Efficacy of Systemic Administration of Omega-3 Fatty Acids as Adjuvants to Scaling and Root Planing on Serum Nuclear factor Kappa B Levels in Patients With Rheumatoid Arthritis and Periodontitis: A Randomized Controlled Study
Gundelly Mrunalini, Rekha Rani Koduganti, Veerendranath Reddy Panthula, Surya Prasanna Jammula, Gireddy Himabindu, Manasa Ambati, Swetha ManchalaAbstract
Objective:
Pro-inflammatory cytokine release and their stimulated bone resorption are regulated by nuclear factor kappa B (NF-κB), which plays an important role in the etiopathogenesis of periodontitis and rheumatoid arthritis (RA). This study assessed if adjunctive therapy with omega-3 fatty acids after scaling and root planing has a role to play in improving the clinical and biochemical parameters (NF-κB levels), compared to scaling and root planing (SRP) alone.
Methods:
This prospective, double-blind trial (Clinical Trials Registry of India registered: February 2023; trial start: March 2023) enrolled systemically diagnosed RA patients (American College of Rheumatology/European Alliance of Associations for Rheumatology 2010 criteria) exhibiting severe periodontitis (Stage IV, Grade B under the 2017/2018 American Academy of Periodontology/European Federation of Periodontology classification). Active smokers were excluded. Participants were allocated via a computer-generated randomization sequence into treatment arms receiving either SRP alone or SRP with adjunctive dietary omega-3 polyunsaturated fatty acids (PUFAs). The clinical and biochemical variables were assessed at baseline and 3 months postoperatively. The allocation protocol was masked to the investigators and laboratory personnel. Compliance and gastrointestinal tolerability were verified monthly.
Results:
Baseline demographic characteristics, disease duration, and clinical parameters were homogeneous across groups (
Conclusions:
Adjunctive dietary omega-3 PUFA therapy effectively attenuates NF-κB-driven inflammation in patients co-managed for RA and periodontitis. The pronounced biochemical suppression demonstrates rapid anti-inflammatory efficacy, establishing a favorable cellular environment prior to clinical structural healing.