ABSTRACT
Background:
Chronic inflammation of the tooth’s supporting tissues is known as periodontal disease. It causes pockets to develop, attachments to break, and eventually the loss of teeth. Because of their well-known anti-inflammatory qualities, omega-3 fatty acids have been recommended as an additional therapy for periodontal inflammation.
Materials and Methods:
A randomized controlled study of 60 individuals suffering from persistent periodontitis was carried out. Two groups of participants were randomly assigned: The test group (n = 30) got conventional periodontal treatment with omega-3 fatty acid supplementation (1000 mg/day), while the control group (n = 30) received normal periodontal therapy alone. Measurements of periodontal parameters were made at baseline, 3 months, and 6 months after therapy, including bleeding on probing (BOP) and pocket depth. Paired t-tests and analysis of variance were used in the statistical analysis to determine the significance of the group differences.
Results:
Participants in the test group showed a greater reduction in probing pocket depth (PPD) and BOP at both 3 and 6 months. Specifically, the mean PPD decreased from 5.4 ± 0.7 mm to 3.0 ± 0.4 mm, and BOP reduced from 71.2 ± 14.5% to 28.3 ± 9.2% in the test group, with both outcomes showing statistically significant differences compared to the control group (P < 0.01).
Conclusion:
In individuals with chronic periodontitis, omega-3 fatty acid supplementation dramatically improves the decrease of periodontal pocket depth and inflammation when administered as an adjuvant to regular periodontal treatment.
KEYWORDS: Anti-inflammatory therapy, chronic periodontitis, omega-3 fatty acids, periodontal inflammation, periodontal treatment, pocket depth reduction
INTRODUCTION
Gingiva, periodontal ligament, cementum, and alveolar bone are among the supporting tissues of teeth that are impacted by the common chronic inflammatory illness known as periodontal disease. It is a significant contributor to adult tooth loss and has been linked to systemic illnesses such diabetes mellitus, cardiovascular disease, and unfavorable pregnancy outcomes.[1,2] The delicate interaction between bacterial biofilms and human immune responses represents a complex etiology of periodontal disease. The host’s inflammatory reaction to the bacterial assault causes the periodontal tissues to be destroyed.[3]
In order to lessen inflammation and stop the course of the illness, scaling and root planing (SRP) are the main techniques used in conventional periodontal treatment to mechanically debride bacterial biofilms.[4] Nonetheless, there is increasing interest in complementary treatments that may be able to control the inflammatory response of the host and improve the results of traditional periodontal therapy. It has been shown that omega-3 fatty acids, in particular docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), have strong anti-inflammatory effects.[5] These polyunsaturated fatty acids function as precursors to the lipid mediators protectins and resolvins, which are essential for reducing inflammation.[6]
According to recent research, taking supplements of omega-3 fatty acids may improve periodontal health by lowering inflammatory mediators and encouraging tissue repair.[7]
MATERIALS AND METHODS
Sixty individuals with persistent periodontitis were included in the research. Based on the following inclusion criteria, patients were chosen: There should be a minimum of 20 natural teeth, two nonadjacent teeth with a probing pocket depth (PPD) of at least 4 mm, and no history of periodontal therapy within the last 6 months. Smoking, breastfeeding, pregnancy, systemic disorders (such as diabetes, cardiovascular diseases), and use of immunosuppressive or anti-inflammatory drugs during the previous 3 months were among the exclusion criteria. The Institutional Ethics Committee granted ethical approval, and each subject provided written informed permission.
Intervention and randomization
Using a computer-generated randomization sequence, participants were divided into two groups at random: the test group (n = 30) and the control group (n = 30). The test group got regular periodontal care in addition to omega-3 fatty acid supplementation (1000 mg/day of EPA and DHA). The control group was not given any supplements; they were given just normal periodontal care. Six months were spent administering the supplements. At baseline, all participants got comprehensive SRP, along with advice on oral hygiene.
Evaluation of periodontal disease
At baseline, 3 months, and 6 months, periodontal parameters were evaluated by a calibrated examiner who was unaware of the group assignment. Probing pocket depth (PPD) was the major outcome measure, while bleeding on probing (BOP) was the secondary end measure.
Analytical statistics
SPSS version 25.0 (IBM Corp., Armonk, NY, USA) was used to analyze the data.
