Evaluating the effect of a mixture of Lactobacillus brevis and Lactobacillus plantarum on the management of periodontitis stage III grade C molar-incisor pattern in Egyptian patients ( Randomize control trial)

Abstract

Abstract Periodontitis is a common disease that represents a public health problem. Aggregatibacter actinomycetemcomitans (A. a ) especially the JP2 genotype plays a major role in the pathogenesis of periodontitis. The aim of this study is to evaluate the effect of topically applied probiotics on the management of periodontitis stage III grade C molar-incisor pattern. Methods: Sixty-five patients having periodontitis stage III grade C molar-incisor pattern. Screening for A. actinomycetemcomians (A.a) and the JP2 genotype was done using conventional polymerase chain reaction (PCR). Patients positive for (A. a) were randomly divided into two groups. Group I: received conventional periodontal treatment combined with topically applied probiotic, while Group II: received conventional periodontal treatment only. Both groups were evaluated microbiologically and clinically. Quantitative assessment of A. a levels was done by real time PCR (qPCR) at baseline as well as one week, 4 weeks, and 12 weeks after treatment. Clinical parameters were assessed before treatment as well as 3,6 and 9 months after treatment. Results: Both treatment groups showed reduction in the levels of A.a as well as clinical parameters at different intervals. Although the use of probiotics plus SRP had a better effect in reducing the levels of A.a and clinical parameters at different intervals than SRP only, the difference between both groups was statistically non-significant. Conclusion: The low prevalence of A. a among patients with periodontitis stage III grade C molar-incisor pattern makes the role of A. a questionable as an important risk factor. Thus, additional studies are needed with large sample size. Probiotics as an adjuvant therapy might have a promising effect, as an alternative to antibiotics, in the management of periodontitis in the future.