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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    • "Probiotics exert similar mechanisms in the mouth, as in other parts of the body, including competition with pathobionts and immunomodulation. These effects may be improved by the use of probiotics that are well adjusted to human oral ecology, together with pretreatment of the oral cavity with antibiotics to reduce the levels of indigenous oral microbiota (Teughels et al., 2011). "
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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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    • "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.
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