engleski

Effect of probiotic Lactobacillus reuteri as an adjunct to nonsurgical treatment on halitosis of patients with periodontitis: a randomised placebo-controlled trial

Intra-oral halitosis is caused by the production of malodorous compounds, a by- product of bacterial metabolic activity. The anaerobic gram- negative bacteria that is causative to periodontitis are also known as contributors to halitosis. Probiotics were evaluated for their effect on halitosis and as an adjunct to nonsurgical treatment, respectively. This study was conducted to evaluate the impact of probiotic L. reuteri on halitosis in a group of subjects with periodontitis when used as an adjunct to nonsurgical treatment. Thirty adult subjects with diagnosed periodontitis and halitosis [at least: organoleptic score (OLS)≥1 + volatile sulphur compounds (VSC) >160 ppb] were evaluated at baseline for parameters of halitosis (OLS judged on a scale 0-5, the concentration of VSC measured with Halimeter), clinical periodontal parameters, tongue coating, microbiological sampling and psychometric testing [Oral Health Impact Profile – 14 (OHIP-14) and Halitosis Associated Life-quality Test (HALT)]. After undergoing nonsurgical periodontal treatment, they were randomised into two groups. They were instructed to use lozenges containing probiotics (combination of two Lactobacillus strains: L. reuteri DSM 17938 and L. reuteri ATCC PTA 5289) or placebo, twice per day for 28 days. At 1 month, OLS, VSC and tongue coating were evaluated. At three months, all parameters were re-evaluated. OLS, VSC, clinical periodontal parameters, tongue coating, OHIP-14 and HALT values significantly reduced in both groups. Both groups had a significant reduction of P. gingivalis, T. forsythia, T. denticola, P. micros, P. intermedia. Unlike in the test group, no statistically significant reduction was observed in the total bacterial count (TBC). No significant differences were observed for OLS and VSC values after three months. However, secondary (OLS≥2) and composite [(OLS)≥1 + (VSC) >160 ppb] parameters of residual halitosis were marginally significant (p=0.068), with better outcomes in the probiotic group. There was a significantly greater magnitude of PPD reduction (p<0.0001) and CAL gain (p<0.0001) in the probiotic group. They also had significantly lower OHIP-14 scores (p=0.043) compared to the test group. The results indicate that the administration of L. reuteri as an adjunct treatment could confer additional benefits in terms of halitosis reduction, improvements in periodontal parameters, change in microbial composition and quality of life.

lactobacillus reuteri ; halitosis ; probiotics ; periodontitis ; nonsurgical periodontal treatment ; tongue coating ; periodontal pathogens

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