Uso de cepas probióticas como coadyuvantes en el tratamiento de la enfermedad periodontal. Revisión sistemática

Aranza Aziz, Claudio Burbano, Andrea Capozzoli, Maury Castro, Jesús Sánchez

Resumen


Introducción: Los probióticos son capaces de crear una biopelícula que actúa como barrera protectora de la cavidad bucal, ubicándose en distintas zonas comúnmente invadidas por patógenos causantes de enfermedades periodontales, compitiendo con estos e inhibiendo su crecimiento. Objetivo: determinar la posología, vehículo y tiempo de administración de los probióticos como coadyuvantes en el tratamiento de la enfermedad periodontal con base en una revisión sistemática de la literatura. Metodología: la búsqueda abarcó un total de 48 artículos con un tiempo de 20 años de publicación en Medline a través de Pubmed, Biblioteca Virtual de la salud (BVS), Google Académico, Scielo y Revista Saber Ula. Se analizaron 1684 pacientes, con una administración de varios tipos de probióticos Resultados: La posología en L. reuteri es 1x108 UFC, L.rhamnosus es de 2x107 UFC /día, y Bifidobacterium lactis en combinación con L. rhamnosus contiene 42% xilitol, 18% sorbitol y 5% de maltitol. Los vehículos probióticos utilizados en las enfermedades periodontales son tabletas de L. reuteri y presentación en polvo de L.rhamnosus. El tiempo promedio de tratamiento es de 4 a 12 semanas 1 vez al día; en menor proporción se utilizan otros probióticos. Conclusión: se ha dado a conocer la posología, vehículo y tiempo en la administración de probióticos para actuar como coadyuvantes no quirúrgicos en las enfermedades periodontales. L. reuteri es la cepa probiótica más utilizada en cavidad bucal, en segundo lugar, el L. rhamnosus y luego el Bifidobacterium lactis junto con el L. rhamnosus proporcionan una disminución significativa en la inflamación gingival. Recibido: 11-11-19 Aceptado:15-06-20


Palabras clave


Probióticos; Enfermedades periodontales; L. Reuteri; L. rhamnosus; Bifidobacterium Lactis; Lactobacillus salivarius

Texto completo:

PDF

Referencias


Food Schlundt J. Health and Nutritional Properties of Probiotics in Food including Powder Milk with Live Lactic Acid Bacteria. Report of a Joint FAO/WHO Expert Consultation on Evaluation of Health and Nutritional Properties of Probiotics in Food Including Powder Milk with Live Lactic Acid Bacteria 2001 [citado 16 Jul 2019]. Disponible en: http://www.fao.org/3/a-a0512e.pdf.

Flichy Fernández, A.; Ata Ali, A.; Alegre Domingo, T.; Candel Martí, E.; Ata Ali, F.; Palacio, J.; Peñarrocha Diago, M. The effect of orally administered probiotic Lactobacillus reuteri containing tablets in periimplant mucositis: a double blind randomized controlled trial. Journal of Periodontal Research [Internet]. 2015; [citado 16 Jul 2019] 50(6): 775-785. Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.1111/jre.12264.

Morales, A; Carvajal, P; Silva, N; Hernández, M; Godoy, C; Rodríguez, G; Cabello, R; Garcia-Sesnich, J; Hoare, A; Diaz, P; Gamonal, J. Clinical Effects of Lactobacillus Rhamnosus in Non-Surgical Treatment of Chronic Periodontitis: A Randomized Placebo-Controlled Trial With 1-Year Follow-up [Internet]. 2016; [citado 17 Jul 2019] Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/26944407

Morales, A.; Bravo, J.; Baeza, M.; Werlinger, F.; Gamonal, J. Las enfermedades periodontales como enfermedades crónicas no transmisibles: cambios en los paradigmas. Rev Clin Periodoncia Implantol Rehabil Oral [Internet]. 2016; [citado 16 Jul 2019] 9(2):203-207. Disponible en: https://www.sciencedirect.com/science/article/pii/S0718539116300362.

Reid, G.; Jass, J.; Sebulsky, M.; Mccormick, J. Potential uses of probiotics in clinical practice. Clin. Microbiol. Rev [Internet]. 2003; [citado 16 Jul 2019] 16: 658-672. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC207122/.

Pelekos, G; Acharya, A; Leung W.K; Mcgrath, C. A double-blind, paralleled-arm, placebo-controlled, randomized clinical trial of the effectiveness of probiotics as an adjunct in periodontal care. J Clin Periodontol [Internet] 2019; [citado 08 Oct 2019] 46 (12): 1217-1227. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/31479530.

G Javier Báez Vilches. Efecto clínico de uso de probiótico oral en conjunto con terapia periodontal no quirúrgica en pacientes con periodontitis crónica. ensayo clínico aleatorizado, enmascarado y controlado por placebo. [Internet] 2015. [citado 08 Oct 2019]. Disponible en: https://mantencion.uchile.cl/.

