A recent study published in the journal Scientific Reports shows that physical exercise combined with omega-3 fatty acid supplementation can help improve immune response and reduce the severity of chronic apical periodontitis.
The researchers pointed out that this combined intervention can inhibit bacterial growth, reduce bone tissue destruction, regulate the release of inflammatory factors, and promote fibroblast activity, thereby alleviating inflammation-related symptoms.
Apical periodontitis is a chronic inflammatory disease caused by bacterial infection. When the pulp tissue is contaminated, bacteria penetrate into the root canal system and spread to the apical area, which will induce an immune response and form lesions.
If the immune system cannot effectively control the infection, it will release inflammatory mediators such as tumor necrosis factor-α (TNF-α) and interleukin-17 (IL-17), which stimulate osteoclast formation and lead to bone loss.
Studies have found that tartrate-resistant acid phosphatase (TRAP) is a key bone destruction marker that is secreted by osteoclasts and can further promote bone resorption.
“Due to the chronic nature of the disease, many patients have no obvious symptoms in the early stages. However, over time, it can lead to loose teeth and even bone destruction.
If the patient’s immune function is weakened, the condition may worsen, causing pain, suppuration, and even facial swelling,” said Rogerio de Castillo, a professor at the Araçatuba Dental School of São Paulo State University (FOA-UNESP) in a press release.
Studies have shown that physical exercise has immunomodulatory functions and helps to enhance the host’s resistance to pathogens; and Omega-3 polyunsaturated fatty acids have also attracted attention for their regulatory effects on a variety of chronic inflammatory diseases.
However, there are still relatively few studies on the effects of exercise or its combination with Omega-3 on apical periodontitis.
To further explore this issue, the researchers designed an animal experiment and selected 30 male Wistar rats aged 6 weeks, weighing about 200 grams, with apical periodontitis.
The experiment divided the rats into three groups: a control group (group C) without intervention, an exercise group (group PE) that performed moderate-intensity exercise, and a comprehensive intervention group (group PEO) that took omega-3 supplements on the basis of exercise.
During the experiment, the rats were placed in a constant temperature room, with a 12-hour day and night alternation system, and 60 minutes of swimming exercise every day.
After 30 days, all rat tooth samples showed pulp necrosis and periapical lesions. In the control group, the inflammatory infiltration was significantly aggravated, with 3 of the 10 rats scoring 2 points, 4 scoring 3 points, and the remaining 3 scoring 4 points; in contrast, the inflammatory scores of the PE and PEO groups were significantly lower, and there was little difference between the two groups.
“Our results show that physical activity alone, even without nutritional supplementation, can have positive effects at both systemic and local levels, helping to regulate immune responses in the periapical region.
When exercise was combined with omega-3, the protective effect of this intervention against endodontic lesions was even more pronounced,” said Ana Paula Fernandes Ribeiro, PhD, of the University of São Paulo School of Dentistry and Arts, and the study’s first author.
In addition, changes in cytokine levels were observed: rats that did not receive any intervention had moderate levels of inflammatory factors, rats that exercised alone had reduced levels of factors, and rats that exercised combined with omega-3 supplements had the lowest levels of inflammatory factors.
“While these findings need to be validated in large-scale clinical trials, this study once again highlights the potential of physical exercise and omega-3 fatty acids in the regulation of inflammatory diseases,” concluded Jacinto, a member of the research team, in the press release.
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