Author, year, country | Study design, follow-up period | Sample size calculation, random allocation, examiner calibration | Participant characteristics: age range, gender, mean age, ethics approval; pre-treatment instruction | Periodontitis definition, probe used, professional who performed SRP | Covariates and dropout | Intervention (Test) | Intervention (Control) | Summary of result |
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Kunsongkeit et al., 2019 [16], Thailand | RCT-double-blind, 1 and 2 month | Yes, yes, NR | 31 uncontrolled type 2 diabetes mellitus and periodontitis patients; all participants received OHI + motivation until PI was ≤ 0.5 pre-treatment | PI, GI, SBI, PD, CAL; UNC 15-probe | Plasma vitamin C, FBS, HbA1c; no dropout | 500 mg/day vitamin C [30 days] + FMSRP | FMSRP + placebo | The periodontal parameters of PI, SBI, GI, PD, and CAL significantly improved in the treatment group and the placebo group. No significant differences were observed in periodontal parameters in treatment group and the placebo group. |
Chitsazi et al., 2017 [17], Iran | RCT, single masked; 3 and 6 month | Yes, yes, NR | 60 periodontitis patients, 23-65 years, mean age 41 years, three groups [20 pts each], all participants were given OHI to toothbrush with modified bass technique + flossing twice a day | GI, PD, CAL; UNC 15-probe; periodontist | Age, sex; no dropout | Treatment group 1, NSPT + melatonin + vitamin C, treatment group 2, and NSPT + melatonin. All groups received NSPT using ultrasonic scaler and curettage. Melatonin dose, 2 mg/day for 4 weeks, and vitamin C dose, 60 mg/day for females and 75 mg/day for males for 4 weeks | NSPT only | Significant improvement in PD and CAL scores at 6-month interval compared to 3 months in the melatonin+ vitamin C group (P < 0.05), while the differences in PD and CAL scores between the mentioned intervals were not significant between the control and melatonin groups (P > 0.05). |
Dodington et al., 2015 [18], Canada | RCT, NR; 3, 4 month | Yes, yes, yes | 98 chronic generalized periodontitis patients [PD of 4 mm or greater in at least 30% of probed sites], mean age 59 years for non-smokers, 53 years for smokers | PD, BoP, % of sites with PD > 3 mm, electronic probe, two oral hygienists | FFQ, age, sex, health condition, medication used, smoking status, beta-carotene, alpha-tocopherol, vitamin D, alpha-linolenic acid (ALA), EPA, and DHA; 31 dropout or lost to follow-up or had missing data | NSPT in non-smokers + dietary intake recording; vitamin C intake (both treatment and control): 1. 42–107 mg/day 2. 108–149 mg/day 3. 151–241 mg/day | NSPT in smokers | A dose-response relationship was observed between vitamin C [dietary and total] intake and reduction in % of sites with PD > 3 mm in people who underwent NSPT. Fruits and vegetables, beta-carotene, alpha-tocopherol, EPA, and DHA are associated with reduced PD after SRP in non-smokers, but not smokers, with chronic generalized periodontitis. |
Shimabukuro et al., 2015 [21], Japan | RCT, double-blind; 3 month | Yes, yes, yes | 300 participants [150 test, 150 control], 20–64 years | GI, GSI | Gingival redness, gingival severity index, total antioxidant activity (TAOC) of the saliva | Dentifrice containing l-ascorbic acid 2-phosphate magnesium salt [0.3%] | Dentifrice without APM | GI, gingival redness, and GSI significantly reduced in the intervention group as compared to the control group. The result suggested that dentifrice containing ascorbic acid were effective in reducing gingivitis. |
Gokhale et al., 2013 [23], India | RCT, double blinded; 14 days | NR, NR, NR | 121 participants with SBI ≥ 2, 30–60 years, four groups: 30 healthy without periodontitis, 30 healthy with periodontitis, 30 healthy with chronic gingivitis, and 30 diabetics with periodontitis | PI, PPD, SBI; periodontitis was defined based on Armitage 1999 definition; chronic gingivitis was defined based on SBI; single dentist | Plasma ascorbic acid concentration | Group1: SRP over two appointment + ascorbic acid supplementation [450 mg] as chewable tablet | SRP over two appointment + lemon flavored chewable tablet | Vitamin C supplementation as an adjunct to NSPT significantly improved the SBI in participants with gingivitis, and diabetics with periodontitis. |
Abou Sulaiman and Shehadeh, 2010 [19], Syria | RCT, single masked; 1 and 3 months | Yes, yes | 60 chronic periodontitis patients [30 treatment group and 30 control group] | PPD, CAL, BOP, GI; standard periodontal probe; single specialist; periodontist | Age, sex; total antioxidant activity (TAOC) of plasma (1 month after periodontal treatment) | Group 1: NSPT + vitamin C (dose of vitamin C, 2000 mg a day for 4 weeks); group 2: NSPT with no vitamin C | NSPT only | There were significant improvements in PPD, CAL, GI, and BOP scores at the 1-month and 3-month interval post-treatment in both the ChP1 and ChP2 groups compared to baseline measures. Vitamin C did not offer a therapeutic effect. No significant difference between group plasma levels post 1-month. |