1
|
Parreira GJG, de Araújo Nobre MA, Moreira AGCR, Luís HPS. Limosilactobacillus reuteri as an Adjuvant in the Treatment of Peri-implant Mucositis in Total Rehabilitation: An Exploratory Study. Eur J Dent 2024; 18:610-618. [PMID: 38555646 PMCID: PMC11132781 DOI: 10.1055/s-0043-1777822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVES Mechanical debridement is the traditional method for the treatment of peri-implant mucositis (P-im) and its success depends on the patient's correct oral hygiene. It is believed that probiotics may help by their ability to modulate the oral biofilm, resulting in anti-inflammatory and antibacterial plaque action. The aim of this study was to evaluate the adjuvant effect of the probiotic Limosilactobacillus reuteri (LR) in the mechanical treatment of P-im. MATERIALS AND METHODS This exploratory study included 29 subjects with implant-supported total rehabilitation and P-im, divided into test (TG) and control (CG) groups, equally subjected to professional mechanical debridement, with the administration of a daily GUM PerioBalance lozenge for 30 days added to the TG. The modified Plaque Index (mPlI) modified Sulcus Bleeding Index (mBI) and pocket depth (PD) were evaluated before the intervention (baseline) and 6 and 10 weeks later. STATISTICAL ANALYSIS Parametric and nonparametric tests with 5% significance level were used in the statistical analysis, using IBM SPSS Statistics 27.0 software. RESULTS Both treatments resulted in reduced mPlI, mBI, and PD at 6 weeks; while from 6 to 10 weeks there was an increase in mPlI and mBI and maintenance of PD. Compared with baseline, differences were close to statistical significance in the reduction in PD at 10 weeks in the CG (p = 0.018), after Bonferroni correction, and statistically significant in the mPlI at 6 weeks in the CG (p = 0.004) and in the TG (p = 0.002) as well as at 10 weeks in the TG (p = 0.016). Comparing the groups in the postintervention assessments, no statistically significant differences were found. CONCLUSION LR adjuvant mechanical treatment of P-im does not show a clear benefit compared with mechanical treatment alone, with both interventions achieving similar clinical results. Further prospective and long-term studies are needed.
Collapse
Affiliation(s)
- Gonçalo J G Parreira
- Universidade de Lisboa, Faculdade de Medicina Dentária, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Lisboa, Portugal
- Oral Hygiene Department, Maló Clinic, Lisbon, Portugal
- Universidade de Lisboa, Faculdade de Medicina Dentária, Rede de Higienistas Orais para o Desenvolvimento da Ciência (RHODes), Lisboa, Portugal
| | - Miguel A de Araújo Nobre
- Oral Hygiene Department, Maló Clinic, Lisbon, Portugal
- Research and Development Department, Maló Clinic, Lisbon, Portugal
- Clínica Universitária de Estomatologia, Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - André G C R Moreira
- Universidade de Lisboa, Faculdade de Medicina Dentária, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Lisboa, Portugal
| | - Henrique P S Luís
- Universidade de Lisboa, Faculdade de Medicina Dentária, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Lisboa, Portugal
- Universidade de Lisboa, Faculdade de Medicina Dentária, Rede de Higienistas Orais para o Desenvolvimento da Ciência (RHODes), Lisboa, Portugal
- Center for Innovative Care and Health Technology (ciTechcare), Polytechnic of Leiria, Leiria, Portugal
| |
Collapse
|
2
|
López-Valverde N, López-Valverde A, Blanco Rueda JA. The role of probiotic therapy on clinical parameters and human immune response in peri-implant diseases: a systematic review and meta-analysis of randomized clinical studies. Front Immunol 2024; 15:1371072. [PMID: 38686378 PMCID: PMC11056541 DOI: 10.3389/fimmu.2024.1371072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/02/2024] [Indexed: 05/02/2024] Open
Abstract
Background Peri-implant diseases (peri-implant mucositis and peri-implantitis) are pathologies of an infectious-inflammatory nature of the mucosa around dental implants. Probiotics are microorganisms that regulate host immunomodulation and have shown positive results in the treatment of peri-implant diseases. The objective of the systematic review and meta-analysis was to evaluate the efficacy of probiotics in the treatment of peri-implant oral diseases. Methods According to the PRISMA guidelines, the research question was established: Are probiotics able to favorably modify clinical and immunological biomarkers determinants of peri-implant pathologies? and an electronic search of the databases MEDLINE/PubMed, Embase, Cochrane Central, Web of Science, (until December 2023) was performed. Inclusion criteria were established for intervention studies (RCTs), according to the PICOs strategy in subjects with peri-implant pathology (participants), treated with probiotics (intervention) compared to patients with conventional treatment or placebo (control) and evaluating the response to treatment (outcomes). Results- 1723 studies were obtained and 10 were selected. Risk of bias was assessed using the Cochrane Risk of Bias Tool and methodological quality using the Joanna Briggs Institute for RCTs. Two meta-analyses were performed, one to evaluate probiotics in mucositis and one for peri-implantitis. All subgroups were homogeneous (I2 = 0%), except in the analysis of IL-6 in mucositis (I2 = 65%). The overall effect was favorable to the experimental group in both pathologies. The analysis of the studies grouped in peri-implantitis showed a tendency to significance (p=0.09). Conclusion The use of probiotics, as basic or complementary treatment of peri-implant diseases, showed a statistically significant trend, but well-designed studies are warranted to validate the efficacy of these products in peri-implant pathologies.
Collapse
Affiliation(s)
- Nansi López-Valverde
- Department of Medicine and Medical Specialties, Faculty of Health Sciences, University of Alcalá de Henares, Madrid, Spain
| | - Antonio López-Valverde
- Department of Surgery, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
| | - José Antonio Blanco Rueda
- Department of Surgery, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
| |
Collapse
|
3
|
Ananda N, Suniarti DF, Bachtiar EW. The antimicrobial effect of Limosilactobacillus reuteri as probiotic on oral bacteria: A scoping review. F1000Res 2024; 12:1495. [PMID: 38434653 PMCID: PMC10905032 DOI: 10.12688/f1000research.139697.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/26/2024] [Indexed: 03/05/2024] Open
Abstract
Dysbiosis among oral microbial community in the oral cavity can lead to several oral diseases. Probiotic therapy is known to correct these imbalances. Limosilactobacillus reuteri is one of the most studied strains of probiotics and can control oral microbiota through reuterin, a wide-spectrum antimicrobial agent. The objective of this review was to evaluate the effect of the antimicrobial activity of Limosilactobacillus reuteri on the oral bacteria of humans. This review used PubMed, Scopus, EMBASE, ScienceDirect, and Google Scholar databases as bibliographic resources. Studies with matching keywords were analyzed and screened with PRISMA-ScR recommendations. Sixteen articles were selected for this review, which included a total of 832 patients. Based on this review, Limosilactobacillus reuteri has a strong antibacterial effect against Streptococcus mutans in healthy individuals but is not effective against Lactobacillus. Additionally, it has a significant antibacterial effect against Porphiromonas gingivalis in patients with periodontitis, although its effectiveness is not stable in patients with peri-implant infections. Furthermore, Limosilactobacillus reuterihas varying results against other bacteria, indicating the need for further extensive research to ensure its efficacy.
Collapse
Affiliation(s)
- Nissia Ananda
- Dental Department, Universitas Indonesia Hospital, Universitas Indonesia, Depok, West Java, 16424, Indonesia
| | - Dewi Fatma Suniarti
- Department of Oral Biology, Oral Science Research Center, Faculty of Dentistry, Universitas Indonesia, Jakarta, 10430, Indonesia
| | - Endang Winiati Bachtiar
- Department of Oral Biology, Oral Science Research Center, Faculty of Dentistry, Universitas Indonesia, Jakarta, 10430, Indonesia
| |
Collapse
|
4
|
Peng X, Guo X, Zhou Y. The Efficacy of Ten Different Adjunctive Measures in Patients with Nonsurgically Treated Peri-Implant Disease: A Network Meta-Analysis of Randomized Controlled Trials. Photobiomodul Photomed Laser Surg 2024; 42:99-124. [PMID: 38294889 DOI: 10.1089/photob.2023.0109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
Objective: This study aimed to evaluate the impact of 10 adjunctive measures on non-surgical therapy outcomes for peri-implant disease. Methods: We formulated the study question and keywords following the Population, Intervention, Comparator, Outcome framework. Randomized controlled trials were identified through searches in PubMed, Embase, the Cochrane Library, and the Web of Science. Two researchers assessed the quality of included literature according to the Cochrane Risk of Bias Assessment Tool. Data analysis and ranking were performed using Stata 15.0 software. Results: This study, involving 51 pieces of literature and 2660 samples, conducted a network meta-analysis (NMA), which revealed that photodynamic therapy (PDT) significantly reduced probing pocket depth values in patients with peri-implant mucositis (SUCRA = 96.3%) and peri-implantitis (SUCRA = 96.7%). In addition, it showed an improvement in bleeding on probing (BOP) values for peri-implantitis (SUCRA = 91.6%). Furthermore, diode lasers improved BOP values for peri-implant mucositis (SUCRA = 76.5%). Conclusions: According to the NMA results and the surface under the cumulative ranking curve (SUCRA), PDT and diode laser outperform other adjuncts in peri-implant disease.
