Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Tüm Ağız Debridmanı ile Birlikte Kullanılan Probiyotikli Solüsyon İrrigasyonunun Evre III Derece B Periodontitis Tedavisi Üzerine Etkisi: Randomize, Çift Kör, Kontrollü Klinik Araştırma
The Effects of Different Irrigation Agents Used with Full Mouth Debridement on the Treatment of Grade III Stage B Periodontitis: A Randomized, Double-Blind, Controlled Clinical Trial
Bahar ANDAÇ URALa , Onur UÇAK TÜRERa , Bahar ALKAYAa
aÇukurova Üniversitesi Diş Hekimliği Fakültesi, Periodontoloji AD, Adana, Türkiye
Turkiye Klinikleri J Dental Sci. 2024;30(4):640-7
doi: 10.5336/dentalsci.2024-102161
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmanın amacı, Evre III Derece B periodontitis tedavisinde tüm ağız debridmanıyla beraber subgingival irrigasyon ajanı olarak kullanılan probiyotikli solüsyonların tedavi sonucu klinik parametrelere etkisini araştırmaktır. Gereç ve Yöntemler: Çalışmaya 25- 63 yaş arası toplam 40 hasta dâhil edildi. Hastalar, rastgele ve eşit şekilde 2 gruba ayrıldı. Hastaların başlangıç tedavisinden önce klinik ağız içi fotoğrafları alındı ve klinik parametreleri (cep derinliği, diş eti çekilmesi, klinik ataçman seviyesi, gingival indeks, plak indeksi) kaydedildi. Oral hijyen eğitimi, diş yüzeyi temizliği ve kök yüzeyi düzleştirmesini içeren cerrahi olmayan periodontal tedaviler 24 saat içerisinde 1 ya da 2 seansta gerçekleştirilen tüm ağız debridmanı işlemine göre yapıldı. Subgingival irrigasyon ajanı olarak kontrol grubu hastalarda serum fizyolojik, çalışma grubu hastalarda ise Bacillus clausii içeren probiyotikli solüsyon kullanıldı. Tedavi sonrasında irrigasyon ajanı olarak serum fizyolojik kullanılan gruba serum fizyolojik, Bacillus clausii kullanılan gruba Bacillus clausii içerikli gargara 10 gün boyunca günde iki kez kullanmaları için verildi. Hastaların 1 ile 3. ayda kontrolleri yapıldı ve klinik parametreler her seansta kaydedildi. Bulgular: Üç ay sonunda her iki grupta da grup içi değerlendirmelerde genel cep derinliği, plak indeksi ve gingival indeks skorlarında istatistiksel olarak anlamlı azalma, klinik ataçman seviyesinde kazanç tespit edilmiştir. Gruplar arası karşılaştırmada ise klinik parametrelerde istatistiksel farklılık gözlenmemiştir. Sonuç: Tüm ağız debribman metodu uygulanan bu çalışmada, probiyotikli irrigasyon solüsyonunun ilave bir etkisi saptanmamıştır. Farklı probiyotik türleri, konsantasyonları ve daha uzun değerlendirme süresi ile ilave çalışmalara ihtiyaç vardır.

Anahtar Kelimeler: Periodontitis; probiyotik; Bacillus clausii; cerrahi olmayan periodontal tedavi; periodontal indeks
ABSTRACT
 Objective: This study aimed to investigate the effects of probiotic solutions, which were used as subgingival irrigation agents together with full mouth debridement, on clinical parameters for the treatment of Stage III Grade B periodontitis patients. Material and Methods: A total of 40 patients aged between 25-63 were included in the study. The patients were randomly and equally divided into 2 groups. Before the treatments, clinical intraoral photographs were taken and clinical parameters (pocket depth, gingival recession, clinical attachment level, gingival index, and plaque index) were recorded. Nonsurgical periodontal treatments including oral hygiene education, scaling and root planning were performed according to the full-mouth debridement procedure performed in 1 or 2 sessions within 24 hours. Sterile saline was used in the control group, while probiotic solutions including Bacillus clausii were used in the test group as subgingival irrigation agents. After treatment, saline was given to the group using saline as irrigation agent and Bacillus clausii mouthrinses Bacillus clausii was given to the group using Bacillus clausii to use twice a day for 10 days. 1st and 3rd months controls were performed, and clinical parameters were recorded. Results: At the end of third month, there were statistically significant decreases for pocket depth, plaque index and gingival index scores and gain in clinical attachment levels in two groups compared to baseline. No statistical differences were observed in clinical parameters between the groups. Conclusion: This study demonstrated no additional effects of probiotic irrigation solution when the whole-mouth debridement method was used. Additional studies with other types of probiotic bacteria and longer evaluation periods are needed.

