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Limosilactobacillus reuteri como coadjuvante no tratamento da mucosite peri-implantar em reabilitação total: um estudo piloto
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Introdução: O desbridamento mecânico é o método tradicional para o tratamento da mucosite peri-implantar (Mp-i) e o seu sucesso depende da correta higiene oral pelo paciente, estando os portadores de reabilitações totais implanto-suportadas sujeitos a uma dificuldade acrescida. Crê-se que os probióticos possam auxiliar pela sua capacidade de modulação do biofilme oral, traduzida numa ação anti-inflamatória e anti-placa bacteriana.
Objetivo: Avaliar o efeito coadjuvante do probiótico Limosilactobacillus reuteri (LR) no tratamento mecânico da Mp-i.
Materiais e métodos: Este estudo piloto incluiu vinte e nove indivíduos com reabilitação total implanto-suportada e Mp-i, divididos pelos grupos de teste (GT) e de controlo (GC), igualmente submetidos a desbridamento mecânico profissional, tendo acrescido ao GT a administração de uma pastilha diária de GUM® PerioBalance® durante 30 dias. Avaliou-se o índice de placa modificado (IPM), índice de hemorragia modificado (IHM) e profundidade de sondagem (PS) previamente à intervenção (baseline) e 6 e 10 semanas depois. Na análise estatística utilizaram- se testes paramétricos e não paramétricos com 5% de nível de significância, recorrendo ao software IBM SPSS Statistics 27.0.
Resultados: Ambos os tratamentos resultaram na redução dos IPM, IHM e PS às 6 semanas e, desta para as 10 semanas, verificou-se o aumento dos IPM e IHM e a manutenção da PS. Comparadas com baseline, observaram-se diferenças muito próximas da significância estatística na redução da PS às 10 semanas no GC (p=0,018) e estatisticamente significativas no IPM às 6 semanas no GC (p=0,004) e no GT (p=0,002) bem como às 10 semanas no GT (p=0,016). Comparados os grupos nas avaliações pós-intervenção, não se verificaram diferenças estatisticamente significativas.
Conclusão: A coadjuvação de LR no tratamento mecânico da Mp-i não apresenta um benefício claro comparada ao tratamento mecânico isolado, alcançando ambas as intervenções resultados clínicos similares. São necessários mais estudos prospetivos e conduzidos a longo prazo.
Introduction: Mechanical debridement is the traditional method for the treatment of peri- implant mucositis (P-im) and its success depends on the patient's correct oral hygiene. It is believed that probiotics may help by their ability to modulate the oral biofilm, resulting in anti- inflammatory and anti-bacterial plaque action. Aim: To evaluate the adjuvant effect of the probiotic Limosilactobacillus reuteri (LR) in the mechanical treatment of P-im. Materials and methods: This pilot study included twenty-nine subjects with implant- supported total rehabilitation and P-im, divided into test (TG) and control (CG) groups, equally subjected to professional mechanical debridement, with the administration of a daily GUM® PerioBalance® lozenge for 30 days added to the TG. The modified Plaque Index (mPlI), modified Sulcus Bleeding Index (mBI) and pocket depth (PD) were evaluated before the intervention (baseline) and 6 and 10 weeks later. Parametric and non-parametric tests with 5% significance level were used in the statistical analysis, using IBM SPSS Statistics 27.0 software. Results: Both treatments resulted in reduced mPlI, mBI and PD at 6 weeks and from this to 10 weeks there was an increase in mPlI and mBI and maintenance of PD. Compared to baseline, differences were close to statistical significance in the reduction of PD at 10 weeks in the CG (p=0,018) and statistically significant in the mPlI at 6 weeks in the CG (p=0,004) and in the TG (p=0,002) as well as at 10 weeks in the TG (p=0,016). Comparing the groups in the post- intervention assessments, no statistically significant differences were found. Conclusion: LR adjuvant mechanical treatment of P-im does not show a clear benefit compared to mechanical treatment alone, both interventions achieving similar clinical results. Further prospective and long-term studies are needed.
Introduction: Mechanical debridement is the traditional method for the treatment of peri- implant mucositis (P-im) and its success depends on the patient's correct oral hygiene. It is believed that probiotics may help by their ability to modulate the oral biofilm, resulting in anti- inflammatory and anti-bacterial plaque action. Aim: To evaluate the adjuvant effect of the probiotic Limosilactobacillus reuteri (LR) in the mechanical treatment of P-im. Materials and methods: This pilot study included twenty-nine subjects with implant- supported total rehabilitation and P-im, divided into test (TG) and control (CG) groups, equally subjected to professional mechanical debridement, with the administration of a daily GUM® PerioBalance® lozenge for 30 days added to the TG. The modified Plaque Index (mPlI), modified Sulcus Bleeding Index (mBI) and pocket depth (PD) were evaluated before the intervention (baseline) and 6 and 10 weeks later. Parametric and non-parametric tests with 5% significance level were used in the statistical analysis, using IBM SPSS Statistics 27.0 software. Results: Both treatments resulted in reduced mPlI, mBI and PD at 6 weeks and from this to 10 weeks there was an increase in mPlI and mBI and maintenance of PD. Compared to baseline, differences were close to statistical significance in the reduction of PD at 10 weeks in the CG (p=0,018) and statistically significant in the mPlI at 6 weeks in the CG (p=0,004) and in the TG (p=0,002) as well as at 10 weeks in the TG (p=0,016). Comparing the groups in the post- intervention assessments, no statistically significant differences were found. Conclusion: LR adjuvant mechanical treatment of P-im does not show a clear benefit compared to mechanical treatment alone, both interventions achieving similar clinical results. Further prospective and long-term studies are needed.
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Teses de mestrado - 2022 Saúde Oral