PROBİYOTİKLER: PERİODONTOLOJİDE ANTİBİYOTİKLERE ALTERNATİF OLABİLİR Mİ?
Periodontitis, actinomycetemcomitans, Prevotella intermedia ve Tannerella forsythia gibi gram negatif anaerobik bakterilerin ve birçok faktörün rol aldığı karmaşık bir enfeksiyondur. İltihabi periodontal hastalıkların tedavisi, zamanla patojenik hale gelen supra ve subgingival biofilmin mekanik tedavi ile uzaklaştırılma ile başlar. Bu mekanik tedaviye ek olarak antibiyotikler ve gargaralar sıklıkla kullanılmaktadır. Ancak son yıllarda antibiyotiklere karşı direnç geliştiğinden ve kullanılan bu ilaçlar oral floranın mikrobiyal dengesini bozabildiğinden dolayı alternatif yöntemler araştırılmaktadır. Probiyotikler yeterli miktarda kullanıldığında konak canlının sağlığı üzerinde yararlı etkiler oluşturan canlı mikroorganizmalardır. Önemli probiyotikler Lactobacillus ve Bifidobacterium, Escherichia, Enterococcus, Bacillus ve Streptococcus türleridir. Probiyotikler patojen bakterilerin büyüme ve gelişimini inhibe etmek, konak immün yanıtını uyarmak ve patojen bakteriler ile yer değiştirmek gibi mekanizmalar yoluyla periodontal dokular üzerinde olumlu etkilere sahiptir. Bu olumlu etkilerinden dolayı periodontal inflamasyonun tedavisinde konvansiyonel tedavilere ek olarak periodontal hastalık açısından yüksek riskli bireylerde son yıllarda koruyucu amaçlı kullanımları umut vaadetmektedir. Bu derlemede probiyotiklerin periodontal inflamasyon ve genel oral hijyenin devamlılığının sağlanmasında kullanımları güncel literatür ışığında değerlendirilmiştir
Periodontitis is a complicated infection that involved by Gram-negative anaerobic bacteria, such as Aggregatibacter actinomycetemcomitans, Prevotella intermedia and Tannerella forsythia and many other predisposing factors. The treatment of inflammatory periodontal diseases starts with mechanical removal of supra and subgingival biofilm that once becomes pathogenic by time. Antibiotics and mouthwashes are widely used in addition to these mechanical treatments. However, alternative methods to antibiotics have been investigated in recent years because of increased resistance to antibiotics and disruption of the balance of oral microbial flora. Probiotics are defined as vital microorganisms that can provide benefits on host when used in sufficient amount. Important probiotic familyof bacteria include Lactobacillus and Bifidobacterium, Escherichia, Enterococcus, Bacillus, and Streptococcus species. Probiotics have positive effects on periodontal tissues by replacement of pathogenic microorganisms in oral flora, by stimulating immune response, by interfering the growth and development of periodontal pathogens. Therefore probiotics are promising of hope because of positive effects on conventional periodontal therapy and as protective agents for high-risk individuals in terms of periodontal disease. In this review, the usage of probiotics for treatment of periodontal inflammation and maintenance of oral hygiene was evaluated considering the current literature
___
- [1] Hernandez M, Dutzan N, Garcia-Sesnich J,
Abusleme L, Dezerega A, Silva N, et al.
Host-pathogen interactions in progressive
chronic periodontitis. J Dent Res.
2011;90:1164-70.
- [2] Paster BJ, Olsen I, Aas JA, Dewhirst FE.
The breadth of bacterial diversity in the
human periodontal pocket and other oral
sites. Periodontol 2000. 2006;42:80-7.
- [3] Van Winkelhoff AJ, Loos BG, van der
Reijden WA, van der Velden U.
Porphyromonas gingivalis, Bacteroides
forsythus and other putative periodontal
pathogens in subjects with and without
periodontal destruction. J Clin Periodontol.
2002;29:1023-8.
- [4] Armitage GC. Development of a
classification system for periodontal diseases
and conditions. Ann Periodontol. 1999;4:1-6.
- [5] Gupta G. Probiotics and periodontal health.
J Med Life. 2011;4:387-94.
- [6] Gismondo M, Drago L, Lombardi A.
Review of probiotics available to modify
gastrointestinal flora. International journal of
antimicrobial agents. 1999;12:287-92.
- [7] Vasiljevic T, Shah,NP. International Dairy
Journal, Probiotics—From Metchnikoff to
bioactives: Elsevier; 2008. 714-28 p.
- [8] Alvarez-Olmos MI, Oberhelman RA.
Probiotic agents and infectious diseases:
a modern perspective on a traditional therapy.
Clin Infect Dis. 2001;32:1567-76.
