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height=3D"91" alt=3D"" style=3D"margin-top:-21.2pt; margin-left:196.75pt; = position:absolute" />&= #xa0; = </div>Vitamina C como modulador del estr=C3=A9s oxida= tivo periodontal: perspectivas actuales y relevancia cl=C3=ADnica. Revisi= =C3=B3n bibliogr=C3=A1fica narrativa<= span style=3D"font-family:'Times New Roman'; font-weight:bold"> </span= ><span= style=3D"font-family:'Times New Roman'; font-style:italic">Vitamin C as a = modulator of periodontal oxidative stress: current perspectives and clinica= l relevance. 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margin-= left:394.5pt; border-style:none; position:absolute" /></a> <ta= ble style=3D"width:403.75pt; margin-bottom:0pt; padding:0pt; border-collaps= e:collapse"><tr style=3D"height:3.4pt"><td style=3D"width:4pt; padding:0pt = 5.4pt; vertical-align:top">1= </td><td style=3D"width:158.45pt; padding:0pt 5.4pt; vertical-align:top= ">Lizbeth Tatiana Aguayza Rodas</td><td st= yle=3D"width:10.45pt; padding:0pt 5.4pt; vertical-align:top"><sp= an style=3D"font-family:'Times New Roman'"> </td><td style= =3D"width:187.65pt; padding:0pt 5.4pt; vertical-align:top">https://orcid.org/0000-0003-4629-9602</td>= </tr><tr style=3D"height:29.55pt"><td style=3D"width:4pt; padding:0pt 5.4pt= ; vertical-align:top"> </td><td colspan=3D"3" style=3D"width:378.15pt; paddin= g:0pt 5.4pt; vertical-align:top">Universidad de Cuenca (UCUENCA), Cuenca, Ecuador.</p= >Estudiante de pr= egrado de la Carrera de Odontolog=C3=ADa<a href=3D"mailto:tatiana.aguayza@ucuenca.edu.ec= " style=3D"text-decoration:none">tatiana.aguayza@ucuenca.edu.ec</spa= n></a> </span= ></td></tr><tr style=3D"height:3.4pt"><td style=3D"width:4pt; padding:0= pt 5.4pt; vertical-align:top">2</sp= an></td><td style=3D"width:158.45pt; padding:0pt 5.4pt; vertical-align:= top">Andrea Soledad Carvajal Endara</td><t= d style=3D"width:10.45pt; padding:0pt 5.4pt; vertical-align:top"><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAA= ABQAAAAUCAYAAACNiR0NAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA2l= JREFUOI21lEtoXVUUhr+197n3nNzbJN6omdTWRmwbikVq4iMxk0ZU2oGgA1FnQcQiUhUnFqo4cG= IRQUGd+KDY+Jp25ouiGCOxElqjhba0URPzsPQmuY9zzj1nLwcnuU1iQ0f+mzXZe///Wv/aiy1cB= V/83NNOPr/VWHunqO5OVNuNlQVjmZCGjCVhcPHR3q8XrsaVNUITu/KSlu7LFeSpNNZ+57RTjDTv= qFM1IvNiGXWJvD/9x8yXB/efizYU/Hy8/0W/aA/Xq43r1P3nOCNIFsW2XLleTd648Z/863v3nkj= WCL59dp/fWSsfzOXNkShKacvfgnMRlXjqqqIrwr5vkihyhxbT+K2ne082AAzADZXyPj+wL8ehQ1= NH700v0N35OAroutW0rxDF6rUUvddaJfdwM9HwqYFSa0GO1SrpfucUVUXEZCQcqQtZ0VEU1QTPt= mAkDygiEBTsTxq6hx65fWTOy7l0exjKgGrGcjTo2/oKS9EUZ2aPcf/Oo1iTI9UGqFJrzDF5+Sv+= Wvg+y+IEVXaGibsbOO5hGBSkbUUQdRT9zaQuBhE6Ct2MT7/D9OIIVnw6Ct3csfk52oNtTMwcBbE= 0YteeC7we4LinSI9Z03dBNUVxTdu1eI7FcBIjHvPVU1Tjv7nn5sNMXv6WSjyFiIg17AAwqpRW9f= qayNkiM0tjqDrag67mDCi0ARiB6gaTsSEEg4htusj2qGeCIr9dW0JR3PKrR2zreIDURZTrZ7NTB= YdeBPAU+cY59zxCkFlXjHiI2GY1pZbtRMkC1gZcX9hFV+lBTs98SDWexYjFGqkldT0J4EkY/Zov= Bb+klbQ/G1zDYvQntXgWFC5VJ9hSGmRLaRCnCZeqE3x34SXK9XMY8bK+BvZ8JUzGAEQV+Wy87xm= /xbwZ1lwewGmCIIhYnCZXjKvDaQNrfIzkAKXYZl11wR16omfkyHIP0RB/2CV8GrRkNldbNmKbYU= 2enC0uV6bkfUNUd8P1ury3ktQADO05UV6azx1IE/dRULDomjGSVXEFhVbrXMoncTV99smBH5ZW3= 27igzP3trY2ONCyyQ6FtbRLUw2yZ8p+FwARifyCvRDV048rcfXdoT3j5fXp1+BVxdx2um+HGnuX= 9egX4dY01U0iVK2R80nMaELy42O7R39fz/1f8C/hZ5YvjpSKGwAAAABJRU5ErkJggg=3D=3D" w= idth=3D"20" height=3D"20" alt=3D"" style=3D"margin-top:0.45pt; margin-left:= -0.3pt; position:absolute" /> </td><td style=3D"width:187.65pt; padding:0pt 5.4pt= ; vertical-align:top">https://orcid.o= rg/0000-0002-4443-6864</td></tr><tr style=3D"height:29.55pt"><td= style=3D"width:4pt; padding:0pt 5.4pt; vertical-align:top"><spa= n style=3D"font-family:'Times New Roman'"> </td><td colspan= =3D"3" style=3D"width:378.15pt; padding:0pt 5.4pt; vertical-align:top">Universidad de Cuenca= (UCUENCA), Cuenca, Ecuador.<= a href=3D"mailto:andrea.carvajal@ucuenca.edu.ec" style=3D"text-decoration:n= one">andrea.carvajal@ucuenca.edu.ec</a> </td></tr></table> </= p> </sp= an><table style=3D"width:437.15pt; margin-bottom:0pt; padding:0pt; bord= er-collapse:collapse"><tr><td colspan=3D"7" style=3D"width:151.1pt; padding= :0pt 5.4pt; vertical-align:top"> </td><td colspan=3D"2" style=3D"width:264.45pt= ; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padd= ing:0pt 5.4pt; vertical-align:top">Art=C3=ADculo de Investigaci=C3=B3n Cient= =C3=ADfica y Tecnol=C3=B3gicaEnviado: 14/04/2026 Revisado: 12/05/2026 Aceptado: 23/06/2026 </span= >Publicado: 15/= 07/2026DOI: <a href=3D"https://doi.org/10.33262/anat= omiadigital.v9i3.3715" style=3D"text-decoration:none">https://doi.= org/10.33262/anatomiadigital.v9i3.3715 </a> <a href=3D"https://doi.org/= 10.33262/anatomiadigital.v8i4.3568" style=3D"text-decoration:none"> </a></td></tr><tr style=3D"= height:3.5pt"><td colspan=3D"7" style=3D"width:151.1pt; padding:0pt 5.4pt; = vertical-align:top"> = 0;</td><td colspan=3D"2" style=3D"width:264.45pt; border-top:0.7= 5pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.4pt; v= ertical-align:top">= </td></tr><tr><td style=3D"width:52pt; border-top:0.75pt s= olid #000000; padding:0pt 5.4pt; vertical-align:top"> C=C3=ADtese: </td><td style= =3D"width:10.35pt; border-top:0.75pt solid #000000; padding:0pt 5.4pt; vert= ical-align:top">&#x= a0;</td><td colspan=3D"6" style=3D"width:337.8pt; border-top:0.7= 5pt solid #000000; padding:0pt 5.4pt; vertical-align:top"> Aguayza Rodas, L. T., & Carvajal E= ndara, A. S. (2026). Vitamina C como modulador del estr=C3=A9s oxidativo pe= riodontal: perspectivas actuales y relevancia cl=C3=ADnica. Revisi=C3=B3n b= ibliogr=C3=A1fica narrativa. Anatom=C3=ADa Digital, 9(3), 40-62. <a = href=3D"https://doi.org/10.33262/anatomiadigital.v9i3.3715" style=3D"text-d= ecoration:none">https://doi.org/10.33262/anatomiadigital.v9i3.3715</a> </td>= <td style=3D"border-top:0.75pt solid #000000; padding:0pt; vertical-align:t= op"></td></tr><tr><td style=3D"width:52pt; padding:0pt 5.4pt; vertical-alig= n:top"><img src=3D"data:image/jpeg;base64,/9j/4AAQS= kZJRgABAQEAYABgAAD/2wBDAAEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEB= AQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQH/2wBDAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQE= BAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQH/wAARCAAiAEEDASIAAhEBAx= EB/8QAHQAAAgMBAAMBAAAAAAAAAAAAAAcGCAkFAQIDBP/EAD0QAAEEAgECBAIFBg8AAAAAAAQCA= wUGAQcIAAkREhMhFDEVFiJxgQoaUWGR0zZBUlNXWHWTlZehsdHW8P/EABwBAAEEAwEAAAAAAAAA= AAAAAAgAAQMEAgUGB//EADYRAAIBAgQCBQoGAwAAAAAAAAECAwQRAAUSIQYxEzJBUXEHIjM0YXS= BkbGzNVOCobLRhMPw/9oADAMBAAIRAxEAPwDaOudw/ZPM/t483Jm1VqLoVw1PSIZAlgo8pKhNnv= 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soporte electr=C3=B3nico tiene como misi=C3=B3n contribuir a la= formaci=C3=B3n de profesional= es competentes con visi=C3=B3n human=C3=ADstica y cr=C3=ADtica que sean cap= aces de exponer sus resultados investigativos y = cient=C3=ADficos en la misma medida que se promueva mediante su intervenci= =C3=B3n cambios positivos en la sociedad. <a href=3D= "https://anatomiadigital.org" style=3D"text-decoration:none">https://anatomiadigital.org</a><span= style=3D"line-height:115%; font-family:'Times New Roman'; font-size:8pt"> = La revista es editada por la Editorial Ciencia Digital (Editorial = de prestigio registrada en la C=C3=A1mara Ecuatoriana de Libro con No de Af= iliaci=C3=B3n 663) <a href=3D"http://www.celibro.org.ec" style=3D"te= xt-decoration:none">www.celib= ro.org.ec</a> </div></td><td style=3D"padding:0p= t; vertical-align:top"></td></tr><tr style=3D"height:23.65pt"><td style=3D"= width:52pt; border-bottom:0.75pt solid #000000; padding:0pt 5.4pt; vertical= -align:top"><img 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t=3D"" style=3D"margin-top:0.15pt; margin-left:0pt; position:absolute" /></= span> </td><t= d style=3D"width:10.35pt; border-bottom:0.75pt solid #000000; padding:0pt 5= .4pt; vertical-align:top"> </td><td colspan=3D"6" style=3D"width:337.8pt; borde= r-bottom:0.75pt solid #000000; padding:0pt 5.4pt; vertical-align:top">Esta revista est=C3=A1 protegida bajo una licencia Creative Common= s Atribuci=C3=B3n-NoComercial-CompartirIgual 4.0 International. Copia de la= licencia: <a href=3D"https://creativecommons.org/licenses/by-nc-sa/= 4.0/deed.es" style=3D"text-decoration:none">https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es</s= pan></a> </td><td style=3D"padding:0pt; vertical-align:top">= </td></tr><tr><td colspan=3D"4" style=3D"width:101.1pt; padding:0pt 5.4pt; = vertical-align:top">P= alabras claves: Vitamina C, = estr=C3=A9s oxidativo, enfermedad periodontal, periodontitis, antioxidantes= .</td><td colspan=3D"2" style=3D"width:0.7pt; padding:0pt 5.4pt;= vertical-align:top"> </td><td colspan=3D"2" style=3D"width:298.35pt; border-t= op:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.= 4pt; vertical-align:top">ResumenIntroducci=C3=B3n:<= /span> la periodontitis es mu= ltifactorial y se manifiesta por la destrucci=C3=B3n progresiva de los teji= dos de soporte dental. Su desarrollo se ha asociado con el aumento del estr= =C3=A9s oxidativo, que resulta del desequilibrio entre la producci=C3=B3n d= e especies reactivas de ox=C3=ADgeno y los antioxidantes. La vitamina C par= ticipa en la s=C3=ADntesis del col=C3=A1geno, en la respuesta del sistema i= nmunol=C3=B3gico, neutraliza y elimina radicales libres, lo que podr=C3=ADa= influir sobre la salud periodontal. Objetivo: analizar la= relaci=C3=B3n entre la vitamina C y el estr=C3=A9s oxidativo con la period= ontitis. Metodolog=C3=ADa:= se realiz=C3=B3 una revisi=C3=B3n bibliogr=C3=A1fica exploratoria de la li= teratura cient=C3=ADfica publicada entre 2020 y 2026, utilizando bases de d= atos como PubMed, Scopus, ScienceDirect y Google Acad=C3=A9mico. Se incorpo= r=C3=B3 investigaciones en humanos que analizaron la relaci=C3=B3n entre la= vitamina C, el estr=C3=A9s oxidativo y la salud periodontal. Despu=C3=A9s = de aplicar los criterios de inclusi=C3=B3n y exclusi=C3=B3n se finaliz=C3= =B3 con un total de 10 estudios para su an=C3=A1lisis. Resultados:<spa= n style=3D"font-family:'Times New Roman'"> la revisi=C3=B3n de los estudios= indic=C3=B3 que los pacientes con enfermedades periodontales presentan cam= bios en los biomarcadores vinculados al estr=C3=A9s oxidativo y, en algunos= casos, niveles reducidos de vitamina C comparados con aquellos con salud p= eriodontal. Adem=C3=A1s, la ingesta de vitamina C mostr=C3=B3 un impacto po= sitivo en ciertos biomarcadores inflamatorios y antioxidantes, sin embargo,= los resultados cl=C3=ADnicos en cuanto a la disminuci=C3=B3n de la profund= idad de sondaje y la mejora de inserci=C3=B3n cl=C3=ADnica variaron entre l= os estudios. Conclusiones:= se identific=C3=B3 una relaci=C3=B3n entre la vitamina C, el estr=C3=A9s o= xidativo y el estado periodontal. A pesar de que la vitamina C tiene propie= dades antioxidantes y podr=C3=ADa servir como coadyuvante en el tratamiento= periodontal, la evidencia cl=C3=ADnica es variada, lo que indica la necesi= dad de investigaciones con m=C3=A9todos estandarizados y un seguimiento pro= longado para establecer de manera m=C3=A1s precisa su efecto terap=C3=A9uti= co. = =C3=81rea de estudio general: Odontolog=C3=ADa. =C3=81rea de estudio espec=C3=ADfica: Periodoncia. Ti= po de estudio: Revisi=C3=B3n bibliogr=C3=A1fica narrativa.</td><td style=3D"paddin= g:0pt; vertical-align:top"></td></tr><tr style=3D"height:28.2pt"><td colspa= n=3D"3" style=3D"width:98.85pt; padding:0pt 5.4pt; vertical-align:top">Keywo= rds: Vitamin C, oxidative st= ress, periodontal disease, periodontitis, antioxidants.</td><td = colspan=3D"2" style=3D"width:1pt; padding:0pt 5.4pt; vertical-align:top"><p= style=3D"margin-bottom:0pt; text-align:justify; line-height:115%; font-siz= e:12pt"> </td= ><td colspan=3D"3" style=3D"width:300.3pt; border-top:0.75pt solid #000000;= border-bottom:0.75pt solid #000000; padding:0pt 5.4pt; vertical-align:top"= >AbstractIntroduction. Periodontal disease is a multifactorial conditio= n characterized by the progressive destruction of the tooth-supporting tiss= ues. Its development has been associated with increased oxidative stress, r= esulting from an imbalance between the production of reactive oxygen specie= s and antioxidants. Vitamin C plays a role in collagen synthesis, immune re= sponse, and the neutralization of free radicals, which may influence period= ontal health. Objective. T= o analyze the relationship between vitamin C, oxidative stress, and periodo= ntal disease. Methodology.= An exploratory literature review of scientific publications published betw= een 2020 and 2026 was conducted using the PubMed, Scopus, ScienceDirect, an= d Google Scholar databases. Studies in humans analyzed the relationship bet= ween vitamin C, oxidative stress, and periodontal disease were included. Af= ter applying the inclusion and exclusion criteria, a total of 10 studies we= re selected for analysis. Results. The reviewed studies indicated that patients with periodontal dise= ase exhibit alterations in biomarkers associated with oxidative stress and,= in some cases, lower levels of vitamin C compared with periodontally healt= hy individuals. Furthermore, vitamin C intake showed positive effects on ce= rtain inflammatory and antioxidant biomarkers. However, clinical outcomes r= egarding reductions in probing depth and improvements in clinical attachmen= t levels varied among the studies. Conclusion. The relationship between vitamin C, oxidative stress, = and periodontal disease was identified. Although vitamin C possesses antiox= idant properties and may serve as an adjunct in periodontal treatment, the = available clinical evidence remains variable, highlighting the need for stu= dies with standardized methodologies and longer follow-up periods to more a= ccurately determine its therapeutic effect. General Area of Study: <span= style=3D"font-family:'Times New Roman'">Dentistry. Specific area of study: </s= pan>Periodontology. <s= pan style=3D"font-family:'Times New Roman'; font-weight:bold; background-co= lor:#ffffff">Type of study: Narrative bibliographic review. </td><td style=3D"paddi= ng:0pt; vertical-align:top"></td></tr><tr style=3D"height:0pt"><td style=3D= "width:62.8pt"></td><td style=3D"width:21.15pt"></td><td style=3D"width:25.= 7pt"></td><td style=3D"width:2.25pt"></td><td style=3D"width:9.55pt"></td><= td style=3D"width:1.95pt"></td><td style=3D"width:38.5pt"></td><td style=3D= "width:270.65pt"></td><td style=3D"width:4.6pt"></td></tr></table> </= p>1. = 0; Introducci=C3=B3nLas enfermedades periodontales, gingivit= is y periodontitis, son condiciones multifactoriales e inmunoinflamatorias = que afectan los tejidos blandos y duros del complejo periodontal, respectiv= amente (1). La respuesta inflamatoria ante la presencia de la biopel=C3=ADc= ula dental puede provocar la destrucci=C3=B3n tisular, induciendo as=C3=AD = un ciclo continuo de retroalimentaci=C3=B3n positiva de prote=C3=B3lisis, i= nflamaci=C3=B3n y enriquecimiento de pat=C3=B3genos periodontales (2). </sp= an>La periodont= itis severa, puede ocasionar p=C3=A9rdida dental presentando alteraciones f= uncionales que afectan negativamente la calidad de vida de las personas; en= Am=C3=A9rica Latina y el Caribe la prevalencia de periodontitis en poblaci= =C3=B3n adulta var=C3=ADa entre el 11,6% y el 99,9%, dependiendo de los gru= pos etarios. Esta extensa variabilidad refleja una alta carga de la enferme= dad y representa un verdadero desaf=C3=ADo para la salud p=C3=BAblica. Por = ende, resulta necesario identificar factores asociados con su prevenci=C3= =B3n y progresi=C3=B3n. La complejidad= de las enfermedades periodontales no solo radica en los microorganismos pe= riodontopat=C3=B3genos, sino que el hu=C3=A9sped tenga la capacidad de reac= cionar ante estos est=C3=ADmulos. Conforme a ello, actualmente existe inter= =C3=A9s por entender los procesos biol=C3=B3gicos que pueden afectar el gra= do de susceptibilidad y desarrollo de la enfermedad (3).El estr=C3=A9s oxidativo es= un desequilibrio producido cuando los oxidantes superan los antioxidantes = del organismo, provocando da=C3=B1o tisular con la liberaci=C3=B3n de radic= ales libres; estos =C3=BAltimos, son mol=C3=A9culas altamente reactivas por= la presencia de electrones desapareados en su capa m=C3=A1s externa, permi= ti=C3=A9ndoles interactuar y alterar estructuras celulares (4). Los radical= es libres, junto a otras mol=C3=A9culas oxidantes, se agrupan bajo el t=C3= =A9rmino de especies reactivas, las cuales pueden ser derivados del ox=C3= =ADgeno, nitr=C3=B3geno y otros elementos (5). Estas mol=C3=A9culas se desarrollan = en condiciones fisiol=C3=B3gicas, as=C3=AD como, como patol=C3=B3gicas; por= ende, para atenuar su efecto a nivel biol=C3=B3gico, las c=C3=A9lulas han = desarrollado sistemas antioxidantes, tanto enzim=C3=A1ticos como no enzim= =C3=A1ticos, que ayudan a neutralizar las especies reactivas y mantener el = equilibrio redox de la c=C3=A9lula (6). Una de las fuentes celulares m=C3= =A1s relevantes para las especies reactivas de ox=C3=ADgeno (ROS), por ejem= plo, es la respiraci=C3=B3n mitocondrial (6). El equilibrio entre la producci=C3=B3n de especies reactivas y los = sistemas antioxidantes es importante para mantener la homeostasis celular y= la integridad de los tejidos; cuando este equilibrio se altera, pueden pro= ducirse procesos relacionados con el da=C3=B1o celular y la inflamaci=C3=B3= n. Por esta raz=C3=B3n, los sistemas antioxidantes han adquirido importanci= a en el estudio del estr=C3=A9s oxidativo y sus efectos a nivel biol=C3=B3g= ico (6). La vitamina C o =C3=A1cido asc=C3=B3rbico, es una vitamina hidrosoluble co= n funciones bien establecidas en diversos procesos fisiol=C3=B3gicos; adem= =C3=A1s de su reconocida funci=C3=B3n como antioxidante y cofactor en la s= =C3=ADntesis de col=C3=A1geno, la vitamina C ha despertado inter=C3=A9s por= sus propiedades inmunomoduladoras y sus potenciales beneficios terap=C3=A9= uticos en enfermedades del sistema inmunitario (7). Tiene efectos directos<= /span> sobre las = c=C3=A9lulas inmunitarias, ya = que desempe=C3=B1a = 0; un papel crucial</sp= an> en = la regulaci=C3=B3n de= la producci=C3=B3n y <spa= n style=3D"font-family:'Times New Roman'">la actividad = de las citocinas,</sp= an> mediadores clave </= span>de la = 0; inflamaci=C3=B3n</s= pan> y l= as respuestas inmunitarias; puede adem=C3=A1s modular <= /span>el equilibrio entre</spa= n> las citocinas </spa= n>proinflamatorias<spa= n style=3D"font-family:'Times New Roman'"> y antiinfla= matorias, </span= >contribuyendo as=C3=AD, a</sp= an> una respuesta </spa= n>inmunitaria equilibrada; siendo que, al suprimir&#= xa0; la producci=C3=B3n de <span= style=3D"font-family:'Times New Roman'">citocinas proinflamatorias, como</s= pan> la = interleucina 6 <= /span>(IL6) y&= #xa0; el factor de</spa= n> necrosis tumoral </= span>alfa (TNF=CE=B1), y</sp= an> al = mismo <sp= an style=3D"font-family:'Times New Roman'">tiempo promover&#= xa0; la s=C3=ADntesis d= e citocinas antiinflamatorias, como la = interleucina 10 (IL 10), la vitamina</= span> C = puede <sp= an style=3D"font-family:'Times New Roman'">ayudar a </= span>mitigar la inflamaci=C3= =B3n <spa= n style=3D"font-family:'Times New Roman'">excesiva y <= /span>el da=C3=B1o tisular (8)= .Por otr= a parte, sus propiedades antioxidantes le permiten eliminar las especies re= activas de ox=C3=ADgeno (ROS)<s= pan style=3D"font-family:'Times New Roman'"> y neutral= izar los radicales libres, reduciendo<= /span> as=C3=AD el estr=C3=A9s oxidativo y li= mitando la inflamaci=C3=B3n. Al mantener el equilibrio, la vitamina C puede= ayudar a proteger las c=C3=A9lulas del da=C3=B1o oxidativo y modular y las= v=C3=ADas de se=C3=B1alizaci=C3=B3n inflamatoria (7)(8). De esta manera, l= a vitamina C contribuye a proteger las c=C3=A9lulas frente al da=C3=B1o oxi= dativo y favorece el mantenimiento de la homeostasis tisular. <p= style=3D"margin-bottom:0pt; text-align:justify; line-height:115%; font-siz= e:12pt">La vitamina C es un m= icronutriente esencial para la salud periodontal, al participar en tres fun= ciones indispensables: s=C3=ADntesis y maduraci=C3=B3n del col=C3=A1geno, m= odulaci=C3=B3n del sistema inmunol=C3=B3gico e inflamatorio y un potente an= tioxidante frente al estr=C3=A9s oxidativo (9). El periodonto depende en gr= an medida del col=C3=A1geno, puesto que constituye un componente fundamenta= l en la matriz extracelular periodontal, la enc=C3=ADa, cemento radicular y= hueso alveolar (10). La vitamina C se caracteriza por ser un cofactor de l= as hidroxilasas de prolina y lisina, enzimas necesarias para formar col=C3= =A1geno tipo I y III; su deficiencia genera escorbuto, afectando los tejido= s gingivales por alteraci=C3=B3n de la s=C3=ADntesis de col=C3=A1geno y oca= sionando sangrado gingival espont=C3=A1neo y ulceraci=C3=B3n de la mucosa o= ral (10).En cuanto a la modulaci=C3=B3n inmunol=C3=B3gica, la quimiotaxis y fagocit= osis de neutr=C3=B3filos; mejora la funci=C3=B3n fagoc=C3=ADtica de los mac= r=C3=B3fagos y fortalece la l=C3=ADnea de defensa inmunitaria de los linfoc= itos T, finalmente la vitamina C act=C3=BAa como antioxidante primario fren= te al estr=C3=A9s oxidativo, neutralizando Especies Reactivas de Ox=C3= =ADgeno (ROS) evitando= da=C3=B1os en el ADN y membranas celulares. Esto favorece a disminuir la i= nflamaci=C3=B3n evitando que la enfermedad periodontal progrese (11).