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Efficacy of Probiotics Compared to Chlorhexidine Mouthwash in Improving Periodontal Status: A Systematic Review and Meta-Analysis. Int J Dent 2023; 2023:4013004. [PMID: 36726858 PMCID: PMC9886484 DOI: 10.1155/2023/4013004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/26/2022] [Accepted: 01/04/2023] [Indexed: 01/25/2023] Open
Abstract
Purpose To critically evaluate the available literature and conduct a systematic review of recent randomized controlled trials to assess the effectiveness of probiotics compared to chlorhexidine mouthwash in enhancing periodontal health. Methods Five databases were searched electronically, as well as the gray literature. Using the Cochrane risk-of-bias tool for randomized clinical trials, the risk of bias was examined. The weighted mean difference (WMD) method was used to calculate the effect sizes. Heterogeneity was assessed using I 2 and τ 2 statistics. The GRADE approach was adopted to assess the certainty of the evidence. To assess the robustness of the findings, sensitivity analysis and publication bias assessment were undertaken. Results A total of 1850 studies were initially identified. Sixteen clinical trials were eligible for qualitative synthesis, and ten were included in the meta-analysis. In terms of the gingival index, in total, no statistically significant difference was observed between chlorhexidine and probiotics within 4 weeks (WMD -0.03, 95% CI: -0.09∼0.04, P = 0.3885). Similar to GI, no statistically significant difference was observed between chlorhexidine and probiotics regarding the plaque index within 4 weeks (WMD 0.11, 95% CI: -0.05∼0.28, P = 0.1726). No statistically significant difference was observed between chlorhexidine and probiotics in all time intervals regarding oral hygiene index-simplified (WMD -0.01, 95% CI: -0.05∼0.04, P = 0.7508). The robustness of these findings was confirmed by sensitivity analysis and publication bias assessments. Conclusions Based on the findings, probiotics were an acceptable alternative to conventional chlorhexidine in improving periodontal health. High-quality studies with rigorous methodology should be conducted to assess the optimum doses of probiotics for clinical implications.
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Cannizzaro S, Maiorani C, Scribante A, Butera A. Personalized Treatment of Periodontitis in a Patient with McArdle's Disease: The Benefits from Probiotics. Case Rep Dent 2023; 2023:5080384. [PMID: 36937222 PMCID: PMC10023231 DOI: 10.1155/2023/5080384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 03/12/2023] Open
Abstract
Introduction McArdle's disease is a severe glycogen storage disease characterized by intolerance to exercise; patients have a syndrome of muscle intolerance to stress, associated with myalgia, cramps, fatigue, and muscle weakness. Periodontal disease is a multifactorial pathology of the supporting tissues of the teeth: one of the main factors is the formation of bacterial biofilm; its control favors the prevention and the maintenance of good health of the oral cavity; and some systemic pathologies can worsen the periodontal disease and hinder its therapy. This case report concerns a woman with McArdle's disease diagnosed with periodontal disease. Material and Methods. A 54-year-old female patient with McArdle's disease has been diagnosed with Stage 3 generalized periodontitis, Grade B. At the baseline, the patient had 82 pockets with probing pocket depth (PPD) equal to or greater than 4 mm. The patient was instructed in the correct methods of oral hygiene and was advised toothpaste and mouthwash based on probiotics; subsequently, a debridement was performed to remove etiological factors using Dental-Biofilm Detection Topographic Technique (D-BioTECH). Results After 60 days, the number of pockets was reduced from 82 to 14 overall with PPD ≥ 4 mm and from 50 to 2 pockets with PPD ≥ 5 mm. Full mouth bleeding score (FMBS) increased from 48% to 15% and full mouth plaque score (FMPS) from 73% to 15%. Conclusions In this case, the use of a correct brushing method combined with the D-BioTECH has reduced the disease state, with the use of probiotics at home to restore and maintain a healthy oral microbiome.
