ISSN: 1859 - 2872
The effect of combining non-surgical treatment with omega-3 polyunsaturated fatty acids (PUFAs) on periodontitis
Main Article Content
Keywords
Periodontitis, omega-3 fatty acids, non-surgical periodontal therapy
Abstract
Objective: To evaluate the efficacy of non-surgical periodontal therapy combined with omega-3 fatty acid supplementation in patients with periodontitis. Subject and method: A clinical trial was conducted on 60 patients diagnosed with periodontitis at the Department of Dentistry, 108 Military Central Hospital, from April 2023 to November 2024. The intervention group (n = 30) was treated with a non-surgical periodontal therapy (scaling and root planning) combined with omega-3 fatty acids containing 720mg of EPA & 480mg of DHA. The control group (n = 30) was treated only with non-surgical periodontal therapy. The clinical parameters, including probing depth (PD), clinical attachment loss (CAL), bleeding on probing (%BoP) and serum C-reactive protein (CRP) concentration were evaluated before treatment (T0) and after 3 months (T1). Result: Both groups showed significant reductions in PD, CAL, and %BoP after 3 months of treatment (p<0.05). The serum CRP concentration of the intervention group decreased significantly (p<0.05). The test group demonstrated statistically significantly better outcomes than the control group (p<0.05), suggesting that adding omega-3 fatty acids enhances the therapeutic benefits of non-surgical periodontal therapy. Conclusion: This study demonstrates that supplementing omega-3 fatty acids with non-surgical periodontal therapy significantly improves clinical outcomes and serum CRP concentration in patients with periodontitis.
Article Details
References
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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Apr 14, 2025
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BìnhT. T., HàT. T. T., HằngP. T. T., HoaN. N., ĐồngT. T., NamN. Đăng, NamN. Đăng, & LyV. K. (2025). The effect of combining non-surgical treatment with omega-3 polyunsaturated fatty acids (PUFAs) on periodontitis. Tạp Chí Y Dược lâm sàng 108, 20(2). https://doi.org/10.52389/ydls.v20i2.2643