</span= > Por lo tanto, estas funciones han despertad= o un creciente inter=C3=A9s cient=C3=ADfico sobre el posible papel de la vi= tamina C en la prevenci=C3=B3n y control de las enfermedades periodontales.= Aunque las enfermedades= periodontales han sido ampliamente estudiadas, todav=C3=ADa existe inter= =C3=A9s por comprender los factores que influyen en su desarrollo y severid= ad. <span= style=3D"font-family:'Times New Roman'">En este contexto, la vitamina C ha= generado inter=C3=A9s por sus caracter=C3=ADsticas inmunomoduladoras, anti= oxidantes y su papel fundamental en la s=C3=ADntesis de col=C3=A1geno. De l= a misma manera, se ha reconocido el estr=C3=A9s oxidativo como un mecanismo= vinculado con el da=C3=B1o tisular periodontal y progresi=C3=B3n de la enf= ermedad. No obstante, la evidencia disponible presenta resultados variables= sobre esta relaci=C3=B3n entre la vitamina C, el estr=C3=A9s oxidativo y l= as enfermedades periodontales, as=C3=AD como sobre el posible beneficio en = la suplementaci=C3=B3n como coadyuvante terap=C3=A9utico. Por ello, surge e= l inter=C3=A9s de integrar y analizar la literatura disponible para compren= der la participaci=C3=B3n de estos factores en la salud periodontal y su po= sible aplicaci=C3=B3n dentro de estrategias preventivas y terap=C3=A9uticas= en periodoncia.Por lo tanto, el objetivo de esta revisi=C3=B3n bibliogr=C3=A1fica= fue analizar la relaci=C3=B3n entre la vitamina C y estr=C3=A9s oxidativo = con la periodontitis.2= . Metodolog=C3=ADa<= /span>La siguie= nte revisi=C3=B3n bibliogr=C3=A1fica narrativa fue desarrollada bajo los li= neamientos de la declaraci=C3=B3n PRISMA (Preferred= Reporting Items for Systematic Reviews and Meta-Analyses), con el prop=C3=B3sito de identificar,= analizar y sintetizar la evidencia cient=C3=ADfica disponible sobre la rel= aci=C3=B3n entre la vitamina C, el estr=C3=A9s oxidativo y la periodontitis= . Se rea= liz=C3=B3 una b=C3=BAsqueda electr=C3=B3nica en las bases de datos PubMed, = Science Direct, Scopus y Google Acad=C3=A9mico. Los t=C3=A9rminos se relaci= onaron con la vitamina C, estr=C3=A9s oxidativo y periodontitis. La estrate= gia incluy=C3=B3 los siguientes t=C3=A9rminos y operadores booleanos: (vita= min C OR =E2=80=9Cascorbic acid=E2=80=9D) AND (=E2=80=9Coxidative stress=E2= =80=9D) AND (=E2=80=9Cperiodontal disease=E2=80=9D OR periodontitis OR "period= ontal diseases"). Los = t=C3=A9rminos descriptores MeSH utilizados para PubMed fueron: <span= style=3D"font-family:'Times New Roman'; font-style:italic">("Periodontitis= "[MeSH] OR "Periodontal Diseases"[MeSH]) AND ("Oxidative Stress" [MeSH] OR = antioxidants) AND ("Ascorbic Acid" [MeSH] OR "Vitamin C"). Para reducir sesgos y excluir factores= se utilizaron los operadores booleanos NOT (diabetes OR c=C3=A1ncer </span= >OR =E2=80= =9Ccardiovascular disease=E2=80=9D OR pregnancy OR obesity OR smoking OR to= bacco OR =E2=80=9Csystemic disease=E2=80=9D). Se incluyeron publicaciones en idioma ingl=C3=A9s publicada= s entre 2020 y 2026, que se llevaron a cabo en adultos humanos y examinaron= biomarcadores de estr=C3=A9s oxidativo y/o vitamina C en relaci=C3=B3n con= las enfermedades periodontales. Se tomaron en consideraci=C3=B3n metaan=C3= =A1lisis, revisiones sistem=C3=A1ticas, ensayos cl=C3=ADnicos controlados y= estudios observacionales. Se eliminaron los estudios que se llevaron a cab= o en pacientes con enfermedades sist=C3=A9micas o condiciones que podr=C3= =ADan modificar los resultados como el embarazo, diabetes mellitus o tabaqu= ismo; as=C3=AD como publicaciones en otros idiomas e investigaci=C3=B3n in = vitro. L= a selecci=C3=B3n de los estudios se efectu=C3=B3 en dos fases: revisi=C3=B3= n de t=C3=ADtulos y res=C3=BAmenes seguida de una lectura completa de los a= rt=C3=ADculos potencialmente elegibles. Inicialmente se identificaron 81 ar= t=C3=ADculos, procedentes de la base de datos seleccionadas, se procedi=C3= =B3 a eliminar los 15 art=C3=ADculos duplicados, se excluyeron art=C3=ADcul= os no compatibles con el tema de investigaci=C3=B3n 36. Posteriormente, los= art=C3=ADculos seleccionados fueron analizados a texto completo para verif= icar el cumplimiento de los criterios de inclusi=C3=B3n y exclusi=C3=B3n. C= omo resultado de este proceso se incluyeron 10 art=C3=ADculos en la s=C3=AD= ntesis cualitativa final, los cuales sirvieron de base para el an=C3=A1lisi= s de la relaci=C3=B3n entre la vitamina C, estr=C3=A9s oxidativo y la perio= dontitis. La informaci=C3=B3n fue organizada en una matriz elaborada en Microsoft E= xcel. Se registraron autor, a=C3=B1o de publicaci=C3=B3n, variables de estu= dio, dise=C3=B1o metodol=C3=B3gico, tama=C3=B1o de muestra, caracter=C3=ADs= ticas de poblaci=C3=B3n, biomarcadores evaluados, niveles de vitamina C, pa= r=C3=A1metros periodontales y resultados. No se requiri=C3=B3 aprobaci=C3=B3n de u= n comit=C3=A9 de =C3=A9tica ni consentimiento informado debido a que se fun= dament=C3=B3 exclusivamente en la revisi=C3=B3n de literatura cient=C3=ADfi= ca previamente publicada. Sin embargo, se respetaron los principios de inte= gridad cient=C3=ADfica y adecuada citaci=C3=B3n de las fuentes consultadas.= El proceso de selecci=C3=B3n de estudios se resume en la <a href=3D= "#fig1" style=3D"text-decoration:none">Figura 1</a>= . <img src=3D"data:im= age/png;base64,iVBORw0KGgoAAAANSUhEUgAAAMgAAACACAYAAABOUyafAAAABHNCSVQICAgI= fAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAErNJREFUeJztnXu0HVV9xz83D29CTGIeEAgxvWK= ighKLBS3hYUBjqNTYqFEsCEakilgXYKWNBLXtqo/6WBhjsEDxhU1qCk2rXS5qDfRhi8KyNFUaoX= WlLJRiSQVplwTR2z++e5h99t2zzzzOnHtuzu+z1l13zuw9sx8zv9mv7/xmBBjHMIwYIzOyjUnNh= mEMFk82GtMmMxeGMeiYgRhGAjMQw0hgBmIYCcxADCOBGYhhJDADMYwEZiCGkcAMxDASmIEYRgIz= EMNIYAZiGAnMQAwjgRmIYSQwAzGMBFUN5P1IKz/utn2ucvuP7EG+/HMu936PAG8Bvg38AfDeILz= X6QEcC1wDzKxwjl7XQ8ibgXNqHvtWlL9n9S47XRkB7gZ29THNnlH1jcK3uL8Yu2l2Y7y0S/gvAu= 8CFgOfAw5vkFZZ1gFzKx7TtB5Cwnp5XcPzXUt/DQTgaKaOgWSNQM+7WD9pcOxc4G1d4jwT2A88B= JwP/HeD9MpyC/BoxWOa1ENIrF7+tOE5H2t4fB0en4Q0G9MLAzkD+DtgGzA9CFsP3AbsJH+CfAs4= 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cwB9Z4cQ/NZcLk2EAvAAPAAPwAPwWx9+4y6hm5659I/MCPuXJkwjef8vdoX5swEe++Fc5atGeLD= +A6JqiOU0u5EEAAAAAElFTkSuQmCC" width=3D"31" height=3D"83" alt=3D"" style=3D= "margin-top:-16.54pt; margin-left:10.55pt; position:absolute" /><spa= n style=3D"font-family:'Times New Roman'"> <= p style=3D"margin-top:12pt; margin-bottom:10pt; text-align:center; line-hei= ght:115%; font-size:10pt"><a id=3D"fig1">Figura 1. Diagrama de flujo PRISMA para la selecci=C3=B3n de estudios = incluidos en la revisi=C3=B3n bibliogr=C3=A1fica</a>3. &= #xa0; Resultados Las investigaciones evaluaron la relaci=C3= =B3n entre vitamina C, estr=C3=A9s oxidativo y enfermedad periodontal media= nte diferentes dise=C3=B1os y procesos metodol=C3=B3gicos, como ensayos cl= =C3=ADnicos aleatorizados, estudios transversales, estudios de casos y cont= roles, revisiones sistem=C3=A1ticas y metaan=C3=A1lisis. Las poblaciones es= tudiadas incluyeron pacientes periodontalmente sanos, con gingivitis y peri= odontitis. La evaluaci=C3=B3n cl=C3=ADnica periodontal se realiz=C3=B3 prin= cipalmente mediante Profundidad de Sondaje (PD), Nivel de Inserci=C3=B3n Cl=C3=ADnica (= CAL), Sangrado al= Sondaje (BOP), </span= >= =C3=8Dndice de Placa (PI), =C3=8Dndice Gingival (GI), recesi=C3=B3n gingival, p=C3=A9rdida =C3=B3sea alveolar y se= veridad de la periodontitis.Los biomarcadores antioxidantes e inflamatorios fueron = evaluados en saliva, Fluido Crevicular Gingival (GCF), suero y plasma sangu=C3=ADneo mediant= e ensayos ELISA, pruebas de capacidad antioxidante total, m=C3=A9todos colo= rim=C3=A9tricos y an=C3=A1lisis espectrofotom=C3=A9tricos. Algunos estudios= analizaron la suplementaci=C3=B3n sist=C3=A9mica o aplicaci=C3=B3n local d= e vitamina C como terapia periodontal coadyuvante no quir=C3=BArgica, combi= n=C3=A1ndola con Fibrina Rica en Plaquetas (PRF), antioxidantes complementarios o enjuagues = bucales. De la misma forma, se observ=C3=B3 heterogeneidad en los m=C3=A9to= dos de evaluaci=C3=B3n, biomarcadores analizados y tiempos de seguimiento c= l=C3=ADnico entre las investigaciones seleccionadas. 3.1. Asociaci=C3=B3n entre niveles de vitamina C y severi= dad periodontalLos estudios reportan que los pacientes con periodontitis presentar= on menores concentraciones de vitamina C en comparaci=C3=B3n con individuos= periodontalmente sanos (2)(12). La disminuci=C3=B3n de vitamina C fue iden= tificada en saliva, suero sangu=C3=ADneo y fluido crevicular gingival (2)(1= 2). Hashim et al. (2) observaron diferencias significativas entre las conce= ntraciones de vitamina C en saliva y GCF 3,16 =CE=BCg/mL y 4,55 =CE=BCg/mL,= respectivamente; (p =3D = 0,022), mientras que Assaf & Rabi (12) reportaron niveles s=C3=A9ricos = significativamente menores de vitamina C en pacientes con periodontitis est= adio IV en comparaci=C3=B3n con estadios menos avanzados (p < 0,05), sugiriendo una relaci=C3=B3n= entre la deficiencia de vitamina C y la progresi=C3=B3n de la enfermedad p= eriodontal (12). Por lo tanto, los hallazgos identificaron una relaci=C3=B3= n inversa entre los niveles de vitamina C y la gravedad de la enfermedad pe= riodontal (2)(12), como se muestra en la <a href=3D"#tabla1" style=3D"te= xt-decoration:none">Tabla 1</= span></a>.<= a id=3D"tabla1">Tabla 1. <= span style=3D"font-family:'Times New Roman'; font-style:italic">Asociaci=C3= =B3n entre deficiencia de vitamina C y enfermedad periodontal</a></p= ><table style=3D"width:101.36%; margin-bottom:0pt; padding:0pt; border-coll= apse:collapse"><tr style=3D"height:32.85pt"><td style=3D"width:8.72%; borde= r-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt= 5.75pt; vertical-align:top">Autor/ A=C3=B1o</td><td style=3D"width:15.98%; border-to= p:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.7= 5pt; vertical-align:top">Estudio y muestra</td><td style=3D"width:12.58%; border-top:= 0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75p= t; vertical-align:top">Condici=C3=B3n periodontal evaluada</td><td style=3D"width:11.= 1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; pa= dding:0pt 5.75pt; vertical-align:top">Tipo de evaluaci=C3=B3n de vitamina C</td><td s= tyle=3D"width:13.12%; border-top:0.75pt solid #000000; border-bottom:0.75pt= solid #000000; padding:0pt 5.75pt; vertical-align:top">Par=C3=A1metros periodontales evaluados<= /span></td><td style=3D"width:8.96%; border-top:0.75pt solid #000000; b= order-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">= Variable</= td><td style=3D"width:14.42%; border-top:0.75pt solid #000000; border-botto= m:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top"><sp= an style=3D"font-family:'Times New Roman'">Resultados</td><td st= yle=3D"width:15.14%; border-top:0.75pt solid #000000; border-bottom:0.75pt = solid #000000; padding:0pt 5.75pt; vertical-align:top">Hallazgo</td></tr><tr style= =3D"height:13.3pt"><td style=3D"width:8.72%; border-top:0.75pt solid #00000= 0; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:t= op"><span= style=3D"font-family:'Times New Roman'">Hashim et al. (2025)(2)</td><td style=3D"width:15= .98%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; = padding:0pt 5.75pt; vertical-align:top">= Estudio transversal; n=3D43 participantes distribuidos en periodontalmente = sanos (n=3D13), grupo periodontitis leve (n=3D9), grupo con </td= ><td style=3D"width:12.58%; border-top:0.75pt solid #000000; border-bottom:= 0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">Salud periodontal / Periodontitis</td><td = style=3D"width:11.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt= solid #000000; padding:0pt 5.75pt; vertical-align:top">Salival y GCF</td><td style=3D"width:13.12%; bor= der-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0= pt 5.75pt; vertical-align:top">PD, CAL, = BOP, Vitamina C salival y GCF</td><td style=3D"width:8.96%; bord= er-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0p= t 5.75pt; vertical-align:top"> </sp= an></td><td style=3D"width:14.42%; border-top:0.75pt solid #000000; bor= der-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top"><p= style=3D"margin-bottom:0pt; line-height:115%; font-size:9pt">Vitamina C en GCF: 4,55 =C2=B5g/mL vs sa= liva: 3,16 =C2=B5g/mL (p=3D0,022). En saliva, las medianas de vitamina C fu= eron 4,7172; </td><td style=3D"width:15.14%; border-top:0.75pt s= olid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; verti= cal-align:top">Los niveles salivales mos= traron diferencias significativas seg=C3=BAn la severidad periodontal (</sp= an>p</span= >=3D0,000136), mientras que l= os niveles de </td></tr></table> Tabla 1. Asociaci=C3=B3n entre deficiencia de vitamina C y enfermedad periodonta= l (continuaci=C3=B3n)<table style=3D"width:100%; margin-bottom:0= pt; padding:0pt; border-collapse:collapse"><tr style=3D"height:34.55pt"><td= style=3D"width:8.44%; border-top:0.75pt solid #000000; border-bottom:0.75p= t solid #000000; padding:0pt 5.75pt; vertical-align:top">Autor/ A=C3=B1o</td><td style=3D"width:15.6%;= border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; paddi= ng:0pt 5.75pt; vertical-align:top">Estud= io y muestra</td><td style=3D"width:12.12%; border-top:0.75pt so= lid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertic= al-align:top">Condici=C3=B3n periodontal= evaluada</td><td style=3D"width:10.68%; border-top:0.75pt solid= #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-= align:top">= Tipo de evaluaci=C3=B3n de vi= tamina C</td><td style=3D"width:12.62%; border-top:0.75pt solid = #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-a= lign:top"><= span style=3D"font-family:'Times New Roman'">Par=C3=A1metros periodontales = evaluados</td><td style=3D"width:9.56%; border-top:0.75pt solid = #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-a= lign:top"><= span style=3D"font-family:'Times New Roman'">Variable</td><td st= yle=3D"width:14.68%; border-top:0.75pt solid #000000; border-bottom:0.75pt = solid #000000; padding:0pt 5.75pt; vertical-align:top">Resultados</td><td style=3D"width:16.3%; border-t= op:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.= 75pt; vertical-align:top">Hallazgo</span= ></td></tr><tr style=3D"height:110.15pt"><td style=3D"width:8.44%; bord= er-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0p= t 5.75pt; vertical-align:top"> </= span></td><td style=3D"width:15.6%; border-top:0.75pt solid #000000; bo= rder-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top"><= p style=3D"margin-bottom:0pt; line-height:115%; font-size:9pt">periodontitis moderada (n=3D12) y grupo = con periodontitis severa (n=3D9)</td><td style=3D"width:12.12%; = border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; paddin= g:0pt 5.75pt; vertical-align:top"> = </td><td style=3D"width:10.68%; border-top:0.75pt solid #000000;= border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top= "> </td><td style=3D"wid= th:12.62%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000= 000; padding:0pt 5.75pt; vertical-align:top"> </td><td style=3D"width:9.56%; border-top:0.75pt soli= d #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical= -align:top"> </td><td st= yle=3D"width:14.68%; border-top:0.75pt solid #000000; border-bottom:0.75pt = solid #000000; padding:0pt 5.75pt; vertical-align:top">0,8743; 2,0600 y 3,4907 para los grupos sano, periodontitis = leve, moderada y severa, respectivamente (p=3D0,000136). En GCF, las medianas fueron 4,9625; 4,4719;= 0,3270 y 4,9625, respectivamente (p=3D0,062)</td><td style=3D"width:16.3%; border-top:0.= 75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt;= vertical-align:top">vitamina C en GCF n= o mostraron diferencias significativas (p =3D0,062)</td></tr><tr style=3D"height:110.15pt= "><td style=3D"width:8.44%; border-top:0.75pt solid #000000; border-bottom:= 0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">Assaf & Rabi et at. (2022)(12)</td><td style=3D"width:15.6%; = border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; paddin= g:0pt 5.75pt; vertical-align:top">Estudi= o transversal: n=3D25 pacientes con periodontitis distribuidos en pacientes= con periodontitis estadio II (n=3D2), periodontitis estadio III (n=3D11) y= grupo con periodontitis estadio IV (n=3D12)</td><td style=3D"wi= dth:12.12%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #00= 0000; padding:0pt 5.75pt; vertical-align:top">Periodontitis estadio IV / controles</td><td style=3D"widt= h:10.68%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #0000= 00; padding:0pt 5.75pt; vertical-align:top">S=C3=A9rica </td><td style=3D"width:12.62%; border-top:0.75p= t solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; ve= rtical-align:top">PD, CAL y vitamina C s= =C3=A9rica</td><td style=3D"width:9.56%; border-top:0.75pt solid= #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-= align:top">= Vitamina C s=C3=A9rica= </td><td style=3D"width:14.68%; border-top:0.75pt solid #000000; border= -bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">Estadio II: no se registr=C3=B3 deficiencia d= e Vit C. En el estadio III se identificaron 5 pacientes con deficiencia de = Vit C, mientras que en el estadio IV se registraron 5 pacientes con deficie= ncia de Vit C. </td><td style=3D"width:16.3%; border-top:0.75pt = solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vert= ical-align:top">Los pacientes con period= ontitis estadio IV presentaron niveles s=C3=A9ricos significativamente meno= res de vitamina C en comparaci=C3=B3n con los estadios menos avanzados (</s= pan>p </sp= an><0,05). </td></tr></table>Nota: elaboraci=C3=B3n a partir de los estudios in= cluidos en la revisi=C3=B3n (2)(12). Abreviaturas: PD: profundidad de sonda= je; CAL: nivel de inserci=C3=B3n cl=C3=ADnica; BOP: sangrado al sondaje; GC= F: fluido crevicular; Vit C: vitamina C; =C2=B5g/mL: microgramos por milili= tro; p: valor de signific= ancia estad=C3=ADstica; n: n=C3=BAmero de participantes; vs: comparado con.= </s= pan>3.2. Efecto terap=C3=A9utico de la vit= amina C como coadyuvante periodontal Los estudios evaluaron la vitamina C com= o coadyuvante de la terapia periodontal no quir=C3=BArgica y regenerativa, = mostrando resultados variables. Se observaron diferencias favorables en el = nivel de inserci=C3=B3n cl=C3=ADnica a los 3 meses (p =3D0,029) y disminuci=C3=B3n en el dolor posto= peratorio a los 2 y 3 d=C3=ADas (p =3D 0,021 y p = =3D 0,001) (13). Adem=C3=A1s, se observ=C3=B3 reducci=C3=B3n de la recesi= =C3=B3n gingival y de la profundidad del defecto radiogr=C3=A1fico en defec= tos intra=C3=B3seos tratados con =C3=A1cido asc=C3=B3rbico y PRF (<s= pan style=3D"font-family:'Times New Roman'; font-style:italic">p <sp= an style=3D"font-family:'Times New Roman'">< 0,05) (14). Por el contrari= o, no se observaron beneficios cl=C3=ADnicos adicionales significativos sob= re los =C3=ADndices de placa, =C3=ADndice gingival y sangrado al sondaje (<= /span>p</s= pan> > 0,05) (15). De la m= isma manera, la suplementaci=C3=B3n con vitamina C no produjo mejoras adici= onales significativas en la capacidad antioxidante total s=C3=A9rica y sali= val (p > 0,05) (16). P= or otro lado, se report=C3=B3 que la suplementaci=C3=B3n combinada con vita= minas C, D, y E mostr=C3=B3 mejoras en la profundidad de sondaje y sangrado= al sondaje, as=C3=AD como un incremento de los niveles s=C3=A9ricos de vit= amina C (17). La <a href=3D"#tabla2" style=3D"text-decoration:none">= Tabla 2</a> presenta los resultados de cada estudio= .