Adjunctive Treatment of Chronic Periodontitis With Daily Dietary Supplementation With Omega‐3 Fatty Acids and Low‐Dose Aspirin

Abstract

Background: Host modulatory therapy has been proposed as a treatment for periodontal diseases. Omega‐3 (ω‐3) polyunsaturated fatty acids (PUFAs), including docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), were shown to have therapeutic anti‐inflammatory and protective actions in inflammatory diseases including periodontitis. The goal of this study was to test an innovative strategy for periodontal treatment in a clinical experiment. Methods: Eighty healthy subjects (40 in each group) with advanced chronic periodontitis were enrolled in Mansoura, Egypt, in a parallel‐design, double‐masked clinical study. The control group was treated with scaling and root planing (SRP) and a placebo, whereas the ω‐3 group was treated with SRP followed by dietary supplementation of fish oil (900 mg EPA + DHA) and 81 mg aspirin daily. Saliva samples were obtained from all patients at baseline and 3 and 6 months for evaluation of receptor activator of nuclear factor‐kappa B ligand (RANKL) and matrix metalloproteinase‐8 (MMP‐8). Plaque and gingival indices, bleeding on probing, probing depths, and attachment levels were recorded at the same time points. Results: Statistical analyses demonstrated a significant reduction in probing depths and a significant attachment gain after 3 and 6 months in the ω‐3 group compared to baseline and the control group ( P <0.05). Salivary RANKL and MMP‐8 levels showed significant reductions in the ω‐3 group in response to treatment at 3 and 6 months and compared to the control group at 6 months ( P <0.01). Supplementation with ω‐3 + aspirin resulted in a significant shift in the frequency of pockets with probing depths <4 mm ( P <0.05). Conclusion: The results of this preliminary clinical study suggest that dietary supplementation with ω‐3 PUFAs and 81 mg aspirin may provide a sustainable, low‐cost intervention to augment periodontal therapy.