CC BY 4.0 · Journal of Health and Allied Sciences NU 2023; 13(02): 268-272
DOI: 10.1055/s-0042-1755448
Original Article

Evaluation of Treatment with Omega-3 Fatty Acid Supplements on Salivary Levels of Resolvin E1 in Chronic Periodontitis Patients

Aparna C Murali
1   Department of Periodontics, Nitte Deemed to be University, AB Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangalore, Karnataka, India
Rahul Bhandary
1   Department of Periodontics, Nitte Deemed to be University, AB Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangalore, Karnataka, India
Amitha Ramesh
1   Department of Periodontics, Nitte Deemed to be University, AB Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangalore, Karnataka, India
Geethu Venugopalan
1   Department of Periodontics, Nitte Deemed to be University, AB Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangalore, Karnataka, India
› Author Affiliations


Context Under healthy conditions, inflammation proceeds through natural healing processes by an organized cycle. Similar to any other systemic infection, periodontal disease is also a manifestation of dysregulated inflammatory pathway.

Endogenous lipid mediators called resolvins and docosatrienes, produced from omega-3 fatty acid precursors, possess various immunoregulatory properties. These polyunsaturated fatty acids cannot be synthesized in body, instead these have to be taken through diet. This study aims to evaluate the effect of adjunctive treatment with daily dietary supplementation of omega-3 fatty acids in chronic periodontitis.

Aims The aim of this study was to assess periodontal parameters and salivary levels of Resolvin E1 with and without dietary supplementation of omega-3 fatty acid capsules in chronic periodontitis patients.

Methods and Materials Three-month comparative clinical study was performed on 52 patients allotted to two groups, each with 26 subjects. Both groups received an initial phase 1 therapy followed by additional dietary supplementation of 500 mg of omega-3 fatty acid capsules for 3 months for the test group. Salivary levels of Resolvin E1, periodontal parameters, including pocket probing depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), and periodontal inflamed surface area (PISA), were assessed at baseline, 1 and 3 months after the study.

Statistical Analysis Used Data was analyzed with an unpaired t-test between the group and paired t-test for within the group comparison. p-Value less than 0.05 was considered significant.

Results PPD and CAL showed statistically significant differences between the two groups and within the groups

Publication History

Article published online:
20 September 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