<a id=3D"tabla2">Tabla 2. </sp= an>Efecto = terap=C3=A9utico de la vitamina C como coadyuvante en el tratamiento period= ontal </a><table style=3D"width:100%; margin-bottom:0pt; padding= :0pt; border-collapse:collapse"><tr><td style=3D"width:12%; border-top:0.75= pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; v= ertical-align:top">Autor/A=C3=B1o</span= ></td><td style=3D"width:16.02%; border-top:0.75pt solid #000000; borde= r-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">Dise=C3=B1o y muestra</td><td st= yle=3D"width:12.32%; border-top:0.75pt solid #000000; border-bottom:0.75pt = solid #000000; padding:0pt 5.75pt; vertical-align:top">Intervenci=C3=B3n terap=C3=A9utica</td><td style= =3D"width:13.68%; border-top:0.75pt solid #000000; border-bottom:0.75pt sol= id #000000; padding:0pt 5.75pt; vertical-align:top">M=C3=A9todo / tipo de evaluaci=C3=B3n</td><td style= =3D"width:13.68%; border-top:0.75pt solid #000000; border-bottom:0.75pt sol= id #000000; padding:0pt 5.75pt; vertical-align:top">Par=C3=A1metros cl=C3=ADnicos evaluados</td><td sty= le=3D"width:15.54%; border-top:0.75pt solid #000000; border-bottom:0.75pt s= olid #000000; padding:0pt 5.75pt; vertical-align:top">Resultados cl=C3=ADnicos principales</td><td styl= e=3D"width:16.76%; border-top:0.75pt solid #000000; border-bottom:0.75pt so= lid #000000; padding:0pt 5.75pt; vertical-align:top">Hallazgo cl=C3=ADnico</td></tr><tr><td style=3D"wi= dth:12%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #00000= 0; padding:0pt 5.75pt; vertical-align:top">Sherif et al. (2= 025) (13)</td><td style=3D"width:16.02%; border-top:0.75pt solid= #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-= align:top">Ensayo cl=C3=ADnico aleatorizado; (n=3D45) pacie= ntes con periodontitis estadio II distribuidos en tres grupos: PMPR+I-PRF+v= itamina C (n=3D15), PMPR+I-PRF(n=3D15) y PMPR solo (n=3D15) </td= ><td style=3D"width:12.32%; border-top:0.75pt solid #000000; border-bottom:= 0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">IPRF + vitamina C como coadyuvante periodontal</td><td style= =3D"width:13.68%; border-top:0.75pt solid #000000; border-bottom:0.75pt sol= id #000000; padding:0pt 5.75pt; vertical-align:top">Evaluac= i=C3=B3n cl=C3=ADnica periodontal y seguimiento postoperatorio a 3 meses</s= pan></td><td style=3D"width:13.68%; border-top:0.75pt solid #000000; bo= rder-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top"><= p style=3D"line-height:115%; font-size:9pt">CAL,&#x= a0; PD, BOP,<sp= an style=3D"font-family:'Times New Roman'"> PI y dolor= postoperatorio</td><td style=3D"width:15.54%; border-top:0.75pt= solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; ver= tical-align:top">Mejor nivel de inserci=C3=B3n cl=C3=ADni= ca (CAL) a los 3 meses en el grupo PMPR+I-PRF/VitC (p=3D0,029). No se obser= varon diferencias intergrupales significativas para BOP, PD, CAL, GM, PI ni= par=C3=A1metros radiogr=C3=A1ficos a los 3 o 6 meses (p>0,05). Menor dolor postoperatorio a = los 2 y 3 d=C3=ADas (p=3D= 0,021; p=3D0,001). </span= ></td><td style=3D"width:16.76%; border-top:0.75pt solid #000000; borde= r-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">La incorporaci=C3=B3n de vitamina C en I-PRF redujo el dolor po= stoperatorio y mostr=C3=B3 una mejor=C3=ADa transitoria del CAL a los 3 mes= es; sin embargo, no aport=C3=B3 beneficios cl=C3=ADnicos periodontales adic= ionales sostenidos frente a PMPR o I-PRF solos. </td></tr></tabl= e> Tabla 2. </spa= n>Efecto t= erap=C3=A9utico de la vitamina C como coadyuvante en el tratamiento periodo= ntal (continuaci=C3=B3n)<table style=3D"width:100%; margin-botto= m:0pt; padding:0pt; border-collapse:collapse"><tr><td style=3D"width:12.6%;= border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; paddi= ng:0pt 5.75pt; vertical-align:top">Aut= or/A=C3=B1o</td><td style=3D"width:16.2%; border-top:0.75pt soli= d #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical= -align:top">Dise=C3=B1o y muestra</td><td style= =3D"width:12.92%; border-top:0.75pt solid #000000; border-bottom:0.75pt sol= id #000000; padding:0pt 5.75pt; vertical-align:top">Interve= nci=C3=B3n terap=C3=A9utica</td><td style=3D"width:13.14%; borde= r-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt= 5.75pt; vertical-align:top"><= span style=3D"font-family:'Times New Roman'">M=C3=A9todo / tipo de evaluaci= =C3=B3n</td><td style=3D"width:13.38%; border-top:0.75pt solid #= 000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-al= ign:top">Par=C3=A1metros cl=C3=ADnicos evaluados= </td><td style=3D"width:16.36%; border-top:0.75pt solid #000000; border-bot= tom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">Resultados cl=C3=ADnicos principales</td><td style=3D"wi= dth:15.4%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000= 000; padding:0pt 5.75pt; vertical-align:top">Hallazgo cl=C3= =ADnico</td></tr><tr><td style=3D"width:12.6%; border-top:0.75pt= solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; ver= tical-align:top">Elbehwashy et al. (20= 21) (14)</td><td= style=3D"width:16.2%; border-top:0.75pt solid #000000; border-bottom:0.75p= t solid #000000; padding:0pt 5.75pt; vertical-align:top">En= sayo cl=C3=ADnico aleatorizado; (n=3D20) paciente con periodontitis estadio= III grado C distribuidos en grupo prueba (OFD+AA/PRF; n=3D10) y grupo cont= rol (OFD+PRF; n=3D10)</td><td style=3D"width:12.92%; border-top:= 0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75p= t; vertical-align:top">PRF + =C3=A1cido asc=C3=B3rbico en d= efectos intra=C3=B3seos</td><td style=3D"width:13.14%; border-to= p:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.7= 5pt; vertical-align:top"><span= style=3D"font-family:'Times New Roman'">Evaluaci=C3=B3n cl=C3=ADnica perio= dontal y regeneraci=C3=B3n tisular</td><td style=3D"width:13.38%= ; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padd= ing:0pt 5.75pt; vertical-align:top">CAL, PD, RD y par=C3=A1= metros radiogr=C3=A1ficos </td><td style=3D"width:16.36%; border= -top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt = 5.75pt; vertical-align:top"><s= pan style=3D"font-family:'Times New Roman'">Ganancia de CAL: 4,25 =C2=B1 1,= 27 mm. Reducci=C3=B3n de recesi=C3=B3n gingival: 0,80 =C2=B1 0,74 mm (</spa= n>p= =3D0,010). El grupo AA/PRF mo= str=C3=B3 una mayor reducci=C3=B3n de la profundidad del defecto radiogr=C3= =A1fico (2,29 =C2=B1 0,61 mm; p=3D0,014). </td><td style=3D"width:15.4%; border-top:0.75p= t solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; ve= rtical-align:top">La incorporaci=C3=B3n del =C3=A1cido asc= =C3=B3rbico al PRF mejor=C3=B3 la reducci=C3=B3n de la recesi=C3=B3n gingiv= al y el relleno radiogr=C3=A1fico de los defectos intra=C3=B3seos en compar= aci=C3=B3n con PRF solo. </td></tr><tr><td style=3D"width:12.6%;= border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; paddi= ng:0pt 5.75pt; vertical-align:top">Ozmeric et al. (2025) (1= 5)</td><td style=3D"width:16.2%; border-top:0.75pt solid #000000= ; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:to= p">Ensayo cl=C3=ADnico multic=C3=A9ntrico; (n=3D51) pacient= es con gingivitis, distribuidos en tres grupos: enjuague con fenoles (n=3D1= 3);CHX (n=3D19) y CHX+VitC (n=3D19)</td><td style=3D"width:12.92= %; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; pad= ding:0pt 5.75pt; vertical-align:top">Enjuague con clorhexid= ina 0,12% + vitamina C</td><td style=3D"width:13.14%; border-top= :0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75= pt; vertical-align:top">Evaluaci=C3=B3n cl=C3=ADnica period= ontal durante 14 d=C3=ADas</td><td style=3D"width:13.38%; border= -top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt = 5.75pt; vertical-align:top"><s= pan style=3D"font-family:'Times New Roman'">PI, GI y BOP</td><td= style=3D"width:16.36%; border-top:0.75pt solid #000000; border-bottom:0.75= pt solid #000000; padding:0pt 5.75pt; vertical-align:top">P= I (d=C3=ADa 14): Fenol 0,28 =C2=B1 0,59; CHX 0,08 =C2=B1 0,23; CHX+VitC 0,1= 3 =C2=B1 0,21. GI: 0,19 =C2=B1 0,18; 0,04 =C2=B1 0,41; 0,06 =C2=B1 0,11. BO= P: 0,05 =C2=B1 0,06; 0,01 =C2=B1 0,19; 0,03 =C2=B1 0,05, respectivamente. N= o se observaron diferencias significativas entre grupos (p > 0,05). </td><td style=3D= "width:15.4%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #= 000000; padding:0pt 5.75pt; vertical-align:top">La suplemen= taci=C3=B3n con vitamina C no mostr=C3=B3 beneficios cl=C3=ADnicos adiciona= les significativos frente al tratamiento convencional.</td></tr>= <tr><td style=3D"width:12.6%; border-top:0.75pt solid #000000; border-botto= m:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">Nisha et al. (2023) (16)</td><td style=3D"width:16.2%; bord= er-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0p= t 5.75pt; vertical-align:top">= Ensayo cl=C3=ADnico aleatoriz= ado; (n=3D105) participantes distribuidos en tres grupos: sujetos </= p></td><td style=3D"width:12.92%; border-top:0.75pt solid #000000; border-b= ottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">NSPT + vitamina C 500 mg/d=C3=ADa</td><td style=3D"widt= h:13.14%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #0000= 00; padding:0pt 5.75pt; vertical-align:top">Evaluaci=C3=B3n= cl=C3=ADnica periodontal y an=C3=A1lisis s=C3=A9rico antioxidante (TAOC-FR= AP)</td><td style=3D"width:13.38%; border-top:0.75pt solid #0000= 00; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:= top">PD, CAL, PI, GI, BOP y TAOC s=C3=A9rico y salival</spa= n></td><td style=3D"width:16.36%; border-top:0.75pt solid #000000; bord= er-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">PD: 3,56 =C2=B1 0,62 =E2=86=92 2,19 =C2=B1 0,44 mm; CAL: 5,16 = =C2=B1 0,41 =E2=86=92 3,18 =C2=B1 0,23 mm; PI: 2,46 =C2=B1 0,13 =E2=86=92 0= ,55 =C2=B1 0,12; </td><td style=3D"width:15.4%; border-top:0.75p= t solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; ve= rtical-align:top">La NSPT mejor=C3=B3 significativamente l= os par=C3=A1metros cl=C3=ADnicos periodontales y la capacidad antioxidante = total; sin </td></tr></table>Tabla 2. Efecto terap=C3=A9utico de la vitamina C como coadyuvante en el tratami= ento periodontal (continuaci=C3=B3n)<table style=3D"width:100%; = margin-bottom:0pt; padding:0pt; border-collapse:collapse"><tr><td style=3D"= width:11.54%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #= 000000; padding:0pt 5.75pt; vertical-align:top">Autor/A=C3= =B1o</td><td style=3D"width:17.52%; border-top:0.75pt solid #000= 000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align= :top">Dise=C3=B1o y muestra</td><td style=3D"wid= th:11.9%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #0000= 00; padding:0pt 5.75pt; vertical-align:top">Intervenci=C3= =B3n terap=C3=A9utica</td><td style=3D"width:13.18%; border-top:= 0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75p= t; vertical-align:top">M=C3=A9todo / tipo de evaluaci=C3=B3= n</td><td style=3D"width:12.32%; border-top:0.75pt solid #000000= ; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:to= p">Par=C3=A1metros cl=C3=ADnicos evaluados</td><= td style=3D"width:15.2%; border-top:0.75pt solid #000000; border-bottom:0.7= 5pt solid #000000; padding:0pt 5.75pt; vertical-align:top">= Resultados cl=C3=ADnicos principales</td><td style=3D"width:18.3= 4%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; pa= dding:0pt 5.75pt; vertical-align:top">Hallazgo cl=C3=ADnico= </td></tr><tr><td style=3D"width:11.54%; border-top:0.75pt solid= #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-= align:top"> </td><td style=3D"width:17.52%;= border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; paddi= ng:0pt 5.75pt; vertical-align:top">periodontalmente sanos (= control) (n=3D35), pacientes con periodontitis tratados con NSPT (n=3D35) y= pacientes con periodontitis tratados con NSPT m=C3=A1s suplementaci=C3=B3n= de vit C (500mg/d=C3=ADa durante 3 meses) (n=3D35)</td><td styl= e=3D"width:11.9%; border-top:0.75pt solid #000000; border-bottom:0.75pt sol= id #000000; padding:0pt 5.75pt; vertical-align:top"> <= /span></td><td style=3D"width:13.18%; border-top:0.75pt solid #000000; = border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top"= > </td><td style=3D"width:12.32%; border-to= p:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.7= 5pt; vertical-align:top"><span= style=3D"font-family:'Times New Roman'"> </td><td style=3D= "width:15.2%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #= 000000; padding:0pt 5.75pt; vertical-align:top">GI: 2,38 = =C2=B1 0,16 =E2=86=92 1,12 =C2=B1 0,18; BOP: 59 =C2=B1 0,55 =E2=86=92 28,14= =C2=B1 16,63 (basal=E2=80=9312 meses). Los niveles s=C3=A9ricos y salivale= s de TAOC aumentaron despu=C3=A9s del tratamiento periodontal, sin diferenc= ias significativas entre NSPT y NSPT + vitamina C (p>0,05).</td><td style=3D"width:18.= 34%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; p= adding:0pt 5.75pt; vertical-align:top">embargo, la suplemen= taci=C3=B3n con vitamina C no mostr=C3=B3 beneficios cl=C3=ADnicos ni antio= xidantes adicionales significativos</td></tr><tr><td style=3D"wi= dth:11.54%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #00= 0000; padding:0pt 5.75pt; vertical-align:top">Jaafer et al.= (2025) (17)</td><td style=3D"width:17.52%; border-top:0.75pt so= lid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertic= al-align:top">Estudio prospectivo; (n=3D120) pacientes con = periodontitis moderada a severa distribuidos en grupo control (SRP; n=3D60)= y grupo experimental (SRP+VitC, D y E n=3D60)</td><td style=3D"= width:11.9%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #0= 00000; padding:0pt 5.75pt; vertical-align:top">Vitaminas C,= D y E + SRP</td><td style=3D"width:13.18%; border-top:0.75pt so= lid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertic= al-align:top">Evaluaci=C3=B3n cl=C3=ADnica periodontal y an= =C3=A1lisis s=C3=A9rico antioxidante</td><td style=3D"width:12.3= 2%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; pa= dding:0pt 5.75pt; vertical-align:top">PD, CAL, BOP y vitami= na C s=C3=A9ricos de vitamina C, D y E</td><td style=3D"width:15= .2%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; p= adding:0pt 5.75pt; vertical-align:top">PD: 5,3 =C2=B1 0,7 = =E2=86=92 3,5 =C2=B1 0,5 mm; CAL: 4,9 =C2=B1 0,8 =E2=86=92 3,7 =C2=B1 0,6 m= m; BOP: 46,2 =C2=B1 9,8% =E2=86=92 20,3 =C2=B1 7,2%; Vitamina C s=C3=A9rica= : 0,8 =C2=B1 0,2 =E2=86=92 1,5 =C2=B1 0,4 mg/dL (basal=E2=80=933 meses). </= span></td><td style=3D"width:18.34%; border-top:0.75pt solid #000000; b= order-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">= La suplementaci=C3=B3n antioxidante combinada se asoci=C3= =B3 con mejoras en los par=C3=A1metros cl=C3=ADnicos periodontal y un incre= mento de los niveles s=C3=A9ricos de antioxidantes</td></tr></ta= ble>Nota: elaboraci=C3= =B3n a partir de los estudios incluidos en la revisi=C3=B3n (13)(14)(15)(16= )(17). Abreviaturas: AA: =C3=A1cido asc=C3=B3rbico; BOP: sangrado al sondaje; CAL: nivel de inserci=C3=B3n cl=C3= =ADnica; CHX: clorhexidina; FRAP: pode= r antioxidante reductor f=C3=A9rrico; GI: =C3=ADndice gingival;<span= style=3D"font-family:'Times New Roman'"> GM: margen gingival; I-PRF: fibrina rica en plaquetas inyectable; NSPT: terapia periodo= ntal no quir=C3=BArgica; PD: profundidad de sondaje; PI: =C3=ADndice de pla= ca; PMPR: remoci=C3=B3n mec=C3=A1nica profesional de placa; PRF: fibrina ri= ca en plaquetas; RD: profundidad de recesi=C3=B3n gingival; SRP: raspado y alisado radicular; TAOC: capacidad ant= ioxidante total.3.3. Biomarcadores de estr=C3=A9s oxidativo asociados con= periodontitis Los estudios relacionados con biomarcadores oxidativos reportaro= n alteraciones en el equilibrio oxidativo-antioxidante en pacientes con per= iodontitis. Los biomarcadores evaluados incluyeron marcadores y respuestas = inflamatoria periodontal (18)(19)(20). Adem=C3=A1s, se observ=C3=B3 una red= ucci=C3=B3n significativa de los niveles de sulfiredoxina despu=C3=A9s de l= a terapia periodontal no quir=C3=BArgica (p=3D0,004) (18). Por otro lado, se report=C3=B3 un increme= nto del estado oxidante total y una disminuci=C3=B3n de la capacidad antiox= idante total en pacientes con periodontitis (p=3D0,001) (19). Asimismo, se identific=C3=B3 una dismi= nuci=C3=B3n de taurina y un incremento de TNF =E2=80=93 =CE=B1 en pacientes= con periodontitis, evidenciando una asociaci=C3=B3n entre inflamaci=C3=B3n= periodontal y desequilibrio oxidativo (20). Los resultados se=C3=B1alan un= a relaci=C3=B3n entre el estr=C3=A9s oxidativo, la respuesta antioxidante y= la inflamaci=C3=B3n periodontal (<a href=3D"#tabla4" style=3D"text-= decoration:none">Tabla 3</spa= n></a>).<a id=3D"tabla4">= Tabla 3.</s= pan> Biomarcadores de estr=C3=A9= s oxidativo asociados con enfermedad periodontal</a><table style= =3D"width:100%; margin-bottom:0pt; padding:0pt; border-collapse:collapse"><= tr><td style=3D"width:11.1%; border-top:0.75pt solid #000000; border-bottom= :0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top"><s= pan style=3D"font-family:'Times New Roman'">Autor/<spa= n style=3D"font-family:'Times New Roman'">A=C3=B1o</td><td style= =3D"width:17.2%; border-top:0.75pt solid #000000; border-bottom:0.75pt soli= d #000000; padding:0pt 5.75pt; vertical-align:top">Dise=C3=B1o y muestra</td><td st= yle=3D"width:13.96%; border-top:0.75pt solid #000000; border-bottom:0.75pt = solid #000000; padding:0pt 5.75pt; vertical-align:top">Biomarcador oxidativo evaluado</= p></td><td style=3D"width:14.88%; border-top:0.75pt solid #000000; border-b= ottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">M=C3=A9todo / tipo de eval= uaci=C3=B3n</td><td style=3D"width:13.18%; border-top:0.75pt sol= id #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertica= l-align:top">Par=C3= =A1metros relacionados</td><td style=3D"width:14.8%; border-top:= 0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75p= t; vertical-align:top">Resultados principales</td><td style=3D"width:14.88%; border= -top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt = 5.75pt; vertical-align:top">Hallazgo principal</td></tr><tr><td style=3D"width:11.1= %; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; pad= ding:0pt 5.75pt; vertical-align:top">Dixit et al. (2025) (1= 8)</td><td style=3D"width:17.2%; border-top:0.75pt solid #000000= ; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:to= p">Estudios de casos y controles; (n=3D41) participantes di= stribuidos en individuos periodontalmente sanos (grupo control; (n=3D20)) y= pacientes con periodontitis cr=C3=B3nica (grupo caso; (n=3D21)); evaluados= antes y despu=C3=A9s de (NSPT)</td><td style=3D"width:13.96%; b= order-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding= :0pt 5.75pt; vertical-align:top">Sulfiredoxina (Srx)= </td><td style=3D"width:14.88%; border-top:0.75pt solid #000000; border= -bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">An=C3=A1lisis de biomarcadores oxidativos en fluido crevicular g= ingival posterior a terapia periodontal no quir=C3=BArgica (NSPT)</p= ></td><td style=3D"width:13.18%; border-top:0.75pt solid #000000; border-bo= ttom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">Estr=C3=A9s oxidativo y respuesta periodontal</td><td st= yle=3D"width:14.8%; border-top:0.75pt solid #000000; border-bottom:0.75pt s= olid #000000; padding:0pt 5.75pt; vertical-align:top">Srx: = 0,532 =C2=B1 0,23=E2=86=920,366 =C2=B1 0,10 ng/mL tras NSPT (p=3D0,004).</td><td style=3D= "width:14.88%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid = #000000; padding:0pt 5.75pt; vertical-align:top">La terapia= periodontal redujo biomarcadores asociados a estr=C3=A9s oxidativo e infla= maci=C3=B3n periodontal.</td></tr><tr><td style=3D"width:11.1%; = border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; paddin= g:0pt 5.75pt; vertical-align:top">Mohideen et al. (2023) (1= 9)</td><td style=3D"width:17.2%; border-top:0.75pt solid #000000= ; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:to= p">Revisi=C3=B3n sistem=C3=A1tica y metaan=C3=A1lisis; 42 e= studios incluidos para s=C3=ADntesis cualitativa y 24 estudios cuantitativo= de TOS y TAC en pacientes con periodontitis y controles sanos</= td><td style=3D"width:13.96%; border-top:0.75pt solid #000000; border-botto= m:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">TOS y TAC</td><td style=3D"width:14.88%; border-top:0.75pt = solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vert= ical-align:top">Evaluaci=C3=B3n s=C3=A9rica y salival de ca= pacidad antioxidante y oxidativa</td><td style=3D"width:13.18%; = border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; paddin= g:0pt 5.75pt; vertical-align:top">Estr=C3=A9s oxidativo sis= t=C3=A9mico y salival en periodontitis</td><td style=3D"width:14= .8%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; p= adding:0pt 5.75pt; vertical-align:top">TOS salival: diferen= cia global 1,784 =C2=B5mol H=E2=82=82O=E2=82=82 Eq/L (p=3D0,001). TAC s=C3=A9rico: disminuci=C3=B3n = global -2,049 mmol Trolox Eq/L (p=3D0,001).</td><td style=3D"width:14.88%; border-top:0.7= 5pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; = vertical-align:top">Los pacientes con periodontitis present= aron incremento de estr=C3=A9s oxidativo y disminuci=C3=B3n de capacidad an= tioxidante.</td></tr></table> Tabla 3. Biomarcadores de estr=C3=A9s oxidativo aso= ciados con enfermedad periodontal (continuaci=C3=B3n)<table styl= e=3D"width:100%; margin-bottom:0pt; padding:0pt; border-collapse:collapse">= <tr><td style=3D"width:10.88%; border-top:0.75pt solid #000000; border-bott= om:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">Autor/A=C3=B1o</td><td style=3D"width:17.52= %; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; pad= ding:0pt 5.75pt; vertical-align:top">Dis= e=C3=B1o y muestra</td><td style=3D"width:13.74%; border-top:0.7= 5pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; = vertical-align:top">Biomarcador oxidativ= o evaluado</td><td style=3D"width:15.16%; border-top:0.75pt soli= d #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical= -align:top">M=C3=A9todo / tipo de evalua= ci=C3=B3n</td><td style=3D"width:12.96%; border-top:0.75pt solid= #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-= align:top">= Par=C3=A1metros relacionados<= /span></td><td style=3D"width:15.08%; border-top:0.75pt solid #000000; = border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top"= >Resultados principales</td><= td style=3D"width:14.66%; border-top:0.75pt solid #000000; border-bottom:0.