Omega-3 plus low-dose aspirin produces antibiotic-like results against severe periodontitis (May 2026, n=109) Immunomodulators, associated or not with systemic antibiotics, to treat periodontitis: A 1-year multicenter, placebo-controlled, double-blind, randomized clinical trial Antibiotics

[Michael Harrop]

https://medicalxpress.com/news/2026-08-omega-dose-aspirin-antibiotic-results.html
https://aap.onlinelibrary.wiley.com/doi/10.1002/jper.70081

By the end of the follow-up period, about 58% of patients treated with antibiotics had met the researchers' established clinical goal of having no more than four remaining deep periodontal pockets. Among those who received omega-3 and ASA, the percentage was virtually the same: 57.7%. In contrast, in the group that received only scaling and a placebo, the rate was 23.1%. Combining the two strategies, antibiotics and supplementation, didn't provide any additional benefits.

Another finding that caught the researchers' attention was the persistence of the observed benefits. Even six months after supplementation ended, patients continued to show results similar to those recorded at the end of treatment. According to Castro, this suggests that modulating the inflammatory response may produce lasting effects, although the mechanisms involved are still being investigated.

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Abstract​

Background​

Immunomodulatory agents such as omega-3 (ω-3) and low-dose aspirin (ASA) have been proposed as effective adjuncts in the treatment of periodontitis. However, they still lack long-term studies and head-to-head evaluation with metronidazole (MTZ) and amoxicillin (AMX), the adjunct protocol with the strongest scientific evidence of clinical benefit. This study aimed to evaluate the clinical effects of (ω)-3 and ASA, alone or combined with MTZ + AMX, to treat periodontitis.

Methods​

Adults with stage III/IV periodontitis were randomly allocated to receive: (i) subgingival instrumentation (SI) and placebo; (ii) SI with adjunctive MTZ (400 mg) + AMX (500 mg) three times/day for 14 days (ATB); (iii) SI with adjunctive ω-3 (3 g) + ASA (100 mg/day) for 6 months (IM); and (iv) SI with adjunctive ATB and IM (ATB + IM). The patients were followed for 1 year post-therapy.

Results​

109 patients were included. At 1 year, 58.6%, 57.7%, and 57.1% of patients receiving ATB, IM, and ATB+IM, respectively, achieved the treatment endpoint [≤4 sites with a probing depth (PD) of ≥5 mm], compared with 23.1% in the SI group (p = 0.023). Each adjunctive therapy resulted in a greater reduction in the number of sites with PD≥5 mm compared with SI (p < 0.05).

Conclusion​

Adjunctive ATB, IM, or ATB+IM each provided clinically meaningful benefits beyond mechanical therapy. The results suggested no added benefit from combining ATB and IM. These findings support MTZ + AMX or ω-3 + ASA, without routine combination, as effective adjuncts in periodontal treatment and provide a basis for precision-based trials and data-driven models to identify patients most likely to benefit from each approach. ensaiosclinicos.gov.br RBR-7nh566t

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Plain language summary​

This study explored whether adding antibiotics or anti-inflammatory supplements (omega-3 and low-dose aspirin), either alone or in combination, could enhance the results of subgingival instrumentation (non-surgical periodontal therapy) in patients with severe periodontitis.

All participants received the standard periodontal treatment and were randomly assigned to also take a placebo, antibiotics, omega-3 with aspirin, or a combination of both therapies. After 1 year, patients who received any of the additional therapies showed greater improvements, with fewer sites of deep periodontal pockets, compared with those who received subgingival instrumentation alone. However, combining antibiotics with omega-3 and aspirin did not lead to better outcomes than using either one of them individually.

These findings suggest that in patients with more severe forms of periodontitis, adding either antibiotics or omega-3 with low-dose aspirin to standard care can provide meaningful clinical benefits.

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