Scientific Frontiers presentation:
Maria Tintoré, Jordi Espadaler and Jordi Cuñé
Objective: To evaluate the efficacy of a probiotic combination in the treatment of gingivitis and its impact on the subgingival microbiota.
Methods: A double-blind, placebo-controlled, clinical trial, with a 6-week follow-up was conducted in 59 gingivitis subjects. After a professional mechanical plaque removal (PMPR), subjects were randomly assigned to test (n=30) or control (n=29) groups. Test treatment consisted on tooth brushing b.i.d plus oral tablets containing strains Lactobacillus plantarum CECT 7481, Lactobacillus brevis CECT 7480 and Pediococcus acidilactici CECT 8633 b.i.d; control group received the same treatment, with placebo tablets. The main endpoint was the change in gingival index (GI). Subgingival samples were analyzed by qPCR for five putative periodontal pathogens.
Results: Both treatment groups experienced a significant clinical improvement in mean GI (p<0.001), without intergroup differences, all patients being in remission at the end of the study (mean GI < 1.3). The test group achieved a significantly higher reduction (p<0.001) in the number of sites with spontaneous bleeding (GI=3). In subgingival samples, after correcting for multiple comparisons, a significant reduction of Aggregatibacter actinomycetemcomitans occurred in both groups, while the reduction in Tannerella forsythia was significant only in the test group (p<0.008). Only levels of T. forsythia correlated to the number of sites with GI=3 throughout the study.
Conclusions: Probiotic tablets containing L. plantarum, L. brevis and P. acidilactici reduced significantly the number of sites with severe inflammation in gingivitis patients after a PMPR. Probiotic use also demonstrated a significant microbiological impact by reducing the counts of T. forsythia.
KEYWORDS: gingivitis, probiotics, gingival index, Lactobacillus spp., subgingival microbiota.