Adjunctive treatment of chronic periodontitis with daily dietary supplementation with omega-3 Fatty acids and low-dose aspirin.
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.
El-Sharkawy
Hesham
H
Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
Aboelsaad
Nayer
N
Eliwa
Mohamed
M
Darweesh
Mahmoud
M
Alshahat
Mohammad
M
Kantarci
Alpdogan
A
Hasturk
Hatice
H
Van Dyke
Thomas E
TE
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
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