The Impact of Omega-3 Fatty Acids Combined With Initial Periodontal Therapy on Salivary Visfatin and TNF-Α Levels in Chronic Periodontitis Patients

Abstract

Recent investigations have demonstrated the positive therapeutic effects of omega-3 polyunsaturated fatty acids (PUFAs) on several chronic inflammatory diseases such as rheumatoid arthritis, chronic inflammatory bowel diseases and periodontitis. The objective of the present study was to evaluate the impact of omega-3 PUFAs in conjunction with initial periodontal therapy (IPT) on periodontal clinical parameters and salivary markers in patients with chronic periodontitis. Thirty four systemically healthy individuals with advanced chronic periodontitis were enrolled and randomly assigned into two groups. The control group (IPT, n=17) was treated with IPT alone whereas the test group (IPT+omega-3, n=17) was treated with IPT and daily dietary supplementation of omega-3 PUFAs (in the form of 2 grams of fish oil capsules per day)for three months. Clinical parameters were recorded at baseline and 3 months following therapy for both groups. Saliva samples were collected at the same time points and analyzed for visfatin and tumor necrosis factor-α (TNF-α). After 3 months, clinical periodontal parameters of advanced chronic periodontitis were significantly improved in both groups. The omega-3 group showed significant greater pocket depth (PD) reduction and clinical attachment (CAL) gain compared to the control group after therapy. Salivary TNF-α levels showed a statistically significant decrease in the omega-3 group at 3 months compared to the control group. Salivary visfatin levels were reduced significantly at 3 months in both groups without any significant variation. It was concluded that dietary supplementation with omega-3 PUFAs could be a potential viable adjunct to IPT that significantly improves all periodontal parameters and reduces salivary visfatin and TNF-α levels in advanced chronic periodontitis. Interestingly, salivary visfatin could be a useful periodontal biomarker to monitor responses to periodontal therapy.

The Impact of Omega-3 Supplements on Non-Surgical Periodontal Therapy: A Systematic Review

“…The following criteria led to exclusion: Screening of titles and abstracts by both independent reviewers (LMM and FBP) resulted in retention of the same 28 articles (Figure 2). After reading all the articles thoroughly, additional exclusions were made due to the following criteria: The diagnosis of the patients in the included studies varied from moderate/severe chronic [41], untreated advanced chronic [43], chronic [38,42], generalized chronic [39,40] to stage II/III periodontitis [44] and stage III/IV periodontitis [45] according to the most recent classification [46]. Six out of eight studies presented detailed criteria for patient selection.…”

“…The number of teeth, as far as presented, varied greatly among studies. Two studies reported the number of teeth examined [42,43]. Four authors did not report the number of teeth examined but defined the inclusion criteria based on the minimum number of teeth present: at least 6 [40], 15 [38], ≥18 [45] and 20 [39].…”

“…In the same table, it can be noted that one study included people with diabetes (type 2 diabetes mellitus) [38], other obese individuals [39], and a third menopausal participants [40]. The diagnosis of the patients in the included studies varied from moderate/severe chronic [41], untreated advanced chronic [43], chronic [38,42], generalized chronic [39,40] to stage II/III periodontitis [44] and stage III/IV periodontitis [45] according to the most recent classification [46]. Six out of eight studies presented detailed criteria for patient selection.…”

“…Six out of eight studies presented detailed criteria for patient selection. Four studies used presence of sites with PPD (probing depth) ≥ 5 mm [38,[40][41][42] and two studies presence of sites with PPD ≥ 6 mm [43,45]. Of the remaining two studies one study included patients with stage II and III grade B periodontitis [44] and the other mentioned only chronic periodontitis, both without any further information [39].…”

“…Besides, information about the number of sites in which the clinical parameters were assessed varied as well. For example, four studies evaluated clinical parameters at six sites per tooth [39,40,42,44,45], one at four sites [41] and the remaining two studies did not provide any information about the number of sites examined [38,43].…”