Clinical and immunological effects of omega-3 polyunsaturated fatty acids and low-dose aspirin as adjuncts to periodontal debridement in patients with type 2 diabetes: randomized clinical trial

Author(s)

Nídia Cristina Castro dos Santos

• Document type: Doctoral Thesis
• Press: São José dos Campos. 2019-06-18.
• Institution: Universidade Estadual Paulista (Unesp). Instituto de Ciência e Tecnologia. São José dos Campos
• Defense date: 2019-05-31
• Advisor: Mauro Pedrine Santamaria; Lucio Murilo dos Santos

Abstract

Daily dietary supplementation with omega-3 (ω-3) polyunsaturated fatty acids (PUFAs) and low-dose aspirin (ASA) have been proposed as a host modulation therapy for the treatment of chronic inflammatory diseases. The aim of this study was to investigate the clinical and immunological actions of ω-3 PUFAs and ASA as an adjunct therapy to full-mouth periodontal debridement for the treatment of periodontitis in patients with type 2 diabetes. Seventy-five patients (n=25/group) meeting the inclusion criteria were randomly assigned to receive placebo and periodontal debridement (CG), ω-3 (3g of fish oil/day for 60 days) and ASA (100mg/day for 60 days) after periodontal debridement (TG1), and ω-3 (3g of fish oil/day for 60 days) and ASA (100mg/day for 60 days) before periodontal debridement (TG2). Periodontal clinical parameters and gingival crevicular fluid (GCF) were collected at baseline (t0), 90 days (TG1 and CG) (t1), after ω-3 and ASA only (TG2) (t1), and 180 days after periodontal debridement (all groups) (t2). Ten patients (40%) in TG1 and nine patients (36%) in TG2 achieved the clinical endpoint for treatment (≤4 periodontal pockets with probing depth (PD)≥ 5mm), as opposed to four (16%) in CG. There was clinical attachment gain in moderate and deep pockets between t0 and t2 for TG1. Concentration levels of IFN-γ, IL-1β, and IL-8 decreased over time for both test groups, with early (t1) significant changes for TG1. IL-6 levels were lower at t1 and t2 for TG1, and MIP-1α decreased at t2 for TG2. In the CG, IL1β was the only marker presenting statistically significant changes over time. The results of this clinical study suggest that the adjunctive use of ω-3 and ASA after periodontal debridement provides clinical and immunological benefits to the treatment of periodontitis in patients with type 2 diabetes when compared to the other treatment protocols evaluated. (AU)

• FAPESP's process: 16/02234-7 - Effect of É-3 polyunsaturated fatty acids plus low dose of aspirin daily supplementation as adjunctive to full-mouth ultrasonic debridement for the treatment of chronic periodontitis in type 2 diabetic patients. Superiority randomized clinical trial
• Grantee: Nidia Cristina Castro dos Santos
• Support Opportunities: Scholarships in Brazil - Doctorate