= 75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">Hallazgo principal</td></tr><tr><td style=3D= "width:10.88%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid = #000000; padding:0pt 5.75pt; vertical-align:top">D=C3=B6nme= z et al. (2025) (20)</td><td style=3D"width:17.52%; border-top:0= .75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt= ; vertical-align:top">Casos y controles; (n=3D40) participa= ntes distribuidos en grupo control periodontalmente sanos (n=3D20) y grupo = con periodontitis generalizada estadio III grado B (n=3D20)</td>= <td style=3D"width:13.74%; border-top:0.75pt solid #000000; border-bottom:0= .75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">Taurina y TNF-=CE=B1</td><td style=3D"width:15.16%; border-top= :0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75= pt; vertical-align:top">Evaluaci=C3=B3n s=C3=A9rica de biom= arcadores inflamatorios y antioxidantes</td><td style=3D"width:1= 2.96%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000;= padding:0pt 5.75pt; vertical-align:top">Inflamaci=C3=B3n p= eriodontal y estr=C3=A9s oxidativo</td><td style=3D"width:15.08%= ; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padd= ing:0pt 5.75pt; vertical-align:top">Taurina disminuida (p= =3D0,009). TNF-=CE=B1 aumentado (p=3D0,004). AUC taurina=3D0,739.</p= ></td><td style=3D"width:14.66%; border-top:0.75pt solid #000000; border-bo= ttom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">La disminuci=C3=B3n de taurina se asoci=C3=B3 con inflamaci=C3=B3n = periodontal y alteraci=C3=B3n antioxidante sist=C3=A9mica.</td><= /tr></table>Nota:</s= pan> elaboraci=C3=B3n a parti= r de los estudios incluidos en la revisi=C3=B3n (18)(19)(20). Abreviaturas.= Srx: sulfiredoxina; NSPT: terapia periodontal no quir=C3=BArgica; TOS: est= ado oxidante total; TAC: capacidad antioxidante total; TNF-=CE=B1: factor d= e necrosis tumoral alfa; AUC: =C3=A1rea bajo la curva; H=E2=82=82O=E2=82=82= Eq/L: equivalentes de per=C3=B3xido de hidr=C3=B3geno por litro. Trolox Eq= /L: equivalentes de Trolox por litro. 4. Di= scusi=C3=B3n El presente estudio evidenci=C3=B3 una relaci=C3=B3n = entre la vitamina C, estr=C3=A9s oxidativo y enfermedades periodontales. Lo= s estudios analizados reportaron que los pacientes con periodontitis presen= taban alteraciones en los sistemas antioxidantes y aumento en los biomarcad= ores inflamatorios y oxidativos en comparaci=C3=B3n con individuos periodon= talmente sanos (19)(20). De la misma manera, se observ=C3=B3 que la disminu= ci=C3=B3n de los niveles de vitamina C tend=C3=ADa a asociarse con una mayo= r severidad periodontal, lo que sugiere una posible relaci=C3=B3n entre el = estado antioxidante del organismo y la progresi=C3=B3n de la periodontitis = (2)(12). Mohideen et al. (19) identificaron niveles significativamente alto= s de Estr=C3=A9s Oxidativo Total (TOS) y menores niveles de Capacidad Antioxidante Tota= l (TAC) en pacientes c= on periodontitis (19). De la misma forma, Hashim et al. (2) y Assaf & R= abi (12) reportaron concentraciones m=C3=A1s bajas de vitamina C en suero, = saliva y fluido crevicular gingival en pacientes con mayor severidad period= ontal (2)(12). Estos hallazgos sugieren que el desarrollo de la periodontit= is podr=C3=ADa asociarse con un desequilibrio entre los mecanismos oxidativ= os y antioxidantes del organismo. Buzatu et al. (9) reportaron que los niveles bajo= s de vitamina C se asociaron con un mayor riesgo de periodontitis (OR=3D1,5= 2; IC95%:1,49=E2=80=931,55), lo que respalda la posible participaci=C3=B3n = de este micronutriente en la progresi=C3=B3n de la enfermedad, aunque desta= caron una elevada heterogeneidad metodol=C3=B3gica entre los estudios inclu= idos (9).Adicionalmente, Rosa et al. (21) indicaron que una mayor ingesta diet=C3= =A9tica de vitamina C se relaciona con mejores condiciones periodontales, o= bservando que los individuos con consumo m=C3=A1s elevado presentaban menor= frecuencia de periodontitis y menor inflamaci=C3=B3n gingival (21).= Estos resultado= s coinciden con Mi et al. quienes en un metaan=C3=A1lisis observaron que un= a mayor ingesta de vitaminas antioxidantes se asociaba con una menor frecue= ncia de enfermedades periodontales, sugiriendo que el estado nutricional po= dr=C3=ADa influir en la respuesta inflamatoria periodontal (11). Por lo tan= to, estos hallazgos respaldan que la vitamina C participa en mecanismos bio= l=C3=B3gicos relacionados con la protecci=C3=B3n periodontal, aunque la nat= uraleza de esta asociaci=C3=B3n todav=C3=ADa requiere mayor investigaci=C3= =B3n cl=C3=ADnica (11). La posible explicaci=C3=B3n biol=C3=B3gica de esta relaci= =C3=B3n puede encontrarse en las funciones antioxidantes e inmunomoduladora= s atribuidas a la vitamina C. De forma similar, Ustianowski et al. (22) sos= tienen que esta vitamina participa en la s=C3=ADntesis de col=C3=A1geno, la= regulaci=C3=B3n de la respuesta inmunitaria y la neutralizaci=C3=B3n de es= pecies reactivas de ox=C3=ADgeno, mecanismos que podr=C3=ADan contribuir a = la protecci=C3=B3n de los tejidos periodontales. As=C3=AD como Van der Veld= en (23) sostuvo que la vitamina C contribuye al mantenimiento de la integri= dad del tejido conectivo periodontal y a los procesos de reparaci=C3=B3n ti= sular. Por ello, una disminuci=C3=B3n de sus niveles podr=C3=ADa favorecer = una mayor susceptibilidad frente al da=C3=B1o oxidativo y la destrucci=C3= =B3n de los tejidos periodontales observados durante la progresi=C3=B3n de = la enfermedad. Los biomarcadores evaluados en los estudios seleccionados respaldan = la participaci=C3=B3n del estr=C3=A9s oxidativo en la fisiopatolog=C3=ADa p= eriodontal. Dixit et al. (18) identificaron niveles elevados de sulfiredoxi= na en pacientes con periodontitis activa, observando una disminuci=C3=B3n p= osterior a la terapia periodontal no quir=C3=BArgica (18). Adicionalmente, = Mohideen et al. (19) reportaron un incremento del estado oxidante total y u= na disminuci=C3=B3n de la capacidad antioxidante total en pacientes con per= iodontitis, evidenciando un desequilibrio entre los mecanismos oxidativos y= antioxidantes (19). Tambi=C3=A9n D=C3=B6nmez et al. (20) dieron a conocer = que los pacientes con periodontitis presentaban concentraciones reducidas d= e taurina y niveles aumentados de TNF-=CE=B1 en pacientes, adem=C3=A1s de a= sociaciones entre estos biomarcadores y par=C3=A1metros cl=C3=ADnicos como = la profundidad de sondaje y la p=C3=A9rdida de inserci=C3=B3n cl=C3=ADnica = (20). En conjunto, estos hallazgos respaldan la participaci=C3=B3n del estr= =C3=A9s oxidativo en la fisiopatolog=C3=ADa periodontal y sugieren que dive= rsos biomarcadores oxidativos podr=C3=ADan reflejar la actividad inflamator= ia y la progresi=C3=B3n de la enfermedad (18)(19)(20). En cuanto a los efectos ter= ap=C3=A9uticos de la vitamina C, los estudios incluidos mostraron resultado= s heterog=C3=A9neos. Sherif et al. (13) hallaron que la utilizaci=C3=B3n de= fibrina rica en plaquetas inyectable suplementada con vitamina C produjo u= na reducci=C3=B3n temprana del dolor postoperatorio y una mejora del nivel = de inserci=C3=B3n cl=C3=ADnica a los 3 meses (p=3D0,029), en pacientes con periodontitis estadio II = (13). De la misma manera Elbehwashy et al. (14) identificaron una mejor res= puesta cicatricial y una mayor reducci=C3=B3n radiogr=C3=A1fica de defectos= intra=C3=B3seos observando una disminuci=C3=B3n promedio de 2,29 =C2=B1 0,= 61 mm en la profundidad del defecto radiogr=C3=A1fico (p=3D0,014) cuando el =C3=A1cido asc=C3=B3= rbico fue incorporado al PRF. De la misma manera Jaafer et al. (17) report= =C3=B3 que la suplementaci=C3=B3n antioxidante combinada con vitamina C, D = y E se asoci=C3=B3 con mejoras cl=C3=ADnicas periodontales, observando una = reducci=C3=B3n de la profundidad de sondaje 5,3 =C2=B1 0,7 mm a 3,5 =C2=B1 = 0,5 mm, una disminuci=C3=B3n del sangrado al sondaje de 46,2 =C2=B1 9,8 % a= 20,3 =C2=B1 7,2 % y un incremento de los niveles s=C3=A9ricos de vitamina = C de 0,8 =C2=B1 0,2 mg/dL a 1,5 =C2=B1 0,4 mg/dL tras 3 meses de seguimient= o. Estos resultados coinciden con Sherif et al. (13) y Elbehwashy et al. (1= 4) quienes obtuvieron beneficios cl=C3=ADnicos asociados al empleo de vitam= ina C como coadyuvante terap=C3=A9utico. Sin embargo, debido a la administr= aci=C3=B3n conjunta de varios antioxidantes resulta dif=C3=ADcil atribuir l= os efectos alcanzados exclusivamente a la vitamina C (17). Por otra parte, Nisha et= al. (16) mencionan que la terapia periodontal no quir=C3=BArgica mejor=C3= =B3 significativamente la capacidad antioxidante total y los par=C3=A1metro= s cl=C3=ADnicos periodontales; sin embargo, la administraci=C3=B3n sist=C3= =A9mica de vitamina C (500mg/d=C3=ADa) no aport=C3=B3 beneficios adicionale= s significativos respecto a la terapia periodontal convencional sola (16). = Esto podr=C3=ADa atribuirse principalmente al efecto de la terapia periodon= tal no quir=C3=BArgica, m=C3=A1s que a la suplementaci=C3=B3n con vitamina = C. De la misma manera Fageeh et al. (1) en una revisi=C3=B3n sistem=C3=A1ti= ca que incluy=C3=B3 seis ensayos cl=C3=ADnicos aleatorizados, se=C3=B1alaro= n que la suplementaci=C3=B3n con vitamina C no produjo mejoras cl=C3=ADnica= mente significativas en la profundidad de sondaje ni en el nivel de inserci= =C3=B3n cl=C3=ADnica en pacientes con periodontitis. Los autores destacan q= ue las diferencias en las dosis administradas, las v=C3=ADas de aplicaci=C3= =B3n y los periodos de seguimiento entre los estudios reportados, dificulta= n la comparaci=C3=B3n directa de los hallazgos y limita el establecimiento = de conclusiones definitivas sobre la eficacia de la vitamina C como coadyuv= ante del tratamiento periodontal (1). Ozmeric et al. (15) hallaron que un e= njuague con vitamina C present=C3=B3 resultados semejantes a los de la clor= hexidina, donde no se encontr=C3=B3 diferencias significativas en el contro= l de placa, gingivitis o sangrado gingival (p > 0,05) (15). Estos resultados mencionan que los ef= ectos cl=C3=ADnicos de la vitamina C podr=C3=ADan ser m=C3=A1s evidentes en= la modulaci=C3=B3n inflamatoria temprana que en la regeneraci=C3=B3n perio= dontal profunda. Un aspecto relevante identificado durante la revisi=C3=B3n fue la = diferencia entre los hallazgos experimentales y la evidencia cl=C3=ADnica d= isponible. Aytekin et al. (24) utilizando un modelo experimental de periodo= ntitis en ratas, demostraron que la aplicaci=C3=B3n local de vitamina C red= ujo la p=C3=A9rdida =C3=B3sea alveolar, la p=C3=A9rdida de inserci=C3=B3n y= la expresi=C3=B3n de biomarcadores relacionados con el estr=C3=A9s oxidati= vo y la destrucci=C3=B3n tisular. Estos resultados sugieren un potencial ef= ecto protector de la vitamina C sobre los tejidos periodontales. Sin embarg= o, los beneficios observados en modelos animales todav=C3=ADa no han sido r= eproducidos de forma consistente en estudios cl=C3=ADnicos realizados en hu= manos, por lo que persisten interrogantes acerca de su verdadero impacto te= rap=C3=A9utico en la pr=C3=A1ctica cl=C3=ADnica.<span= style=3D"font-family:'Times New Roman'">Los hallazgos de esta revisi=C3=B3= n presentan algunas limitaciones. Primero, los estudios incluidos presentar= on dise=C3=B1os metodol=C3=B3gicos diversos, tama=C3=B1os de muestras varia= bles y diferentes estrategias de administraci=C3=B3n de vitamina C. Segundo= , los biomarcadores evaluados no fueron uniformes entre las investigaciones= , lo que dificulta la comparaci=C3=B3n directa de los resultados. En conjun= to, la evidencia disponible sugiere que la vitamina C podr=C3=ADa contribui= r al equilibrio antioxidante y a la modulaci=C3=B3n de la respuesta inflama= toria periodontal, particularmente durante etapas tempranas de la enfermeda= d. Sin embargo, los beneficios cl=C3=ADnicos observados contin=C3=BAan sien= do inconsistentes y no permiten recomendar su utilizaci=C3=B3n como tratami= ento periodontal independiente. Actualmente, la terapia periodontal convenc= ional contin=C3=BAa siendo el tratamiento de elecci=C3=B3n (25)(26)(27), mi= entras que la vitamina C podr=C3=ADa considerarse un complemento potencial = cuya utilidad cl=C3=ADnica requiere ser confirmada mediante ensayos cl=C3= =ADnicos aleatorizados con nuestras muestras m=C3=A1s amplias, seguimiento = prolongado y metodolog=C3=ADas homog=C3=A9neas.5. </sp= an>Conclusiones<ul style=3D"margin:0pt; padding-left:0pt"><l= i class=3D"ListParagraph" style=3D"margin-left:32.33pt; margin-bottom:0pt; = text-align:justify; line-height:115%; padding-left:3.67pt; font-family:seri= f; font-size:12pt">La literat= ura cient=C3=ADfica revisada permiti=C3=B3 identificar una relaci=C3=B3n en= tre la disminuci=C3=B3n de los niveles de vitamina C, incremento del estr= =C3=A9s oxidativo y la severidad de la enfermedad periodontal. La evidencia= mostr=C3=B3 que los pacientes con periodontitis presentan alteraciones en = los sistemas antioxidantes, aumento de biomarcadores oxidativos y reducci= =C3=B3n de mecanismos de defensa antioxidante en comparaci=C3=B3n con indiv= iduos periodontalmente sanos. De la misma forma, diversos estudios reportar= on concentraciones reducidas de vitamina C en saliva, suero y fluido crevic= ular gingival en pacientes con mayor severidad periodontal, sugiriendo una = posible participaci=C3=B3n de esta vitamina en los mecanismos biol=C3=B3gic= os relacionados con la inflamaci=C3=B3n y destrucci=C3=B3n de los tejidos p= eriodontales.</li><li class=3D"ListParagraph" style=3D"margin-left:3= 2.33pt; margin-bottom:0pt; text-align:justify; line-height:115%; padding-le= ft:3.67pt; font-family:serif; font-size:12pt">Los estudios analizados respaldan la importancia del estr= =C3=A9s oxidativo en la fisiopatolog=C3=ADa de la periodontitis. El desequi= librio entre oxidantes y antioxidantes favorece la producci=C3=B3n excesiva= de especies reactivas de ox=C3=ADgeno, contribuyendo al da=C3=B1o celular,= la degradaci=C3=B3n del col=C3=A1geno y la p=C3=A9rdida progresiva de los = tejidos de soporte dental. En este contexto, la vitamina C adquiere relevan= cia debido a sus propiedades antioxidantes, inmunomoduladoras y a su papel = esencial en la s=C3=ADntesis y mantenimiento del col=C3=A1geno periodontal.= Estas caracter=C3=ADsticas permiten considerar que niveles adecuados de vi= tamina C podr=C3=ADan contribuir al mantenimiento de la homeostasis tisular= y a la protecci=C3=B3n frente al da=C3=B1o oxidativo asociado con la enfer= medad periodontal.</li><li class=3D"ListParagraph" style=3D"margin-l= eft:32.33pt; margin-bottom:0pt; text-align:justify; line-height:115%; paddi= ng-left:3.67pt; font-family:serif; font-size:12pt">En relaci=C3=B3n con su aplicaci=C3=B3n cl=C3=ADnica,= los estudios incluidos mostraron resultados variables. Aunque algunos auto= res observaron mejor=C3=ADas en biomarcadores inflamatorios y antioxidantes= , as=C3=AD como beneficios cl=C3=ADnicos relacionados con la cicatrizaci=C3= =B3n periodontal, la reducci=C3=B3n del sangrado al sondaje y la mejor=C3= =ADa del nivel de inserci=C3=B3n cl=C3=ADnica, los resultados continuaron s= iendo heterog=C3=A9neos entre los estudios. Por esta raz=C3=B3n, la evidenc= ia disponible no permite establecer conclusiones definitivas sobre la efica= cia de la vitamina C como tratamiento periodontal independiente. Actualment= e, la terapia periodontal convencional contin=C3=BAa siendo la principal es= trategia terap=C3=A9utica para el control de la enfermedad, mientras que la= vitamina C podr=C3=ADa considerarse =C3=BAnicamente como un complemento po= tencial dentro del manejo integral de determinados pacientes.</li><l= i class=3D"ListParagraph" style=3D"margin-left:32.33pt; margin-bottom:0pt; = text-align:justify; line-height:115%; padding-left:3.67pt; font-family:seri= f; font-size:12pt">Es importa= nte se=C3=B1alar que los estudios analizados presentaron diferencias metodo= l=C3=B3gicas relacionadas con el dise=C3=B1o de investigaci=C3=B3n, el tama= =C3=B1o muestral, las dosis administradas, las v=C3=ADas de aplicaci=C3=B3n= , los biomarcadores evaluados y per=C3=ADodos de seguimiento. Estas variaci= ones dificultan la comparaci=C3=B3n directa de los resultados y limitan la = posibilidad de establecer recomendaciones cl=C3=ADnicas universales. Adem= =C3=A1s, la evidencia disponible contin=C3=BAa siendo insuficiente para det= erminar con precisi=C3=B3n qu=C3=A9 pacientes podr=C3=ADan beneficiarse en = mayor medida de la suplementaci=C3=B3n con vitamina C y cu=C3=A1les ser=C3= =ADan las dosis y protocolos m=C3=A1s adecuados.</li><li class=3D"Li= stParagraph" style=3D"margin-left:32.33pt; margin-bottom:10pt; text-align:j= ustify; line-height:115%; padding-left:3.67pt; font-family:serif; font-size= :12pt">Finalmente, se requier= en ensayos cl=C3=ADnicos aleatorizados con muestras m=C3=A1s amplias, segui= miento a largo plazo y metodolog=C3=ADas estandarizadas que permitan esclar= ecer el verdadero impacto de la vitamina C sobre la progresi=C3=B3n de la e= nfermedad periodontal. Futuras investigaciones deber=C3=ADan integrar simul= t=C3=A1neamente par=C3=A1metros cl=C3=ADnicos, radiogr=C3=A1ficos y biomarc= adores relacionados con el estr=C3=A9s oxidativo para comprender mejor la i= nteracci=C3=B3n entre vitamina C, respuesta inflamatoria y salud periodonta= l. De esta manera, ser=C3=A1 posible determinar con mayor precisi=C3=B3n el= papel que esta vitamina puede desempe=C3=B1ar como coadyuvante terap=C3=A9= utico dentro de la pr=C3=A1ctica cl=C3=ADnica periodontal. </li></ul= >6.</spa= n> Conflicto de intereses<= /p>Los autores dec= laran que no existe conflicto de intereses en relaci=C3=B3n con el art=C3= =ADculo presentado.7. <span= style=3D"font-family:'Times New Roman'; font-weight:bold; color:#767171">D= erechos de autor (copyrigth)Los autores son los titulares de los derechos de autor (patrimoniales y/o de explotaci=C3=B3n) de = los contenidos de la revista (copyright).8. Decl= araci=C3=B3n de contribuci=C3=B3n de los autoresLos autores declaran haber particip= ado de manera equitativa y sustancial en la realizaci=C3=B3n de esta invest= igaci=C3=B3n, bajo las responsabilidades seg=C3=BAn la <a href=3D"ht= tps://credit.niso.org/" style=3D"text-decoration:none">Taxonom=C3=ADa CRediT<= /a> para describir las contri= buciones individuales de cada autor al trabajo. Lizbeth Tatiana Aguayza Rodas reali= z=C3=B3 la conceptualizaci=C3=B3n de la investigaci=C3=B3n, organizaci=C3= =B3n y ejecuci=C3=B3n del ensayo, recopilaci=C3=B3n y curaci=C3=B3n de los = datos, revisi=C3=B3n del an=C3=A1lisis estad=C3=ADstico, interpretaci=C3=B3= n de los resultados, elaboraci=C3=B3n del borrador original, preparaci=C3= =B3n de tablas y figuras, revisi=C3=B3n cr=C3=ADtica del contenido y aproba= ci=C3=B3n de la versi=C3=B3n final del manuscrito.<spa= n style=3D"font-family:'Times New Roman'">Andrea Soledad Carvajal Endara re= aliz=C3=B3 la supervisi=C3=B3n acad=C3=A9mica y metodol=C3=B3gica de la inv= estigaci=C3=B3n, brind=C3=B3 orientaci=C3=B3n durante el desarrollo del ens= ayo, revis=C3=B3 el an=C3=A1lisis y la interpretaci=C3=B3n de los resultado= s, efectu=C3=B3 la revisi=C3=B3n cr=C3=ADtica del manuscrito, realiz=C3=B3 = la correcci=C3=B3n cient=C3=ADfica y acad=C3=A9mica y aprob=C3=B3 la versi= =C3=B3n final para su publicaci=C3=B3n.Divulgaci=C3=B3n de la de= legaci=C3=B3n a la IA generativaDeclaraci=C3=B3n sobre la delegaci=C3=B3n de tare= as a IA generativaLos autores declaran el uso de IA generativa en el proceso de i= nvestigaci=C3=B3n y preparaci=C3=B3n del manuscrito. De acuerdo con la taxo= nom=C3=ADa GAIDeT (2025), las siguientes tareas se delegaron a herramientas= de IA generativa bajo supervisi=C3=B3n humana:<span= style=3D"font-family:'Times New Roman'">- Correcci=C3=B3n y edici=C3=B3n</= span>- Resume= n de texto- Traducci=C3=B3nHerramienta de IA generativa utilizada: ChatGPT (OpenAI).</s= pan>Los autor= es son totalmente responsables del manuscrito final.= Las herramientas de IA genera= tiva no figuran como autoras ni son responsables de los resultados finales.= Declara= ci=C3=B3n presentada por: Lizbeth Tatiana Aguayza Rodas.9.</spa= n> Costos de financiamiento</span= > </= p>La presente inve= stigaci=C3=B3n fue financiada en su totalidad con fondos propios de los aut= ores.<span= >10. 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Available from: <a href=3D"h= ttps://doi.org/10.33262/anatomiadigital.v6i4.3.2813" style=3D"text-decorati= on:none">https://doi.org/= 10.33262/anatomiadigital.v6i4.3.2813</a></li></ol> = <a id=3D"_heading_h.m2eci05r1w34"></a> </sp= an> = </= p>&= #xa0;El art=C3=ADculo que se publica es de exclusiva responsabilid= ad de los autores y no necesariamente reflejan el pensamiento de la = Revista Ana= tom=C3=ADa Digital. </= span><img sr= c=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAN8AAAA5CAYAAAC25P6zAAAA= BHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAIABJREFUeJztXXl8VcW9/82c7S7= Jvdk3kpBI2AWUolAVFbUW7dPWorEubRGXPLFQQ1WktXq0PsSVimvEKtW+vmeor1Vb26oQCyKKkX= 1PCNm3m3tz9+Us83t/3NysN8lNSEja8v18zgdyzrkzv5kzv5nf/LYhMI6AiGS0yiYAAITgaJU/E= GRZprqmv+1xe24mBIDn+N1mS9w1siw3jnbda9asmaKElDJAzEpJSf15SA09K8uyMtr1dsf69eun= N9Y3fqZpekJCYuLejMy0wqKiohOnk4bxCH4sKkVE8tprX/NNTd/QZZkwAIDlr39esGzjV2mjVec= PkepVv9rqNPCCyjMMpFsVZdHMSb7bFuUHR6vOCFLiUnK+3vvVd4KhAAAACIJQkCPknVdaWvrnws= 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Revisi= =C3=B3n bibliogr=C3=A1fica narrativa<= span style=3D"font-family:'Times New Roman'; font-weight:bold"> </span= ><span= style=3D"font-family:'Times New Roman'; font-style:italic">Vitamin C as a = modulator of periodontal oxidative stress: current perspectives and clinica= l relevance. 