Download PDF
CC BY 4.0 · Eur J Dent 2020; 14(02): 281-287
DOI: 10.1055/s-0040-1709924
Original Article

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

Ahmed Alshareef
1   Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
,
Alaa Attia
1   Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
2   Faculty of Dentistry, Al-Azhar University, Assiut, Egypt
,
Mohammed Almalki
1   Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
,
Faisal Alsharif
1   Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
,
Ahmed Melibari
1   Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
,
Bassel Mirdad
1   Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
,
Ehab Azab
1   Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
,
Abdel-Rahman Youssef
1   Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
3   Department of Microbiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
,
Ahmed Dardir
1   Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
4   Faculty of Dentistry, Al-Ahram Canadian University, Giza Governorate, Egypt
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Objective The main purpose of this article was to evaluate the effect of probiotics used as an adjunctive to scaling and root planing (SRP) on the periodontal parameters and matrix metalloproteinase-8 (MMP-8) levels in gingival crevicular fluid (GCF) of chronic periodontitis patients.

Materials and Methods A total of 25 chronic periodontitis patients who completed the treatment course of 40 subjects, aged 25 to 58 years, participated in this study. They were categorized into two groups: the first group was treated by SRP while the second group was treated by SRP and probiotic lozenges twice a day for 30 days. All patients were evaluated clinically by measuring the plaque index, bleeding index (BI), pocket depth, clinical attachment loss, and immunologically by assaying GCF/MMP-8 at baseline and 30 days after periodontal management.

Results There was a significant improvement in periodontal parameters after SRP treatment with and without probiotic lozenges in both groups. However, there was a significant decrease in the BI (p = 0.05) in SRP and probiotic lozenges group after 30 days compared with SRP alone. In addition, there was a significant decrease in GCF/MMP-8 levels after 30 days in patients managed by SRP only (p = 0.017) compared with the baseline in both groups, whereas a highly significant decrease in patients treated by SRP and probiotics (p = 0.001).

Conclusion The current study suggested that the probiotics might have a beneficial effect on clinical and immunological outcomes in the management of chronic periodontitis patients. Further research is needed on a large-scale population and for a long recall time to confirm the response to probiotics as an adjunctive to SRP.

Keywords

probiotic lozenges - GCF/MMP-8 - chronic periodontitis - periodontal therapy


Publication History

Article published online:
21 May 2020

© .

