Background: Efficacy of mechanical debridement (MD) with adjunctive probiotic therapy (PT) in the treatment of peri-implant mucositis (PiM) in cigarette-smoking and never-smoking subjects remains uninvestigated.Purpose: The aim was to assess the efficacy of MD with adjunctive PT in the treatment of PiM in cigarette-smoking and never-smoking individuals.Materials and Methods: Patients with (group I) and without PiM (group II) were included. Demographic data was collected using a questionnaire. Treatment-wise, patients in groups I and II were subdivided into: (a) Patients that underwent MD with adjunct PT (using Lactobacillus reuteri); and (b) MD alone. In all groups, probing depth (PD), plaque index (PI), and bleeding on probing (BOP) were measured at baseline and compared after 3-and 6-months. Baseline peri-implant crestal bone levels were also measured. Sample-size estimation was performed, and statistical comparisons were done using one-way analysis of variance and Bonferroni post-hoc adjustment tests.P values under .05 were deemed significant.Results: Eighty individuals (group I: 40 cigarette-smokers and group II: 40 neversmokers) with PiM participated in this study. At all-time intervals, no significant difference in PD, PI, and BOP were observed in all patients in group I. At 3-months' follow-up, the differences in BOP (P < .05), and PI (P < .05) were significantly higher in group II that underwent MD + PT than MD alone. At 6-months' follow-up, there was no difference in the changes in BOP and PI among subjects that underwent MD with and without adjunct PT.Conclusion: On a short-term basis, MD with adjunct PT is more effectual in the treatment of PiM than MD alone in never-smokers. Cigarette-smoking compromises periimplant soft tissue healing following MD with or without adjunct PT. K E Y W O R D Sbleeding on probing, cigarette smoking, dental implant, inflammation, Lactobacillus reuteri, probiotics

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Background To evaluate the efficacy of probiotics in the treatment of gingivitis. Methods MEDLINE, EMBASE and CENTRAL were searched up to May 2019. Randomized controlled clinical trials (RCTs) and/or controlled clinical trials were considered. Studies consisting of ≥10 patients per group clinically diagnosed with gingivitis were selected that compared the efficacy of probiotics in any form with placebo. The primary outcome measure was bleeding on probing (BOP) and gingival index (GI), while the secondary outcome measure was plaque index (PI). Forest plots were created reporting weighted mean difference (WMD) of outcomes with 95% confidence intervals (CI). Results A total of 10 double‐blind placebo‐parallel RCTs were included. All studies showed that probiotic administration was effective in the treatment of gingivitis at follow‐up. The mean percentage of BOP ranged from 11.87% to 21.7% in the probiotics group and from 15% to 33% in the placebo groups at follow‐up, respectively. Considering the effects of Lactobacillus reuteri, the overall mean difference for GI (WMD = −0.48, 95% CI = −1.69 to 0.72, P = 0.42) and PI (WMD = 0.18, 95% CI = −0.23 to 0.61, P = 0.37) did not show any statistical significance between probiotic and placebo groups. Conclusions The outcomes of this review show weak evidence to support the use of probiotics in reducing inflammatory periodontal parameters in gingivitis. Significant heterogeneity and limited available data may reduce the impact of these conclusions.

BackgroundThe aim of this systematic review and meta‐analyses was to assess the quality of evidence and efficacy of antimicrobial photodynamic therapy (aPDT) and laser irradiation (LI) as an adjunct to open flap debridement (OFD) in the treatment of chronic periodontitis.MethodsElectronic searches were conducted in databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases) up to March 2019. Randomized clinical trials (RCTs) comparing clinical efficacy of either aPDT and/or LI, placebo, or no treatment were included. Primary outcomes included clinical attachment level (CAL), while secondary outcomes were reduction in probing depth (PD) and gingival recession (GR) depth. The weighted mean differences (WMD) of outcomes and 95% confidence intervals (CI) for each variable were calculated using random effect model.ResultsSix RCTs were included. For aPDT studies, the overall mean difference for CAL gain (WMD = −0.61, 95% CI = −1.22 to −0.016, P = .044) and PD reduction (WMD = −1.79, 95% CI = −3.44 to −0.14, P = .034) was significant between aPDT and OFD groups at follow‐up. No significant overall mean difference was observed for GR depth (WMD = 0.02, 95% CI = −0.75 to 0.79, P = .95). For LI studies, none of the clinical periodontal parameters including CAL gain (WMD = 0.23, 95% CI = −0.09 to 0.55, P = .159, Figure 3A), PD reduction (WMD = 0.31, 95% CI = −0.67 to 1.31, P = .52, Figure 3B) and GR depth (WMD = −0.34, 95% CI = −2.47 to 1.78, P = .74, Figure 3C) were found to be significant between LI and OFD groups at follow‐up.ConclusionWith the limited data available, only aPDT as an adjunct to OFD showed superior results for clinical periodontal parameters compared to OFD alone in the treatment of chronic periodontitis. Further RCTs are warranted in order to obtain robust conclusions with regard to laser therapy.

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