- [9] Gibson GR, Roberfroid MB. Dietary
modulation of the human colonic microbiota:
introducing the concept of prebiotics. J Nutr.
1995;125:1401-12.
- [10] De Vrese M, Schrezenmeir J. Probiotics,
prebiotics, and synbiotics. Adv Biochem Eng
Biotechnol. 2008;111:1-66.
- [11] Borchers AT, Selmi C, Meyers FJ, Keen
CL, Gershwin ME. Probiotics and immunity.
J Gastroenterol. 2009;44:26-46.
- [12] Caglar E, Kavaloglu SC, Kuscu OO, Sandalli
N, Holgerson PL, Twetman S. Effect of
chewing gums containing xylitol or
probiotic bacteria on salivary mutans
streptococci and lactobacilli. Clin Oral
Investig. 2007;11:425-9.
- [13] Arunachalam K, Gill HS, Chandra RK.
Enhancement of natural immune function
by dietary consumption of Bifidobacterium
lactis (HN019). Eur J Clin Nutr. 2000;54:263-7
- [14] McDonough FE, Hitchins AD, Wong NP,
Wells P, Bodwell CE. Modification of sweet
acidophilus milk to improve utilization
by lactose-intolerant persons. Am J Clin Nutr.
1987;45:570-4.
- [15] Elmer GW, Surawicz CM, McFarland LV.
Biotherapeutic agents. A neglected modality
for the treatment and prevention of selected
intestinal and vaginal infections.
JAMA. 1996;275:870-6.
- [16] Hilton E, Isenberg HD, Alperstein P,
France K, Borenstein MT. Ingestion of
yogurt containing Lactobacillus acidophilus
as prophylaxis for candidal vaginitis.
Ann Intern Med. 1992;116:353-7.
- [17] Fuller R. Probiotics 2: applications and
practical aspects: Springer Science
& Business Media; 1997.
- [18] Hatakka K, Savilahti E, Ponka A, Meurman
JH, Poussa T, Nase L, et al. Effect of long
term consumption of probiotic milk on
infections in children attending day care
centres: double blind, randomised trial. BMJ.
2001;322:1327.
- [19] Von Bultzingslowen I, Adlerberth I,
Wold AE, Dahlen G, Jontell M. Oral and
intestinal microflora in 5-fluorouracil
treated rats, translocation to cervical and
mesenteric lymph nodes and
effects of probiotic bacteria. Oral
Microbiol Immunol. 2003;18:278-84.
- [20] Caglar E, Kargul B, Tanboga I.
Bacteriotherapy and probiotics’ role on oral
health. Oral Dis. 2005;11:131-7.
- [21] Erickson KL, Hubbard NE. Probiotic
immunomodulation in health and disease.
J Nutr. 2000;130:403S-9S.
- [22] Comelli EM, Guggenheim B, Stingele F,
Neeser JR. Selection of dairy bacterial
strains as probiotics for oral health. Eur J
Oral Sci. 2002;110:218-24.
- [23] Selwitz RH, Ismail AI, Pitts NB. Dental
caries. Lancet. 2007;369:51-9.
- [24] Jensen ME, Wefel JS. Effects of processed
cheese on human plaque pH and
demineralization and remineralization.
Am J Dent. 1990;3:217-23.
- [25] Delanghe G, Ghyselen J, van Steenberghe
D, Feenstra L. Multidisciplinary breath-odour
clinic. Lancet. 1997;350:187.
- [26] Kang MS, Kim BG, Chung J, Lee HC, Oh
JS. Inhibitory effect of Weissella cibaria
isolates on the production of volatile sulphur
compounds. J Clin Periodontol.
2006;33:226-32.
- [27] Burton JP, Chilcott CN, Moore CJ,
Speiser G, Tagg JR. A preliminary study of
the effect of probiotic Streptococcus
salivarius K12 on oral malodour parameters.
J Appl Microbiol. 2006;100:754-64.
- [28] Takei N CK. Carranza’s Clinical
Periodontology. 11th Edition ed: St.
Louis, Missouri; 2012.
- [29] Higgins TJ, Hunter N, Knox KW. Current
concepts in periodontal diseases. Med J Aust.
1985;142:590-4.
- [30] Saier MH, Jr., Mansour NM. Probiotics
and prebiotics in human health. J Mol
Microbiol Biotechnol. 2005;10:22-5.
- [31] Yanine N, Araya I, Brignardello-Petersen
R, Carrasco-Labra A, Gonzalez A, Preciado
A, et al. Effects of probiotics in
periodontal diseases: a systematic
review. Clin Oral Investig. 2013;17:1627-34.
