Effects of Bifidobacterium probiotic on the treatment of chronic periodontitis: A randomized clinical trial

Abstract

Aim: This randomized placebo-controlled clinical trial evaluated the effect of Bifidobacterium animalis subsp. lactis (B. lactis) HN019-containing probiotic lozenges as adjuvant to scaling and root planing (SRP) in patients with generalized chronic periodontitis.

Materials and methods: Forty-one chronic periodontitis patients were recruited and monitored clinically, immunologically, and microbiologically at baseline (before SRP) and 30 and 90 days after SRP. All patients were randomly assigned to a Test (SRP + Probiotic, n = 20) or Control (SRP + Placebo, n = 21) group. The probiotic lozenges were used twice a day for 30 days. The data were statistically analysed.

Results: The Test group presented a decrease in probing pocket depth and a clinical attachment gain significantly higher than those of the Control group at 90 days. The Test group also demonstrated significantly fewer periodontal pathogens of red and orange complexes, as well as lower proinflammatory cytokine levels when compared to the Control group. Only the Test group showed an increase in the number of B. lactis HN019 DNA copies on subgingival biofilm at 30 and 90 days.

Conclusion: The use of B. lactis HN019 as an adjunct to SRP promotes additional clinical, microbiological, and immunological benefits in the treatment of chronic periodontitis (NCT03408548).

Keywords: Bifidobacterium lactis; periodontitis; probiotics; root planing.

© 2018 The Authors Journal of Clinical Periodontology Published by John Wiley & Sons Ltd.

Figures

Figure 1

Flowchart of the study design

Figure 2

Profiles of the mean counts (×105) of 40 taxa in subgingival biofilm samples at baseline and at 30 and 90 days post‐treatment. The panel at the far right presents the changes in the mean counts of each species between baseline and 90 days post‐treatment. The species were ordered according to the microbial complexes described by Socransky et al. (1998). The significance of differences among time points was determined using Friedman test (*p < 0.05 at 30 days and #p < 0.05 at 90 days) and between groups at 90 days using Mann–Whitney test (&p < 0.05). All the analyses were adjusted for multiple comparisons (Socransky et al., 1991). (a) deep pockets, (b) moderate pocktes

Figure 3

Cumulative mean proportions of microbial complexes in subgingival biofilm samples taken from subjects at baseline and at 30 and 90 days post‐treatment. The colours represent different microbial complexes (Socransky et al., 1998). The light green colour represents the proportion of Aa. The grey colour represents species that did not fall into any complex, and Actinomyces species are represented in blue. The significance of differences among time points was determined using Friedman and Dunn multiple‐comparison tests (different letters represent significant differences between time points, p < 0.05). The significance of differences between the two groups at 30 days and 90 days was determined by using Mann–Whitney test (*p < 0.05 at 30 days and **p < 0.05 at 90 days)

Figure 4

Number of copies/μL of Bifidobacterium animalis subsp. lactis HN019 DNA and standard deviations (numbers above the columns) in samples of subgingival biofilm of Test and Control groups at baseline, 30 days, and 90 days, as well as intra‐ and inter‐group comparisons. Different majuscule letters indicate significant differences in each group over experimental time (Friedman test, Dunn, p < 0.05). Different minuscule letters indicate inter group differences within the same time point (Mann–Whitney test, p < 0.05)

Figure 5

Levels (pg/mL) of IL‐8 (a), IL‐1β (b), and IL‐10 (c) for each subject of groups Test and Control at baseline and at 30 and 90 days post‐treatment. The mean changes in cytokines levels in relation to baseline values for Control and Test groups can be observed in d–f. *Significant difference in Test group when compared with baseline values (Repeated Measures ANOVA, Bonferroni, p < 0.05). †Significant difference in Control group when compared with baseline values (Repeated Measures ANOVA, Bonferroni, p < 0.05). ‡Significant difference among groups in the same time point (Student t test, p < 0.05)