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

Abstract

Introduction: Periodontitis is a multifactorial chronic inflammatory disease induced by a dysbiosis between the host and oral microbiota, which can compromise the host’s immune defenses and lead to the destruction of periodontal tissues. Despite the efficacy of non-surgical periodontal therapy (NSPT) as the gold standard of periodontal treatment, its application can produce lower results due to anatomical and microbiological limitations. This systematic literature review was performed to assess the long-term efficacy of the effects of probiotics as an adjunct to NSPT compared to the control groups with follow-up of clinical, microbiological and immunological outcomes. Materials and methods: A literature review was conducted, considering manuscripts published from November 2016 to February 2022. The research question was formulated following the population, intervention, comparison and outcome strategies. Randomized controlled trials (RCT), systematic review and meta-analysis investigating the periodontal efficacy of domiciliary probiotic therapy in an adjunct to the mechanical therapy were included. Results: Regarding clinical outcomes, there is a reduction in periodontal probing depth (PPD), clinical attachments level (CAL), bleeding on probing (BoP) and plaque index (PI) for the test groups compared to the control groups in a short-term period. No differences were generally observed in the following indices over a period of more than 3 months for most studies considered. Conclusions: Weak evidence suggests that the use of probiotics as an adjunct to non-surgical periodontal therapy treatment may be able to show improvements in periodontal clinical parameters for up to 3 months. However, a significant and large heterogeneity of studies, along with the absence of long-term microbiological and immunological data, preclude any definitive conclusions.

Oxygen-Releasing Hyaluronic Acid-Based Dispersion with Controlled Oxygen Delivery for Enhanced Periodontal Tissue Engineering

“…Novel approaches that constitute an adjunct to nonsurgical periodontal therapy involve the development of selective antimicrobial agents, such as oxygen or plant extracts or probiotics, parabiotics, and postbiotics to support eubiosis [ 12 , 13 , 14 , 15 , 16 , 51 ]. Furthermore, host modulation is an effective adjunctive therapy and the combination of host modulation and the recovery of oral eubiosis is key to the development of targeted microbial peptides, antimicrobial peptides, and inhibitors of inflammasomes [ 52 , 53 ].…”

“…To positively influence the dysbiotic oral microbiota, there are various approaches such as probiotics, parabiotics, and postbiotics as an adjunct to nonsurgical periodontal therapy treatment provided as toothpastes or lozenges, which seem to be beneficial to suppress specific periodontopathogens [ 12 , 13 , 14 , 15 , 16 ]. Another therapeutic strategy involves the use of oxygen.…”

Periodontal disease in down syndrome: Predisposing factors and potential non‐surgical therapeutic approaches

“…Antimicrobial photodynamic therapy 138 Use of a low-level light (led or laser) to remove infected tissue, promote gum reattachment, and reduce periodontopathogens particularly P. gingivalis in periodontal pockets Probiotics, prebiotics, symbiotics 139 Use of probiotics (live microorganisms), prebiotics (non-digestible substances), and symbiotics (a combination of probiotics and prebiotics) to the restoration of microbial balance, immune modulation and reduction of pathogens photosensitizer is exposed, it transitions into a high-energy triplet state, which interacts with surrounding molecules. These interactions generate ROS such as superoxide, hydrogen peroxide, hydroxyl radicals, as well as singlet oxygen ( 1 O 2 ), another highly reactive form of oxygen.…”

In-office dental bleaching in adolescents using 6% hydrogen peroxide with and without gingival barrier: a randomized double-blind clinical trial

“…Dental bleaching is very effective both in the case of intrinsic and extrinsic discolorations 3 , 4 , 5 and can be done in various ways. In-office bleaching techniques that use high or medium concentrations of hydrogen peroxide (HP) (20% to 40%) provide faster results.…”