Efficacy of omega-3 fatty acids supplementation as an adjunct to nonsurgical periodontal therapy in periodontitis: a systematic review and meta-analysis of randomized controlled trials.

INTRODUCTION: This study aimed to evaluate the efficacy of omega-3 fatty acids (n3-FA) supplementation as adjunct to scaling and root planing (SRP) in patients with periodontitis. METHODS: A systematic review of randomized controlled trials (RCTs) evaluating n3-FA supplementation as a single adjunct therapy for SRP was conducted through a comprehensive search in Scopus, PubMed, Web of Science, Cochrane Library, and EBSCO. The Cochrane RoB2 tool was used as a tool for evaluating risk of bias. The outcomes of probing pocket depth (PPD) and clinical attachment level (CAL) were analyzed using a random-effects model meta-analysis and reported as mean differences (MD) and 95% confidence intervals (CI). The certainty of evidence was evaluated using the GRADE approach. RevMan 5.4 software was used for all statistical analysis. RESULTS: Nine RCTs were included in the meta-analysis. Compared with SRP alone, adjunctive n3-FA supplementation showed a greater reduction in PPD (MD = -0.66; 95% CI: -1.03, -0.30; p = 0.0003; I2 = 91%) and gain in CAL (MD = -0.69; 95% CI: -1.06, -0.32; p = 0.0002; I2 = 88%). Sensitivity and subgroup analyses yielded consistent effect directions, although the overall certainty of evidence was rated as low. CONCLUSION: Adjunctive n3-FA supplementation as a host modulation therapy may provide additional benefits when combined with SRP in patients with periodontitis. However, given the substantial heterogeneity and low level of evidence, these findings should be interpreted cautiously. Further high-quality, more rigorously designed RCTs are required to confirm their long-term efficacy and safety.