ISSN: 1859 - 2872
Hiệu quả điều trị viêm quanh răng bằng phương pháp không phẫu thuật kết hợp với axít béo omega-3
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Keywords
Viêm quanh răng, điều trị không phẫu thuật, axít béo omega-3
Tóm tắt
Mục tiêu: Nghiên cứu nhằm đánh giá kết quả điều trị viêm quanh răng (VQR) bằng phương pháp điều trị không phẫu thuật kết hợp với axít béo omega-3. Đối tượng và phương pháp: Thử nghiệm lâm sàng có đối chứng trên 60 bệnh nhân được chẩn đoán VQR theo phân loại viêm quanh răng 2017 tại Khoa Răng, Bệnh viện Trung ương Quân đội 108 từ tháng 4/2023 đến tháng 11/2024. Nhóm can thiệp (n = 30) được điều trị bằng phương pháp không phẫu thuật (lấy cao răng, làm sạch bề mặt chân răng) kèm sử dụng axit béo omega-3 hàm lượng 720mg EPA & 480mg DHA. Nhóm chứng (n = 30) chỉ điều trị bằng phương pháp không phẫu thuật. Các chỉ số chiều sâu túi quanh răng (PD), mất bám dính lâm sàng (CAL), phần trăm chảy máu khi thăm khám (%BoP) và nồng độ protein phản ứng C (CRP) huyết thanh được đánh giá tại thời điểm trước điều trị (T0) và sau 3 tháng (T1). Kết quả: Giá trị trung bình của các chỉ số PD, CAL và %BoP sau 3 tháng của hai nhóm giảm có ý nghĩa thống kê so với trước điều trị (p<0,05). Nồng độ CRP huyết thanh của nhóm can thiệp giảm có ý nghĩa thống kê (p<0,05). Chỉ số PD, CAL và %BoP của nhóm can thiệp giảm có ý nghĩa thống kê so với nhóm chứng (p<0,05). Kết luận: Kết hợp axit béo omega-3 với phương pháp điều trị không phẫu thuật giúp cải thiện đáng kể các chỉ số PD, CAL, %BoP và nồng độ CRP huyết thanh của bệnh nhân VQR.
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Các tài liệu tham khảo
1. Singhrao SK, Olsen I (2019) Assessing the role of Porphyromonas gingivalis in periodontitis to determine a causative relationship with Alzheimer’s disease. J Oral Microbiol 11(1): 1563405. doi:10.1080/20002297.2018.1563405.
2. Kassebaum NJ, Smith AGC, Bernabé E et al (2017) Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990-2015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors. J Dent Res 96(4): 380-387. doi:10.1177/0022034517693566.
3. Gutknecht N, Van Betteray C, Ozturan S, Vanweersch L, Franzen R (2015) Laser supported reduction of specific microorganisms in the periodontal pocket with the aid of an Er,Cr:YSGG laser: A pilot study. Scientific ScientificWorldJournal. 2015:450258. doi:10.1155/2015/450258.
4. Offenbacher S, Heasman PA, Collins JG (1993) Modulation of Host PGE2 Secretion as a Determinant of Periodontal Disease Expression. J Periodontol 64(5): 432-444. doi:10.1902/jop.1993.64.5s.432.
5. Reddy MS, Geurs NC, Gunsolley JC (2003) Periodontal host modulation with antiproteinase, anti-inflammatory, and bone-sparing agents. A systematic review. Ann Periodontol 8(1): 12-37. doi:10.1902/annals.2003.8.1.12.
6. Bhatavadekar N, Williams R (2009) New directions in host modulation for the management of periodontal disease: Commentary. Journal of Clinical Periodontology 36: 124-126. doi:10.1111/j.1600-051X.2008.01354.x.
7. Salvi GE, Lang NP (2005) Host response modulation in the management of periodontal diseases. Journal of Clinical Periodontology 32(6): 108-129. doi: 10.1111/j.1600-051X.2005.00785.x.
8. Elwakeel NM, Hazaa HH (2015) Effect of omega 3 fatty acids plus low-dose aspirin on both clinical and biochemical profiles of patients with chronic periodontitis and type 2 diabetes: A randomized double blind placebo-controlled study. Journal of periodontal research 50(6). doi:10.1111/jre.12257.
9. Deore GD, Gurav AN, Patil R, Shete AR, NaikTari RS, Inamdar SP (2014) Omega 3 fatty acids as a host modulator in chronic periodontitis patients: A randomised, double-blind, palcebo-controlled, clinical trial. J Periodontal Implant Sci 44(1): 25-32. doi:10.5051/jpis.2014.44.1.25.