Collapse
Affiliation(s)
- Xuepei Peng
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xingtong Guo
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuwen Zhou
- Department of Stomatology, Jiaxing Maternal and Child Health Hospital, Jiaxing, China
| |
Collapse
|
5
|
Figuero E, Serrano J, Arweiler NB, Auschill TM, Gürkan A, Emingil G. Supra and subgingival application of antiseptics or antibiotics during periodontal therapy. Periodontol 2000 2023. [PMID: 37766668 DOI: 10.1111/prd.12511] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/17/2023] [Accepted: 06/22/2023] [Indexed: 09/29/2023]
Abstract
Periodontal diseases (gingivitis and periodontitis) are characterized by inflammatory processes which arise as a result of disruption of the balance in the oral ecosystem. According to the current S3 level clinical practice guidelines, therapy of patients with periodontitis involves a stepwise approach that includes the control of the patient's risk factors and the debridement of supra and subgingival biofilm. This debridement can be performed with or without the use of some adjuvant therapies, including physical or chemical agents, host modulating agents, subgingivally locally delivered antimicrobials, or systemic antimicrobials. Therefore, the main aim of this article is to review in a narrative manner the existing literature regarding the adjuvant application of local agents, either subgingivally delivered antibiotics and antiseptics or supragingivally applied rinses and dentifrices, during the different steps in periodontal therapy performed in Europe.
Collapse
Affiliation(s)
- Elena Figuero
- Department of Dental Clinical Specialties, Etiology and Therapy of Periodontal and Peri-implant Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
- Etiology and Therapy of Periodontal and Peri-implant Research Group, University Complutense of Madrid, Madrid, Spain
| | - Jorge Serrano
- Etiology and Therapy of Periodontal and Peri-implant Research Group, University Complutense of Madrid, Madrid, Spain
| | - Nicole Birgit Arweiler
- Department of Periodontology and Peri-implant Diseases, Philipps University of Marburg, Marburg, Germany
| | - Thorsten Mathias Auschill
- Department of Periodontology and Peri-implant Diseases, Philipps University of Marburg, Marburg, Germany
| | - Ali Gürkan
- Department of Peridontology, Ege University School of Dentistry, Bornova, Turkey
| | - Gülnur Emingil
- Department of Peridontology, Ege University School of Dentistry, Bornova, Turkey
| |
Collapse
|
6
|
Ambili R, Nazimudeen NB. Adjunctive benefit of probiotic supplementation along with nonsurgical therapy for peri-implant diseases - A systematic review and meta-analysis. J Indian Soc Periodontol 2023; 27:352-361. [PMID: 37593565 PMCID: PMC10431221 DOI: 10.4103/jisp.jisp_308_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 01/07/2023] [Accepted: 01/10/2023] [Indexed: 08/19/2023] Open
Abstract
Peri-implant diseases are prevalent conditions, but a predictable management strategy is still lacking. The objective of the present article was to evaluate the adjunctive benefits of probiotics with nonsurgical therapy in the management of peri-implant diseases. The review protocol was registered in PROSPERO and prepared according to PRISMA guidelines. Randomized controlled clinical trials in patients diagnosed with the peri-implant disease where probiotic was used as an adjunct to nonsurgical therapy were included in the study. The risk difference of percentage reduction in bleeding on probing, plaque accumulation, and mean difference in probing pocket depth reductions at implant level were estimated using a random effect model due to high heterogeneity among studies. Four studies fulfilled the criteria for selection. Two of them presented data on both peri-implantitis and peri-implant mucositis and they were considered separate studies during meta-analysis. Significant reduction in percentage of bleeding on probing was noticed at 1 and 3 months (-0.28 [-0.48, -0.09], P = 0.004 and - 0.19 [-0.35, -0.02], P = 0.03, respectively), but the reduction was not statistically significant at 6 months. Similar results were also observed for plaque accumulation. No statistically significant reduction in probing pocket depth was observed in the probiotic group during any of the re-evaluations. Conclusion Adjunctive therapy of probiotics may improve the efficacy of nonsurgical therapy of peri-implant diseases for up to 3 months. However, moderate certainty was observed for a reduction in bleeding on probing after 1-month re-evaluation alone.
Collapse
Affiliation(s)
- R. Ambili
- Department of Periodontics, PMS College of Dental Sciences and Research, Thiruvananthapuram, Kerala, India
| | - Nias Bin Nazimudeen
- Department of Periodontics, PMS College of Dental Sciences and Research, Thiruvananthapuram, Kerala, India
| |
Collapse
|
7
|
Fallah M, Amin N, Moghadasian MH, Jafarnejad S. Probiotics for the Management of Oral Mucositis: An Interpretive Review of Current Evidence. Adv Pharm Bull 2023; 13:269-274. [PMID: 37342370 PMCID: PMC10278207 DOI: 10.34172/apb.2023.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 11/03/2021] [Accepted: 01/05/2022] [Indexed: 04/04/2024] Open
Abstract
Mucositis is one of the major side effects of anti-cancer therapies. Mucositis may lead to other abnormalities such as depression, infection, and pain, especially in young patients. Although there is no specific treatment for mucositis, several pharmacological and non-pharmacological options are available to prevent its complications. Probiotics have been recently considered as a preferable protocol to lessen the complications of chemotherapy, including mucositis. Probiotics could affect mucositis by anti-inflammatory and anti-bacterial mechanisms as well as augmenting the overall immune system function. These effects may be mediated through anti microbiota activities, regulating cytokine productions, phagocytosis, stimulating IgA releasement, protection of the epithelial shield, and regulation of immune responses. We have reviewed available literature pertaining to the effects of probiotics on oral mucositis in animal and human studies. While animal studies have reported protective effects of probiotics on oral mucositis, the evidence from human studies is not convincing.
Collapse
Affiliation(s)
- Maryam Fallah
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | - Negin Amin
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | - Mohammed H. Moghadasian
- Department of Food and Human Nutritional Sciences and the Canadian Centre for Agri-Food Research in Health and Medicine, University of Manitoba, Winnipeg, Canada
| | - Sadegh Jafarnejad
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran
| |
Collapse
|
8
|
Van Holm W, Carvalho R, Delanghe L, Eilers T, Zayed N, Mermans F, Bernaerts K, Boon N, Claes I, Lebeer S, Teughels W. Antimicrobial potential of known and novel probiotics on in vitro periodontitis biofilms. NPJ Biofilms Microbiomes 2023; 9:3. [PMID: 36681674 PMCID: PMC9867767 DOI: 10.1038/s41522-023-00370-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/04/2023] [Indexed: 01/22/2023] Open
Abstract
Several oral diseases are characterized by a shift within the oral microbiome towards a pathogenic, dysbiotic composition. Broad-spectrum antimicrobials are often part of patient care. However, because of the rising antibiotic resistance, alternatives are increasingly desirable. Alternatively, supplying beneficial species through probiotics is increasingly showing favorable results. Unfortunately, these probiotics are rarely evaluated comparatively. In this study, the in vitro effects of three known and three novel Lactobacillus strains, together with four novel Streptococcus salivarius strains were comparatively evaluated for antagonistic effects on proximal agar growth, antimicrobial properties of probiotic supernatant and the probiotic's effects on in vitro periodontal biofilms. Strain-specific effects were observed as differences in efficacy between genera and differences within genera. While some of the Lactobacillus candidates were able to reduce the periodontal pathobiont A. actinomycetemcomitans, the S. salivarius strains were not. However, the S. salivarius strains were more effective against periodontal pathobionts P. intermedia, P. gingivalis, and F. nucleatum. Vexingly, most of the Lactobacillus strains also negatively affected the prevalence of commensal species within the biofilms, while this was lower for S. salivarius strains. Both within lactobacilli and streptococci, some strains showed significantly more inhibition of the pathobionts, indicating the importance of proper strain selection. Additionally, some species showed reductions in non-target species, which can result in unexpected and unexplored effects on the whole microbiome.
