Aim: Omega-3 polyunsaturated fatty acids and aspirin are increasingly explored as adjuncts in periodontal therapy for patients with type II diabetes, owing to their anti-inflammatory properties. Despite preliminary evidence suggesting their effectiveness in reducing periodontal inflammation and improving metabolic control, comprehensive evaluations at the clinical level remain limited. This systematic review seeks to critically assess the existing evidence to determine the efficacy of these agents in modifying clinical, biochemical, and metabolic parameters in this high-risk patient group. Methods: A comprehensive search was conducted across electronic databases, including CINAHL, MEDLINE, PubMed, Embase, Dentistry & Oral Sciences Source, and Cochrane Library, to identify relevant studies from inception to January 22, 2024. Included studies were required to be randomised controlled trials and comprise both omega-3 and aspirin as an adjunct to non-surgical treatment. Data extraction was completed independently, and accuracy confirmed by a second reviewer. Data were synthesised using the revised Cochrane risk of bias tool for randomised trials. Results: A total of 76 records were identified, and three studies met the inclusion criteria. One demonstrated a statistically significant difference in pocket depth, clinical attachment gain and inflammatory markers compared to the control group, and two showed a significant improvement in glycated haemoglobin levels. Conclusion: Omega-3 and aspirin combined have the potential to improve clinical parameters and reduce inflammatory markers in the gingival crevicular fluid. Following non-surgical periodontal treatment, this combination may enhance glycemic control and aid in managing type II diabetes. This systematic review offers insights into the potential effectiveness of omega-3 polyunsaturated fatty acids and aspirin as adjuncts to non-surgical periodontal therapy in patients with type II diabetes and periodontitis. However, current research is limited by small sample sizes and varied study designs. Consequently, there is insufficient evidence to integrate this approach into clinical practice at present.

The authors have declared no competing interest.

This study did not receive any funding

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

All data produced in the present work are contained in the manuscript