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Ausenda F, Barbera E, Cotti E, Romeo E, Natto ZS, Valente NA. Clinical, microbiological and immunological short, medium and long-term effects of different strains of probiotics as an adjunct to non-surgical periodontal therapy in patients with periodontitis. Systematic review with meta-analysis. JAPANESE DENTAL SCIENCE REVIEW 2023; 59:62-103. [PMID: 36915665 PMCID: PMC10006838 DOI: 10.1016/j.jdsr.2023.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 01/25/2023] [Accepted: 02/05/2023] [Indexed: 03/07/2023] Open
Abstract
Introduction/objectives Probiotics have been proposed as adjuncts to non-surgical periodontal therapy (NSPT), however, the effect of their use remains unclear. The aim of this systematic review and meta-analysis was to analyze the evidence regarding the use of probiotics as an adjunct to NSPT in patients with periodontitis at a clinical, microbiological and immunological level. Data/sources A comprehensive search to identify clinical studies investigating the use of probiotics as an adjunct to NSPT in patients treated for periodontitis was performed. The data were grouped according to probiotic strain, frequency, form and duration of the probiotic intake. Study selection A total of 25 articles were included, all articles analysed clinical parameters, 10 included also microbiological findings and only 4 had immunological findings. The difference in probing depth (PD) between the test and the control group was statistically significant in favour of the test group when the probiotics were in the form of lozenges, administered twice a day and when the strain was L. reuteri. In terms of Clinical Attachment Level (CAL) gain the difference was statistically significant in the short and in the medium term but not in the long term. Due to the heterogeneity of the data, it was not possible to compare trough a meta analysis the immunological and the microbiological findings that were therefore analysed only descriptively. Conclusions The use of probiotics as an adjunct to NSPT in patients with periodontitis appears to provide additional clinical benefits that depend on the duration, the frequency, the form and the strain of probiotic used. Clinical significance This review not only shows data on the efficacy of probiotics in non-surgical periodontal therapy, but provides important information on their effects over time and which forms of probiotic administration might be most clinically useful.
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Affiliation(s)
- Federico Ausenda
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan, Italy
- Department fo Periodontology, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Emanuele Barbera
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan, Italy
| | - Elisabetta Cotti
- School of Dental Medicine, Department of Surgical Sciences, Faculty of Medicine and Surgery, University of Cagliari, Cagliari, Italy
| | - Eugenio Romeo
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan, Italy
| | - Zuhair S Natto
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nicola Alberto Valente
- Division of Periodontology, School of Dental Medicine, Department of Surgical Sciences, Faculty of Medicine and Surgery, University of Cagliari, Cagliari, Italy
- Correspondence to: Cittadella Universitaria snc, Blocco I, Facoltà di Medicina e Chirurgia, Università di Cagliari, Monserrato, CA, Italy.
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Balan P, Belibasakis G, Ivanovski S, Bostanci N, Seneviratne CJ. Community dynamics of subgingival microbiome in periodontitis and targets for microbiome modulation therapy. Crit Rev Microbiol 2023; 49:726-738. [PMID: 36260510 DOI: 10.1080/1040841x.2022.2133594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/24/2022] [Accepted: 09/29/2022] [Indexed: 11/03/2022]
Abstract
The microbial aetiology for periodontitis has been widely studied and deciphered for more than a century. The evolving and changing concepts about periodontal microbiology can be attributed to continuously developing laboratory techniques. The current sequencing platforms have not only expanded the catalog of periodontal pathogens but have also facilitated the understanding of functional interactions of the ecological framework. However, the translation of this new knowledge to advance periodontal therapeutics is minimal. We contend that novel clinical interventions directed beyond conventional therapies need to be emphasized. A clear understanding of the structural and functional dynamics of subgingival microbiota is a pre-requisite for developing any microbiome-based interventions for applications in periodontal health care. In this review, we discuss the 16 s-rRNA gene sequencing-based knowledge of the subgingival microbial community structure, its interactions and functions, and our perspective on the potential to engineer it for periodontal therapeutics. Harnessing this next-generation sequencing-based knowledge, microbiome modulation therapies are poised to change microbiome therapeutics' face.
