The aim of this randomised, placebo-controlled study was to evaluate the effects of the probiotic Lactobacillus reuteri Prodentis as an adjunct to scaling and root planing in chronic periodontitis patients. 30 chronic periodontitis patients were recruited and monitored clinically and microbiologically at baseline, 3, 6, 9 and 12 weeks after therapy start. All patients received one-stage full mouth disinfection and scaling and root planing before being randomly assigned to either two lozenges per day of Lactobacillus reuteri Prodentis (L. reuteri Prodentis, 2×10^8 CFU, n=15) or placebo (n=15).

By the end of the study 53% fewer sites in patients with deep pockets and supplemented by Lactobacillus reuteri Prodentis was in need for surgery compared to placebo (18.3% compared to 34.4%, p<0.019). A site was considered as in need for surgery if the pocket depth was ≥6 mm or ≥5 mm and bleeding.

Significantly less patients with deep pockets in need for surgery

pockets_in_need_of_surgery

After the intervention period it was also concluded that 67% of the patients in the placebo group fell into the high-risk category for disease progression, while the corresponding figure for patients supplemented by Lactobacillus reuteri Prodentis was 27% (p<0.027). In the published article the authors point out that these figures are comparable to what is reported in different studies using a combination of two different antibiotics as an adjunct to scaling and root planing.

At week 12 all clinical parameters were significantly reduced in both groups while there was significantly more pocket depth reduction (p<0.001) and attachment gain (p<0.007) in deep pockets in the group that had received Lactobacillus reuteri Prodentis.

Significantly larger reductions in P. gingivalis numbers (p<0.05) were found in the subgingival, supragingival and saliva samples in the group supplemented by Lactobacillus reuteri Prodentis over the study period compared to placebo.

Significantly more reduction of pocket depth with Lactobacillus reuteri Prodentis

reduction_of_pocket_depth

Significantly more attachment gain with Lactobacillus reuteriProdentis

attachment_gain

Conclusions
Oral administration of Lactobacillus reuteri Prodentis lozenges could be a useful adjunct to scaling and root planing in patients with chronic periodontitis.

 

Reference

Teughels W, Durukan A, Ozcelik O, Pauwels M, Quirynen M, Haytac MC. (2013) Clinical and microbiological effects of Lactobacillus reuteri probiotics in the treatment of chronic periodontitis: a randomized placebo-controlled study. J Clin Periodontol. 40:1025–1035. Open access: http://onlinelibrary.wiley.com/doi/10.1111/jcpe.12155/pdf

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