Clinical Significance
It is questionable as to whether probiotics have any benefit in the treatment or prevention of periodontal disease based on current evidence. More studies are needed to determine the efficacy of probiotics in
InquiryProbiotics and periodontal disease
Section snippets
Background
The two general stages of periodontal disease are gingivitis and periodontitis. The differences between the two are that gingivitis is gingival inflammation with no loss of connective tissue attachment and periodontitis is gingival inflammation with loss of connective tissue attachment and resorption of coronal parts of tooth supporting alveolar bone. Plaque bacteria are essential in the development of both conditions. Efforts to improve periodontal therapies using complementary treatments are
Methods
The literature searches included the MEDLINE, Embase, and Cochrane databases as well as selected articles reporting randomized clinical trials comparing probiotics to placebo or other interventions for periodontal disease in adults. Four randomized clinical trials met the criteria and were reviewed.
Results
The probiotics studied were Lactobacillus salivarius, Lactobacillus reuteri, and Lactobacillus casei. The effects of the probiotics were measured in terms of probing pocket depth (PPD), clinical attachment loss (CAL), plaque index (PI), gingival inflammation (GI), bleeding on probing (BOP), and adverse side effects. The two trials assessing PPD found a statistically significant benefit of probiotics for smokers and when probiotics were combined with sealing and root planning, but no significant
Discussion
The available evidence does not clearly indicate that probiotics are effective, with different trials having varying outcomes. The primary indicator of periodontal disease, PPD, specifically demonstrated no clinically relevant beneficial effect for most patients.
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Yanine N, Araya I, Brignardello-Petersen R, et al: Effects of probiotics in periodontal diseases: A systematic review. Clin Oral Invest 17:1627-1634, 2013.
Reprints available from N Yanine, Dept of Maxillofacial Surgery, School of Dentistry, Universidad de Chile, Sergio Livingstone 943 Independencia, Santiago, Chile; e-mail: [email protected]
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