Role of probiotics containing Lactobacillus reuteri in adjunct to scaling and root planing for management of patients with chronic periodontitis: a meta-analysis

OBJECTIVE: Probiotics, nowadays are the effective in management of chronic periodontitis when used as an adjunct to non-surgical periodontal therapy. However, the beneficial effects of probiotics are varied with the nature of bacterial strain. Our meta-analysis aims at evaluating the magnitude of improvement in clinical and microbiological parameters, with administration of Lactobacillus reuteri alone in adjunct to scaling and root planning (SRP). MATERIALS AND METHODS: A digitalized database search was made in MEDLINE (PubMed), Scopus, CENTRAL (Cochrane Registry of Trials), Web of Science, and EMBASE, to identify eleven randomized clinical trials published within last decade (2009-2019), with double blind, placebo controlled study design. The data extraction was carried out and subject to both qualitative and quantitative synthesis. The primary outcomes assessed were gain in clinical attachment level (CAL). reduction in probing pocket depth (PPD), and reduction in microbial levels. RESULTS: The meta-analysis plots were used to assess all the clinical outcomes. The mean difference of reduction in PPD at 21 days (MD-0.61) and 3 months (MD-0.40), and CAL gain at 3 month (MD-0.30) showed favourable response in the sites treated with probiotics containing Lactobacillus reuteri in addition to SRP. The meta-plots for major peridonto-pathogens constructed at 21 days follow-up, showed short-term effective reduction. CONCLUSIONS: Within the limits of the study, Lactobacillus reuteri containing probiotics showed a significant clinical and microbiological benefit, however, the favourable effect was shown to be short-term.