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. [Internet] 2009. [citado 08 Oct 2019]. ; 67(1):19-24. Disponible en: https://www.tandfonline.com/doi/abs/10.1080/00016350802516170?journalCode=iode20

Laleman I, Pauwels M, Marc Q, Teughels. A dual strain Lactobacilli, reuteri probiotic improves themtreatment of residual pockets: a randomized controlled-clinical trial. J Clin Periodontol. [Internet] 2019. [citado 08 Oct 2019] Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/31520543.

Szkaradkiewicz AK, Stopa J, Karpiński 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) [Internet] 2014. [Citado 08 Oct 2019] 62(6):495-500. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24509697/.

Vivekananda, M; Vandana, K; Bhat, K. Effect of the probiotic Lactobacilli reuteri (Prodentis) in the management of periodontal disease: a preliminary randomized clinical trial.[Internet] 2010; [citado 28 Oct 2019] 2:1, 5344 Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/21523225

İnce, G; Gürsoy, H; Dirikan İpçi, S; Cakar, G; Emekli-Alturfan, E; Yılmaz, S. Clinical and Biochemical Evaluation of Lactobacillus Reuteri Containing Lozenges as an Adjunct to Non-Surgical Periodontal Therapy in Chronic Periodontitis. [Internet]. 2015; [citado 29 Oct 2019] 140612. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/25741580

Bravo, J; Morales, A; Lefimil, C; Galaz, C; Gamonal, J. Efectos clínicos de Lactobacillus reuteri en el tratamiento de la gingivitis: Ensayo clínico aleatorizado controlado. [Internet]. 2018; [citado 30 Oct 2019] 11(1); 32-35. Disponible en: https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0719-01072018000100032

Tekce , M; Ince, G; Gursoy, H; Dirikan Ipci, S; Cakar, G; Kadir, T; Yilmaz, S. Clinical and microbiological effects of probiotic lozenges in the treatment of chronic periodontitis: a 1-year follow-up study. [Internet]. 2015; [citado 30 Oct 2019] 42: 363–372. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/25728888

Martin-Cabezas, R; Davideau, J-L; 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. [Internet]. 2016; [citado 30 Oct 2019] 43: 520–530. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/26970230

Iniesta M, Herrera D, Montero E, Zurbriggen M, Matos AR, Marin MJ, Sánchez-Beltrán MC, Llama-Palacio A, Sanz M. Probiotic effects of orally administered Lactobacillus reuteri-containing tablets on the subgingival and salivary microbiota in patients with gingivitis. A randomized clinical trial. [Internet]. 2012 [citado 30 Oct 2019] 1600-051X.2012.01914.x. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/22694350

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. [Internet]. 2013 [citado 30 Oct 2019] 40: 1025–1035. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/24164569

Gutiérrez, R; Lunini, P; Goyoneche, P. Lactobacillus reuteri como coadyuvante en el tratamiento de la enfermedad gingival y periodontal. Revisión sistemática de la literatura. [Internet]. 2019 [citado 31 Oct 2019] 8(1): 105-121. Disponible en: http://erevistas.saber.ula.ve/index.php/rvio/article/view/15634

Ince Kuka, G; Gursoy, H; Emekli-Alturfan, E; Veli Ustundag, U; Kuru, B. Evaluation of nitric oxide levels in chronic periodontitis patients treated with initial periodontal therapy and probiotic food supplements: a double blind, randomized controlled clinical trial. [Internet]. 2019 [citado 31 Oct 2019] 33:1, 974-979. Disponible en: https://www.tandfonline.com/doi/full/10.1080/13102818.2019.1632740

Schlagenhauf, U; Jakob, L; Eigenthaler, M; Segerer, S; Jockel-Schneider, Y; Rehn, M. Regular consumption of Lactobacillus reuteri-containing lozenges reduces Pregnancy gingivitis: an RCT. [Internet]. 2016 [citado 31 Oct 2019] 43: 948–954. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/27461133

Alanzi, S. Honkala, E. Honkala, A. Varghese, M. Tolvanen, E. Söderling Effect of Lactobacillus rhamnosus and. Bifidobacterium lactis on gingival health, dental plaque, and periodontopathogens in adolescents: a randomised placebocontrolled clinical trial. J Clin Periodontol [Internet] 2018; [citado 08 Oct 2019] 15; 9 (4):593-602. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/29633646.

Morales, A.; Galaz, C.; González, J.; Silva, N.; Hernández, M.; Godoy, C.; et al. Efecto clínico del uso de probiótico en el tratamiento de la periodontitis crónica: ensayo clínico. [Internet] 2016; [citado 28 oct 2019] 9(2):146-152. Disponible en: https://www.sciencedirect.com/science/article/pii/S0718539116300106.

