Effect of adjuvant probiotic therapy (Lactobacillus reuteri) in the treatment of periodontitis associated with diabetes mellitus: clinical, controlled, and randomized study.

Autor: Jardini MAN; Department of Diagnosis and Surgery, Institute of Science and Technology of São José Dos Campos, Universidade Estadual Paulista (Unesp), São José Dos Campos, SP, Brazil. maria.jardini@unesp.br., Pedroso JF; Department of Diagnosis and Surgery, Institute of Science and Technology of São José Dos Campos, Universidade Estadual Paulista (Unesp), São José Dos Campos, SP, Brazil., Ferreira CL; Department of Dentistry, Universidade de Taubaté (UNITAU), Taubaté, SP, Brazil., Nunes CMM; Department of Diagnosis and Surgery, Institute of Science and Technology of São José Dos Campos, Universidade Estadual Paulista (Unesp), São José Dos Campos, SP, Brazil., Reichert CO; Lipids, Oxidation and Cell Biology Team-LIM-19, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil., Aldin MN; Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil., Figueiredo Neto AM; Institute of Physics, University of São Paulo, São Paulo, SP, Brazil., Levy D; Lipids, Oxidation and Cell Biology Team-LIM-19, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil., Damasceno NRT; Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: Clinical oral investigations [Clin Oral Investig] 2024 Jan 06; Vol. 28 (1), pp. 80. Date of Electronic Publication: 2024 Jan 06.
DOI: 10.1007/s00784-023-05441-0
Abstrakt: Objectives: Subgingival instrumentation (SI) with probiotics may be a proposal for the treatment of periodontitis (P), for patients with type 2 diabetes mellitus (T2DM). The Lactobacillus reuteri probiotic as an adjunctive therapy in the treatment of P associated with T2DM was evaluated.
Materials and Methods: Forty diabetic participants diagnosed with P (stage III and IV, grade B) were randomized into SI + Placebo (n = 20): subgingival instrumentation plus placebo lozenges and SI + Probi (n = 20): subgingival instrumentation plus probiotics. Probing depth (PD), gingival recession (GR), clinical attachment level (CAL), plaque index (PI), bleeding on probing (BoP), and PISA index were performed at baseline and 30, 90, and 180 days. Cytokine concentration in the gingival crevicular fluid, subgingival biofilm sample, and LDL and HDL subfractions were evaluated.
Results: In the deep pockets, PD in SI + Probi showed increased values (p = 0.02) compared to SI + Placebo at 90 days. For CAL, SI + Probi showed increased values compared to SI + Placebo, with a significant difference at 30 days (p = 0.03), 90 days (p = 0.02), and 180 days (p = 0.04). At #PD ≥ 7 mm, SI + Probi had a more frequent number of sites (p = 0.03) compared to SI + Placebo only at baseline. For the PISA, SI + Probi showed a significant difference (p = 0.04) compared to SI + Placebo at 90 days. For cytokines, SI + Probi showed higher quantification than SI + Placebo for IL-10 (p < 0.001) at 90 days, IL-12 (p = 0.010) at 90 days, IL-1β (p = 0.035) at 90 days, and IL-8 (p = 0.003) at baseline. SI + Placebo showed higher quantification of IL-1β (p = 0.041) compared to SI + Probi only at 30 days. There was a reduction in all microbial complexes. SI + Probi improved LDL size (246.7 nm vs 260.4 nm; p < 0.001), while large HDL subfractions were reduced aft 180 days of treatment (24.0% vs 20.3%; p = 0.022) when compared with SI + Placebo; this response was dependent of probiotics (1.0 mg/dL vs - 6.2 mg/dL; p = 0.002).
Conclusion: Subgingival instrumentation improved the clinical periodontal parameters in patients with T2DM. The use of L. reuteri probiotics had no additional effects compared with the placebo; however, there was a positive effect on the lipoprotein subfraction.
Clinical Relevance: Scientific rationale for study: subgingival instrumentation with probiotics may be a proposal for the treatment of periodontitis (P), especially for patients with type 2 diabetes mellitus (T2DM).
Principal Findings: the use of L. reuteri probiotics had no additional effects compared with the placebo; however, there was a positive effect on the lipoprotein subfraction.  Practical implications: L. reuteri as an adjunct to subgingival instrumentation may have significant therapeutic implications in dyslipidemia.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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