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Affiliation(s)
- Salvatore Cannizzaro
- 1Ordinary Member of Academy of Advanced Technologies in Oral Hygiene Sciences, Siracusa, Italy
| | - Carolina Maiorani
- 2Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia 27100, Italy
| | - Andrea Scribante
- 2Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia 27100, Italy
- 3Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia 27100, Italy
| | - Andrea Butera
- 2Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia 27100, Italy
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Amato M, Di Spirito F, D’Ambrosio F, Boccia G, Moccia G, De Caro F. Probiotics in Periodontal and Peri-Implant Health Management: Biofilm Control, Dysbiosis Reversal, and Host Modulation. Microorganisms 2022; 10:2289. [PMID: 36422359 PMCID: PMC9694231 DOI: 10.3390/microorganisms10112289] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/10/2022] [Accepted: 11/16/2022] [Indexed: 07/30/2023] Open
Abstract
Periodontitis and peri-implantitis are microbially associated diseases of the tissues supporting the teeth and dental implants that are mediated by host inflammation and eventually lead to tooth and dental implant loss. Given the probiotics' role in biofilm control, dysbiosis reversal, and host modulation, their potential beneficial effects on the improvement of periodontitis and peri-implantitis have been recently investigated. Moreover, probiotics use has also been proposed in periodontal health management in patients undergoing fixed orthodontic therapy. Therefore, the present study aimed to review, considering the periodontal microbiome composition around teeth and dental implants in healthy and pathological conditions, the putative favorable effects of probiotics on gingivitis, periodontitis, and peri-implantitis. The secondary aim of the present narrative review was to synthesize the supporting evidence and proposed protocols for probiotics use as adjuncts in periodontitis and peri-implantitis treatment and the periodontal health management of orthodontic patients with fixed appliances. Contrasting findings from the literature may be due to the different methods, posology, and duration of probiotics prescriptions and due to the heterogeneous biological and clinical measurement methods employed. Thus, no definitive conclusions could be drawn about the effectiveness of probiotics in periodontal management, both in healthy and pathological conditions. Further studies are needed to validate probiotics for periodontal management and provide recommended protocols.
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Wang J, Liu Y, Wang W, Ma J, Zhang M, Lu X, Liu J, Kou Y. The rationale and potential for using Lactobacillus in the management of periodontitis. JOURNAL OF MICROBIOLOGY (SEOUL, KOREA) 2022; 60:355-363. [PMID: 35344188 DOI: 10.1007/s12275-022-1514-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 02/07/2022] [Accepted: 02/25/2022] [Indexed: 01/13/2023]
Abstract
Periodontitis refers to a wide range of the inflammatory conditions of supporting dental structures. For some patients with periodontitis, antibacterial agents are needed as an adjuvant to mechanical debridement treatments and oral hygiene maintenance. However, the widespread use of broad-spectrum antibiotics for the prophylaxis and treatment of periodontal infections results in the emergence of resistant pathogens. Therefore, probiotics have become markedly interesting to researchers as a potentially safe alternative to periodontal treatment and maintenance. Probiotics have been used in medicine for decades and extensively applied to the treatment of inflammatory diseases through the modulation of microbial synergy and other mechanisms. A growing amount of evidence has shown that using Lactobacillus strains for oral cavity maintenance could improve periodontal health. In this study, we reviewed studies showing proof of the inhibitory effects of Lactobacillus species on periodontal inflammation. We also explored the rationale and potential for using Lactobacillus species in the management of periodontitis.
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Affiliation(s)
- Jiaqi Wang
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China
| | - Yingman Liu
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China
| | - Weiru Wang
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China
| | - Jiaojiao Ma
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China
| | - Manman Zhang
- Department of Oral Biology, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China
| | - Xiaoying Lu
- Department of Oral Biology, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China
| | - Jie Liu
- Science Experiment Center, China Medical University, Shenyang, 110122, P. R. China
| | - Yurong Kou
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China. .,Department of Oral Biology, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110122, P. R. China.
