Probiotic strains of Lactobacillus brevis and Lactobacillus plantarum as adjunct to non-surgical periodontal therapy: 3-month results of a randomized controlled clinical trial

Pudgar, P; Povšič, Katja; Čuk, Katarina; Seme, Katja; Petelin, Milan; Gašperšič, Rok

doi:10.1007/s00784-020-03449-4

Cited by 27 publications

(25 citation statements)

References 41 publications

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“…However, the majority of included studies involving Lactobacillus and other species showed improvement either in clinical or microbiological parameters [ 135 , 136 , 137 , 138 ]. The lack of any significance difference in clinical and microbiological outcomes at the end of the trial when compared to control was observed in other studies [ 139 , 140 ]. In fact, results from the work of Pudgar and coauthors (2021) showed that higher numbers of residual pockets of 4 mm with BOP was associated with the probiotic group when compared to the control arm [ 139 ].…”

Section: Novel Antibacterial Agents and Strategies To Overcome Bacterial Resistance In Dental Biofilm: Pros And Conssupporting

confidence: 48%

Classic vs. Novel Antibacterial Approaches for Eradicating Dental Biofilm as Adjunct to Periodontal Debridement: An Evidence-Based Overview

et al. 2021

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Periodontitis is a multifactorial chronic inflammatory disease that affects tooth-supporting soft/hard tissues of the dentition. The dental plaque biofilm is considered as a primary etiological factor in susceptible patients; however, other factors contribute to progression, such as diabetes and smoking. Current management utilizes mechanical biofilm removal as the gold standard of treatment. Antibacterial agents might be indicated in certain conditions as an adjunct to this mechanical approach. However, in view of the growing concern about bacterial resistance, alternative approaches have been investigated. Currently, a range of antimicrobial agents and protocols have been used in clinical management, but these remain largely non-validated. This review aimed to evaluate the efficacy of adjunctive antibiotic use in periodontal management and to compare them to recently suggested alternatives. Evidence from in vitro, observational and clinical trial studies suggests efficacy in the use of adjunctive antimicrobials in patients with grade C periodontitis of young age or where the associated risk factors are inconsistent with the amount of bone loss present. Meanwhile, alternative approaches such as photodynamic therapy, bacteriophage therapy and probiotics showed limited supportive evidence, and more studies are warranted to validate their efficiency.

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Section: Novel Antibacterial Agents and Strategies To Overcome Bacterial Resistance In Dental Biofilm: Pros And Conssupporting

confidence: 48%

Classic vs. Novel Antibacterial Approaches for Eradicating Dental Biofilm as Adjunct to Periodontal Debridement: An Evidence-Based Overview

et al. 2021

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“…The random intercept was individually predicted for every subject and tooth, allowing for variability in the probability of site healing with regards to each tooth and subject. The multivariate multilevel logistic regression model was used to account for the interdependent influence of gender, age, smoking, tooth being a molar, interdental site location, treatment mode and the presence/absence of specific bacteria at baseline on the healing of diseased sites 6 months after treatment [28]. SPSS v. 26 was used for the analyses.…”

Section: Discussionmentioning

confidence: 99%

“…The same clinical protocol as described in a previously published article was followed [28]. In brief: at baseline, an experienced, calibrated examiner (R. G.) conducted a full periodontal examination of each patient using a manual Williams probe (POW6, Hu-Friedy, Chicago, Illinois, USA).…”

Section: Clinical Protocolmentioning

confidence: 99%

“…Clinical attachment loss (CAL) was calculated as a sum of PD and REC. Since surgical intervention is indicated for pockets measuring ≥5 mm and further clinical attachment loss is expected at sites that demonstrate persistent BOP, sites demonstrating both features (PD ≥ 5 mm + BOP) were defined as diseased sites (DS); the number of DS per patient was calculated [2,3,28]. Furcation involvement and tooth mobility was assessed for each tooth but not included in the report.…”

