Clinical and microbiological effects of probiotic containing lozenges in comparison to sub-antimicrobial dose doxycycline in the treatment of chronic periodontitis: 3-month follow-up

Abstract

The aim of this study is to evaluate clinical and microbiological effects of Lactobacillus reuteri (L.reuteri) containing lozenges in comparison with the usage of sub-antimicrobial dose-doxycycline (SDD) containing tablets as adjunctive to initial periodontal therapy in chronic periodontitis (CP) patientsA total of 45 patients, with 2 teeth in each quadrant having at least one approximal site with a probing depth (PD) of 5-7 mm and gingival index (GI) of ≥2, were selected and divided randomly into 3 groups. Group I received scaling and root planning (SRP) + L. reuteri containing lozenges, whereas Group II received SRP + SDD containing tablets, and Group III received SRP + placebo. Plaque index (PI), GI, PD, relative attachment level (RAL) and bleeding on probing (BoP) were measured for clinical evaluation. Microbiological sampling was performed at baseline and at day 90, and was analyzed by culture method. Total viable count (TVC) and proportions of obligate anaerobic bacteria were evaluated.The paired sample t test was used for intra-group comparison of the clinical parameters and the proportions of obligate anaerobic bacteria, whereas the Wilcoxon sign test was used for the TVC values. One-way ANOVA test was used for the inter-group comparisons of mean differences of clinical parameters and proportions of the obligate anaerobic bacteria (%), while Kruskal-Wallis Test was used for the TVC values. Statistical significance was set as p<0.05. Tukey test was used to evaluate the comparisons of the clinical parameters and proportions of obligate anaerobes in pairs, whereas Mann–Whitney U-test was used for the evaluation of TVC values in pairs. Statistical significance was set as p<0.05.All treatments resulted in statistical significantly improvements in terms of the clinical and microbiological parameters at the end of the observation period.Intergroup comparisons of the mean differences of PI, GI, BoP, PD and attachment gain revealed statistical significance in favor of both SRP + Probiotic and SRP + SDD groups (p<0.05) at the end of day 90. Intergroup comparisons of TVC values revealed significance in favor of the SRP + Probiotic group at the end of day 90 (p<0.05). Intergroup comparisons of proportions of obligate anaerobic bacteria revealed statistical significance in favor of the SRP + Probiotic and SRP + SDD groups when compared to the SRP + Placebo between days 0 and 90 (p<0.05).Within the limitation of this study, it can be concluded that L. reuteri containing lozenges and SDD containing tablets might be adjunctive useful agents for the improvement of periodontal health in CP patients.

The aim of this study is to evaluate clinical and microbiological effects of Lactobacillus reuteri (L.reuteri) containing lozenges in comparison with the usage of sub-antimicrobial dose-doxycycline (SDD) containing tablets as adjunctive to initial periodontal therapy in chronic periodontitis (CP) patientsA total of 45 patients, with 2 teeth in each quadrant having at least one approximal site with a probing depth (PD) of 5-7 mm and gingival index (GI) of ≥2, were selected and divided randomly into 3 groups. Group I received scaling and root planning (SRP) + L. reuteri containing lozenges, whereas Group II received SRP + SDD containing tablets, and Group III received SRP + placebo. Plaque index (PI), GI, PD, relative attachment level (RAL) and bleeding on probing (BoP) were measured for clinical evaluation. Microbiological sampling was performed at baseline and at day 90, and was analyzed by culture method. Total viable count (TVC) and proportions of obligate anaerobic bacteria were evaluated.The paired sample t test was used for intra-group comparison of the clinical parameters and the proportions of obligate anaerobic bacteria, whereas the Wilcoxon sign test was used for the TVC values. One-way ANOVA test was used for the inter-group comparisons of mean differences of clinical parameters and proportions of the obligate anaerobic bacteria (%), while Kruskal-Wallis Test was used for the TVC values. Statistical significance was set as p<0.05. Tukey test was used to evaluate the comparisons of the clinical parameters and proportions of obligate anaerobes in pairs, whereas Mann–Whitney U-test was used for the evaluation of TVC values in pairs. Statistical significance was set as p<0.05.All treatments resulted in statistical significantly improvements in terms of the clinical and microbiological parameters at the end of the observation period.Intergroup comparisons of the mean differences of PI, GI, BoP, PD and attachment gain revealed statistical significance in favor of both SRP + Probiotic and SRP + SDD groups (p<0.05) at the end of day 90. Intergroup comparisons of TVC values revealed significance in favor of the SRP + Probiotic group at the end of day 90 (p<0.05). Intergroup comparisons of proportions of obligate anaerobic bacteria revealed statistical significance in favor of the SRP + Probiotic and SRP + SDD groups when compared to the SRP + Placebo between days 0 and 90 (p<0.05).Within the limitation of this study, it can be concluded that L. reuteri containing lozenges and SDD containing tablets might be adjunctive useful agents for the improvement of periodontal health in CP patients.