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5
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The immunomodulating role of probiotics in the prevention and treatment of oral diseases. Cent Eur J Immunol 2021; 46:99-104. [PMID: 33897290 PMCID: PMC8056348 DOI: 10.5114/ceji.2021.104412] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 12/31/2020] [Indexed: 11/23/2022] Open
Abstract
Probiotics are defined as non-pathogenic live microorganisms which, when administered in appropriate amounts, are beneficial to the health of the host. Currently, the group of probiotic microorganisms includes bacteria that produce lactic acid of the genera Lactobacillus and Bifidobacterium, belonging to the so-called LAB (lactic acid bacteria) groups, and the yeast Saccharomyces boulardii. Probiotics have a protective role in Candida spp. oral infection and especially colonization. Lactobacillus limits the progression of chronic periodontitis by inhibiting the secretory activity of Th17 lymphocytes, which in the pathogenesis of this disease are responsible for an excessive cytokine response causing adverse changes in periodontal tissues. A meta-analysis of the results of studies on the clinical evaluation of the effectiveness of probiotics in the treatment of gingivitis showed that the use of probiotics improved the condition of the gums in the course of the therapeutic process. Regular use of probiotics during orthodontic treatment significantly reduces the number of bacteria from the Streptococcus mutans group in the patient’s saliva and significantly inhibits the expression of inflammatory mediators and an excessive immune response. The main mechanisms of the action of probiotics, such as elimination and inhibition of the growth of pathogenic microorganisms through competition for receptor sites and the secretion of metabolites with antibacterial activity, as well as the stimulation of specific and non-specific immune responses by activating T lymphocytes, and stimulating the production of cytokines, make it possible to also effectively use pro-health bacteria in oral diseases.
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NĘdzi-GÓra M, WrÓblewska M, GÓrska R. The Effect of Lactobacillus salivarius SGL03 on Clinical and Microbiological Parameters in Periodontal Patients. Pol J Microbiol 2020; 69:441-451. [PMID: 33574872 PMCID: PMC7812367 DOI: 10.33073/pjm-2020-047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/29/2020] [Accepted: 10/02/2020] [Indexed: 02/06/2023] Open
Abstract
The destruction of periodontal tissues during periodontitis is the result of the immune-inflammatory reactions to the bacteria of dental biofilm. Probiotics may reduce dysbiosis by the modification of the dental microbiome, which can influence the immune-inflammatory mechanisms. The aim of this study was to estimate the clinical and microbiological parameters, before and after 30 days of application of the dietary supplement containing Lactobacillus salivarius SGL03 or placebo. The study was conducted in 51 patients with stage I or II periodontitis during the maintenance phase of treatment. The clinical parameters and the number of colony forming units (CFU) of bacteria in supragingival plaque were assessed before and after 30 days of the oral once daily administration of the dietary supplement in the form of suspension containing L. salivarius SGL03 or placebo. There were no changes in the PI scores between and within the groups. The value of BOP decreased in both groups. In the study group the significant reduction of the mean pocket depth was revealed (from 2.5 to 2.42, p = 0,027) but without the difference between the groups. There were no significant changes in the number of bacteria within the groups. In the control, but not the study group, positive correlations were observed between the clinical parameters (variables) and the number of bacteria. The use of the dietary supplement containing L. salivarius SGL03 may reduce pocket depth despite the lack of changes in other clinical parameters and the number of bacteria in supragingival plaque.
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Affiliation(s)
| | - Marta WrÓblewska
- Department of Dental Microbiology, Medical University of Warsaw, Warsaw, Poland.,Department of Microbiology, Central Clinical Hospital, University Clinical Centre, Medical University of Warsaw, Warsaw, Poland
| | - Renata GÓrska
- Department of Periodontology and Oral Mucosa Diseases, Medical University of Warsaw, Warsaw, Poland
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Hajishengallis G, Chavakis T, Lambris JD. Current understanding of periodontal disease pathogenesis and targets for host-modulation therapy. Periodontol 2000 2020; 84:14-34. [PMID: 32844416 DOI: 10.1111/prd.12331] [Citation(s) in RCA: 166] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Recent advances indicate that periodontitis is driven by reciprocally reinforced interactions between a dysbiotic microbiome and dysregulated inflammation. Inflammation is not only a consequence of dysbiosis but, via mediating tissue dysfunction and damage, fuels further growth of selectively dysbiotic communities of bacteria (inflammophiles), thereby generating a self-sustained feed-forward loop that perpetuates the disease. These considerations provide a strong rationale for developing adjunctive host-modulation therapies for the treatment of periodontitis. Such host-modulation approaches aim to inhibit harmful inflammation and promote its resolution or to interfere directly with downstream effectors of connective tissue and bone destruction. This paper reviews diverse strategies targeted to modulate the host periodontal response and discusses their mechanisms of action, perceived safety, and potential for clinical application.
