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Oral Health


Peri-Implant Mucositis and Peri-Implantitis

Reference

Alqahtani F, 2021 Pakistan

Study Objectives

To compare the efficay of L. reuteri Prodentis with antibiot ics as an adjunct to mechanical debridement in the treatment of peri-implant mucositis. Primary outcomes were plaque index, bleeding on probing, probing depth and crestal-bone-loss, recorded at baseline and at 3-and 6-months follow-up.

Study Design*

R, Open Lr: 21 days Antibiotics: 7 days

No. of Subjects (dose)

1) MD + L. reuteri (4×108 CFU)
2) MD + antibiotics
3) MD

Results

At 3 months, peri-implant plaque index, bleeding on probing and probing depth were significantly lower in the probiotic group compared to the placebo group. However, at 6 months no differences were seen between the groups.

Reference

Alqahtani F 2019 Pakistan

Study Objectives

To evaluate the effect of L. reuteri Prodentis as adjuvant to mechani cal debridement (MD) in the treat ment of peri-implant mucositis in smoking and non-smoking patients.

Study Design*

R, open 3 weeks + follow-up at 3- and 6 months

No. of Subjects (dose)

80 in total. 40 smokers and 40 non-smokers L. reuteri (2 tabl/d): 40 (20 in each group) (4×108 CFU)

Results

In non-smokers, the mean pocket depth, plaque index and bleeding on probing were significantly lower in the subjects that received L. reuteri Prodentis as adjunct to MD, compared to those who received MD alone at the 3 months’ follow-up. At the 6 months’ follow-up, there were no sign differences between the groups. In smokers, there were no significant dif ferences at any of the time points.

Reference

Peña M, 2019 Spain

Study Objectives

To evaluate the additional effect of L. reuteri Prodentis after mecha nical debridement and 0.12% chlorhexidine in the treatment of peri-implant mucositis, compared to mechanical debridement and chlorhexidine alone.

Study Design*

R, DB, PC 1 month + 3 months follow-up

No. of Subjects (dose)

L. reuteri: 25 (2×108 CFU) Placebo: 25

Results

The administration of L. reuteri did not provide any additional effect on clinical or microbiological parameters after treat ment with mechanical debridement and 0.12% chlorhexidine.

Reference

Galofré M, 2018 Spain

Study Objectives

To evaluate the clinical and micro biological effect of L. reuteri Prodentis as adjuvant to non- surgical mechanical therapy in implants with mucositis or peri implantitis.

Study Design*

R, DB, PC 1 month + 2 months follow-up

No. of Subjects (dose)

L. reuteri: : 22 (2×108 CFU) Placebo: 22

Results

L. reuteri significantly decreased probing pocket depth in implants with mucositis or peri-implantitis. In addition, blee ding on probing decreased in implants with peri-implantitis, and general bleeding on probing in patients with mucositis. L. reuteri had limited effect on the peri-implant microbiota, although a significant decrease of was found in implants with mucositis.

Reference

Tada H, 2018 Japan

Study Objectives

To evaluate the effect of L. reuteri Prodentis, as an adjunct to antibiot ics, on clinical and microbiological parameters in patients with mild to moderate peri-implantitis.

Study Design*

R, DB, PC 6 months

No. of Subjects (dose)

L. reuteri : 15 (2×108 CFU) Placebo: 15

Results

• L. reuteri significantly reduced modified bleeding index compared to placebo
• Significant improvements in probing pocket depth in the L. reuteri group, but not in the placebo group
• No significant differences in bleeding on probing. However, number of patients with high bleeding on probing scores were fewer in the L. reuteri group
• No significant differences in bacterial numbers

Reference

Hallström H, 2016 Sweden

Study Objectives

To investigate if L. reuteri Prodentis, administered as oil and lozenges, has any additive effect to mechanical treatment on clinical parameters, microbiota and cre vicular fluid around implants with peri-implant mucositis, in adults 24-85y old

Study Design*

R, DB, PC 3 months Topical oil was applied at the baseline clea ning session, the subjects thereafter used the study lozenges

No. of Subjects (dose)

L. reuteri (2 tabl): 22 (4×108 CFU) Placebo (2 tabl): 24 Follow-up at 6 mo.

Results

L. reuteri did not add any benefit to conventional therapy in this study: all clinical variables improved over a 6-month period in both groups.
The study groups harboured low-to-moderate levels of the main pathogens associated with periodontitis, and a single topical application of L. reuteri Prodentis oil, followed by a daily oral administration of lozenges, did not affect the profile of the subgingival microbiota.
The levels of inflammatory mediators IL-1β, IL-8, CCL5 and TNF-α were reduced by 40–50% compared with baseline after 4 weeks in both groups, with no difference between them.

Reference

Flichy- Fernández AJ, 2015 Spain

Study Objectives

To assess clinical and immune sys tem effects of L. reuteri Prodentis in edentulous adult patients with tooth implants, comparing a group with healthy implants to a group with peri-implant mucositis at one or more implants.

Study Design*

R, DB, PC crossover 1 mo. with active product, follo wed by 7 mo. of washout period, then 1 mo. with placebo pro duct and 7 mo. of follow-up

No. of Subjects (dose)

A) L. reuteri + healthy implants (1 tabl): 22 (2×108 CFU)

B) L. reuteri + peri implant mucositis (1 tabl): 12

Results

After 1 month with L. reuteri Prodentis, the decreases in plaque, probing depth, gingival index and crevicular fluid were signi ficantly greater than with placebo in both group A and B. The effects were, however, more pronounced in group B, who had peri-implant mucositis.
The pro-inflammatory immune parameters IL-1β, IL-6 and IL-8 were all improved after the probiotic supplementation, but to a greater extent in the peri-implantitis group.

Reference

Flichy- Fernández AJ, 2012 (abstract) Spain

Study Objectives

Effect of L. reuteri Prodentis lozenges on counts of periodontal pathogens in adults with 1-2 dental implants and in comparison with teeth in the same individual.

Study Design*

R, DB, PC, crossover 28 days per product

No. of Subjects (dose)

30 in total L. reuteri: 30 (2×108 CFU) Placebo: 30

Results

Compared to placebo the counts of P. gingivalis, T. denticola and of total bacterial load were significantly reduced in dental implants. In the teeth there was a significant reduction in counts of T. forsythia, T. denticola and total bacterial load.

Reference

Ata-Ali J, 2012 (abstract) Spain

Study Objectives

Effect of L. reuteri Prodentis lozenges on counts of periodontal pathogens at dental implants in smoking and non-smoking adults.

Study Design*

Open 28 days

No. of Subjects (dose)

54 in total, 37 non smokers and 17 smokers L. reuteri: 54 (2×108 CFU)

Results

In both smokers and non-smokers L. reuteri reduced the counts of T. forsythia, P. gingivalis and T. denticola at the implants.
A. actinomycetemcomitans was not detected in any group. Total bacterial load was reduced in non-smokers but not in smokers.