Pomegranate supplementation (40% ellagic acid) as an antioxidant in the treatment of smokers with chronic periodontitis

Smoking is considered to be a classical risk factor for periodontitis. It leads to a subsequent state of circulating lipid peroxidation byproducts in blood, such as lipid hydroperoxides and superoxides resulting in oxidative stress worsening periodontal health. In the past, studies have proved that the intake of fruits and vegetables can reduce oxidative damage in patients who smoke. Ellagic acid, a primary constituent of pomegranate fruit is one of the natural polyphenols with potent antioxidant capacity. In the present study we evaluated the effect of 40% ellagic acid supplementation on total antioxidant capacity and periodontal status in heavy and light smokers with chronic periodontitis. This was a randomized controlled trial with 40 smoker patients as part of the study. The patients were divided into two major groups (20 patients each): GROUP A - heavy smokers and GROUP B - light smokers. At baseline, clinical measurements and total antioxidant capacity were evaluated. Scaling and root planing was performed for all patients. Each of the major were then groups then were randomized into two subgroups each (A1, A2, B1 and B2).Groups A1 and B1 were given 40% ellagic acid supplementation, while A2 and B2 were not. Clinical parameters and total antioxidant capacity were reevaluated after 1 month. There was a significant improvement seen in the total antioxidant capacity (TAOC) in all the groups.This improvement was significantly higher in the groups which received the adjunctive ellagic acid supplementation. Within the groups; TAOC was maximum in light smokers who received the supplementation (B1) followed by heavy smokers who received the supplementation (A1). Significant improvements were seen in the clinical parameters in all groups. The results of the study show that the supplementation of Ellagic acid as an adjunct to scaling and root planing shows a promise in reducing the periodontal destruction and the total antioxidant capacity.