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

Background: Host modulatory therapy has been proposed as a treatment for periodontal diseases. Omega-3 (omega-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 omega-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 omega-3 group compared to baseline and the control group (P <0.05). Salivary RANKL and MMP-8 levels showed significant reductions in the omega-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 omega-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 omega-3 PUFAs and 81 mg aspirin may provide a sustainable, low-cost intervention to augment periodontal therapy. J Periodontol 2010; 81 : 1635-1643.