Adjunctive daily supplementation with encapsulated fruit, vegetable and berry juice powder concentrates and clinical periodontal outcomes: a double-blind RCT

Iain L C Chapple, Michael R Milward, Nicola Ling-Mountford, Paul Weston, Kevin Carter, Keeley Askey, Gerard E Dallal, Silke De Spirt, Helmut Sies, Dina Patel, John B Matthews, Iain L C Chapple, Michael R Milward, Nicola Ling-Mountford, Paul Weston, Kevin Carter, Keeley Askey, Gerard E Dallal, Silke De Spirt, Helmut Sies, Dina Patel, John B Matthews

Abstract

Aim: A double-blind randomized controlled trial to determine whether dietary supplementation with fruit/vegetable/berry juice powder concentrates, simultaneously with non-surgical periodontal therapy, improved 2-month treatment outcomes.

Methods: Volunteers with chronic periodontitis were randomly assigned to one of three groups: fruit/vegetable (FV), fruit/vegetable/berry (FVB) or placebo. Supplements were taken daily during non-surgical debridement and maintenance and outcomes assessed at 2, 5 and 8 months after completion. Primary outcomes were mean probing pocket depth (PPD), clinical attachment gain, % sites bleeding on probing (% BOP) at 2 months. Adherence and plasma β-carotene were determined.

Results: Sixty-one nutritionally replete (by serum biochemistry) volunteers enrolled and 60 (n = 20 per arm) completed the 2-month review. Clinical outcomes improved in all groups at 2 months, with additional improvement in PPD versus placebo for FV (p < 0.03). Gingival crevicular fluid volumes diminished more in supplement groups than placebo (FVB; p < 0.05) at 2 months, but not at later times. The % BOP (5 months) and cumulative plaque scores (8 months) were lowered more in the FV group (p < 0.05).

Conclusions: Adjunctive juice powder concentrates appear to improve initial pocket depth reductions in nutritionally replete patients, where plasma micronutrient bioavailability is attainable. Definitive multicentre studies in untreated and treated patients are required to ascertain the clinical significance of such changes.

Trial registration: ClinicalTrials.gov NCT00952536.

© 2011 John Wiley & Sons A/S.

Figures

Fig. 1
Fig. 1
Study flow chart.
Fig. 2
Fig. 2
Percentage change in plasma beta-carotene concentrations from baseline.
Fig. 3
Fig. 3
Changes in primary outcomes during the study period (mean ± SD). (a) Sites >4 mm deep; (b) PPD (mm); (c) CAL (mm); (d) %BOP. Bars represent comparisons with baseline. Symbols alone represent comparisons with placebo. *p < 0.0001; ▪p = 0.002; •p < 0.01; +p < 0.03; ♦p < 0.05.
Fig. 4
Fig. 4
Changes in secondary outcomes during the study period (mean ± SD). (a) Gingival crevicular fluid (GCF) volumes (μl) – shallow sites; (b) GCF volume (μl) – deep sites; (c) cumulative plaque index; (d) recession (mm); (e) Gingival redness (MGI). Bars represent comparisons with baseline. Symbols alone represent comparisons with placebo. *p < 0.0001; ‡p < 0.007; ▪p < 0.005; ≠p < 0.002; •p < 0.01; □ p < 0.02; +p < 0.03; ♦p < 0.05; $p < 0.001.

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