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Affiliation(s)
- George Hajishengallis
- Department of Basic and Translational Sciences, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Triantafyllos Chavakis
- Department of Clinical Pathobiochemistry, Faculty of Medicine, Institute for Clinical Chemistry and Laboratory Medicine, Technische Universität Dresden, Dresden, Germany
| | - John D Lambris
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Zhang G, Lu M, Liu R, Tian Y, Vu VH, Li Y, Liu B, Kushmaro A, Li Y, Sun Q. Inhibition of Streptococcus mutans Biofilm Formation and Virulence by Lactobacillus plantarum K41 Isolated From Traditional Sichuan Pickles. Front Microbiol 2020; 11:774. [PMID: 32425911 PMCID: PMC7203412 DOI: 10.3389/fmicb.2020.00774] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 03/31/2020] [Indexed: 02/05/2023] Open
Abstract
Among cariogenic microbes, Streptococcus mutans is considered a major etiological pathogen of dental caries. Lactobacilli strains have been promoted as possible probiotic agents against S. mutans, although the inhibitory effect of Lactobacilli on caries has not yet been properly addressed. The objective of this study was to screen Lactobacillus strains found in traditional Sichuan pickles and to evaluate their antagonistic properties against S. mutans in vitro and in vivo. In the current study, we analyzed 54 Lactobacillus strains isolated from pickles and found that strain L. plantarum K41 showed the highest inhibitory effect on S. mutans growth as well as on the formation of exopolysaccharides (EPS) and biofilm in vitro. Scanning electron microscopy (SEM) and confocal laser scanning microscope (CLSM) revealed the reduction of both EPS and of the network-like structure in S. mutans biofilm when these bacteria were co-cultured with strain L. plantarum K41. Furthermore, when rats were treated with strain L. plantarum K41, there was a significant reduction in the incidence and severity of dental caries. Due to K41's origin in a high salinity environment, it showed a high tolerance to acids and salts. This may give this strain an advantage in harsh oral conditions. Results showed that L. plantarum K41 isolated from traditional Sichuan pickles effectively inhibited S. mutans biofilm formation and thus possesses a potential inhibitory effect on dental caries in vivo.
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Affiliation(s)
- Guojian Zhang
- Department of Food Science and Technology, College of Light Industry, Textile and Food Engineering, Sichuan University, Chengdu, China
| | - Miao Lu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodonics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Rongmei Liu
- Key Laboratory of Bio-resources & Eco-environment of the Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, China
| | - Yuanyuan Tian
- Key Laboratory of Bio-resources & Eco-environment of the Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, China
| | - Viet Ha Vu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodonics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yang Li
- Key Laboratory of Bio-resources & Eco-environment of the Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, China
| | - Bao Liu
- Key Laboratory of Bio-resources & Eco-environment of the Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, China
| | - Ariel Kushmaro
- Avram and Stella Goldstein-Goren Department of Biotechnology Engineering, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Yuqing Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodonics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qun Sun
- Department of Food Science and Technology, College of Light Industry, Textile and Food Engineering, Sichuan University, Chengdu, China
- Key Laboratory of Bio-resources & Eco-environment of the Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, China
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Megha S, Shalini G, Varsha SA, Abhishek D, Neetu J. Effect of Short-Term Placebo-Controlled Consumption of Probiotic Yoghurt and Indian Curd on the Streptococcus mutans Level in Children Undergoing Fixed Interceptive Orthodontic Therapy. Turk J Orthod 2019; 32:16-21. [PMID: 30944895 DOI: 10.5152/turkjorthod.2019.18016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 08/05/2018] [Indexed: 11/22/2022]
Abstract
Objective To examine the effect of short-term consumption of probiotic yoghurt, Indian curd, and ultra-heated yoghurt as placebo on the levels of salivary and plaque Streptococcus mutans (S. mutans) in children undergoing fixed interceptive orthodontic therapy. Methods A placebo-controlled double-blind study was carried out in a total of 30 children (8-15 years). The S. mutans level in the plaque and saliva were taken at the baseline and 2 weeks after the initiation of fixed orthodontic treatment by Dentocult SM kits. An equal number of participants randomized in three groups were asked to ingest 200 g of yoghurt containing Lactobacillus acidophilus La-1 and La-2 (>1×109 cfu/mL) once daily, Indian curd, or ultra-heated control yoghurt without viable bacteria and were followed for the S. mutans level after 2 weeks. Results A significant reduction in salivary S. mutans levels was recorded after probiotic yoghurt ingestion (p=0.001) in addition to a reduction in the plaque S. mutans, which was observed after Indian curd consumption (p=0.026). Conclusion Our findings suggest that short-term daily consumption of probiotic yoghurt along with Indian curd may help to reduce the levels of S. mutans in the saliva and plaque in children undergoing interceptive fixed orthodontic therapy.
