title: The effect of orally administered probiotic Lactobacillus reuteri-containing tablets in peri-implant mucositis: a double-blind randomized controlled trial.
abstract: OBJECTIVE
  Probiotics create a biofilm and protect the oral tissues against the action of periodontal pathogenic bacteria. The aim of this study was to evaluate the effects of the oral probiotic Lactobacillus reuteri Prodentis upon the peri-implant health of edentulous patients with dental implants and peri-implant mucositis, establishing comparisons vs implants without peri-implant disease.
  
  
  METHODS
  A double-blind, placebo-controlled, prospective cross-over study was made. The patients were all edentulous and were divided into two groups, (A) no peri-implant disease, and (B) peri-implant mucositis affecting one or more implants. Patients with peri-implantitis were excluded. The dosage was one tablet every 24 h over 30 d. All patients in both groups initially received the oral probiotic Lactobacillus reuteri Prodentis, followed by placebo. Patients started with probiotic treatment during 30 d, followed by a 6 mo washout period and the administration of placebo for the same period. The following parameters were studied: crevicular fluid volume, modified plaque index, probing depth, modified gingival index, and concentrations of interleukin 1β, interleukin 6 and interleukin 8.
  
  
  RESULTS
  A total of 77 implants were evaluated in 34 patients. Group A involved 22 patients with 54 implants without peri-implant alterations, and group B, 12 patients with mucositis affecting one or more implants (23 implants). After treatment with the probiotic, both the patients with mucositis and the patients without peri-implant disease showed improvements in the clinical parameters, with reductions in cytokine levels. In contrast, no such changes were observed with placebo.
  
  
  CONCLUSIONS
  After treatment with the probiotic Lactobacillus reuteri in patients with implants presenting mucositis, the clinical parameters improved, and the cytokine levels decreased - in contraposition to the observations in the placebo group. Probiotic administration may be regarded as a good alternative for both the treatment of peri-implant mucositis and its prevention, as it also improved clinical parameters in the healthy individuals. Further studies involving larger patient series are needed regarding the effects of probiotics upon peri-implant health.
authors.affiliation: Oral Surgery and Implantology, University of Valencia, Valencia, Spain.
authors.forename: A J
authors.initials: AJ
authors.lastname: Flichy-Fernández
authors.affiliation: Oral Surgery and Medicine, Oral Surgery and Implantology, Public Dental Health Service, Arnau de Vilanova Hospital, Valencia University Medical and Dental School, Valencia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Ata-Ali
authors.affiliation: Oral Surgery and Implantology, University of Valencia, Valencia, Spain.
authors.forename: T
authors.initials: T
authors.lastname: Alegre-Domingo
authors.affiliation: Oral Surgery and Implantology, University of Valencia, Valencia, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Candel-Martí
authors.affiliation: Valencia University Medical and Dental School, Valencia, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Ata-Ali
authors.affiliation: Biotechnology and Biomedicine Institute, Barcelona Autonomous University, Barcelona, Spain.
authors.forename: J R
authors.initials: JR
authors.lastname: Palacio
authors.affiliation: Oral Surgery, Oral Surgery and Implantology, University of Valencia, Valencia, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Peñarrocha-Diago
mesh_terms: D000368:Aged; D018592:Cross-Over Studies; D016207:Cytokines / Q000032:analysis; D003757:Dental Implantation / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D052200:Limosilactobacillus reuteri / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000473:pathology / Q000517:prevention & control*; D010919:Placebos / Q000008:administration & dosage; D019936:Probiotics / Q000008:administration & dosage*; D011446:Prospective Studies; D013607:Tablets / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D016207:Cytokines; D010919:Placebos; D013607:Tablets
keywords: Lactobacillus reuteri; dental implant; peri-implant mucositis; probiotics