Can systemic resveratrol improve periodontal treatment outcomes in smokers?

a commentary onLucchesi, VH, Giorgetti, APO, Corrêa, MG. et al. Impact of systemic resveratrol on non-surgical periodontal treatment of smokers: A 12-month randomized clinical trial. Clin Oral Invest 2025;29:428. https://doi.org/10.1007/s00784-025-06517-9

designThis double-blind, placebo-controlled randomized clinical trial evaluated whether systemic resveratrol (500 mg/day for 180 days) improves outcomes of non-surgical periodontal therapy in smokers with Stage III or IV, Grade C periodontitis. CASE SELECTION: Thirty-eight adult smokers were recruited from a university periodontal clinic and randomly assigned to receive full-mouth ultrasonic debridement combined with either systemic resveratrol or placebo (n = 19 per group). Eligible participants had at least 20 teeth, smoked a minimum of 10 cigarettes daily for at least five years, and presented with multiple periodontal sites exhibiting probing depth (PD) and clinical attachment loss ≥5 mm; patients with recent periodontal therapy, systemic diseases, pregnancy, or recent use of antibiotics or anti-inflammatory medications were excluded. Clinical parameters, including PD, clinical attachment level (CAL), position of gingival margin (PGM), full-mouth plaque score (FMPS), and full-mouth bleeding score (FMBS), were assessed at baseline and at 3-, 6-, and 12-month follow-up, alongside microbiological and immunoinflammatory markers. DATA ANALYSIS: The primary outcome was CAL, while secondary outcomes included PD, PGM, FMPS, subgingival microbiological profiles, and inflammatory cytokine concentrations. Data distribution was assessed using exploratory and normality testing, with appropriate transformations applied where necessary. Repeated clinical measures were analyzed using restricted maximum likelihood models and generalized estimating equations, while microbiological and immunological outcomes were compared using non-parametric tests. Missing data were addressed using multiple imputation, and statistical significance was set at p < 0.05.

resultsCompared with placebo, the resveratrol group demonstrated significantly lower PD and improved CAL throughout follow-up. At 12 months, PD was 2.80 mm in the resveratrol group versus 3.02 mm in controls, while CAL was 3.87 mm versus 4.39 mm, respectively. Resveratrol was also associated with lower levels of Aggregatibacter actinomycetemcomitans, reduced IL-1β at 3 months, and reduced IL-6 at 3 and 12 months. Both groups showed substantial improvements following therapy, and no major adverse effects were reported.

conclusionsSystemic resveratrol may improve clinical, microbiological, and inflammatory outcomes when used as an adjunct to non-surgical periodontal therapy in smokers with Stage III or IV, Grade C periodontitis.