The efficacy of host response modulation therapy (omega-3 plus low-dose aspirin) as an adjunctive treatment of chronic periodontitis (clinical and biochemical study).
OBJECTIVE
Regeneration of lost periodontal tissues is considered to be one of the most challenging aspects of periodontal therapy. Our current understanding of the role of the host immuno-inflammatory response in periodontal diseases forms the basis of new therapeutic approaches. The aim of this study was to evaluate the efficacy of systemic administration of omega-3 polyunsaturated fatty acids plus low-dose aspirin as an adjunctive treatment to regenerative therapy of furcation defects.


METHODS
Forty patients displaying at least a single grade II furcation defect were enrolled in the study. They were randomly allocated into two groups: an experimental group receiving decalcified freeze-dried bone allograft (DFDBA) + omega-3 polyunsaturated fatty acids combined with low-dose aspirin; and a control group receiving DFDBA + placebo. Clinical parameters were monitored at baseline, and at 3 and 6 mo following therapy, and included plaque index, gingival index, gingival bleeding index, probing pocket depth and clinical attachment level. The biochemical markers assessed in gingival crevicular fluid samples were interleukin-1β and interleukin-10.


RESULTS
The experimental intervention resulted in a greater mean probing pocket depth reduction (P < 0.001) and gain in clinical attachment (P < 0.05) compared with the control at 6 mo. Furthermore, the experimental protocol was able to achieve a significant modulatory effect on the levels of interleukin-1β and interleukin-10 compared with control therapy.


CONCLUSIONS
The findings suggest that the combination therapy demonstrated successful reduction of gingival inflammation, reduction of pocket depth and attachment level gain, accompanied by a trend for modulation of the cytokines profile in gingival crevicular fluid.
Oral Medicine and Periodontology Department, Faculty of Dentistry, October 6 University, Cairo, Egypt. amrelkhouli@hotmail.com
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Elkhouli
D000284:Administration, Oral; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000379:methods; D055113:Chronic Periodontitis / Q000276:immunology / Q000601:surgery*; D003131:Combined Modality Therapy; D003774:Dental Plaque Index; D004311:Double-Blind Method; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D017823:Furcation Defects / Q000276:immunology / Q000601:surgery*; D005883:Gingival Crevicular Fluid / Q000276:immunology; D005884:Gingival Hemorrhage / Q000601:surgery; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods; D006801:Humans; D056747:Immunomodulation / Q000276:immunology; D016753:Interleukin-10 / Q000032:analysis; D053583:Interleukin-1beta / Q000032:analysis; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000601:surgery; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000601:surgery; D010919:Placebos
D000894:Anti-Inflammatory Agents, Non-Steroidal; D015525:Fatty Acids, Omega-3; D053583:Interleukin-1beta; D010919:Placebos; D016753:Interleukin-10; D001241:Aspirin