Lactobacillus brevisCD2 attenuates traumatic oral lesions induced by fixed orthodontic appliance: A randomized phase 2 trial

Abstract

Objective: To evaluate the effect of the probiotic Lactobacillus brevis CD2 on the prevention of early traumatic oral lesions induced by a fixed orthodontic appliance. Settings and Sample Population:Twenty orthodontic patients (14-57 yo) were recruited from a private clinic. Subjects and Methods:In a phase 2, double-blind clinical trial, all patients were randomly allocated (1:1 ratio) to a 21-day course of soluble tablets containing L brevis CD2 (4 billion colony-forming units after breakfast, lunch and dinner) or placebo, starting at the day of orthodontic appliance placement. The primary outcomes were days with oral lesions and lesion-related pain [ranging between 0 (no pain) and 10 (maximum pain)]. Oral health-related quality of life was measured using OHIP-14 before and after treatments.Results: All patients completed the study. Ten were treated with L brevis (28.1 ± 13.3 yo, 70% women), and 10 received placebo (27.5 ± 9.1 yo, 60% women). The oral lesions lasted significantly less time (P = .018) in patients treated with L brevis (2.5 ± 1.0 days) than with placebo (4.9 ± 3.0 days). Pain score was significantly lower (P = .039) when L brevis was used [median (min-max): 0 (0-4) vs. 3 (0-5)]. OHIP-14 scores were not significantly different between treatments. Conclusions:Lactobacillus brevis CD2 reduced almost 50% the persistence of traumatic oral lesions in patients with fixed orthodontics. Yet, there was no improvement in quality of life compared to placebo, suggesting that such differences in persistency and pain related to oral lesions may be considered clinically irrelevant.

Effect of probiotics on pain and ulceration in patients undergoing fixed orthodontic treatment

“…Silva et al 13 showed that L. brevis CD2 soluble tablets used in the first 21 days of orthodontic treatment reduced the length of traumatic oral lesions from 4.9 to 2.5 days. Oral pain related to traumatic lesions was also alleviated with the use of probiotics.…”

“…A study reported that Lactobacillus brevis reduced almost 50% of the persistence of traumatic oral lesions in patients with fixed orthodontics. 13 Considering the significant effect of the pain and ulcers of orthodontic treatments on patients’ quality of life and the lack of definite treatment or prevention method, this study compared the effect of probiotic lozenges along with orthodontic wax on the amount of pain and ulcers in patients undergoing fixed orthodontic treatment.…”

Microbiome First Approaches in Pain Prevention and Management

“…Examples are included that focus on pain associated with gastrointestinal issues (ulcerative colitis and irritable bowel), osteoarthritis, probiotics and headaches, post-surgical pain, neurologic and visceral pain, menopausal status, the risk-benefit role of opioids, the connections between microbiota and microglia activation, and gut microbiota as pertains to pain hypersensitivity vs. tolerance. While a variety of microbiome studies are described within the review articles in Table 1, the most recent preclinical and clinical trials from the past 2-3 years are highlighted in Table 2 [52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71]. Several areas of activity are notable.…”