Collagen peptide food supplements are already used as adjuvant treatment to reduce inflammation in cases of chronic osteoarthritis and rheumatoid arthritis, which “share common risk factors and aetiological pathways with periodontitis”, according to the authors of a new study published in Nutrients.
However, there is also widespread support for therapeutic solutions that modulate inflammation and reduce disease-promoting bacterial dysbiosis after mechanical plaque control, they write.
“This may involve the systemic or local administration of drugs that either inhibit the inflammatory response or actively promote its resolution, as well as targeted changes in the daily diet of patients or the consumption of food supplements such as probiotics or omega-3 fatty acids.”
Professional mechanical plaque control is an established approach to support oral hygiene, but a clinically relevant amount of periodontal inflammation persists after treatment that manifests in bleeding on probing (BoP) - and is associated with increased risk of disease recurrence or progression, the authors explain.
“In animal and human interventional trials, the consumption of collagen peptides high in hydroxyproline, glycine and proline resulted in improved wound healing and the remediation of impaired immune system function,” they say.
The researchers therefore studied the impact of adjuvant consumption of a commercially available collagen peptide in aftercare patients. BoP parameters (primary outcomes) and inflammation, gingival, and plaque scores measures (secondary outcomes) were assessed to determine effects.
Parameters and eligibility
The two-arm, double blind, randomised trial involved 39 chronic periodontitis patients receiving regular supportive aftercare at the Department of Periodontology at the University Hospital of Wuerzburg.
To be eligible, patients needed to have a minimum of 10 natural teeth, a history of treated chronic periodontitis followed by regular supportive periodontal aftercare, and the presence of mild to moderate chronic gingivitis.
Patients consumed a test preparation of bioactive collagen peptides (Verisol B, Gelita AG, Germany) or placebo for three months. The experimental preparations were packaged in individual sachets containing a daily dose of 5g.
BoP and periodontal inflammation were assessed at baseline and re-evaluated at study completion (Day 90), including gingival index (GI), plaque control record (PCR), gingival recession (REC) and probing pocket depth (PPD) scores.
At re-evaluation, the mean percentage of BoP sites had significantly decreased (by 3%) in the test group and periodontal inflamed surface area (PISA) scores were significantly lower, compared to baseline. Mean GI reductions were also noted in both groups.
“This demonstrates that the anti-inflammatory efficacy of adjuvant collagen peptide consumption in the control of periodontal inflammation is comparable to the benefits of the adjuvant use of antimicrobial agents reported by a recent meta-analysis,” the authors say.
Lower PCR scores indicate that the beneficial impact of collagen peptides was not primarily due to improved plaque control, but “appears to be based on a systemic immune modulation and/or the resolution of disease-promoting bacterial dysbiosis”.
They speculate this may be due to the high L-arginine content of the preparation used in the study (7.8g/100g) that promotes nitric oxide (NO) formation and ameliorates inflammatory episodes.
Results indicate improved anti-inflammatory efficacy of PMPR with supplementation, as demonstrated by fewer BoP sites, the authors conclude.
“The difference in the primary outcome was associated with significantly more pronounced improvements in the secondary outcomes of PISA and GI, corresponding to a significantly greater decrease in overall periodontal inflammatory burden.”
Future studies should, however, include a larger cohort of patients with higher inflammatory burdens, with observations over a longer period, to establish optimal dosage, they add.
Published online, October 25, 2022: http://doi.org/10.3390/nu14214473
‘Impact of a Specific Collagen Peptide Food Supplement on Periodontal Inflammation in Aftercare Patients—A Randomised Controlled Trial’
Authors: Y. Jockel-Schneider, et al.