RESULTS
The study included 60 participants, who were randomly assigned to either the test group (omega-3 supplementation with standard periodontal therapy) or the control group (standard periodontal therapy alone). All participants completed the study, and no adverse events were reported.
The baseline characteristics of the participants are presented in Table 1. There were no significant differences between the test and control groups in terms of age, gender distribution, PPD, or BOP at baseline (P > 0.05 for all comparisons).
Table 1.
Baseline Characteristics of Participants
| Characteristic | Test Group (n=30) | Control Group (n=30) | P |
|---|---|---|---|
| Age (years) | 46.2±7.9 | 45.7±8.1 | 0.68 |
| Gender (Male/Female) | 16/14 | 18/12 | 0.72 |
| Probing Pocket Depth (mm) | 5.4±0.7 | 5.3±0.6 | 0.61 |
| Bleeding on Probing (%) | 71.2±14.5 | 70.8±15.0 | 0.82 |
The changes in periodontal parameters are summarized in Table 2.
Table 2.
Changes in Periodontal Parameters
| Parameter | Test Group (n=30) | Control Group (n=30) | P |
|---|---|---|---|
| Probing Pocket Depth (mm) | |||
| Baseline | 5.4±0.7 | 5.3±0.6 | 0.61 |
| 3 months | 3.9±0.5 | 4.7±0.7 | <0.01* |
| 6 months | 3.0±0.4 | 4.1±0.6 | <0.01* |
| Bleeding on Probing (%) | |||
| Baseline | 71.2±14.5 | 70.8±15.0 | 0.82 |
| 3 months | 42.1±11.0 | 59.4±12.7 | <0.01* |
| 6 months | 28.3±9.2 | 51.7±10.5 | <0.01* |
*Statistically significant
Probing Pocket Depth (PPD): At 3 months, the mean PPD in the test group decreased significantly from 5.4 ± 0.7 mm to 3.9 ± 0.5 mm, while the control group showed a reduction from 5.3 ± 0.6 mm to 4.7 ± 0.7 mm. By 6 months, the test group exhibited a further reduction to 3.0 ± 0.4 mm, compared to 4.1 ± 0.6 mm in the control group. The differences between the groups at both 3 and 6 months were statistically significant (P < 0.01).
Bleeding on Probing (BOP): Similarly, BOP reduced significantly in the test group, from 71.2 ± 14.5% at baseline to 42.1 ± 11.0% at 3 months and 28.3 ± 9.2% at 6 months. In the control group, BOP decreased from 70.8 ± 15.0% at baseline to 59.4 ± 12.7% at 3 months and 51.7 ± 10.5% at 6 months. The differences between the groups were also statistically significant at both 3 and 6 months (P < 0.01).
DISCUSSION
The test group’s significant decrease in PPD as compared to the control group is in line with the effects of omega-3 fatty acids, which are known to modulate the inflammatory response. Specific proresolving lipid mediators, such resolvins and protectins, are derived from omega-3 fatty acids, especially EPA and DHA.[3] These mediators are essential for reducing inflammation and fostering tissue repair. The test group had superior clinical results, which may be attributed to this mechanism, as seen by the higher decrease in PPD and BOP.
A more notable reduction in bleeding on probing, a clinical indicator of periodontal inflammation, was also seen in the test group as compared to the control group. The results of this study indicate that omega-3 fatty acids may directly reduce gingival inflammation, maybe via the inhibition of proinflammatory cytokines like TNF-α and interleukin-1β (IL-1β).[4] These cytokines are known to promote bone resorption and tissue degradation, which are important steps in the pathophysiology of periodontal disease.[5]
Other clinical studies that have investigated the effect of omega-3 fatty acids in periodontal treatment are consistent with the findings of this research. In a randomized controlled experiment, Naqvi et al.[6] discovered that in people with periodontitis, supplementing with DHA dramatically decreased gingival inflammation and periodontal pocket depth. In a similar vein, Elkhouli et al.[7] found that in patients with chronic periodontitis, omega-3 fatty acid supplementation significantly improved clinical attachment levels and decreased inflammatory biomarkers.
CONCLUSION
The study’s findings, taken together, indicate that supplementing with omega-3 fatty acids may significantly enhance periodontal health and serve as an efficient addition to traditional periodontal treatment.
Conflicts of interest
There are no conflicts of interest.
Funding Statement
Nil.
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