Clinical and laboratory assessment of the effectiveness of a probiotic S. salivarius M18 complex inclusion as a prevention of children’s dental diseases with impaired phosphorus-calcium metabolism

Abstract

A healthy oral microbiota balance maintaining is a key strategy for preventing caries and periodontal diseases. Childhood is considered a critical period for the development of an immune response. Children with somatic diseases and metabolic disorders have higher risk of developing caries and periodontal diseases increases.
Materials and methods.
The clinical and laboratory study involved 46 patients aged 6—17 years (average age — 12 years) with orphan diseases with phosphorus-calcium metabolism impairment. After oral sanitation, the patients underwent measures aimed at preventing caries and periodontal diseases, including dental education, oral hygiene training and supervised tooth brushing. 26 patients (Group I, the main group) were selected to additionally take a probiotic complex with S. salivarius M18, while the remaining 20 patients formed Group II (comparison). The therapeutic and preventive measures lasted for 3 months. Some parameters of the dental status (CPD, OHI-S, SBI, and PMA) were determined at the beginning and after 3 months of the study. The concentration of some markers of inflammatory and reparative processes in mixed saliva was measured: monocyte chemoattractant protein (MCP-1), fatty acid-binding protein (FABP), procalcitonin (PCT), D-dimer, and vascular endothelial growth factor (VEGF).
Results.
After 3 months, Group I showed suppression of inflammatory processes in the oral cavity and normalization of the periodontal condition, as evidenced by a statistically significant decrease in clinical indices: OHI-S by 3 times to 0.70 points; SBI to near-zero values (from 1.84 to 0.09 points), and PMA by 4.8 times (from 54.1 to 11.3%). The clinical data were accompanied by a statistically highly significant decrease (p<0.001) in the concentration of biochemical markers in mixed saliva: MRS-1, FABP, PCT, and D-dimer. Group I MCP-1 was not detected in mixed saliva at an initial concentration of 132.5 pg/ml; the concentration of FABP decreased by 1.6 times to 0.07 ng/ml; the content of PCT in mixed saliva decreased by three times from 0.69 to 0.22 ng/ml; and the concentration of D-dimer decreased by 3.9 times, from 466.75 to 119.67 ng/ml. At the same time, Group I showed a statistically significant increase in VEGF concentration by 1.7 times to 1353.14 ME/ml (p<0.001), reflecting the stimulation of regenerative processes and improved vascularization of oral tissues.
Conclusions.
The use of the probiotic bacteria S. salivarius M18 “DentoBLIS” drug by children with orphan diseases with impaired phosphorus-calcium metabolism, blocks the growth of cariesogenic and periodontopathogenic microflora; leads to a decrease in the level of inflammation in the oral cavity and restoration of the immune balance, contributes to the normalization of homeostasis and regeneration processes in the oral cavity.