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Affiliation(s)
| | - Garg Shalini
- Sudha Rustagi College of Dental Sciences and Research, Faridabad, India
| | - Singh A Varsha
- Department of Microbiology, M. M. College of Medical Sciences and Research, Maharishi Markandeshwar University, Mullana, India
| | - Dhindsa Abhishek
- Department of Pediatric and Preventive Dentistry, Swami Devi Dyal Hospital and Dental College, Barwala, India
| | - Jain Neetu
- Department of Pediatric and Preventive Dentistry, M. M. College of Dental Sciences and Research, Maharishi Markandeshwar University, Mullana, India
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Ahmedbeyli DR, Seyidbekov OS, Dirikan IS, Mamedov FY, Ahmedbeyli RM. [Efficacy of probiotic application in the treatment and prevention of peri-implant mucositis]. STOMATOLOGIIA 2019; 98:20-24. [PMID: 31513143 DOI: 10.17116/stomat20199804120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The aim of this study was to evaluate the effectiveness of probiotics in the treatment and prevention of peri-implant complications. Clinical, immunological and microbiological studies were conducted before, 1 and 6 months after the periodontal treatment in 42 patients (120 implants) with peri-implant mucositis. The use of probiotics in the treatment of peri-implant mucositis led to a significant and more pronounced improvement in oral health state in terms of an increased functional activity of the salivary glands, local immunity factors and microbiocenosis.
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Affiliation(s)
- D R Ahmedbeyli
- Aziz Aliyev Azerbaijani State Advanced Training Institute for Doctors, Baku, Azerbaijan
| | - O S Seyidbekov
- Aziz Aliyev Azerbaijani State Advanced Training Institute for Doctors, Baku, Azerbaijan
| | | | - F Yu Mamedov
- Azerbaijani Medical University, Baku, Azerbaijan
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Nadelman P, Magno MB, Masterson D, da Cruz AG, Maia LC. Are dairy products containing probiotics beneficial for oral health? A systematic review and meta-analysis. Clin Oral Investig 2018; 22:2763-2785. [PMID: 30298454 DOI: 10.1007/s00784-018-2682-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 10/01/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To evaluate the effect of probiotic containing in dairy products on oral and salivary parameters. MATERIAL AND METHODS Electronic searches were performed based on the PICO criteria. Randomized controlled trials in adults/children (P) in which dairy products containing probiotics (I) were compared to controls (C) for establishment of oral health (O) were included. Risk of bias and data extraction were performed. The meta-analysis evaluated the influence of probiotics on Streptococcus mutans (SM), Lactobacillus spp. (LB), and yeast counts, plaque index, and salivary pH. Random or fixed effect models were used, and heterogeneity was tested. RESULTS Thirty-two studies were included in the qualitative synthesis, and 24 in the meta-analysis. For dichotomous results, individuals who consumed probiotics exhibited decreased scores in SM concentrations (RD 0.15 [0.02, 0.28] p = 0.03, I2 = 70%), but no change was observed for LB (RD 0.10 [- 0.03, 0.23] p = 0.13, I2 = 94%), or yeast levels (RD 0.05 [- 0.02, 0.12] p = 0.7, I2 = 48%). For continuous analysis, both probiotic and control groups presented similar results for SM and LB (MD - 0.55 [- 1.16, 0.07] p = 0.08, I2 = 62%, and RD 0.10 [- 0.03, 0.23] p = 0.13, I2 = 94%, respectively). The consumption of probiotics increased salivary pH (MD 0.20 [0.04, 0.35] p = 0.01, I2 = 46%) and plaque index (MD 0.38 [0.11, 0.65] p = 0.005, I2 = 0%). The probiotic milk reduced SM (MD - 0.59 [- 0.96, - 0.22] p = 0.002, I2 = 0%), and the probiotic yogurt decreased LB counts (RD 0.35 [0.19, 0.51] p < 0.0001, I2 = 0%). CONCLUSIONS In general, dairy probiotics were effective in reducing SM, increasing salivary pH, and promoting a higher plaque index. Liquid matrices, such as milk and yogurt, seem to be more effective in reducing SM and LB levels. CLINICAL RELEVANCE Consumption of dairy products containing probiotics could be a supporting method in caries prevention.
