Table 4.
Results of the included studies.
| Study | Measured outcome using probiotics | ||
|---|---|---|---|
| Clinical outcomes | Microbiological outcomes | Immunologic outcomes | |
| RCTs | |||
| Invernici et al (2020)12 | Compared to the control group, the test group had a lower BOMP at 90 days and a lower PI at 30 days | – | Between the test and control groups at 30 and 90 days in the immunoglobulin A levels, no significant differences; higher βD-3, TLR4, and CD-4 expressions were observed in gingival tissues in the test group than in the control group |
| Invernici et al (2018)13 | The test group had larger clinical attachment gain and lower PPD than the control group at 90 days | For deep periodontal pockets: the test group exhibited a larger count of Actinomyces naeslundii and Streptococcus mitis and a more pronounced reduction in the count of P gingivalis, Treponema denticola, Fusobacterium nucleatum vincentii, Campylobacter showae, and Eubacterium nodatum than the control group | The test group had higher levels of IL-10 than those at baseline at 30 days; the control group had a higher ratio of IL-1β (at 30 and 90 days) and of IL-8 (at 30 days) |
| Kuru et al (2017)18 | After abstinence from oral hygiene practices, B animalis positively affected plaque accumulation and gingival inflammatory parameters, lower PI and GI, less BOP, and a minor increase in GCF volume | – | Total amount and concentration of IL-1β in GCF were lowered |
| In vitro studies | |||
| Argandoña Valdez et al (2021)19 | – | B infantis and B lactis, as single species, have antagonist effects on F nucleatum and P gingivalis biofilms; double combinations of bifidobacteria tested to have an inhibitory effect on F nucleatum and P gingivalis biofilms; single and double combinations of bifidobacteria did not affect S oralis counts | – |
| Invernici et al (2020)12 | – | In vitro evaluation of the adhesion of B lactis HN019 and P gingivalis to BEC; lower mean adhesion of P gingivalis combined with B lactis HN019 when compared to the mean adhesion of P gingivalis alone to BEC; in vitro evaluation of B lactis HN019 antimicrobial activity; growth inhibition of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, and Fusobacterium nucleatum | – |
| Jasberg et al (2016)20 | – | The growth of Porphyromonas gingivalis was reduced significantly in biofilms assays and P. gingivalis growth was completely inhibited in agar-overlay tests with Bifidobacterium | – |
| Animal model studies | |||
| Silva et al (2022)21 | The PEP and MSPEP groups showed lower levels of alveolar bone loss when compared with the PE and MSPE groups | – | B lactis HN019 reduced the severity of periodontitis significantly in rats with metabolic syndrome; immunoenzymatic analysis showed higher levels of IL-1β and a higher RANKL/OPG ratio in the MSPE group when compared with the MSPEP group; the PEP group showed lower levels of TNF-α and IL-6 when compared with the PE group |
| Oliveira et al (2017)22 | Topical use of B lactis HN019 promotes a protective effect against alveolar bone loss and connective tissue attachment loss | EP+PROB group vs EP: more significant proportions of Actinomyces- and Streptococcus-like species and lower proportions of Veillonella parvula, Capnocytophaga sputigena, Eikenella corrodens, and Prevotella intermedia-like species than group EP | EP+PROB group vs EP: group EP-HN019 presented more significant expressions of OPG and βDs than group EP (P < .05); group EP presented greater levels of IL-1β and RANKL than group EP+PROB |
| Ricoldi et al (2017)23 | Group EP-SRP-PROB presented reduced alveolar bone resorption and attachment loss when compared with group EP-SRP; B lactis HN019 potentiates the effects of SRP in the treatment of EP in rats | B lactis promoted a higher ratio between aerobic and anaerobic bacteria in biofilm samples | Group EP-SRP-PROB vs group EP-SRP: the PROB group showed significantly fewer osteoclasts, increased expression of anti-inflammatory cytokines, and reduced expression of proinflammatory cytokines compared with the comparator |
βD, β-defensin; BEC, buccal epithelial cells; BOMP, bleeding on marginal probing; BOP, bleeding on probing; CD, cluster of differentiation; GCF, gingival crevicular fluid; GI, gingival index; IL, interleukin; MSPE, periodontitis associated with metabolic syndrome; MSPEP, probiotic in group with experimental periodontitis with metabolic syndrome; OPG, osteoprotegerin; PE/EP, experimental periodontitis; PEP, probiotic in group with experimental periodontitis; PI, plaque index; PPD, probing pocket depth; PROB, probiotic; RANKL, receptor activator of nuclear factor kappa-B ligand; RCT, randomised controlled trial; SRP, scaling and root planning; TLR4, toll-like receptor 4; TNF, tumour necrosis factor.