Clinical and microbiological effects of probiotic lozenges in the treatment of chronic periodontitis: A 1-year follow-up study

The objective of this study was to evaluate the effect of Lactobacillus reuteri (L. reuteri) containing lozenges as an adjunct to initial periodontal therapy in chronic periodontitis (CP) patients and to detect L. reuteri colonization in periodontal pockets. A total of 40 patients, with at least 2 teeth having one approximal site with a probing depth (PD) of 5-7 mm and gingival index (GI) of ≥2 in each quadrant, were selected and randomly divided into 2 groups. Group I received scaling and root planing (SRP) + L. reuteri containing lozenges, whereas Group II received SRP + Placebo. Plaque index (PI) and (GI), bleeding on probing (BoP), PD and relative attachment level (RAL) were measured. Microbiological sampling was performed at baseline and days, 21, 90, 180 and 360 and was analyzed by culture method including total viable count (TVC) and proportions of obligate anaerobes. Repeated measure analysis of variance was used for intra-group comparison of the clinical parameters and proportions of obligate anaerobes whereas the Friedman test was used for the TVC values at different time point measurements. The Bonferroni corrected Paired sample t was used to evaluate intra-group comparisons of the clinical parameters and proportions of obligate anaerobes in pairs. The Bonferroni corrected Wilcoxon signed ranks test was used to evaluate the intra-group comparisons of the TVC values in pairs. The Student t or Mann-Whitney U tests were used to evaluate the inter-group comparisons of the mean differences according to their distribution. Intergroup comparisons of PI, GI, BoP and PD revealed significance in favor of Group I at all time intervals (p<0.05). Intergroup comparisons of total viable cell count and proportions of obligate anaerobes revealed significance in favor of Group I at all time intervals, except day 360 (p<0.05). In conclusion, within the limits of this study it can be stated that L. reuteri containing lozenges might be an adjunctive useful agent for retarding recolonization and the improvement of periodontal health. Further studies are warranted to clarify the administration dose of the lozenges.