Efficacy of Probiotics Compared to Chlorhexidine Mouthwash in Improving Periodontal Status: A Systematic Review and Meta-Analysis

Purpose. To critically evaluate the available literature and conduct a systematic review of recent randomized controlled trials to assess the effectiveness of probiotics compared to chlorhexidine mouthwash in enhancing periodontal health. Methods. Five databases were searched electronically, as well...

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Main Authors: Kaio Henrique Soares, Parsa Firoozi, Glaciele Maria de Souza, Olga Beatriz Lopes Martins, Saulo Gabriel Moreira Falci, Cassio Roberto Rocha dos Santos
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:International Journal of Dentistry
Online Access:http://dx.doi.org/10.1155/2023/4013004
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author Kaio Henrique Soares
Parsa Firoozi
Glaciele Maria de Souza
Olga Beatriz Lopes Martins
Saulo Gabriel Moreira Falci
Cassio Roberto Rocha dos Santos
author_facet Kaio Henrique Soares
Parsa Firoozi
Glaciele Maria de Souza
Olga Beatriz Lopes Martins
Saulo Gabriel Moreira Falci
Cassio Roberto Rocha dos Santos
author_sort Kaio Henrique Soares
collection DOAJ
description Purpose. To critically evaluate the available literature and conduct a systematic review of recent randomized controlled trials to assess the effectiveness of probiotics compared to chlorhexidine mouthwash in enhancing periodontal health. Methods. Five databases were searched electronically, as well as the gray literature. Using the Cochrane risk-of-bias tool for randomized clinical trials, the risk of bias was examined. The weighted mean difference (WMD) method was used to calculate the effect sizes. Heterogeneity was assessed using I2 and τ2 statistics. The GRADE approach was adopted to assess the certainty of the evidence. To assess the robustness of the findings, sensitivity analysis and publication bias assessment were undertaken. Results. A total of 1850 studies were initially identified. Sixteen clinical trials were eligible for qualitative synthesis, and ten were included in the meta-analysis. In terms of the gingival index, in total, no statistically significant difference was observed between chlorhexidine and probiotics within 4 weeks (WMD −0.03, 95% CI: −0.09∼0.04, P = 0.3885). Similar to GI, no statistically significant difference was observed between chlorhexidine and probiotics regarding the plaque index within 4 weeks (WMD 0.11, 95% CI: −0.05∼0.28, P = 0.1726). No statistically significant difference was observed between chlorhexidine and probiotics in all time intervals regarding oral hygiene index-simplified (WMD −0.01, 95% CI: −0.05∼0.04, P = 0.7508). The robustness of these findings was confirmed by sensitivity analysis and publication bias assessments. Conclusions. Based on the findings, probiotics were an acceptable alternative to conventional chlorhexidine in improving periodontal health. High-quality studies with rigorous methodology should be conducted to assess the optimum doses of probiotics for clinical implications.
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spelling doaj-art-b6e6c2c63d9f4dc6b2b04e0a77eecfb92025-08-20T02:23:09ZengWileyInternational Journal of Dentistry1687-87362023-01-01202310.1155/2023/4013004Efficacy of Probiotics Compared to Chlorhexidine Mouthwash in Improving Periodontal Status: A Systematic Review and Meta-AnalysisKaio Henrique Soares0Parsa Firoozi1Glaciele Maria de Souza2Olga Beatriz Lopes Martins3Saulo Gabriel Moreira Falci4Cassio Roberto Rocha dos Santos5Department of DentistryStudent Research CommitteeDepartment of DentistryDepartment of DentistryDepartment of DentistryDepartment of DentistryPurpose. To critically evaluate the available literature and conduct a systematic review of recent randomized controlled trials to assess the effectiveness of probiotics compared to chlorhexidine mouthwash in enhancing periodontal health. Methods. Five databases were searched electronically, as well as the gray literature. Using the Cochrane risk-of-bias tool for randomized clinical trials, the risk of bias was examined. The weighted mean difference (WMD) method was used to calculate the effect sizes. Heterogeneity was assessed using I2 and τ2 statistics. The GRADE approach was adopted to assess the certainty of the evidence. To assess the robustness of the findings, sensitivity analysis and publication bias assessment were undertaken. Results. A total of 1850 studies were initially identified. Sixteen clinical trials were eligible for qualitative synthesis, and ten were included in the meta-analysis. In terms of the gingival index, in total, no statistically significant difference was observed between chlorhexidine and probiotics within 4 weeks (WMD −0.03, 95% CI: −0.09∼0.04, P = 0.3885). Similar to GI, no statistically significant difference was observed between chlorhexidine and probiotics regarding the plaque index within 4 weeks (WMD 0.11, 95% CI: −0.05∼0.28, P = 0.1726). No statistically significant difference was observed between chlorhexidine and probiotics in all time intervals regarding oral hygiene index-simplified (WMD −0.01, 95% CI: −0.05∼0.04, P = 0.7508). The robustness of these findings was confirmed by sensitivity analysis and publication bias assessments. Conclusions. Based on the findings, probiotics were an acceptable alternative to conventional chlorhexidine in improving periodontal health. High-quality studies with rigorous methodology should be conducted to assess the optimum doses of probiotics for clinical implications.http://dx.doi.org/10.1155/2023/4013004
spellingShingle Kaio Henrique Soares
Parsa Firoozi
Glaciele Maria de Souza
Olga Beatriz Lopes Martins
Saulo Gabriel Moreira Falci
Cassio Roberto Rocha dos Santos
Efficacy of Probiotics Compared to Chlorhexidine Mouthwash in Improving Periodontal Status: A Systematic Review and Meta-Analysis
International Journal of Dentistry
title Efficacy of Probiotics Compared to Chlorhexidine Mouthwash in Improving Periodontal Status: A Systematic Review and Meta-Analysis
title_full Efficacy of Probiotics Compared to Chlorhexidine Mouthwash in Improving Periodontal Status: A Systematic Review and Meta-Analysis
title_fullStr Efficacy of Probiotics Compared to Chlorhexidine Mouthwash in Improving Periodontal Status: A Systematic Review and Meta-Analysis
title_full_unstemmed Efficacy of Probiotics Compared to Chlorhexidine Mouthwash in Improving Periodontal Status: A Systematic Review and Meta-Analysis
title_short Efficacy of Probiotics Compared to Chlorhexidine Mouthwash in Improving Periodontal Status: A Systematic Review and Meta-Analysis
title_sort efficacy of probiotics compared to chlorhexidine mouthwash in improving periodontal status a systematic review and meta analysis
url http://dx.doi.org/10.1155/2023/4013004
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