This is seen from the significant improvements to bleeding on probing percentage (BOP) - a criterion widely used to diagnose gingival inflammation.
There were also significant improvements to the Gingival Index (GI) - a scale that quantifies the degree of gingival inflammation, based on visual assessment of redness and swelling etc.
Writing in the Journal of Periodontology, researchers from the Institute of Science Tokyo, Bunkyo University, Otsuka Pharmaceutical and Tokyo Center Clinic, said that the results showed that the use of the postbiotic could reduce gingival inflammation with no apparent safety concerns.
Study method
A total of 116 individuals with gingival inflammation, including symptoms such as bleeding and gingival pain during tooth brushing, but no periodontitis, were involved in this six-week double-blind randomized trial.
They were randomized to the postbiotic and placebo group, where the former took a gummy containing 500m of the heat-inactivated Lactiplantibacillus pentosus ONRICb0240 or a placebo twice per day.
Lactiplantibacillus pentosus ONRICb0240 was previously shown in a 12-week study to have significantly accelerated salivary secretory IgA (SIgA) secretion. This, in turn, indicates its potential utility in improving mucosal immunity and resistance against infection in the elderly.
The postbiotic gummy was developed and prepared by Otsuka Pharmaceutical Co., Ltd., which also financially supported the clinical trial.
The gummy format was chosen as it could provide prolonged oral retention of the postbiotic and stimulate salivary flow.
Aside from taking the gummies, no specific oral hygiene instructions or dental treatments were provided during the study period, and participants were asked to maintain their original oral hygiene habits.
To assess the effects of postbiotic supplementation, researchers measured BOP as the primary endpoint, as well as secondary endpoints such as probing pocket depth (PPD), clinical attachment level (CAL), gingival index (GI), plaque control record (PCR) and salivary volume.
Key findings
Significant improvements were seen in the primary endpoint, where BOP significantly decreased from the baseline in the postbiotic group as compared to the placebo group by the end of the six-week study.
For example, BOP in the postbiotic group dropped from 17.6 ± 8.4% at baseline to 12.3 ± 8.6% by the end of the study.
Although the BOP of the placebo group also went down from 18.9 ± 8.5% to 16.6 ± 10.1%, the decrease was not statistically significant.
“We found that b0240GC treatment was associated with a clinically relevant reduction in gingival inflammation, as reflected by a decrease in the BOP from 18% to 12%,” the researchers wrote.
They added that maintaining BOP levels close to 10% has been associated with periodontal stability and a lower risk of disease progression.
Gingival index reduction
In addition, GI in the postbiotic group was significantly lower than in the placebo group by the end of the study.
Specifically, GI fell from 1.3 ± 0.4 at baseline to 1.1 ± 0.6 by week six for the postbiotic group, which was a statistically significant decrease.
In contrast, GI in the placebo group showed only a small decrease from 1.4 ± 0.4 at baseline to 1.3 ± 0.6.
No significant changes were observed in other secondary endpoints, including PPD, CAL, PCR, and salivary volume.
The researchers said that bioactive components of postbiotics, including organic acids and bacteriocins, could have interfered with pathogenic bacterial adhesion and colonization. However, they also acknowledged that the study did not directly assess these mechanisms, although they are biologically plausible.
“Furthermore, although postbiotics can influence host metabolism, epithelial barrier function, and microbial balance, mechanistic evidence of such effects in the oral cavity remains limited,” the researchers wrote. “Consistent with the context-dependent effect, the response to b0240GC was weaker in participants with higher than lower baseline PCRs, suggesting that baseline oral conditions modulate the magnitude of the effect of the intervention.”
Source: Journal of Periodontology. doi:10.1002/jper.70141. “Consuming heat-inactivated Lactiplantibacillus pentosus ONRICb0240-containing postbiotics reduces gingival inflammation: A double-blind randomized clinical trial.“ Authors: Takanori Iwata et al.
