PMID- 38183505 OWN - NLM STAT- MEDLINE DCOM- 20240108 LR - 20240205 IS - 1436-3771 (Electronic) IS - 1432-6981 (Linking) VI - 28 IP - 1 DP - 2024 Jan 6 TI - Effect of adjuvant probiotic therapy (Lactobacillus reuteri) in the treatment of periodontitis associated with diabetes mellitus: clinical, controlled, and randomized study. PG - 80 LID - 10.1007/s00784-023-05441-0 [doi] AB - OBJECTIVES: Subgingival instrumentation (SI) with probiotics may be a proposal for the treatment of periodontitis (P), for patients with type 2 diabetes mellitus (T2DM). The Lactobacillus reuteri probiotic as an adjunctive therapy in the treatment of P associated with T2DM was evaluated. MATERIALS AND METHODS: Forty diabetic participants diagnosed with P (stage III and IV, grade B) were randomized into SI + Placebo (n = 20): subgingival instrumentation plus placebo lozenges and SI + Probi (n = 20): subgingival instrumentation plus probiotics. Probing depth (PD), gingival recession (GR), clinical attachment level (CAL), plaque index (PI), bleeding on probing (BoP), and PISA index were performed at baseline and 30, 90, and 180 days. Cytokine concentration in the gingival crevicular fluid, subgingival biofilm sample, and LDL and HDL subfractions were evaluated. RESULTS: In the deep pockets, PD in SI + Probi showed increased values (p = 0.02) compared to SI + Placebo at 90 days. For CAL, SI + Probi showed increased values compared to SI + Placebo, with a significant difference at 30 days (p = 0.03), 90 days (p = 0.02), and 180 days (p = 0.04). At #PD >/= 7 mm, SI + Probi had a more frequent number of sites (p = 0.03) compared to SI + Placebo only at baseline. For the PISA, SI + Probi showed a significant difference (p = 0.04) compared to SI + Placebo at 90 days. For cytokines, SI + Probi showed higher quantification than SI + Placebo for IL-10 (p < 0.001) at 90 days, IL-12 (p = 0.010) at 90 days, IL-1beta (p = 0.035) at 90 days, and IL-8 (p = 0.003) at baseline. SI + Placebo showed higher quantification of IL-1beta (p = 0.041) compared to SI + Probi only at 30 days. There was a reduction in all microbial complexes. SI + Probi improved LDL size (246.7 nm vs 260.4 nm; p < 0.001), while large HDL subfractions were reduced aft 180 days of treatment (24.0% vs 20.3%; p = 0.022) when compared with SI + Placebo; this response was dependent of probiotics (1.0 mg/dL vs - 6.2 mg/dL; p = 0.002). CONCLUSION: Subgingival instrumentation improved the clinical periodontal parameters in patients with T2DM. The use of L. reuteri probiotics had no additional effects compared with the placebo; however, there was a positive effect on the lipoprotein subfraction. CLINICAL RELEVANCE: Scientific rationale for study: subgingival instrumentation with probiotics may be a proposal for the treatment of periodontitis (P), especially for patients with type 2 diabetes mellitus (T2DM). PRINCIPAL FINDINGS: the use of L. reuteri probiotics had no additional effects compared with the placebo; however, there was a positive effect on the lipoprotein subfraction. Practical implications: L. reuteri as an adjunct to subgingival instrumentation may have significant therapeutic implications in dyslipidemia. CI - (c) 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. FAU - Jardini, Maria Aparecida Neves AU - Jardini MAN AD - Department of Diagnosis and Surgery, Institute of Science and Technology of Sao Jose Dos Campos, Universidade Estadual Paulista (Unesp), Sao Jose Dos Campos, SP, Brazil. maria.jardini@unesp.br. FAU - Pedroso, Juliana Fatima AU - Pedroso JF AD - Department of Diagnosis and Surgery, Institute of Science and Technology of Sao Jose Dos Campos, Universidade Estadual Paulista (Unesp), Sao Jose Dos Campos, SP, Brazil. FAU - Ferreira, Camila Lopes AU - Ferreira CL AD - Department of Dentistry, Universidade de Taubate (UNITAU), Taubate, SP, Brazil. FAU - Nunes, Camilla Magnoni Moretto AU - Nunes CMM AD - Department of Diagnosis and Surgery, Institute of Science and Technology of Sao Jose Dos Campos, Universidade Estadual Paulista (Unesp), Sao Jose Dos Campos, SP, Brazil. FAU - Reichert, Cadiele Oliana AU - Reichert CO AD - Lipids, Oxidation and Cell Biology Team-LIM-19, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil. FAU - Aldin, Marlene Nunez AU - Aldin MN AD - Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil. FAU - Figueiredo Neto, Antonio Martins AU - Figueiredo Neto AM AD - Institute of Physics, University of Sao Paulo, Sao Paulo, SP, Brazil. FAU - Levy, Debora AU - Levy D AD - Lipids, Oxidation and Cell Biology Team-LIM-19, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil. FAU - Damasceno, Nagila Raquel Teixeira AU - Damasceno NRT AD - Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil. LA - eng GR - (CNPq - 465259/2014-6)/National Council for Scientific and Technological Development ./ GR - (CNPq - 465259/2014-6)/National Council for Scientific and Technological Development ./ GR - (CNPq - 465259/2014-6)/National Council for Scientific and Technological Development ./ GR - (CNPq - 465259/2014-6)/National Council for Scientific and Technological Development ./ GR - (FAPESP - 2014/50983-3), (FAPESP - 2016/24531-3)./National Institute of Science and Technology Complex Fluids (INCT-Fcx), and the Sao Paulo Research Foundation/ GR - (FAPESP - 2014/50983-3), (FAPESP - 2016/24531-3)./National Institute of Science and Technology Complex Fluids (INCT-Fcx), and the Sao Paulo Research Foundation/ GR - (FAPESP - 2014/50983-3), (FAPESP - 2016/24531-3)./National Institute of Science and Technology Complex Fluids (INCT-Fcx), and the Sao Paulo Research Foundation/ GR - (FAPESP - 2014/50983-3), (FAPESP - 2016/24531-3)./National Institute of Science and Technology Complex Fluids (INCT-Fcx), and the Sao Paulo Research Foundation/ GR - Finance Code 001/Coordination for the Improvement of Higher Education Personnel - Brasil (CAPES)/ PT - Journal Article PT - Randomized Controlled Trial DEP - 20240106 PL - Germany TA - Clin Oral Investig JT - Clinical oral investigations JID - 9707115 RN - 0 (Adjuvants, Immunologic) RN - 0 (Cytokines) RN - 0 (Lipoproteins) MH - Humans MH - *Limosilactobacillus reuteri MH - *Diabetes Mellitus, Type 2/complications/therapy MH - Combined Modality Therapy MH - Adjuvants, Immunologic MH - *Periodontitis/therapy MH - Cytokines MH - Lipoproteins OTO - NOTNLM OT - LDL and HDL OT - Periodontitis OT - Probiotics OT - Subgingival biofilm OT - Subgingival instrumentation OT - Type 2 diabetes mellitus EDAT- 2024/01/07 06:42 MHDA- 2024/01/08 06:43 CRDT- 2024/01/06 11:07 PHST- 2023/08/30 00:00 [received] PHST- 2023/12/16 00:00 [accepted] PHST- 2024/01/08 06:43 [medline] PHST- 2024/01/07 06:42 [pubmed] PHST- 2024/01/06 11:07 [entrez] AID - 10.1007/s00784-023-05441-0 [pii] AID - 10.1007/s00784-023-05441-0 [doi] PST - epublish SO - Clin Oral Investig. 2024 Jan 6;28(1):80. doi: 10.1007/s00784-023-05441-0.