牙周炎
安慰剂
医学
益生菌
内科学
随机对照试验
肠道菌群
粪便
胃肠病学
临床试验
临床附着丧失
牙科
生物
免疫学
微生物学
病理
细菌
替代医学
遗传学
作者
Adriana Miranda de Oliveira,Talita Gomes Baêta Lourenço,Ana Paula Vieira Colombo
摘要
The oral-gut axis may be a route linking periodontal and systemic diseases. Probiotics could be an alternative for the treatment of microbial dysbiotic conditions, including periodontitis. This randomized placebo-controlled clinical trial evaluated the short-term efficacy of systemic probiotics adjunctive to subgingival instrumentation (SI) in promoting a better restoration of the oral-gut microbiotas and greater periodontal clinical outcome.Systemically healthy adults with untreated periodontitis were recruited from a Dental School setting and allocated to receive SI plus placebo (n = 24) or probiotics (n = 24), one capsule/day for 30 days. Subgingival biofilm and stool were obtained at baseline and 2-months post-therapy for microbiological analyses by checkerboard and 16S rRNA gene sequencing. Differences in all parameters between placebo (n = 23) and probiotics (n = 19) groups were assessed by non-parametric tests.Most subgingival species and α-diversity decreased after therapies (P <0.05), whereas gut composition/diversity were slightly or not affected by treatments. In parallel, significant clinical improvement (P <0.05) was similar between groups, although a trend for a higher proportion of poor responders in the placebo (60.8%) than the probiotic group (31.5%) was observed (P = 0.07). Strong correlations between oral and fecal species were found (P <0.01), and distinct species related to poor response for different therapies (P <0.05). Patients were classified into five periodontitis oral-gut microbial clusters, which correlated differently with attachment loss after therapies (P <0.05).Systemic probiotics combined with SI did not provide short-term additional clinical or microbiological benefits in the treatment of periodontitis; however, response to therapies seemed to correlate with distinct oral-gut microbial profiles.
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