n-3 PUFA Effects on Periodontitis in Humans

Dietary n-3 polyunsaturated fatty acids (n-3 PUFA) have shown an immunomodulating effect on host responses in chronic inflammation.  However, there is limited information regarding n-3 PUFA as an adjunctive treatment of chronic periodontitis.  Objective: This study evaluated changes in clinical parameters of periodontitis and the levels of three periodontal pathogens in patients treated with n-3 PUFA.  Methods: A randomized double-blind placebo controlled study has enrolled 56 subjects into four groups: Grp1) oral hygiene instruction (OHI) +placebo, Grp2) OHI + n-3 PUFA, Grp3) scaling/root planing (S/RP) +placebo, Grp4) S/RP + n-3 PUFA.  Clinical evaluation and microbiologic samples from diseased and healthy sites were collected at baseline, 8, 16 and 28 weeks and were processed by qPCR.  A universal primer was used to estimate total microbial counts and species-specific primers were used to quantify P. gingivalis, T. denticola, T. forsythia.  Results: SRP treatment significantly improved the clinical parameters of bleeding and tissue destruction (PD, AL).  PUFA alone had a minimal impact on destruction, but did appear to lower the overall level of bleeding.  The combination treatment also significantly improved periodontal health  although there was no obvious synergism of S/RP and PUFA.  The pathogens were initially approximately 15% of the total bacteria in diseased sites.  Grp1 and Grp2 showed no effect on the total bacteria or individual species.  In contrast, Grp3 demonstrated a significant decrease in their overall proportions (~4%), as well as significant decreases in each of the three species.  Finally, addition of PUFA (Grp4) did not appear to provide any additional impact on the pathogenic species in the plaque.  Conclusions:  The initial outcomes suggest that dietary n-3 PUFA may provide some adjunctive benefit to S/RP in treating periodontitis; however, this did not appear to be via alterations of the microbial composition of diseased sites.  Supported by P20 RR020145 from the NCRR.