Effects of adjunctive probioticL. reuterilozenges on S/RSD outcomes at molar sites with deep pockets

Aim To evaluate effects of probioticLactobacillus reuteri(L. reuteri) lozenges as an S/RSD adjunct on site-level changes at molars with deep pockets. Materials and methods 447 molar sites with pockets >= 5 mm from a previous randomized clinical trial of adjunctiveL. reuterilozenges for 28 days were analyzed. Multilevel mixed-effect models (MLM) were constructed to analyze site-level outcomes change in CAL and pocket closure (residual PPD < 5 mm) in placebo and probiotic groups at 90 and 180 days. Possible patient-, tooth-, and site-level predictors were analyzed as fixed-effects. Results Estimated change in CAL in probiotic (90 day: 0.87 mm, 180 day: 0.68 mm) was greater than placebo treated molar sites (90 day: 0.73 mm, 180 day: 0.66 mm) and the relative risk (RR) of pocket closure in the probiotic group (90 day: 1.7, 180 day: 1.6) was higher as compared to placebo. Furcation involvement and BOP at site predicted significantly worse treatment outcomes. Conclusion As compared to S/RSD with placebo, a 28-day course of adjunctive probioticL. reuterilozenges improved CAL change at molar sites with >= 5 mm deep pockets and conferred a higher probability of shallow residual pocket depth. Presence of furcation-involvement and bleeding on probing worsened treatment outcomes.