Hydrogen-rich water(HRW)shows excellent antibacterial,anti-inflammatory,antioxidant,and wound-heal-ing properties and plays a positive role in the treatment of various diseases,such as brain injury,kidney injury,and peri-odontitis.Current studies found that HRW can inhibit periodontopathogenic biofilm formation,inhibit oral connective tis-sue and bone tissue destruction,and show anti-inflammatory and antioxidant properties in periodontitis.Additionally,HRW can alleviate periodontal tissue damage by inhibiting oxidative stress and up-regulating the expression of antioxi-dant enzymes,such as glutathione peroxidase and superoxide dismutase.HRW exerts anti-inflammatory effects by regu-lating the nuclear factor erythroid 2-related factor 2 and mitogen-activated protein kinase pathways,which are closely as-sociated with inflammation.Additionally,HRW inhibits the expression of inflammatory cytokines,such as interleukins,inhibits the growth and proliferation of bacterial plaque biofilms,and down-regulates glycosyltransferases and glucan-binding proteins to prevent bacterial adhesion and subsequent development of periodontitis.Furthermore,HRW has a positive effect on the expression of various cell growth factors,α-smooth muscle actin,and type Ⅰ collagen,which pro-motes wound healing.Current clinical studies have demonstrated the biological safety of HRW(to a certain extent)and reported no adverse reactions.However,most studies on HRW in oral diseases are preclinical in vivo and in vitro stud-ies.Therefore,further clinical studies are required to validate the therapeutic significance and optimal therapeutic regi-men of HRW in human periodontitis.This article aims to review the therapeutic role and the underlying mechanisms of HRW in periodontitis.
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