Clinical Efficacy of Probiotics as An Adjunct to Scaling and Root Planning in The Treatment Of Chronic Periodontitis

Objective: The objective of this study was to assess the clinical efficacy of scaling and root planing (SRP) alone and SRP along with adjunctive probiotic containing Lactobacillus reuteri (L.reuteri) in the management of chronic periodontitis (CP) and comparing the efficacy of two treatment modalities. Methods: Twenty-eight systemically healthy participants, clinically diagnosed with CP on the bases of pocket depth were enrolled from the outpatient department of Periodontology, Ziauddin College of Den- tistry, Ziauddin University, Clifton, Karachi, Pakistan. After complete periodontal examination all clinical periodontal parameter i.e., Probing Pocket depth (PPD), Clinical attachment level (CAL), percentage sites for plaque accumulation (PI) and bleeding on probing (BOP) were measured and recorded at baseline, 6 weeks and 12 weeks after therapy. Patients meeting the inclusion criteria underwent non- surgical periodontal therapy i.e. SRP both with hand instruments and with ultrasonic scalers. After SRP oral hygiene measures were reassured and then participants were randomly allocated to one of two groups i.e., Probiotics (N=14) or Placebo (N=14). Both L. reuteri and placebo were given twice daily for 12 weeks and patients were recalled for assessment. Results: At baseline both groups were similar clinically. Intra-group comparison of clinical periodontal parameters showed improvement in the participants of both groups. Inter-group comparison showed greater reduction in PPD and BOP and more gain in CAL in probiotic group on each follow up visits and statistically significant difference was observed in two groups. Whereas for PI the difference between two groups at follow-up visit was insignificant i.e. both treatment strategies were equal in reducing per- centage sites of plaque accumulation. Conclusion: The results of our study concludes L.reuteri containing probiotic along with SRP is superior when compared to SRP alone in terms of resolving inflammation and improving periodontal health. Probiotics can be used as a promising alternative adjunctive therapy with minimal or no side effects in the treatment of chronic periodontitis.