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16.10.2019 | Original Article

Clinical efficacy of Lactobacillus reuteri-containing lozenges in the supportive therapy of generalized periodontitis stage III and IV, grade C: 1-year results of a double-blind randomized placebo-controlled pilot study

verfasst von: Maria Gabriella Grusovin, Simone Bossini, Stefano Calza, Veronica Cappa, Gianluca Garzetti, Eleonara Scotti, Enrico Felice Gherlone, Magda Mensi

Erschienen in: Clinical Oral Investigations | Ausgabe 6/2020

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Abstract

Objective

The aim of this 12-month mono-centre double-blind randomized placebo-controlled clinical study was to evaluate the efficacy of Lactobacillus reuteri-containing lozenges during the supportive therapy of generalized periodontitis stage III and IV, grade C (GPIII-IVC) patients.

Material and methods

Twenty treated GPIII-IVC patients were randomly divided into 2 groups. The test group received two 3-month-long administrations of L. reuteri (2 lozenges/day after brushing) with a 3-month washout period, while the control one received a placebo. Outcome measures were tooth survival, complications and adverse events, change in probing pockets depth (PPD), change in probing attachment level (PAL), presence of bleeding on probing (BOP) and patient’s evaluation of treatment. Measurements were collected at 3, 6, 9 and 12 months.

Results

At 1 year, no dropout, tooth loss, complications or adverse event were recorded. Mean PPD and mean PAL and percentages of sites with BOP were statistically improved (p < 0.05) compared with baseline in both groups, while more PPD reduction at all time points (p < 0.05) and more PAL gain at 6 months and more BOP reduction at 6 and 9 months were found in the probiotic group (p < 0.05).

Conclusions

Within the limitation of the study, the use of L. reuteri probiotics lozenges improved some clinical outcomes in treated GPIII-IVC patients during maintenance therapy. Studies with a larger number of patients are needed to confirm these data.

Clinical relevance

The use of L. reuteri probiotic lozenges could be considered as an adjunct in the maintenance therapy of GPIII-IVC patients.

Hu-Friedy, Chicago, IL, USA.

Tonetti MS, Chapple ILC (2011) on Behalf of Working Group 3 of the Seventh European Workshop on Periodontology. Biological approaches to the development of novel periodontal therapies – consensus of the Seventh European Workshop on Periodontology. J Clin Periodontol 2011 38(Suppl. 11):114–118. https://doi.org/10.1111/j.1600-051X.2010.01675.x CrossRef

Quirynen M, Vogels R, Pauwels M, Haffajee AD, Socransky SS, Uzel N, van Steenberghe D (2005) Initial subgingival colonization of “pristine” pockets. J Dent Res 83:340–344CrossRef

Teughels W, Newman MG, Coucke W, Haffajee AD, Van Der Mei HC, Haake SK, Schepers E, Cassiman JJ, Van Eldere J, van Steenberghe D, Quirynen M (2007) Guiding periodontal pocket recolonization: a proof of concept. J Dent Res 86:1078–1082CrossRefPubMed

Teughels W, Loozen G, Quirynen M (2011) Do probiotics offer opportunities to manipulate the periodontal oral microbiota? J Clin Periodontol 38 (Suppl. 1):158–176CrossRef

Schlundt J. (2001) Health and Nutritional Properties of Probiotics in Food including Powder Milk with Live Lactic Acid Bacteria. Report of a Joint FAO/WHO Expert Consultation on Evaluation of Health and Nutritional Properties of Probiotics in Food Including Powder Milk with Live Lactic Acid Bacteria (2001) [cited 2013 22 February]; Available from: http://www.who.int/foodsafety/ publications/fs_management/en/probiotics.pdf

Broekaert IJ, Walker WA (2006) Probiotics and chronic disease. J Clin Gastroenterol 40:270–274CrossRefPubMed

Jones SE (2009) Versalovic J (2009) Probiotic Lactobacillus reuteri biofilms produce antimicrobial and anti-inflammatory factors. BMC Microbiol 9:35. https://doi.org/10.1186/1471-2180-9-35 CrossRefPubMedPubMedCentral

