Clinical Effects of Locally Delivered Lactobacillus reuteri as Adjunctive Therapy in Patients with Periodontitis: A Split-Mouth Study

Irina-Georgeta Sufaru,Eliza-Maria Froicu,Dorina-Cerasella Sincar,Ada Stefanescu,Sorina-Mihaela Solomon,Liliana Pasarin,Luminita Lazar,Maria-Alexandra Martu,Elena-Odette Luca

doi:10.3390/app12052470

Abstract

Different methods and products have been investigated as measures of adjunctive therapy to scaling and root planing (SRP). Probiotic use has gained interest for this particular application, especially Lactobacillus spp. This split-mouth interventional prospective study aimed to evaluate the clinical effects of L. reuteri DSM 17938 with local application in periodontal pockets of severe periodontitis patients. The study was conducted on 40 subjects with stage 3–4 periodontitis who, based on a split-mouth model, followed SRP and SRP + L. reuteri solution in five weekly sessions. Probing depth (PD), clinical attachment loss (CAL), and bleeding on probing (BOP) were assessed at baseline and at three months after probiotic treatment completion. Both SRP and SRP + L. reuteri generated significant improvements of all three clinical parameters, but the changes were significantly better for SRP + L. reuteri treated sites. Therefore, we can conclude that adjunctive therapy with L. reuteri DSM 17938 could represent an interesting treatment option, particularly for severe periodontitis cases.

Highlights

Periodontal disease represents an infectious disease, extremely widespread worldwide [1]
No significant differences were observed between study sites groups at baseline regarding probing depth, clinical attachment loss, or bleeding on probing (p = 0.650, p = 0.650 and p = 0.595, respectively) (Figure 1a–c)
In the control group of sites who followed only scaling and root planing (SRP), we observed a significant reduction of all three examined parameters after three months (6.09 ± 0.51 mm to 5.58 ± 0.49 mm for Probing depth (PD); 5.02 ± 0.65 mm to 4.65 ± 0.62 mm for clinical attachment loss (CAL); 81.67 ± 6.5 to 26.40 ± 9.54 for bleeding on probing (BOP)) (p < 0.001 for all three parameters in the same study group) (Figure 2a–c)

Summary

Introduction

Periodontal disease represents an infectious disease, extremely widespread worldwide [1]. The human body will react to bacterial aggression by activating non-specific and specific immune systems, generating the inflammatory reaction [3] This interaction may involve grafting or a series of local and/or systemic risk factors that may influence the quantity or quality of the supraand subgingival bacterial plaque, or the immune response capacity of the host, or even both components [4]. Following this exacerbated inflammatory response, the first clinical changes appear in the superficial periodontal tissues (gingival tissues), a pathological phenomenon included in the group of gingivitis. Inflammatory and bacterial products can affect the supporting periodontal tissues, such as periodontal ligaments, cementum, or alveolar bone, with gingivitis evolving into periodontitis, a disease that can have as a negative endpoint teeth loss [5]

Methods

Results

Discussion

Conclusion