Effects of amine fluoride and probiotic mouthwash on levels of Porphyromonas gingivalis in orthodontic patients: A randomized controlled trial

Abstract

Introduction: Porphyromonas gingivalis is one among the major etiological agent in periodontal diseases and has been proved to cause gingival inflammation under orthodontic appliances. Aim: To assess the effect of amine fluoride and probiotic mouthwashes on levels of P. gingivalis during orthodontic treatment, using real time-polymerase chain reaction (RT-PCR). Materials and Methods: A randomised controlled trial was performed including 45 patients. There were three groups: Group A (control group), Group B (patients using Amflor mouthwash) and Group C (patients using probiotic mouthwash). During the treatment, all the 3 groups were advised to brush twice a day using Colgate tooth paste and Group B patients were advised to swish 15 ml fluoridated mouthwash (Amflor) and Group C advised to swish probiotic for 60 s before swallowing, once in the morning and once before sleep. After gently removing supragingival plaque, subgingival plaque samples were collected by inserting a sterile dental curette into the bottom of the gingival crevice around 31, 32, 41, and 42 at two different intervals: T1 at start and T2 after 6 months of fixed orthodontic treatment. Sub-gingival plaque samples collected were transferred to laboratory within 48 h for RT-PCR analysis in Tris-buffer solution, to maintain the integrity of bacterial DNA. Results: The levels of P. gingivalis were significantly decreased with probiotic mouth wash. Conclusions: Probiotic mouth wash can be used as an adjunctive measure along with regular brushing to improve periodontal status during fixed orthodontic treatment.

The impact of fixed orthodontic appliances on oral microbiome dynamics in Japanese patients

“…For example, increases in the incidence of dental caries and S. mutans bacterial counts were seen with fixed orthodontic appliances 17,18 . Similarly, placement of orthodontic appliances influenced clinical parameters and colonization of periodontal pathogenic bacteria such as P. gingivalis, P. intermedia, P. nigrescens, and F. nucleatum [19][20][21] . In this study, the number of detected OTUs slightly increased with time both in plaque and saliva, although there was no significant difference, suggesting that bacterial structure may have become more diverse after application of orthodontic appliances.…”

Orally Administered Probiotics Decrease Aggregatibacter actinomycetemcomitans but Not Other Periodontal Pathogenic Bacteria Counts in the Oral Cavity: A Systematic Review and Meta-Analysis

“…An email requesting the exact number of bacteria was sent to the corresponding author of the study; however, no reply was received. One study ( Goyal et al, 2019 ) did not specify whether the participants had periodontal disease, and another ( Vivekananda et al, 2010 ) waited 21 days before administering probiotics to the participants. Finally, two other investigations ( Shah et al, 2013 ; Shah et al, 2017 ) combined probiotics with antibiotics.…”

“…Eight of the 14 studies ( Mayanagi et al, 2009 ; Teughels et al, 2013 ; Laleman et al, 2015 ; Montero et al, 2017 ; Alanzi et al, 2018 ; Invernici et al, 2018 ; Morales et al, 2018 ; Laleman et al, 2019 ) were randomized, double-blind, placebo-controlled parallel trials. The other four investigations ( Shah et al, 2013 ; Dhaliwal et al, 2017 ; Shah et al, 2017 ; Goyal et al, 2019 ) were randomized, open, controlled parallel trials. The work of Iniesta and coworkers ( Iniesta et al, 2012 ) was a randomized, double-blind, placebo-controlled, crossover clinical trial.…”

“…Biases in the 14 included studies were assessed by using the Cochrane Risk of Bias Tool for randomized trials. All included studies identified or explained the randomization method, except one ( Goyal et al, 2019 ), which did not specify the method. Allocation concealment was determined as high in five studies because the staff who assigned the participants to the groups was not blinded.…”

“…Most of the included studies had a double-blind design, and the performance and detection biases were evaluated as low. However, four studies ( Shah et al, 2013 ; Dhaliwal et al, 2017 ; Shah et al, 2017 ; Goyal et al, 2019 ) were open trials; the performance and detection biases of these were therefore determined as high. One study ( Morales et al, 2018 ) was assessed as having an unclear risk in performance bias for microbiological parameters because the sample collector was not blinded.…”