Do probiotic offer opportunities to manipulate the periodontal oral microbiota?

Department of Periodontology, Research Group for Microbial Adhesion, Catholic University Leuven, Leuven, Belgium.
Journal Of Clinical Periodontology (Impact Factor: 4.01). 03/2011; 38 Suppl 11(Suppl. 11):159-77. DOI: 10.1111/j.1600-051X.2010.01665.x
Source: PubMed


As in other fields of healthcare, probiotics have been introduced for prevention and treatment of periodontal diseases.
This review was initiated to explore whether the use of probiotics can influence the periodontal microbiota and periodontal health.
Literature on the mode of action of oral probiotics was reviewed and a systematic review was performed on the microbiological and clinical effects of oral probiotics on periodontal health.
Three animal and 11 in vivo human studies were retrieved. Six studies reported on microbiological effects whereas eight studies report on clinical effects. Seven studies were performed on healthy or gingivitis patients and four studies on periodontitis patients. Many of the retrieved studies are pilot in nature and with low quality. The high degree of heterogeneity between studies hampered analysis.
Taking into consideration all limitations, the currently available data indicate an effect of probiotics on the oral microbiota and a more limited effect on clinical periodontal outcome measures. However, there is an urgent need for properly conducted clinical trials where probiotics are used as adjuncts to standard periodontal care, similar to antibiotics, using probiotic strains with, at least at an in vitro level, proven periodontal probiotic effects.

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    • "[56] Other host modulatory therapies Probiotics Probiotics have demonstrated significant potential as therapeutic options for a variety of disease as they have been known to modulate cytokine secretion profiles, influence T-lymphocyte populations, protect against physiologic stress, and enhance intestinal epithelial cell function and antibody secretion. [57] Recently, Teughels et al. (2011) explored the use of probiotics in influencing the periodontal microbiota and periodontal health and concluded that probiotics might offer opportunities to manipulate the oral microbiota, and periodontal health by either direct microbiological interactions or by immunomodulatory interactions. [58] Periodontal vaccines George Hajishengallis reported that toll like receptors (TLRs) may offer novel targets for host-modulation therapy in periodontitis since manipulation of TLR signalling may contribute to control of infection or regulation of inflammation and, moreover, synthetic or natural TLR agonists could serve as novel periodontal vaccine adjuvants. "
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    ABSTRACT: Traditionally, only antimicrobials have been used as the chemotherapeutic modality for the treatment of periodontitis. Though bacteria are the primary etiologic factors of periodontal diseases, yet the extent and severity of tissue destruction seen in periodontitis is determined by the host immuno-inflammatory response to these bacteria. This increasing awareness and knowledge of the host-microbial interaction in periodontal pathogenesis has presented the opportunity for exploring new therapeutic strategies for periodontitis by means of targeting host response via host-modulating agents. This has lead to the emergence of the field of "Perioceutics" i.e. the use of parmacotherapeutic agents including antimicrobial therapy as well as host modulatory therapy for the management of periodontitis. These host-modulating agents used as an adjunct tip the balance between periodontal health and disease progression in the direction of a healing response. In this article the host-modulating role of various systemically and locally delivered perioceutic agents will be reviewed.
    Journal of Indian Society of Periodontology 05/2014; 18(3):282-8. DOI:10.4103/0972-124X.134559
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    • "Despite this, the clinical results showed a clinically relevant benefit for the patient as " risk for disease progression " and " need for additional surgery " outcome measures were significantly better when L. reuteri lozenges were used as an adjunct to SRP. It needs to be emphasized that these results cannot be generalized to other probiotic products or modes of application (Teughels et al. 2011). "
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    ABSTRACT: The aim of this randomized placebo-controlled clinical trial was to evaluate the effects of Lactobacillus reuteri-containing probiotic lozenges as an adjunct to scaling and root planing (SRP). Thirty chronic periodontitis patients were recruited and monitored clinically and microbiologically at baseline, 3, 6, 9 and 12 weeks after therapy. All patients received one-stage full-mouth disinfection and randomly assigned over a test (SRP + probiotic, n = 15) or control (SRP + placebo, n = 15) group. The lozenges were used two times a day for 12 weeks. At week 12, all clinical parameters were significantly reduced in both groups, while there was significantly more pocket depth reduction (p < 0.05) and attachment gain (p < 0.05) in moderate and deep pockets; more Porphyromonas gingivalis reduction was observed in the SRP + probiotic group. The results indicate that oral administration of L. reuteri lozenges could be a useful adjunct to SRP in chronic periodontitis.
    Journal Of Clinical Periodontology 11/2013; 40(11):1025-35. DOI:10.1111/jcpe.12155 · 4.01 Impact Factor
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    • "Probiotics have been found to be efficacious in the treatment of halitosis, oral candidiasis and tooth decay [11]. Probiotics have also been introduced in the field of periodontal healthcare and they have been found to be efficacious in the treatment of gingivitis and periodontitis [11]. "
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    ABSTRACT: Introduction: The purpose of the present study was to evaluate the effect of a probiotic (Inersan®) alone, a combination of the probiotic with doxycycline and doxycycline alone on aggressive periodontitis patients. Methods: Thirty patients who satisfied the inclusion and exclusion criteria, were assigned to one of the above mentioned three groups by using block randomization. The clinical and the microbiological parameters were recorded on day 0, at 2 weeks and at 2 months. On day 0, before recording the clinical parameters, 0.5 ml of unstimulated saliva was collected for the evaluation of the microbiological parameters. The clinical parameters which were recorded were the plaque index, the gingival index, the probing pocket depth and the clinical attachment level. The microbiological parameters which were recorded were Lactobacilli and Aggregatibacter actinomycetemcomitans. After this, Scaling and Root Planing (SRP) was performed on day 0. Two weeks after the SRP, the patients were recalled for the saliva sample collection and for the evaluation of the clinical parameters. On the same day, medications were given to the patients to be taken for fourteen days according to the group which they belonged to (Group A - probiotic alone, Group B - a combination of the probiotic with doxycycline, Group C - doxycycline alone). The patients were then recalled at two months for the saliva sample collection and for the evaluation of the clinical parameters. Results: The administration of the probiotic alone, a combination of the probiotic with doxycycline and doxycycline alone, resulted in a decrease in the plaque index, the gingival index, the probing pocket depth and the clinical attachment level at 2 months, which was statistically significant (p < 0.05). The A. actinomycetemcomitans count tended to decrease in all the three groups at 2 months, which was statistically non-significant (p > 0.05). The Lactobacilli count tended to increase significantly in the probiotic alone group (p < 0.05). Conclusion: Probiotics have a future in the treatment of aggressive periodontitis, as antibiotics are prescribed most of the time. These antibiotics can lead to the emergence of drug resistant micro-organisms and they can also disturb the beneficial microflora of the body. Thus, as an alternative to antibiotics, probiotics can be used, as they repopulate the beneficial microflora and reduce the pathogenic bacteria.
    03/2013; 7(3):595-600.
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