Collapse
Affiliation(s)
- Wannes Van Holm
- grid.5596.f0000 0001 0668 7884Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium ,grid.5342.00000 0001 2069 7798Centre for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - Rita Carvalho
- grid.5596.f0000 0001 0668 7884Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium
| | - Lize Delanghe
- grid.5284.b0000 0001 0790 3681Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - Tom Eilers
- grid.5284.b0000 0001 0790 3681Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - Naiera Zayed
- grid.5596.f0000 0001 0668 7884Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium ,grid.5342.00000 0001 2069 7798Centre for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium ,grid.411775.10000 0004 0621 4712Faculty of Pharmacy, Menoufia University, Shibin el Kom, Egypt
| | - Fabian Mermans
- grid.5342.00000 0001 2069 7798Centre for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - Kristel Bernaerts
- grid.5596.f0000 0001 0668 7884Bio- and Chemical Systems Technology, Reactor Engineering and Safety, Department of Chemical Engineering, University of Leuven (KU Leuven), Leuven, Belgium
| | - Nico Boon
- grid.5342.00000 0001 2069 7798Centre for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | | | - Sarah Lebeer
- grid.5284.b0000 0001 0790 3681Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - Wim Teughels
- grid.5596.f0000 0001 0668 7884Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium
| |
Collapse
|
9
|
Moaven H, Giacaman A, Beltrán V, Sam YH, Betancur D, Mainas G, Tarjomani SA, Donos N, Sousa V. Biomarker Expression of Peri-Implantitis Lesions before and after Treatment: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14085. [PMID: 36360962 PMCID: PMC9659150 DOI: 10.3390/ijerph192114085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/05/2022] [Accepted: 09/15/2022] [Indexed: 06/16/2023]
Abstract
The need to predict, diagnose and treat peri-implant diseases has never been greater. We present a systematic review of the literature on the changes in the expression of biomarkers in peri-implant crevicular fluid (PICF) before and after treatment of peri-implantitis. Bacterial composition, clinical and radiographic parameters, and systemic biomarkers before and after treatment are reported as secondary outcomes. A total of 17 studies were included. Treatment groups were non-surgical treatment or surgical treatment, either alone or with adjunctive therapy. Our findings show that non-surgical treatment alone does not influence biomarker levels or clinical outcomes. Both adjunctive photodynamic therapy and local minocycline application resulted in a reduction of interleukin (IL)-1β and IL-10 twelve months after treatment. Non-surgical treatments with adjunctive use of lasers or antimicrobials were more effective at improving the clinical outcomes in the short-term only. Access flap debridement led to matrix metalloproteinase (MMP)-8 and tumour necrosis factor-α reduction twelve months post-surgery. Surgical debridement with adjunctive antimicrobials achieved a decrease in MMP-8 at three months. Adjunctive use of Emdogain™ (EMD) was associated with a reduction in 40 PICF proteins compared to access flap surgery alone. Surgical interventions were more effective at reducing probing pocket depth and bleeding on probing both in the short- and long-term. Surgical treatment in combination with EMD was found to be more effective in resolving inflammation up to twelve months.
Collapse
Affiliation(s)
- Haniyeh Moaven
- Centre for Oral Clinical Research, Centre for Oral Immunobiology & Regenerative Medicine, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London, London E1 2AD, UK
| | - Annesi Giacaman
- Center of Excellence in Translational Medicine, Faculty of Medicine, Universidad de la Frontera, Temuco 4780000, Chile
| | - Víctor Beltrán
- Clinical Investigation and Dental Innovation Center, Dental School & Center for Translational Medicine, Universidad de La Frontera, Temuco 4780000, Chile
| | - Ye Han Sam
- Periodontology and Periodontal Medicine, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
| | - Daniel Betancur
- Discipline of Periodontology, Department of Surgical Stomatology, Faculty of Dentistry, Universidad de Concepción, Concepción 4030000, Chile
| | - Giuseppe Mainas
- Periodontology and Periodontal Medicine, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
| | - Seyed Ali Tarjomani
- Periodontology and Periodontal Medicine, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Centre for Oral Immunobiology & Regenerative Medicine, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London, London E1 2AD, UK
| | - Vanessa Sousa
- Periodontology and Periodontal Medicine, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
| |
Collapse
|
10
|
Chuachamsai S, Acharya A, Fischer K, Nibali L, Ho D, Pelekos G. The effectiveness of adjunctive measures in managing peri-implant mucositis: an umbrella review. Int J Implant Dent 2022; 8:26. [PMID: 35674882 PMCID: PMC9177933 DOI: 10.1186/s40729-022-00426-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/30/2022] [Indexed: 11/28/2022] Open
Abstract
Objectives The purpose of this umbrella review was to gather and summarize the data from published systematic reviews (SRs) that compared non-surgical mechanical debridement (NSMD) with and without the use of adjunctive treatments on the management of peri-implant mucositis (PIM). Materials and methods A protocol was developed and registered in PROSPERO (CRD42021254350) before the systematic search for the SRs. Seven electronic databases, including Cochrane Library, Embase (via Ovid), MEDLINE (via Pubmed), Proquest, Prospero, Scopus and Web of Science, were searched for published reviews. The search for unpublished and informally published reviews was further attempted in the last four databases. The methodological quality of the included reviews was assessed using AMSTAR 2. Results Twelve included SRs assessed clinical studies published between 2014 and 2020, including a total of seventeen primary clinical trials. All SRs summarized data from individual studies and provided a narrative conclusion regarding the effectiveness of the adjunctive treatments. Only six SRs performed a meta-analysis (MA) of additional benefits of the adjunctive therapy for PIM, with results indicating no significant difference between the different treatment modalities. The overall confidence was adjudged ranging from critically low to low using AMSTAR 2 and significant additional benefits of any adjunctive treatments in comparison with NSMD were not apparent. Conclusion Overall, the reviewed evidence did not support the use of adjunctive treatments for improvement of clinical outcomes in PM management as compared to NSMD alone. Supplementary Information The online version contains supplementary material available at 10.1186/s40729-022-00426-2.
Collapse
Affiliation(s)
- Sompol Chuachamsai
- Division of Periodontology and Implant Dentistry Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Aneesha Acharya
- Dr D. Y. Patil Dental College and Hospital, Dr D. Y. Patil Vidyapeeth, Pune, India.,Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Kai Fischer
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, University of Zurich, Zurich, Switzerland
| | - Luigi Nibali
- Periodontology Unit, Faculty of Dentistry, Oral and Craniofacial Sciences, Centre for Host-Microbiome Interactions, King's College London, London, UK
| | - Dominic Ho
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Georgios Pelekos
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China. .,Department of Periodontology, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong, 999077, SAR, China.
| |
Collapse
|
11
|
Santana SI, Silva PHF, Salvador SL, Casarin RCV, Furlaneto FAC, Messora MR. Adjuvant use of multispecies probiotic in the treatment of peri-implant mucositis: A randomized controlled trial. J Clin Periodontol 2022; 49:828-839. [PMID: 35634695 DOI: 10.1111/jcpe.13663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 05/01/2022] [Accepted: 05/06/2022] [Indexed: 01/28/2023]
Abstract
AIM This randomized placebo-controlled clinical trial evaluated the effects of multispecies probiotic containing Lactobacillus rhamnosus HN001™, Lactobacillus paracasei Lpc-37®, and Bifidobacterium animalis subsp lactis HN019™ as an adjunct to mechanical debridement (MD) on changes in bleeding on probing (BOP) in edentulous patients with peri-implant mucositis (PiM). MATERIALS AND METHODS Patients were randomly assigned to test (probiotic) or control (placebo) groups. All sites with PiM received MD and topical gel application (probiotic or placebo) at baseline and 12 weeks. After initial MD, patients consumed probiotic or placebo capsules twice a day for 12 weeks. Clinical (modified sulcus bleeding index [mSBI]; modified plaque index [mPI]; probing depth [PD]; and BOP) and immunological parameters were collected at baseline and after 12 and 24 weeks. Data were statistically analysed (p < .05). RESULTS Thirty-six patients with PiM were recruited. The test group presented higher prevalence (p < .05) of cases of restored peri-implant health at 24 weeks than did the control group (72.2% and 33.3%, respectively). No significant difference was observed between test (n = 18) and control (n = 18) groups for mPI and PD. mSBI %-score 0 was higher in the test group than in the control group at 24 weeks (p < .05). When compared with baseline, both groups presented reduced BOP at 12 and 24 weeks (p < .05). BOP was lower in the test group than in the control group at 12 (mean difference = -14.54%; 95% confidence interval [CI] = -28.87 to 0.22; p = .0163) and 24 (mean difference = -12.56%; 95% CI = -26.51 to 1.37; p = .0090) weeks. At 24 weeks, only the test group presented lower levels of interleukin (IL)-1β, IL-6, IL-8, and tumour necrosis factor (TNF)-α than those at baseline (p < .05). CONCLUSIONS The multispecies probiotic (administered locally and systemically) containing L. rhamnosus HN001™, L. paracasei Lpc-37®, and B. lactis HN019™ as an adjunct to repeated MD promotes additional clinical and immunological benefits in the treatment of PiM in edentulous patients (ClinicalTrials.gov NCT04187222).
Collapse
Affiliation(s)
- Sandro I Santana
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo-USP, Ribeirao Preto, São Paulo, Brazil
| | - Pedro H F Silva
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo-USP, Ribeirao Preto, São Paulo, Brazil
| | - Sérgio L Salvador
- Department of Clinical Analyses, School of Pharmaceutical Sciences of Ribeirao Preto, University of São Paulo-USP, Ribeirão Preto, São Paulo, Brazil
| | - Renato C V Casarin
- Department of Prosthodontics and Periodontics, School of Dentistry, Campinas State University-UNICAMP, Piracicaba, São Paulo, Brazil
| | - Flávia A C Furlaneto
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo-USP, Ribeirao Preto, São Paulo, Brazil
| | - Michel R Messora
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo-USP, Ribeirao Preto, São Paulo, Brazil
| |
Collapse
|
12
|
Butera A, Maiorani C, Gallo S, Pascadopoli M, Venugopal A, Marya A, Scribante A. Evaluation of Adjuvant Systems in Non-Surgical Peri-Implant Treatment: A Literature Review. Healthcare (Basel) 2022; 10:healthcare10050886. [PMID: 35628025 PMCID: PMC9140356 DOI: 10.3390/healthcare10050886] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 04/30/2022] [Accepted: 05/05/2022] [Indexed: 02/04/2023] Open
Abstract
Can the use of lasers, ozone, probiotics, glycine and/or erythritol, and chlorhexidine in combination with non-surgical peri-implant treatment have additional beneficial effects on the clinical parameters? Objectives: The non-surgical treatment of peri-implant pathologies is based on mechanical debridement to eliminate bacterial biofilm and reduce tissue inflammation; some additional therapies have been studied to achieve more detailed clinical results. Materials and methods: A literature search for publications until January 2022 was conducted. The research question is formulated following the Problem, Intervention, Comparison/Control, and Outcome. Studies investigating adjunctive therapies were included. Results: In total, 29 articles were included. Most of the studies did not show any additional benefit of these therapies in the evaluation of bleeding on probing, probing pocket depth, or plaque index; among the proposed treatments, the use of laser was the one most studied in the literature, with the achievement of a reduction of bleeding and pocket depth. More studies would be needed to assess the benefit of other therapies. Conclusions: This review showed no significant improvements in the state of health in support of mechanical debridement therapy. However, the few benefits found would deserve to be considered in new clinical studies.
