*1.1.1.2.6 Cysteine*

*Gingival Disease - A Professional Approach for Treatment and Prevention*

−

periodontitis [15].

*1.1.1.2.1 Melatonin*

*1.1.1.2.2 Ceruloplasmin*

periodontitis [23].

*1.1.1.2.3 Transferrin*

*1.1.1.2.4 Lactoferrin*

*1.1.1.1.6 Mitochondrial cytochrome oxidase*

receptors in the periodontal ligament.

*1.1.1.2 Nonenzymatic antioxidants*

and detoxifies superoxide (O2

cells against the harmful effects of these radicals. This enzyme plays a role in the intracellular destruction of phagocytosed bacteria and is important for granulocyte function [14]. Gingival SOD activity was found to be higher in patients with chronic

Mitochondrial cytochrome oxidase is the last enzyme in the respiratory chain

chondrial cytochrome oxidase is a useful marker enzyme for demonstrating sensory

It is found in foods such as sour cherries, almonds, hazelnuts, chamomile tea, and St. John's wort [18]. Because it has lipophilic properties, melatonin can be found in almost all cells. It exerts its antioxidant effect by quenching hydroxyl and superoxide radicals. Melatonin shows strong antioxidant properties in the inflammatory process and oxidative injuries. Melatonin was found to be lower in gingival crevicular fluid and saliva of individuals with periodontitis compared to healthy individuals. It has also been reported to enhance bone formation [19, 20]. Melatonin is released with saliva to the oral cavity and protects the mucosa and gingival tissues from radical damage [21].

Ceruloplasmin oxidizes Fe2+ to Fe3+ to prevent the Fenton reaction and hydroxyl

Transferrin prevents the Fenton reaction by binding free iron ions [22]. There was an inverse relationship between transferrin serum levels and chronic periodontitis [24].

Lactoferrin binds to iron ions in low pH environments [25]. Lourenço et al. [26] indicated that lactoferrin (Lf) is a possible marker for periodontal diseases in

Glutathione, which eliminates the effects of harmful compounds in the body,

is found in all cells. GSH is reduced glutathione and serves as a substrate for antioxidant enzymes by acting as a radical scavenger during radical cell damage. Glutathione is a very important molecule, especially for the activities of peroxidase and reductase enzymes. GSSG is produced by the oxidation of GSH. During oxidative stress, GSH levels are decreased, and the GSSG levels are increased. H2O2 and organic hydroperoxides, which are produced during oxidative stress, are removed

by the action of glutathione peroxidase and glutathione reductase [25].

immunocompetent and immunocompromised subjects.

*1.1.1.2.5 Glutathione (GSH and GSSG)*

radical formation [22]. In CP and AgP patients, the serum ceruloplasmin level increases, especially in AgP patients, it may be a potential marker for diagnosis of

) [16]. Maeda et al. [17] have suggested that mito-

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Cysteine is a superoxide and hydroxyl radical scavenger [29]. The measurement of salivary cysteine may be useful for identifying periodontitis patients with hopeless teeth [30].

### *1.1.1.2.7 Uric acid*

Uric acid, which is synthesized as the final product of purine metabolism, functions as an endogenous free radical scavenger and antioxidant. It is found in body fluids at a concentration of approximately 0.5 mmol/L [31]. In a recent study, uric acid levels in periodontitis patients have been found to be higher than in gingivitis patients. Moreover, uric acid has many roles in periodontitis than in gingivitis as an antioxidant agent [32].

## *1.1.1.2.8 Glucose*

Glucose is a hydroxyl radical scavenger [33]. The relationship between the periodontal disease and the blood glucose level among type II diabetic patients has been demonstrated [34].