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Affiliation(s)
- Patricia Nadelman
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco, 325, Cidade Universitária, Rio de Janeiro, RJ, 21941-617, Brazil
| | - Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco, 325, Cidade Universitária, Rio de Janeiro, RJ, 21941-617, Brazil
| | - Daniele Masterson
- Central Library of the Health Science Center, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Adriano Gomes da Cruz
- Ciência e Tecnologia do Rio de Janeiro (IFRJ), Departamento de Alimentos, Instituto Federal de Educação, Rua Senador Furtado, 171, Maracanã, Rio de Janeiro, RJ, 20270-021, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco, 325, Cidade Universitária, Rio de Janeiro, RJ, 21941-617, Brazil.
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12
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Jiang Q, Kainulainen V, Stamatova I, Korpela R, Meurman JH. Lactobacillus rhamnosus GG in Experimental Oral Biofilms Exposed to Different Carbohydrate Sources. Caries Res 2018; 52:220-229. [PMID: 29353279 DOI: 10.1159/000479380] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 07/04/2017] [Indexed: 12/31/2022] Open
Abstract
Probiotic administration may favour caries prevention, as recent research has shown. This in vitro study aimed to investigate the growth of Lactobacillus rhamnosus GG (LGG) in experimental biofilms exposed to various carbohydrates, and also to assess its cariogenic potential. Multispecies experimental oral biofilms with or without LGG were grown with a sole-carbohydrate source (fructose/glucose/lactose/sorbitol/sucrose). The viable cells of LGG and structure of the biofilms were examined after 64.5 h of incubation, and pH values of spent media were measured at 16.5, 40.5, and 64.5 h. Fermentation profiles of LGG in biofilm media were assessed with study carbohydrate as the sole energy source. Our results showed that LGG reached higher viable cell numbers with glucose and sucrose in 64.5-h multispecies experimental oral biofilms compared to other carbohydrates. When LGG was incorporated in biofilms, no distinct pH changes at any time points were observed under any of the carbohydrates used; the pH values of spent media at each time point were lower when lactose was used, compared to other carbohydrates. The fermentation profiles of LGG in biofilm media were similar to its growth in MRS (no obvious growth with lactose or sucrose). In conclusion, LGG in our in vitro multispecies experimental oral biofilms was capable of surviving and growing well in each carbohydrate source. LGG might not have harmful effects on dental hard tissues. Another finding from our study was that the lowest pH values were observed in the presence of lactose, and the thickest biofilms were in sucrose.
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Affiliation(s)
- Qingru Jiang
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Mahasneh SA, Mahasneh AM. Probiotics: A Promising Role in Dental Health. Dent J (Basel) 2017; 5:E26. [PMID: 29563432 PMCID: PMC5806962 DOI: 10.3390/dj5040026] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 08/21/2017] [Accepted: 08/24/2017] [Indexed: 12/15/2022] Open
Abstract
Probiotics have a role in maintaining oral health through interaction with oral microbiome, thus contributing to healthy microbial equilibrium. The nature and composition of any individual microbiome impacts the general health, being a major contributor to oral health. The emergence of drug resistance and the side effects of available antimicrobials have restricted their use in an array of prophylactic options. Indeed, some new strategies to prevent oral diseases are based on manipulating oral microbiota, which is provided by probiotics. Currently, no sufficient substantial evidence exists to support the use of probiotics to prevent, treat or manage oral cavity diseases. At present, probiotic use did not cause adverse effects or increased risks of caries or periodontal diseases. This implicates no strong evidence against treatment using probiotics. In this review, we try to explore the use of probiotics in prevention, treatment and management of some oral cavity diseases and the possibilities of developing designer probiotics for the next generation of oral and throat complimentary healthcare.
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Affiliation(s)
- Sari A Mahasneh
- School of Dental Medicine, The University of Manchester, Manchester, M13 9PL, UK.
| | - Adel M Mahasneh
- Department of Biological Sciences, The University of Jordan, Amman 11942, Jordan.
