Abstract
BackgroundThe aim of this triple-blind placebo-controlled parallel-arm randomized clinical trial was to evaluate the clinical effects of Lactobacillus rhamnosus SP1 or azithromycin as an adjunct to scaling and root planing (SRP) in patients with stage III periodontitis.MethodsForty-seven systemically healthy participants with stage III periodontitis were recruited. Following SRP, the participants were randomly assigned to one of three treatment modalities; (1) placebo (n = 15), (2) probiotics (n = 16) and (3) antibiotics-azithromycin (n = 16). The participants were monitored at baseline, 3, 6, 9 and 12 months after therapy. Probing pocket depth (PPD), bleeding on probing (BOP), clinical attachment loss (CAL) and plaque accumulation (PI) were evaluated.ResultsAll 47 participants completed the study. At 12 months, all groups showed significant improvements of PPD and PI (p < 0.012) irrespective of the treatment modality and without significant differences between the groups. Probiotics and azithromycin showed no added benefit in terms of CAL. While the placebo (p = 0.002) and the antibiotic-azithromycin (p = 0.002) group showed a significant reduction of BOP, only the placebo group revealed a significant reduction of CAL at 12 months follow-up (p = 0.003). The number of sites and teeth with PPD ≥ 5, ≥ 6 and ≥ 7 mm were significantly reduced in all groups at 12 months follow-up (p < 0.025) irrespective of the treatment regime and without significant differences between the groups.ConclusionThe use of probiotics or azithromycin as an adjunct to SRP failed to provide additional benefits in the treatment of stage III periodontitis. The benefits of these two treatment regimes as an adjunct to SRP remain unclear.Trial registrationNCT02839408, 10/28/2017, Clinicaltrial.gov.
Highlights
The aim of this triple-blind placebo-controlled parallel-arm randomized clinical trial was to evaluate the clinical effects of Lactobacillus rhamnosus SP1 or azithromycin as an adjunct to scaling and root planing (SRP) in patients with stage III periodontitis
The antibiotic and placebo group showed at 12 months a reduced necessity for additional therapy in ≥ 3 sites but without significant differences between the both groups (Additional file 1: Table S1). This triple-blind placebo-controlled parallel-arm randomized clinical trial evaluated the clinical effects of L. rhamnosus SP1 administered once a day for 3 months or azithromycin plus SRP in stage III periodontitis generalized grade B
All treatment groups revealed a significant improvement in probing pocket depth (PPD), bleeding on probing (BOP), clinical attachment loss (CAL) and plaque accumula‐ tion (PI), without significant differences between the treatment modalities
Summary
The aim of this triple-blind placebo-controlled parallel-arm randomized clinical trial was to evaluate the clinical effects of Lactobacillus rhamnosus SP1 or azithromycin as an adjunct to scaling and root planing (SRP) in patients with stage III periodontitis. Periodontitis is characterized by a microbially‐associated and host‐mediated inflammation resulting in the loss of periodontal attachment [1]. This is caused by a dysbiotic microbiome in the subgingival biofilm in a susceptible host. The gold standard treatment to manage periodontitis is scaling and root planing (SRP) [2, 3]. This failure could be due to the presence of deep pockets and the ensuing difficulties during the instrumentation, including the inaccessibility of certain areas such as furcations [5]. Patients with deep pockets, progressive or ‘active’ disease, or specific microbiological profile, can benefit from an antibiotic adjunctive therapy [6]
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