Immunoregulatory role of resolvins in periodontal disease and treatment: a systematic review

Resolvins are vital in resolving inflammation and are crucial in various disease activities. Their therapeutic potential has also been identified in several traditional systems. Resolvin-mediated pathways for resolving inflammation in periodontitis have demonstrated potential for preventing and treating periodontal lesions. The current systematic review investigated the application of resolvins (omega-3 Fatty acids, specifically EPA [Eicosapentaenoic acid] and DHA [docosahexaenoic acid]) as against placebo agents in managing periodontitis patients based on outcome parameters such as plaque, bleeding on probing and pocket depth reduction. A comprehensive search of electronic databases, including Clarivate™ Web of Science (WOS), Cochrane Library, Medline/PubMed, and Scopus, was conducted, along with grey literature search (e.g. medRxiv, bioRxiv and dissertations), to identify original peer-reviewed randomized controlled trials, clinical, and longitudinal studies published in English. Of the 379 records initially identified, 125 articles were screened after removing duplicates and those that didn’t meet the inclusion criteria. From these, 18 studies were evaluated in detail, and 9 articles qualified for inclusion in this systematic review. Four studies revealed a significantly reduced pocket depth (PD) and clinical attachment level (CAL) compared to placebo groups. In two studies, bleeding on probing (BOP) was markedly reduced, while three exhibited a significant reduction in gingival index (GI). Additionally, three out of seven investigations demonstrated a notable plaque index (PI) reduction. Although further research is required to confirm the role of resolvins in managing periodontal disease—whether used alone or in combination with other treatments—the findings from this study support their beneficial effects, even at doses below 300 mg.