Oda, Y.; Furutani, C.; Mizota, Y.; Wakita, A.; Mimura, S.; Kihara, T.; et al. Effect of bovine milk fermented with Lactobacillus rhamnosus L8020 on periodontal disease in individuals with intellectual disability: a randomized clinical trial. [Internet] 2018; [citado 28 oct 2019] 29; 27:e20180564. Disponible en: http://dx.doi.org/10.1590/1678-7757-2018-0564.

. Morales, A; Gandolfo, A; Bravo, J; Carvajal, P; Silva, N; Godoy, C; Garcia-Sesnic J; Hoare, A; Diaz, P; Gamonal, J. Microbiological and clinical effects of probiotics and antibiotics on nonsurgical treatment of chronic periodontitis: a randomized placebocontrolled trial with 9-month follow-up. . [Internet]. 2017 [citado 31 Oct 2019] 26:e20170075 disponible en: https://www.ncbi.nlm.nih.gov/pubmed/29364340

Toiviainen A; Jalasvuori H, Lahti E; Gursoy U; Salminen S; Fontana M; Flannagan S; Eckert G; Kokaras A; Paster MB; Söderling E. 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 Invest; [Internet]. 2014; [citado 28 Oct 2019] 19:77–83. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/24638207.

Sajedinejad, N; Paknejad, M; Houshmand, B; Sharafi, H; Jelodar, R; Shahbani Zahiri, H; Akbari Noghabi, K. Lactobacillus salivarius NK02: a Potent Probiotic for Clinical Application in Mouthwash. [Internet]. 2017 [citado 31 Oct 2019] 12602-017-9296-4. Disponible en: https://link.springer.com/article/10.1007/s12602-017-9296-4.

Mayanagi, G; Kimura, M; Nakaya, S; Hirata, H; Sakamoto M; Benno, Y; Shimauchi, H. Probiotic effects of orally administered Lactobacillus salivarius WB21-containing tablets on periodontopathic bacteria: a double-blinded, placebo controlled, randomized clinical trial. [Internet]. 2009 [citado 01 Nov 2019] 36: 506–513. Disponible en: https://doi.org/10.1111/j.1600-051X.2009.01392.x.

Higuchi, T; Suzuki, N; Nakaya, S; Omagari, S; Yoneda, M; Hanioka, T; Hirofuji, T. Effects of Lactobacillus salivarius WB21 combined with green tea catechins on dental caries, periodontitis, and oral malodor. [Internet]. 2018 [citado 01 Nov 2019] S0003-9969(18)30424-2. Disponible en: https://doi.org/10.1016/j.archoralbio.2018.11.027.

Shimauchi, H; Mayanagi, G; Nakaya, S; Minamibuchi, M; Ito, Y; Yamaki, K; Hirata, H. Improvement of periodontal condition by probiotics with Lactobacillus salivarius WB21: a randomized, double-blind, placebo-controlled study. [Internet]. 2008 [citado 01 Nov 2019] 35: 897–905. Disponible en: https://doi.org/10.1111/j.1600-051X.2008.01306.x

Ikram, S; Hassan, N; Raffat, M; Mirza, S; Akram, Z. Systematic review and meta-analysis of double-blind, placebo-controlled, randomized clinical trials using probiotics in chronic periodontitis. [Internet]. 2018 [citado 01 Nov 2019] 10.1111/jicd.12338. disponible en: https://doi.org/10.1111/jicd.12338.

Yanine, N; Araya, I; Brignardello-Petersen, R; Carrasco-Labra, A; González, A; Preciado, A; Villanueva, J; Sanz, M; Martin, C. Effects of probiotics in periodontal diseases: a systematic review. [Internet]. 2013 [citado 01 Nov 2019] 17:1627–1634. Disponible en: https://link.springer.com/article/10.1007/s00784-013-0990-7.

Imran, F; Das, S; Padmanabhan, S; Rao, R; Suresh, A; Bharath, D. Evaluation of the efficacy of a probiotic drink containing Lactobacillus casei on the levels of periodontopathic bacteria in periodontitis: A clinico-microbiologic study. [Internet]. 2015 [citado 01 Nov 2019] 26(5): 462-468. Disponible en: www.ijdr.in/article.asp?issn=09709290;year=2015;volume=26;issue=5;spage=462;epage=468;aulast=Imran.

Staab B, Eick S, Kno¨fler G, Jentsch H. The influence of a probiotic milk drink on the development of gingivitis: a pilot study. [Internet]. 2009 [citado 02 Nov 2019] 36: 850–856. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/19682173.

Szkaradkiewicz, A.K; Karpinski, T; Zeidler, A; Wyganowska-Swiatkowaska, M; Szkaradkiewic, A. Protective effect of oral Lactobacilli in pathogenesis of chronic periodontitis. [Internet]. 2011 [citado 02 Nov 2019] 62, 6, 685-689. Disponible en: https://www.researchgate.net/publication/221814782.