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margin-= left:394.5pt; border-style:none; position:absolute" /></a> <ta= ble style=3D"width:403.75pt; margin-bottom:0pt; padding:0pt; border-collaps= e:collapse"><tr style=3D"height:3.4pt"><td style=3D"width:4pt; padding:0pt = 5.4pt; vertical-align:top">1= </td><td style=3D"width:158.45pt; padding:0pt 5.4pt; vertical-align:top= ">Lizbeth Tatiana Aguayza Rodas</td><td st= yle=3D"width:10.45pt; padding:0pt 5.4pt; vertical-align:top"><sp= an style=3D"font-family:'Times New Roman'"> </td><td style= =3D"width:187.65pt; padding:0pt 5.4pt; vertical-align:top">https://orcid.org/0000-0003-4629-9602</td>= </tr><tr style=3D"height:29.55pt"><td style=3D"width:4pt; padding:0pt 5.4pt= ; vertical-align:top"> </td><td colspan=3D"3" style=3D"width:378.15pt; paddin= g:0pt 5.4pt; vertical-align:top">Universidad de Cuenca (UCUENCA), Cuenca, Ecuador.</p= >Estudiante de pr= egrado de la Carrera de Odontolog=C3=ADa<a href=3D"mailto:tatiana.aguayza@ucuenca.edu.ec= " style=3D"text-decoration:none">tatiana.aguayza@ucuenca.edu.ec</spa= n></a> </span= ></td></tr><tr style=3D"height:3.4pt"><td style=3D"width:4pt; padding:0= pt 5.4pt; vertical-align:top">2</sp= an></td><td style=3D"width:158.45pt; padding:0pt 5.4pt; vertical-align:= top">Andrea Soledad Carvajal Endara</td><t= d style=3D"width:10.45pt; padding:0pt 5.4pt; vertical-align:top"><img src=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAA= ABQAAAAUCAYAAACNiR0NAAAABHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAA2l= JREFUOI21lEtoXVUUhr+197n3nNzbJN6omdTWRmwbikVq4iMxk0ZU2oGgA1FnQcQiUhUnFqo4cG= IRQUGd+KDY+Jp25ouiGCOxElqjhba0URPzsPQmuY9zzj1nLwcnuU1iQ0f+mzXZe///Wv/aiy1cB= V/83NNOPr/VWHunqO5OVNuNlQVjmZCGjCVhcPHR3q8XrsaVNUITu/KSlu7LFeSpNNZ+57RTjDTv= qFM1IvNiGXWJvD/9x8yXB/efizYU/Hy8/0W/aA/Xq43r1P3nOCNIFsW2XLleTd648Z/863v3nkj= WCL59dp/fWSsfzOXNkShKacvfgnMRlXjqqqIrwr5vkihyhxbT+K2ne082AAzADZXyPj+wL8ehQ1= NH700v0N35OAroutW0rxDF6rUUvddaJfdwM9HwqYFSa0GO1SrpfucUVUXEZCQcqQtZ0VEU1QTPt= mAkDygiEBTsTxq6hx65fWTOy7l0exjKgGrGcjTo2/oKS9EUZ2aPcf/Oo1iTI9UGqFJrzDF5+Sv+= Wvg+y+IEVXaGibsbOO5hGBSkbUUQdRT9zaQuBhE6Ct2MT7/D9OIIVnw6Ct3csfk52oNtTMwcBbE= 0YteeC7we4LinSI9Z03dBNUVxTdu1eI7FcBIjHvPVU1Tjv7nn5sNMXv6WSjyFiIg17AAwqpRW9f= qayNkiM0tjqDrag67mDCi0ARiB6gaTsSEEg4htusj2qGeCIr9dW0JR3PKrR2zreIDURZTrZ7NTB= YdeBPAU+cY59zxCkFlXjHiI2GY1pZbtRMkC1gZcX9hFV+lBTs98SDWexYjFGqkldT0J4EkY/Zov= Bb+klbQ/G1zDYvQntXgWFC5VJ9hSGmRLaRCnCZeqE3x34SXK9XMY8bK+BvZ8JUzGAEQV+Wy87xm= /xbwZ1lwewGmCIIhYnCZXjKvDaQNrfIzkAKXYZl11wR16omfkyHIP0RB/2CV8GrRkNldbNmKbYU= 2enC0uV6bkfUNUd8P1ury3ktQADO05UV6azx1IE/dRULDomjGSVXEFhVbrXMoncTV99smBH5ZW3= 27igzP3trY2ONCyyQ6FtbRLUw2yZ8p+FwARifyCvRDV048rcfXdoT3j5fXp1+BVxdx2um+HGnuX= 9egX4dY01U0iVK2R80nMaELy42O7R39fz/1f8C/hZ5YvjpSKGwAAAABJRU5ErkJggg=3D=3D" w= idth=3D"20" height=3D"20" alt=3D"" style=3D"margin-top:0.45pt; margin-left:= -0.3pt; position:absolute" /> </td><td style=3D"width:187.65pt; padding:0pt 5.4pt= ; vertical-align:top">https://orcid.o= rg/0000-0002-4443-6864</td></tr><tr style=3D"height:29.55pt"><td= style=3D"width:4pt; padding:0pt 5.4pt; vertical-align:top"><spa= n style=3D"font-family:'Times New Roman'"> </td><td colspan= =3D"3" style=3D"width:378.15pt; padding:0pt 5.4pt; vertical-align:top">Universidad de Cuenca= (UCUENCA), Cuenca, Ecuador.<= a href=3D"mailto:andrea.carvajal@ucuenca.edu.ec" style=3D"text-decoration:n= one">andrea.carvajal@ucuenca.edu.ec</a> </td></tr></table> </= p> </sp= an><table style=3D"width:437.15pt; margin-bottom:0pt; padding:0pt; bord= er-collapse:collapse"><tr><td colspan=3D"7" style=3D"width:151.1pt; padding= :0pt 5.4pt; vertical-align:top"> </td><td colspan=3D"2" style=3D"width:264.45pt= ; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padd= ing:0pt 5.4pt; vertical-align:top">Art=C3=ADculo de Investigaci=C3=B3n Cient= =C3=ADfica y Tecnol=C3=B3gicaEnviado: 14/04/2026 Revisado: 12/05/2026 Aceptado: 23/06/2026 </span= >Publicado: 15/= 07/2026DOI: <a href=3D"https://doi.org/10.33262/anat= omiadigital.v9i3.3715" style=3D"text-decoration:none">https://doi.= org/10.33262/anatomiadigital.v9i3.3715 </a> <a href=3D"https://doi.org/= 10.33262/anatomiadigital.v8i4.3568" style=3D"text-decoration:none"> </a></td></tr><tr style=3D"= height:3.5pt"><td colspan=3D"7" style=3D"width:151.1pt; padding:0pt 5.4pt; = vertical-align:top"> = 0;</td><td colspan=3D"2" style=3D"width:264.45pt; border-top:0.7= 5pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.4pt; v= ertical-align:top">= </td></tr><tr><td style=3D"width:52pt; border-top:0.75pt s= olid #000000; padding:0pt 5.4pt; vertical-align:top"> C=C3=ADtese: </td><td style= =3D"width:10.35pt; border-top:0.75pt solid #000000; padding:0pt 5.4pt; vert= ical-align:top">&#x= a0;</td><td colspan=3D"6" style=3D"width:337.8pt; border-top:0.7= 5pt solid #000000; padding:0pt 5.4pt; vertical-align:top"> Aguayza Rodas, L. T., & Carvajal E= ndara, A. S. (2026). Vitamina C como modulador del estr=C3=A9s oxidativo pe= riodontal: perspectivas actuales y relevancia cl=C3=ADnica. Revisi=C3=B3n b= ibliogr=C3=A1fica narrativa. Anatom=C3=ADa Digital, 9(3), 40-62. <a = href=3D"https://doi.org/10.33262/anatomiadigital.v9i3.3715" style=3D"text-d= ecoration:none">https://doi.org/10.33262/anatomiadigital.v9i3.3715</a> </td>= <td style=3D"border-top:0.75pt solid #000000; padding:0pt; vertical-align:t= op"></td></tr><tr><td style=3D"width:52pt; padding:0pt 5.4pt; vertical-alig= n:top"><img src=3D"data:image/jpeg;base64,/9j/4AAQS= kZJRgABAQEAYABgAAD/2wBDAAEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEB= AQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQH/2wBDAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQE= BAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQEBAQH/wAARCAAiAEEDASIAAhEBAx= EB/8QAHQAAAgMBAAMBAAAAAAAAAAAAAAcGCAkFAQIDBP/EAD0QAAEEAgECBAIFBg8AAAAAAAQCA= wUGAQcIAAkREhMhFDEVFiJxgQoaUWGR0zZBUlNXWHWTlZehsdHW8P/EABwBAAEEAwEAAAAAAAAA= AAAAAAgAAQMEAgUGB//EADYRAAIBAgQCBQoGAwAAAAAAAAECAwQRAAUSIQYxEzJBUXEHIjM0YXS= BkbGzNVOCobLRhMPw/9oADAMBAAIRAxEAPwDaOudw/ZPM/t483Jm1VqLoVw1PSIZAlgo8pKhNnv= 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soporte electr=C3=B3nico tiene como misi=C3=B3n contribuir a la= formaci=C3=B3n de profesional= es competentes con visi=C3=B3n human=C3=ADstica y cr=C3=ADtica que sean cap= aces de exponer sus resultados investigativos y = cient=C3=ADficos en la misma medida que se promueva mediante su intervenci= =C3=B3n cambios positivos en la sociedad. <a href=3D= "https://anatomiadigital.org" style=3D"text-decoration:none">https://anatomiadigital.org</a><span= style=3D"line-height:115%; font-family:'Times New Roman'; font-size:8pt"> = La revista es editada por la Editorial Ciencia Digital (Editorial = de prestigio registrada en la C=C3=A1mara Ecuatoriana de Libro con No de Af= iliaci=C3=B3n 663) <a href=3D"http://www.celibro.org.ec" style=3D"te= xt-decoration:none">www.celib= ro.org.ec</a> </div></td><td style=3D"padding:0p= t; vertical-align:top"></td></tr><tr style=3D"height:23.65pt"><td style=3D"= width:52pt; border-bottom:0.75pt solid #000000; padding:0pt 5.4pt; vertical= -align:top"><img 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t=3D"" style=3D"margin-top:0.15pt; margin-left:0pt; position:absolute" /></= span> </td><t= d style=3D"width:10.35pt; border-bottom:0.75pt solid #000000; padding:0pt 5= .4pt; vertical-align:top"> </td><td colspan=3D"6" style=3D"width:337.8pt; borde= r-bottom:0.75pt solid #000000; padding:0pt 5.4pt; vertical-align:top">Esta revista est=C3=A1 protegida bajo una licencia Creative Common= s Atribuci=C3=B3n-NoComercial-CompartirIgual 4.0 International. Copia de la= licencia: <a href=3D"https://creativecommons.org/licenses/by-nc-sa/= 4.0/deed.es" style=3D"text-decoration:none">https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es</s= pan></a> </td><td style=3D"padding:0pt; vertical-align:top">= </td></tr><tr><td colspan=3D"4" style=3D"width:101.1pt; padding:0pt 5.4pt; = vertical-align:top">P= alabras claves: Vitamina C, = estr=C3=A9s oxidativo, enfermedad periodontal, periodontitis, antioxidantes= .</td><td colspan=3D"2" style=3D"width:0.7pt; padding:0pt 5.4pt;= vertical-align:top"> </td><td colspan=3D"2" style=3D"width:298.35pt; border-t= op:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.= 4pt; vertical-align:top">ResumenIntroducci=C3=B3n:<= /span> la periodontitis es mu= ltifactorial y se manifiesta por la destrucci=C3=B3n progresiva de los teji= dos de soporte dental. Su desarrollo se ha asociado con el aumento del estr= =C3=A9s oxidativo, que resulta del desequilibrio entre la producci=C3=B3n d= e especies reactivas de ox=C3=ADgeno y los antioxidantes. La vitamina C par= ticipa en la s=C3=ADntesis del col=C3=A1geno, en la respuesta del sistema i= nmunol=C3=B3gico, neutraliza y elimina radicales libres, lo que podr=C3=ADa= influir sobre la salud periodontal. Objetivo: analizar la= relaci=C3=B3n entre la vitamina C y el estr=C3=A9s oxidativo con la period= ontitis. Metodolog=C3=ADa:= se realiz=C3=B3 una revisi=C3=B3n bibliogr=C3=A1fica exploratoria de la li= teratura cient=C3=ADfica publicada entre 2020 y 2026, utilizando bases de d= atos como PubMed, Scopus, ScienceDirect y Google Acad=C3=A9mico. Se incorpo= r=C3=B3 investigaciones en humanos que analizaron la relaci=C3=B3n entre la= vitamina C, el estr=C3=A9s oxidativo y la salud periodontal. Despu=C3=A9s = de aplicar los criterios de inclusi=C3=B3n y exclusi=C3=B3n se finaliz=C3= =B3 con un total de 10 estudios para su an=C3=A1lisis. Resultados:<spa= n style=3D"font-family:'Times New Roman'"> la revisi=C3=B3n de los estudios= indic=C3=B3 que los pacientes con enfermedades periodontales presentan cam= bios en los biomarcadores vinculados al estr=C3=A9s oxidativo y, en algunos= casos, niveles reducidos de vitamina C comparados con aquellos con salud p= eriodontal. Adem=C3=A1s, la ingesta de vitamina C mostr=C3=B3 un impacto po= sitivo en ciertos biomarcadores inflamatorios y antioxidantes, sin embargo,= los resultados cl=C3=ADnicos en cuanto a la disminuci=C3=B3n de la profund= idad de sondaje y la mejora de inserci=C3=B3n cl=C3=ADnica variaron entre l= os estudios. Conclusiones:= se identific=C3=B3 una relaci=C3=B3n entre la vitamina C, el estr=C3=A9s o= xidativo y el estado periodontal. A pesar de que la vitamina C tiene propie= dades antioxidantes y podr=C3=ADa servir como coadyuvante en el tratamiento= periodontal, la evidencia cl=C3=ADnica es variada, lo que indica la necesi= dad de investigaciones con m=C3=A9todos estandarizados y un seguimiento pro= longado para establecer de manera m=C3=A1s precisa su efecto terap=C3=A9uti= co. = =C3=81rea de estudio general: Odontolog=C3=ADa. =C3=81rea de estudio espec=C3=ADfica: Periodoncia. Ti= po de estudio: Revisi=C3=B3n bibliogr=C3=A1fica narrativa.</td><td style=3D"paddin= g:0pt; vertical-align:top"></td></tr><tr style=3D"height:28.2pt"><td colspa= n=3D"3" style=3D"width:98.85pt; padding:0pt 5.4pt; vertical-align:top">Keywo= rds: Vitamin C, oxidative st= ress, periodontal disease, periodontitis, antioxidants.</td><td = colspan=3D"2" style=3D"width:1pt; padding:0pt 5.4pt; vertical-align:top"><p= style=3D"margin-bottom:0pt; text-align:justify; line-height:115%; font-siz= e:12pt"> </td= ><td colspan=3D"3" style=3D"width:300.3pt; border-top:0.75pt solid #000000;= border-bottom:0.75pt solid #000000; padding:0pt 5.4pt; vertical-align:top"= >AbstractIntroduction. Periodontal disease is a multifactorial conditio= n characterized by the progressive destruction of the tooth-supporting tiss= ues. Its development has been associated with increased oxidative stress, r= esulting from an imbalance between the production of reactive oxygen specie= s and antioxidants. Vitamin C plays a role in collagen synthesis, immune re= sponse, and the neutralization of free radicals, which may influence period= ontal health. Objective. T= o analyze the relationship between vitamin C, oxidative stress, and periodo= ntal disease. Methodology.= An exploratory literature review of scientific publications published betw= een 2020 and 2026 was conducted using the PubMed, Scopus, ScienceDirect, an= d Google Scholar databases. Studies in humans analyzed the relationship bet= ween vitamin C, oxidative stress, and periodontal disease were included. Af= ter applying the inclusion and exclusion criteria, a total of 10 studies we= re selected for analysis. Results. The reviewed studies indicated that patients with periodontal dise= ase exhibit alterations in biomarkers associated with oxidative stress and,= in some cases, lower levels of vitamin C compared with periodontally healt= hy individuals. Furthermore, vitamin C intake showed positive effects on ce= rtain inflammatory and antioxidant biomarkers. However, clinical outcomes r= egarding reductions in probing depth and improvements in clinical attachmen= t levels varied among the studies. Conclusion. The relationship between vitamin C, oxidative stress, = and periodontal disease was identified. Although vitamin C possesses antiox= idant properties and may serve as an adjunct in periodontal treatment, the = available clinical evidence remains variable, highlighting the need for stu= dies with standardized methodologies and longer follow-up periods to more a= ccurately determine its therapeutic effect. General Area of Study: <span= style=3D"font-family:'Times New Roman'">Dentistry. Specific area of study: </s= pan>Periodontology. <s= pan style=3D"font-family:'Times New Roman'; font-weight:bold; background-co= lor:#ffffff">Type of study: Narrative bibliographic review. </td><td style=3D"paddi= ng:0pt; vertical-align:top"></td></tr><tr style=3D"height:0pt"><td style=3D= "width:62.8pt"></td><td style=3D"width:21.15pt"></td><td style=3D"width:25.= 7pt"></td><td style=3D"width:2.25pt"></td><td style=3D"width:9.55pt"></td><= td style=3D"width:1.95pt"></td><td style=3D"width:38.5pt"></td><td style=3D= "width:270.65pt"></td><td style=3D"width:4.6pt"></td></tr></table> </= p>1. = 0; Introducci=C3=B3nLas enfermedades periodontales, gingivit= is y periodontitis, son condiciones multifactoriales e inmunoinflamatorias = que afectan los tejidos blandos y duros del complejo periodontal, respectiv= amente (1). La respuesta inflamatoria ante la presencia de la biopel=C3=ADc= ula dental puede provocar la destrucci=C3=B3n tisular, induciendo as=C3=AD = un ciclo continuo de retroalimentaci=C3=B3n positiva de prote=C3=B3lisis, i= nflamaci=C3=B3n y enriquecimiento de pat=C3=B3genos periodontales (2). </sp= an>La periodont= itis severa, puede ocasionar p=C3=A9rdida dental presentando alteraciones f= uncionales que afectan negativamente la calidad de vida de las personas; en= Am=C3=A9rica Latina y el Caribe la prevalencia de periodontitis en poblaci= =C3=B3n adulta var=C3=ADa entre el 11,6% y el 99,9%, dependiendo de los gru= pos etarios. Esta extensa variabilidad refleja una alta carga de la enferme= dad y representa un verdadero desaf=C3=ADo para la salud p=C3=BAblica. Por = ende, resulta necesario identificar factores asociados con su prevenci=C3= =B3n y progresi=C3=B3n. La complejidad= de las enfermedades periodontales no solo radica en los microorganismos pe= riodontopat=C3=B3genos, sino que el hu=C3=A9sped tenga la capacidad de reac= cionar ante estos est=C3=ADmulos. Conforme a ello, actualmente existe inter= =C3=A9s por entender los procesos biol=C3=B3gicos que pueden afectar el gra= do de susceptibilidad y desarrollo de la enfermedad (3).El estr=C3=A9s oxidativo es= un desequilibrio producido cuando los oxidantes superan los antioxidantes = del organismo, provocando da=C3=B1o tisular con la liberaci=C3=B3n de radic= ales libres; estos =C3=BAltimos, son mol=C3=A9culas altamente reactivas por= la presencia de electrones desapareados en su capa m=C3=A1s externa, permi= ti=C3=A9ndoles interactuar y alterar estructuras celulares (4). Los radical= es libres, junto a otras mol=C3=A9culas oxidantes, se agrupan bajo el t=C3= =A9rmino de especies reactivas, las cuales pueden ser derivados del ox=C3= =ADgeno, nitr=C3=B3geno y otros elementos (5). Estas mol=C3=A9culas se desarrollan = en condiciones fisiol=C3=B3gicas, as=C3=AD como, como patol=C3=B3gicas; por= ende, para atenuar su efecto a nivel biol=C3=B3gico, las c=C3=A9lulas han = desarrollado sistemas antioxidantes, tanto enzim=C3=A1ticos como no enzim= =C3=A1ticos, que ayudan a neutralizar las especies reactivas y mantener el = equilibrio redox de la c=C3=A9lula (6). Una de las fuentes celulares m=C3= =A1s relevantes para las especies reactivas de ox=C3=ADgeno (ROS), por ejem= plo, es la respiraci=C3=B3n mitocondrial (6). El equilibrio entre la producci=C3=B3n de especies reactivas y los = sistemas antioxidantes es importante para mantener la homeostasis celular y= la integridad de los tejidos; cuando este equilibrio se altera, pueden pro= ducirse procesos relacionados con el da=C3=B1o celular y la inflamaci=C3=B3= n. Por esta raz=C3=B3n, los sistemas antioxidantes han adquirido importanci= a en el estudio del estr=C3=A9s oxidativo y sus efectos a nivel biol=C3=B3g= ico (6). La vitamina C o =C3=A1cido asc=C3=B3rbico, es una vitamina hidrosoluble co= n funciones bien establecidas en diversos procesos fisiol=C3=B3gicos; adem= =C3=A1s de su reconocida funci=C3=B3n como antioxidante y cofactor en la s= =C3=ADntesis de col=C3=A1geno, la vitamina C ha despertado inter=C3=A9s por= sus propiedades inmunomoduladoras y sus potenciales beneficios terap=C3=A9= uticos en enfermedades del sistema inmunitario (7). Tiene efectos directos<= /span> sobre las = c=C3=A9lulas inmunitarias, ya = que desempe=C3=B1a = 0; un papel crucial</sp= an> en = la regulaci=C3=B3n de= la producci=C3=B3n y <spa= n style=3D"font-family:'Times New Roman'">la actividad = de las citocinas,</sp= an> mediadores clave </= span>de la = 0; inflamaci=C3=B3n</s= pan> y l= as respuestas inmunitarias; puede adem=C3=A1s modular <= /span>el equilibrio entre</spa= n> las citocinas </spa= n>proinflamatorias<spa= n style=3D"font-family:'Times New Roman'"> y antiinfla= matorias, </span= >contribuyendo as=C3=AD, a</sp= an> una respuesta </spa= n>inmunitaria equilibrada; siendo que, al suprimir&#= xa0; la producci=C3=B3n de <span= style=3D"font-family:'Times New Roman'">citocinas proinflamatorias, como</s= pan> la = interleucina 6 <= /span>(IL6) y&= #xa0; el factor de</spa= n> necrosis tumoral </= span>alfa (TNF=CE=B1), y</sp= an> al = mismo <sp= an style=3D"font-family:'Times New Roman'">tiempo promover&#= xa0; la s=C3=ADntesis d= e citocinas antiinflamatorias, como la = interleucina 10 (IL 10), la vitamina</= span> C = puede <sp= an style=3D"font-family:'Times New Roman'">ayudar a </= span>mitigar la inflamaci=C3= =B3n <spa= n style=3D"font-family:'Times New Roman'">excesiva y <= /span>el da=C3=B1o tisular (8)= .Por otr= a parte, sus propiedades antioxidantes le permiten eliminar las especies re= activas de ox=C3=ADgeno (ROS)<s= pan style=3D"font-family:'Times New Roman'"> y neutral= izar los radicales libres, reduciendo<= /span> as=C3=AD el estr=C3=A9s oxidativo y li= mitando la inflamaci=C3=B3n. Al mantener el equilibrio, la vitamina C puede= ayudar a proteger las c=C3=A9lulas del da=C3=B1o oxidativo y modular y las= v=C3=ADas de se=C3=B1alizaci=C3=B3n inflamatoria (7)(8). De esta manera, l= a vitamina C contribuye a proteger las c=C3=A9lulas frente al da=C3=B1o oxi= dativo y favorece el mantenimiento de la homeostasis tisular. <p= style=3D"margin-bottom:0pt; text-align:justify; line-height:115%; font-siz= e:12pt">La vitamina C es un m= icronutriente esencial para la salud periodontal, al participar en tres fun= ciones indispensables: s=C3=ADntesis y maduraci=C3=B3n del col=C3=A1geno, m= odulaci=C3=B3n del sistema inmunol=C3=B3gico e inflamatorio y un potente an= tioxidante frente al estr=C3=A9s oxidativo (9). El periodonto depende en gr= an medida del col=C3=A1geno, puesto que constituye un componente fundamenta= l en la matriz extracelular periodontal, la enc=C3=ADa, cemento radicular y= hueso alveolar (10). La vitamina C se caracteriza por ser un cofactor de l= as hidroxilasas de prolina y lisina, enzimas necesarias para formar col=C3= =A1geno tipo I y III; su deficiencia genera escorbuto, afectando los tejido= s gingivales por alteraci=C3=B3n de la s=C3=ADntesis de col=C3=A1geno y oca= sionando sangrado gingival espont=C3=A1neo y ulceraci=C3=B3n de la mucosa o= ral (10).En cuanto a la modulaci=C3=B3n inmunol=C3=B3gica, la quimiotaxis y fagocit= osis de neutr=C3=B3filos; mejora la funci=C3=B3n fagoc=C3=ADtica de los mac= r=C3=B3fagos y fortalece la l=C3=ADnea de defensa inmunitaria de los linfoc= itos T, finalmente la vitamina C act=C3=BAa como antioxidante primario fren= te al estr=C3=A9s oxidativo, neutralizando Especies Reactivas de Ox=C3= =ADgeno (ROS) evitando= da=C3=B1os en el ADN y membranas celulares. Esto favorece a disminuir la i= nflamaci=C3=B3n evitando que la enfermedad periodontal progrese (11).