A Blissful Role of Probiotic Therapy as an Adjunct to Periodontal Surgery in the Treatment of Periodontitis.

Background Periodontitis is a chronic inflammatory disease that alters the alveolar bone structure, requiring treatment ranging from non-surgical to surgical periodontal therapies based on its severity. Surgical interventions, such as the modified Widman flap procedure and the open flap technique combined with methods like platelet-rich fibrin (PRF), guided tissue regeneration (GTR), and bone grafts, aim to reduce periodontal pockets and regenerate lost tissues. The presence of pathogenic bacteria and the absence of beneficial bacteria contribute to periodontitis, with probiotics-live microorganisms that offer health benefits emerging as a promising adjunct in periodontal therapy. Probiotics can inhibit harmful organisms and enhance the oral mucosal lining, potentially improving clinical outcomes when used alongside surgical procedures. This study aims to evaluate the efficacy of combining probiotics with open flap debridement (OFD) in managing chronic periodontitis, comparing it to OFD alone. Methodology Eighty individuals were recruited in this double-blind, randomization clinically controlled, split-mouth trial. The enrolled individuals were categorized in a random manner into either Group A (OFD) or Group B (OFD with probiotic therapy, OFD + P). Results Based on the results, significant differences were observed between the OFD and OFD + P groups. At baseline, the mean probing pocket depth (PPD) was 6.49 mm in the OFD group and 5.68 mm in the OFD + P group. After three weeks, the PPD decreased to 4.71 mm in the OFD group and 3.95 mm in the OFD + P group, with a p-value of 0.021, indicating a significant difference. By 12 weeks, the PPD was 3.20 mm for OFD and 2.74 mm for OFD + P, though the difference was not statistically significant (p-value 0.108). For relative attachment level (RAL), a significant difference was noted after three weeks with a p-value of 0.018; however, differences at baseline and 12 weeks were not significant. The gingival index (GI) did not show significant differences between the groups at any time point. Within-group analyses revealed significant improvements in PPD, RAL, and GI for both groups over time, with all p-values < 0.001. The OFD + P group demonstrated superior outcomes compared to the OFD group in PPD and RAL after three weeks. Conclusion The use of probiotics in managing periodontal disease offers a cost-effective and convenient treatment option for periodontitis. Its integration into periodontal therapy should be emphasized for its potential benefits across all age groups, benefiting both periodontal surgeons and general dentists. Further research is needed to understand how well probiotics persist in the oral microflora and their precise effects on periodontal health. The future of periodontal therapy could greatly benefit from probiotics as a natural, food-based approach to enhancing immunity and improving oral health.
Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethics Committee (IEC) of Hi-Tech Dental College and Hospital, Bhubaneswar, India, issued approval EC/MFS/ 0824. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
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