Effectiveness of scaling and root planing with and without adjunct probiotic therapy in the treatment of chronic periodontitis among shamma users and non-users: A randomized controlled trial

Fahim Vohra; Ishfaq A Bukhari; Saeed A Sheikh; Refal Albaijan; Mustafa Naseem; Mudassir Hussain

doi:10.1002/JPER.19-0464

Effectiveness of scaling and root planing with and without adjunct probiotic therapy in the treatment of chronic periodontitis among shamma users and non-users: A randomized controlled trial

J Periodontol. 2020 Sep;91(9):1177-1185. doi: 10.1002/JPER.19-0464. Epub 2020 Feb 14.

Authors

Fahim Vohra¹, Ishfaq A Bukhari², Saeed A Sheikh², Refal Albaijan¹, Mustafa Naseem³, Mudassir Hussain⁴

Affiliations

¹ Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
² Department of Pharmacology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
³ Department of Community And Preventive Dental sciences, Dow International Dental College (DIDC), Pakistan.
⁴ Department of Community Dentistry, Karachi Medical and Dental College, Karachi, Pakistan.

PMID: 31985066
DOI: 10.1002/JPER.19-0464

Abstract

Background: Effectiveness of scaling and root planing (SRP) with/without adjunct probiotic (Lactobacillus reuteri) treatment towards the reduction in periodontal inflammatory parameters (clinical attachment loss [AL], marginal bone loss [MBL], plaque index [PI], and bleeding on probing [BOP] in shamma users and non-users [controls] with chronic periodontitis [CP]) remains uninvestigated. The aim of the present randomized controlled trial was to compare the efficacy of SRP with and without adjunct probiotic therapy (PT) in the treatment of CP among shamma users and controls (individuals not using tobacco in any form).

Methods: The study was conducted in accordance with the Consolidated Standards of Reporting Trials guidelines. Patient demographics were recorded using a questionnaire. Therapeutically, patients were allotted into four groups as follows: 1) group 1: Shamma chewers that underwent SRP alone; 2) group 2: Shamma-chewers that underwent SRP + PT; 3) group 3: Non-chewers that underwent SRP alone; and 4) group 4: Non-chewers that underwent SRP + PT. Periodontal parameters (PI, BOP, PD, clinical AL and mesial and distal MBL) were measured on all teeth except third molars at baseline and at 3- and 6-month follow-ups. Level of significance was set at P < 0.05.

Results: In total, 31, 32, 31, and 33 individuals were included in groups 1, 2, 3, and 4, respectively. Among shamma users, there was no significant difference in the scores of PI, BOP, PD, clinical AL and MBL when SRP was performed with/without adjunct PT. Amongst controls, SRP with adjunct PT was more effective in reducing PI (P < 0.05), BOP (P < 0.05) and PD (P < 0.05) at 3-month follow-up. There was no significant difference in periodontal parameters at 3- and 6-month follow-ups in patients that underwent SRP with and without adjunct PT.

Conclusions: Habitual shamma use compromises the outcome of SRP in patients with CP. Among patients that do not use any form of ST product, SRP is an effective treatment modality for the treatment of CP, and this relationship is independent of use of adjunct PT.

Keywords: alveolar bone loss; gingival bleeding; periodontal disease; questionnaire; smokeless tobacco.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Chronic Periodontitis* / complications
Chronic Periodontitis* / therapy
Dental Scaling
Follow-Up Studies
Humans
Periodontal Attachment Loss / therapy
Periodontal Index
Probiotics* / therapeutic use
Root Planing