  • References

  • 1 Newman MG, Takei HH, Klokkevold PR, Carranza FA. Carranza's Clinical Periodontology. 13th edition. Philadelphia: Saunders Elsevier; 2019:62
  • 2 Tonetti MS, Jepsen S, Jin L, Otomo-Corgel J. Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: a call for global action. J Clin Periodontol 2017; 44 (05) 456-462
  • 3 Kruse AB, Kowalski CD, Leuthold S, Vach K, Ratka-Krüger P, Woelber JP. What is the impact of the adjunctive use of omega-3 fatty acids in the treatment of periodontitis? A systematic review and meta-analysis. Lipids Health Dis 2020; 19 (01) 100
  • 4 Zhao G, Etherton TD, Martin KR, Gillies PJ, West SG, Kris-Etherton PM. Dietary alpha-linolenic acid inhibits proinflammatory cytokine production by peripheral blood mononuclear cells in hypercholesterolemic subjects. Am J Clin Nutr 2007; 85 (02) 385-391
  • 5 Eberhard J, Heilmann F, Açil Y, Albers HK, Jepsen S. Local application of n-3 or n-6 polyunsaturated fatty acids in the treatment of human experimental gingivitis. J Clin Periodontol 2002; 29 (04) 364-369
  • 6 Ji RR, Xu ZZ, Strichartz G, Serhan CN. Emerging roles of resolvins in the resolution of inflammation and pain. Trends Neurosci 2011; 34 (11) 599-609
  • 7 Ariel A, Serhan CN. Resolvins and protectins in the termination program of acute inflammation. Trends Immunol 2007; 28 (04) 176-183
  • 8 Abeywardena MY, Fischer S, Schweer H, Charnock JS. In vivo formation of metabolites of prostaglandins I2 and I3 in the marmoset monkey (Callithrix jacchus) following dietary supplementation with tuna fish oil. Biochim Biophys Acta 1989; 1003 (02) 161-166
  • 9 Abou Sulaiman AE, Shehadeh RM. Assessment of total antioxidant capacity and the use of vitamin C in the treatment of non-smokers with chronic periodontitis. J Periodontol 2010; 81 (11) 1547-1554
  • 10 Bannenberg GL, Chiang N, Ariel A. et al. Molecular circuits of resolution: formation and actions of resolvins and protectins. J Immunol 2005; 174 (07) 4345-4355
  • 11 Ahrens I, Ellwanger C, Smith BK. et al. Selenium supplementation induces metalloproteinase-dependent L-selectin shedding from monocytes. J Leukoc Biol 2008; 83 (06) 1388-1395
  • 12 Al-Sarraj T, Saadi H, Calle MC, Volek JS, Fernandez ML. Carbohydrate restriction, as a first-line dietary intervention, effectively reduces biomarkers of metabolic syndrome in Emirati adults. J Nutr 2009; 139 (09) 1667-1676
  • 13 Salman SA, Akram HM, Ali OH. Omega-3 as an adjunctive to non-surgical treatment of chronic periodontitis patients. IOSR J Dent Med Sci 2014; 13 (06) 8-11
  • 14 Mishra A, Shergill N. Effect of topical application of omega-3 fatty acids in the treatment of chronic gingivitis: a clinical study. J Med Res Prac. 2016; 5 (06) 1-4
  • 15 Elkhouli AM. The efficacy of host response modulation therapy (omega-3 plus low-dose aspirin) as an adjunctive treatment of chronic periodontitis (clinical and biochemical study). J Periodontal Res 2011; 46 (02) 261-268
  • 16 Harris WS, Silveira S, Dujovne CA. The combined effects of N-3 fatty acids and aspirin on hemostatic parameters in man. Thromb Res 1990; 57 (04) 517-526
  • 17 Hujoel PP, White BA, García RI, Listgarten MA. The dentogingival epithelial surface area revisited. J Periodontal Res 2001; 36 (01) 48-55
  • 18 Nesse W, Abbas F, van der Ploeg I, Spijkervet FK, Dijkstra PU, Vissink A. Periodontal inflamed surface area: quantifying inflammatory burden. J Clin Periodontol 2008; 35 (08) 668-673
  • 19 Kujur SK, Goswami V, Nikunj AM, Singh G, Bandhe S, Ghritlahre H. Efficacy of omega 3 fatty acid as an adjunct in the management of chronic periodontitis: a randomized controlled trial. Indian J Dent Res 2020; 31 (02) 229-235
  • 20 El-Sharkawy H, Aboelsaad N, Eliwa M. et al. Adjunctive treatment of chronic periodontitis with daily dietary supplementation with omega-3 fatty acids and low-dose aspirin. J Periodontol 2010; 81 (11) 1635-1643
  • 21 Naqvi AZ, Buettner C, Phillips RS, Davis RB, Mukamal KJ. n-3 fatty acids and periodontitis in US adults. J Am Diet Assoc 2010; 110 (11) 1669-1675
  • 22 Park SY, Ahn S, Lee JT. et al. Periodontal inflamed surface area as a novel numerical variable describing periodontal conditions. J Periodontal Implant Sci 2017; 47 (05) 328-338
  • 23 Tobón-Arroyave SI, Isaza-Guzmán DM, Gómez-Ortega J, Flórez-Alzate AA. Salivary levels of specialized pro-resolving lipid mediators as indicators of periodontal health/disease status. J Clin Periodontol 2019; 46 (10) 978-990
  • 24 Zaloga GP. Narrative review of n-3 polyunsaturated fatty acid supplementation upon immune functions, resolution molecules and lipid peroxidation. Nutrients 2021; 13 (02) 662
  • 25 Thorngren M, Gustafson A. Effects of 11-week increases in dietary eicosapentaenoic acid on bleeding time, lipids, and platelet aggregation. Lancet 1981; 2 (8257): 1190-1193
  • 26 Giannobile WV, Beikler T, Kinney JS, Ramseier CA, Morelli T, Wong DT. Saliva as a diagnostic tool for periodontal disease: current state and future directions. Periodontol 2000 2009; 50: 52-64
  • 27 Miller CS, King Jr CP, Langub MC, Kryscio RJ, Thomas MV. Salivary biomarkers of existing periodontal disease: a cross-sectional study. J Am Dent Assoc 2006; 137 (03) 322-329
  • 28 Sanz I, Alonso B, Carasol M, Herrera D, Sanz M. Nonsurgical treatment of periodontitis. J Evid Based Dent Pract 2012; 12 (3, Suppl): 76-86