Effects of adjunctive probiotic L. reuteri lozenges on S/RSD outcomes at molar sites with deep pockets

Abstract

Aim: To evaluate effects of probiotic Lactobacillus reuteri (L. reuteri) lozenges as an S/RSD adjunct on site‐level changes at molars with deep pockets.

Materials and methods: 447 molar sites with pockets ≥ 5 mm from a previous randomized clinical trial of adjunctive L. reuteri lozenges for 28 days were analyzed. Multilevel mixed‐effect models (MLM) were constructed to analyze site‐level outcomes “change in CAL” and “pocket closure” (residual PPD < 5 mm) in placebo and probiotic groups at 90 and 180 days. Possible patient‐, tooth‐, and site‐level predictors were analyzed as fixed‐effects.

Results: Estimated change in CAL in probiotic (90 day: 0.87 mm, 180 day: 0.68 mm) was greater than placebo treated molar sites (90 day: 0.73 mm, 180 day: 0.66 mm) and the relative risk (RR) of pocket closure in the probiotic group (90 day: 1.7, 180 day: 1.6) was higher as compared to placebo. Furcation involvement and BOP at site predicted significantly worse treatment outcomes.

Conclusion: As compared to S/RSD with placebo, a 28‐day course of adjunctive probiotic L. reuteri lozenges improved CAL change at molar sites with ≥ 5 mm deep pockets and conferred a higher probability of shallow residual pocket depth. Presence of furcation‐involvement and bleeding on probing worsened treatment outcomes.