Evaluating the effects of topical administration of probiotics after SRP on periodontal condition in patients with moderate to severe chronic periodontitis - a randomized clinical trial
Evaluating the effects of topical administration of probiotics after SRP on periodontal condition in patients with moderate to severe chronic periodontitis - a randomized clinical trial
Naser Sargolzaei,1Kimia Kelidari,2Negin Riahi,3,*Negar Bahrami,4Milad Bonyatpour,5
1. Department of periodontitis, College of dentistry, Mashhad University of medical sciences, Mashhad, Iran 2. Student Research Committee, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran 3. Student Research Committee, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran 4. Student Research Committee, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
Introduction: Periodontitis is an infection-driven inflammatory disease of teeth surrounding tissues. The presence of pathogenic bacteria, the susceptibility of the host and the absence of beneficial bacteria are its main ethological factors. Oral hygiene instructions, scaling and root planning (SRP), antibiotics and surgery are the existing therapeutic techniques which only target the first two factors and are not long-lasting. Thus, researchers are looking for a medicament by using beneficial bacteria. The chosen method is to employ probiotics, which are bacteria with beneficial effects for humans because of their anti-microbial and anti-inflammatory effects. Several studies proved the efficacy of probiotics in the treatment of periodontitis, but only a few studies evaluated the effect of probiotics in the treatment of chronic periodontitis. Given that none of these studies have been carried out in Iran and several risk factors including genetics, environmental and behavioral factors are associated with periodontal diseases, the necessity of conducting such a study in Iran is of high importance. The aim of this study, therefore, was to evaluate the effects of probiotic administration as mouthwash after SRP on periodontal condition in patients with moderate to severe chronic periodontitis.
Methods: In this study which was a double-blinded randomized clinical trial, 51 eligible patients with moderate to severe generalized chronic periodontitis who were referred to dental clinics in Mashhad, Iran, were randomly allocated to two treatment groups (test and control). All the subjects were given 20 capsules (dissolved in water and used as mouthwash) similar in shape after receiving SRP and oral hygiene instructions. These capsules contained probiotic (FamiLact) in the test group, and in the control group they were placebo. At the initial phase of the study we used clinical attachment loss (CAL) in order to determine moderate to severe generalized chronic periodontitis. Afterwards, we employed bleeding on probing (BOP) and pocket probing depth (PPD) before and after the 20-day course of treatment.
Results: Before therapeutic interventions, there was no statically significant difference in study indicators (age, gender, BOP, PPD). After the baseline treatments and the 20-day period of administration of the capsules, the test group demonstrated a 34.7% reduction in BOP index, and a 28.7% reduction was observed in the control group (P-value= 0.001, difference= 6%). The test group also showed a 1.68 mm reduction in PPD index which was significantly higher than that of the control group with 0.88 mm reduction (P-value=0.0001, difference= 0.79 mm).
Conclusion: According to the significant difference of treatment results between our two studied groups, it is concluded that topical administration of probiotics after SRP can help reduce periodontal inflammation by changing the subgingival microflora in patients with chronic periodontitis at least in the short-term.
Keywords: Chronic periodontitis, Gingiva, Scaling and root planning, Probiotic, Oral health