</span= > Por lo tanto, estas funciones han despertad= o un creciente inter=C3=A9s cient=C3=ADfico sobre el posible papel de la vi= tamina C en la prevenci=C3=B3n y control de las enfermedades periodontales.= Aunque las enfermedades= periodontales han sido ampliamente estudiadas, todav=C3=ADa existe inter= =C3=A9s por comprender los factores que influyen en su desarrollo y severid= ad. <span= style=3D"font-family:'Times New Roman'">En este contexto, la vitamina C ha= generado inter=C3=A9s por sus caracter=C3=ADsticas inmunomoduladoras, anti= oxidantes y su papel fundamental en la s=C3=ADntesis de col=C3=A1geno. De l= a misma manera, se ha reconocido el estr=C3=A9s oxidativo como un mecanismo= vinculado con el da=C3=B1o tisular periodontal y progresi=C3=B3n de la enf= ermedad. No obstante, la evidencia disponible presenta resultados variables= sobre esta relaci=C3=B3n entre la vitamina C, el estr=C3=A9s oxidativo y l= as enfermedades periodontales, as=C3=AD como sobre el posible beneficio en = la suplementaci=C3=B3n como coadyuvante terap=C3=A9utico. Por ello, surge e= l inter=C3=A9s de integrar y analizar la literatura disponible para compren= der la participaci=C3=B3n de estos factores en la salud periodontal y su po= sible aplicaci=C3=B3n dentro de estrategias preventivas y terap=C3=A9uticas= en periodoncia.Por lo tanto, el objetivo de esta revisi=C3=B3n bibliogr=C3=A1fica= fue analizar la relaci=C3=B3n entre la vitamina C y estr=C3=A9s oxidativo = con la periodontitis.2= . Metodolog=C3=ADa<= /span>La siguie= nte revisi=C3=B3n bibliogr=C3=A1fica narrativa fue desarrollada bajo los li= neamientos de la declaraci=C3=B3n PRISMA (Preferred= Reporting Items for Systematic Reviews and Meta-Analyses), con el prop=C3=B3sito de identificar,= analizar y sintetizar la evidencia cient=C3=ADfica disponible sobre la rel= aci=C3=B3n entre la vitamina C, el estr=C3=A9s oxidativo y la periodontitis= . Se rea= liz=C3=B3 una b=C3=BAsqueda electr=C3=B3nica en las bases de datos PubMed, = Science Direct, Scopus y Google Acad=C3=A9mico. Los t=C3=A9rminos se relaci= onaron con la vitamina C, estr=C3=A9s oxidativo y periodontitis. La estrate= gia incluy=C3=B3 los siguientes t=C3=A9rminos y operadores booleanos: (vita= min C OR =E2=80=9Cascorbic acid=E2=80=9D) AND (=E2=80=9Coxidative stress=E2= =80=9D) AND (=E2=80=9Cperiodontal disease=E2=80=9D OR periodontitis OR "period= ontal diseases"). Los = t=C3=A9rminos descriptores MeSH utilizados para PubMed fueron: <span= style=3D"font-family:'Times New Roman'; font-style:italic">("Periodontitis= "[MeSH] OR "Periodontal Diseases"[MeSH]) AND ("Oxidative Stress" [MeSH] OR = antioxidants) AND ("Ascorbic Acid" [MeSH] OR "Vitamin C"). Para reducir sesgos y excluir factores= se utilizaron los operadores booleanos NOT (diabetes OR c=C3=A1ncer </span= >OR =E2=80= =9Ccardiovascular disease=E2=80=9D OR pregnancy OR obesity OR smoking OR to= bacco OR =E2=80=9Csystemic disease=E2=80=9D). Se incluyeron publicaciones en idioma ingl=C3=A9s publicada= s entre 2020 y 2026, que se llevaron a cabo en adultos humanos y examinaron= biomarcadores de estr=C3=A9s oxidativo y/o vitamina C en relaci=C3=B3n con= las enfermedades periodontales. Se tomaron en consideraci=C3=B3n metaan=C3= =A1lisis, revisiones sistem=C3=A1ticas, ensayos cl=C3=ADnicos controlados y= estudios observacionales. Se eliminaron los estudios que se llevaron a cab= o en pacientes con enfermedades sist=C3=A9micas o condiciones que podr=C3= =ADan modificar los resultados como el embarazo, diabetes mellitus o tabaqu= ismo; as=C3=AD como publicaciones en otros idiomas e investigaci=C3=B3n in = vitro. L= a selecci=C3=B3n de los estudios se efectu=C3=B3 en dos fases: revisi=C3=B3= n de t=C3=ADtulos y res=C3=BAmenes seguida de una lectura completa de los a= rt=C3=ADculos potencialmente elegibles. Inicialmente se identificaron 81 ar= t=C3=ADculos, procedentes de la base de datos seleccionadas, se procedi=C3= =B3 a eliminar los 15 art=C3=ADculos duplicados, se excluyeron art=C3=ADcul= os no compatibles con el tema de investigaci=C3=B3n 36. Posteriormente, los= art=C3=ADculos seleccionados fueron analizados a texto completo para verif= icar el cumplimiento de los criterios de inclusi=C3=B3n y exclusi=C3=B3n. C= omo resultado de este proceso se incluyeron 10 art=C3=ADculos en la s=C3=AD= ntesis cualitativa final, los cuales sirvieron de base para el an=C3=A1lisi= s de la relaci=C3=B3n entre la vitamina C, estr=C3=A9s oxidativo y la perio= dontitis. La informaci=C3=B3n fue organizada en una matriz elaborada en Microsoft E= xcel. Se registraron autor, a=C3=B1o de publicaci=C3=B3n, variables de estu= dio, dise=C3=B1o metodol=C3=B3gico, tama=C3=B1o de muestra, caracter=C3=ADs= ticas de poblaci=C3=B3n, biomarcadores evaluados, niveles de vitamina C, pa= r=C3=A1metros periodontales y resultados. No se requiri=C3=B3 aprobaci=C3=B3n de u= n comit=C3=A9 de =C3=A9tica ni consentimiento informado debido a que se fun= dament=C3=B3 exclusivamente en la revisi=C3=B3n de literatura cient=C3=ADfi= ca previamente publicada. Sin embargo, se respetaron los principios de inte= gridad cient=C3=ADfica y adecuada citaci=C3=B3n de las fuentes consultadas.= El proceso de selecci=C3=B3n de estudios se resume en la <a href=3D= "#fig1" style=3D"text-decoration:none">Figura 1</a>= . <img src=3D"data:im= age/png;base64,iVBORw0KGgoAAAANSUhEUgAAAMgAAACACAYAAABOUyafAAAABHNCSVQICAgI= fAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAErNJREFUeJztnXu0HVV9xz83D29CTGIeEAgxvWK= ighKLBS3hYUBjqNTYqFEsCEakilgXYKWNBLXtqo/6WBhjsEDxhU1qCk2rXS5qDfRhi8KyNFUaoX= WlLJRiSQVplwTR2z++e5h99t2zzzzOnHtuzu+z1l13zuw9sx8zv9mv7/xmBBjHMIwYIzOyjUnNh= mEMFk82GtMmMxeGMeiYgRhGAjMQw0hgBmIYCcxADCOBGYhhJDADMYwEZiCGkcAMxDASmIEYRgIz= EMNIYAZiGAnMQAwjgRmIYSQwAzGMBFUN5P1IKz/utn2ucvuP7EG+/HMu936PAG8Bvg38AfDeILz= X6QEcC1wDzKxwjl7XQ8ibgXNqHvtWlL9n9S47XRkB7gZ29THNnlH1jcK3uL8Yu2l2Y7y0S/gvAu= 8CFgOfAw5vkFZZ1gFzKx7TtB5Cwnp5XcPzXUt/DQTgaKaOgWSNQM+7WD9pcOxc4G1d4jwT2A88B= JwP/HeD9MpyC/BoxWOa1ENIrF7+tOE5H2t4fB0en4Q0G9MLAzkD+DtgGzA9CFsP3AbsJH+CfAs4= 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cwB9Z4cQ/NZcLk2EAvAAPAAPwAPwWx9+4y6hm5659I/MCPuXJkwjef8vdoX5swEe++Fc5atGeLD= +A6JqiOU0u5EEAAAAAElFTkSuQmCC" width=3D"31" height=3D"83" alt=3D"" style=3D= "margin-top:-16.54pt; margin-left:10.55pt; position:absolute" /><spa= n style=3D"font-family:'Times New Roman'"> <= p style=3D"margin-top:12pt; margin-bottom:10pt; text-align:center; line-hei= ght:115%; font-size:10pt"><a id=3D"fig1">Figura 1. Diagrama de flujo PRISMA para la selecci=C3=B3n de estudios = incluidos en la revisi=C3=B3n bibliogr=C3=A1fica</a>3. &= #xa0; Resultados Las investigaciones evaluaron la relaci=C3= =B3n entre vitamina C, estr=C3=A9s oxidativo y enfermedad periodontal media= nte diferentes dise=C3=B1os y procesos metodol=C3=B3gicos, como ensayos cl= =C3=ADnicos aleatorizados, estudios transversales, estudios de casos y cont= roles, revisiones sistem=C3=A1ticas y metaan=C3=A1lisis. Las poblaciones es= tudiadas incluyeron pacientes periodontalmente sanos, con gingivitis y peri= odontitis. La evaluaci=C3=B3n cl=C3=ADnica periodontal se realiz=C3=B3 prin= cipalmente mediante Profundidad de Sondaje (PD), Nivel de Inserci=C3=B3n Cl=C3=ADnica (= CAL), Sangrado al= Sondaje (BOP), </span= >= =C3=8Dndice de Placa (PI), =C3=8Dndice Gingival (GI), recesi=C3=B3n gingival, p=C3=A9rdida =C3=B3sea alveolar y se= veridad de la periodontitis.Los biomarcadores antioxidantes e inflamatorios fueron = evaluados en saliva, Fluido Crevicular Gingival (GCF), suero y plasma sangu=C3=ADneo mediant= e ensayos ELISA, pruebas de capacidad antioxidante total, m=C3=A9todos colo= rim=C3=A9tricos y an=C3=A1lisis espectrofotom=C3=A9tricos. Algunos estudios= analizaron la suplementaci=C3=B3n sist=C3=A9mica o aplicaci=C3=B3n local d= e vitamina C como terapia periodontal coadyuvante no quir=C3=BArgica, combi= n=C3=A1ndola con Fibrina Rica en Plaquetas (PRF), antioxidantes complementarios o enjuagues = bucales. De la misma forma, se observ=C3=B3 heterogeneidad en los m=C3=A9to= dos de evaluaci=C3=B3n, biomarcadores analizados y tiempos de seguimiento c= l=C3=ADnico entre las investigaciones seleccionadas. 3.1. Asociaci=C3=B3n entre niveles de vitamina C y severi= dad periodontalLos estudios reportan que los pacientes con periodontitis presentar= on menores concentraciones de vitamina C en comparaci=C3=B3n con individuos= periodontalmente sanos (2)(12). La disminuci=C3=B3n de vitamina C fue iden= tificada en saliva, suero sangu=C3=ADneo y fluido crevicular gingival (2)(1= 2). Hashim et al. (2) observaron diferencias significativas entre las conce= ntraciones de vitamina C en saliva y GCF 3,16 =CE=BCg/mL y 4,55 =CE=BCg/mL,= respectivamente; (p =3D = 0,022), mientras que Assaf & Rabi (12) reportaron niveles s=C3=A9ricos = significativamente menores de vitamina C en pacientes con periodontitis est= adio IV en comparaci=C3=B3n con estadios menos avanzados (p < 0,05), sugiriendo una relaci=C3=B3n= entre la deficiencia de vitamina C y la progresi=C3=B3n de la enfermedad p= eriodontal (12). Por lo tanto, los hallazgos identificaron una relaci=C3=B3= n inversa entre los niveles de vitamina C y la gravedad de la enfermedad pe= riodontal (2)(12), como se muestra en la <a href=3D"#tabla1" style=3D"te= xt-decoration:none">Tabla 1</= span></a>.<= a id=3D"tabla1">Tabla 1. <= span style=3D"font-family:'Times New Roman'; font-style:italic">Asociaci=C3= =B3n entre deficiencia de vitamina C y enfermedad periodontal</a></p= ><table style=3D"width:101.36%; margin-bottom:0pt; padding:0pt; border-coll= apse:collapse"><tr style=3D"height:32.85pt"><td style=3D"width:8.72%; borde= r-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt= 5.75pt; vertical-align:top">Autor/ A=C3=B1o</td><td style=3D"width:15.98%; border-to= p:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.7= 5pt; vertical-align:top">Estudio y muestra</td><td style=3D"width:12.58%; border-top:= 0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75p= t; vertical-align:top">Condici=C3=B3n periodontal evaluada</td><td style=3D"width:11.= 1%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; pa= dding:0pt 5.75pt; vertical-align:top">Tipo de evaluaci=C3=B3n de vitamina C</td><td s= tyle=3D"width:13.12%; border-top:0.75pt solid #000000; border-bottom:0.75pt= solid #000000; padding:0pt 5.75pt; vertical-align:top">Par=C3=A1metros periodontales evaluados<= /span></td><td style=3D"width:8.96%; border-top:0.75pt solid #000000; b= order-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">= Variable</= td><td style=3D"width:14.42%; border-top:0.75pt solid #000000; border-botto= m:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top"><sp= an style=3D"font-family:'Times New Roman'">Resultados</td><td st= yle=3D"width:15.14%; border-top:0.75pt solid #000000; border-bottom:0.75pt = solid #000000; padding:0pt 5.75pt; vertical-align:top">Hallazgo</td></tr><tr style= =3D"height:13.3pt"><td style=3D"width:8.72%; border-top:0.75pt solid #00000= 0; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:t= op"><span= style=3D"font-family:'Times New Roman'">Hashim et al. (2025)(2)</td><td style=3D"width:15= .98%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; = padding:0pt 5.75pt; vertical-align:top">= Estudio transversal; n=3D43 participantes distribuidos en periodontalmente = sanos (n=3D13), grupo periodontitis leve (n=3D9), grupo con </td= ><td style=3D"width:12.58%; border-top:0.75pt solid #000000; border-bottom:= 0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">Salud periodontal / Periodontitis</td><td = style=3D"width:11.1%; border-top:0.75pt solid #000000; border-bottom:0.75pt= solid #000000; padding:0pt 5.75pt; vertical-align:top">Salival y GCF</td><td style=3D"width:13.12%; bor= der-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0= pt 5.75pt; vertical-align:top">PD, CAL, = BOP, Vitamina C salival y GCF</td><td style=3D"width:8.96%; bord= er-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0p= t 5.75pt; vertical-align:top"> </sp= an></td><td style=3D"width:14.42%; border-top:0.75pt solid #000000; bor= der-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top"><p= style=3D"margin-bottom:0pt; line-height:115%; font-size:9pt">Vitamina C en GCF: 4,55 =C2=B5g/mL vs sa= liva: 3,16 =C2=B5g/mL (p=3D0,022). En saliva, las medianas de vitamina C fu= eron 4,7172; </td><td style=3D"width:15.14%; border-top:0.75pt s= olid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; verti= cal-align:top">Los niveles salivales mos= traron diferencias significativas seg=C3=BAn la severidad periodontal (</sp= an>p</span= >=3D0,000136), mientras que l= os niveles de </td></tr></table> Tabla 1. Asociaci=C3=B3n entre deficiencia de vitamina C y enfermedad periodonta= l (continuaci=C3=B3n)<table style=3D"width:100%; margin-bottom:0= pt; padding:0pt; border-collapse:collapse"><tr style=3D"height:34.55pt"><td= style=3D"width:8.44%; border-top:0.75pt solid #000000; border-bottom:0.75p= t solid #000000; padding:0pt 5.75pt; vertical-align:top">Autor/ A=C3=B1o</td><td style=3D"width:15.6%;= border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; paddi= ng:0pt 5.75pt; vertical-align:top">Estud= io y muestra</td><td style=3D"width:12.12%; border-top:0.75pt so= lid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertic= al-align:top">Condici=C3=B3n periodontal= evaluada</td><td style=3D"width:10.68%; border-top:0.75pt solid= #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-= align:top">= Tipo de evaluaci=C3=B3n de vi= tamina C</td><td style=3D"width:12.62%; border-top:0.75pt solid = #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-a= lign:top"><= span style=3D"font-family:'Times New Roman'">Par=C3=A1metros periodontales = evaluados</td><td style=3D"width:9.56%; border-top:0.75pt solid = #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-a= lign:top"><= span style=3D"font-family:'Times New Roman'">Variable</td><td st= yle=3D"width:14.68%; border-top:0.75pt solid #000000; border-bottom:0.75pt = solid #000000; padding:0pt 5.75pt; vertical-align:top">Resultados</td><td style=3D"width:16.3%; border-t= op:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.= 75pt; vertical-align:top">Hallazgo</span= ></td></tr><tr style=3D"height:110.15pt"><td style=3D"width:8.44%; bord= er-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0p= t 5.75pt; vertical-align:top"> </= span></td><td style=3D"width:15.6%; border-top:0.75pt solid #000000; bo= rder-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top"><= p style=3D"margin-bottom:0pt; line-height:115%; font-size:9pt">periodontitis moderada (n=3D12) y grupo = con periodontitis severa (n=3D9)</td><td style=3D"width:12.12%; = border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; paddin= g:0pt 5.75pt; vertical-align:top"> = </td><td style=3D"width:10.68%; border-top:0.75pt solid #000000;= border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top= "> </td><td style=3D"wid= th:12.62%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000= 000; padding:0pt 5.75pt; vertical-align:top"> </td><td style=3D"width:9.56%; border-top:0.75pt soli= d #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical= -align:top"> </td><td st= yle=3D"width:14.68%; border-top:0.75pt solid #000000; border-bottom:0.75pt = solid #000000; padding:0pt 5.75pt; vertical-align:top">0,8743; 2,0600 y 3,4907 para los grupos sano, periodontitis = leve, moderada y severa, respectivamente (p=3D0,000136). En GCF, las medianas fueron 4,9625; 4,4719;= 0,3270 y 4,9625, respectivamente (p=3D0,062)</td><td style=3D"width:16.3%; border-top:0.= 75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt;= vertical-align:top">vitamina C en GCF n= o mostraron diferencias significativas (p =3D0,062)</td></tr><tr style=3D"height:110.15pt= "><td style=3D"width:8.44%; border-top:0.75pt solid #000000; border-bottom:= 0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">Assaf & Rabi et at. (2022)(12)</td><td style=3D"width:15.6%; = border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; paddin= g:0pt 5.75pt; vertical-align:top">Estudi= o transversal: n=3D25 pacientes con periodontitis distribuidos en pacientes= con periodontitis estadio II (n=3D2), periodontitis estadio III (n=3D11) y= grupo con periodontitis estadio IV (n=3D12)</td><td style=3D"wi= dth:12.12%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #00= 0000; padding:0pt 5.75pt; vertical-align:top">Periodontitis estadio IV / controles</td><td style=3D"widt= h:10.68%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #0000= 00; padding:0pt 5.75pt; vertical-align:top">S=C3=A9rica </td><td style=3D"width:12.62%; border-top:0.75p= t solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; ve= rtical-align:top">PD, CAL y vitamina C s= =C3=A9rica</td><td style=3D"width:9.56%; border-top:0.75pt solid= #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-= align:top">= Vitamina C s=C3=A9rica= </td><td style=3D"width:14.68%; border-top:0.75pt solid #000000; border= -bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">Estadio II: no se registr=C3=B3 deficiencia d= e Vit C. En el estadio III se identificaron 5 pacientes con deficiencia de = Vit C, mientras que en el estadio IV se registraron 5 pacientes con deficie= ncia de Vit C. </td><td style=3D"width:16.3%; border-top:0.75pt = solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vert= ical-align:top">Los pacientes con period= ontitis estadio IV presentaron niveles s=C3=A9ricos significativamente meno= res de vitamina C en comparaci=C3=B3n con los estadios menos avanzados (</s= pan>p </sp= an><0,05). </td></tr></table>Nota: elaboraci=C3=B3n a partir de los estudios in= cluidos en la revisi=C3=B3n (2)(12). Abreviaturas: PD: profundidad de sonda= je; CAL: nivel de inserci=C3=B3n cl=C3=ADnica; BOP: sangrado al sondaje; GC= F: fluido crevicular; Vit C: vitamina C; =C2=B5g/mL: microgramos por milili= tro; p: valor de signific= ancia estad=C3=ADstica; n: n=C3=BAmero de participantes; vs: comparado con.= </s= pan>3.2. Efecto terap=C3=A9utico de la vit= amina C como coadyuvante periodontal Los estudios evaluaron la vitamina C com= o coadyuvante de la terapia periodontal no quir=C3=BArgica y regenerativa, = mostrando resultados variables. Se observaron diferencias favorables en el = nivel de inserci=C3=B3n cl=C3=ADnica a los 3 meses (p =3D0,029) y disminuci=C3=B3n en el dolor posto= peratorio a los 2 y 3 d=C3=ADas (p =3D 0,021 y p = =3D 0,001) (13). Adem=C3=A1s, se observ=C3=B3 reducci=C3=B3n de la recesi= =C3=B3n gingival y de la profundidad del defecto radiogr=C3=A1fico en defec= tos intra=C3=B3seos tratados con =C3=A1cido asc=C3=B3rbico y PRF (<s= pan style=3D"font-family:'Times New Roman'; font-style:italic">p <sp= an style=3D"font-family:'Times New Roman'">< 0,05) (14). Por el contrari= o, no se observaron beneficios cl=C3=ADnicos adicionales significativos sob= re los =C3=ADndices de placa, =C3=ADndice gingival y sangrado al sondaje (<= /span>p</s= pan> > 0,05) (15). De la m= isma manera, la suplementaci=C3=B3n con vitamina C no produjo mejoras adici= onales significativas en la capacidad antioxidante total s=C3=A9rica y sali= val (p > 0,05) (16). P= or otro lado, se report=C3=B3 que la suplementaci=C3=B3n combinada con vita= minas C, D, y E mostr=C3=B3 mejoras en la profundidad de sondaje y sangrado= al sondaje, as=C3=AD como un incremento de los niveles s=C3=A9ricos de vit= amina C (17). La <a href=3D"#tabla2" style=3D"text-decoration:none">= Tabla 2</a> presenta los resultados de cada estudio= .