Probiotic candidates among dairy Lactobacilli and Streptococcus thermophiles strains for control of the oral pathogen Porphyromonas gingivalis

Introduction: The gram-negative bacterium Porphyromonas gingivalis is a major causative agent of periodontitis in adults. It is also associated with disorders of the cardiovascular and endocrine systems, rheumatoid arthritis, pancreatic cancer, and Alzheimer’s disease. Lactic acid bacteria (LAB) present in the oral cavity or introduced as probiotic preparations can support successful treatment of periodontitis due to their antagonism with the pathogen.Aim: The aim of this study was in vitro assessment of the antimicrobial activity of Lactobacillus spp. and Streptococcus thermophilus against P. gingivalis.Materials and methods: The antimicrobial effect of lactobacilli or S. thermophilus from the LBB Culture collection against P. gingivalis DSM 20709 was evaluated with the well diffusion assay on Wilkins Chalgren blood agar. Inhibition of the pathogen was evaluated by measuring the diameter of clear zones around the wells.Results: Application of milk fermented with selected LAB resulted in а bacteriostatic effect. The most active culture was S. thermophilus 187/4, followed by L. delbr. ssp. bulgaricus (LBB.B1054, C3/2 and LBB.B120), L. helveticus LBB.H48/1 and L. rhamnosus I-1/13. The respective reconstituted freeze-dried preparations had a stronger inhibitory effect on the pathogen with the formation of clear bactericidal zones. The effect of milk acidified with lactic acid was apparent with minimal bactericidal zone observed at concentration of 0.1%. The effectiveness of the assay was confirmed with Elgydium and Eludril.Conclusions: P. gingivalis DSM 20709 was sensitive to the metabolites produced in fermented milk by selected strains of L. delbr. ssp. bulgaricus, L. helveticus, L. rhamnosus, and S. thermophilus. Reconstituted freeze dried fermented milk had а stronger inhibitory effect compared to fresh samples. Lactic acid produced by lactic acid bacteria was the key component for inhibition of the pathogen

Treatment of Residual Periodontal Pockets Using a Hyaluronic Acid-Based Gel: A 12 Month Multicenter Randomized Triple-Blinded Clinical Trial.

The aim of the present study was to evaluate the adjunctive effect of hyaluronic acid (HA) gel in the treatment of residual periodontal pockets over a 12-month period. Periodontal patients presenting at least one residual periodontal pocket 5-9 mm of depth in the anterior area were recruited from six university-based centers. Each patient was randomly assigned to subgingival instrumentation (SI) with the local adjunctive use of HA for test treatment or adjunctive use of local placebo for control treatment at baseline and after 3 months. Clinical parameters ( )probing depth (PD), bleeding on probing (BoP), plaque index (PI), recession (REC), clinical attachment level (CAL)) and microbiological samples for the investigation of the total bacterial count (TBC) and presence of specific bacterial species (Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, Fusobacterium nucleatum) were taken at baseline and every 3 months, until study termination. PD was determined as the primary outcome variable. From a total of 144 enrolled, 126 participants (53 males, 73 females) completed the entire protocol. Both treatments resulted in statistically significant clinical and microbiological improvements compared to baseline. Although the local application of HA showed a tendency for better results, there was a lack of statistically significant differences between the groups