Probiotics in the non-surgical treatment of periodontitis: a systematic review and network meta-analysis

source extracted confidence: high 2026-04-09
#humans #dental-plaque #lactobacillus #periodontal-index #periodontal-pocket

Probiotics in the non-surgical treatment of periodontitis: a systematic review and network meta-analysis

Mendonça et al., 2024 | BMC Oral Health | Systematic Review

Citation

Mendonça Carlota Duarte de, Mata António Duarte Sola Pereira da, ... Marques Duarte Nuno da Silva. Probiotics in the non-surgical treatment of periodontitis: a systematic review and network meta-analysis. BMC Oral Health. 2024-Oct-15;24(1):1224. doi:10.1186/s12903-024-05027-6

Abstract

This systematic review and network meta-analysis aimed to assess the impact of combining professional mechanical plaque removal (PMPR) with probiotics compared to PMPR + placebo on probing pocket depth (PPD) and clinical attachment level (CAL). Randomized controlled trials published until November 2023 were searched across electronic databases, peer-reviewed journals, and grey literature. Two authors independently selected, extracted data, and assessed bias risk. Primary outcomes were mean changes in PPD and CAL. Secondary outcomes included mean changes in bleeding on probing (BOP), plaque index, and colony-forming units. Network meta-analysis with the frequentist weighted least squares approach evaluated the data quantitatively, and CINeMA framework evaluated the quality of evidence. In 33 articles involving 1290 patients, results were stratified by follow-up period (short and long-time studies) and sensitivity analyses conducted based on probiotic therapy duration (1 month reference). Network meta-analysis revealed significant mean differences in PPD for nine probiotic interventions, CAL for eighteen interventions, and BOP for eight interventions, with Lactobacillus demonstrating the most substantial effects. Combining PMPR with probiotics as adjuvants to subgingival instrumentation may be more effective in improving PPD and CAL. Lactobacillus emerged as the most comprehensive and effective among the studied probiotic.

Key Findings

Lactobacillus emerged as the most comprehensive and effective among the studied probiotic.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 1290
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Dental Plaque
  • Lactobacillus
  • Periodontal Index
  • Periodontal Pocket
  • Periodontitis
  • Probiotics
  • Randomized Controlled Trials as Topic

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review, Network Meta-Analysis
  • Vertical: probiotics

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09