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Lactobacillus Reuteri como coadjuvante no tratamento da doença periodontal
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Introdução: Após o tratamento mecânico da doença periodontal há uma rápida recolonização dos nichos existentes na cavidade oral. Os probióticos surgem como possíveis coadjuvantes devido às suas propriedades antimicrobianas, anti-inflamatórias e anti-placa.
Objetivo: Avaliar o efeito da utilização do probiótico Lactobacillus reuteri como coadjuvante no tratamento periodontal não cirúrgico.
Materiais e Métodos: Foi realizado um ensaio clínico em 20 pacientes com periodontite crónica. Durante a fase inicial do tratamento periodontal, especificamente após o alisamento radicular, foi dado o probiótico Lactobacillus reuteri sob a forma de pastilhas (Gum Periobalance). Os pacientes fizeram a toma diária de 2 pastilhas, após a escovagem. Foi feita a avaliação no início do estudo, às 6 e às 12 semanas. Os parâmetros avaliados foram índice percentual de placa bacteriana, índice gengival, profundidade de sondagem, índice percentual de hemorragia e nível de inserção clínico. A análise estatística e representações gráficas foram realizadas através da base de dados SPSS (Statistic Package for Social Sciences). De forma a avaliar a normalidade da distribuição dos dados, recorreu-se ao teste de Saphiro-Wilk. A análise estatística foi realizada através de testes paramétricos e não paramétricos. Foram também testadas possíveis associações entre variáveis.
Resultados: Às 6 semanas, apenas o IPP e o IG gerais e o IPH dos quadrantes a receberem tratamento ativo, mostraram uma diminuição estaticamente significativa.
Todos os parâmetros clínicos analisados apresentaram uma redução estatisticamente significativa após 12 semanas.
Conclusão: Apesar das limitações do estudo, conclui-se que a utilização de Lactobacillus reuteri como coadjuvante do tratamento periodontal, induz uma redução estatisticamente significativa dos parâmetros clínicos ao longo das 12 semanas do estudo. Futuramente, serão necessários novos estudos, com uma maior amostra, uma maior duração, diminuição dos fatores de viés e com um grupo de comparação placebo. Poderá ser benéfico a realização de um estudo que compare, também, as espécies microbianas presentes e o efeito do probiótico nas mesmas.
Introduction: After the periodontal disease’s mechanical treatment, there is a rapid recolonization of the niches in the oral cavity. Probiotics appear as possible adjuvants because of their antimicrobial, anti-inflammatory and anti-plaque properties. Aim: To evaluate the effect of the use of probiotic Lactobacillus reuteri as a coadjuvant in non-surgical periodontal treatment. Materials and Methods: A clinical trial was conducted in 20 patients with chronic periodontitis. After root scaling, the probiotic Lactobacillus reuteri was given to the patient in the form of Gum Periobalance tablets. Patients were given 2 lozenges per day after brushing. The evaluation was done at the beginning of the study, at 6 and at 12 weeks. The parameters evaluated were plaque index, gingival index, probing depth, bleeding on probing and clinical attachment level. Statistical analysis and graphical representations were performed through the SPSS (Statistic Package for Social Sciences) database. In order to evaluate the normality of the data distribution, the Saphiro-Wilk test was used. Statistical analysis was performed using the parametric and nonparametric tests. Possible associations between variables were tested. Results: At 6 weeks, only the general plaque index, gingival index and the bleeding on probing of the quadrants receiving active treatment showed a statistically significant decrease. All clinical parameters analyzed showed a statistically significant reduction after 12 weeks. Conclusion: Despite the limitations of the study, it is concluded that the use of Lactobacillus reuteri as a adjuvant of the periodontal treatment induces a statistically significant reduction of the clinical parameters during the 12 weeks of the study. In future, further studies will be needed, with a larger sample, longer duration, reduction of bias factors and with a placebo comparison group. It may be beneficial to carry out a study that also compares the microbial species present and the effect of the probiotic on them.
Introduction: After the periodontal disease’s mechanical treatment, there is a rapid recolonization of the niches in the oral cavity. Probiotics appear as possible adjuvants because of their antimicrobial, anti-inflammatory and anti-plaque properties. Aim: To evaluate the effect of the use of probiotic Lactobacillus reuteri as a coadjuvant in non-surgical periodontal treatment. Materials and Methods: A clinical trial was conducted in 20 patients with chronic periodontitis. After root scaling, the probiotic Lactobacillus reuteri was given to the patient in the form of Gum Periobalance tablets. Patients were given 2 lozenges per day after brushing. The evaluation was done at the beginning of the study, at 6 and at 12 weeks. The parameters evaluated were plaque index, gingival index, probing depth, bleeding on probing and clinical attachment level. Statistical analysis and graphical representations were performed through the SPSS (Statistic Package for Social Sciences) database. In order to evaluate the normality of the data distribution, the Saphiro-Wilk test was used. Statistical analysis was performed using the parametric and nonparametric tests. Possible associations between variables were tested. Results: At 6 weeks, only the general plaque index, gingival index and the bleeding on probing of the quadrants receiving active treatment showed a statistically significant decrease. All clinical parameters analyzed showed a statistically significant reduction after 12 weeks. Conclusion: Despite the limitations of the study, it is concluded that the use of Lactobacillus reuteri as a adjuvant of the periodontal treatment induces a statistically significant reduction of the clinical parameters during the 12 weeks of the study. In future, further studies will be needed, with a larger sample, longer duration, reduction of bias factors and with a placebo comparison group. It may be beneficial to carry out a study that also compares the microbial species present and the effect of the probiotic on them.
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Saúde oral Teses de mestrado - 2019