Abstract
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.
Highlights
Periodontitis is a highly prevalent oral disease in humans, affecting nearly 50% of the population worldwide [1]
Dietary Supplementation with Omega-3 polyunsaturated fatty acids (PUFA) Resulted in the Improvement of clinical attachment level (CAL) and bleeding on probing (BOP)
The present study showed that supplementation with high-dose omega-3 PUFA as an adjunct to non-surgical treatment of periodontitis can be helpful in management of periodontal disease
Summary
Periodontitis is a highly prevalent oral disease in humans, affecting nearly 50% of the population worldwide [1]. The Global Burden of Disease 2015 study conducted by Kassebaum et al revealed that the severe form of periodontitis affects 11.2% of the world’s population and it is the sixth most common human disease [2]. Nutrients 2020, 12, 2614 in Gram-negative bacteria, mainly Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Prevotella intermedia, Treponema denticola and Fusobacterium nucleatum ssp., in gingival sulcus [3]. This results in the immune response activation and clinical signs of periodontal tissue inflammation. Bacterial burden elicits an increase in lipopolysaccharide, resulting in an increase in pro-inflammatory mediators such as interleukin (IL)-1 β, IL-6 and tumor necrosis factor (TNF)-α [4]
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