Adjuvant use of multispecies probiotic in the treatment of peri‐implant mucositis: A randomized controlled trial

Abstract Aim This randomized placebo‐controlled clinical trial evaluated the effects of multispecies probiotic containing Lactobacillus rhamnosus HN001™, Lactobacillus paracasei Lpc‐37®, and Bifidobacterium animalis subsp lactis HN019™ as an adjunct to mechanical debridement (MD) on changes in bleeding on probing (BOP) in edentulous patients with peri‐implant mucositis (PiM). Materials and Methods Patients were randomly assigned to test (probiotic) or control (placebo) groups. All sites with PiM received MD and topical gel application (probiotic or placebo) at baseline and 12 weeks. After initial MD, patients consumed probiotic or placebo capsules twice a day for 12 weeks. Clinical (modified sulcus bleeding index [mSBI]; modified plaque index [mPI]; probing depth [PD]; and BOP) and immunological parameters were collected at baseline and after 12 and 24 weeks. Data were statistically analysed ( p < .05). Results Thirty‐six patients with PiM were recruited. The test group presented higher prevalence ( p < .05) of cases of restored peri‐implant health at 24 weeks than did the control group (72.2% and 33.3%, respectively). No significant difference was observed between test ( n = 18) and control ( n = 18) groups for mPI and PD. mSBI %—score 0 was higher in the test group than in the control group at 24 weeks ( p < .05). When compared with baseline, both groups presented reduced BOP at 12 and 24 weeks ( p < .05). BOP was lower in the test group than in the control group at 12 (mean difference = −14.54%; 95% confidence interval [CI] = −28.87 to 0.22; p = .0163) and 24 (mean difference = −12.56%; 95% CI = −26.51 to 1.37; p = .0090) weeks. At 24 weeks, only the test group presented lower levels of interleukin (IL)‐1β, IL‐6, IL‐8, and tumour necrosis factor (TNF)‐α than those at baseline ( p < .05). Conclusions The multispecies probiotic (administered locally and systemically) containing L. rhamnosus HN001™, L. paracasei Lpc‐37®, and B. lactis HN019™ as an adjunct to repeated MD promotes additional clinical and immunological benefits in the treatment of PiM in edentulous patients (ClinicalTrials.gov NCT04187222).