Collapse
Affiliation(s)
- Andrea Butera
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Correspondence: (A.B.); (C.M.); (M.P.)
| | - Carolina Maiorani
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Correspondence: (A.B.); (C.M.); (M.P.)
| | - Simone Gallo
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (S.G.); (A.S.)
| | - Maurizio Pascadopoli
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (S.G.); (A.S.)
- Correspondence: (A.B.); (C.M.); (M.P.)
| | - Adith Venugopal
- Department of Orthodontics, Saveetha Institute of Medical and Technical Science, Saveetha Dental College, Saveetha University, Chennai 600077, India;
| | - Anand Marya
- Department of Orthodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh 12211, Cambodia;
- Center for Transdisciplinary Research, Saveetha Institute of Medical and Technical Science, Saveetha Dental College, Saveetha University, Chennai 600077, India
| | - Andrea Scribante
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (S.G.); (A.S.)
| |
Collapse
|
13
|
Butera A, Maiorani C, Gallo S, Pascadopoli M, Venugopal A, Marya A, Scribante A. Evaluation of Adjuvant Systems in Non-Surgical Peri-Implant Treatment: A Literature Review. Healthcare (Basel) 2022. [PMID: 35628025 DOI: 10.3390/healthcare10050886.pmid:35628025;pmcid:pmc9140356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
Can the use of lasers, ozone, probiotics, glycine and/or erythritol, and chlorhexidine in combination with non-surgical peri-implant treatment have additional beneficial effects on the clinical parameters? Objectives: The non-surgical treatment of peri-implant pathologies is based on mechanical debridement to eliminate bacterial biofilm and reduce tissue inflammation; some additional therapies have been studied to achieve more detailed clinical results. Materials and methods: A literature search for publications until January 2022 was conducted. The research question is formulated following the Problem, Intervention, Comparison/Control, and Outcome. Studies investigating adjunctive therapies were included. Results: In total, 29 articles were included. Most of the studies did not show any additional benefit of these therapies in the evaluation of bleeding on probing, probing pocket depth, or plaque index; among the proposed treatments, the use of laser was the one most studied in the literature, with the achievement of a reduction of bleeding and pocket depth. More studies would be needed to assess the benefit of other therapies. Conclusions: This review showed no significant improvements in the state of health in support of mechanical debridement therapy. However, the few benefits found would deserve to be considered in new clinical studies.
Collapse
Affiliation(s)
- Andrea Butera
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Carolina Maiorani
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Simone Gallo
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Maurizio Pascadopoli
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Adith Venugopal
- Department of Orthodontics, Saveetha Institute of Medical and Technical Science, Saveetha Dental College, Saveetha University, Chennai 600077, India
| | - Anand Marya
- Department of Orthodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh 12211, Cambodia
- Center for Transdisciplinary Research, Saveetha Institute of Medical and Technical Science, Saveetha Dental College, Saveetha University, Chennai 600077, India
| | - Andrea Scribante
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| |
Collapse
|
14
|
Sayardoust S, Johansson A, Jönsson D. Do Probiotics Cause a Shift in the Microbiota of Dental Implants—A Systematic Review and Meta-Analysis. Front Cell Infect Microbiol 2022; 12:823985. [PMID: 35372118 PMCID: PMC8966653 DOI: 10.3389/fcimb.2022.823985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 02/03/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThe primary aim of this current systematic review and meta-analysis was to evaluate the potential microbiological effect of probiotics on the implant microbiota. The secondary aim was to evaluate if probiotics have any effect as an adjunct to non-surgical peri-implant treatment in reducing peri-implant mucositis and peri-implantitis clinical parameters—bleeding on probing, modified Gingival Index, and pocket depth.MethodsThe research focus questions were constructed in accordance with the Participants, Intervention, Comparison, and Outcomes (PICO) criteria, and a PROSPERO protocol was registered. A comprehensive systematic search in MEDLINE via the PubMed, Scopus, and Web of Science Core Collection databases was conducted. Two independent reviewers screened the reports based on the PICO criteria—inclusion and exclusion criteria.ResultsIn total, 467 records were identified, and ultimately, 7 papers were included: 3 papers in the qualitative synthesis of microbiological effect and 4 in the meta-analysis synthesis on pocket depth. The data synthesis showed that probiotics had no detectable effect on the implant microflora, and in the following data synthesis, no clinical peri-implantitis variable showed a significantly beneficial effect from probiotics in the test group compared to the control group.ConclusionWithin the limitations of this review, the oral implant microflora is not affected by probiotics nor do probiotics add any effect to the conventional non-surgical treatment of peri-implant mucositis and peri-implantitis.
Collapse
Affiliation(s)
- Shariel Sayardoust
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- *Correspondence: Shariel Sayardoust,
| | - Anders Johansson
- Division of Molecular Periodontology, Department of Odontology, Umeå University, Umeå, Sweden
| | - Daniel Jönsson
- Faculty of Odontology, Malmö University, Malmö, Sweden
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Odontology and Oral Health, Public Dental Care of Skåne, Lund, Sweden
| |
Collapse
|
15
|
Canut-Delgado N, Giovannoni ML, Chimenos-Küstner E. Are probiotics a possible treatment of periodontitis? Probiotics against periodontal disease: a systematic review. Br Dent J 2021:10.1038/s41415-021-3624-5. [PMID: 34815484 DOI: 10.1038/s41415-021-3624-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 02/24/2021] [Indexed: 11/09/2022]
Abstract
Introduction Periodontal disease is one of the most prevalent oral diseases. Until now, periodontal disease treatments offer good results but periodontal pockets can be immediately recolonised by pathogenic bacteria. The limitations of these treatments have led to the need to find more effective alternatives that reinforce the periodontal treatments.Aim To evaluate the clinical effect of probiotics as an adjuvant treatment to scaling and root planing in patients with periodontitis.Materials and methods An electronic search in Medline (via PubMed) of randomised clinical trials published in the last ten years that include the effects of using probiotics in periodontal disease was performed.Results In total, ten trials were included and in seven of them the evaluated clinical parameters were significantly improved in the test group compared to the placebo group. In five trials, a significant reduction of the main periodontal pathogens was reported. No side effects were observed in any trial.Conclusions The administration of probiotics as an adjuvant treatment to periodontal treatment helps improve the clinical parameters, significantly decreases the concentration of the main periodontal pathogens and does not cause any side effects.
Collapse
Affiliation(s)
| | - María Laura Giovannoni
- Dentist and Associate Professor, University of Barcelona, Department of Odontostomatology, School of Medicine and Health Sciences, Bellvitge Campus, Spain
| | - Eduardo Chimenos-Küstner
- Stomatologist and Titular Professor, University of Barcelona, Department of Odontostomatology, School of Medicine and Health Sciences, Bellvitge Campus, Spain
| |
Collapse
|
16
|
Maitre Y, Mahalli R, Micheneau P, Delpierre A, Guerin M, Amador G, Denis F. Pre and Probiotics Involved in the Modulation of Oral Bacterial Species: New Therapeutic Leads in Mental Disorders? Microorganisms 2021; 9:1450. [PMID: 34361886 PMCID: PMC8306040 DOI: 10.3390/microorganisms9071450] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 07/02/2021] [Accepted: 07/04/2021] [Indexed: 12/12/2022] Open
Abstract
This systematic review aims to identify probiotics and prebiotics for modulating oral bacterial species associated with mental disorders. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline, we search the electronic MEDLINE database published till January 2021 to identify the studies on probiotics and/or prebiotics for preventing and treating major oral dysbiosis that provokes mental disorders. The outcome of the search produces 374 records. After excluding non-relevant studies, 38 papers were included in the present review. While many studies suggest the potential effects of the oral microbiota on the biochemical signalling events between the oral microbiota and central nervous system, our review highlights the limited development concerning the use of prebiotics and/or probiotics in modulating oral dysbiosis potentially involved in the development of mental disorders. However, the collected studies confirm prebiotics and/or probiotics interest for a global or targeted modulation of the oral microbiome in preventing or treating mental disorders. These outcomes also offer exciting prospects for improving the oral health of people with mental disorders in the future.
