Adjunctive efficacy of probiotics in the treatment of experimental peri-implant mucositis with mechanical and photodynamic therapy: a randomized, cross-over clinical trial

Aim: To evaluate the adjunctive clinical efficacy of probiotics in the treatment of peri-implant mucositis (p-iM) with professionally administered plaque removal (PAPR) and photodynamic therapy (PDT). Materials and methods: Following p-iM induction, patients underwent PAPR + PDT and were randomly assigned to receive the professional and home-based administration of probiotics (Lactobacillus plantarum and Lactobacillus brevis) (test treatment) or placebo preparation (control treatment) according to a cross-over design. Clinical parameters were assessed at six sites for each implant before as well as at 2 and 6 weeks after professional treatment administration. Results: Twenty patients contributing one dental implant each were included. Immediately before treatment and at 6 weeks, the median number of sites with bleeding on probing (BoP+) sites per implant unit was 4 (3–6) and 2 (0–2) (p < 0.001), respectively, for test treatment, and 3.5 (2–4) and 2 (0–3) (p = 0.03), respectively, for control treatment. No significant difference in clinical outcomes was observed between treatment groups. Conclusion: The combination of PAPR and PDT either alone or associated with probiotics determined a significant reduction in the number of BoP+ sites at 2 and 6 weeks around implants with p-iM. The adjunctive use of probiotics did not significantly enhance the clinical outcomes of PAPR + PDT.