Kujur Shirish K, Goswami Varsha, Nikunj Anand M, Singh Gangesh, Bandhe Shweta, Ghritlahre Himanta
Department of Oral Pathology, Govt Dental College, Raipur, Chhattisgarh, India.
Indian J Dent Res. 2020 Mar-Apr;31(2):229-235. doi: 10.4103/ijdr.IJDR_647_18.
: Periodontitis is conventionally treated with both surgical and nonsurgical methods. Various adjuncts have been used previously with compromised efficacy. Recently omega-3(ώ-3) polyunsaturated fatty acids (PUFA) including docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) were shown to have therapeutic anti-inflammatory and protective actions in inflammatory diseases including periodontitis. The purpose of the present study was to evaluate and compare the clinical efficacy of ώ-3 fatty acids as an adjunct to scaling and root planing in the treatment of periodontitis.
110 Patients were selected for the study out of which 20 were excluded (12 not meeting the inclusion criteria and 8 refused to participate). 90 patients (48 in test and 42 in the control group) after randomisation through a coin toss method were enrolled in a single-blind randomised controlled trial conducted in the Periodontics department of a dental college. Full mouth subgingival scaling and root planing and ώ-3 fatty acid 500 mg (EPA/DHA 180/120 mg), BD daily for 1 month was given to the test group and subgingival scaling and root planing only was given to the control group. Clinical parameters like probing pocket depth, clinical attachment level, plaque index and gingival index were recorded at baseline, 1 and 3 months and were compared.
Statistical analyses demonstrated a significant reduction in probing pocket depth (t = 65.56, P = 0.000) and (t = 51.69, P = 0.000) at 1 and 3 months, respectively, in test group compared to baseline and control group. There was a significant gain in clinical attachment level (t = 63.29, P = 0.000) and (t = 31.03, P = 0.000) at 1 and 3 months, respectively, in test group compared to baseline and control group. The gingival index shows an appreciable reduction in both groups, and in test group, it is statistically significant at 3 months (t = 2.15, P = 0.03). There was no statistical significant reduction in plaque index at 3 months (t = 0, P = 0.997).
The present study showed that adjunctive use of ώ-3 fatty acids proved to be beneficial over scaling and root planing alone in the treatment of chronic moderate periodontitis. The beneficial effects were in terms of significant improvements in clinical parameters, probing pocket depth, and clinical attachment level and gingival index. Dietary modulation is now emerging as an adjunct to periodontal therapy. Hence, omega-3 fatty acid may be used routinely in the management of chronic periodontitis.
传统上,牙周炎采用手术和非手术方法治疗。以前曾使用过各种辅助治疗方法,但疗效不佳。最近,包括二十二碳六烯酸(DHA)和二十碳五烯酸(EPA)在内的ω-3多不饱和脂肪酸(PUFA)在包括牙周炎在内的炎症性疾病中显示出治疗性抗炎和保护作用。本研究的目的是评估和比较ω-3脂肪酸作为龈下刮治和根面平整辅助治疗牙周炎的临床疗效。
从110名患者中选取进行研究,其中20名被排除(12名不符合纳入标准,8名拒绝参与)。通过抛硬币法随机分组后,90名患者(试验组48名,对照组42名)参加了在一所牙科学院牙周科进行的单盲随机对照试验。试验组接受全口龈下刮治和根面平整,并每天服用500毫克ω-3脂肪酸(EPA/DHA 180/120毫克),共1个月,对照组仅接受龈下刮治和根面平整。在基线、1个月和3个月时记录临床参数,如探诊深度、临床附着水平、菌斑指数和牙龈指数,并进行比较。
统计分析表明,试验组在1个月和3个月时的探诊深度(t = 65.56,P = 0.000)和(t = 51.69,P = 0.000)与基线和对照组相比均有显著降低。试验组在1个月和3个月时的临床附着水平(t = 63.29,P = 0.000)和(t = 31.03,P = 0.000)与基线和对照组相比均有显著增加。两组的牙龈指数均有明显降低,试验组在3个月时具有统计学意义(t = 2.15,P = 0.03)。3个月时菌斑指数无统计学意义的降低(t = 0,P = 0.997)。
本研究表明,在慢性中度牙周炎的治疗中,辅助使用ω-3脂肪酸比单独进行龈下刮治和根面平整更有益。有益效果体现在临床参数、探诊深度、临床附着水平和牙龈指数的显著改善方面。饮食调节正在成为牙周治疗的辅助手段。因此,ω-3脂肪酸可常规用于慢性牙周炎的治疗。