Orthodontic treatment uses fixed appliances to promote oral health and correct malocclusions. Several inflammatory mediators are released in response to the mechanical forces applied during treatment. The ensuing inflammation in the oral cavity leads to oxidative stress, which is defined as the imbalance between the production of free radicals and the body’s ability to arrest or minimize their harmful effects through neutralization by anti-oxidants. It is a pathologic asymptomatic event, highly detrimental to tissues, and in recent years, has been considered as a trigger event for several human diseases.

Oxidative damage is caused mainly by the release of free radicals generated by exposure to UV rays, X rays and can also be produced by leukocytes and macrophages during the inflammatory process. From a biological and pathological point of view, the most important free radicals are the reactive oxidative species(ROS) and the important ones to be considered are the superoxide anion (O2), hydrogen peroxide(H2O2), hydroxyl radical(OH), and hypochloric acid(HOCl).

Phospholipid membranes are primarily the biological targets of oxidative stress. The most abundant cellular component, proteins, are also significant targets for free radicals; even minor changes to one protein can have a significant impact on the biological activity and functionality of cells.

Oxidative stress (O.S.) has been implicated to be the causative factor of numerous pathological illnesses, such as rheumatoid arthritis, neurological diseases, atherosclerosis, inflammatory diseases, chronic renal failure, and even diabetes. Intraorally, it is involved in the development of enamel surface alteration, caries, squamous cell carcinoma and periodontitis. Osteoblastic and osteoclastic cells involved in the bone remodeling process are also particularly sensitive to oxidative damage. 

Saliva is a vital component of the oral cavity and can be considered as the first barrier to oxidative stress due to its antioxidant capacity. It helps to maintain oral health, contributes to the body’s oral defense, and the balance of the oral environment. Saliva has gained popularity as a diagnostic tool in clinical studies in recent years, due to its accessibility, ease of collection, and the possibility of taking repeated, non-invasive samples for screening, diagnosing, and researching a variety of illnesses. Therefore, oxidative status assessment in the oral cavity has been proposed as a key diagnostic and progression assessment method for these disorders.

Over the past few years, several studies have provided evidence of O.S. associated with orthodontic treatment which may have significant clinical implications with serious consequences for long-term oral health. Antioxidant supplements have been proposed to be effective in containing the oxidative stress produced however there is no published literature available on the same. This trial was therefore taken up to assess and compare the effect of antioxidant supplementation on the oxidative stress produced by fixed orthodontic treatment.