20 November 2019

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Probiotics in periodontology and their effectiveness

Lara Figini

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Scaling and root planing (SRP) is the gold standard for the treatment of periodontitis. However, treated sites are subject to recolonization with a microbiota similar to that present before therapy. Given the limitations of SRP in the treatment of periodontitis adjuvant therapies as antibiotic therapy, antimicrobial photodynamic therapy, and probiotic therapy have been proposed. The World Health Organization (WHO) defined probiotics as "live microorganisms that, which when administered in adequate amounts confer a health benefit on the host”.

Materials and Methods
In a randomized controlled clinical study published on Journal of Clinical Periodontology, the authors evaluated the effect of the administration of probiotics containing Bifidobacterium animalis subsp. lactis (B. lactis) and HN019 as adjuvant to scaling and root-planing (SRP) in patients with generalized chronic periodontitis.
Forty-one patients with chronic periodontitis were recruited and monitored clinically, immunologically and microbiologically at baseline  (before SRP) and 30 and 90 days after SRP.
All patients were randomly assigned to one of two groups:
- Test Group (SRP + Probiotics n = 20) o
- Control Group (SRP + Placebo, n = 21).
The probiotic lozenges were used twice a day for 30 days. The data were statistically analyzed.

Results
The Test group presented a decrease in probing pocket depth and a clinical attachment gain significantly higher than those of the Control group at 90 days. The Test group also demonstrated significantly fewer periodontal pathogens of red and orange complexes, as well as lower pro-inflammatory cytokine levels when compared to the Control group. Only the Test group showed an increase in the number of B. lactis HN019 DNA copies on subgingival biofilm at 30 and 90 days.

Conclusions
By the date of this study, which have to be confirmed with other similar studies, it can be concluded that the use of B. lactis HN019 as an adjunct to SRP promotes additional clinical, microbiological, and immunological benefits in the treatment of chronic periodontitis.

Clinical implications
The administration of B. lactis HN019 as an adjunct to scaling and root-planing may reduce the need for additional periodontal therapies after non-surgical treatment of chronic periodontitis.

For additional informations:  Effects of Bifidobacterium probiotic on the treatment of chronic periodontitis: A randomized clinical trial.

Italian version: http://www.odontoiatria33.it/parodontologia/18017/probiotici-in-parodontologia-e-loro-efficacia.html