Evaluation of the clinical effect of a probiotic mouthwash in the treatment of generalized marginal chronic gingivitis. Randomized pilot study.
AbstractObjective. To evaluate the clinical effect of a probiotic mouthwash in reducing generalized marginal chronic gingivitis using positive and negative control groups. Methodology. Four-week study conducted in San Luis Potosí, Mexico, from January to March 2017. Participants were healthy, non-smokers with generalized marginal chronic gingivitis; age range 18-45 years. Subjects were randomized and divided into three groups: Group A: mouthwash based on 0.05% cetylpyridinium chloride (CPC) (positive control); Group B: mouthwash based on probiotics (experimental); Group C: placebo mouthwash (negative control). No oral hygiene practices or routines were modified; subjects were followed for 4 weeks. The primary outcome variable of interest was the Löe and Silness gingival index, and the secondary one, the Quigley Heinn plaque index modified by Turesky. Results. Of the 45 patients included, 19 (42.2%) were men and 26 (57.7%) women, mean age was 22.8±2.07. Each group consisted of 15 subjects; all subjects completed the study. There was no statistically significant reduction in gingival inflammation when comparing the 3 treatment groups (p=0.540) with respect to the gingival index. A comparison was made before and after the treatment and in the 3 groups there was no reduction of the gingival inflammation. Plaque reduction was not statistically significant when comparing the 3 groups (p=0.278). However, when doing intra-group comparison, it was found that the patients in group A had a reduction in plaque index (p<0.005), which was not observed in groups B (p=0.1103) and C (p=0.1508). Conclusions. The use of a probiotic mouth mouthwash did not reduce gingival inflammation or the accumulation of dentobacterial plaque in a period of 4 weeks. There were no statistically significant differences between the study groups.
2. Hajishengallis G, Lamont RJ. Beyond the red complex and into more complexity: the polymicrobial synergy and dysbiosis (PSD) model of periodontal disease etiology. Mol Oral Microbiol. 2012;27(6):409–19.
3. Fejerskov O. Changing paradigms in concepts on dental caries: consequences for oral health care. Caries Res. 2004;38(3):182–91.
4. Borges-Yáñez SA, Castrejón-Pérez RC, Camacho MEI. Effect of a School-Based Supervised Tooth Brushing Program In Mexico City: A Cluster Randomized Intervention. J Clin Pediatr Dent. 2017;41(3):204–13.
5. James P, Worthington HV, Parnell C, Harding M, Lamont T, Cheung A, Whelton H, Riley P. Chlorhexidine mouthrinse as an adjunctive treatment for gingival health. Cochrane Database Syst Rev. 2017;31(3):CD008676.
6. Costa X, Laguna E, Herrera D, Serrano J, Alonso B, Sanz M. Efficacy of a new mouth rinse formulation based on 0.07% cetylpyridinium chloride in the control of plaque and gingivitis: a 6-month randomized clinical trial. J Clin Periodontol. 2013;40(11):1007–15.
7. Herrera D, Santos S, Ferrús J, Barbieri G, Trombelli L, Sanz M. Efficacy of a 0.15% benzydamine hydrochloride and 0.05% cetylpyridinium chloride mouth rinse on 4-day de novo plaque formation. J Clin Periodontol. 2005;32(6):595–603.
8. Caglar E, Kargul B, Tanboga I. Bacteriotherapy and probiotics' role on oral health. Oral Dis. 2005;11(3):131–7.
9. Laleman I, Teughels W. Probiotics in the dental practice: a review. Quintessence Int. 2015;46(3):255–64.
10. Allaker RP, Stephen AS. Use of Probiotics and Oral Health. Curr Oral Health Rep. 2017;4(4):309–18.
11. Eldridge SM, Chan CL, Campbell MJ, Bond CM, Hopewell S, Thabane L, Lancaster GA, PAFS consensus group. CONSORT 2010 statement: extension to randomised pilot and feasibility trials. Pilot Feasibility Stud. 2016;2:64.
12. Loe H, Silness J. Periodontal disease in pregnancy. I. prevalence and severity. Acta Odontol Scand. 1963;21:533–51.
13. Turesky S, Gilmore ND, Glickman I. Reduced plaque formation by the chloromethyl analogue of victamine C. J Periodontol. 1970;41(1):41–3.
14. Nadkerny PV, Ravishankar PL, Pramod V, Agarwal LA, Bhandari S. A comparative evaluation of the efficacy of probiotic and chlorhexidine mouthrinses on clinical inflammatory parameters of gingivitis: A randomized controlled clinical study. J Indian Soc Periodontol. 2015;19(6):633–9.
15. Krasse P, Carlsson B, Dahl C, Paulsson A, Nilsson A, Sinkiewicz G. Decreased gum bleeding and reduced gingivitis by the probiotic Lactobacillus reuteri. Swed Dent J. 2006;30(2):55–60.
16. Shimauchi H, Mayanagi G, Nakaya S, Minamibuchi M, Ito Y, Yamaki K, Hirata H. Improvement of periodontal condition by probiotics with Lactobacillus salivarius WB21: a randomized, double-blind, placebo-controlled study. J Clin Periodontol. 2008;35(10):897–905.
17. Montero E, Iniesta M, Rodrigo M, Marín MJ, Figuero E, Herrera D, Sanz M. Clinical and microbiological effects of the adjunctive use of probiotics in the treatment of gingivitis: A randomized controlled clinical trial. J Clin Periodontol. 2017;44(7):708–16.
18. Alkaya B, Laleman I, Keceli S, Ozcelik O, Cenk Haytac M, Teughels W. Clinical effects of probiotics containing Bacillus species on gingivitis: a pilot randomized controlled trial. J Periodontal Res. 2017;52(3):497–504.
19. Kozak KM, Gibb R, Dunavent J, White DJ. Efficacy of a high bioavailable cetylpyridinium chloride mouthrinse over a 24-hour period: a plaque imaging study. Am J Dent. 2005;18(Spec No):18A–23A.
20. Witt J, Bsoul S, He T, Gibb R, Dunavent J, Hamilton A. The effect of toothbrushing regimens on the plaque inhibitory properties of an experimental cetylpyridinium chloride mouthrinse. J Clin Periodontol. 2006;33(10):737–42.
21. Jayaram P, Chatterjee A, Raghunathan V. Probiotics in the treatment of periodontal disease: A systematic review. J Indian Soc Periodontol. 2016;20:488–95.
22. Iniesta M, Herrera D, Montero E, Zurbriggen M, Matos AR, Marín MJ, Sánchez-Beltrán MC, Llama-Palacio A, Sanz M. Probiotic effects of orally administered Lactobacillus reuteri-containing tablets on the subgingival and salivary microbiota in patients with gingivitis. A randomized clinical trial. J Clin Periodontol. 2012;39(8):736–44.
The copyright of all the articles published in the J Oral Res. belongs to the Universidad de Concepción, Chile. All information about theJ Oral Res. is licensed under Creative Commons Attribution License 3.0 and must be cited correctly.