Boron Levels, Oxidative Stress, and Inflammation in Periodontitis

Periodontitis is a chronic inflammatory disease characterized by the destruction of the tooth-supporting tissues and is associated with an imbalance between oxidative stress and antioxidant defense mechanisms. Boron is a trace element that has been suggested to have potential roles in antioxidant and inflammatory processes; however, its relationship with periodontal disease remains unclear.

This cross-sectional observational study will include 60 systemically healthy, non-smoking participants: 30 periodontally healthy individuals and 30 patients diagnosed with Stage III-IV periodontitis. Periodontal clinical parameters will be recorded for all participants.

Unstimulated saliva samples will be collected before periodontal surgical procedures. Gingival tissue samples will be obtained during clinically indicated periodontal surgical procedures, including crown-lengthening procedures in periodontally healthy participants and periodontal surgery in participants with periodontitis.

Boron levels will be determined in saliva and gingival tissue samples. Oxidative stress and antioxidant defense will be evaluated using selected biomarkers, including reactive oxygen species, total oxidant status, malondialdehyde, total antioxidant status, glutathione, superoxide dismutase, and catalase. Interleukin-1 beta will be evaluated as an inflammatory marker.

Boron levels and biochemical parameters will be compared between periodontally healthy individuals and participants with periodontitis, and their relationships with periodontal clinical parameters, oxidative stress, antioxidant defense, and inflammation will be investigated.

Inclusion criteria

• Volunteering to participate in the study and signing the informed consent form
• Being between 18 and 65 years of age
• Being systemically healthy
• No antibiotic use within the last 3 months
• No periodontal treatment within the last 6 months
• Being a non-smoker or having quit smoking at least 5 years ago
• Not being pregnant or breastfeeding
• No current use of steroids, immunosuppressive drugs, or non-steroidal anti-inflammatory drugs
• No current use of medications associated with gingival enlargement, such as calcium channel blockers, phenytoin, or cyclosporine
• No regular use of boron-containing supplements or multivitamin complexes
• For the periodontally healthy group: no clinical attachment loss, bleeding on probing <10%, probing depth ≤3 mm, no radiographic bone loss, and an indication for crown-lengthening surgery
• For the periodontitis group: diagnosis of Stage III or IV periodontitis according to the 2017 World Workshop classification and an indication for periodontal flap surgery

Exclusion criteria

• Incomplete or unreliable clinical measurements
• Insufficient saliva or gingival tissue sample for biochemical analyses
• Regular use of boron-containing oral care products within the last 3 months
• Regular consumption of boron-rich supplements or mineral waters
• Failure to comply with the study protocol