Effects of adjunctive light-activated disinfection and probiotics on clinical and microbiological parameters in periodontal treatment: a randomized, controlled, clinical pilot study

Abstract

Objectives The aim of this pilot study was to evaluate the clinical and microbiological outcomes of light-activated disinfection (LAD) alone or combined with probiotics as an adjunct to non-surgical periodontal treatment. Materials and methods In this single-blinded, randomized, controlled clinical pilot study, 48 patients (28 females and 20 males) with untreated periodontitis (stages II and III, grade B) were included. Using a parallel-group design, patients were randomly assigned into 3 groups to receive subgingival debridement (SD) alone (group 1, n = 16), SD with LAD (group 2, n = 16), or SD with LAD plus probiotic treatment (group 3, n = 16). Probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), gingiva-index simplified (GIs), plaque-control record (PCR), and subgingival microbiological samples were analyzed at baseline, 3 months, and 6 months of follow-up. Results All treatment modalities demonstrated clinical improvements in PPD and CAL at 6 months compared to baseline but without a statistical significant difference between the groups. The combination of SD + LAD + probiotic treatment (group 3) demonstrated significantly greater reductions in BOP, GIs, and red complex bacteria P. gingivalis and T. forsythia compared with other groups at 6 months (p < 0.05). Conclusions A single application of LAD as an adjunct to SD provided no additional clinical and microbiological benefits compared to SD alone. The combination of SD + LAD + probiotic treatment in group 3 led to further improvements of the inflammatory parameters. Clinical relevance The additional use of probiotics in periodontal treatment can be a useful approach to support inflammation and infection control of periodontal tissues. Further studies are necessary to determine the extent of added benefit for this treatment approach.

The Use of Probiotics as Adjuvant Therapy of Periodontal Treatment: A Systematic Review and Meta-Analysis of Clinical Trials

“…A total of 28 full-text articles were assessed for eligibility. Of these, 3 were not considered for the qualitative analysis because they were not clinical trials, and 25 articles were included in the qualitative analysis [ 1 , 2 , 3 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. Of these, four studies [ 6 , 25 , 26 , 29 ] were excluded from the meta-analysis because the mean and standard deviation could not be retrieved.…”

Evaluation of the Efficacy of Probiotics Domiciliary Protocols for the Management of Periodontal Disease, in Adjunction of Non-Surgical Periodontal Therapy (NSPT): A Systematic Literature Review

“…A total of 11 studies of the 67 remaining articles met the inclusion criteria [21][22][23][24][25][26][27][28][29][30][31]. The characteristics of the included studies are listed in Table 1.…”

“…The characteristics of the included studies are listed in Table 1. Among these studies, nine of them [21][22][23][25][26][27][29][30][31] were double-blind placebo-controlled RCTs and two studies [24,28] were placebo-controlled RCTs. The publication date of the articles ranged from 2018 to 2020.…”

“…Six studies [23,[26][27][28]30,31] used Lactobacillus reuterii probiotic; patients evaluated in two studies [21,22] were treated with Bifidobacterium animalis subsp. lactis; three studies [24,25,31] examined Lactobacillus brevis and Lactobacillus Plantarum; lastly, another study [29] used Lactobacillus rhamnosus. Six studies [21,22,24,27,29,31] have reported microbiological outcomes.…”

“…Table 2 shows the risk of bias in the selected studies. Patyna et al 2020 [25] (Chicago Work Shop-2017) diagnosis of periodontal disease, and only two cluded smoking subjects. All of them received NSPT treatment associated with domiciliary probiot or placebo therapy.…”