title: Adjunctive treatment of chronic periodontitis with daily dietary supplementation with omega-3 Fatty acids and low-dose aspirin.
abstract: BACKGROUND
  Host modulatory therapy has been proposed as a treatment for periodontal diseases. Omega-3 (ω-3) polyunsaturated fatty acids (PUFAs), including docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), were shown to have therapeutic anti-inflammatory and protective actions in inflammatory diseases including periodontitis. The goal of this study was to test an innovative strategy for periodontal treatment in a clinical experiment.
  
  
  METHODS
  Eighty healthy subjects (40 in each group) with advanced chronic periodontitis were enrolled in Mansoura, Egypt, in a parallel-design, double-masked clinical study. The control group was treated with scaling and root planing (SRP) and a placebo, whereas the ω-3 group was treated with SRP followed by dietary supplementation of fish oil (900 mg EPA + DHA) and 81 mg aspirin daily. Saliva samples were obtained from all patients at baseline and 3 and 6 months for evaluation of receptor activator of nuclear factor-kappa B ligand (RANKL) and matrix metalloproteinase-8 (MMP-8). Plaque and gingival indices, bleeding on probing, probing depths, and attachment levels were recorded at the same time points.
  
  
  RESULTS
  Statistical analyses demonstrated a significant reduction in probing depths and a significant attachment gain after 3 and 6 months in the ω-3 group compared to baseline and the control group (P <0.05). Salivary RANKL and MMP-8 levels showed significant reductions in the ω-3 group in response to treatment at 3 and 6 months and compared to the control group at 6 months (P <0.01). Supplementation with ω-3 + aspirin resulted in a significant shift in the frequency of pockets with probing depths <4 mm (P <0.05).
  
  
  CONCLUSIONS
  The results of this preliminary clinical study suggest that dietary supplementation with ω-3 PUFAs and 81 mg aspirin may provide a sustainable, low-cost intervention to augment periodontal therapy.
authors.affiliation: Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
authors.forename: Hesham
authors.initials: H
authors.lastname: El-Sharkawy
authors.forename: Nayer
authors.initials: N
authors.lastname: Aboelsaad
authors.forename: Mohamed
authors.initials: M
authors.lastname: Eliwa
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Darweesh
authors.forename: Mohammad
authors.initials: M
authors.lastname: Alshahat
authors.forename: Alpdogan
authors.initials: A
authors.lastname: Kantarci
authors.forename: Hatice
authors.initials: H
authors.lastname: Hasturk
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Van Dyke
mesh_terms: D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001241:Aspirin / Q000008:administration & dosage*; D055113:Chronic Periodontitis / Q000628:therapy*; D003131:Combined Modality Therapy; D003774:Dental Plaque Index; D012534:Dental Scaling; D019587:Dietary Supplements; D004281:Docosahexaenoic Acids / Q000627:therapeutic use; D004311:Double-Blind Method; D015118:Eicosapentaenoic Acid / Q000627:therapeutic use; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000628:therapy; D006801:Humans; D008297:Male; D020784:Matrix Metalloproteinase 8 / Q000032:analysis; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000628:therapy; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000628:therapy; D010919:Placebos; D053245:RANK Ligand / Q000032:analysis; D016745:Root Planing; D012463:Saliva / Q000737:chemistry; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D015525:Fatty Acids, Omega-3; D010919:Placebos; D053245:RANK Ligand; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid; C488762:MMP8 protein, human; D020784:Matrix Metalloproteinase 8; D001241:Aspirin