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Affiliation(s)
- Preethi Balan
- Singapore Oral Microbiomics Initiative, National Dental Research Institute Singapore, National Dental Center, Singapore, Singapore
- Oral Health Academic Clinical Program, Duke NUS Medical School, Singapore, Singapore
| | | | - Saso Ivanovski
- School of Dentistry, University of Queensland, Queensland, Australia
| | - Nagihan Bostanci
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Chaminda Jayampath Seneviratne
- Singapore Oral Microbiomics Initiative, National Dental Research Institute Singapore, National Dental Center, Singapore, Singapore
- Oral Health Academic Clinical Program, Duke NUS Medical School, Singapore, Singapore
- School of Dentistry, University of Queensland, Queensland, Australia
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Gheisary Z, Mahmood R, Harri shivanantham A, Liu J, Lieffers JRL, Papagerakis P, Papagerakis S. The Clinical, Microbiological, and Immunological Effects of Probiotic Supplementation on Prevention and Treatment of Periodontal Diseases: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14051036. [PMID: 35268009 PMCID: PMC8912513 DOI: 10.3390/nu14051036] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/23/2022] [Accepted: 02/23/2022] [Indexed: 02/01/2023] Open
Abstract
(1) Background: Periodontal diseases are a global health concern. They are multi-stage, progressive inflammatory diseases triggered by the inflammation of the gums in response to periodontopathogens and may lead to the destruction of tooth-supporting structures, tooth loss, and systemic health problems. This systematic review and meta-analysis evaluated the effects of probiotic supplementation on the prevention and treatment of periodontal disease based on the assessment of clinical, microbiological, and immunological outcomes. (2) Methods: This study was registered under PROSPERO (CRD42021249120). Six databases were searched: PubMed, MEDLINE, EMBASE, CINAHL, Web of Science, and Dentistry and Oral Science Source. The meta-analysis assessed the effects of probiotic supplementation on the prevention and treatment of periodontal diseases and reported them using Hedge’s g standardized mean difference (SMD). (3) Results: Of the 1883 articles initially identified, 64 randomized clinical trials were included in this study. The results of this meta-analysis indicated statistically significant improvements after probiotic supplementation in the majority of the clinical outcomes in periodontal disease patients, including the plaque index (SMD = 0.557, 95% CI: 0.228, 0.885), gingival index, SMD = 0.920, 95% CI: 0.426, 1.414), probing pocket depth (SMD = 0.578, 95% CI: 0.365, 0.790), clinical attachment level (SMD = 0.413, 95% CI: 0.262, 0.563), bleeding on probing (SMD = 0.841, 95% CI: 0.479, 1.20), gingival crevicular fluid volume (SMD = 0.568, 95% CI: 0.235, 0.902), reduction in the subgingival periodontopathogen count of P. gingivalis (SMD = 0.402, 95% CI: 0.120, 0.685), F. nucleatum (SMD = 0.392, 95% CI: 0.127, 0.658), and T. forsythia (SMD = 0.341, 95% CI: 0.050, 0.633), and immunological markers MMP-8 (SMD = 0.819, 95% CI: 0.417, 1.221) and IL-6 (SMD = 0.361, 95% CI: 0.079, 0.644). (4) Conclusions: The results of this study suggest that probiotic supplementation improves clinical parameters, and reduces the periodontopathogen load and pro-inflammatory markers in periodontal disease patients. However, we were unable to assess the preventive role of probiotic supplementation due to the paucity of studies. Further clinical studies are needed to determine the efficacy of probiotic supplementation in the prevention of periodontal diseases.
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Affiliation(s)
- Zohre Gheisary
- Laboratory of Oral, Head and Neck Cancer—Personalized Diagnostics and Therapeutics, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada; (Z.G.); (R.M.); (A.H.s.)
| | - Razi Mahmood
- Laboratory of Oral, Head and Neck Cancer—Personalized Diagnostics and Therapeutics, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada; (Z.G.); (R.M.); (A.H.s.)
| | - Aparna Harri shivanantham
- Laboratory of Oral, Head and Neck Cancer—Personalized Diagnostics and Therapeutics, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada; (Z.G.); (R.M.); (A.H.s.)
| | - Juxin Liu
- Department of Mathematics and Statistics, College of Arts and Science, University of Saskatchewan, 106 Wiggins Road, Saskatoon, SK S7N 5E6, Canada;
| | - Jessica R. L. Lieffers
- College of Pharmacy and Nutrition, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada;
| | - Petros Papagerakis
- Laboratory of Precision Oral Health and Chronobiology, College of Dentistry, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada;
| | - Silvana Papagerakis
- Laboratory of Oral, Head and Neck Cancer—Personalized Diagnostics and Therapeutics, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada; (Z.G.); (R.M.); (A.H.s.)
