Introduction
periodontitis, inflammation, chronic multifactorial disease, Periodontitis
GENERALIZED PERIODONTITIS, PERIODONTITIS, INFLAMMATION, PERIODONTITIS, INFLAMMATORY DISEASE
Periodontitis is a chronic multifactorial disease induced by a microbial biofilm that is characterized by progressive destruction of the tooth-supporting apparatus [The current strategy of treatment of periodontitis is based on the reduction of the subgingival biofilm that helps to reestablish homeostasis and health. This concept is based on the mechanical subgingival instrumentation, conventionally called scaling and root planing (SRP), combined with proper control of risk factors and home control of bacterial biofilm [Diet is an important factor affecting periodontal health. A cross-sectional analysis in U.S. population showed that consumption of more pro-inflammatory diet was associated with moderate/severe periodontitis especially among older and male participants [A special interest in omega-3 PUFAs comes from their anti-inflammatory properties. Omega-3 PUFAs are natural substances that may be derived from oily fish, flaxseed oil, canola oil and walnuts. High-fat fish like mackerel or salmon can provide about 1.5 g – 3.0 g of omega-3 PUFAs per meal, whereas low-fat fish like cod can provide about 0.2 g – 0.3 g of omega-3 PUFAs per meal. Since Western diet is mainly rich in low-fat fish, omega-3 PUFA daily intake in Great Britain, Northern and Eastern Europe, Northern America or Australia is very low (0.1 g – 0.2 g) [Numerous studies demonstrated positive correlation between consumption of omega-3 PUFAs and reduction of inflammation in various inflammatory diseases, including periodontitis [Aside from the potential benefits of omega-3 PUFAs in the patients with periodontitis, the results of the clinical studies assessing their use in combination with non-surgical treatment are still inconclusive. Therefore, in the present randomized clinical trial we analyzed whether adjunctive administration of fish oil containing high-dose omega-3 PUFAs during non-surgical treatment of patients with untreated generalized periodontitis stage III and IV provides better clinical and microbiological outcomes than SRP alone.