Effect of a Locally Delivered Probiotic-Prebiotic Mixture as an Adjunct to Scaling and Root Planing in the Management of Chronic Periodontitis.

Objectives: This study aimed to determine the efficacy of a probiotic, Saccharomyces boulardii (S. boulardii), mixed with a prebiotic, fructooligosaccharide (FOS), in the treatment of periodontal disease when used as an adjunct to non-surgical periodontal therapy (NSPT).

Methods: The study was carried out on 30 subjects who were diagnosed as having chronic periodontitis and had at least two sites in two different quadrants with ≥ 5 mm probing pocket depth (PPD). Two sites in each subject were randomly selected: in control sites, scaling and root planing (SRP) was performed, while the study sites received SRP followed by placement of the probiotic mixture. The viability of the probiotic (S. boulardii) in the pocket (at baseline, 2 days, 4 days and 7 days after treatment) and in vitro (at baseline, 1 week and 2 weeks after treatment) was estimated at designated time periods. Site-specific measures of plaque, gingival inflammation and periodontitis were recorded at baseline and specific intervals.

Results: S. boulardii in vivo survived up to 4 days, while in vitro reduction in the mean counts of S. boulardii did not differ statistically from baseline to 14 days. Significant reduction in probing pocket depths and gain in clinical attachment level in the test sites was observed when compared to controls.

Conclusion: The results suggest that S. boulardii is effective in improving the clinicalmeasures of periodontal disease. S. boulardii seems to thrive well in the subgingival environment and may function as an effective oral probiotic in subjects with periodontitis.