EC Dental Science

Introduction: Periodontal bacteria can produce free radical overproduction, which can lead to the loss of collagen and periodontal tissue. Antioxidants are utilized as supplements to combat the excessive generation of free radicals in periodontal disease, which can prevent collagen breakdown. Coenzyme Q10 functions as an endogenous antioxidant, regenerates other antioxidants, promotes cell development, and prevents cell death. Perio-EXCEL gel may be useful as an intra-pocket medication and as an adjuvant to scaling and root planing in the treatment of gingivitis and chronic periodontitis.

Objective: The objective of this study was to test the efficacy of coenzyme Q 10 in the form of gel (Perio-EXCEL) in patients with chronic gingivitis and periodontitis.

Methods: This clinical trial will be designed as a prospective, single center, randomized, controlled, split mouth study of 6 weeks duration. Patients with chronic periodontitis will be recruited from the outpatient Department of Periodontology, Chandra Dental College and Hospital, Safedabad, Barabanki (U.P.). A total of 15 patients were enrolled. A split mouth design was used for intra-pocket application alone, intra-pocket application combined with scaling and roots planing (SRP) and SRP only in each quadrant, respectively. Clinical parameters such as plaque index, gingival index, gingival bleeding index, probing pocket depth, clinical attachment level were assessed at baseline, 3^rd week, and 6^th week. The results were subjected to statistical analysis, which were expressed as mean ± SD and proportions as percentages. Intra group comparisons were made by paired t-test and one way analysis of variance (ANOVA) for inter-group comparisons. Categorical data was analyzed by Fisher's exact test.

Results: The results showed on intra-group analysis significant reduction (P < 0.01) of clinical parameters (plaque index (PI), gingival index (GI), gingival bleeding index (GBI), periodontal probing pocket depth (PPD), and clinical attachment level (CAL)) in all three treatment groups, whereas on inter-group analysis, intra-pocket gel application in combination with SRP showed Significant reduction (P < 0.05) for PI, GI, GBI, and CAL in comparison to intra-pocket gel alone.

Conclusion: In the present study, in chronic periodontitis patients, sub-gingival mechanical debridement only and with Perio-EXCEL gel showed almost similar clinical results. Hence, it confirmed the primary role of basic mechanical approaches in periodontal therapy and did not provide enough clinical support for the superiority of adjunctive use of Perio-EXCEL gel.

 Keywords: Antioxidants; Chronic Periodontitis; Coenzyme Q10

1. Abiri Behnaz. “Impact of coenzyme Q10 on inflammatory biomarkers and its role in future therapeutic strategies impact of coenzyme Q10 on inflammatory biomarkers and its role in future therapeutic strategies”. Clinical Nutrition ESPEN 43 (2021): 25-30.
2. Shoukheba M and El-Kholy S. “Coenzyme Q10 food supplement on the treatment of chronic periodontitis in patients with type II diabetes mellitus: a randomized control study”. Egyptian Dental Journal1 (2019): 253-261.
3. Gaurav Pandav., et al. “Evaluation of the efficacy of coenzyme Q10 in the management of chronic periodontitis: a clinical study”. Dental Journal of Advanced Studies3 (2021): 138-146.
4. Joseph Kishore Reddy and Darshan BM. “Co enzyme q10-an adjunctive in the periodontal management of type ii diabetic patients”. World Journal of Pharmaceutical Research8 (2021): 1344-1353.
5. Elaheh Akhavan Rasoolzadeh., et al. “The effect of coenzyme q10 on periodontitis: a systematic review and meta-analysis of clinical trials”. Journal of Evidence-Based Dental Practice2 (2022): 101710.
6. Pallotti F., et al. “The roles of coenzyme Q in disease: direct and indirect involvement in cellular functions”. International Journal of Molecular Sciences1 (2022): 128.
7. Soni A., et al. “Comparative effect of 1.2% atorvastatin gel and 1.2% rosuvastatin as a local drug delivery in treatment of intra-bony defects in chronic periodontitis”. Indian Journal of Dental Research 2 (2022): 180-183.
8. ElBarbary A., et al. “The effect of using coenzyme Q10 with non-surgical periodontal treatment on MMP9 gingival crevicular fluid level in patients with periodontitis: randomized controlled trial”. Advanced Dental Journal2 (2022): 85-95.
9. Merle CL., et al. “Systematic review on protocols of coenzyme Q10 supplementation in non-surgical periodontitis therapy”. Nutrients 7 (2023): 1585.
10. Saha S., et al. “A comparative analysis of three antioxidants in addition to scaling and root planing in stage three grade B periodontitis”. Cureus1 (2024): e51916.
11. Patil KS., et al. “Efficacy of 1.5% metformin gelasan adjuvant to scaling, root planing and curettage for the treatment of infrabony defects in chronic periodontitis patients”. Contemporary Clinical Dentistry 1 (2022): 18-23.
12. Al Saadi T., et al. “Coenzyme Q10 for heart failure”. Cochrane Database of Systematic Reviews 2 (2021): CD008684.
13. Elaheh Akhavan Rasoolzadeh., et al. “The effect of coenzyme Q10 on periodontitis: a systematic review and meta-analysis of clinical trials”. Journal of Evidence-Based Dental Practice2 (2022): 101710.
14. Salman Faraed., et al. “Co-enzyme Q-10 and its effect on periodontal disease and oral cancer: a systematic review article”. Acta Scientific Medical Sciences3 (2023): 92-103.
15. Amirhossein Farahmand., et al. “Comparative assessment of Omega-3 and CoQ10 as adjuncts to periodontal therapy and total antioxidant capacity of saliva in patients with chronic periodontitis: A double-blind, randomized clinical trial”. The Saudi Dental Journal12 (2024): 1509-1514.
16. Stähli A., et al. “Effect of Coenzyme Q10 on early wound healing after recession coverage surgery with the modified coronally advanced tunnel technique and a connective tissue graft: A 6-month, triple-blinded, randomized, placebo-controlled pilot trial”. Clinical Oral Investigations 8 (2024): 424.
17. Fernandez MDS., et al. “Clinical efficacy of adjunctive use of coenzyme Q10 in non-surgical periodontal treatment: A systematic review”. European Journal of Oral Sciences 2 (2025): e70002.