Effectiveness of Probiotic Lozenges in Periodontal Management of Chronic Periodontitis Patients: Clinical and Immunological Study.

Bassel Mirdad,Ahmed Alshareef,Ehab Azab,Faisal Alsharif,Abdel-Rahman Youssef,Alaa Attia,Ahmed Dardir,Mohammed Almalki,Ahmed Melibari

doi:10.1055/s-0040-1709924

Abstract

Objective The main purpose of this article was to evaluate the effect of probiotics used as an adjunctive to scaling and root planing (SRP) on the periodontal parameters and matrix metalloproteinase-8 (MMP-8) levels in gingival crevicular fluid (GCF) of chronic periodontitis patients. Materials and Methods A total of 25 chronic periodontitis patients who completed the treatment course of 40 subjects, aged 25 to 58 years, participated in this study. They were categorized into two groups: the first group was treated by SRP while the second group was treated by SRP and probiotic lozenges twice a day for 30 days. All patients were evaluated clinically by measuring the plaque index, bleeding index (BI), pocket depth, clinical attachment loss, and immunologically by assaying GCF/MMP-8 at baseline and 30 days after periodontal management. Results There was a significant improvement in periodontal parameters after SRP treatment with and without probiotic lozenges in both groups. However, there was a significant decrease in the BI ( p = 0.05) in SRP and probiotic lozenges group after 30 days compared with SRP alone. In addition, there was a significant decrease in GCF/MMP-8 levels after 30 days in patients managed by SRP only ( p = 0.017) compared with the baseline in both groups, whereas a highly significant decrease in patients treated by SRP and probiotics ( p = 0.001). Conclusion The current study suggested that the probiotics might have a beneficial effect on clinical and immunological outcomes in the management of chronic periodontitis patients. Further research is needed on a large-scale population and for a long recall time to confirm the response to probiotics as an adjunctive to SRP.

Highlights

Periodontitis is an infection caused by specific microorganisms that produce inflammation and destruction of periodontium
Note: G1 = patients treated without probiotics; G2 = patients treated with probiotics. *The p-value < 0.01
Note: G1 = patients treated without probiotics; G2 = patients treated with probiotics. *The p- value < 0.05

Summary

Introduction

Periodontitis is an infection caused by specific microorganisms that produce inflammation and destruction of periodontium. The chronic periodontitis is the most common type of periodontal disease that results in periodontal defects, intermittent pain, and, losing the tooth. The risk factors of periodontitis include a combination of environmental, acquired and genetic factors. Microbial plaque and host response are the critical factors for the developing of chronic periodontitis.[1]. Generalized periodontitis is considered when 30% of the sites assessed in the mouth show bone and attachment loss, while localized periodontitis when < 30% of the evaluated sites are affected.[2] The rate of the disease activity is usually slow but may be modified by systemic, local, and behavioral factors. Chronic periodontitis occurs mainly in adult and old-age patients in association with local factors, primarily dental plaque. The severity of periodontitis is different from patient to patient and from site to site in the same patient.[3]

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Discussion

Conclusion