Probiotics as adjuncts in peri-implantitis therapy. A prospective clinical study on enhancing clinical indices and mitigating Porphyromonas gingivalis load

OBJECTIVES: Peri-implantitis, a significant complication of dental implants, is characterized by progressive inflammatory destruction of peri-implant tissues. Probiotics and other adjunctive therapies have the potential to improve microbial balance and clinical outcomes, even though mechanical debridement is still the standard of care. The goal of the current study was to assess how probiotics could improve clinical indices and lower Porphyromonas gingivalis loads during peri-implantitis treatment.

METHODS: A prospective clinical study involving fifty patients with peri-implantitis was carried out. Mechanical debridement (Group 1) and mechanical debridement with Lactobacillus reuteri probiotics (Group 2) were the two categories into which they were divided. Clinical indices — plaque index (PI), gingival index (GI), peri-implant probing depth (PPD), and crestal bone loss (CBL) — were assessed alongside microbial analysis of P. gingivalis at baseline and 3 months post-intervention.

RESULTS: Following treatment, both groups showed notable gains in PI, GI, and PPD. When compared to Group 1, Group 2 showed better decreases in these indices and P. gingivalis loads (p < 0.05). In both groups, the levels of crestal bone did not change.

CONCLUSIONS: When used in conjunction with mechanical debridement, probiotics greatly improve microbiological and clinical results in peri-implantitis treatment. These results demonstrate the potential of probiotics as a secure and efficient adjunct to conventional therapies.

CLINICAL SIGNIFICANCE: Probiotics used alongside mechanical debridement enhance clinical outcomes and significantly reduce P. gingivalis levels, offering a safe, non-invasive adjunct to improve peri-implantitis management.

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