Title : Adjunctive probiotic lactobacillus therapy in the treatment of peri-implant disease
Abstract:
Background: Peri-implant diseases are biofilm induced inflammation that jeopardise peri-implant mucosa (peri-implant mucositis) or surrounding bone (peri-implantitis). Non-surgical mechanical debridement shows limited effects in cases with more advanced pathology or complex peri-implant defect configuration. Probiotic Lactobacillus has been considered to be potentially beneficial in the management of peri-implant diseases. However, existing studies show obvious clinical diversity, an optimal protocol for probiotic application remains inconclusive.
Perpose: 1) To identify a modified probiotic therapy based on existing studies. 2) To evaluate the clinical outcomes following non-surgical mechanical debridement and the modified probiotic therapy in the management of peri-implant diseases.
Material and Methods: Patients with peri-implant mucositis were included. After non-surgical debridement, probiotic Lactobacillus solution was topically applied to the peri-implant sulcus and the patients were instructed to take oral probiotic tablets regularly during the follow-up period. Clinical outcomes such as probing depth (PD), bleeding on probing (BOP) and Plaque index (PI) were measured after a follow-up period of 1 month.
Results: Compared to pre-operation, probiotic therapy led to the disappearance of swelling of the peri- implant mucosa, reduced BOP, and an obvious reduction and excellent control of plaque and pigmentation; however, there was no significant change in PD.
Conclusion: We suggested a modified probiotic protocol including the combination of professional topical use and home administration of probiotic Lactobacillus. This protocol demonstrated the effectiveness of probiotic Lactobacillus in controlling peri-implant mucosal inflammation.
Clinical Relevance: As a modified protocol based on our systematic review of relative studies, this probiotic therapy helps to facilitate a consistent and evidence-based approach of probiotics in the treatment of peri-implant diseases.
Audience Take Away:
- During the treatment of peri-implant disease, dental clinicians can use commercially available probiotics for topical application in peri-implant sulcus and instruct patients to take them orally, following our published protocol.
- This is an open protocol that can be used by other faculty to extend their research and teaching.
- This study provides a modified probiotic management that can improve clinical indicators of peri-implant disease.
- This modified probiotic protocol improved the accuracy of study design, helped to reduce clinical heterogeneity and facilitate a consistent and evidence-based management of probiotics in the treatment of peri-implant diseases.