- Correspondence: ; Tel.: +1-3069661960
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Schlagenhauf U, Jockel-Schneider Y. Probiotics in the Management of Gingivitis and Periodontitis. A Review. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.708666] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
In the management of intestinal health problems, the targeted use of probiotic microorganisms is a common therapeutic measure with a long-standing tradition. In clinical dentistry however, probiotics-based therapy is still a rather new and developing field, whose usefulness for the control of gingivitis and periodontitis has been questioned by recent meta-analyses and systematic reviews. The purpose of the subsequent descriptive review is to provide an introduction to the concept of probiotic microorganisms and their multifaceted health-promoting interactions with the human host and microbial competitors, followed by a detailed comparison of the results of available controlled clinical trials assessing the use of probiotics in the control of gingival and periodontal inflammations. It aims at contributing to a deeper understanding of the unique capabilities of probiotics to resolve chronic plaque-induced inflammation even in the absence of mechanical plaque control and will discuss how possible misconceptions about the rationale for using probiotics may have led to the present controversies about their usefulness as a therapeutic option.
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Silva GA, Moreira ALG, Silva PHF, Salvador SL, Casarin RCV, Vicente RM, Ferreira GC, Dos Santos JET, Furlaneto FAC, Messora MR. The use of probiotics can reduce the severity of experimental periodontitis in rats with metabolic syndrome: an immunoenzymatic and microtomographic study. J Periodontol 2021; 93:e1-e12. [PMID: 34374081 DOI: 10.1002/jper.21-0285] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/08/2021] [Accepted: 07/29/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND This study evaluated the effects of Bifidobacterium animalis subsp. lactis HN019 (B. lactis HN019) in the development of periodontitis (PE), associated or not with metabolic syndrome, (MS) in rats. METHODS 96 rats were grouped according to a food protocol: high-fat diet for induction of MS or standard diet for the control groups (C). They were subdivided into groups with (+) and without (-) PE, receiving (*) or not (**) probiotic (PROB): C -**, CP-*, PE+**, PEP+*, MS-**, MSP-*, MSPE+** and MSPEP+*. PROB administration started on the 8th week of the study and PE was induced on the 14th week by placing ligature on the animals' lower first molars. Euthanasia occurred in the 16th week. Biomolecular analyzes, immunoenzymatic assays, and microtomographic analyses were performed. The data obtained were analyzed statistically (p <0.05). RESULTS The PEP and MSPEP groups showed lower levels of alveolar bone loss when compared to the PE and MSPE groups, respectively (p <0.05). The immunoenzymatic analysis showed higher levels of interleukin (IL)-1β and a higher receptor activator of NF-kappaB ligand (RANKL)/ osteoprotegerin (OPG) ratio in the MSPE group when compared to the MSPEP group (p <0.05). The PEP group showed lower levels of tumor necrosis factor (TNF)-α and IL-6 when compared to the PE group. The use of PROB attenuated dyslipidemia parameters in animals with MS, with or without PE. CONCLUSION B. lactis HN019 reduced more significantly the severity of PE in rats with MS, modulating both systemic metabolic and immunoinflammatory parameters in periodontal tissues. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Giselle A Silva
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil
| | - André L G Moreira
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil
| | - Pedro H F Silva
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil
| | - Sérgio L Salvador
- Department of Clinical Analyses, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil
| | - Renato C V Casarin
- Department of Prosthodontics and Periodontics, School of Dentistry, Campinas State University, Piracicaba, São Paulo, Brazil
| | - Raphael M Vicente
- Department of Orthopedics and Anesthesiology, Ribeirao Preto Medical School, University of Sao Paulo - USP, Ribeirão Preto, São Paulo, Brazil
| | - Graziele C Ferreira
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil
| | - José E T Dos Santos
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil
| | - Flávia A C Furlaneto
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil
| | - Michel R Messora
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil
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