Schaefer L, Auchtung TA, Hermans KE, Whitehead D, Borhan B, Britton RA (2010) The antimicrobial compound reuterin (3-hydroxypropionaldehyde) induces oxidative stress via interaction with thiol groups. Microbiology. 156(Pt 6):1589–1599. https://doi.org/10.1099/mic.0.035642-0 Epub 2010 Feb 11CrossRefPubMedPubMedCentral

Vivekananda MR, Vandana KL, Bhat KG (2010) Effect of the probiotic Lactobacilli reuteri (Prodentis) in the management of periodontal disease: a preliminary randomized clinical trial. J Oral Microbiol 2:1–10CrossRef

10.

Twetman, S., Derawi, B., Keller, M., Ekstrand,K. I. M., Yucel-lindberg, L. A. Y. & Steckse, C. (2009) Short-term effect of chewing gums containing probiotic Lactobacillus reuteri on the levels of inflammatory mediators in gingival crevicular fluid. Acta Odontol Scand 67, 19–24.

11.

Tekce M, Ince G, Gursoy H, Dirikan Ipci S, Cakar G, Kadir T, Yilmaz S (2015) Clinical and microbiological effects of probiotic lozenges in the treatment of chronic periodontitis: a 1-year follow-up study. J Clin Periodontol 2015. https://doi.org/10.1111/jcpe.12387 CrossRefPubMed

12.

Martin-Cabezas R, Davideau JL, Tenenbaum H, Huck O (2016) 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 43(6):520–530. https://doi.org/10.1111/jcpe.12545 Epub 2016 May 7CrossRefPubMed

13.

Ikram S, Hassan N, Raffat MA, Mirza S, Akram Z (2018) Systematic review and meta-analysis of double-blind, placebo-controlled, randomized clinical trials using probiotics in chronic periodontitis. J Investig Clin Dent e12338. https://doi.org/10.1111/jicd.12338 CrossRefPubMed

14.

Teughels W, Durukan A, Ozcelik O, Pauwels M, Quirynen M, Haytac Mehmet C (2013) Clinical and microbiological effects of Lactobacillus reuteri probiotics in the treatment of chronic periodontitis: a randomized placebo controlledstudy. J Clin Periodontol 40:1025 1035CrossRefPubMedCentral

15.

İnce G, Gürsoy H, İpçi ŞD, Cakar G, Emekli-Alturfan E, Yılmaz S (2015) Clinical and biochemical evaluation of lozenges containing Lactobacillus reuteri as an adjunct to nonsurgical periodontal therapy in chronic periodontitis. J Periodontol 86:746–754CrossRefPubMed

16.

Penala S, Kalakonda B, Pathakota KR et al (2016) Efficacy of local use of probiotics as an adjunct to scaling and root planing in chronic periodontitis and halitosis: a randomized controlled trial. J Res Pharm Pract 2016(5):86CrossRef

17.

Szkaradkiewicz AK, Stopa J, Karpiński TM (2014) 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 62:495–500CrossRef

18.

Vicario M, Santos A, Violant D, Nart J, Giner L (2013) Clinical changes in periodontal subjects with the probiotic Lactobacillus reuteri Prodentis: a preliminary randomized clinical trial. Acta Odontol Scand 71:813–819CrossRefPubMed

19.

Armitage GC (1999) Development of a classification system for periodontal diseases and conditions. Ann Periodontol 4(1):1–6CrossRefPubMed

20.

Caton JG, Armitage G, Berglundh T, Chapple ILC, Jepsen S, Kornman KS, Mealey BL, Papapanou PN, Sanz M, Tonetti MS (2018) A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. J Periodontol 89(Suppl 1):S1–S8. https://doi.org/10.1002/JPER.18-0157 CrossRefPubMed

21.

Claffey N (1995) Egelberg J (1995) Clinical indicators of probing attachment loss following initial periodontal treatment in advanced periodontitis patients. J Clin Periodontol 22:690–696CrossRefPubMed

22.

Lindhe Jan (1989) Examination of patients with periodontal disease. In Lindhe Jan Textbook of Clinical Periodontology. Blackwell Munksgaard, Copenhagen, Denmark, pp 316

23.

