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Guiding Periodontal Pocket Recolonization: a Proof of Concept

¹ Catholic University Leuven, Research Group for Microbial Adhesion, Department of Periodontology, Kapucijnenvoer 7, 3000 Leuven, Belgium;
² UCLA, School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA, USA;
³ The Forsyth Institute, Department of Periodontics, 140 The Fenway, Boston, MA, USA;
⁴ University of Groningen, Department of Biomedical Engineering, Antonius Deusinglaan 1, 9713 AV Groningen, the Netherlands;
⁵ Catholic University Leuven, BioMat Research Cluster, Kapucijnenvoer 7, 3000 Leuven, Belgium;
⁶ Catholic University Leuven, Department of Human Genetics, Herestraat 49, 3000 Leuven, Belgium; and
⁷ Catholic University Leuven, Centre for Molecular Diagnostics, Herestraat 49, 3000 Leuven, Belgium

^* corresponding author, Wim.Teughels{at}med.kuleuven.be

The complexity of the periodontal microbiota resembles that of the gastro-intestinal tract, where infectious diseases are treatable via probiotics. In the oropharyngeal region, probiotic or replacement therapies have shown some benefit in the prevention of dental caries, otitis media, and pharyngitis, but their effectiveness in the treatment of periodontitis is unknown. Therefore, this study addressed the hypothesis that the application of selected beneficial bacteria, as an adjunct to scaling and root planing, would inhibit the periodontopathogen recolonization of periodontal pockets. Analysis of the data showed, in a beagle dog model, that when beneficial bacteria were applied in periodontal pockets adjunctively after root planing, subgingival recolonization of periodontopathogens was delayed and reduced, as was the degree of inflammation, at a clinically significant level. The study confirmed the hypothesis and provides a proof of concept for a guided pocket recolonization (GPR) approach in the treatment of periodontitis.

KEY WORDS: probiotics • periodontitis • therapy • microbial interference • replacement therapy • treatment