What are microbiological effects of the adjunctive use of probiotics in the treatment of periodontal diseases? A systematic review

Abstract

Probiotics have aroused great interest as an adjunctive treatment to periodontal therapy, due to the frequent colonisation by periodontopathogens after therapy. The aim of this systematic review was to analyse in the scientific literature, evidence of the microbiological effects of probiotics as an adjunct to periodontal therapy in the treatment of periodontal diseases (PD). Only randomised controlled trials (RCT), evaluating the microbiological effect of probiotics as an adjunct to periodontal therapy. The authors conducted a search in PubMed/MEDLINE, LILACS, ScienceDirect, Web of Science and Cochrane Library to identify articles published in English until February 2020. The quality of the studies was assessed using the JADAD scale and the risk of bias was assessed according to the Cochrane Collaboration assessment tool. Of the 265 articles potentially relevant to this review, 10 studies were included. The most frequently used probiotic bacteria were those of the genus Lactobacillus spp. and the time of administration of the probiotics was between 14 days to 3 months. Most studies have shown that the adjuvant use of probiotics reduces the total mean counts of gram-negative anaerobic species (Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola and Prevotella intermedia) and gram-negative coccobacillus (Aggregatibacter actinomycetemcomitans) of subgingival plaque samples. Probiotics adjuvant to periodontal therapy reduces periodontopathogenic species in a greater proportion, compared only to periodontal therapy. Especially the Lactobacillus reuteri strain, without combination with other strains, offered a greater reduction in pathogenic bacteria associated with greater destruction of periodontal tissues and deep periodontal pockets. Researchers should perform high-quality RCT, evaluating single strains without combinations, in order to observe the microbiological benefits as adjunctive treatment of PD.

The Clinical, Microbiological, and Immunological Effects of Probiotic Supplementation on Prevention and Treatment of Periodontal Diseases: A Systematic Review and Meta-Analysis

“…A previous systematic review was unable to assess the immunological benefits of probiotic supplementation due to limited studies; however, the included individual studies indicated an immunomodulatory effect of probiotics [ 47 ]. Microbiological findings suggested that probiotic supplementation reduced periodontopathogens in subgingival plaque samples [ 47 ]; however, there is conflicting evidence in the literature [ 48 ].…”

Prevotella intermedia, an orthodontic point of view

“…A high pulse power neodymiumdoped yttrium aluminium garnet laser monotherapy before the surgical protocol of periodontal treatment reduces almost 60% of periodontal pathogens of the red/orange complex [30] . The use of probiotics in pregnant patients helps to reduce inflammatory indices; and they function as very good adjuvants to periodontal therapy, reducing P. Gingivalis, T. Forsythia, T. Denticola, P. Intermedia and A. Actinomycetemcomitans [1,31] . Within the diversity of oral probiotics, Weissella cibaria CMU and CMS1 inhibit biofilm formation by reducing bacterial species and Limosilactobacillus fermentum ALAL020 shows higher antibacterial activity against P. gingivalis and P. Intermedia [32,33] .…”