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Seminario-Amez M, López-López J, Estrugo-Devesa A, Ayuso-Montero R, Jané-Salas E. Probiotics and oral health: A systematic review. Med Oral Patol Oral Cir Bucal 2017; 22:e282-e288. [PMID: 28390121 PMCID: PMC5432076 DOI: 10.4317/medoral.21494] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 01/17/2017] [Indexed: 12/14/2022] Open
Abstract
Background Probiotics are microorganisms, mainly bacteria, which benefit the host’s health. Many studies support the role of probiotics as a contributor to gastrointestinal health, and nowadays many authors are trying to prove its influence in oral health maintenance. Objectives To review the published literature with the purpose of knowing the importance of using probiotics as a preventive and therapeutic method for oral infectious diseases management. Material and Methods An electronic search in PubMed database with the keywords “oral health AND probiotics AND dentistry” was conducted. The inclusion criteria were: randomized clinical trials (RCTs) that assess the action of any probiotic strain in the treatment and / or prevention of an infectious oral disease, RCTs that assess the action of any probiotic strain on counting colony forming units (CFU) of oral pathogens, systematic reviews and meta-analysis. The Jadad scale was used to assess the high quality of RCTs. Results Fifteen articles were considered for this review. Of which, 12 were RCTs of good / high quality (Jadad scale), two meta-analysis and one systematic review. Conclusions The literature reviewed suggests probiotics usage could be beneficial for the maintenance of oral health, due to its ability to decrease the colony forming units (CFU) counts of the oral pathogens. However, randomized clinical trials with long-term follow-up periods are needed to confirm their efficacy in reducing the prevalence/incidence of oral infectious diseases. Furthermore, the recognition of specific strains with probiotic activity for each infectious oral disease is required, in order to determine exact dose, treatment time and ideal vehicles. Key words:Probiotics, periodontal diseases, dental caries, oral health.
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Affiliation(s)
- M Seminario-Amez
- Department of Odontostomatology - School of Dentistry, Pabellón de Gobierno - Bellvitge University Campus, C/Feixa LLarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain,
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Jørgensen MR, Kragelund C, Jensen PØ, Keller MK, Twetman S. Probiotic Lactobacillus reuteri has antifungal effects on oral Candida species in vitro. J Oral Microbiol 2017; 9:1274582. [PMID: 28326154 PMCID: PMC5328390 DOI: 10.1080/20002297.2016.1274582] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 12/14/2016] [Accepted: 12/16/2016] [Indexed: 12/18/2022] Open
Abstract
Background: An alternative approach for managing Candida infections in the oral cavity by modulating the oral microbiota with probiotic bacteria has been proposed. Objective: The aim was to investigate the antifungal potential of the probiotic bacterium Lactobacillus reuteri (DSM 17938 and ATCC PTA 5289) against six oral Candida species (C. albicans, C. glabrata, C. krusei, C. tropicalis, C. dubliniensis, and C. parapsilosis).
Design: The lactobacilli were tested for their ability to co-aggregate with and inhibit the growth of the yeasts assessed by spectrophotometry and the agar overlay inhibition assay. Additionally, the pH was evaluated with microsensors, and the production of hydrogen peroxide (H2O2) by the lactobacilli was verified. Results: Both L. reuteri strains showed co-aggregation abilities with the yeasts. The lactobacilli almost completely inhibited the growth of C. albicans and C. parapsilosis, but did not affect C. krusei. Statistically significant differences in co-aggregation and growth inhibition capacities between the two L. reuteri strains were observed (p<0.001). The pH measurements suggested that C. krusei can resist the acids produced by the lactobacilli. Conclusions:L. reuteri exhibited antifungal properties against five of the six most common oral Candida species. Further, the results reconfirms that the probiotic capacity of L. reuteri is strain specific.