10. Elkhouli AM (2011) The efficacy of host response modulation therapy (omega-3 plus low-dose aspirin) as an adjunctive treatment of chronic periodontitis (Clinical and biochemical study). Journal of Periodontal Research 46(2): 261-268. doi:10.1111/j.1600-0765.2010.01336.x.
11. Naqvi AZ, Hasturk H, Mu L et al (2014) Docosahexaenoic acid and periodontitis in adults: A randomized controlled trial. J Dent Res 93(8): 767-773. doi:10.1177/0022034514541125.
12. Stańdo M, Piatek P, Namiecinska M, Lewkowicz P, Lewkowicz N (2020) Omega-3 Polyunsaturated Fatty Acids EPA and DHA as an adjunct to non-surgical treatment of periodontitis: A randomized clinical trial. Nutrients 12(9): 2614. doi:10.3390/nu12092614.
13. dos Santos NCC, Andere NM, Araujo CF et al (2020) Omega-3 PUFA and aspirin as adjuncts to periodontal debridement in patients with periodontitis and type 2 diabetes mellitus. randomized clinical trial. J Periodontol 91(10):1318-1327. doi:10.1002/JPER.19-0613.
14. Rampally P, Koduganti RR, Ganapathi SN, Panthula VR, Surya PJ (2019) Comparison of effectiveness of low-dose aspirin versus omega-3 fatty acids as adjuvants to nonsurgical periodontal therapy in Type II diabetic patients with chronic periodontitis. J Indian Soc Periodontol 23(3): 249-256. doi:10.4103/jisp.jisp_528_18.
15. El-Sharkawy H, Aboelsaad N, Eliwa M et al (2010) Adjunctive treatment of chronic periodontitis with daily dietary supplementation with omega-3 Fatty acids and low-dose aspirin. J Periodontol 81(11): 1635-1643. doi:10.1902/jop.2010.090628.
16. Wall R, Ross RP, Fitzgerald GF, Stanton C (2010) Fatty acids from fish: the anti-inflammatory potential of long-chain omega-3 fatty acids. Nutr Rev 68(5): 280-289. doi:10.1111/j.1753-4887.2010.00287.x.
17. Serhan CN, Chiang N, Van Dyke TE (2008) Resolving inflammation: dual anti-inflammatory and pro-resolution lipid mediators. Nat Rev Immunol 8(5): 349-361. doi:10.1038/nri2294.
18. Umrania VV, Rao Deepika PC, Kulkarni M (2017) Evaluation of dietary supplementation of omega-3 polyunsaturated fatty acids as an adjunct to scaling and root planing on salivary interleukin-1β levels in patients with chronic periodontitis: A clinico-immunological study. J Indian Soc Periodontol 21(5): 386-390. doi:10.4103/jisp.jisp_16_16.
1. Singhrao SK, Olsen I (2019) Assessing the role of Porphyromonas gingivalis in periodontitis to determine a causative relationship with Alzheimer’s disease. J Oral Microbiol 11(1): 1563405. doi:10.1080/20002297.2018.1563405.
2. Kassebaum NJ, Smith AGC, Bernabé E et al (2017) Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990-2015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors. J Dent Res 96(4): 380-387. doi:10.1177/0022034517693566.
3. Gutknecht N, Van Betteray C, Ozturan S, Vanweersch L, Franzen R (2015) Laser supported reduction of specific microorganisms in the periodontal pocket with the aid of an Er,Cr:YSGG laser: A pilot study. Scientific ScientificWorldJournal. 2015:450258. doi:10.1155/2015/450258.
4. Offenbacher S, Heasman PA, Collins JG (1993) Modulation of Host PGE2 Secretion as a Determinant of Periodontal Disease Expression. J Periodontol 64(5): 432-444. doi:10.1902/jop.1993.64.5s.432.
5. Reddy MS, Geurs NC, Gunsolley JC (2003) Periodontal host modulation with antiproteinase, anti-inflammatory, and bone-sparing agents. A systematic review. Ann Periodontol 8(1): 12-37. doi:10.1902/annals.2003.8.1.12.
6. Bhatavadekar N, Williams R (2009) New directions in host modulation for the management of periodontal disease: Commentary. Journal of Clinical Periodontology 36: 124-126. doi:10.1111/j.1600-051X.2008.01354.x.
7. Salvi GE, Lang NP (2005) Host response modulation in the management of periodontal diseases. Journal of Clinical Periodontology 32(6): 108-129. doi: 10.1111/j.1600-051X.2005.00785.x.
