Probiotic supplements and debridement of peri-implant mucositis: a randomized controlled trial

Acta Odontol Scand. 2016;74(1):60-6. doi: 10.3109/00016357.2015.1040065. Epub 2015 May 8.

Abstract

Objective: The aim of this double-blind randomized placebo-controlled trial was to evaluate the effects of probiotic supplements in adjunct to conventional management of peri-implant mucositis.

Materials and methods: Forty-nine adult patients with peri-implant mucositis were consecutively recruited after informed consent. After initial mechanical debridement and oral hygiene instructions, the patients received a topical oil application (active or placebo) followed by twice-daily intake of lozenges (active or placebo) for 3 months. The active products contained a mix of two strains of Lactobacillus reuteri. Patients were clinically monitored and sampled at baseline and after 1, 2, 4, 12 and 26 weeks. The clinical end-points were pocket-probing depth (PPD), plaque index (PI) and bleeding on probing (BOP). In addition, the subgingival microbiota was processed with checkerboard DNA-DNA hybridization and samples of gingival crevicular fluid (GCF) were analyzed for selected cytokines with the aid of multiplex immunoassays.

Results: After 4 and 12 weeks, all clinical parameters were improved in both the test and the placebo group. PPD and BOP were significantly reduced compared with baseline (p < 0.05), but no significant differences were displayed between the groups. The clinical improvements persisted 3 months after the intervention. No major alterations of the subgingival microflora were disclosed and the levels of inflammatory mediators in GCF did not differ between the groups.

Conclusions: Mechanical debridement and oral hygiene reinforcement resulted in clinical improvement of peri-implant mucositis and a reduction in cytokine levels. Probiotic supplements did not provide added benefit to placebo.

Keywords: Cytokines; gingival crevicular fluid; lactobacilli; lozenges; subgingival bacteria.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bacteria / classification
  • Cytokines / analysis
  • Dental Implants*
  • Dental Plaque Index
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Gingival Crevicular Fluid / chemistry
  • Humans
  • Inflammation Mediators / analysis
  • Limosilactobacillus reuteri
  • Male
  • Middle Aged
  • Mucositis / microbiology
  • Mucositis / therapy*
  • Oral Hygiene / education
  • Periodontal Debridement / methods*
  • Periodontal Index
  • Periodontal Pocket / therapy
  • Placebos
  • Probiotics / therapeutic use*
  • Young Adult

Substances

  • Cytokines
  • Dental Implants
  • Inflammation Mediators
  • Placebos