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Affiliation(s)
- Mette Rose Jørgensen
- 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
| | | | - Mette Kirstine Keller
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen , Denmark
| | - Svante Twetman
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen , Denmark
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Yousuf A, Sidiq M, Ganta S, Nagaraj A, Vishnani P, Jan I. Effect of Freeze Dried Powdered Probiotics on Gingival Status and Plaque Inhibition: A Randomized, Double-blind, Parallel Study. Contemp Clin Dent 2017; 8:116-121. [PMID: 28566862 PMCID: PMC5426143 DOI: 10.4103/ccd.ccd_836_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: The study aimed to evaluate the effectiveness of freeze dried powdered probiotics on gingival status and plaque inhibition among 12–15-year-old schoolchildren. Materials and Methods: This randomized controlled trial was conducted among 12–15-year-old schoolchildren in Jaipur. Commercially available freeze dried probiotics containing Lactobacillus acidophilus, Bifidobacterium longum, Bifidobacterium bifidum and Bifidobacterium lactis (Prowel, Alkem Laboratories), lactic acid bacillus only (Sporolac, Sangyo), and a placebo powder calcium carbonate 250 g (Calcium Sandoz, Novartis) were assigned to two intervention groups and a placebo group each comprising 11 schoolchildren. All subjects were instructed to mix the powder in 30 ml of water and swish once daily for 3 min, for 3 weeks. Periodontal clinical parameters were assessed by examining the subjects for Turesky-Gilmore-Glickman plaque index (PI) (Modification of Quigley-Hein PI) and gingival index at baseline, 7th day, 14th day, and 21st day. Results: For both the probiotic groups, a statistically significant reduction (P < 0.05) in gingival status and plaque inhibition was recorded up to 2nd week of probiotic ingestion. However, no significant difference was observed in the placebo group. Conclusion: The use of probiotic mouth rinses improves the oral health in children by significantly reducing the plaque and gingival scores. Further studies are warranted to prove or refute the long-term effects, means of administering probiotics and the dosages needed to achieve different preventive or therapeutic purposes.
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Affiliation(s)
- Asif Yousuf
- Department of Public Health Dentistry, Government Dental College, Srinagar, Jammu and Kashmir, India
| | - Mohsin Sidiq
- Department of Pedodontics and Preventive Dentistry, Government Dental College, Srinagar, Jammu and Kashmir, India
| | - Shravani Ganta
- Department of Public Health Dentistry, Jaipur Dental College, Jaipur, Rajasthan, India
| | - Anup Nagaraj
- Department of Public Health Dentistry, Jaipur Dental College, Jaipur, Rajasthan, India
| | - Preeti Vishnani
- Masters in Public Health (MPH) Student, Hamburg University of Applied Sciences, Hamburg, Germany
| | - Iram Jan
- Intern, Government Dental College, Srinagar, Jammu and Kashmir, India
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Hedayati-Hajikand T, Lundberg U, Eldh C, Twetman S. Effect of probiotic chewing tablets on early childhood caries--a randomized controlled trial. BMC Oral Health 2015; 15:112. [PMID: 26403472 PMCID: PMC4583156 DOI: 10.1186/s12903-015-0096-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 09/16/2015] [Indexed: 01/16/2023] Open
Abstract
Background To evaluate the effect of probiotic chewing tablets on early childhood caries development in preschool children living in a low socioeconomic multicultural area. Methods The investigation employed a randomized double-blind placebo-controlled design. The study group consisted of 138 healthy 2-3-year-old children that were consecutively recruited after informed parental consent. After enrollment, they were randomized to a test or a placebo group. The parents of the test group were instructed to give their child one chewing tablet per day containing three strains of live probiotic bacteria (ProBiora3®) and the placebo group got identical tablets without bacteria. The duration was one year and the prevalence and increment of initial and manifest caries lesions was examined at baseline and follow-up. All parents were thoroughly instructed to brush the teeth of their off-springs twice daily with fluoride toothpaste. Results The groups were balanced at baseline and the attrition rate was 20 %. Around 2/3 of the children in both groups reported an acceptable compliance. The caries increment (Δds) was significantly lower in the test group when compared with the placebo group, 0.2 vs. 0.8 (p < 0.05). The risk reduction was 0.47 (95 % CI 0.24–0.98) and the number needed to treat close to five. No differences were displayed between the groups concerning presence of visible plaque or bleeding-on-brushing. No side effects were reported. Conclusions The results suggested that early childhood caries development could be reduced through administration of these probiotic chewing tablets as adjunct to daily use of fluoride toothpaste in preschool children. Further studies on a possible dose–response relationship seem justified Trial registration ClinicalTrials.gov Identifier: NCT01720771. First received: October 31, 2012. Electronic supplementary material The online version of this article (doi:10.1186/s12903-015-0096-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Trifa Hedayati-Hajikand
- Public Dental Care Service, Scania Region, Sweden. .,Postgraduate Dental Education Center, Region Örebro län, Sweden.
| | | | | | - Svante Twetman
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Allé 20, 2200, Copenhagen, Denmark.
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