Evaluation of the effect of omega-3 fatty acids supplementation as an adjunct to non-surgical periodontal therapy: a systematic review and meta-analysis

Abstract

OBJECTIVES: Omega-3 fatty acids have been investigated due to their anti-inflammatory and immunomodulatory properties identified in basic studies. This systematic review and meta-analysis aimed to evaluate the effect of omega-3 fatty acids as a supplement to SRP on improving periodontal clinical indices. METHODS: A comprehensive search was conducted in reputable databases, including PubMed, Scopus, Embase, ProQuest, ScienceDirect, Web of Science, and Cochrane, from inception to August 11, 2025, for randomized controlled clinical trials. Eligible articles were selected to compare the effect of SRP plus omega-3 supplementation versus SRP alone or placebo in patients with periodontitis. The quality of the studies was assessed using the Cochrane Risk of Bias Tool (RoB 2.0), and data on probing pocket depth (PPD) and clinical attachment level (CAL) were extracted. Meta-analysis was performed using a random-effects model in Stata software (version 17). RESULTS: A total of 21 studies were incorporated into this systematic review. The statistical analysis conducted on 18 of these studies demonstrated that omega-3 supplementation as an adjunct to SRP resulted in statistically significant improvements in periodontal indices. This improvement was observed in CAL, with a mean difference (MD) of 0.54 mm (95 CI: 0.36-0.72), and in PPD, with an MD of 0.57 mm (95 CI: 0.4-0.74). The beneficial effects of this treatment were sustained over time and were more pronounced in long-term assessments (6-12 months). CONCLUSION: Omega-3 supplementation may offer a small adjunctive benefit, specifically for CAL gain. These results should be interpreted with caution given very high heterogeneity and moderate/low certainty evidence.