Here, bacteria and environmental factors play important roles in causing the infection and its development. The goal in treating periodontitis is to get rid of the bacteria using machines or hand tools in the area below the gum line. This treatment, in medical terms, is called subgingival debridement (SD).
In addition to gum cleaning, antimicrobials are also commonly used in the treatment. However, the worldwide concern on the increase of antibiotic resistance led to considering these two potential alternatives to antibiotics — Light-activated Disinfection (LAD) and probiotics. LAD uses light and targets the infected area to produce singlet oxygen that is toxic to bacteria.
The present pilot study aimed to assess the effects of LAD alone or combined with probiotics as a supplement to SD in non-surgical periodontal therapy.
The Study Method on Using Probiotics for Periodontitis
48 patients with untreated periodontitis were studied. They were divided equally into three groups, and each group received a different treatment. The treatments were: subgingival debridement (SD) alone, SD with LAD, or SD with LAD plus probiotic treatment.
The probiotics were in the form of a gel and lozenges that contained Lactobacillus brevis and Lactobacillus plantarum. The gel was put in the pockets between the gums and teeth. The lozenges were taken by mouth every day for three months.
An examiner assessed the following five parameters:
- Probing pocket depth (PPD)
- Clinical attachment level (CAL)
- Bleeding on probing (BOP)
- Gingiva-index simplified (GIs)
- And plaque-control record (PCR)
He also collected plaque samples below the gum line to identify the bacteria present. These were all done at the start of the study, three and six months after the treatment.
The three treatment procedures showed improvements in all parameters at six months compared to baseline. However, SD + LAD + probiotic treatment combined showed significantly greater reductions in BOP, GIs, and the bacteria Tannerella forsythia and Porphyromonas gingivalis at six months after treatment.
It appears in this study that the combination of SD + LAD + probiotic treatment can be a valuable approach to address periodontal tissue inflammation and infection control.
As for the other treatment approach, a single application of LAD as an adjunct to SD provided no additional clinical and microbiological benefits compared to SD alone.