Retrospective Review of Oral Probiotic Therapy

Probiotics for oral health: a critical evaluation of bacterial strains

Oral health is critical for total body health and well-being; however, little improvement in oral health status has occurred in the U.S. over the past 20 years. Tooth decay and gum disease remain highly prevalent, with more than 90% and 50% of adults suffering from these conditions, respectively. To combat this lack of improvement, alternative approaches to dental care are now being suggested. One such alternative therapy is probiotics for oral care. In the oral cavity, probiotic strains have been shown to reduce levels of oral pathogens, inhibit the formation of dental caries, and reduce the levels of bacteria that cause halitosis. However, as the oral care probiotic market expands, many products contain bacterial species and strains with no documented health benefits leading to confusion and mistrust among consumers and clinicians. This confusion is enhanced by the regulatory status of probiotic products which puts the onus of safety and efficacy on the manufacturer rather than a central regulatory body. The overarching goal of this review is to provide consumers and clinicians with documented evidence supporting (or refuting) the health benefits of oral care probiotics marketed for sale in the United States. This includes defining what constitutes an oral care probiotic product and a strain level analysis of candidate probiotics from the genera Streptococcus, Lactobacillus, Bifidobacterium, and Bacillus. Additionally, prebiotics and postbiotics will be discussed. Finally, a set of considerations for consumers and clinicians is provided to empower probiotic product decision making. Together, this review will improve understanding of oral care probiotics marketed in the US for dental professionals and consumers.

Limosilactobacillus reuteri as an Adjuvant in the Treatment of Peri-implant Mucositis in Total Rehabilitation: An Exploratory Study

OBJECTIVES

 Mechanical debridement is the traditional method for the treatment of peri-implant mucositis (P-im) and its success depends on the patient's correct oral hygiene. It is believed that probiotics may help by their ability to modulate the oral biofilm, resulting in anti-inflammatory and antibacterial plaque action. The aim of this study was to evaluate the adjuvant effect of the probiotic Limosilactobacillus reuteri (LR) in the mechanical treatment of P-im.

MATERIALS AND METHODS

 This exploratory study included 29 subjects with implant-supported total rehabilitation and P-im, divided into test (TG) and control (CG) groups, equally subjected to professional mechanical debridement, with the administration of a daily GUM PerioBalance lozenge for 30 days added to the TG. The modified Plaque Index (mPlI) modified Sulcus Bleeding Index (mBI) and pocket depth (PD) were evaluated before the intervention (baseline) and 6 and 10 weeks later.

STATISTICAL ANALYSIS

 Parametric and nonparametric tests with 5% significance level were used in the statistical analysis, using IBM SPSS Statistics 27.0 software.

RESULTS

 Both treatments resulted in reduced mPlI, mBI, and PD at 6 weeks; while from 6 to 10 weeks there was an increase in mPlI and mBI and maintenance of PD. Compared with baseline, differences were close to statistical significance in the reduction in PD at 10 weeks in the CG (p = 0.018), after Bonferroni correction, and statistically significant in the mPlI at 6 weeks in the CG (p = 0.004) and in the TG (p = 0.002) as well as at 10 weeks in the TG (p = 0.016). Comparing the groups in the postintervention assessments, no statistically significant differences were found.

CONCLUSION

 LR adjuvant mechanical treatment of P-im does not show a clear benefit compared with mechanical treatment alone, with both interventions achieving similar clinical results. Further prospective and long-term studies are needed.

Evaluation of the antibacterial activity of Lactobacilli probiotics supernatants against Enterococcus faecalis (in-vitro study)

Background

There is an increasing demand to find a potent antibacterial agent against endodontic pathogens with the least toxic effect. The study aimed to evaluate the antibacterial activity of Lactobacilli probiotics on Enterococcus faecalis (E. faecalis) in comparison to calcium hydroxide paste.

Methods

The study involved two stages; (stage one): determination of the antibacterial properties of three strains of Lactobacilli probiotics supernatants (PS); Lactobacillus plantarum, Lactobacillus rhamnosus, Lactobacillus acidophilus, and a cocktail mix of the three supernatants against E. faecalis using agar well diffusion method in both solution and gel phase. The formed zones of inhibition (ZOI) were measured in millimeters (mm) and compared to each other. PS solution and gel of the largest ZOI were further compared with calcium hydroxide paste (35% Ultra Cal XS Ca(OH)₂) This was followed by (stage two): assessment of the minimum inhibitory concentration (MIC) of the PS that showed the largest ZOI against E. faecalis by agar well diffusion assay for both PS solution and gel.

Results

All supernatants showed growth inhibition against E. faecalis, and the cocktail mix showed the largest ZOI. However, no significant difference was found between the supernatants in both the solution and gel phases (p > 0.05). Ca(OH)₂ showed a significantly lower effect than both the cocktail mix solution and gel (p < 0.05). The MIC of the cocktail mix solution and gel against E. faecalis was 50 mg/ml. (p > 0.05).

Conclusion

PS has an antibacterial effect on E. faecalis and was more effective than Ca(OH)_2.Lactobacilli probiotics could be a promising antibacterial agent used as an irrigant or an intracanal medication.

The role of yogurt enriched with lactobacillus rhamnosus GG culture in dental caries prevention

Introduction/Objective. Contemporary tendencies suggest that probiotics can significantly reduce the prevalence of caries in children, so it can be considered that they have a positive effect on general and oral health. Lactobacillus rhamnosus GG (LGG) is a probiotic culture of particular importance in preventive dentistry. The aim was to assess the effects of consumption of probiotic strain Lactobacillus rhamnosus GG on the dental plaque accumulation in children with mixed dentition. Methods. Research included 90 children with mixed dentition (5-12 years old). First study group consumed 200 ml of Lactobacillus rhamnosus GG-enriched yogurt (B-Activ LGG, Dukat) daily for a period of 14 days, while the remaining 30 formed the second study group who consumed 200 ml of yogurt (Jogurt 1,5% milk fat, Imlek) with manually added powder from probiotic capsule (Wayaforte LGG capsule, Medis) daily for14 days. The control group consisted of 30 children who had regular diet during examination period. Silness-L?e plaque index and saliva pH (pH-Fix-0-14, Macherey-Nagel) were determined at baseline and also upon intervention completion. Results. An increase in pH values was observed in both study groups. In general sample, there is a significant decrease of mean plaque index values (p ? 0.001). Both study groups had significant decrease of mean plaque index values on the baseline and after 14 days consumption of yogurt. In the control group the number of subjects with decrease plaque index values did not correlate and no association was found. Conclusion. Consistent consumption of LGG culture-enriched yogurt inhibits dental film accumulation and promotes saliva pH increase in children with mixed dentition.