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Probiotic strains of Lactobacillus brevis and Lactobacillus plantarum as adjunct to non-surgical periodontal therapy: 3-month results of a randomized controlled clinical trial

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Abstract

Objectives

To determine if periodontitis patients benefit from treatment with Lactobacillus brevis and Lactobacillus plantarum strains, applied into periodontal pockets as gel and thereafter taken as lozenges, as an adjunct to scaling and root planing (SRP).

Materials and methods

In a double-blind, randomized, placebo-controlled trial, 40 patients received scaling and root planing (SRP) in two sessions within 7 days. Patients then received either probiotic gel and lozenges (n = 20) or placebo (n = 20). The primary outcome variable was the number of diseased sites (DS: PD > 4 mm + BOP) at the 3-month re-evaluation. The effects of gender, age, probiotic therapy, presence of Porphyromonas gingivalis or Aggregatibacter actinomycetemcomitans, smoking, tooth being a molar and interdental location were evaluated using a multivariate multilevel logistic regression model.

Results

The number of DS after 3 months was similar in the test (Me = 8, IQR = 5–11) and control (Me = 5, IQR = 1–10) groups. Both groups showed substantial but equivalent improvements in periodontal parameters. The logistic regression showed higher odds for the healing of gingival bleeding (OR = 2.12, p = 0.048) and lower odds for the healing of DS (OR = 0.51; p < 0.001) in the probiotic group.

Conclusions

Patients with periodontitis benefit from adjunctive use of probiotics containing L. brevis and L. plantarum in terms of reduction of gingival bleeding. However, adjunctive probiotics increase the number of persisting diseased sites with PD > 4 mm and BOP.

Clinical relevance

The adjunctive use of probiotics containing L. brevis and L. plantarum strains in treating chronic periodontitis results in a higher number of residual diseased sites when compared with SRP + placebo; its use is therefore unfounded.

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Funding

The study was supported by the Ministry of Science and Technology of the Republic of Slovenia, grant No. P3-0293. We thank to Mrs. Vanja Erčulj, PhD (RHO sigma, Ljubljana) for statistical analysis. Probiotic and placebo gel and lozenges were donated by CMS Dental, Copenhagen, Denmark. The authors have declared no conflicts of interest in connection with this article.

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Authors and Affiliations

  1. Public Health Centre, 2360, Radlje ob Dravi, Slovenia

    P. Pudgar

  2. Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana, Hrvatski trg 6, 1000, Ljubljana, Slovenia

    K. Povšič, K. Čuk, M. Petelin & R. Gašperšič

  3. Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, 1000, Ljubljana, Slovenia

    K. Seme

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Ethical approval

All procedures involving human participants were in accordance with the ethical standards of the 1964 Helsinki declaration and the Code of Medical Ethics of the Medical Association of Slovenia. The study protocol was reviewed by the National Medical Ethic Committee (No. 0120-365/2018/5) of the Republic of Slovenia. It was also registered at Clinicaltrials.gov (NCT04137419).

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Informed consent was obtained from all individual participants included in the study.

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Pudgar, P., Povšič, K., Čuk, K. et al. Probiotic strains of Lactobacillus brevis and Lactobacillus plantarum as adjunct to non-surgical periodontal therapy: 3-month results of a randomized controlled clinical trial. Clin Oral Invest 25, 1411–1422 (2021). https://doi.org/10.1007/s00784-020-03449-4

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