8. Elwakeel NM, Hazaa HH (2015) Effect of omega 3 fatty acids plus low-dose aspirin on both clinical and biochemical profiles of patients with chronic periodontitis and type 2 diabetes: A randomized double blind placebo-controlled study. Journal of periodontal research 50(6). doi:10.1111/jre.12257.
9. Deore GD, Gurav AN, Patil R, Shete AR, NaikTari RS, Inamdar SP (2014) Omega 3 fatty acids as a host modulator in chronic periodontitis patients: A randomised, double-blind, palcebo-controlled, clinical trial. J Periodontal Implant Sci 44(1): 25-32. doi:10.5051/jpis.2014.44.1.25.
10. Elkhouli AM (2011) The efficacy of host response modulation therapy (omega-3 plus low-dose aspirin) as an adjunctive treatment of chronic periodontitis (Clinical and biochemical study). Journal of Periodontal Research 46(2): 261-268. doi:10.1111/j.1600-0765.2010.01336.x.
11. Naqvi AZ, Hasturk H, Mu L et al (2014) Docosahexaenoic acid and periodontitis in adults: A randomized controlled trial. J Dent Res 93(8): 767-773. doi:10.1177/0022034514541125.
12. Stańdo M, Piatek P, Namiecinska M, Lewkowicz P, Lewkowicz N (2020) Omega-3 Polyunsaturated Fatty Acids EPA and DHA as an adjunct to non-surgical treatment of periodontitis: A randomized clinical trial. Nutrients 12(9): 2614. doi:10.3390/nu12092614.
13. dos Santos NCC, Andere NM, Araujo CF et al (2020) Omega-3 PUFA and aspirin as adjuncts to periodontal debridement in patients with periodontitis and type 2 diabetes mellitus. randomized clinical trial. J Periodontol 91(10):1318-1327. doi:10.1002/JPER.19-0613.
14. Rampally P, Koduganti RR, Ganapathi SN, Panthula VR, Surya PJ (2019) Comparison of effectiveness of low-dose aspirin versus omega-3 fatty acids as adjuvants to nonsurgical periodontal therapy in Type II diabetic patients with chronic periodontitis. J Indian Soc Periodontol 23(3): 249-256. doi:10.4103/jisp.jisp_528_18.
15. El-Sharkawy H, Aboelsaad N, Eliwa M et al (2010) Adjunctive treatment of chronic periodontitis with daily dietary supplementation with omega-3 Fatty acids and low-dose aspirin. J Periodontol 81(11): 1635-1643. doi:10.1902/jop.2010.090628.
16. Wall R, Ross RP, Fitzgerald GF, Stanton C (2010) Fatty acids from fish: the anti-inflammatory potential of long-chain omega-3 fatty acids. Nutr Rev 68(5): 280-289. doi:10.1111/j.1753-4887.2010.00287.x.
17. Serhan CN, Chiang N, Van Dyke TE (2008) Resolving inflammation: dual anti-inflammatory and pro-resolution lipid mediators. Nat Rev Immunol 8(5): 349-361. doi:10.1038/nri2294.
18. Umrania VV, Rao Deepika PC, Kulkarni M (2017) Evaluation of dietary supplementation of omega-3 polyunsaturated fatty acids as an adjunct to scaling and root planing on salivary interleukin-1β levels in patients with chronic periodontitis: A clinico-immunological study. J Indian Soc Periodontol 21(5): 386-390. doi:10.4103/jisp.jisp_16_16.
2. Kassebaum NJ, Smith AGC, Bernabé E et al (2017) Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990-2015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors. J Dent Res 96(4): 380-387. doi:10.1177/0022034517693566.
3. Gutknecht N, Van Betteray C, Ozturan S, Vanweersch L, Franzen R (2015) Laser supported reduction of specific microorganisms in the periodontal pocket with the aid of an Er,Cr:YSGG laser: A pilot study. Scientific ScientificWorldJournal. 2015:450258. doi:10.1155/2015/450258.
4. Offenbacher S, Heasman PA, Collins JG (1993) Modulation of Host PGE2 Secretion as a Determinant of Periodontal Disease Expression. J Periodontol 64(5): 432-444. doi:10.1902/jop.1993.64.5s.432.
5. Reddy MS, Geurs NC, Gunsolley JC (2003) Periodontal host modulation with antiproteinase, anti-inflammatory, and bone-sparing agents. A systematic review. Ann Periodontol 8(1): 12-37. doi:10.1902/annals.2003.8.1.12.