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Kornman KS. Mapping the pathogenesis of periodontitis: a new look. J Periodontol 2008; 79 (08) (Suppl) 1560-1568
    CrossrefPubMedGoogle Scholar
  • 2 Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. Lancet 2005; 366 (9499) 1809-1820
    CrossrefPubMedGoogle Scholar
  • 3 Demmer RT, Papapanou PN. Epidemiologic patterns of chronic and aggressive periodontitis. Periodontol 2000 2010; 53: 28-44
    CrossrefPubMedGoogle Scholar
  • 4 Shaddox LM, Walker CB. Treating chronic periodontitis: current status, challenges, and future directions. Clin Cosmet Investig Dent 2010; 2 (02) 79-91
    CrossrefPubMedGoogle Scholar
  • 5 Fermin A. Carranza, Henrry H, Takei. Rationale for periodontal treatment. In: Carranza’s Clinical Periodontology. Amsterdam: Elsevier Saunders; 2014: 404-407, Chap. 34
    Google Scholar
  • 6 Loesche WJ, Grossman NS. Periodontal disease as a specific, albeit chronic, infection: diagnosis and treatment. Clin Microbiol Rev 2001; 14 (04) 727-752
    CrossrefPubMedGoogle Scholar
  • 7 Ikram S, Hassan N, Baig S, Borges KJJ, Raffat MA, Akram Z. Effect of local probiotic (Lactobacillus reuteri) vs systemic antibiotic therapy as an adjunct to non-surgical periodontal treatment in chronic periodontitis. J Investig Clin Dent 2019; 10 (02) e12393
    CrossrefPubMedGoogle Scholar
  • 8 Shimauchi H, Mayanagi G, Nakaya S. et al. Improvement of periodontal condition by probiotics with Lactobacillus salivarius WB21: a randomized, double-blind, placebo-controlled study. J Clin Periodontol 2008; 35 (10) 897-905
    CrossrefPubMedGoogle Scholar
  • 9 Fijan S. Microorganisms with claimed probiotic properties: an overview of recent literature. Int J Environ Res Public Health 2014; 11 (05) 4745-4767
    CrossrefPubMedGoogle Scholar
  • 10 Nishihara T, Suzuki N, Yoneda M. Hirofuji T Effects of Lactobacillus salivarius-containing tablets on caries risk factors: a randomized open-label clinical trial. BMC Oral Health 2014; 14: 110
    CrossrefPubMedGoogle Scholar
  • 11 Elavarasu S, Jayapalan P, Murugan T. Bugs that debugs: probiotics. J Pharm Bioallied Sci 2012; 4 (Suppl 2) S319-S322
    CrossrefPubMedGoogle Scholar
  • 12 Chapman CM, Gibson GR, Rowland I. Health benefits of probiotics: are mixtures more effective than single strains?. Eur J Nutr 2011; 50 (01) 1-17
    CrossrefPubMedGoogle Scholar
  • 13 Twetman S, Derawi B, Keller M, Ekstrand K, Yucel-Lindberg T, Stecksen-Blicks C. Short-term effect of chewing gums containing probiotic Lactobacillus reuteri on the levels of inflammatory mediators in gingival crevicular fluid. Acta Odontol Scand 2009; 67 (01) 19-24
    CrossrefPubMedGoogle Scholar
  • 14 Chatterjee A, Bhattacharya H, Kandwal A. Probiotics in periodontal health and disease. J Indian Soc Periodontol 2011; 15 (01) 23-28
    CrossrefPubMedGoogle Scholar
  • 15 Teughels W, Newman MG, Coucke W. et al. Guiding periodontal pocket recolonization: a proof of concept. J Dent Res 2007; 86 (11) 1078-1082
    Google Scholar
  • 16 Nunn ME. Understanding the etiology of periodontitis: an overview of periodontal risk factors. Periodontol 2000 2003; 32: 11-23
    CrossrefPubMedGoogle Scholar
  • 17 Leppilahti JM, Hernández-Ríos PA, Gamonal JA. et al. Matrix metalloproteinases and myeloperoxidase in gingival crevicular fluid provide site-specific diagnostic value for chronic periodontitis. J Clin Periodontol 2014; 41 (04) 348-356
    CrossrefPubMedGoogle Scholar
  • 18 Nędzi-Góra M, Górska R, Kostrzewa-Janicka J, Kowalski J. Concentration of MMP-8 and IL-1βin gingival crevicular fluid in patients with chronic and aggressive periodontitis. Cent Eur J Immunol 2017; 42 (04) 342-346
    PubMedGoogle Scholar
  • 19 Javed F, Ahmed HB, Saeed A, Mehmood A, Bain C. Whole salivary interleukin-6 and matrix metalloproteinase-8 levels in patients with chronic periodontitis with and without prediabetes. J Periodontol 2014; 85 (05) e130-e135
