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Oral Health


Periodontitis

Reference

Ghazal M, 2023 Pakistan

Study Objectives

To compare probiotics and an tibiotics as adjuvant treatment to NSPT in smokers with stage III periodontitis.

Study Design*

R, DB, PC 30 days Follow-up at 3 months

No. of Subjects (dose)

L. reuteri: 33 (4×108 CFU) Antibiotics: 33 (Amoxicillin and metro nidazole for 7 days)

Results

Significantly improved PD, BOP, PI and GI in both groups at the 3-month follow-up.

Reference

Laleman I, 2020 Belgium

Study Objectives

To evaluate the effect of L. reuteri Prodentis lozenges as an adjunct to mechanical debridement on residual pockets in patients with periodontitis.

Study Design*

R, DB, PC 12 weeks with follow-up at 24 weeks

No. of Subjects (dose)

L. reuteri (2 tabl/d): 20 (4×108 CFU) Placebo (2 tabl/d): 19

Results

At 24 weeks, the overall probing pocket depth in the L. reu teri Prodentis group was significantly lower compared to the placebo group (p=0.034). This difference was even more pro nounced in moderate (4-6mm) and deep (≥7mm) pockets.

Reference

Pelekos G, 2020 China

Study Objectives

Sub-analysis of data from a previous study evaluating the effect of L. reuteri Prodentis as an adjunct to Scaling and Root Surface Debridement (S/RSD). This study evaluated changes at molars with deep pockets (PPD≥5mm).

Study Design*

R, DB, PC 28 days

No. of Subjects (dose)

L. reuteri (2 tabl/d): 21 (4×108 CFU) Placebo (2 tabl/d): 20

Results

Compared to placebo, L. reuteri significantly improved CAL and conferred a higher probability of shallow residual pocket depth.

Reference

Grusovin MG, 2019 Italy

Study Objectives

Pilot study to evaluate the effect of L. reuteri Prodentis as an adjunct to Full Mouth Guided Biofilm Therapy (FM-GBT) in pa tients with severe and advanced forms of periodontitis (stage III and IV, grade C).

Study Design*

R, DB, PC 3 months + 3 months wash out + 3 months + 3 months washout (1 year in total)

No. of Subjects (dose)

L. reuteri: (2 tabl/d): 10 (4×108 CFU) Placebo (2 tabl/d): 10

Results

L. reuteri Prodentis significantly reduced mean probing pocket depth at all time-points (3, 6, 9, and 12 months), sites with BOP at 6 and 9 months, and increased probing attach ment level at 6 months, compared to placebo. No complications or adverse events were reported.

Reference

Teughels W, 2013 Turkey

Study Objectives

To evaluate the effects of L. reuteri Prodentis lozenges on clinical and microbiological parameters, as an adjunct to scaling and root planing (SRP) in adults with chronic periodontitis (mean age 46y).

Study Design*

R, DB, PC 12 weeks

No. of Subjects (dose)

L. reuteri (2 tabl/d): 15 (4×108 CFU) Placebo (2 tabl/d): 15

Results

At week 12, all clinical parameters were significantly reduced in both groups. Compared to placebo, subjects in the L. reuteri group showed significant effects on:
• More pocket depth reduction and attachment gain in moderate and deep pockets
• Number of subjects with a high and low risk for disease progression, respectively
• Number of subjects in need of surgery on ≥3 teeth
• Larger reduction in counts of Porphyromonas gingivalis in sub-, supragingival and saliva samples at 12 weeks

Reference

Vicario M, 2013 Spain

Study Objectives

Effect of short-term use of L. reuteri Prodentis lozenges on initial to moderate chronic periodontitis in non-smoking and otherwise healthy adults.

Study Design*

R, DB, PC 30 days

No. of Subjects (dose)

L. reuteri: 10 (2×108 CFU) Placebo: 9

Results

L. reuteri Prodentis significantly decreased:
• Plaque index
• Bleeding on probing
• Pocket probing depths of 5-6 mm and ≥6 mm All indices increased in the placebo group, although non significantly. No adverse effects were recorded in any of the groups.

