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Moreover, proteomic analysis revealed upregulation of peroxisome beta-oxidation of fatty acids by acetyl-coenzyme oxidases (ACOXs), which through the generation of free radicals, can trigger lipid peroxidation in a non-enzymatic or Fenton reaction 10,16,39,41,42

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This review has synthesized current mechanistic and translational evidence demonstrating that oxidative stress is not merely a bystander phenomenon but a central disease-modifying factor in both periodontitis and peri-implantitis