The authors found that periodontitis, which is usually treated with antibiotics, responded positively to the Lactobacillus reuteri probiotic species providing a viable alternative and lowering antibiotic resistance risk.
The antibiotics commonly used in periodontal treatment are penicillin, tetracycline, macrolide and metronidazole and microbiota of the oral cavity can act as a reservoir of antibiotic-resistant microorganisms, some of which are capable of causing disease.
Currently, in Europe, China, and the United States, periodontitis is reported to affect more than half of the adult population.
In ageing populations, the prevalence of periodontitis is even higher, with 70–90% of individuals aged between 60 and 74 suffering from the malady.
Review methodology
Researchers from the University of Strasbourg began by searching electronic databases up to July 2015.
Randomised controlled trials (RCTs) comparing scale and root planning (SRP) with probiotic treatment vs SRP were included.
A meta-analysis of these database results showed that the use of the probiotic supplement resulted in reduced values that measured the severity of periodontitis (PPD), improvements in measures of clinical manifestation and determinant of periodontal disease (CAL) and reduced bleeding on probing (BOP) in the short term.
“Certain probiotics could be used in combination with SRP for the management of chronic periodontitis, especially in case of deep pockets, with similar results to other adjunctive methods,” the authors noted.
The use of probiotics to accompany SRP has long been suggested as a better decontamination of the root surfaces alongside more first-line treatments such as antibiotics, antiseptics or photodynamic therapy.
Probiotic species such as Lactobacillius or Bifidobacterium are commonly used to treat diseases related to the gastrointestinal tract, as well as urogenital infections, eczema and oro-pharyngeal infections.
At the periodontal level, the application of probiotics in combination with SRP had been previously studied in animal models and produced evidence of delayed and reduced periodontopathogen recolonisation.
“The most described probiotic regarding CP treatment is L. reuteri, a bacterium able to produce an antimicrobial compound resistant to proteolytic and liplytic enzymes. L.reuteri has shown in vitro an inhibitory effect against periodontopathogenic bacteria,” the study observed.
Conflicting studies
While the influence of L. reuteri on the reduction of gingival inflammation and plaque accumulation had been evaluated in several studies, there were some discrepancies among the results.
One study concluded that L. reuteri reduced both gingivitis and plaque in patients with moderate to severe ginigivitis in 14 days. However, in another study no significant differences in plaque index (PI) or gingival index (GI) were found at 8 weeks between test and control groups
Source: Journal of Clinical Periodontology
Published online ahead of print, doi: 10.1111/jcpe.12545
“Clinical efficacy of probiotic as an adjunctive therapy to non-surgical periodontal treatment of chronic periodontitis: A systematic review and meta-analysis.”
Authors: Martin-Cabezas R, Davideau JL, Tenenbaum H, Huck O.