Salivary Metabolome Shifts and Mucosal Healing Trajectories under Tailored Micronutrient Therapy for Chronic Periodontitis

Abstract

Background: Chronic periodontitis is an inflammatory condition that destroys the different tissues that make up the periodontium. A person's nutrition influences the severity of the condition. Monitoring of biochemicals in bodily fluids is a qualitative approach, and the effects of customized micronutrient supplements on the metabolome and on epithelial healing have yet to be studied.

Objective: This study focuses on the healing of the epithelium and the changes in metabolomes of patients with chronic periodontitis after customized supplementation of micronutrients.

Methods: A prospective interventional study was conducted on 60 patients with moderate-to-severe chronic periodontitis. Participants were given customized micronutrient therapy (vitamin D, vitamin C, zinc, and omega-3 fatty acids) after a nutritional assessment conducted 12 weeks prior, and baseline unstimulated saliva samples were collected. Metabolomic changes were assessed using liquid chromatography–mass spectrometry (LC-MS) analysis. Clinical measures of periodontitis, such as probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP), were recorded. Comparisons of relevant clinical parameters were performed using paired t-tests and correlation analysis. Statistical significance was established at p < 0.05.

Results: After treatment, most changes in the metabolome were positive, with fewer pro-inflammatory metabolites, such as cadaverine (−28.1%, p = 0.006), and higher concentrations of antioxidant metabolites, such as glutathione (+21.4%, p = 0.01). The study noted healing of the tissues affected by periodontitis, with the mean PD dropping from 5.2 ± 0.8 mm to 3.6 ± 0.6 mm (p < 0.001), and an improvement in CAL of 1.4 ± 0.5 mm (p < 0.001); BOP decreased by 38% (p = 0.002). A moderate positive correlation (r = 0.62, p < 0.01) was observed between changes in the metabolome and improvements in epithelial function.

Conclusion: Personalized micronutrient therapy alters salivary metabolites and improves periodontal healing. There is merit in combining personalized nutrition and salivary diagnostics for the treatment of chronic periodontitis.