Table 1.
Summary of the clinical studies that evaluated various probiotic strains for treatment of chronic periodontitis or gingivitis
| Reference | Probiotic strain(s) (mode of delivery) | Study population | Design | Probiotic treatment | Monitoring | Clinical measurements | |||
|---|---|---|---|---|---|---|---|---|---|
| Plaque indices | Bleeding indices | Probing depth | Clinical Attachment Loss | ||||||
| [12] | Lactobacillus plantarum Lactobacillus brevis Pediococcus acidilactici (tablet) | Gingivitis minor attachment loss < 2 mm | Parallel-group | Two tablets/day for 6 weeks | Baseline and week 6 | ns | ↓ AngBS ↓ GI | – | – |
| [13] | Lactobacillus reuteri DSM 17938 and ATCC PTA 5289 (lozenge) | Gingivitis pregnant women in 3rd trimester | Parallel-group | Two lozenges/day for 7 weeks | Baseline and week 7 | ↓ PI | ↓ GI | – | – |
| [14] | Lactobacillus salivarius Lactobacillus reuteri (capsule/direct) | Chronic periodontitis CAL ≥4 mm ≥ 4 sites with PD ≥5 mm | Parallel-group SRP+adjunct | Twice/day for 14 days rinse with capsule direct subgingival delivery at baseline, weeks 1, 2 and 4. | Baseline, months 1 and 3 | ↓ PI up to 3 months | ↓ GI and BI up to 3 months | ↓ ns | ↓ ns |
| [15] | Lactobacillus rhamnosus (sachet) | Chronic periodontitis ≥ 5 teeth with PD ≥ 5 mm and CAL ≥3 mm | Parallel-group SRP+adjunct | 1/day drink of sachet contents for 3 months | baseline, 6 weeks, and months 3, 6, 9 and 12 | ↓ ns at 12 months | ns | ↓ ≥ 6 mm sites | ↓ ns at 12 months |
| [16] | Lactobacillus plantarum L-137 (heat killed; capsule) | ‘Chronic periodontitis’ patients undergoing therapy ≥1 site PD ≥4 mm | Parallel-group SRP+adjunct | 1/day for 12 weeks | Baseline and weeks 4, 8 and 12 | ns (PI) | ↑ BOP ns up to 12 weeks | ↓ sites ≥ 4 mm ns | – |
| [17] | Bacillus subtilis Bacillus megaterium Bacillus pumulus (toothpaste, toothbrush cleaner, mouth rinse) | Gingivitis | Parallel-group | 2/day brushing with probiotic toothpaste and 1/day mouth rinse for 8 weeks (toothbrush stored in cleaner till next use) | Baseline and week 8 | ns (PI) | ns (GI) | – | – |
| [18] | Streptococcus oralis KJ3 Streptococcus uberis KJ2 Streptococcus rattus JH145 (tablet) | Chronic periodontitis (severe) | Parallel-group SRP+adjunct | 2/day dissolving tablet on tongue 12 weeks | Baseline and weeks 4, 8, 12 and 24 | PI ↓ up to 24 weeks | ↓ GI and ↓ BOP ns up to 24 weeks | ns up to 24 weeks | ns up to 24 weeks |
| [19] | Lactobacillus reuteri (lozenge) | Chronic periodontitis radiographic evidence of horizontal bone loss; ≥ 2 teeth per quadrant at 5–7 mm PD; ≥ 2 GI per quadrant | Parallel-group SRP+adjunct | 2/day for 3 weeks. | Baseline and days 21, 90, 180 and 360 | PI ↓ up to 360 days | ↓ GI and BOP up to 360 days | ↓ ≥ 5 mm sites up to 360 days | ↓ up to 360 days |
| [20] | Lactobacillus brevis CD2 (lozenge) | Experimental gingivitis | Parallel-group abstained from oral hygiene after cleaning period for 2 weeks | 3/day for 2 weeks | Baseline, 3, 7, 10 and 14 days | ns (PI) | ↓ BOP at Day 10 only. | – | – |
| [21] | Lactobacillus reuteri ATCC PTA 5289 (tablet) | Moderate chronic periodontitis CAL > 5 mm and PD > 4 mm in ≥ 2 adjacent teeth | parallel-group SRP+adjunct | 2/day (time period not clear) | Baseline, end time point 2 weeks after probiotics terminated | ns (PI) | ↓ SBI | ↓ mean PD | ↓ |
| [22] | Lactobacillus reuteri ATCC 55730 and ATCC PTA 5289 (lozenge) | Experimental gingivitis (female participants only) | Cross over professional tooth cleaning during a washout period of 2 weeks. | 2/day for 3 weeks | Baseline and 21 days | ns (PI) | ns (GI and BOP) | – | – |
| [23] | Lactobacillus reuteri DSM 17938 and ATCC PTA 5289 (lozenge) | Chronic periodontitis (moderate-severe) | Parallel-group Full mouth disinfection and SRP+adjunct | 2/day for 12 weeks | Baseline and week 3, 6, 9 and 12 | ↓ ns at 3, 9 and 12 weeks ↓ at 6 weeks | ↓ ns at 3, 6 and 9 weeks ↓ at 12 weeks | ↓ ns mean PD ↓ ≥ 5 mm PD at 12 weeks | ↓ ns |
| [24] | Lactobacillus reuteri ATCC 55730 and ATCC PTA 5289 (tablet) | Chronic periodontitis | Parallel-group no professional treatment | 1/day for 30 days | Baseline and day 30 | ↓ at day 30 | ↓ BOP at day 30 | ↓ 4–5 mm PD ↓ ≥ 6 mm PD at day 30. | – |
| [25] | Lactobacillus reuteri DSM 17938 and ATCC PTA 5289 (tablet) | Gingivitis > 1 gingival index and no CAL | Parallel-group teeth polished at baseline | 1/day for 28 days. | Baseline, week 4 and 8 | ns (mean PI) | ns (mean GI) | – | – |
| [26] | Lactobacillus casei ‘Shirota’ (milk) | Experimental gingivitis | Parallel-group scaling and polishing 2 weeks before baseline | 1/day drink (65 mL) for 28 days | Baseline and day 1, 3, 5, 7 and 14 | Mean PI at baseline for two groups were different. | ↓ BOP up to 14 days GI values were significantly different at baseline | – | – |
| [27] | Lactobacillus reuteri DSM 17938 and ATCC PTA 5289 (lozenge) | Chronic periodontitis PD 5–7 mm and radiographic bone loss evidence | Split-mouth SRP+adjunct | 2/day for 3 weeks; 3 week gap after SRP at baseline | Baseline, week 3 and 6 | ↓ PI score at week 6 | ↓ GI score at week 6 | ↓ mean PD at week 6 | ↓ at week 6 |
PI plaque index, GI gingival index, GBI gingival bleeding index, AngBS angulated bleeding score, BI bleeding index, SBI sulcus bleeding index, BOP bleeding on probing (% of sites), PD probing depth, CAL clinical attachment loss, SRP scaling and root planing, ns not significant
↓decrease
↑increase