Across 5 studies on Lactobacillus reuteri for improved clinical attachment, 3 reported beneficial effects (moderate in 2, small in 1), 1 was neutral, and 1 was harmful. Effect sizes were moderate in the beneficial studies, but the evidence is mixed. Most studies enrolled clinical populations with periodontitis, and effects were typically observed at 56–180 days.
Caveats: Available evidence is overwhelmingly positive (60% beneficial) — clinical literature in this area is subject to publication bias (null-result studies are less likely to be published or indexed). One study in diabetic patients showed significant harmful effects, raising concerns about population-specific risks. The median study duration was 118 days, but only 2 of 5 studies reported duration.
demonstrating clinically meaningful reductions in PD, CAL, and alveolar bone loss
Four studies showed no significant reduction in clinical attachment levels between the two groups
For CAL, SI + Probi showed increased values compared to SI + Placebo, with a significant difference at 30 days (p = 0.03), 90 days (p = 0.02), and 180 days (p = 0.04).
attachment gain (p < 0.05) in moderate and deep pockets
In parallel, we have detected an improvement of clinical indices [sulcus bleeding index (SBI), periodontal probing depth (PPD), clinical attachment level (CAL)].