6. Bhatavadekar N, Williams R (2009) New directions in host modulation for the management of periodontal disease: Commentary. Journal of Clinical Periodontology 36: 124-126. doi:10.1111/j.1600-051X.2008.01354.x.
7. Salvi GE, Lang NP (2005) Host response modulation in the management of periodontal diseases. Journal of Clinical Periodontology 32(6): 108-129. doi: 10.1111/j.1600-051X.2005.00785.x.
8. Elwakeel NM, Hazaa HH (2015) Effect of omega 3 fatty acids plus low-dose aspirin on both clinical and biochemical profiles of patients with chronic periodontitis and type 2 diabetes: A randomized double blind placebo-controlled study. Journal of periodontal research 50(6). doi:10.1111/jre.12257.
9. Deore GD, Gurav AN, Patil R, Shete AR, NaikTari RS, Inamdar SP (2014) Omega 3 fatty acids as a host modulator in chronic periodontitis patients: A randomised, double-blind, palcebo-controlled, clinical trial. J Periodontal Implant Sci 44(1): 25-32. doi:10.5051/jpis.2014.44.1.25.
10. Elkhouli AM (2011) The efficacy of host response modulation therapy (omega-3 plus low-dose aspirin) as an adjunctive treatment of chronic periodontitis (Clinical and biochemical study). Journal of Periodontal Research 46(2): 261-268. doi:10.1111/j.1600-0765.2010.01336.x.
11. Naqvi AZ, Hasturk H, Mu L et al (2014) Docosahexaenoic acid and periodontitis in adults: A randomized controlled trial. J Dent Res 93(8): 767-773. doi:10.1177/0022034514541125.
12. Stańdo M, Piatek P, Namiecinska M, Lewkowicz P, Lewkowicz N (2020) Omega-3 Polyunsaturated Fatty Acids EPA and DHA as an adjunct to non-surgical treatment of periodontitis: A randomized clinical trial. Nutrients 12(9): 2614. doi:10.3390/nu12092614.
13. dos Santos NCC, Andere NM, Araujo CF et al (2020) Omega-3 PUFA and aspirin as adjuncts to periodontal debridement in patients with periodontitis and type 2 diabetes mellitus. randomized clinical trial. J Periodontol 91(10):1318-1327. doi:10.1002/JPER.19-0613.
14. Rampally P, Koduganti RR, Ganapathi SN, Panthula VR, Surya PJ (2019) Comparison of effectiveness of low-dose aspirin versus omega-3 fatty acids as adjuvants to nonsurgical periodontal therapy in Type II diabetic patients with chronic periodontitis. J Indian Soc Periodontol 23(3): 249-256. doi:10.4103/jisp.jisp_528_18.
15. El-Sharkawy H, Aboelsaad N, Eliwa M et al (2010) Adjunctive treatment of chronic periodontitis with daily dietary supplementation with omega-3 Fatty acids and low-dose aspirin. J Periodontol 81(11): 1635-1643. doi:10.1902/jop.2010.090628.
16. Wall R, Ross RP, Fitzgerald GF, Stanton C (2010) Fatty acids from fish: the anti-inflammatory potential of long-chain omega-3 fatty acids. Nutr Rev 68(5): 280-289. doi:10.1111/j.1753-4887.2010.00287.x.
17. Serhan CN, Chiang N, Van Dyke TE (2008) Resolving inflammation: dual anti-inflammatory and pro-resolution lipid mediators. Nat Rev Immunol 8(5): 349-361. doi:10.1038/nri2294.
18. Umrania VV, Rao Deepika PC, Kulkarni M (2017) Evaluation of dietary supplementation of omega-3 polyunsaturated fatty acids as an adjunct to scaling and root planing on salivary interleukin-1β levels in patients with chronic periodontitis: A clinico-immunological study. J Indian Soc Periodontol 21(5): 386-390. doi:10.4103/jisp.jisp_16_16.
1. Singhrao SK, Olsen I (2019) Assessing the role of Porphyromonas gingivalis in periodontitis to determine a causative relationship with Alzheimer’s disease. J Oral Microbiol 11(1): 1563405. doi:10.1080/20002297.2018.1563405.
2. Kassebaum NJ, Smith AGC, Bernabé E et al (2017) Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990-2015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors. J Dent Res 96(4): 380-387. doi:10.1177/0022034517693566.
3. Gutknecht N, Van Betteray C, Ozturan S, Vanweersch L, Franzen R (2015) Laser supported reduction of specific microorganisms in the periodontal pocket with the aid of an Er,Cr:YSGG laser: A pilot study. Scientific ScientificWorldJournal. 2015:450258. doi:10.1155/2015/450258.
