Impact of omega-3 fatty acids on periodontal inflammation.

Abstract

Objective: To investigate the impact of omega 3 (fish oil supplements) on periodontal inflammation when used as an adjunct to conventional periodontal treatment. Methods: A double-blinded, randomized, placebo-controlled, two centred pilot study of 13 months duration was carried out (n=34). Adults with newly diagnosed chronic periodontitis were recruited according to strict inclusion and exclusion criteria. Participants were randomly allocated (by computer number generator) to consume 6 x 1g capsules per day containing either Soybean oil (control group) or fish oil. Plaque and gingival crevicular fluid (GCF) samples were taken from two worst sites at non-adjacent teeth determined at initial clinical examination appointment. Non-surgical periodontal treatment was carried out once a week for 4 weeks. After 3 months of healing, 4 months data were collected then maintenance appointment was carried out every 3 months. Data at 4 months were used as end point for the purpose of preliminary analysis. Clinical measurements (probing pocket depth (PPD), clinical attachment level (CAL)) as well as the difference in the levels of various inflammatory markers, interleukin (IL)-1β, tumour necrosis factor (TNF)-α, C-reactive protein (CRP) in both plasma and GCF, at baseline (Before treatment) and at 4 months (3 months post treatment) were compared. Results: In this study where fish oil supplements were used as an adjunct to non-surgical periodontal treatment, there were no statistical nor clinically significant differences after 4 months. The level of inflammatory mediators in GCF, IL-1β, TNF-α and CRP, showed no statistically significant differences within placebo nor fish oil group at baseline and 4 months. Unpaired T- test revealed no statistical difference between placebo and fish oil at baseline and 4 months. Conclusion: This study showed no benefit of fish oil supplement as an adjunct to nonsurgical periodontal treatment in terms of reduction in PPD and CAL gain as well as suppression of inflammatory markers. However this result could be due to: 1. Short follow up period, 2. Small sample numbers, 3. GCF may not be the best way to measure inflammatory marker level. Further study with larger sample number and longer duration should be carried out.