    CrossrefPubMedGoogle Scholar
  • 20 Liu KZ, Hynes A, Man A, Alsagheer A, Singer DL, Scott DA. Increased local matrix metalloproteinase-8 expression in the periodontal connective tissues of smokers with periodontal disease. Biochim Biophys Acta 2006; 1762 (08) 775-780
    PubMedGoogle Scholar
  • 21 Mouzakiti E, Pepelassi E, Fanourakis G, Markopoulou C, Tseleni-Balafouta S, Vrotsos I. The effect of smoking on the mRNA expression of MMPs and TIMP-1 in untreated chronic periodontitis patients: a cross-sectional study. J Periodontal Res 2011; 46 (05) 576-583
    PubMedGoogle Scholar
  • 22 O’Leary TJ, Drake RB, Naylor JE. The plaque control record. J Periodontol 1972; 43 (01) 38
    CrossrefPubMedGoogle Scholar
  • 23 Carter HG, Barnes GP. The Gingival bleeding index. J Periodontol 1974; 45 (11) 801-805
    CrossrefPubMedGoogle Scholar
  • 24 Ramfjord SP, Nissle RR, Shick RA. Cooper H Jr. Subgingival curettage versus surgical elimination of periodontal pockets. J Periodontol 1968; 39 (03) 167-175
    CrossrefPubMedGoogle Scholar
  • 25 Ebersole JL, Taubman MA. The protective nature of host responses in periodontal diseases. Periodontol 2000 1994; 5: 112-141
    CrossrefPubMedGoogle Scholar
  • 26 Gupta G. Probiotics and periodontal health. J Med Life 2011; 4 (04) 387-394
    PubMedGoogle Scholar
  • 27 Geier MS, Butler RN, Howarth GS. Inflammatory bowel disease: current insights into pathogenesis and new therapeutic options; probiotics, prebiotics and synbiotics. Int J Food Microbiol 2007; 115 (01) 1-11
    CrossrefPubMedGoogle Scholar
  • 28 Marco ML, Pavan S, Kleerebezem M. Towards understanding molecular modes of probiotic action. Curr Opin Biotechnol 2006; 17 (02) 204-210
    CrossrefPubMedGoogle Scholar
  • 29 Bustamante M, Oomah BD, Mosi-Roa Y, Rubilar M, Burgos-Díaz C. Probiotics as an adjunct therapy for the treatment of halitosis, dental caries and periodontitis. Probiotics Antimicrob Proteins 2019; 7 (Febrary) 1-10
    Google Scholar
  • 30 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 (03) 378-390
    CrossrefPubMedGoogle Scholar
  • 31 İnce G, Gürsoy H, İpçi SD, Cakar G, Emekli-Alturfan E, Yılmaz S. Clinical and biochemical evaluation of lozenges containing Lactobacillus reuteri as an adjunct to non-surgical periodontal therapy in chronic periodontitis. J Periodontol 2015; 86 (06) 746-754
    CrossrefPubMedGoogle Scholar
  • 32 Morales A, Gandolfo A, Bravo J. et al. Microbiological and clinical effects of probiotics and antibiotics on nonsurgical treatment of chronic periodontitis: a randomized placebo- controlled trial with 9-month follow-up. J Appl Oral Sci 2018; 26: e20170075
    PubMedGoogle Scholar
  • 33 Martin-Cabezas R, Davideau JL, Tenenbaum H, Huck O. Clinical efficacy of probiotics as an adjunctive therapy to non-surgical periodontal treatment of chronic periodontitis: a systematic review and meta-analysis. J Clin Periodontol 2016; 43 (06) 520-530
    CrossrefPubMedGoogle Scholar
  • 34 Szkaradkiewicz AK, Stopa J, Karpiński TM. Effect of oral administration involving a probiotic strain of Lactobacillus reuteri on pro-inflammatory cytokine response in patients with chronic periodontitis. Arch Immunol Ther Exp (Warsz) 2014; 62 (06) 495-500
    CrossrefPubMedGoogle Scholar
  • 35 Kinane DF, Darby IB, Said S. et al. Changes in gingival crevicular fluid matrix metalloproteinase-8 levels during periodontal treatment and maintenance. J Periodontal Res 2003; 38 (04) 400-404
    CrossrefPubMedGoogle Scholar
  • 36 Kurgan Ş, Fentoğlu Ö, Önder C. et al. The effects of periodontal therapy on gingival crevicular fluid matrix metalloproteinase-8, interleukin-6 and prostaglandin E2 levels in patients with rheumatoid arthritis. J Periodontal Res 2016; 51 (05) 586-595
    CrossrefPubMedGoogle Scholar