Immunological actions of daily supplementation of omega-3 polyunsaturated fatty acids plus low-dose aspirin as an adjunct to periodontal debridement for the treatment of chronic periodontitis in patients with type 2 diabetes
Diabetes mellitus (DM) has become a global epidemic. Its complications can have a significant impact on quality of life, longevity, and costs in public health. Periodontal diseases are considered the sixth complication of DM. This close relationship between both diseases is characterized by a mutual influence. Thus, an appropriate control of periodontal disease may facilitate the DM control, improving quality of life on diabetic patients. Additionally, the presence of DM might impair prognosis of diverse dental treatments due to its inflammatory nature, negative influence on wound healing, on bone biology, and the establishment of infections. Daily dietary supplementation with omega-3 (É-3) polyunsaturated fatty acids and low-dose aspirin (ASA) has been proposed as an adjunct host modulation therapy (HMT) for the treatment of chronic periodontitis, showing good clinical and biochemical results in normoglycemic patients. Therefore, the aim of this study is to investigate the immunological impact of daily supplementation with É-3 polyunsaturated fatty acids and low-dose ASA as adjunct therapy to one-stage full-mouth periodontal debridement for the treatment of chronic periodontitis in patients with type 2 diabetes. For this investigation, forty-five patients were selected according to inclusion and exclusion criteria and allocated in three treatment groups: periodontal debridement and É-3 (3g/day for 60 days) plus ASA (100mg/day for 60 days) (TG1) (n=15), É-3 (3g/day for 60 days) plus ASA (100mg/day for 60 days) followed by periodontal debridement (TG2) (n=15), and periodontal debridement and placebo (n=15) (CG). Gingival crevicular fluid was collected from two periodontal pockets with probing depth (PD) e5mm in each patient before É-3 plus ASA therapy (TG2), and at baseline, 90, and 180 days (all groups). Inflammatory markers, such as interferon (IFN)-³, interleukins (IL)-10, -1², -4, -6, -8, tumor necrosis factor (TNF)-±, macrophage inflammatory protein 1± (MIP1±), and monocyte chemotactic protein 1± (MCP-1±) will be analyzed with the purpose of observing changes in the inflammatory profile between groups and time points.
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