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Randomized Controlled Trial
. 2021 Jan 7;21(1):12.
doi: 10.1186/s12903-020-01276-3.

Clinical effects of probiotic or azithromycin as an adjunct to scaling and root planning in the treatment of stage III periodontitis: a pilot randomized controlled clinical trial

Alicia Morales  1   2 , Rafael Contador  1 , Joel Bravo  3 , Paola Carvajal  1   2 , Nora Silva  4 , Franz-Josef Strauss  1   5   6 , Jorge Gamonal  7   8
Affiliations
Randomized Controlled Trial

Clinical effects of probiotic or azithromycin as an adjunct to scaling and root planning in the treatment of stage III periodontitis: a pilot randomized controlled clinical trial

Alicia Morales et al. BMC Oral Health. .

Abstract

Background: The aim of this triple-blind placebo-controlled parallel-arm randomized clinical trial was to evaluate the clinical effects of Lactobacillus rhamnosus SP1 or azithromycin as an adjunct to scaling and root planing (SRP) in patients with stage III periodontitis.

Methods: Forty-seven systemically healthy participants with stage III periodontitis were recruited. Following SRP, the participants were randomly assigned to one of three treatment modalities; (1) placebo (n = 15), (2) probiotics (n = 16) and (3) antibiotics-azithromycin (n = 16). The participants were monitored at baseline, 3, 6, 9 and 12 months after therapy. Probing pocket depth (PPD), bleeding on probing (BOP), clinical attachment loss (CAL) and plaque accumulation (PI) were evaluated.

Results: All 47 participants completed the study. At 12 months, all groups showed significant improvements of PPD and PI (p < 0.012) irrespective of the treatment modality and without significant differences between the groups. Probiotics and azithromycin showed no added benefit in terms of CAL. While the placebo (p = 0.002) and the antibiotic-azithromycin (p = 0.002) group showed a significant reduction of BOP, only the placebo group revealed a significant reduction of CAL at 12 months follow-up (p = 0.003). The number of sites and teeth with PPD ≥ 5, ≥ 6 and ≥ 7 mm were significantly reduced in all groups at 12 months follow-up (p < 0.025) irrespective of the treatment regime and without significant differences between the groups.

Conclusion: The use of probiotics or azithromycin as an adjunct to SRP failed to provide additional benefits in the treatment of stage III periodontitis. The benefits of these two treatment regimes as an adjunct to SRP remain unclear.

Trial registration: NCT02839408, 10/28/2017, Clinicaltrial.gov.

Keywords: Azithromycin; Lactobacillus rhamnosus; Periodontitis; Scaling and root planing.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

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Fig. 1
Flow chart of the study design
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