- [32] Koll-Klais P, Mandar R, Leibur E, Marcotte
H, Hammarstrom L, Mikelsaar M. Oral
lactobacilli in chronic periodontitis and
periodontal health: species composition
and antimicrobial activity. Oral
Microbiol Immunol. 2005;20:354-61.
- [33] Sookkhee S, Chulasiri M, Prachyabrued
W. Lactic acid bacteria from healthy oral
cavity of Thai volunteers: inhibition of oral
pathogens. J Appl Microbiol. 2001;90:172-9.
[34] Bonifait L, Chandad F, Grenier D. Probiotics for oral health: myth or reality? J Can Dent
Assoc. 2009;75:585-90.
- [35] Krasse P, Carlsson B, Dahl C, Paulsson A,
Nilsson A, Sinkiewicz G. Decreased gum
bleeding and reduced gingivitis by the
probiotic Lactobacillus reuteri. Swed Dent J.
2006;30:55-60.
- [36] Pena JA, Rogers AB, Ge Z, Ng V, Li SY,
Fox JG, et al. Probiotic Lactobacillus spp.
diminish Helicobacter hepaticus-induced
inflammatory bowel disease in interleukin10-deficient
mice. Infect Immun.
2005;73:912-20.
- [37] Teughels W, Loozen G, Quirynen M. Do
probiotics offer opportunities to manipulate
the periodontal oral microbiota? J Clin
Periodontol. 2011;38 Suppl 11:159-77.
- [38] Vivekananda MR, Vandana KL, Bhat KG.
Effect of the probiotic Lactobacilli reuteri
(Prodentis) in the management of periodontal
disease: a preliminary randomized clinical
trial. J Oral Microbiol. 2010;2.
- [39] Mayanagi G, Kimura M, Nakaya S,
Hirata H, Sakamoto M, Benno Y, et al.
Probiotic effects of orally administered
Lactobacillus salivarius WB21-containing
tablets on periodontopathic bacteria:
a double blinded, placebo-controlled,
randomized clinical trial. J Clin Periodontol.
2009;36:506-13.
- [40] Szkaradkiewicz AK, Stopa J, Karpinski
TM. Effect of oral administration
involving a probiotic strain of Lactobacillus
reuteri on pro-inflammatory cytokine
response in patients with chronic
periodontitis. Arch Immunol Ther Exp
(Warsz). 2014;62:495-500.
- [41] Twetman S, Derawi B, Keller M, Ekstrand
K, Yucel-Lindberg T, Stecksen-Blicks
C. Short-term effect of chewing gums
containing probiotic Lactobacillus reuteri
on the levels of inflammatory mediators
in gingival crevicular fluid. Acta Odontol
Scand. 2009;67:19-24.
- [42] Staab B, Eick S, Knofler G, Jentsch H.
The influence of a probiotic milk drink on
the development of gingivitis: a pilot study.
J Clin Periodontol. 2009;36:850-6.
- [43] Shimauchi H, Mayanagi G, Nakaya S,
Minamibuchi M, Ito Y, Yamaki K, et al.
Improvement of periodontal condition by
probiotics with Lactobacillus salivarius
WB21: a randomized, double-blind,
placebo-controlled study. J Clin Periodontol.
2008;35:897-905.
- [44] Toiviainen A, Jalasvuori H, Lahti E, Gursoy
U, Salminen S, Fontana M, et al. Impact
of orally administered lozenges with
Lactobacillus rhamnosus GG and
Bifidobacterium animalis subsp.
lactis BB-12 on the number of salivary
mutans streptococci, amount of plaque,
gingival inflammation and the oral
microbiome in healthy adults. Clin Oral
Investig. 2015;19:77-83.
- [45] Teughels W, Durukan A, Ozcelik O,
Pauwels M, Quirynen M, Haytac MC.
Clinical and microbiological effects
of Lactobacillus reuteri probiotics in the
treatment of chronic periodontitis: a
randomized placebo-controlled study.
J Clin Periodontol. 2013;40:1025-35.
- [46] Zahradnik RT, Magnusson I, Walker C,
McDonell E, Hillman CH, Hillman JD.
Preliminary assessment of safety and
effectiveness in humans of ProBiora3,
a probiotic mouthwash. J Appl Microbiol.
2009;107:682-90.
- [47] Shah MP, Gujjari SK, Chandrasekhar VS.
Evaluation of the effect of probiotic
(inersan(R)) alone, combination of probiotic
with doxycycline and doxycycline alone
on aggressive periodontitis - a clinical and
microbiological study. J Clin Diagn
Res. 2013;7:595-600.
- [48] Laleman I, Yilmaz E, Ozcelik O, Haytac
C, Pauwels M, Herrero ER, et al. The effect
of a streptococci containing probiotic in
periodontal therapy: a randomized controlled
trial. J Clin Periodontol. 2015;42:1032-41.