Long-term effect of Lactobacillus brevis CD2 (Inersan(®)) and/or doxycycline in aggressive periodontitis

CONTEXT: The over usage and broad use of antibiotics resulted in the emergence of resistant microorganisms to the drugs which also disturb the indigenous microflora, which include the Lactobacillus in the oral cavity. Hence, it is preferred to avoid the use of antibiotics. AIMS: The hypothesis tested in this study was that 14 days of treatment with Lactobacillus brevis CD2 lozenges, L. brevis CD2 with oral doxycycline, or doxycycline alone would have a beneficial effect on periodontal health after 5 months. SETTINGS AND DESIGN: It was a randomized clinical trial. MATERIALS AND METHODS: Eighteen nonsmoking patients aged 14–35 years, with aggressive periodontitis, were randomized to receive 14 days of treatment with L. brevis CD2 lozenges (two lozenges daily), L. brevis CD2 lozenges with oral doxycycline (100 mg tablet once daily), or doxycycline alone. Saliva samples were taken on day 0, 2 weeks, 2 months, and 5 months. Clinical parameters (plaque index, gingival index, probing pocket depth, and clinical attachment level) and microbiological parameters (lactobacilli and Aggregatibacter actinomycetemcomitans) were evaluated. STATISTICAL ANALYSIS USED: Changes between groups were evaluated using repeated measure analysis of variance. RESULTS: All clinical parameters shown to be numerically improved at 5 months when compared with baseline in all the three groups. The improvement (P < 0.01) in gingival index was statistically significant, and the intergroup results were also statistically significant (P < 0.01). CONCLUSIONS: Fourteen days of treatment with lozenges having L. brevis CD2 have a lasting effect on clinical measures of aggressive periodontitis, particularly gingival index. This effect appears to be equivalent to that produced by doxycycline.