Collapse
Affiliation(s)
- Yoann Maitre
- Emergency Department, Montpellier University Hospital, 2415 Montpellier, France;
- Aide à la Décision pour une Médecine Personnalisée, Université de Montpellier, 2415 Montpellier, France
| | - Rachid Mahalli
- Department of Odontology, Tours University Hospital, 7505 Tours, France; (R.M.); (P.M.); (A.D.)
| | - Pierre Micheneau
- Department of Odontology, Tours University Hospital, 7505 Tours, France; (R.M.); (P.M.); (A.D.)
| | - Alexis Delpierre
- Department of Odontology, Tours University Hospital, 7505 Tours, France; (R.M.); (P.M.); (A.D.)
| | - Marie Guerin
- Faculty of Dentistry, Clermont-Ferrand University, 63000 Clermont-Ferrand, France;
| | - Gilles Amador
- Faculty of Dentistry, Nantes University, 44035 Nantes, France;
| | - Frédéric Denis
- Department of Odontology, Tours University Hospital, 7505 Tours, France; (R.M.); (P.M.); (A.D.)
- Faculty of Dentistry, Nantes University, 44035 Nantes, France;
- Faculté de Médecine, Education, Ethique, Santé, Université François-Rabelais, 7505 Tours, France
| |
Collapse
|
17
|
Ng E, Tay JRH, Ong MMA, Bostanci N, Belibasakis GN, Seneviratne CJ. Probiotic therapy for periodontal and peri-implant health - silver bullet or sham? Benef Microbes 2021; 12:215-230. [PMID: 34057054 DOI: 10.3920/bm2020.0182] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Probiotics are thought to be beneficial microbes that influence health-related outcomes through host immunomodulation and modulation of the bacteriome. Its reported success in the treatment of gastrointestinal disorders has led to further research on its potential applicability within the dental field due to similarities such as a polymicrobial aetiology and disease associated microbial-shifts. Although the literature is replete with studies demonstrating its efficacy, the use of probiotics in dentistry continues to polarise opinion. Here, we explore the evidence for probiotics and its effect on periodontal and peri-implant health. MEDLINE, EMBASE, and CENTRAL were systemically searched from June 2010 to June 2020 based on a formulated search strategy. Of 1,956 potentially relevant articles, we selected 27 double-blinded randomised clinical trials in the areas of gingivitis, periodontitis, residual pockets during supportive periodontal therapy, and peri-implant diseases, and reviewed their efficacy in these clinical situations. We observed substantial variation in treatment results and protocols between studies. Overall, the evidence for probiotic therapy for periodontal and peri-implant health appears unconvincing. The scarcity of trials with adequate power and follow-up precludes any meaningful clinical recommendations. Thus, the routine use of probiotics for these purposes are currently unsubstantiated. Further multi-centre trials encompassing a standardised investigation on the most promising strains and administration methods, with longer observation times are required to confirm the benefits of probiotic therapy for these applications.
Collapse
Affiliation(s)
- E Ng
- Department of Restorative Dentistry, National Dental Centre Singapore, 5 Second Hospital Ave, 168938, Singapore
| | - J R H Tay
- Department of Restorative Dentistry, National Dental Centre Singapore, 5 Second Hospital Ave, 168938, Singapore
| | - M M A Ong
- Department of Restorative Dentistry, National Dental Centre Singapore, 5 Second Hospital Ave, 168938, Singapore.,Oral Health Academic Clinical Programme, Duke-NUS Medical School, 8 College Road, 169857, Singapore
| | - N Bostanci
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, P.O. Box 4064, 14104 Huddinge, Sweden
| | - G N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, P.O. Box 4064, 14104 Huddinge, Sweden
| | - C J Seneviratne
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, 8 College Road, 169857, Singapore.,Singapore Oral Microbiomics Initiative, National Dental Research Institute Singapore, National Dental Centre Singapore, Second Hospital Ave, 168938, Singapore
| |
Collapse
|
18
|
A concerted probiotic activity to inhibit periodontitis-associated bacteria. PLoS One 2021; 16:e0248308. [PMID: 33667279 PMCID: PMC7935250 DOI: 10.1371/journal.pone.0248308] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/23/2021] [Indexed: 12/19/2022] Open
Abstract
Periodontitis can result in tooth loss and the associated chronic inflammation can provoke several severe systemic health risks. Adjunctive to mechanical treatment of periodontitis and as alternatives to antibiotics, the use of probiotic bacteria was suggested. In this study, the inhibitory effect of the probiotic Streptococcus salivarius subsp. salivarius strains M18 and K12, Streptococcus oralis subsp. dentisani 7746, and Lactobacillus reuteri ATCC PTA 5289 on anaerobic periodontal bacteria and Aggregatibacter actinomycetemcomitans was tested. Rarely included in other studies, we also quantified the inverse effect of pathogens on probiotic growth. Probiotics and periodontal pathogens were co-incubated anaerobically in a mixture of autoclaved saliva and brain heart infusion broth. The resulting genome numbers of the pathogens and of the probiotics were measured by quantitative real-time PCR. Mixtures of the streptococcal probiotics were also used to determine their synergistic, additive, or antagonistic effects. The overall best inhibitor of the periodontal pathogens was L. reuteri ATCC PTA 5289, but the effect is coenzyme B12-, anaerobiosis-, as well as glycerol-dependent, and further modulated by L. reuteri strain DSM 17938. Notably, in absence of glycerol, the pathogen-inhibitory effect could even turn into a growth spurt. Among the streptococci tested, S. salivarius M18 had the most constant inhibitory potential against all pathogens, followed by K12 and S. dentisani 7746, with the latter still having significant inhibitory effects on P. intermedia and A. actinomycetemcomitans. Overall, mixtures of the streptococcal probiotics did inhibit the growth of the pathogens equally or–in the case of A. actinomycetemcomitans- better than the individual strains. P. gingivalis and F. nucleatum were best inhibited by pure cultures of S. salivarius K12 or S. salivarius M18, respectively. Testing inverse effects, the growth of S. salivarius M18 was enhanced when incubated with the periodontal pathogens minus/plus other probiotics. In contrast, S. oralis subsp. dentisani 7746 was not much influenced by the pathogens. Instead, it was significantly inhibited by the presence of other streptococcal probiotics. In conclusion, despite some natural limits such as persistence, the full potential for probiotic treatment is by far not utilized yet. Especially, further exploring concerted activity by combining synergistic strains, together with the application of oral prebiotics and essential supplements and conditions, is mandatory.
Collapse
|
19
|
Bourdillon AT, Edwards HA. Review of probiotic use in otolaryngology. Am J Otolaryngol 2021; 42:102883. [PMID: 33453564 DOI: 10.1016/j.amjoto.2020.102883] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 12/25/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Probiotics have garnered considerable attention as an intervention for various conditions common to otolaryngology. The purpose of this review is to evaluate the current literature to offer recommendations about the safety and efficacy of probiotic management in otolaryngologic conditions. STUDY DESIGN Narrative review. METHODS PubMed and Google Scholar were queried using pertinent keywords to retrieve relevant studies with particular focus in the recent 5 years. All abstracts were assessed and studies, reviews and meta-analyses achieving evaluation of probiotic therapies or characterization of microbiome changes were included for further review. Studies were categorized by condition or anatomic region across various subspecialties. Key data parameters were extracted and evaluated across studies and treatment types. RESULTS Strong evidence exists for the use probiotic agents to improve symptoms for allergic rhinitis, chronic rhinosinusitis and certain dental conditions. Despite promising results, further investigation is needed to evaluate and optimize probiotic delivery for mitigating otitis media, oropharyngeal inflammation and upper respiratory tract infections. Preclinical studies suggest that probiotics may potentially offer benefit for voice prosthesis maintenance, wound healing and mitigation of oral dysplasia. CONCLUSION Probiotic therapies may offer clinical benefit in a variety of contexts within the field of otolaryngology, especially for short-term relief of certain inflammatory conditions of the oral cavity, auditory and nasal cavities. Further investigation is warranted for evaluation of long-term outcomes and pathogenic deterrence.
Collapse
Affiliation(s)
- Alexandra T Bourdillon
- Division of Otolaryngology, Department of Surgery, Yale University School of Medicine, New Haven, CT, United States of America.
| | - Heather A Edwards
- Department of Otolaryngology, Boston University School of Medicine, Boston, MA, United States of America.
| |
Collapse
|
20
|
Zhao R, Hu H, Wang Y, Lai W, Jian F. Efficacy of Probiotics as Adjunctive Therapy to Nonsurgical Treatment of Peri-Implant Mucositis: A Systematic Review and Meta-Analysis. Front Pharmacol 2021; 11:541752. [PMID: 33536901 PMCID: PMC7847846 DOI: 10.3389/fphar.2020.541752] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 11/20/2020] [Indexed: 02/05/2023] Open
Abstract
Background: Peri-implant mucositis (PiM) is an inflammation of the soft tissues surrounding the dental implant and is the precursor of the destructive inflammatory peri-implantitis. PiM is usually reversible, but difficult to eradicate. Mechanical debridement (MD) is the conventional procedure to treat PiM although not enough to reach a complete resolution. Recently, probiotics have been considered in the treatment of peri-implant disease. Therefore, the aim of this systematic review and meta-analysis was to investigate the efficacy of the probiotic therapy combined with MD compared with MD alone or MD + placebo in patients with PiM. Methods: A search using electronic databases (MEDLINE, Science Direct databases, and Cochrane Central Register of Controlled Trials) and a manual search were performed up to November 2019 by two reviewers independently of each other. Eligible randomized controlled trials (RCTs) comparing MD + probiotic vs. MD were included. The quality assessment for all the selected RCTs was conducted according to the Cochrane Handbook for Systematic Reviews of Interventions. Probing depth reduction was selected as the primary outcome. Weighted mean difference (WMD) and 95% confidence interval (CI) were calculated for continuous outcomes, and odds ratio (OR) and 95% CI were calculated for dichotomous outcomes, using random effect models. This review was registered on the PROSPERO database (CRD42020213625). Results: Five eligible publications were included in this systematic review and four in the meta-analysis. As regards the implant, the WMD in the probing depth reduction between the test and control group was −0.12 mm [95% CI (−0.38, 0.14), p = 0.38], meaning that the adjunctive probiotic therapy was not improving PiM compared with MD alone or MD + placebo. The meta-analysis also showed no statistically significant results in the secondary outcomes (reduction of full mouth plaque index and full mouth bleeding on probing, absence of bleeding on probing at implant level, and changes in microorganism load and species). Conclusion: The findings of this systematic review and meta-analysis suggested that the additional use of probiotics did not improve the efficacy of MD in PiM treatment regarding clinical and microbial outcomes, at least in a short-term.
