BIOLOGICAL EFFECTS OF PROBIOTICS AS AN ADJUVANT IN BASIC PERIODONTAL TREATMENT: A LITERATURE REVIEW

Abstract

Periodontal disease is a chronic bacterial infection caused by the presence of gram-negative anaerobic bacteria against the host's immune response. Initially, it presents reversible changes in soft tissues, which may progress to irreversible destruction of the periodontal ligament, root cementum and alveolar bone (GUPTA, 2011; BONIFAIT et al., 2009; LAWANDE, 2012; ALLAKER et al., 2009; ESFAHANIAN et al., 2012; JOHNSTON et al., 2013; KOUSHYAR et al., 2010; AKCALI et al., 2013). Treatment and prevention are based on the reduction of pathogenic agents and strengthening of the epithelial barrier, allowing a decrease in susceptibility to infection (SOHI et al., 2011; STAMATOVA, 2009; LIU et al., 2010). It is done by removing the biofilm by mechanical means, scraping and crown root planing, but there are cases in which this type of therapy alone is not effective and can be complemented by antibiotic therapy (GUPTA, 2011; ABREU et al., 2010). However, this therapy contributes to the development of bacterial resistance, losing its effectiveness over time. In this context, probiotics emerge as a new treatment perspective for periodontal disease, acting in the control of the immune response and the microbial environment of the periodontal pocket, production of bacteriocins against periodontopathogens and by competitive mechanisms of exclusion. The present study evaluated, through a literature review, the biological effects of probiotics, comparing the results of existing studies, carried out in humans and animals. We observed results that indicate beneficial effects of probiotics in the treatment of periodontal disease, such as significant changes in the microflora and reduction in the plaque index, improvement in periodontal parameters and a relevant increase in bone density in the sites where the bacteria were applied. Although the results are promising, there is still a need for other studies that concomitantly address clinical periodontal, immunological and microbiological parameters, in order to ensure, in a consistent and grounded way, the effectiveness of its use in the clinical treatment of patients with periodontal disease.