<a id=3D"tabla2">Tabla 2. </sp= an>Efecto = terap=C3=A9utico de la vitamina C como coadyuvante en el tratamiento period= ontal </a><table style=3D"width:100%; margin-bottom:0pt; padding= :0pt; border-collapse:collapse"><tr><td style=3D"width:12%; border-top:0.75= pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; v= ertical-align:top">Autor/A=C3=B1o</span= ></td><td style=3D"width:16.02%; border-top:0.75pt solid #000000; borde= r-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">Dise=C3=B1o y muestra</td><td st= yle=3D"width:12.32%; border-top:0.75pt solid #000000; border-bottom:0.75pt = solid #000000; padding:0pt 5.75pt; vertical-align:top">Intervenci=C3=B3n terap=C3=A9utica</td><td style= =3D"width:13.68%; border-top:0.75pt solid #000000; border-bottom:0.75pt sol= id #000000; padding:0pt 5.75pt; vertical-align:top">M=C3=A9todo / tipo de evaluaci=C3=B3n</td><td style= =3D"width:13.68%; border-top:0.75pt solid #000000; border-bottom:0.75pt sol= id #000000; padding:0pt 5.75pt; vertical-align:top">Par=C3=A1metros cl=C3=ADnicos evaluados</td><td sty= le=3D"width:15.54%; border-top:0.75pt solid #000000; border-bottom:0.75pt s= olid #000000; padding:0pt 5.75pt; vertical-align:top">Resultados cl=C3=ADnicos principales</td><td styl= e=3D"width:16.76%; border-top:0.75pt solid #000000; border-bottom:0.75pt so= lid #000000; padding:0pt 5.75pt; vertical-align:top">Hallazgo cl=C3=ADnico</td></tr><tr><td style=3D"wi= dth:12%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #00000= 0; padding:0pt 5.75pt; vertical-align:top">Sherif et al. (2= 025) (13)</td><td style=3D"width:16.02%; border-top:0.75pt solid= #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-= align:top">Ensayo cl=C3=ADnico aleatorizado; (n=3D45) pacie= ntes con periodontitis estadio II distribuidos en tres grupos: PMPR+I-PRF+v= itamina C (n=3D15), PMPR+I-PRF(n=3D15) y PMPR solo (n=3D15) </td= ><td style=3D"width:12.32%; border-top:0.75pt solid #000000; border-bottom:= 0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">IPRF + vitamina C como coadyuvante periodontal</td><td style= =3D"width:13.68%; border-top:0.75pt solid #000000; border-bottom:0.75pt sol= id #000000; padding:0pt 5.75pt; vertical-align:top">Evaluac= i=C3=B3n cl=C3=ADnica periodontal y seguimiento postoperatorio a 3 meses</s= pan></td><td style=3D"width:13.68%; border-top:0.75pt solid #000000; bo= rder-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top"><= p style=3D"line-height:115%; font-size:9pt">CAL,&#x= a0; PD, BOP,<sp= an style=3D"font-family:'Times New Roman'"> PI y dolor= postoperatorio</td><td style=3D"width:15.54%; border-top:0.75pt= solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; ver= tical-align:top">Mejor nivel de inserci=C3=B3n cl=C3=ADni= ca (CAL) a los 3 meses en el grupo PMPR+I-PRF/VitC (p=3D0,029). No se obser= varon diferencias intergrupales significativas para BOP, PD, CAL, GM, PI ni= par=C3=A1metros radiogr=C3=A1ficos a los 3 o 6 meses (p>0,05). Menor dolor postoperatorio a = los 2 y 3 d=C3=ADas (p=3D= 0,021; p=3D0,001). </span= ></td><td style=3D"width:16.76%; border-top:0.75pt solid #000000; borde= r-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">La incorporaci=C3=B3n de vitamina C en I-PRF redujo el dolor po= stoperatorio y mostr=C3=B3 una mejor=C3=ADa transitoria del CAL a los 3 mes= es; sin embargo, no aport=C3=B3 beneficios cl=C3=ADnicos periodontales adic= ionales sostenidos frente a PMPR o I-PRF solos. </td></tr></tabl= e> Tabla 2. </spa= n>Efecto t= erap=C3=A9utico de la vitamina C como coadyuvante en el tratamiento periodo= ntal (continuaci=C3=B3n)<table style=3D"width:100%; margin-botto= m:0pt; padding:0pt; border-collapse:collapse"><tr><td style=3D"width:12.6%;= border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; paddi= ng:0pt 5.75pt; vertical-align:top">Aut= or/A=C3=B1o</td><td style=3D"width:16.2%; border-top:0.75pt soli= d #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical= -align:top">Dise=C3=B1o y muestra</td><td style= =3D"width:12.92%; border-top:0.75pt solid #000000; border-bottom:0.75pt sol= id #000000; padding:0pt 5.75pt; vertical-align:top">Interve= nci=C3=B3n terap=C3=A9utica</td><td style=3D"width:13.14%; borde= r-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt= 5.75pt; vertical-align:top"><= span style=3D"font-family:'Times New Roman'">M=C3=A9todo / tipo de evaluaci= =C3=B3n</td><td style=3D"width:13.38%; border-top:0.75pt solid #= 000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-al= ign:top">Par=C3=A1metros cl=C3=ADnicos evaluados= </td><td style=3D"width:16.36%; border-top:0.75pt solid #000000; border-bot= tom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">Resultados cl=C3=ADnicos principales</td><td style=3D"wi= dth:15.4%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000= 000; padding:0pt 5.75pt; vertical-align:top">Hallazgo cl=C3= =ADnico</td></tr><tr><td style=3D"width:12.6%; border-top:0.75pt= solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; ver= tical-align:top">Elbehwashy et al. (20= 21) (14)</td><td= style=3D"width:16.2%; border-top:0.75pt solid #000000; border-bottom:0.75p= t solid #000000; padding:0pt 5.75pt; vertical-align:top">En= sayo cl=C3=ADnico aleatorizado; (n=3D20) paciente con periodontitis estadio= III grado C distribuidos en grupo prueba (OFD+AA/PRF; n=3D10) y grupo cont= rol (OFD+PRF; n=3D10)</td><td style=3D"width:12.92%; border-top:= 0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75p= t; vertical-align:top">PRF + =C3=A1cido asc=C3=B3rbico en d= efectos intra=C3=B3seos</td><td style=3D"width:13.14%; border-to= p:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.7= 5pt; vertical-align:top"><span= style=3D"font-family:'Times New Roman'">Evaluaci=C3=B3n cl=C3=ADnica perio= dontal y regeneraci=C3=B3n tisular</td><td style=3D"width:13.38%= ; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padd= ing:0pt 5.75pt; vertical-align:top">CAL, PD, RD y par=C3=A1= metros radiogr=C3=A1ficos </td><td style=3D"width:16.36%; border= -top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt = 5.75pt; vertical-align:top"><s= pan style=3D"font-family:'Times New Roman'">Ganancia de CAL: 4,25 =C2=B1 1,= 27 mm. Reducci=C3=B3n de recesi=C3=B3n gingival: 0,80 =C2=B1 0,74 mm (</spa= n>p= =3D0,010). El grupo AA/PRF mo= str=C3=B3 una mayor reducci=C3=B3n de la profundidad del defecto radiogr=C3= =A1fico (2,29 =C2=B1 0,61 mm; p=3D0,014). </td><td style=3D"width:15.4%; border-top:0.75p= t solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; ve= rtical-align:top">La incorporaci=C3=B3n del =C3=A1cido asc= =C3=B3rbico al PRF mejor=C3=B3 la reducci=C3=B3n de la recesi=C3=B3n gingiv= al y el relleno radiogr=C3=A1fico de los defectos intra=C3=B3seos en compar= aci=C3=B3n con PRF solo. </td></tr><tr><td style=3D"width:12.6%;= border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; paddi= ng:0pt 5.75pt; vertical-align:top">Ozmeric et al. (2025) (1= 5)</td><td style=3D"width:16.2%; border-top:0.75pt solid #000000= ; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:to= p">Ensayo cl=C3=ADnico multic=C3=A9ntrico; (n=3D51) pacient= es con gingivitis, distribuidos en tres grupos: enjuague con fenoles (n=3D1= 3);CHX (n=3D19) y CHX+VitC (n=3D19)</td><td style=3D"width:12.92= %; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; pad= ding:0pt 5.75pt; vertical-align:top">Enjuague con clorhexid= ina 0,12% + vitamina C</td><td style=3D"width:13.14%; border-top= :0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75= pt; vertical-align:top">Evaluaci=C3=B3n cl=C3=ADnica period= ontal durante 14 d=C3=ADas</td><td style=3D"width:13.38%; border= -top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt = 5.75pt; vertical-align:top"><s= pan style=3D"font-family:'Times New Roman'">PI, GI y BOP</td><td= style=3D"width:16.36%; border-top:0.75pt solid #000000; border-bottom:0.75= pt solid #000000; padding:0pt 5.75pt; vertical-align:top">P= I (d=C3=ADa 14): Fenol 0,28 =C2=B1 0,59; CHX 0,08 =C2=B1 0,23; CHX+VitC 0,1= 3 =C2=B1 0,21. GI: 0,19 =C2=B1 0,18; 0,04 =C2=B1 0,41; 0,06 =C2=B1 0,11. BO= P: 0,05 =C2=B1 0,06; 0,01 =C2=B1 0,19; 0,03 =C2=B1 0,05, respectivamente. N= o se observaron diferencias significativas entre grupos (p > 0,05). </td><td style=3D= "width:15.4%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #= 000000; padding:0pt 5.75pt; vertical-align:top">La suplemen= taci=C3=B3n con vitamina C no mostr=C3=B3 beneficios cl=C3=ADnicos adiciona= les significativos frente al tratamiento convencional.</td></tr>= <tr><td style=3D"width:12.6%; border-top:0.75pt solid #000000; border-botto= m:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">Nisha et al. (2023) (16)</td><td style=3D"width:16.2%; bord= er-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0p= t 5.75pt; vertical-align:top">= Ensayo cl=C3=ADnico aleatoriz= ado; (n=3D105) participantes distribuidos en tres grupos: sujetos </= p></td><td style=3D"width:12.92%; border-top:0.75pt solid #000000; border-b= ottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">NSPT + vitamina C 500 mg/d=C3=ADa</td><td style=3D"widt= h:13.14%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #0000= 00; padding:0pt 5.75pt; vertical-align:top">Evaluaci=C3=B3n= cl=C3=ADnica periodontal y an=C3=A1lisis s=C3=A9rico antioxidante (TAOC-FR= AP)</td><td style=3D"width:13.38%; border-top:0.75pt solid #0000= 00; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:= top">PD, CAL, PI, GI, BOP y TAOC s=C3=A9rico y salival</spa= n></td><td style=3D"width:16.36%; border-top:0.75pt solid #000000; bord= er-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">PD: 3,56 =C2=B1 0,62 =E2=86=92 2,19 =C2=B1 0,44 mm; CAL: 5,16 = =C2=B1 0,41 =E2=86=92 3,18 =C2=B1 0,23 mm; PI: 2,46 =C2=B1 0,13 =E2=86=92 0= ,55 =C2=B1 0,12; </td><td style=3D"width:15.4%; border-top:0.75p= t solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; ve= rtical-align:top">La NSPT mejor=C3=B3 significativamente l= os par=C3=A1metros cl=C3=ADnicos periodontales y la capacidad antioxidante = total; sin </td></tr></table>Tabla 2. Efecto terap=C3=A9utico de la vitamina C como coadyuvante en el tratami= ento periodontal (continuaci=C3=B3n)<table style=3D"width:100%; = margin-bottom:0pt; padding:0pt; border-collapse:collapse"><tr><td style=3D"= width:11.54%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #= 000000; padding:0pt 5.75pt; vertical-align:top">Autor/A=C3= =B1o</td><td style=3D"width:17.52%; border-top:0.75pt solid #000= 000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align= :top">Dise=C3=B1o y muestra</td><td style=3D"wid= th:11.9%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #0000= 00; padding:0pt 5.75pt; vertical-align:top">Intervenci=C3= =B3n terap=C3=A9utica</td><td style=3D"width:13.18%; border-top:= 0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75p= t; vertical-align:top">M=C3=A9todo / tipo de evaluaci=C3=B3= n</td><td style=3D"width:12.32%; border-top:0.75pt solid #000000= ; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:to= p">Par=C3=A1metros cl=C3=ADnicos evaluados</td><= td style=3D"width:15.2%; border-top:0.75pt solid #000000; border-bottom:0.7= 5pt solid #000000; padding:0pt 5.75pt; vertical-align:top">= Resultados cl=C3=ADnicos principales</td><td style=3D"width:18.3= 4%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; pa= dding:0pt 5.75pt; vertical-align:top">Hallazgo cl=C3=ADnico= </td></tr><tr><td style=3D"width:11.54%; border-top:0.75pt solid= #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-= align:top"> </td><td style=3D"width:17.52%;= border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; paddi= ng:0pt 5.75pt; vertical-align:top">periodontalmente sanos (= control) (n=3D35), pacientes con periodontitis tratados con NSPT (n=3D35) y= pacientes con periodontitis tratados con NSPT m=C3=A1s suplementaci=C3=B3n= de vit C (500mg/d=C3=ADa durante 3 meses) (n=3D35)</td><td styl= e=3D"width:11.9%; border-top:0.75pt solid #000000; border-bottom:0.75pt sol= id #000000; padding:0pt 5.75pt; vertical-align:top"> <= /span></td><td style=3D"width:13.18%; border-top:0.75pt solid #000000; = border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top"= > </td><td style=3D"width:12.32%; border-to= p:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.7= 5pt; vertical-align:top"><span= style=3D"font-family:'Times New Roman'"> </td><td style=3D= "width:15.2%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #= 000000; padding:0pt 5.75pt; vertical-align:top">GI: 2,38 = =C2=B1 0,16 =E2=86=92 1,12 =C2=B1 0,18; BOP: 59 =C2=B1 0,55 =E2=86=92 28,14= =C2=B1 16,63 (basal=E2=80=9312 meses). Los niveles s=C3=A9ricos y salivale= s de TAOC aumentaron despu=C3=A9s del tratamiento periodontal, sin diferenc= ias significativas entre NSPT y NSPT + vitamina C (p>0,05).</td><td style=3D"width:18.= 34%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; p= adding:0pt 5.75pt; vertical-align:top">embargo, la suplemen= taci=C3=B3n con vitamina C no mostr=C3=B3 beneficios cl=C3=ADnicos ni antio= xidantes adicionales significativos</td></tr><tr><td style=3D"wi= dth:11.54%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #00= 0000; padding:0pt 5.75pt; vertical-align:top">Jaafer et al.= (2025) (17)</td><td style=3D"width:17.52%; border-top:0.75pt so= lid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertic= al-align:top">Estudio prospectivo; (n=3D120) pacientes con = periodontitis moderada a severa distribuidos en grupo control (SRP; n=3D60)= y grupo experimental (SRP+VitC, D y E n=3D60)</td><td style=3D"= width:11.9%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #0= 00000; padding:0pt 5.75pt; vertical-align:top">Vitaminas C,= D y E + SRP</td><td style=3D"width:13.18%; border-top:0.75pt so= lid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertic= al-align:top">Evaluaci=C3=B3n cl=C3=ADnica periodontal y an= =C3=A1lisis s=C3=A9rico antioxidante</td><td style=3D"width:12.3= 2%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; pa= dding:0pt 5.75pt; vertical-align:top">PD, CAL, BOP y vitami= na C s=C3=A9ricos de vitamina C, D y E</td><td style=3D"width:15= .2%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; p= adding:0pt 5.75pt; vertical-align:top">PD: 5,3 =C2=B1 0,7 = =E2=86=92 3,5 =C2=B1 0,5 mm; CAL: 4,9 =C2=B1 0,8 =E2=86=92 3,7 =C2=B1 0,6 m= m; BOP: 46,2 =C2=B1 9,8% =E2=86=92 20,3 =C2=B1 7,2%; Vitamina C s=C3=A9rica= : 0,8 =C2=B1 0,2 =E2=86=92 1,5 =C2=B1 0,4 mg/dL (basal=E2=80=933 meses). </= span></td><td style=3D"width:18.34%; border-top:0.75pt solid #000000; b= order-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">= La suplementaci=C3=B3n antioxidante combinada se asoci=C3= =B3 con mejoras en los par=C3=A1metros cl=C3=ADnicos periodontal y un incre= mento de los niveles s=C3=A9ricos de antioxidantes</td></tr></ta= ble>Nota: elaboraci=C3= =B3n a partir de los estudios incluidos en la revisi=C3=B3n (13)(14)(15)(16= )(17). Abreviaturas: AA: =C3=A1cido asc=C3=B3rbico; BOP: sangrado al sondaje; CAL: nivel de inserci=C3=B3n cl=C3= =ADnica; CHX: clorhexidina; FRAP: pode= r antioxidante reductor f=C3=A9rrico; GI: =C3=ADndice gingival;<span= style=3D"font-family:'Times New Roman'"> GM: margen gingival; I-PRF: fibrina rica en plaquetas inyectable; NSPT: terapia periodo= ntal no quir=C3=BArgica; PD: profundidad de sondaje; PI: =C3=ADndice de pla= ca; PMPR: remoci=C3=B3n mec=C3=A1nica profesional de placa; PRF: fibrina ri= ca en plaquetas; RD: profundidad de recesi=C3=B3n gingival; SRP: raspado y alisado radicular; TAOC: capacidad ant= ioxidante total.3.3. Biomarcadores de estr=C3=A9s oxidativo asociados con= periodontitis Los estudios relacionados con biomarcadores oxidativos reportaro= n alteraciones en el equilibrio oxidativo-antioxidante en pacientes con per= iodontitis. Los biomarcadores evaluados incluyeron marcadores y respuestas = inflamatoria periodontal (18)(19)(20). Adem=C3=A1s, se observ=C3=B3 una red= ucci=C3=B3n significativa de los niveles de sulfiredoxina despu=C3=A9s de l= a terapia periodontal no quir=C3=BArgica (p=3D0,004) (18). Por otro lado, se report=C3=B3 un increme= nto del estado oxidante total y una disminuci=C3=B3n de la capacidad antiox= idante total en pacientes con periodontitis (p=3D0,001) (19). Asimismo, se identific=C3=B3 una dismi= nuci=C3=B3n de taurina y un incremento de TNF =E2=80=93 =CE=B1 en pacientes= con periodontitis, evidenciando una asociaci=C3=B3n entre inflamaci=C3=B3n= periodontal y desequilibrio oxidativo (20). Los resultados se=C3=B1alan un= a relaci=C3=B3n entre el estr=C3=A9s oxidativo, la respuesta antioxidante y= la inflamaci=C3=B3n periodontal (<a href=3D"#tabla4" style=3D"text-= decoration:none">Tabla 3</spa= n></a>).<a id=3D"tabla4">= Tabla 3.</s= pan> Biomarcadores de estr=C3=A9= s oxidativo asociados con enfermedad periodontal</a><table style= =3D"width:100%; margin-bottom:0pt; padding:0pt; border-collapse:collapse"><= tr><td style=3D"width:11.1%; border-top:0.75pt solid #000000; border-bottom= :0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top"><s= pan style=3D"font-family:'Times New Roman'">Autor/<spa= n style=3D"font-family:'Times New Roman'">A=C3=B1o</td><td style= =3D"width:17.2%; border-top:0.75pt solid #000000; border-bottom:0.75pt soli= d #000000; padding:0pt 5.75pt; vertical-align:top">Dise=C3=B1o y muestra</td><td st= yle=3D"width:13.96%; border-top:0.75pt solid #000000; border-bottom:0.75pt = solid #000000; padding:0pt 5.75pt; vertical-align:top">Biomarcador oxidativo evaluado</= p></td><td style=3D"width:14.88%; border-top:0.75pt solid #000000; border-b= ottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">M=C3=A9todo / tipo de eval= uaci=C3=B3n</td><td style=3D"width:13.18%; border-top:0.75pt sol= id #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertica= l-align:top">Par=C3= =A1metros relacionados</td><td style=3D"width:14.8%; border-top:= 0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75p= t; vertical-align:top">Resultados principales</td><td style=3D"width:14.88%; border= -top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt = 5.75pt; vertical-align:top">Hallazgo principal</td></tr><tr><td style=3D"width:11.1= %; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; pad= ding:0pt 5.75pt; vertical-align:top">Dixit et al. (2025) (1= 8)</td><td style=3D"width:17.2%; border-top:0.75pt solid #000000= ; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:to= p">Estudios de casos y controles; (n=3D41) participantes di= stribuidos en individuos periodontalmente sanos (grupo control; (n=3D20)) y= pacientes con periodontitis cr=C3=B3nica (grupo caso; (n=3D21)); evaluados= antes y despu=C3=A9s de (NSPT)</td><td style=3D"width:13.96%; b= order-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding= :0pt 5.75pt; vertical-align:top">Sulfiredoxina (Srx)= </td><td style=3D"width:14.88%; border-top:0.75pt solid #000000; border= -bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">An=C3=A1lisis de biomarcadores oxidativos en fluido crevicular g= ingival posterior a terapia periodontal no quir=C3=BArgica (NSPT)</p= ></td><td style=3D"width:13.18%; border-top:0.75pt solid #000000; border-bo= ttom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">Estr=C3=A9s oxidativo y respuesta periodontal</td><td st= yle=3D"width:14.8%; border-top:0.75pt solid #000000; border-bottom:0.75pt s= olid #000000; padding:0pt 5.75pt; vertical-align:top">Srx: = 0,532 =C2=B1 0,23=E2=86=920,366 =C2=B1 0,10 ng/mL tras NSPT (p=3D0,004).</td><td style=3D= "width:14.88%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid = #000000; padding:0pt 5.75pt; vertical-align:top">La terapia= periodontal redujo biomarcadores asociados a estr=C3=A9s oxidativo e infla= maci=C3=B3n periodontal.</td></tr><tr><td style=3D"width:11.1%; = border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; paddin= g:0pt 5.75pt; vertical-align:top">Mohideen et al. (2023) (1= 9)</td><td style=3D"width:17.2%; border-top:0.75pt solid #000000= ; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:to= p">Revisi=C3=B3n sistem=C3=A1tica y metaan=C3=A1lisis; 42 e= studios incluidos para s=C3=ADntesis cualitativa y 24 estudios cuantitativo= de TOS y TAC en pacientes con periodontitis y controles sanos</= td><td style=3D"width:13.96%; border-top:0.75pt solid #000000; border-botto= m:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">TOS y TAC</td><td style=3D"width:14.88%; border-top:0.75pt = solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vert= ical-align:top">Evaluaci=C3=B3n s=C3=A9rica y salival de ca= pacidad antioxidante y oxidativa</td><td style=3D"width:13.18%; = border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; paddin= g:0pt 5.75pt; vertical-align:top">Estr=C3=A9s oxidativo sis= t=C3=A9mico y salival en periodontitis</td><td style=3D"width:14= .8%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; p= adding:0pt 5.75pt; vertical-align:top">TOS salival: diferen= cia global 1,784 =C2=B5mol H=E2=82=82O=E2=82=82 Eq/L (p=3D0,001). TAC s=C3=A9rico: disminuci=C3=B3n = global -2,049 mmol Trolox Eq/L (p=3D0,001).</td><td style=3D"width:14.88%; border-top:0.7= 5pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; = vertical-align:top">Los pacientes con periodontitis present= aron incremento de estr=C3=A9s oxidativo y disminuci=C3=B3n de capacidad an= tioxidante.</td></tr></table> Tabla 3. Biomarcadores de estr=C3=A9s oxidativo aso= ciados con enfermedad periodontal (continuaci=C3=B3n)<table styl= e=3D"width:100%; margin-bottom:0pt; padding:0pt; border-collapse:collapse">= <tr><td style=3D"width:10.88%; border-top:0.75pt solid #000000; border-bott= om:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">Autor/A=C3=B1o</td><td style=3D"width:17.52= %; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; pad= ding:0pt 5.75pt; vertical-align:top">Dis= e=C3=B1o y muestra</td><td style=3D"width:13.74%; border-top:0.7= 5pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; = vertical-align:top">Biomarcador oxidativ= o evaluado</td><td style=3D"width:15.16%; border-top:0.75pt soli= d #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical= -align:top">M=C3=A9todo / tipo de evalua= ci=C3=B3n</td><td style=3D"width:12.96%; border-top:0.75pt solid= #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-= align:top">= Par=C3=A1metros relacionados<= /span></td><td style=3D"width:15.08%; border-top:0.75pt solid #000000; = border-bottom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top"= >Resultados principales</td><= td style=3D"width:14.66%; border-top:0.75pt solid #000000; border-bottom:0.