Probiotic strains of Lactobacillus brevis and Lactobacillus plantarum as adjunct to non-surgical periodontal therapy: 3-month results of a randomized controlled clinical trial
- 2020-07-14
- Clinical Oral Investigations 25(3)
- P. Pudgar
- K. Povšič
- K. Čuk
- K. Seme
- M. Petelin
- R. Gašperšič
- PubMed: 32666349
- DOI: 10.1007/s00784-020-03449-4
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
| Supplement | Health Outcome | Effect Type | Effect Size |
|---|---|---|---|
| Lactobacillus brevis | Increased Number of Persistent Diseased Sites | Harmful | Large |
| Lactobacillus brevis | Reduced Gingival Bleeding | Beneficial | Small |
| Lactobacillus brevis HA-112 | Reduced Gingival Bleeding | Beneficial | Small |
| Lactobacillus brevis KABP™-052 | Increased Number of Persistent Diseased Sites | Harmful | Large |
| Lactobacillus brevis KABP™-052 | Reduced Gingival Bleeding | Beneficial | Small |
| Lactobacillus brevis LB01 | Increased Number of Persistent Diseased Sites | Harmful | Large |
| Lactobacillus brevis Lbr-35 | Reduced Gingival Bleeding | Beneficial | Small |
| Lactobacillus brevis MAK11L82B | Reduced Gingival Bleeding | Beneficial | Small |
| Lactobacillus brevis SD-5214 | Reduced Gingival Bleeding | Beneficial | Small |
| Lactobacillus brevis UALbr-02 | Increase in Persistent Diseased Sites | Harmful | Moderate |
| Lactobacillus brevis UALbr-02 | Reduced Gingival Bleeding | Beneficial | Small |
| Lactobacillus plantarum DSM 6595 | Reduced Gingival Bleeding | Beneficial | Small |
| Lactobacillus plantarum DSM 6596 | Increased Number of Persisting Diseased Sites with Pocket Depth Greater than 4 mm | Harmful | Moderate |
| Lactobacillus plantarum DSM 6596 | Reduced Gingival Bleeding | Beneficial | Small |
| Lactobacillus plantarum HA-119 | Reduced Gingival Bleeding | Beneficial | Small |
| Lactobacillus plantarum HEAL9 | Persistent Diseased Sites | Harmful | Moderate |
| Lactobacillus plantarum SD5209 | Increase in Persistent Diseased Sites | Harmful | Moderate |
| Lactobacillus plantarum SD5209 | Reduced Gingival Bleeding | Beneficial | Small |