Keywords: Periodontitis; probiotic; Bacillus clausii; nonsurgical periodontal debridement; periodontal indices
REFERENCES:
  1. Flemmig TF. Periodontitis. Ann Periodontol. 1999;4(1):32-8. [Crossref]  [PubMed] 
  2. Greenstein G. Nonsurgical periodontal therapy in 2000: a literature review. J Am Dent Assoc. 2000;131(11):1580-92. [Crossref]  [PubMed] 
  3. Kinane DF, Attström R; European Workshop in Periodontology group B. Advances in the pathogenesis of periodontitis. Group B consensus report of the fifth European Workshop in Periodontology. J Clin Periodontol. 2005;32 Suppl 6:130-1. [Crossref]  [PubMed] 
  4. Schwartz Z, Goultschin J, Dean DD, Boyan BD. Mechanisms of alveolar bone destruction in periodontitis. Periodontol 2000. 1997;14:158-72. [Crossref]  [PubMed] 
  5. Heitz-Mayfield LJ, Trombelli L, Heitz F, Needleman I, Moles D. A systematic review of the effect of surgical debridement vs non-surgical debridement for the treatment of chronic periodontitis. J Clin Periodontol. 2002;29 Suppl 3:92-102; discussion 160-2. [Crossref]  [PubMed] 
  6. Van der Weijden GA, Timmerman MF. A systematic review on the clinical efficacy of subgingival debridement in the treatment of chronic periodontitis. J Clin Periodontol. 2002;29 Suppl 3:55-71; discussion 90-1. [Crossref]  [PubMed] 
  7. Badersten A, Nilveus R, Egelberg J. Effect of nonsurgical periodontal therapy. II. Severely advanced periodontitis. J Clin Periodontol. 1984;11(1):63-76. [Crossref]  [PubMed] 
  8. Roberts FA, Darveau RP. Beneficial bacteria of the periodontium. Periodontol 2000. 2002;30:40-50. [Crossref]  [PubMed] 
  9. Ximénez-Fyvie LA, Haffajee AD, Som S, Thompson M, Torresyap G, Socransky SS. The effect of repeated professional supragingival plaque removal on the composition of the supra- and subgingival microbiota. J Clin Periodontol. 2000;27(9):637-47. [Crossref]  [PubMed] 
  10. Özener HÖ, Kuru Eren B. Probiyotiklerin periodontal tedavideki yeri [Probiotics in periodontal therapy]. Clin Exp Health Sci. 2015;5(1):53-64. [Crossref] 
  11. Quirynen M, De Soete M, Dierickx K, van Steenberghe D. The intra-oral translocation of periodontopathogens jeopardises the outcome of periodontal therapy. A review of the literature. J Clin Periodontol. 2001;28(6):499-507. [Crossref]  [PubMed] 
  12. Eberhard J, Jepsen S, Jervøe-Storm PM, Needleman I, Worthington HV. Full-mouth treatment modalities (within 24 hours) for chronic periodontitis in adults. Cochrane Database Syst Rev. 2015;2015(4):CD004622. Update in: Cochrane Database Syst Rev. 2022;6:CD004622. [Crossref]  [PubMed]  [PMC] 
  13. Hotel ACP, Cordoba A. Health and nutritional properties of probiotics in food including powder milk with live lactic acid bacteria. Prevention. 2001;5(1):1-10. [Link] 
  14. Teughels W, Van Essche M, Sliepen I, Quirynen M. Probiotics and oral healthcare. Periodontol 2000. 2008;48:111-47. [Crossref]  [PubMed] 
  15. Floch MH. Recommendations for probiotic use in humans-a 2014 update. Pharmaceuticals (Basel). 2014;7(10):999-1007. [Crossref]  [PubMed]  [PMC] 
  16. Suva MA, Sureja VP, Kheni DB. Novel insight on probiotic Bacillus subtilis: Mechanism of action and clinical applications. J. Curr. Res. in Sci. Med. 2016;2(2):65-72. [Crossref] 
  17. Urdaci MC, Bressollier P, Pinchuk I. Bacillus clausii probiotic strains: antimicrobial and immunomodulatory activities. J Clin Gastroenterol. 2004;38(6 Suppl):S86-90. [Crossref]  [PubMed] 
  18. Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, et al. Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol. 2018;89 Suppl 1:S173-S182. [PubMed] 
  19. Silness J, Loe H. Periodontal disease in pregnancy. II. correlation between oral hygiene and periodontal condtion. Acta Odontol Scand. 1964;22:121-35. [Crossref]  [PubMed] 