Collapse
Affiliation(s)
- Rui Zhao
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Huimin Hu
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yan Wang
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wenli Lai
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Fan Jian
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| |
Collapse
|
21
|
Abstract
Abstract
Purpose of the Review
Peri-implant diseases are inflammatory reactions to bacterial infections affecting osseointegrated dental implants. In recent years, scientific interest on this topic has increased, as demonstrated by the appearance of a large number of protocols for treating peri-implant mucositis (PIM) and peri-implantitis (PI). The aim of the present narrative review is to provide an overview of the recent (e.g., 2014–present) published protocols for the non-surgical treatment of peri-implant diseases.
Recent Findings
Several adjunctive measures for mechanical debridement have been proposed and investigated to achieve implant surface decontamination and resolution of mucosal inflammation. However, none of the adjunctive measures has been shown to significantly improve peri-implant conditions compared with non-surgical mechanical debridement alone.
Summary
Non-surgical approaches for the treatment of peri-implant diseases have been proved to be reliable in reducing clinical signs of peri-implant inflammation (e.g., BoP), although with limited capability to achieve complete disease resolution. Due to the limited benefits from the use of currently proposed adjunctive methods (e.g., chlorhexidine, lasers, photodynamic therapy, systemic probiotics) their application is not recommended until further investigations prove their clinical utility.
Collapse
|
22
|
Mariani GM, Ercoli E, Guzzi N, Bongiovanni L, Bianco L, Romano F, Aimetti M. One-year clinical outcomes following non-surgical treatment of peri-implant mucositis with adjunctive diode laser application. ACTA ACUST UNITED AC 2020; 69:269-277. [PMID: 32278340 DOI: 10.23736/s0026-4970.20.04340-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Limited information is available on the application of diode laser in the treatment of peri-implant diseases. The aim of this study was to investigate the clinical efficacy of the adjunctive application of diode laser in the non-surgical treatment of peri-implant mucositis during a 12-month follow-up period. METHODS The sample was composed of 73 systemically healthy patients with one implant diagnosed with peri-implant mucositis (bleeding on probing [BoP] with no loss of supporting bone). Implants were randomly assigned to mechanical debridement with hand and powered instruments and 980-nm diode laser application (test group, N.=38) or mechanical debridement alone (control group, N.=35). At the completion of active treatment patients were included in a periodontal maintenance program. Recalls were provided every three months in both treatment groups for reinforcement in oral hygiene instructions and professional implant cleaning with rubber cups. Baseline parameters were repeated at 3 and 12 months postoperatively. RESULTS Intragroup analysis showed that plaque index, BoP and probing depth presented statistically significant improvements when compared with baseline values (all P<0.001). No statistically significant difference in clinical outcomes was observed between treatment groups at each time point. At 12 months no significant difference in the percentage of sites showing BoP resolution was observed between test (60.9%) and control treatment (52.6%), as well. CONCLUSIONS Based on the present results, the adjunct use of diode laser showed little but not statistically significant additional benefits in the treatment of peri-implant mucositis after an observation period of one year.
Collapse
Affiliation(s)
- Giulia M Mariani
- Section of Periodontology, C.I.R. Dental School, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Elena Ercoli
- Section of Periodontology, C.I.R. Dental School, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Nicoletta Guzzi
- Section of Periodontology, C.I.R. Dental School, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Loretta Bongiovanni
- Section of Periodontology, C.I.R. Dental School, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Laura Bianco
- Section of Periodontology, C.I.R. Dental School, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Federica Romano
- Section of Periodontology, C.I.R. Dental School, Department of Surgical Sciences, University of Turin, Turin, Italy -
| | - Mario Aimetti
- Section of Periodontology, C.I.R. Dental School, Department of Surgical Sciences, University of Turin, Turin, Italy
| |
Collapse
|
23
|
Vives-Soler A, Chimenos-Küstner E. Effect of probiotics as a complement to non-surgical periodontal therapy in chronic periodontitis: a systematic review. Med Oral Patol Oral Cir Bucal 2020; 25:e161-e167. [PMID: 31893476 PMCID: PMC7103449 DOI: 10.4317/medoral.23147] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 12/23/2019] [Indexed: 02/06/2023] Open
Abstract
Background To improve the results of the classic periodontal treatment, probiotics have been suggested recently to decrease the number of bacteria and the expression of mediators of inflammation. This systematic review aimed to assess the literature for the effectiveness of different probiotic strains as adjuvants to non-surgical periodontal therapy.
Material and Methods The electronic database of MEDLINE (via Pubmed) was searched up to December 2017 for randomised clinical trials in English comparing non-surgical periodontal treatment and probiotics versus periodontal treatment and placebo. The primary outcome investigated was reduction in pocket probing depth. Secondary outcomes were bleeding on probing, plaque index reduction and bacteria counts.
Results Nine trials were included. A narrative data synthesis did not result in any major improvement of overall pocket probing depth but moderate pockets from 4 to 6 mm showed larger reductions in study groups, which could decrease the need for surgery. Sites with bleeding on probing and presence of plaque decreased after treatment. For periimplant mucositis, there was a small tendency to better results in the study group.
Conclusions With the available data, it is concluded that probiotics may provide an additional benefit to manual debridement in chronic periodontitis. More studies are required on dose, route of administration and strains of probiotics used. Key words:Periodontics, chronic periodontitis, probiotics, periodontal treatment, lactobacillus, streptococcus.
Collapse
Affiliation(s)
- A Vives-Soler
- C/Sabino Arana, 6, 10th floor 1st door 08028, Barcelona, Spain
| | | |
Collapse
|
24
|
Gao J, Yu S, Zhu X, Yan Y, Zhang Y, Pei D. Does Probiotic Lactobacillus Have an Adjunctive Effect in the Nonsurgical Treatment of Peri-Implant Diseases? A Systematic Review and Meta-analysis. J Evid Based Dent Pract 2020; 20:101398. [PMID: 32381407 DOI: 10.1016/j.jebdp.2020.101398] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 12/11/2019] [Accepted: 01/17/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To evaluate the additional effect of probiotic Lactobacillus in the nonsurgical management of peri-implant diseases (peri-implant mucositis and peri-implantitis). METHODS Six databases were searched up to May 2019 without time and language restrictions. Study selection and data extraction were conducted independently by 2 reviewers. The inclusion criteria for this systematic review were defined based on the participants, intervention, comparison, outcomes, and study design (PICOS) format. Randomized controlled trials comparing nonsurgical treatment combined with probiotic Lactobacillus or placebo agent in patients with peri-implant diseases were included. The methodological quality of retrieved studies was assessed according to the Cochrane Collaboration's Risk of Bias tool, and the quality of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. Odds ratio and 95% confidence interval (CI) were used to describe dichotomous data, while mean difference and standardized mean difference with 95% CI were used to describe continuous variables. RESULTS Seven randomized controlled trials with 296 implants were included in this meta-analysis. The mean difference of probing pocket depth (PPD) was -0.05 (95% CI: -0.28 to 0.18; P = .67) immediately after treatment termination and -0.17 (95% CI: -1.01 to 0.67, P = .69) at least 2 months after treatment termination. There was a slight reduction of PPD after treatment termination. Compared with placebo, Lactobacillus provided limited benefits in peri-implant mucositis. There were no significant differences in the secondary outcomes of bleeding on probing or plaque index (P > .05). In a narrative synthesis of peri-implantitis, the effect of Lactobacillus on PPD and bleeding on probing remained controversial. CONCLUSIONS This systematic review and meta-analysis showed that probiotic Lactobacillus provide limited benefits to the nonsurgical treatment of peri-implant mucositis or peri-implantitis.
