Department of Periodontology, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium.
Clin Exp Dent Res. 2023 Aug;9(4):545-556. doi: 10.1002/cre2.736. Epub 2023 Jun 21.
BACKGROUND AND OBJECTIVES: Promoting resolution of inflammation using new classes of lipids mediators has been proposed for the management of inflammatory disease. This systematic review and meta-analysis aimed to evaluate the benefits of the use of omega-3 fatty acids as an adjuvant in the nonsurgical treatment of periodontitis.
The data search was conducted into three main databases: PubMed, Embase, and Cochrane. The search equation was built around the PICO framework in which the population was constituted by human adults suffering from chronic periodontitis that had to be treated with conventional SRP with the adjunction of omega-3 fatty acids (I) or without the adjunction of omega-3 fatty acids (C), with, as a first outcome the probing pocket depth reduction (PPD) and as a second outcome the clinical attachment loss reduction (CAL). Risk of bias within studies was evaluated for each included study using the Cochrane collaboration tool for randomized studies (RoB Tool). A meta-analysis was performed using REVMAN 5.3.
After a global search, 117 studies were selected but only seven of them were eligible for the systematic review and meta-analysis. Six out of seven studies showed a significantly better PPD reduction in the omega-3 fatty acids group compared to the control group and five out of seven studies showed a significantly better CAL reduction in the omega-3 fatty acids group compared to the control group. The meta-analysis showed a statistically significant difference for PPD reduction (SMD: -0.78 [95% CI: -1.02, -0.54, p < .0001]) and CAL reduction (SMD: -0.80 [95% CI: -1.04, -0.56, p < .0001]) in favor of the test group.
After scaling and root planning, PPD reduction and CAL reduction were observed in both control and test groups, but with statistically significant better values for the omega-3 fatty acids group. Patients suffering from periodontitis could benefit from the use of omega-3 fatty acids to increase the effectiveness of a nonsurgical treatment.
使用新型脂质介质促进炎症消退，已被提议用于治疗炎症性疾病。本系统评价和荟萃分析旨在评估ω-3 脂肪酸作为辅助治疗牙周炎非手术治疗的益处。
数据检索在三个主要数据库中进行：PubMed、Embase 和 Cochrane。搜索方程是围绕 PICO 框架构建的，其中人群由患有慢性牙周炎的成年人组成，这些成年人必须接受常规的 SRP 治疗，外加 ω-3 脂肪酸（I）或不加 ω-3 脂肪酸（C）。第一个结果是探测袋深度减少（PPD），第二个结果是临床附着丧失减少（CAL）。使用 Cochrane 协作工具对随机研究（RoB Tool）评估纳入研究的每个研究的偏倚风险。使用 REVMAN 5.3 进行荟萃分析。
经过全球搜索，共筛选出 117 项研究，但只有 7 项研究符合系统评价和荟萃分析的条件。7 项研究中有 6 项显示 ω-3 脂肪酸组的 PPD 减少明显优于对照组，7 项研究中有 5 项显示 ω-3 脂肪酸组的 CAL 减少明显优于对照组。荟萃分析显示 PPD 减少（SMD：-0.78 [95% CI：-1.02，-0.54，p<0.0001]）和 CAL 减少（SMD：-0.80 [95% CI：-1.04，-0.56，p<0.0001]）有统计学意义，有利于试验组。
在进行牙周刮治和根面平整后，对照组和试验组均观察到 PPD 减少和 CAL 减少，但试验组的数值有统计学意义上的显著改善。患有牙周炎的患者可能受益于使用 ω-3 脂肪酸来提高非手术治疗的效果。
