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http://dx.doi.org/10.5051/jpis.2004140207

Localized probiotic-guided pocket recolonization in the treatment of chronic periodontitis: a randomized controlled clinical trial  

Kumar, Vikram (Department of Periodontology, Faculty of Dental Sciences, King George's Medical University)
Singhal, Rameshwari (Department of Periodontology, Faculty of Dental Sciences, King George's Medical University)
Rastogi, Pavitra (Department of Periodontology, Faculty of Dental Sciences, King George's Medical University)
Lal, Nand (Department of Periodontology, Faculty of Dental Sciences, King George's Medical University)
Pandey, Shivani (Department of Periodontology, Faculty of Dental Sciences, King George's Medical University)
Mahdi, Abbas Ali (Department of Periodontology, Faculty of Dental Sciences, King George's Medical University)
Publication Information
Journal of Periodontal and Implant Science / v.51, no.3, 2021 , pp. 199-212 More about this Journal
Abstract
Purpose: This randomized clinical placebo-controlled trial was conducted to evaluate the effectiveness of Lactobacillus reuteri as a probiotic in guided pocket recolonization (GPR) for the treatment of chronic periodontitis (CP) adjunctive to scaling and root planing (SRP). Methods: Forty-eight CP patients were randomly assigned to 3 treatment groups: group 1 (SRP+placebo), group 2 (SRP+single application of probiotic), and group 3 (SRP+incremental application of probiotic). Clinical parameters were evaluated at baseline and at 8, 12, and 24 weeks, whereas biochemical parameters were measured at baseline and 12 weeks. Results: At 24 weeks, the probing pocket depth and clinical attachment level improved in all 3 groups from baseline with no significant intergroup differences; however, a statistically significant difference was observed in localized plaque and gingival scores between groups 1 and 3 (P<0.05). At 12 weeks, matrix metalloproteinase-8 (MMP-8), nitric oxide (NO), and gingipains-R (Rgps) levels improved in all 3 groups, with statistically significant differences between groups 1 and 3 for MMP-8 and NO (P<0.05), but no difference for Rgps levels. Conclusions: Within its limitations, the results of this study show that incremental 3-time application of L. reuteri as a probiotic led to improvements in clinical and biochemical parameters. This protocol can be a useful adjunct to SRP in the non-surgical management of CP.
Keywords
Gingipain cysteine endopeptidases; Matrix metalloproteinases; Nitric oxide; Periodontal pocket; Probiotics; Randomized controlled trial;
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