Collapse
Affiliation(s)
- Jinxia Gao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China; Department of Prosthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Shuchen Yu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Xiufeng Zhu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Yuzhu Yan
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Yuchen Zhang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Dandan Pei
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China; Department of Prosthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.
| |
Collapse
|
25
|
Laleman I, Pauwels M, Quirynen M, Teughels W. A dual-strain Lactobacilli reuteri probiotic improves the treatment of residual pockets: A randomized controlled clinical trial. J Clin Periodontol 2019; 47:43-53. [PMID: 31520543 PMCID: PMC6973056 DOI: 10.1111/jcpe.13198] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/16/2019] [Accepted: 09/09/2019] [Indexed: 01/08/2023]
Abstract
Aim To examine the adjunctive effect of a Lactobacillus reuteri probiotic (ATCC PTA 5289 & DSM 17938) on the re‐instrumentation of residual pockets. Materials and Methods This randomized, double‐blind, placebo‐controlled study included 39 previously non‐surgically treated periodontitis patients. A re‐instrumentation was carried out, and probiotic and/or placebo drops were applied according to the study protocoll. Patients afterwards received lozenges to use 2×/day for 12 weeks. Probing pocket depth (PPD), recession, bleeding on probing and plaque levels were analysed, next to the microbiological impact. Results No effects of the probiotic drops could be found. However, after 24 weeks, the overall PPD in the probiotic lozenges group (2.64 ± 0.33 mm) was significantly lower compared to the control lozenges (2.92 ± 0.42 mm). This difference was even more pronounced in moderate (4–6 mm) and deep (≥7 mm) pockets. In the probiotic lozenges group, there were also significantly more pockets converting from ≥4 mm at baseline to ≤3 mm at 24 weeks (67 ± 18% versus 54 ± 17%) and less sites in need for surgery (4 ± 4% versus 8 ± 6%). However, the probiotic products did not influence the microbiological counts of the periodontopathogens. Conclusion The adjunctive consumption of L. reuteri lozenges after re‐instrumentation improved the PPD reduction, without an impact on pocket colonization with periodontopathogens.
Collapse
Affiliation(s)
- Isabelle Laleman
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Martine Pauwels
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Marc Quirynen
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| |
Collapse
|
26
|
Laleman I, Pauwels M, Quirynen M, Teughels W. The usage of a lactobacilli probiotic in the non-surgical therapy of peri-implantitis: A randomized pilot study. Clin Oral Implants Res 2019; 31:84-92. [PMID: 31705683 DOI: 10.1111/clr.13555] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 10/09/2019] [Accepted: 10/19/2019] [Indexed: 01/16/2023]
Abstract
OBJECTIVES Examine the clinical and microbiological benefits of a dual-strain Lactobacillus reuteri probiotic on the non-surgical therapy of initial peri-implantitis. MATERIALS AND METHODS This randomized, double-blind study targeted patients with initial peri-implantitis, that is peri-implantitis with a maximum mean probing pocket depth of 6 mm and maximum 3 mm bone loss compared with loading. A full-mouth prophylaxis was performed and the peri-implantitis sites were debrided. Subsequently, local application of the study drops was carried out at the peri-implantitis sites and the study lozenges were handed out. The patients in the probiotic group received drops and lozenges containing L. reuteri (ATCC PTA 5289 & DSM 17938), those in the control group received placebo products. At the implant level the measurements of interest were bleeding, probing pocket depth and plaque. Full-mouth bleeding and plaque scores were also recorded. Microbiological samples were taken from the tongue, saliva and subgingivally around the implants. RESULTS All clinical parameters were significantly decreased after 12 and 24 weeks. At the implant level the only statistically significant difference was a greater decrease in plaque levels in the probiotic versus the control group (p = .002 at 24 weeks). At the full-mouth level, the only intergroup difference was the greater decrease in full-mouth bleeding on probing sites in the probiotic group compared with the control group (p < .001 at 24 weeks). Concerning the microbiological outcomes, no significant differences could be found at any time point, neither intra- nor intergroup. CONCLUSIONS No adjunctive effects of the use of L. reuteri probiotics in the treatment of peri-implantitis were found.
Collapse
Affiliation(s)
- Isabelle Laleman
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Martine Pauwels
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Marc Quirynen
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| |
Collapse
|
27
|
Anti-infective therapy of peri-implant mucositis with adjunctive delivery of a sodium hypochlorite gel: a 6-month randomized triple-blind controlled clinical trial. Clin Oral Investig 2019; 24:1971-1979. [DOI: 10.1007/s00784-019-03060-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 08/14/2019] [Indexed: 10/26/2022]
|
28
|
Alqahtani F, Alqahtani M, Shafqat SS, Akram Z, Al‐Kheraif AA, Javed F. Efficacy of mechanical debridement with adjunctive probiotic therapy in the treatment of peri‐implant mucositis in cigarette‐smokers and never‐smokers. Clin Implant Dent Relat Res 2019; 21:734-740. [DOI: 10.1111/cid.12795] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 04/29/2019] [Accepted: 05/02/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Fawaz Alqahtani
- Department of ProsthodonticsCollege of Dentistry, Prince Sattam bin Abdulaziz University Al‐Kharj Saudi Arabia
| | - Mana Alqahtani
- Faculty of MedicineUniversity of Tabuk Tabuk Kingdom of Saudi Arabia
| | - Syed S. Shafqat
- Faculty of DentistryZiauddin Medical University Karachi Pakistan
| | - Zohaib Akram
- Department of Periodontology, Faculty of DentistryZiauddin‐University Karachi Pakistan
| | - Abdulaziz A. Al‐Kheraif
- Dental Biomaterials Research Chair, Dental Health DepartmentCollege of Applied Medical Sciences, King Saud University Riyadh Saudi Arabia
| | - Fawad Javed
- Department of PeriodontologyStony Brook University Stony Brook New York
- Laboratory for Periodontal‐, Implant‐, Phototherapy (LA‐PIP), School of Dental MedicineStony Brook University Stony Brook New York
| |
Collapse
|
29
|
Frickmann H, Klenk C, Warnke P, Redanz S, Podbielski A. Influence of Probiotic Culture Supernatants on In Vitro Biofilm Formation of Staphylococci. Eur J Microbiol Immunol (Bp) 2018; 8:119-127. [PMID: 30719328 PMCID: PMC6348700 DOI: 10.1556/1886.2018.00022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Accepted: 08/27/2018] [Indexed: 01/15/2023] Open
Abstract
Background The effects of cell-free culture supernatants of probiotic Lactobacillus rhamnosus GG and Streptococcus salivarius K12 on replication and biofilm forming of Staphylococcus aureus and S. epidermidis were assessed in vitro. Methods S. aureus and S. epidermidis strains were exposed to cell-free culture supernatants of L. rhamnosus GG and S. salivarius K12 at different concentrations starting at 0, 4, and 24 h after the onset of incubation. Bacterial amplification was measured on microplate readers, as well as biofilm growth after safranine staining. Scanning electron microscopy was performed for visualization of biofilm status. Results The S. salivarius K12 culture supernatant not only reduced or prevented the formation and maturation of fresh biofilms but even caused a reduction of preformed S. epidermidis biofilms. The L. rhamnosus GG culture supernatant did not show clear inhibitory effects regardless of concentration or time of addition of supernatant, and even concentration-depending promotional effects on the planktonic and biofilm growth of S. aureus and S. epidermidis were observed. Conclusion In particular, the inhibitory effects of the S. salivarius K12 culture supernatant on the formation of staphylococcal biofilms are of potential relevance for biofilm-associated diseases and should be further assessed by in vivo infection models.
Collapse
Affiliation(s)
- Hagen Frickmann
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Rostock, Germany.,Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, Hamburg, Germany
| | - Caroline Klenk
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Rostock, Germany
| | - Philipp Warnke
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Rostock, Germany
| | - Sylvio Redanz
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Rostock, Germany.,Kreth Lab, Department of Restorative Dentistry, Oregon Health & Science University, Portland, OR, USA
| | - Andreas Podbielski
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Rostock, Germany
| |
Collapse
|
30
|
Abstract
PURPOSE OF REVIEW To provide an updated perspective on the use of probiotics as adjuvant treatment strategy for patients suffering from or at risk of developing mucositis. RECENT FINDINGS Studies suggest that oral and intestinal microbiota could be relevant to mucositis development and treatment, but no clear high-risk pattern has been identified and no single probiotic formulation has emerged from human clinical trials for strong recommendation. Promising results from available clinical trials suggest their use in patients with peri-implant mucositis or at risk of anticancer treatment-related oral or intestinal mucositis. In general, a positive effects of Lactobacillus species is becoming consistent, particularly Lactobacillus reuteri, in the treatment of peri-implant mucositis and Lactobacillus brevi CD2 in the prevention of chemoradiotherapy-related oral mucositis. However, several limitations still need to be addressed by future research. Nonetheless, their use appears to be safe. Therefore, decision to consider the use of probiotics ultimately depends on the preference of the clinicians. SUMMARY In the ongoing era of 'precision medicine', efforts should be directed toward the identification of high-risk patient populations which could benefit most from targeted interventions with probiotics enabling an improvement of clinical outcomes and quality of life in a cost-effective manner.