Eren Kuru, B; Laleman, I; Yalnızoğlu, T; Kuru, L; Teughels, W. The Influence of a Bifidobacterium Animalis Probiotic on Gingival Health: a Randomized Controlled Clinical Trial. [Internet]. 2017 [citado 02 Nov 2019] 10.1902. Disponible en: https://doi.org/10.1902/jop.2017.170213.

Invernici, M; Salvador, S; Silva, P; Soares, M; Casarin, R; Palioto, D; Souza, S; Taba Jr., M; Novaes Jr., A; Furlaneto, F; Messora, M. Effects of Bifidobacterium probiotic on the treatment of chronic periodontitis: A randomized clinical trial. [Internet]. 2018 [citado 02 Nov 2019] Disponible en: https://doi.org/10.1111/jcpe.12995.

Hojo, K; Mizoguchi, C; Taketomo, N; Ohshima, T; Gomi, K; Arai, T; Maeda, N. Distribution of Salivary Lactobacillus and Bifidobacterium Species in Periodontal Health and Disease. [Internet]. 2007 [citado 02 Nov 2019] 71 (1), 152–157. Disponible en: https://doi.org/10.1271/bbb.60420.

Akram, Z; Saad Shafqat, S; Aati, S; Kujan, O; Fawzy, A. Clinical efficacy of probiotics in the treatment of gingivitis: A systematic review and metaanalysis. [Internet]. 2019 [citado 02 Nov 2019] Doi: 10.1111/adj.12733 Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/31682012

Caglar, E; Sandalli, N; Twetman, S; Kavaloglu, S; Ergeneli, S; Selvi, S. Effect of yogurt with Bifidobacterium DN-173 010 on salivary mutans streptococci and lactobacilli in young adults. [Internet]. 2005 [citado 03 Nov 2019] Doi: 63: 317–320. Disponible en: https://www.tandfonline.com/doi/abs/10.1080/00016350510020070?journalCode=iode20

Laleman, I; Yilmaz, E; Ozcelik, O; Haytac, C; Pauwels, M; Herrero, ER; Slomka, V; Quirynen, M; Alkaya, B; Teughels, W. The effect of a streptococci containing probiotic in periodontal therapy: a randomized controlled trial. [Internet]. 2015 [citado 03 Nov 2019] 42: 1032–1041. Doi: 10.1111/jcpe.12464. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/26427036

Caglar, E; Kavaloglu, S; Ergeneli, S; Sandalli, N; Twetman, S. Salivary mutans streptococci and lactobacilli levels after ingestion of the probiotic bacterium Lactobacillus reuteri ATCC 55730 by straws or tablets. [Internet]. 2006 [citado 03 Nov 2019]Doi: 64: 314318. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/16945898

Caglar, E; Kavaloglu, S; Kuscu, O; Sandalli, N; Holgerson, P; Twetman, S. Effect of chewing gums containing xylitol or probiotic bacteria on salivary mutans streptococci and lactobacilli. [Internet]. 2007 [citado 03 Nov 2019]. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/17574481

Gruner, D; Paris, S; Schwendicke, F. Probiotics for managing caries and periodontitis: Systematic Review and Meta-Analysis. [Internet]. 2015 [citado 04 Nov 2019] (16)30027-6. Disponible en: http://dx.doi.org/10.1016/j.jdent.2016.03.002.

Matsubara V.H., Bandara H.M.H.N., Ishikawa K.H., Mayer M.P.A., Samaranayake, L.P. The role of probiotic bacteria in managing periodontal disease: a systematic review. . [Internet]. 2016 [citado 04 Nov 2019] 1478-7210. Disponible en: http://dx.doi.org/10.1080/14787210.2016.1194198.

Tsubura, S; Mizunuma , H; Ishikawa, S; Oyake, I; Okabayashi, M; Katoh, K; Shibata, M; Iizuka, T; Toda ,T; Iizuka, T. The effect of Bacillus subtilis mouth rinsing in patients with periodontitis. [Internet]. 2009 [citado 05 Nov 2019] Doi: 28:1353–1356. Disponible en: https://link.springer.com/article/10.1007/s10096-009-0790-9

Jayaram, P; Chatterjee, A; Raghunathan, V. Probiotics in the treatment of periodontal disease: A systematic review. [Internet]. 2016 [citado 05 Nov 2019] 20:488-95. Disponible en: http://www.jisponline.com.




Creative Commons License
Todos los documentos publicados en esta revista se distribuyen bajo una
Licencia Creative Commons Atribución -No Comercial- Compartir Igual 4.0 Internacional.
Por lo que el envío, procesamiento y publicación de artículos en la revista es totalmente gratuito.