Reference

Vivekananda MR, 2010 India

Study Objectives

To investigate the effect of L. reuteri Prodentis lozenges on chronic periodontitis, alone or in combination with scaling and root planing (SRP).

Study Design*

R, DB, PC Day 0-21 = SRP only, day 22-42 study product added

No. of Subjects (dose)

L. reuteri (2 tabl/d): 15 (4×108 CFU) Placebo (2 tabl/d): 15

Results

• L. reuteri Prodentis alone and in combination with SRP significantly inhibited chronic periodontitis inflammation, plaque formation and counts of oral pathogens
• The combined treatments significantly reduced clinical attachment level and probing pocket depth

Reference

Tekce M, 2015 Turkey

Study Objectives

Investigation of short- and long-term effects on clinical and microbiological parameters of L. reuteri Prodentis (Lr) as an adjunct to initial treatment with scaling and root planing in subjects with chronic peri odontitis, aged 35-50 years. The colonisation ability of L. reuteri in the periodontal pockets was also assessed.

Study Design*

R, DB, PC 3 weeks, with follow-up at days 21, 90, 180 and 360

No. of Subjects (dose)

L. reuteri (2 tabl/d): 20 (4×108 CFU) Placebo (2 tabl/d): 20

Results

Significant effects for L. reuteri Prodentis compared to placebo were shown as:
• Consistently greater reductions in pocket depths (primary outcome) from baseline to days 21, 90, 180 and 360
• Significantly fewer patients in need of surgery at day 360. The proportion of teeth in need of surgery at day 360 was 0.8% and 41.2%, respectively After one year, the total viable cell counts of bacteria and proportions of obligate anaerobes had returned to the baseline levels in both groups after initial significant reductions.
In the probiotic group Lr was found in subgingival pockets in 6 and 11 patients on day 21 and 90, respectively. All patients completed until follow-up at day 360, and with out any adverse reactions.

Reference

Ince G, 2015
(subgroup analysis of Tekce 2015 trial) Turkey

Study Objectives

Investigation of short- and long- term effects on clinical and micro-biological parameters of L. reuteri Prodentis (Lr) as an adjunct to initial treatment with scaling and root planing in sub jects with chronic periodontitis, aged 35-50 years.

Study Design*

R, DB, PC 3 weeks, with follow-up at days 21, 90, 180, 360

No. of Subjects (dose)

L. reuteri (2 tabl/d): 15 (4×108 CFU) Placebo (2 tabl/d): 15

Results

Compared to the placebo group, subjects in the L. reuteri Prodentis group had significant changes in the inflamma tion-associated markers in the gingival crevicular fluid up to day 180: there was a decrease in the level of MMP-8 (matrix metalloproteinases-8) and increase in the TIMP-1 (tissue in hibitor of metalloproteinases-1). For the clinical markers, the effect compared to placebo was sustained up to day 360.

Reference

Szkaradkie wicz AK, 2014 Poland

Study Objectives

To assess if supplementation with L. reuteri Prodentis (Lr) can improve clinical and inflamma tory parameters in subjects with moderate chronic periodontitis, aged 31-46y, and previously untreated for periodontitis.

Study Design*

Open.
Lr was admin. from two weeks (for an unknown period of time) after professional cleaning and tre atment to subjects with low response to the professional treatment. Sub jects with good clinical response at this time point remained as a control group.

No. of Subjects (dose)

L. reuteri (2 tabl/d): 24 (4×108 CFU) Control: 14

Results

18/24 (75%) of subjects given L. reuteri evaluated 2 weeks after stopping the use of the probiotic, had significant de crease in severity of periodontitis by the clinical measures bleeding on probing, pocket probing depth and clinical attachment level. The levels of the pro-inflammatory cyto kines TNF-α, IL-1β and IL-17 in the crevicular fluid were also significantly decreased in these 18 subjects.
The remaining 6 of the intervention group showed no response, and their levels of the different parameters were similar to the 14 control group subjects at the same time point.