Mirella Stańdo-Retecka

Purpose: This study aimed to evaluate the impact of dietary supplementation with omega-3 polyunsaturated fatty acids (PUFAs) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) combined with scaling and root planing (SRP) in untreated periodontitis stage III and IV. Methods: Forty patients were randomly assigned to the test group receiving SRP plus omega-3 PUFAs (n = 20) or control group receiving SRP alone (n = 20). Clinical changes of pocket probing depths (PD), clinical attachment level (CAL), bleeding on probing (BOP) and rates of closed pockets (PPD ≤ 4 mm without BOP) were evaluated at baseline and after 3 and 6 months. Phorphyromonas gingivalis, Tanarella forsythia, Treponema denticola and Aggregatibacter actinomycetemcomitans counts were analysed at baseline and at 6 months. Serum was subjected to lipid gas chromatography/mass spectrometry analysis at baseline and at 6 months. Results: Significant improvement of all clinical parameters at 3 and 6 months was observed in both groups. For the primary outcome “change of mean PD,” no significant difference was detected between the groups. Patients treated with omega-3 PUFAs demonstrated significantly lower rates of BOP, higher gain of CAL and higher number of closed pockets at 3 months in comparison to the control group. After 6 months, no clinical differences between the groups were found, with the exception of lower BOP rates. Moreover, in the test group, the number of key periodontal bacteria was significantly lower than in the control group at 6 months. Increased proportions of serum n-3 PUFAs and decreased proportions of n-6 PUFAs were detected at 6 months in the patients from the test group. Conclusion: High-dose omega-3 PUFA intake during non-surgical treatment of periodontitis results in short-term clinical and microbiological benefits. The study protocol was approved by the ethical committee of Medical University of Lodz (reference number RNN/251/17/KE) and registered at clinicaltrials.gov (NCT04477395) on 20/07/2020.

Introduction: Periodontitis is a chronic multifactorial disease induced by a microbial biofilm leading to progressive destruction of the tooth-supporting tissue. Severe periodontitis often contributes to pathologic tooth migration (PTM) or tooth loss. In consequence, patients with advanced...

Periodontitis is a chronic multifactorial inflammatory disease that leads to the loss of supportive tissues around the teeth with gradual deterioration of masticatory function and esthetics, resulting eventually in the decrease of the life quality. Host immune response triggered by bacterial biofilm is responsible for the chronic periodontal inflammation and ongoing tissue loss. Omega-3 polyunsaturated fatty acids (PUFA) such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have anti-inflammatory properties, thus may be used for the treatment of chronic inflammatory diseases. In this study, we aimed to evaluate the effect of dietary supplementation with omega-3 PUFA in the patients with stage III and IV periodontitis. Thirty otherwise healthy patients were treated with scaling and root planning (SRP). In the test group (n = 16), patients were additionally supplemented with 2.6 g of EPA and 1.8 g of DHA. In the control group (n = 14), patients received only SRP. Periodontal examination was performed at baseline and three months following initial therapy. Salivary samples were taken twice at baseline and at the end of the experiment. We found that there was a statistically significant reduction in the bleeding on probing (BOP) and improvement of clinical attachment loss (CAL) at three months in the test group compared to the control group. Moreover, a statistically significant higher percentage of closed pockets (probing depth ≤ 4 mm without BOP) was achieved in the test group vs. control group after three months of treatment. Accordingly, the levels of pro-inflammatory cytokines/chemokines interleukin (IL)-8 and IL-17 were markedly lower, while the level of anti-inflammatory IL-10 was significantly higher in the salivary samples of the patients supplemented with omega-3 PUFA at three months in comparison to the patients treated with SRP alone. Our findings demonstrate that dietary intervention with high-dose of omega-3 PUFA during non-surgical therapy may have potential benefits in the management of periodontitis.

Recently, a growing interest in products containing omega‐3 polyunsaturated fatty acids (PUFAs) docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) has emerged. It turned out that omega‐3 PUFAs have therapeutic, anti‐inflammatory, and protective properties in the patients with rheumatoid arthritis, ulcerative colitis, asthma, cardiovascular and periodontal diseases. Omega‐3 PUFAs inhibit the synthesis of pro‐inflammatory factors such as cytokines and eicosanoids. Moreover, omega‐3 PUFAs are enzymatically transformed into lipid mediators, i.a. resolvins and protectins possessing the properties to soothe the ongoing inflammatory process and minimize tissue damage as well as to increase tissue protection in acute inflammation. The use of omega‐3 PUFAs in the treatment of periodontitis may be beneficial due to controlling an inflammatory response against subgingival biofilm, reducing the level of pro‐inflammatory cytokines and inhibiting osteoclast function. This, in turn, improves clinical parameters of periodontitis, such as bleeding on probing (BOP), periodontal probing depth (PD), and connective tissue attachment level (CAL). In this paper, the most important information about the mechanisms of omega‐3 PUFAs EPA and DHA action, and their sources in the daily diet are discussed. The recent literature regarding the effects of using omega‐3 PUFAs as a complementary and supportive element in the non‐surgical treatment of periodontitis are also reviewed.Practical Applications: Studies in humans and animals have suggested a beneficial therapeutic effect of omega‐3 fatty acids in the control of inflammation and periodontal tissue protection in periodontitis.The multidirectional action of omega‐3 polyunsaturated fatty acids (PUFAs) and their role in periodontal inflammation are reviewed here.