Oral Microbial Shift Following 1-Month Supplementation of Probiotic Chewable Tablets Containing Lactobacillus reuteri UBLRu-87 as an Adjunct to Phase 1 Periodontal Therapy in Chronic Periodontitis Patients: A Randomized Controlled Clinical Trial

Assessment of the Effectiveness of Probiotics-assisted Physical Interventions in the Management of Chronic Periodontitis: A Randomized Controlled Clinical Trial

Live micro-ecological agents, such as probiotics, have demonstrated a significant role in the preservation of human health, encompassing oral health maintenance and regulation of oral microbiota. Here, a total of 20 patients diagnosed with chronic periodontitis were recruited and randomly assigned into two cohorts based on completion of physiotherapy: a placebo group (n = 10) and a probiotic group (n = 10). The actual efficacy was assessed by administering chewable tablets (5 × 109 CFU/tablet) containing the probiotics Lactobacillus salivarius LS97, Lactobacillus paracasei LC86, and Lactobacillus acidophilus LA85 to patients with chronic periodontitis. For the placebo group, chewable tablets without probiotics were administered, while maintaining consistency with the rest of the ingredients used in the probiotic group. Saliva and plaque samples were collected at different time points (0, 1, and 3 months) and subjected to 16S amplicon sequencing for microbial structure analysis. Salivary IgA content was determined using enzyme immunoassay, whereas clinical chronic periodontal pocket depth (PD) and bleeding on probe index (BOP +) were employed to evaluate the actual efficacy of probiotic-assisted physiological intervention in chronic periodontitis treatment. Compared to the placebo group, the probiotic intervention resulted in a significant increase in salivary IgA levels among patients, accompanied by a notable decrease in PD and BOP + levels. Furthermore, the probiotic intervention led to a substantial reduction in Fusobacterium and Porphyromonas counts, while significantly increasing Lactobacillus abundance within the dental plaque microbiota of patients. Importantly, no significant alterations were observed in the overall structure of both salivary and dental plaque microbiota following the probiotic intervention. The administration of this live probiotic agent consistently and significantly enhances the oral immune response in patients with chronic periodontitis, thereby augmenting the effectiveness of physical interventions for this condition. Moreover, it effectively reduces the abundance of pathogenic microbes associated with chronic periodontitis without causing substantial alterations to the salivary and dental plaque microbiota composition. Trial registration: Chinese Clinical Trial Registry (ChiCTR) ( https://www.chictr.org.cn ) under the registration number ChiCTR2300074108.

Therapeutic Strategies and Genetic Implications for Periodontal Disease Management: A Systematic Review

The objective of this review is to identify the microbiological alterations caused by various therapy modalities by critically analyzing the current findings. We limited our search to English-language papers published between 1 January 2004 and 7 May 2024 in PubMed, Scopus, and Web of Science that were relevant to our topic. In the search approach, the Boolean keywords "microbio*" AND "periodontitis" were used. A total of 5152 papers were obtained from the databases Web of Science (2205), PubMed (1793), and Scopus (1154). This resulted in 3266 articles after eliminating duplicates (1886), and 1411 entries were eliminated after their titles and abstracts were examined. The qualitative analysis of the 22 final articles is included in this study. Research on periodontal disease shows that periodontitis alters the oral microbiome and increases antibiotic resistance. Treatments like scaling and root planing (SRP), especially when combined with minocycline, improve clinical outcomes by reducing harmful bacteria. Comprehensive mechanical debridement with antibiotics, probiotics, EMD with bone grafts, and other adjunctive therapies enhances periodontal health. Personalized treatment strategies and advanced microbial analyses are crucial for effective periodontal management and antibiotic resistance control.

Lactobacillus reuteri for chronic periodontitis: focus on underlying mechanisms and future perspectives

Chronic periodontitis is a common oral disorder caused by pathogenic bacteria. Despite the wide use of antibiotics as the conventional adjunctive treatment, the challenges of increased antibiotic resistance and limited therapeutic effect receive considerable attention and the developments of alternative treatments gain increasing consideration. Growing evidence showed that Lactobacillus reuteri (LR) may represent a promising alternative adjunct for chronic periodontitis. It can attenuate inflammation and reduce tissue disruption. LR-assisted treatment has been shown to be effective and relatively safe in multiple clinical trials, and accumulating evidence suggests its significant biological roles. In the current review, we focus on capturing the underlying mechanisms of LR involved in chronic periodontitis, thereby representing a scientific foundation for LR-assisted therapy. Furthermore, we point out the challenges and future directions for further clinical trials to improve the clinical applicability for LR.

Mechanism and application of Lactobacillus in type 2 diabetes-associated periodontitis

Type 2 diabetes mellitus (T2DM) accelerates the progression of periodontitis through diverse pathways. Abnormal immune responses, excessive activation of inflammation, increased levels of advanced glycation end products, and oxidative stress have defined roles in the pathophysiological process of T2DM-associated periodontitis. Furthermore, in the periodontium of diabetic individuals, there are high levels of advanced glycation end-products and glucose. Meanwhile, progress in microbiomics has revealed that dysbacteriosis caused by T2DM also contributes to the progression of periodontitis. Lactobacillus, owing to its fine-tuning function in the local microbiota, has sparked tremendous interest in this field. Accumulating research on Lactobacillus has detailed its beneficial role in both diabetes and oral diseases. In this study, we summarize the newly discovered mechanisms underlying Lactobacillus-mediated improvement of T2DM-associated periodontitis and propose the application of Lactobacillus in the clinic.