Mensi M, Dalè E, Sordillo A (2017) A new method for biofilm removal with erythritol powder guided by disclosing agent. Dental Cadmos 85(2):112–118CrossRef

24.

Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Lawrence Earlbaum Associates, Hillsdale, NJ

25.

Faul F, Erdfelder E, Lang A-G, Buchner A (2007) G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39:175–191CrossRefPubMed

26.

Liu GF, Lu K, Mogg R, Mallick M, Mehrotra DV (2009) Should baseline be a covariate or dependent variable in analyses of change from baseline in clinical trials? Stat Med 28:2509–2530CrossRefPubMed

27.

Baumer A, Pretzl B, Cosgarea R, Kim TS, Reitmeir P, EickholzP, Dannewitz B. (2011) Tooth loss in aggressive periodontitis after active periodontal therapy: patient-related and tooth-related prognostic factors. J Clin Periodontol 2011:38: 644–651.CrossRefPubMed

28.

Iwasaki K, Maeda K, Hidaka K, Nemoto K, Hirose Y, Deguchi S (2016) (2016) Daily intake of heat-killed Lactobacillus plantarum L-137 decreases the probing depth in patients undergoing supportive periodontal therapy. Oral Health Prev Dent 14(3):207–214. https://doi.org/10.3290/j.ohpd.a36099 CrossRefPubMed

29.

Teughels W, Van Essche M, Sliepen I, Quirynen M (2008) Probiotics and oral healthcare. Periodontol 48:111–147CrossRef

30.

Sacristan JA (2013) Patient-centered medicine and patient-oriented research: Improving health outcomes for individual patients. BMC Med Informat Dec Making 13:6 Salanti, G., Ades, A. E., & Ioannidis, J. P. (2011)CrossRef

31.

Gwaltney CJ (2010) Patient-reported outcomes (PROs) in dental clinical trials and product development: introduction to scientific and regulatory considerations. J Evidence Based Dent Pract Vol 10,Issue 2, pag.86–90CrossRefPubMed

32.

Smiley CJ, Tracy SL, Abt E, Michalowicz BS, John MT, Gunsolley J, Cobb CM, Rossmann J, Harrel SK, Forrest JL, Hujoel PP, Noraian KW, Greenwell H, Frantsve-Hawley J, Estrich C, Hanson N (2015) Evidence-based clinical practice guideline on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts. J Am Dent Assoc 146(7):525–535. https://doi.org/10.1016/j.adaj.2015.01.026 CrossRefPubMed

33.

Sgolastra F, Petrucci A, Gatto R, Monaco A (2012) Effectiveness of systemic amoxicillin/metronidazole as an adjunctive therapy to full-mouth scaling and root planing in the treatment of aggressive periodontitis: a systematic review and meta-analysis. J Periodontol 83(6):731–743. https://doi.org/10.1902/jop.2011.110432 CrossRefPubMed

34.

Shah MP, Gujjari SK, Chandrasekhar VS (2013) Evaluation of the effect of probiotic (inersan^®) alone, combination of probiotic with doxycycline and doxycycline alone on aggressive periodontitis - a clinical and microbiological study. J Clin Diagn Res 7(3):595–600. https://doi.org/10.7860/JCDR/2013/5225.2834

Titel: Clinical efficacy of Lactobacillus reuteri-containing lozenges in the supportive therapy of generalized periodontitis stage III and IV, grade C: 1-year results of a double-blind randomized placebo-controlled pilot study
verfasst von: Maria Gabriella Grusovin
Simone Bossini
Stefano Calza
Veronica Cappa
Gianluca Garzetti
Eleonara Scotti
Enrico Felice Gherlone
Magda Mensi
Publikationsdatum: 16.10.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Oral Investigations / Ausgabe 6/2020
Print ISSN: 1432-6981
Elektronische ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-019-03065-x

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Clinical efficacy of Lactobacillus reuteri-containing lozenges in the supportive therapy of generalized periodontitis stage III and IV, grade C: 1-year results of a double-blind randomized placebo-controlled pilot study