= 75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">Hallazgo principal</td></tr><tr><td style=3D= "width:10.88%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid = #000000; padding:0pt 5.75pt; vertical-align:top">D=C3=B6nme= z et al. (2025) (20)</td><td style=3D"width:17.52%; border-top:0= .75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75pt= ; vertical-align:top">Casos y controles; (n=3D40) participa= ntes distribuidos en grupo control periodontalmente sanos (n=3D20) y grupo = con periodontitis generalizada estadio III grado B (n=3D20)</td>= <td style=3D"width:13.74%; border-top:0.75pt solid #000000; border-bottom:0= .75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">Taurina y TNF-=CE=B1</td><td style=3D"width:15.16%; border-top= :0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding:0pt 5.75= pt; vertical-align:top">Evaluaci=C3=B3n s=C3=A9rica de biom= arcadores inflamatorios y antioxidantes</td><td style=3D"width:1= 2.96%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000;= padding:0pt 5.75pt; vertical-align:top">Inflamaci=C3=B3n p= eriodontal y estr=C3=A9s oxidativo</td><td style=3D"width:15.08%= ; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padd= ing:0pt 5.75pt; vertical-align:top">Taurina disminuida (p= =3D0,009). TNF-=CE=B1 aumentado (p=3D0,004). AUC taurina=3D0,739.</p= ></td><td style=3D"width:14.66%; border-top:0.75pt solid #000000; border-bo= ttom:0.75pt solid #000000; padding:0pt 5.75pt; vertical-align:top">La disminuci=C3=B3n de taurina se asoci=C3=B3 con inflamaci=C3=B3n = periodontal y alteraci=C3=B3n antioxidante sist=C3=A9mica.</td><= /tr></table>Nota:</s= pan> elaboraci=C3=B3n a parti= r de los estudios incluidos en la revisi=C3=B3n (18)(19)(20). Abreviaturas.= Srx: sulfiredoxina; NSPT: terapia periodontal no quir=C3=BArgica; TOS: est= ado oxidante total; TAC: capacidad antioxidante total; TNF-=CE=B1: factor d= e necrosis tumoral alfa; AUC: =C3=A1rea bajo la curva; H=E2=82=82O=E2=82=82= Eq/L: equivalentes de per=C3=B3xido de hidr=C3=B3geno por litro. Trolox Eq= /L: equivalentes de Trolox por litro. 4. Di= scusi=C3=B3n El presente estudio evidenci=C3=B3 una relaci=C3=B3n = entre la vitamina C, estr=C3=A9s oxidativo y enfermedades periodontales. Lo= s estudios analizados reportaron que los pacientes con periodontitis presen= taban alteraciones en los sistemas antioxidantes y aumento en los biomarcad= ores inflamatorios y oxidativos en comparaci=C3=B3n con individuos periodon= talmente sanos (19)(20). De la misma manera, se observ=C3=B3 que la disminu= ci=C3=B3n de los niveles de vitamina C tend=C3=ADa a asociarse con una mayo= r severidad periodontal, lo que sugiere una posible relaci=C3=B3n entre el = estado antioxidante del organismo y la progresi=C3=B3n de la periodontitis = (2)(12). Mohideen et al. (19) identificaron niveles significativamente alto= s de Estr=C3=A9s Oxidativo Total (TOS) y menores niveles de Capacidad Antioxidante Tota= l (TAC) en pacientes c= on periodontitis (19). De la misma forma, Hashim et al. (2) y Assaf & R= abi (12) reportaron concentraciones m=C3=A1s bajas de vitamina C en suero, = saliva y fluido crevicular gingival en pacientes con mayor severidad period= ontal (2)(12). Estos hallazgos sugieren que el desarrollo de la periodontit= is podr=C3=ADa asociarse con un desequilibrio entre los mecanismos oxidativ= os y antioxidantes del organismo. Buzatu et al. (9) reportaron que los niveles bajo= s de vitamina C se asociaron con un mayor riesgo de periodontitis (OR=3D1,5= 2; IC95%:1,49=E2=80=931,55), lo que respalda la posible participaci=C3=B3n = de este micronutriente en la progresi=C3=B3n de la enfermedad, aunque desta= caron una elevada heterogeneidad metodol=C3=B3gica entre los estudios inclu= idos (9).Adicionalmente, Rosa et al. (21) indicaron que una mayor ingesta diet=C3= =A9tica de vitamina C se relaciona con mejores condiciones periodontales, o= bservando que los individuos con consumo m=C3=A1s elevado presentaban menor= frecuencia de periodontitis y menor inflamaci=C3=B3n gingival (21).= Estos resultado= s coinciden con Mi et al. quienes en un metaan=C3=A1lisis observaron que un= a mayor ingesta de vitaminas antioxidantes se asociaba con una menor frecue= ncia de enfermedades periodontales, sugiriendo que el estado nutricional po= dr=C3=ADa influir en la respuesta inflamatoria periodontal (11). Por lo tan= to, estos hallazgos respaldan que la vitamina C participa en mecanismos bio= l=C3=B3gicos relacionados con la protecci=C3=B3n periodontal, aunque la nat= uraleza de esta asociaci=C3=B3n todav=C3=ADa requiere mayor investigaci=C3= =B3n cl=C3=ADnica (11). La posible explicaci=C3=B3n biol=C3=B3gica de esta relaci= =C3=B3n puede encontrarse en las funciones antioxidantes e inmunomoduladora= s atribuidas a la vitamina C. De forma similar, Ustianowski et al. (22) sos= tienen que esta vitamina participa en la s=C3=ADntesis de col=C3=A1geno, la= regulaci=C3=B3n de la respuesta inmunitaria y la neutralizaci=C3=B3n de es= pecies reactivas de ox=C3=ADgeno, mecanismos que podr=C3=ADan contribuir a = la protecci=C3=B3n de los tejidos periodontales. As=C3=AD como Van der Veld= en (23) sostuvo que la vitamina C contribuye al mantenimiento de la integri= dad del tejido conectivo periodontal y a los procesos de reparaci=C3=B3n ti= sular. Por ello, una disminuci=C3=B3n de sus niveles podr=C3=ADa favorecer = una mayor susceptibilidad frente al da=C3=B1o oxidativo y la destrucci=C3= =B3n de los tejidos periodontales observados durante la progresi=C3=B3n de = la enfermedad. Los biomarcadores evaluados en los estudios seleccionados respaldan = la participaci=C3=B3n del estr=C3=A9s oxidativo en la fisiopatolog=C3=ADa p= eriodontal. Dixit et al. (18) identificaron niveles elevados de sulfiredoxi= na en pacientes con periodontitis activa, observando una disminuci=C3=B3n p= osterior a la terapia periodontal no quir=C3=BArgica (18). Adicionalmente, = Mohideen et al. (19) reportaron un incremento del estado oxidante total y u= na disminuci=C3=B3n de la capacidad antioxidante total en pacientes con per= iodontitis, evidenciando un desequilibrio entre los mecanismos oxidativos y= antioxidantes (19). Tambi=C3=A9n D=C3=B6nmez et al. (20) dieron a conocer = que los pacientes con periodontitis presentaban concentraciones reducidas d= e taurina y niveles aumentados de TNF-=CE=B1 en pacientes, adem=C3=A1s de a= sociaciones entre estos biomarcadores y par=C3=A1metros cl=C3=ADnicos como = la profundidad de sondaje y la p=C3=A9rdida de inserci=C3=B3n cl=C3=ADnica = (20). En conjunto, estos hallazgos respaldan la participaci=C3=B3n del estr= =C3=A9s oxidativo en la fisiopatolog=C3=ADa periodontal y sugieren que dive= rsos biomarcadores oxidativos podr=C3=ADan reflejar la actividad inflamator= ia y la progresi=C3=B3n de la enfermedad (18)(19)(20). En cuanto a los efectos ter= ap=C3=A9uticos de la vitamina C, los estudios incluidos mostraron resultado= s heterog=C3=A9neos. Sherif et al. (13) hallaron que la utilizaci=C3=B3n de= fibrina rica en plaquetas inyectable suplementada con vitamina C produjo u= na reducci=C3=B3n temprana del dolor postoperatorio y una mejora del nivel = de inserci=C3=B3n cl=C3=ADnica a los 3 meses (p=3D0,029), en pacientes con periodontitis estadio II = (13). De la misma manera Elbehwashy et al. (14) identificaron una mejor res= puesta cicatricial y una mayor reducci=C3=B3n radiogr=C3=A1fica de defectos= intra=C3=B3seos observando una disminuci=C3=B3n promedio de 2,29 =C2=B1 0,= 61 mm en la profundidad del defecto radiogr=C3=A1fico (p=3D0,014) cuando el =C3=A1cido asc=C3=B3= rbico fue incorporado al PRF. De la misma manera Jaafer et al. (17) report= =C3=B3 que la suplementaci=C3=B3n antioxidante combinada con vitamina C, D = y E se asoci=C3=B3 con mejoras cl=C3=ADnicas periodontales, observando una = reducci=C3=B3n de la profundidad de sondaje 5,3 =C2=B1 0,7 mm a 3,5 =C2=B1 = 0,5 mm, una disminuci=C3=B3n del sangrado al sondaje de 46,2 =C2=B1 9,8 % a= 20,3 =C2=B1 7,2 % y un incremento de los niveles s=C3=A9ricos de vitamina = C de 0,8 =C2=B1 0,2 mg/dL a 1,5 =C2=B1 0,4 mg/dL tras 3 meses de seguimient= o. Estos resultados coinciden con Sherif et al. (13) y Elbehwashy et al. (1= 4) quienes obtuvieron beneficios cl=C3=ADnicos asociados al empleo de vitam= ina C como coadyuvante terap=C3=A9utico. Sin embargo, debido a la administr= aci=C3=B3n conjunta de varios antioxidantes resulta dif=C3=ADcil atribuir l= os efectos alcanzados exclusivamente a la vitamina C (17). Por otra parte, Nisha et= al. (16) mencionan que la terapia periodontal no quir=C3=BArgica mejor=C3= =B3 significativamente la capacidad antioxidante total y los par=C3=A1metro= s cl=C3=ADnicos periodontales; sin embargo, la administraci=C3=B3n sist=C3= =A9mica de vitamina C (500mg/d=C3=ADa) no aport=C3=B3 beneficios adicionale= s significativos respecto a la terapia periodontal convencional sola (16). = Esto podr=C3=ADa atribuirse principalmente al efecto de la terapia periodon= tal no quir=C3=BArgica, m=C3=A1s que a la suplementaci=C3=B3n con vitamina = C. De la misma manera Fageeh et al. (1) en una revisi=C3=B3n sistem=C3=A1ti= ca que incluy=C3=B3 seis ensayos cl=C3=ADnicos aleatorizados, se=C3=B1alaro= n que la suplementaci=C3=B3n con vitamina C no produjo mejoras cl=C3=ADnica= mente significativas en la profundidad de sondaje ni en el nivel de inserci= =C3=B3n cl=C3=ADnica en pacientes con periodontitis. Los autores destacan q= ue las diferencias en las dosis administradas, las v=C3=ADas de aplicaci=C3= =B3n y los periodos de seguimiento entre los estudios reportados, dificulta= n la comparaci=C3=B3n directa de los hallazgos y limita el establecimiento = de conclusiones definitivas sobre la eficacia de la vitamina C como coadyuv= ante del tratamiento periodontal (1). Ozmeric et al. (15) hallaron que un e= njuague con vitamina C present=C3=B3 resultados semejantes a los de la clor= hexidina, donde no se encontr=C3=B3 diferencias significativas en el contro= l de placa, gingivitis o sangrado gingival (p > 0,05) (15). Estos resultados mencionan que los ef= ectos cl=C3=ADnicos de la vitamina C podr=C3=ADan ser m=C3=A1s evidentes en= la modulaci=C3=B3n inflamatoria temprana que en la regeneraci=C3=B3n perio= dontal profunda. Un aspecto relevante identificado durante la revisi=C3=B3n fue la = diferencia entre los hallazgos experimentales y la evidencia cl=C3=ADnica d= isponible. Aytekin et al. (24) utilizando un modelo experimental de periodo= ntitis en ratas, demostraron que la aplicaci=C3=B3n local de vitamina C red= ujo la p=C3=A9rdida =C3=B3sea alveolar, la p=C3=A9rdida de inserci=C3=B3n y= la expresi=C3=B3n de biomarcadores relacionados con el estr=C3=A9s oxidati= vo y la destrucci=C3=B3n tisular. Estos resultados sugieren un potencial ef= ecto protector de la vitamina C sobre los tejidos periodontales. Sin embarg= o, los beneficios observados en modelos animales todav=C3=ADa no han sido r= eproducidos de forma consistente en estudios cl=C3=ADnicos realizados en hu= manos, por lo que persisten interrogantes acerca de su verdadero impacto te= rap=C3=A9utico en la pr=C3=A1ctica cl=C3=ADnica.<span= style=3D"font-family:'Times New Roman'">Los hallazgos de esta revisi=C3=B3= n presentan algunas limitaciones. Primero, los estudios incluidos presentar= on dise=C3=B1os metodol=C3=B3gicos diversos, tama=C3=B1os de muestras varia= bles y diferentes estrategias de administraci=C3=B3n de vitamina C. Segundo= , los biomarcadores evaluados no fueron uniformes entre las investigaciones= , lo que dificulta la comparaci=C3=B3n directa de los resultados. En conjun= to, la evidencia disponible sugiere que la vitamina C podr=C3=ADa contribui= r al equilibrio antioxidante y a la modulaci=C3=B3n de la respuesta inflama= toria periodontal, particularmente durante etapas tempranas de la enfermeda= d. Sin embargo, los beneficios cl=C3=ADnicos observados contin=C3=BAan sien= do inconsistentes y no permiten recomendar su utilizaci=C3=B3n como tratami= ento periodontal independiente. Actualmente, la terapia periodontal convenc= ional contin=C3=BAa siendo el tratamiento de elecci=C3=B3n (25)(26)(27), mi= entras que la vitamina C podr=C3=ADa considerarse un complemento potencial = cuya utilidad cl=C3=ADnica requiere ser confirmada mediante ensayos cl=C3= =ADnicos aleatorizados con nuestras muestras m=C3=A1s amplias, seguimiento = prolongado y metodolog=C3=ADas homog=C3=A9neas.5. </sp= an>Conclusiones<ul style=3D"margin:0pt; padding-left:0pt"><l= i class=3D"ListParagraph" style=3D"margin-left:32.33pt; margin-bottom:0pt; = text-align:justify; line-height:115%; padding-left:3.67pt; font-family:seri= f; font-size:12pt">La literat= ura cient=C3=ADfica revisada permiti=C3=B3 identificar una relaci=C3=B3n en= tre la disminuci=C3=B3n de los niveles de vitamina C, incremento del estr= =C3=A9s oxidativo y la severidad de la enfermedad periodontal. La evidencia= mostr=C3=B3 que los pacientes con periodontitis presentan alteraciones en = los sistemas antioxidantes, aumento de biomarcadores oxidativos y reducci= =C3=B3n de mecanismos de defensa antioxidante en comparaci=C3=B3n con indiv= iduos periodontalmente sanos. De la misma forma, diversos estudios reportar= on concentraciones reducidas de vitamina C en saliva, suero y fluido crevic= ular gingival en pacientes con mayor severidad periodontal, sugiriendo una = posible participaci=C3=B3n de esta vitamina en los mecanismos biol=C3=B3gic= os relacionados con la inflamaci=C3=B3n y destrucci=C3=B3n de los tejidos p= eriodontales.</li><li class=3D"ListParagraph" style=3D"margin-left:3= 2.33pt; margin-bottom:0pt; text-align:justify; line-height:115%; padding-le= ft:3.67pt; font-family:serif; font-size:12pt">Los estudios analizados respaldan la importancia del estr= =C3=A9s oxidativo en la fisiopatolog=C3=ADa de la periodontitis. El desequi= librio entre oxidantes y antioxidantes favorece la producci=C3=B3n excesiva= de especies reactivas de ox=C3=ADgeno, contribuyendo al da=C3=B1o celular,= la degradaci=C3=B3n del col=C3=A1geno y la p=C3=A9rdida progresiva de los = tejidos de soporte dental. En este contexto, la vitamina C adquiere relevan= cia debido a sus propiedades antioxidantes, inmunomoduladoras y a su papel = esencial en la s=C3=ADntesis y mantenimiento del col=C3=A1geno periodontal.= Estas caracter=C3=ADsticas permiten considerar que niveles adecuados de vi= tamina C podr=C3=ADan contribuir al mantenimiento de la homeostasis tisular= y a la protecci=C3=B3n frente al da=C3=B1o oxidativo asociado con la enfer= medad periodontal.</li><li class=3D"ListParagraph" style=3D"margin-l= eft:32.33pt; margin-bottom:0pt; text-align:justify; line-height:115%; paddi= ng-left:3.67pt; font-family:serif; font-size:12pt">En relaci=C3=B3n con su aplicaci=C3=B3n cl=C3=ADnica,= los estudios incluidos mostraron resultados variables. Aunque algunos auto= res observaron mejor=C3=ADas en biomarcadores inflamatorios y antioxidantes= , as=C3=AD como beneficios cl=C3=ADnicos relacionados con la cicatrizaci=C3= =B3n periodontal, la reducci=C3=B3n del sangrado al sondaje y la mejor=C3= =ADa del nivel de inserci=C3=B3n cl=C3=ADnica, los resultados continuaron s= iendo heterog=C3=A9neos entre los estudios. Por esta raz=C3=B3n, la evidenc= ia disponible no permite establecer conclusiones definitivas sobre la efica= cia de la vitamina C como tratamiento periodontal independiente. Actualment= e, la terapia periodontal convencional contin=C3=BAa siendo la principal es= trategia terap=C3=A9utica para el control de la enfermedad, mientras que la= vitamina C podr=C3=ADa considerarse =C3=BAnicamente como un complemento po= tencial dentro del manejo integral de determinados pacientes.</li><l= i class=3D"ListParagraph" style=3D"margin-left:32.33pt; margin-bottom:0pt; = text-align:justify; line-height:115%; padding-left:3.67pt; font-family:seri= f; font-size:12pt">Es importa= nte se=C3=B1alar que los estudios analizados presentaron diferencias metodo= l=C3=B3gicas relacionadas con el dise=C3=B1o de investigaci=C3=B3n, el tama= =C3=B1o muestral, las dosis administradas, las v=C3=ADas de aplicaci=C3=B3n= , los biomarcadores evaluados y per=C3=ADodos de seguimiento. Estas variaci= ones dificultan la comparaci=C3=B3n directa de los resultados y limitan la = posibilidad de establecer recomendaciones cl=C3=ADnicas universales. Adem= =C3=A1s, la evidencia disponible contin=C3=BAa siendo insuficiente para det= erminar con precisi=C3=B3n qu=C3=A9 pacientes podr=C3=ADan beneficiarse en = mayor medida de la suplementaci=C3=B3n con vitamina C y cu=C3=A1les ser=C3= =ADan las dosis y protocolos m=C3=A1s adecuados.</li><li class=3D"Li= stParagraph" style=3D"margin-left:32.33pt; margin-bottom:10pt; text-align:j= ustify; line-height:115%; padding-left:3.67pt; font-family:serif; font-size= :12pt">Finalmente, se requier= en ensayos cl=C3=ADnicos aleatorizados con muestras m=C3=A1s amplias, segui= miento a largo plazo y metodolog=C3=ADas estandarizadas que permitan esclar= ecer el verdadero impacto de la vitamina C sobre la progresi=C3=B3n de la e= nfermedad periodontal. Futuras investigaciones deber=C3=ADan integrar simul= t=C3=A1neamente par=C3=A1metros cl=C3=ADnicos, radiogr=C3=A1ficos y biomarc= adores relacionados con el estr=C3=A9s oxidativo para comprender mejor la i= nteracci=C3=B3n entre vitamina C, respuesta inflamatoria y salud periodonta= l. De esta manera, ser=C3=A1 posible determinar con mayor precisi=C3=B3n el= papel que esta vitamina puede desempe=C3=B1ar como coadyuvante terap=C3=A9= utico dentro de la pr=C3=A1ctica cl=C3=ADnica periodontal. </li></ul= >6.</spa= n> Conflicto de intereses<= /p>Los autores dec= laran que no existe conflicto de intereses en relaci=C3=B3n con el art=C3= =ADculo presentado.7. <span= style=3D"font-family:'Times New Roman'; font-weight:bold; color:#767171">D= erechos de autor (copyrigth)Los autores son los titulares de los derechos de autor (patrimoniales y/o de explotaci=C3=B3n) de = los contenidos de la revista (copyright).8. Decl= araci=C3=B3n de contribuci=C3=B3n de los autoresLos autores declaran haber particip= ado de manera equitativa y sustancial en la realizaci=C3=B3n de esta invest= igaci=C3=B3n, bajo las responsabilidades seg=C3=BAn la <a href=3D"ht= tps://credit.niso.org/" style=3D"text-decoration:none">Taxonom=C3=ADa CRediT<= /a> para describir las contri= buciones individuales de cada autor al trabajo. Lizbeth Tatiana Aguayza Rodas reali= z=C3=B3 la conceptualizaci=C3=B3n de la investigaci=C3=B3n, organizaci=C3= =B3n y ejecuci=C3=B3n del ensayo, recopilaci=C3=B3n y curaci=C3=B3n de los = datos, revisi=C3=B3n del an=C3=A1lisis estad=C3=ADstico, interpretaci=C3=B3= n de los resultados, elaboraci=C3=B3n del borrador original, preparaci=C3= =B3n de tablas y figuras, revisi=C3=B3n cr=C3=ADtica del contenido y aproba= ci=C3=B3n de la versi=C3=B3n final del manuscrito.<spa= n style=3D"font-family:'Times New Roman'">Andrea Soledad Carvajal Endara re= aliz=C3=B3 la supervisi=C3=B3n acad=C3=A9mica y metodol=C3=B3gica de la inv= estigaci=C3=B3n, brind=C3=B3 orientaci=C3=B3n durante el desarrollo del ens= ayo, revis=C3=B3 el an=C3=A1lisis y la interpretaci=C3=B3n de los resultado= s, efectu=C3=B3 la revisi=C3=B3n cr=C3=ADtica del manuscrito, realiz=C3=B3 = la correcci=C3=B3n cient=C3=ADfica y acad=C3=A9mica y aprob=C3=B3 la versi= =C3=B3n final para su publicaci=C3=B3n.Divulgaci=C3=B3n de la de= legaci=C3=B3n a la IA generativaDeclaraci=C3=B3n sobre la delegaci=C3=B3n de tare= as a IA generativaLos autores declaran el uso de IA generativa en el proceso de i= nvestigaci=C3=B3n y preparaci=C3=B3n del manuscrito. De acuerdo con la taxo= nom=C3=ADa GAIDeT (2025), las siguientes tareas se delegaron a herramientas= de IA generativa bajo supervisi=C3=B3n humana:<span= style=3D"font-family:'Times New Roman'">- Correcci=C3=B3n y edici=C3=B3n</= span>- Resume= n de texto- Traducci=C3=B3nHerramienta de IA generativa utilizada: ChatGPT (OpenAI).</s= pan>Los autor= es son totalmente responsables del manuscrito final.= Las herramientas de IA genera= tiva no figuran como autoras ni son responsables de los resultados finales.= Declara= ci=C3=B3n presentada por: Lizbeth Tatiana Aguayza Rodas.9.</spa= n> Costos de financiamiento</span= > </= p>La presente inve= stigaci=C3=B3n fue financiada en su totalidad con fondos propios de los aut= ores.<span= >10. 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Available from: <a href=3D"h= ttps://doi.org/10.33262/anatomiadigital.v6i4.3.2813" style=3D"text-decorati= on:none">https://doi.org/= 10.33262/anatomiadigital.v6i4.3.2813</a></li></ol> = <a id=3D"_heading_h.m2eci05r1w34"></a> </sp= an> = </= p>&= #xa0;El art=C3=ADculo que se publica es de exclusiva responsabilid= ad de los autores y no necesariamente reflejan el pensamiento de la = Revista Ana= tom=C3=ADa Digital. </= span><img sr= c=3D"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAN8AAAA5CAYAAAC25P6zAAAA= BHNCSVQICAgIfAhkiAAAAAlwSFlzAAAOxAAADsQBlSsOGwAAIABJREFUeJztXXl8VcW9/82c7S7= Jvdk3kpBI2AWUolAVFbUW7dPWorEubRGXPLFQQ1WktXq0PsSVimvEKtW+vmeor1Vb26oQCyKKkX= 1PCNm3m3tz9+Us83t/3NysN8lNSEja8v18zgdyzrkzv5kzv5nf/LYhMI6AiGS0yiYAAITgaJU/E= GRZprqmv+1xe24mBIDn+N1mS9w1siw3jnbda9asmaKElDJAzEpJSf15SA09K8uyMtr1dsf69eun= N9Y3fqZpekJCYuLejMy0wqKiohOnk4bxCH4sKkVE8tprX/NNTd/QZZkwAIDlr39esGzjV2mjVec= PkepVv9rqNPCCyjMMpFsVZdHMSb7bFuUHR6vOCFLiUnK+3vvVd4KhAAAACIJQkCPknVdaWvrnws= 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