4. Offenbacher S, Heasman PA, Collins JG (1993) Modulation of Host PGE2 Secretion as a Determinant of Periodontal Disease Expression. J Periodontol 64(5): 432-444. doi:10.1902/jop.1993.64.5s.432.
5. Reddy MS, Geurs NC, Gunsolley JC (2003) Periodontal host modulation with antiproteinase, anti-inflammatory, and bone-sparing agents. A systematic review. Ann Periodontol 8(1): 12-37. doi:10.1902/annals.2003.8.1.12.
6. Bhatavadekar N, Williams R (2009) New directions in host modulation for the management of periodontal disease: Commentary. Journal of Clinical Periodontology 36: 124-126. doi:10.1111/j.1600-051X.2008.01354.x.
7. Salvi GE, Lang NP (2005) Host response modulation in the management of periodontal diseases. Journal of Clinical Periodontology 32(6): 108-129. doi: 10.1111/j.1600-051X.2005.00785.x.
8. Elwakeel NM, Hazaa HH (2015) Effect of omega 3 fatty acids plus low-dose aspirin on both clinical and biochemical profiles of patients with chronic periodontitis and type 2 diabetes: A randomized double blind placebo-controlled study. Journal of periodontal research 50(6). doi:10.1111/jre.12257.
9. Deore GD, Gurav AN, Patil R, Shete AR, NaikTari RS, Inamdar SP (2014) Omega 3 fatty acids as a host modulator in chronic periodontitis patients: A randomised, double-blind, palcebo-controlled, clinical trial. J Periodontal Implant Sci 44(1): 25-32. doi:10.5051/jpis.2014.44.1.25.
10. Elkhouli AM (2011) The efficacy of host response modulation therapy (omega-3 plus low-dose aspirin) as an adjunctive treatment of chronic periodontitis (Clinical and biochemical study). Journal of Periodontal Research 46(2): 261-268. doi:10.1111/j.1600-0765.2010.01336.x.
11. Naqvi AZ, Hasturk H, Mu L et al (2014) Docosahexaenoic acid and periodontitis in adults: A randomized controlled trial. J Dent Res 93(8): 767-773. doi:10.1177/0022034514541125.
12. Stańdo M, Piatek P, Namiecinska M, Lewkowicz P, Lewkowicz N (2020) Omega-3 Polyunsaturated Fatty Acids EPA and DHA as an adjunct to non-surgical treatment of periodontitis: A randomized clinical trial. Nutrients 12(9): 2614. doi:10.3390/nu12092614.
13. dos Santos NCC, Andere NM, Araujo CF et al (2020) Omega-3 PUFA and aspirin as adjuncts to periodontal debridement in patients with periodontitis and type 2 diabetes mellitus. randomized clinical trial. J Periodontol 91(10):1318-1327. doi:10.1002/JPER.19-0613.
14. Rampally P, Koduganti RR, Ganapathi SN, Panthula VR, Surya PJ (2019) Comparison of effectiveness of low-dose aspirin versus omega-3 fatty acids as adjuvants to nonsurgical periodontal therapy in Type II diabetic patients with chronic periodontitis. J Indian Soc Periodontol 23(3): 249-256. doi:10.4103/jisp.jisp_528_18.
15. El-Sharkawy H, Aboelsaad N, Eliwa M et al (2010) Adjunctive treatment of chronic periodontitis with daily dietary supplementation with omega-3 Fatty acids and low-dose aspirin. J Periodontol 81(11): 1635-1643. doi:10.1902/jop.2010.090628.
16. Wall R, Ross RP, Fitzgerald GF, Stanton C (2010) Fatty acids from fish: the anti-inflammatory potential of long-chain omega-3 fatty acids. Nutr Rev 68(5): 280-289. doi:10.1111/j.1753-4887.2010.00287.x.
17. Serhan CN, Chiang N, Van Dyke TE (2008) Resolving inflammation: dual anti-inflammatory and pro-resolution lipid mediators. Nat Rev Immunol 8(5): 349-361. doi:10.1038/nri2294.
18. Umrania VV, Rao Deepika PC, Kulkarni M (2017) Evaluation of dietary supplementation of omega-3 polyunsaturated fatty acids as an adjunct to scaling and root planing on salivary interleukin-1β levels in patients with chronic periodontitis: A clinico-immunological study. J Indian Soc Periodontol 21(5): 386-390. doi:10.4103/jisp.jisp_16_16.
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