Effects of Bifidobacterium probiotic on the treatment of chronic periodontitis: A randomized clinical trial

Abstract

AimThis randomized placebo‐controlled clinical trial evaluated the effect of Bifidobacterium animalis subsp. lactis (B. lactis) HN019‐containing probiotic lozenges as adjuvant to scaling and root planing (SRP) in patients with generalized chronic periodontitis.Materials and MethodsForty‐one chronic periodontitis patients were recruited and monitored clinically, immunologically, and microbiologically at baseline (before SRP) and 30 and 90 days after SRP. All patients were randomly assigned to a Test (SRP + Probiotic, n = 20) or Control (SRP + Placebo, n = 21) group. The probiotic lozenges were used twice a day for 30 days. The data were statistically analysed.ResultsThe Test group presented a decrease in probing pocket depth and a clinical attachment gain significantly higher than those of the Control group at 90 days. The Test group also demonstrated significantly fewer periodontal pathogens of red and orange complexes, as well as lower proinflammatory cytokine levels when compared to the Control group. Only the Test group showed an increase in the number of B. lactis HN019 DNA copies on subgingival biofilm at 30 and 90 days.ConclusionThe use of B. lactis HN019 as an adjunct to SRP promotes additional clinical, microbiological, and immunological benefits in the treatment of chronic periodontitis (NCT03408548).

Probiotics, including nisin‐based probiotics, improve clinical and microbial outcomes relevant to oral and systemic diseases

“…Mixed outcomes were also observed with the use of adjunctive probiotics in the treatment of periodontal diseases, although most studies did show positive clinical results. For chronic periodontitis patients, most studies found significant clinical improvements in periodontal pocket depth, especially in the deeper periodontal pocket depth, clinical attachment level, bleeding on probing, sulcus bleeding index, gingival and plaque indices, and/or percentage of sites with plaque following the adjunctive use of probiotics . As a result of these improved clinical parameters, some studies found a decreased need for periodontal surgery .…”

“…Several studies also found that adjunctive probiotics in the treatment of chronic periodontitis improved host response parameters. Specifically, probiotics improved or lowered the levels of matrix metalloproteinase‐8, tissue inhibitor of metalloproteinase‐1, and pro‐inflammatory cytokines, including tumor necrosis factor‐alpha, interleukin‐1beta, and interleukin‐17 …”

“…Colonization as a result of adjunctive probiotics in periodontitis reveals variable results. Some studies show low retention rates and others show long‐term retention rates of up to 60 days after discontinuation of the probiotic . Here, again, differences may be because of the use of different strains and doses of probiotics.…”

Osteoimmunology: Inflammatory osteolysis and regeneration of the alveolar bone

“…Probiotics thus have an immunomodulatory effect on the host immune system (Dar, Shukla, et al., ). First clinical evidence supports the concept that probiotic‐induced immunomodulation can prevent alveolar bone loss (Ikram, Hassan, Raffat, Mirza, & Akram, ; Invernici et al., ). For example, B. lactis decreased probing pocket depth, periodontal pathogens, pro‐inflammatory cytokines and increased clinical attachment gain (Invernici et al., ).…”

“…First clinical evidence supports the concept that probiotic‐induced immunomodulation can prevent alveolar bone loss (Ikram, Hassan, Raffat, Mirza, & Akram, ; Invernici et al., ). For example, B. lactis decreased probing pocket depth, periodontal pathogens, pro‐inflammatory cytokines and increased clinical attachment gain (Invernici et al., ). Thus, the microbiome can set the threshold of inflammation including the T cells thereby becoming a candidate for therapeutic intervention and diagnosis.…”