Collapse
Affiliation(s)
- Emanuele Cereda
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | | |
Collapse
|
31
|
Evaluation of the effect of probiotics in the treatment of peri-implant mucositis: a triple-blind randomized clinical trial. Clin Oral Investig 2018; 23:1673-1683. [DOI: 10.1007/s00784-018-2578-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 08/16/2018] [Indexed: 10/28/2022]
|
32
|
Galofré M, Palao D, Vicario M, Nart J, Violant D. Clinical and microbiological evaluation of the effect of Lactobacillus reuteri
in the treatment of mucositis and peri-implantitis: A triple-blind randomized clinical trial. J Periodontal Res 2018; 53:378-390. [DOI: 10.1111/jre.12523] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2017] [Indexed: 12/15/2022]
Affiliation(s)
- M. Galofré
- Department of Periodontology; Universitat Internacional de Catalunya; Barcelona Spain
| | - D. Palao
- Department of Periodontology; Universitat Internacional de Catalunya; Barcelona Spain
| | - M. Vicario
- Department of Periodontology; Universitat Internacional de Catalunya; Barcelona Spain
| | - J. Nart
- Department of Periodontology; Universitat Internacional de Catalunya; Barcelona Spain
| | - D. Violant
- Department of Periodontology; Universitat Internacional de Catalunya; Barcelona Spain
| |
Collapse
|
33
|
Keller MK, Brandsborg E, Holmstrøm K, Twetman S. Effect of tablets containing probiotic candidate strains on gingival inflammation and composition of the salivary microbiome: a randomised controlled trial. Benef Microbes 2017; 9:487-494. [PMID: 29264967 DOI: 10.3920/bm2017.0104] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim of the study was to investigate clinical and microbial effects of probiotic candidate strains in patients with moderate gingivitis. The null hypothesis was that the clinical measurements with treatment would not differ from placebo. 47 adult patients were enrolled in a randomised placebo-controlled trial with a 4-week intervention of tablets containing a mix of Lactobacillus rhamnosus PB01, DSM 14869 and Lactobacillus curvatus EB10, DSM 32307 or placebo. Clinical examinations and samplings were done at baseline and after 2, 4 and 6 weeks. The clinical endpoints were general bleeding on probing (BOP), general plaque index (PI) and flow of gingival crevicular fluid (GCF). In addition, the concentration of selected cytokines (interleukin (IL)-1β, IL-6, IL-8, IL-10, tumour necrosis factor alpha (TNF-α)) in GCF was determined with multiplex immunoassays. The profiles of the salivary microbiome were analysed with Next Generation Sequencing (NGS) and qPCR. In contrast to the placebo group, there was a significant reduction in BOP and amount of GCF (P<0.05) after 4 weeks in the probiotic test group when compared with baseline. The general PI was less affected although there was a tendency of decreased plaque levels in the probiotic group (P=0.05-0.09). The cytokines were unaffected by the intervention as well as the salivary microbiome. The Shannon index showed no significant differences between the groups or alterations over time. The occurrence of both probiotic strains increased in saliva of the test subjects during the intervention but returned to baseline levels within 2 weeks. Although a marked improvement in gingival health was recorded in the probiotic group, the null hypothesis could not be rejected.
Collapse
Affiliation(s)
- M K Keller
- 1 Department of Dentistry, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Allé 20, 2200 Copenhagen N, Denmark
| | - E Brandsborg
- 2 Bifodan A/S, Bogbinderivej 6, 3390 Hundested, Denmark
| | - K Holmstrøm
- 3 Bioneer A/S, Kogle Allé 2, 2970 Hørsholm, Denmark
| | - S Twetman
- 1 Department of Dentistry, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Allé 20, 2200 Copenhagen N, Denmark
| |
Collapse
|
34
|
The effects of Lactobacillus reuteri probiotics combined with azithromycin on peri-implantitis: A randomized placebo-controlled study. J Prosthodont Res 2017; 62:89-96. [PMID: 28756115 DOI: 10.1016/j.jpor.2017.06.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 06/19/2017] [Accepted: 06/28/2017] [Indexed: 11/22/2022]
Abstract
PURPOSE The aim of this randomized placebo-controlled clinical study was to investigate the effects of a probiotic tablet containing Lactobacillus reuteri in peri-implantitis patients. METHODS Subjects comprised 30 patients with mild to moderate peri-implantitis. A baseline clinical examination and microbiological assessment were conducted, followed by an antibiotics treatment (azithromycin, 500mg, once a day for 3 days). Subjects were divided into probiotic and placebo groups. The clinical examination and bacterial sampling were performed 0, 4, 12 and 24 weeks after the intake of probiotics. The clinical examination included probing pocket depth (PPD), bleeding on probing (BOP), the modified plaque index (mPI), and modified bleeding index (mBI). The number of bacteria was assessed using the PCR-invader method. The Wilcoxon rank-sum test and Wilcoxon signed-rank test with Bonferroni corrections were used for data analyses. RESULTS Although the number of bacteria decreased after the administration of azithromycin in both groups, they increased again thereafter. No significant difference was observed in bacterial numbers between the two groups. Although PPD in the probiotics group was significantly lower at 4 and 24 weeks than at 0 weeks (p<0.05), a significant decrease did not occur in the placebo group. The mBI score at 24 weeks was significantly lower in the probiotics group than in the placebo group (p<0.05). No significant difference was observed in BOP or mPI between the two groups. CONCLUSION These results suggested that probiotics prevent inflammation by affecting host responses rather than improving microbial flora in peri-implant sulci in peri-implantitis patients.
Collapse
|
35
|
Mongardini C, Pilloni A, Farina R, Di Tanna G, Zeza B. Adjunctive efficacy of probiotics in the treatment of experimental peri-implant mucositis with mechanical and photodynamic therapy: a randomized, cross-over clinical trial. J Clin Periodontol 2017; 44:410-417. [PMID: 28032908 DOI: 10.1111/jcpe.12689] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2016] [Indexed: 10/20/2022]
Abstract
AIM To evaluate the adjunctive clinical efficacy of probiotics in the treatment of peri-implant mucositis (p-iM) with professionally administered plaque removal (PAPR) and photodynamic therapy (PDT). MATERIALS AND METHODS Following p-iM induction, patients underwent PAPR + PDT and were randomly assigned to receive the professional and home-based administration of probiotics (Lactobacillus plantarum and Lactobacillus brevis) (test treatment) or placebo preparation (control treatment) according to a cross-over design. Clinical parameters were assessed at six sites for each implant before as well as at 2 and 6 weeks after professional treatment administration. RESULTS Twenty patients contributing one dental implant each were included. Immediately before treatment and at 6 weeks, the median number of sites with bleeding on probing (BoP+) sites per implant unit was 4 (3-6) and 2 (0-2) (p < 0.001), respectively, for test treatment, and 3.5 (2-4) and 2 (0-3) (p = 0.03), respectively, for control treatment. No significant difference in clinical outcomes was observed between treatment groups. CONCLUSION The combination of PAPR and PDT either alone or associated with probiotics determined a significant reduction in the number of BoP+ sites at 2 and 6 weeks around implants with p-iM. The adjunctive use of probiotics did not significantly enhance the clinical outcomes of PAPR + PDT.
Collapse
Affiliation(s)
- Claudio Mongardini
- Section of Periodontics, Department of Dentistry and Maxillofacial Surgery, Sapienza University of Rome, Rome, Italy
| | - Andrea Pilloni
- Section of Periodontics, Department of Dentistry and Maxillofacial Surgery, Sapienza University of Rome, Rome, Italy
| | - Roberto Farina
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
| | - Gianluca Di Tanna
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Blerina Zeza
- Section of Periodontics, Department of Dentistry and Maxillofacial Surgery, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
36
|
Jørgensen MR, Keller MK, Kragelund C, Hamberg K, Ericson D, Nielsen CH, Twetman S. Lactobacillus reuteri supplements do not affect salivary IgA or cytokine levels in healthy subjects: A randomized, double-blind, placebo-controlled, cross-over trial. Acta Odontol Scand 2016; 74:399-404. [PMID: 27104984 DOI: 10.3109/00016357.2016.1169439] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To evaluate the effect of daily ingestion of probiotic lactobacilli on the levels of secretory IgA (sIgA) and selected cytokines in whole saliva of healthy young adults. MATERIALS AND METHODS The study group consisted of 47 healthy adults (18-32 years) who volunteered for a randomized, double-blind, placebo-controlled, cross-over trial after informed consent. During intervention, the subjects ingested two lozenges per day containing two strains of the probiotic bacterium Lactobacillus reuteri (DSM 17938 and ATCC PTA 5289) or placebo lozenges. The intervention and wash-out periods were 3 weeks. Saliva samples were collected at baseline, immediately after each intervention period and 3 weeks post-intervention. ELISA was used to measure sIgA and luminex technology was used to measure the interleukins (IL)-1β, IL-6, IL-8 and IL-10. For statistical analyses a mixed ANOVA model was employed to calculate changes in the salivary outcome variables. RESULTS Forty-one subjects completed the study and reported a good compliance. No significant differences in the concentrations of salivary sIgA or cytokines were recorded between the L. reuteri and placebo interventions or between baseline and 3 weeks post-intervention levels. No side- or adverse effects were reported. CONCLUSIONS Supplementation with two strains of the probiotic L. reuteri did not affect sIgA or cytokine levels in whole saliva in healthy young adults. The results thereby indicate that daily oral supplementation with L. reuteri do not seem to modulate the salivary oral immune response in healthy young subjects (ClinicalTrials.gov NCT02017886).
Collapse
Affiliation(s)
- Mette Rose Jørgensen
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Kirstine Keller
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Camilla Kragelund
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kristina Hamberg
- Department of Cariology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Dan Ericson
- Department of Cariology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Claus Henrik Nielsen
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Institute for Inflammation Research, Department of Rheumatology and Spine Disease, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Svante Twetman
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|