Section: Clinical Protocolmentioning

confidence: 99%

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Influence of adjunctive azithromycin on microbiological and clinical outcomes in periodontitis patients: 6-month results of randomized controlled clinical trial

et al. 2020

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Background: Our aim was to determine if azithromycin therapy, as an adjunct to scaling and root planing (SRP), decreases the number of pathobiontic subgingival plaque species and sites demonstrating pocket depth (PD) ≥ 5 mm and bleeding on probing (BOP) 6 months post-treatment. Methods: In a double-blind randomized parallel-arm placebo-controlled trial, 40 patients received nonsurgical periodontal treatment in two sessions within 7 days. Patients then received systemic antibiotic therapy (n = 20, azithromycin 500 mg/day for 3 days) or placebo (n = 20). Pooled microbiologic samples were taken before and 6 months after therapy and analysed by established culture methods. The primary outcome variable was the number of sites with PD ≥ 5 mm and BOP at the 6-month re-evaluation. Using multivariate multilevel logistic regression, the effects of gender, age, antibiotic therapy, presence of P. gingivalis or A. actinomycetemcomitans, smoking, tooth being a molar and interdental location were evaluated. Results: The number of sites with PD ≥ 5 mm and BOP after 6 months was similar in the test (Me = 4, IQR = 0-11) and control (Me = 5, IQR = 1-22) group. Adjunctive azithromycin treatment, compared to SRP alone, resulted in more frequent eradication of A. actinomycetemcomitans (p = 0.013) and C. rectus (p = 0.029), decreased proportion (p = 0.006) and total counts (p = 0.003) of P. gingivalis, and decreased proportion of C. rectus (p = 0.012). Both groups showed substantial but equivalent improvements in periodontal parameters, with no intergroups differences at initially shallow or deep sites. The logistic regression showed a lower odds ratio for healing of diseased sites on molars (OR = 0.51; p < 0,001). Conclusion: Despite significant changes in numbers of A. actinomycetemcomitans, P. gingivalis and C. rectus, patients with periodontitis do not benefit from adjunctive systemic azithromycin in terms of number of persisting sites with PD ≥ 5 mm and BOP.

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“…In 14 out of 20 RCTs assessed in this review the reduction of pocket depth was the primary study outcome (66)(67)(68)(69)(70)(71)(72)(73)(74)(75)(76)(77)(78)82), followed by the gain of clinical attachment (64,80,81) and the reduction of markers of inflammation, like gingival bleeding or bleeding on probing (54,65,79).…”

Section: Evaluated Study Outcomesmentioning

confidence: 99%

Probiotics in the Management of Gingivitis and Periodontitis. A Review

Schlagenhauf

Jockel‐Schneider

2021

Front. Dent. Med

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In the management of intestinal health problems, the targeted use of probiotic microorganisms is a common therapeutic measure with a long-standing tradition. In clinical dentistry however, probiotics-based therapy is still a rather new and developing field, whose usefulness for the control of gingivitis and periodontitis has been questioned by recent meta-analyses and systematic reviews. The purpose of the subsequent descriptive review is to provide an introduction to the concept of probiotic microorganisms and their multifaceted health-promoting interactions with the human host and microbial competitors, followed by a detailed comparison of the results of available controlled clinical trials assessing the use of probiotics in the control of gingival and periodontal inflammations. It aims at contributing to a deeper understanding of the unique capabilities of probiotics to resolve chronic plaque-induced inflammation even in the absence of mechanical plaque control and will discuss how possible misconceptions about the rationale for using probiotics may have led to the present controversies about their usefulness as a therapeutic option.

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Probiotic strains of Lactobacillus brevis and Lactobacillus plantarum as adjunct to non-surgical periodontal therapy: 3-month results of a randomized controlled clinical trial

Cited by 27 publications

References 41 publications

Classic vs. Novel Antibacterial Approaches for Eradicating Dental Biofilm as Adjunct to Periodontal Debridement: An Evidence-Based Overview

Classic vs. Novel Antibacterial Approaches for Eradicating Dental Biofilm as Adjunct to Periodontal Debridement: An Evidence-Based Overview

Influence of adjunctive azithromycin on microbiological and clinical outcomes in periodontitis patients: 6-month results of randomized controlled clinical trial

Probiotics in the Management of Gingivitis and Periodontitis. A Review

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