Effect of Lactobacillus reuteri probiotic lozenges on Porphyromonas gingivalis count in fixed orthodontic appliance users / Pengaruh tablet hisap probiotik Lactobacillus reuteri terhadap jumlah bakteri Porphyromonas gingivalis pada pengguna ortodonti cekat

Fixed orthodontic appliances facilitate plaque retention and may disturb the oral microbial ecosystem, thereby increasing susceptibility to periodontal inflammation. Porphyromonas gingivalis is a keystone periodontal pathogen, whereas Lactobacillus reuteri has been proposed as an adjunctive probiotic strategy. This randomized controlled trial evaluated the effect of L. reuteri probiotic lozenges on salivary P. gingivalis counts in fixed orthodontic appliance users. Thirty-eight dental students aged 18–25 years were analyzed (19 per group). The probiotic group consumed one L. reuteri lozenge nightly for 14 days, while the control group received standardized oral-hygiene education. Unstimulated saliva was collected at baseline and after the intervention and quantified by quantitative polymerase chain reaction (qPCR). Median (IQR) P. gingivalis counts decreased from 10,503,530 (34,139,942) to 7,855,643 (15,907,250) copies/mL in the control group and from 10,329,601 (20,433,321) to 8,144,486 (11,820,528) copies/mL in the probiotic group. The between-group difference in change was not significant (Mann–Whitney U, Z = −0.131; p = 0.895; r = 0.02), although significant within-group reductions occurred in both the probiotic (p = 0.027) and control (p = 0.033) groups. A 14-day course of L. reuteri lozenges did not provide an additional reduction in salivary P. gingivalis beyond that observed with oral-hygiene education alone.

Pemakaian alat ortodonti cekat meningkatkan retensi plak dan dapat mengganggu ekosistem mikroba oral sehingga meningkatkan kerentanan terhadap inflamasi periodontal. Porphyromonas gingivalis merupakan patogen periodontal kunci, sedangkan Lactobacillus reuteri telah dikembangkan sebagai strategi probiotik tambahan. Uji klinis acak terkontrol ini mengevaluasi pengaruh tablet hisap probiotik L. reuteri terhadap jumlah P. gingivalis saliva pada pengguna ortodonti cekat. Sebanyak 38 mahasiswa kedokteran gigi berusia 18–25 tahun dianalisis (19 subjek per kelompok). Kelompok probiotik mengonsumsi satu tablet hisap L. reuteri setiap malam selama 14 hari, sedangkan kelompok kontrol menerima edukasi kebersihan mulut terstandar. Saliva tidak terstimulasi dikumpulkan pada awal dan setelah intervensi, kemudian dikuantifikasi dengan quantitative polymerase chain reaction (qPCR). Median (IQR) jumlah P. gingivalis menurun dari 10.503.530 (34.139.942) menjadi 7.855.643 (15.907.250) copy/mL pada kelompok kontrol dan dari 10.329.601 (20.433.321) menjadi 8.144.486 (11.820.528) copy/mL pada kelompok probiotik. Perbedaan perubahan antar kelompok tidak bermakna (Mann–Whitney U, Z = −0,131; p = 0,895; r = 0,02), meskipun penurunan intra-kelompok bermakna pada kelompok probiotik (p = 0,027) maupun kontrol (p = 0,033). Pemberian tablet hisap L. reuteri selama 14 hari tidak memberikan penurunan tambahan jumlah P. gingivalis saliva dibandingkan edukasi kebersihan mulut saja.