clinical studies are needed to clarify their role in routine periodontal care.