  20. Loe H, Silness J. Periodontal disease in pregnancy. I. prevalence and severity. Acta Odontol Scand. 1963;21:533-51. [Crossref]  [PubMed] 
  21. Quirynen M, Bollen CM, Vandekerckhove BN, Dekeyser C, Papaioannou W, Eyssen H. Full- vs. partial-mouth disinfection in the treatment of periodontal infections: short-term clinical and microbiological observations. J Dent Res. 1995;74(8):1459-67. [Crossref]  [PubMed] 
  22. Knowles JW, Burgett FG, Nissle RR, Shick RA, Morrison EC, Ramfjord SP. Results of periodontal treatment related to pocket depth and attachment level. Eight years. J Periodontol. 1979;50(5):225-33. [Crossref]  [PubMed] 
  23. Hämmerle CH, Joss A, Lang NP. Short-term effects of initial periodontal therapy (hygienic phase). J Clin Periodontol. 1991;18(4):233-9. [Crossref]  [PubMed] 
  24. Haffajee AD, Cugini MA, Dibart S, Smith C, Kent RL Jr, Socransky SS. The effect of SRP on the clinical and microbiological parameters of periodontal diseases. J Clin Periodontol. 1997;24(5):324-34. [Crossref]  [PubMed] 
  25. Quirynen M, Mongardini C, de Soete M, Pauwels M, Coucke W, van Eldere J, et al. The rôle of chlorhexidine in the one-stage full-mouth disinfection treatment of patients with advanced adult periodontitis. Long-term clinical and microbiological observations. J Clin Periodontol. 2000;27(8):578-89. [Crossref]  [PubMed] 
  26. Saïz P, Taveira N, Alves R. Probiotics in oral health and disease: A systematic review. Appl. Sci. 2021;11(17):8070. [Crossref] 
  27. Chatterjee A, Bhattacharya H, Kandwal A. Probiotics in periodontal health and disease. J Indian Soc Periodontol. 2011;15(1):23-8. [Crossref]  [PubMed]  [PMC] 
  28. Hardy JH, Newman HN, Strahan JD. Direct irrigation and subgingival plaque. J Clin Periodontol. 1982;9(1):57-65. [Crossref]  [PubMed] 
  29. Reynolds MA, Lavigne CK, Minah GE, Suzuki JB. Clinical effects of simultaneous ultrasonic scaling and subgingival irrigation with chlorhexidine. Mediating influence of periodontal probing depth. J Clin Periodontol. 1992;19(8):595-600. [Crossref]  [PubMed] 
  30. Nosal G, Scheidt MJ, O'Neal R, Van Dyke TE. The penetration of lavage solution into the periodontal pocket during ultrasonic instrumentation. J Periodontol. 1991;62(9):554-7. [Crossref]  [PubMed] 
  31. Morales A, Carvajal P, Silva N, Hernandez M, Godoy C, Rodriguez G, et al. Clinical effects of lactobacillus rhamnosus in non-surgical treatment of chronic periodontitis: a randomized placebo-controlled trial with 1-year follow-up. J Periodontol. 2016;87(8):944-52. [Crossref]  [PubMed] 
  32. Tsubura S, Mizunuma H, Ishikawa S, Oyake I, Okabayashi M, Katoh K, et al. The effect of Bacillus subtilis mouth rinsing in patients with periodontitis. Eur J Clin Microbiol Infect Dis. 2009;28(11):1353-6. [Crossref]  [PubMed] 
  33. Alkaya B, Laleman I, Keceli S, Ozcelik O, Cenk Haytac M, Teughels W. Clinical effects of probiotics containing Bacillus species on gingivitis: a pilot randomized controlled trial. J Periodontal Res. 2017;52(3):497-504. [Crossref]  [PubMed] 
  34. Martin-Cabezas R, Davideau JL, Tenenbaum H, Huck O. Clinical efficacy of probiotics as an adjunctive therapy to non-surgical periodontal treatment of chronic periodontitis: a systematic review and meta-analysis. J Clin Periodontol. 2016;43(6):520-30. [Crossref]  [PubMed] 
  35. Gheisary Z, Mahmood R, Harri Shivanantham A, Liu J, Lieffers JRL, Papagerakis P, et al. The Clinical, Microbiological, and Immunological Effects of Probiotic Supplementation on Prevention and Treatment of Periodontal Diseases: A Systematic Review and Meta-Analysis. Nutrients. 2022;14(5):1036. [Crossref]  [PubMed]  [PMC] 

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