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Abstract

Objectives: To determine if periodontitis patients benefit from treatment with Lactobacillus brevis and Lactobacillus plantarum strains, applied into periodontal pockets as gel and thereafter taken as lozenges, as an adjunct to scaling and root planing (SRP).

Materials and methods: In a double-blind, randomized, placebo-controlled trial, 40 patients received scaling and root planing (SRP) in two sessions within 7 days. Patients then received either probiotic gel and lozenges (n = 20) or placebo (n = 20). The primary outcome variable was the number of diseased sites (DS: PD > 4 mm + BOP) at the 3-month re-evaluation. The effects of gender, age, probiotic therapy, presence of Porphyromonas gingivalis or Aggregatibacter actinomycetemcomitans, smoking, tooth being a molar and interdental location were evaluated using a multivariate multilevel logistic regression model.

Results: The number of DS after 3 months was similar in the test (Me = 8, IQR = 5-11) and control (Me = 5, IQR = 1-10) groups. Both groups showed substantial but equivalent improvements in periodontal parameters. The logistic regression showed higher odds for the healing of gingival bleeding (OR = 2.12, p = 0.048) and lower odds for the healing of DS (OR = 0.51; p < 0.001) in the probiotic group.

Conclusions: Patients with periodontitis benefit from adjunctive use of probiotics containing L. brevis and L. plantarum in terms of reduction of gingival bleeding. However, adjunctive probiotics increase the number of persisting diseased sites with PD > 4 mm and BOP.

Clinical relevance: The adjunctive use of probiotics containing L. brevis and L. plantarum strains in treating chronic periodontitis results in a higher number of residual diseased sites when compared with SRP + placebo; its use is therefore unfounded.

Keywords: Lactobacillus brevis; Lactobacillus plantarum; Periodontitis; Probiotic; Scaling and root planing.

Research Insights

SupplementHealth OutcomeEffect TypeEffect Size
Lactobacillus brevisIncreased Number of Persistent Diseased SitesHarmful
Large
Lactobacillus brevisReduced Gingival BleedingBeneficial
Small
Lactobacillus brevis HA-112Reduced Gingival BleedingBeneficial
Small
Lactobacillus brevis KABP™-052Increased Number of Persistent Diseased SitesHarmful
Large
Lactobacillus brevis KABP™-052Reduced Gingival BleedingBeneficial
Small
Lactobacillus brevis LB01Increased Number of Persistent Diseased SitesHarmful
Large
Lactobacillus brevis Lbr-35Reduced Gingival BleedingBeneficial
Small
Lactobacillus brevis MAK11L82BReduced Gingival BleedingBeneficial
Small
Lactobacillus brevis SD-5214Reduced Gingival BleedingBeneficial
Small
Lactobacillus brevis UALbr-02Increase in Persistent Diseased SitesHarmful
Moderate
Lactobacillus brevis UALbr-02Reduced Gingival BleedingBeneficial
Small
Lactobacillus plantarum DSM 6595Reduced Gingival BleedingBeneficial
Small
Lactobacillus plantarum DSM 6596Increased Number of Persisting Diseased Sites with Pocket Depth Greater than 4 mmHarmful
Moderate
Lactobacillus plantarum DSM 6596Reduced Gingival BleedingBeneficial
Small
Lactobacillus plantarum HA-119Reduced Gingival BleedingBeneficial
Small
Lactobacillus plantarum HEAL9Persistent Diseased SitesHarmful
Moderate
Lactobacillus plantarum SD5209Increase in Persistent Diseased SitesHarmful
Moderate
Lactobacillus plantarum SD5209Reduced Gingival BleedingBeneficial
Small
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