Evaluation of the effect of probiotics in the treatment of peri-implant mucositis: a triple-blind randomized clinical trial.

OBJECTIVES: To determine if the treatment of mucositis with mechanical debridement, 0.12% chlorhexidine, and a further application of Lactobacillus reuteri (L. reuteri) will result in an improvement of the clinical and microbiological parameters in comparison to the treatment with mechanical debridement and 0.12% chlorhexidine alone. MATERIAL AND METHODS: Fifty dental implants with mucositis in 50 patients were randomly assigned to one of the following groups: mechanical debridement, 0.12% chlorhexidine mouthwash, and the subsequent administration of a probiotic agent (test group) or mechanical debridement and 0.12% chlorhexidine mouthwash (control group). Data were analyzed to determine clinical and microbiological changes during treatment and after a follow-up period of 3 months. RESULTS: After the administration of 0.12% chlorhexidine, all clinical parameters improved in the test and the control group, observing a significant decrease in Full Mouth Plaque Index (FMPI), full mouth bleeding on probing (FMBOP), Plaque Index (PI), and bleeding on probing (BOP) at the implant. However, following the administration of probiotics or placebo, the clinical variables, except for probing pocket depth, slightly and progressively increased up to 3 months of follow-up, but without reaching baseline levels. From a microbiological point of view, no major alterations of the subgingival microflora were recorded at different time points between groups during the study. CONCLUSIONS: Treatment with mechanical debridement, oral hygiene reinforcement, and administration of 0.12% chlorhexidine was effective in reducing mucositis, but it did not always result in complete resolution of inflammation. The administration of probiotics did not seem to provide an additional clinical or microbiological benefit. CLINICAL RELEVANCE: The use of probiotics does not seem to provide an additional benefit in the treatment of peri-implant mucositis.

Comparison of Periodontal Biotypes Between Maxillary and Mandibular Anterior Teeth: A Clinical and Radiographic Study.

Periodontal biotype is a key element influencing esthetic treatment outcomes in clinical practice. However, while the soft and hard tissue thicknesses of maxillary anterior teeth have been widely studied, information regarding mandibular anterior teeth is scarce. Therefore, the aim of this study was to determine whether there is a relationship in terms of hard and soft tissue thickness between maxillary and mandibular anterior teeth. The present study included 90 maxillary and 90 mandibular anterior teeth in 15 healthy patients. Clinical and cone beam computed tomography measurements were taken to determine gingival and buccal bone thickness, respectively, and a correlation was made between maxillary and mandibular anterior teeth. No statistically significant differences were found when comparing gingival and buccal bone thickness at the crestal third and midpoint of maxillary and mandibular teeth (P > .05). However, some differences were observed at the apical third between the two groups. The results suggest that soft and hard tissue dimensions of maxillary and mandibular anterior teeth are comparable, especially in the coronal third. However, more studies are necessary to confirm that maxillary anterior teeth can be used as a reference when dealing with mandibular incisors and canines.

Coronally Advanced Flap for Root Coverage: A 2-Year Case Series Follow-up.

The coronally advanced flap (CAF) has demonstrated controversial results in the treatment of gingival recession (GRs). The hypothesis of this study was that the CAF can partially reduce GR values over time. Root coverage (RC) in 24 Miller Class I GRs treated with a CAF by one experienced operator is presented with several periodontal parameters and postoperative morbidity. The mean percentage of RC was 80.35% at 3 months and 58.56% at 24 months; these differences were statistically significant. Keratinized gingival width, keratinized papillary gingival height, and gingival thickness were related to RC at 6 months. Postoperative pain was not statistically different over time. The CAF is not a predictable treatment for Miller Class I GRs after a 2-year follow-up period.

Clinical changes in periodontal subjects with the probiotic Lactobacillus reuteri Prodentis: a preliminary randomized clinical trial.

OBJECTIVES: The aim of this study was to assess the clinical effect of the administration of Lactobacillus reuteri Prodentis as a probiotic agent in the treatment of initial to moderate chronic periodontitis. Secondary objectives were to evaluate the patient 'compliance' factor and to observe the potential side-effects of the probiotic agent. MATERIALS AND METHODS: Twenty systemically healthy, non-smoking subjects with initial-to-moderate chronic periodontitis were enrolled in this 1-month double-blind, placebo-controlled, randomized clinical trial. Subjects were randomly assigned to receive tablets containing Lactobacillus reuteri Prodentis or placebo once a day for 30 days. Clinical parameters were collected at baseline and 30 days post-treatment. RESULTS: Periodontal clinical parameters were improved in the test group after a 30-day intervention. The test group demonstrated a statistically significant reduction (p < 0.05) in all the periodontal parameters included in the study (plaque index, bleeding on probing and pocket probing depths), while the control group treated with placebo did not show any statistically significant change in periodontal parameters. CONCLUSIONS: These data indicate that oral administration of Lactobacillus reuteri Prodentis improved the short-term clinical outcomes in non-smoking patients with initial-to-moderate chronic periodontitis.