   Introduction   History   Definitions   Mechanism of action   Probiotics in periodontal health   Risks during prob...
   Periodontitis       Multifactorial     Conventional treatment modalities                           Mechanical Debridem...
ANTIBIOTIC RESISTANCE AND           RECOLONIZATION BY        Need for new treatment  PATHOGENIC BACTERIA                ...
   Probiotics = „pro‟(for) and „bios‟( life) term coined by Lilley    and Stillwell(1965)        Concept of probiotics b...
Probiotic   Currently adopted definition                       By FAO /WHO            Live microorganisms which when admi...
PrebioticA non-digestible food ingredient that confers benefits on thehost by selectively stimulating the growth and/or ac...
SynbioticThe term synbiotic is used when a product contains bothprobiotics and prebiotics. Because the word alludes tosyne...
ANTIBIOTICS VS PROBIOTICS     Antibiotics             Probiotics                        Favours good bacteriaPathogenic ba...
Lactobacillus species.   L acidophilus   L. casei   L. crispatus   L. delbrueckii subsp.   L. fermentum   L. Gasseri...
Bifidobacterium species   B. bifidum   B. breve   B. Infantis   B. longum   B. lactis   B. adolescentis
Others   Lactococcus lactis subsp. Cremoris   Enterococcus faecalum   Streptococcus salivarius subsp.thermophilus   S....
 Lactobacillus: enhance innate and acquired immunity inhibition of pro-inflammatory mediators production of enzymes to...
 Bifidobacterium   metabolization of lactose, generate lactic ions from lactic acid    and synthesize vitamins.   ferme...
 Streptococcus   thermophilus and    Lactobacillus bulgaricus   metabolize lactose, improve lactose tolerance and    ant...
 Saccharomyces boulardii: secrete proteases and other substances that breakdown  bacterial enterotoxins and inhibits the...
1.   Direct interaction2.   Competitive exclusion3.   Modulation of host immune response
Direct interaction:   Probiotics interact directly with the disease-causing    microbes, making it harder for them to cau...
Competitive exclusion:    Beneficial microbes directly compete with the disease    developing microbes for nutrition or e...
Modulation of host immune response:   Probiotics interact with and strengthen the immune system and    help prevent disea...
    Modulate host immunity both systemically and locally      Stimulate dendritic cells (antigen presenting cells)       ...
   Glycoprotein-carbohydrate cell surface interaction mediate by    interspecies interactions   Apoptosis is yet another...
Production of     • Organic acidsantimicrobial     • Hydrogen peroxide substances       • Bacteriocins                  • ...
   Produce antioxidants- neutralize free electrons that are needed    for mineral formation.   Break down putrescense od...
   High cell viability, resistant to low pH and acids   Ability to persist   Adhesion to cancel the flushing agent   A...
   Plaque modification, altering anaerobic organisms    colonization,altering pocket depth, improving clinical    attatch...
   Protect epithelium barrier by maintaining tight junction    protein expression   Lactobacillus paracasei and Lactobac...
   W. cibaria secretes a significant quantity of hydrogen    peroxide as well as bacteriocin that acts against gram posit...
The antiplaque activity of the Probiotic mouth rinse:. reduces the adhesion of bacteria to the tooth surface inhibits th...
   A decrease in gingival bleeding and reduced gingivitis has    been observed by Krasse et al with the application of L....
  Probiotics are provided into the food items in one of four basic   ways:(i) as a culture concentrate added to beverages...
   As lyophilized, dried cells packaged as dietary supplements    (tablets, chewing gums, straws).   The archetypical pr...
LOZENGES
Yoghurt
Probiotic MintsChewing gums
Sepsis    Lactobacillus species are a rare but well-recognized cause of    endocarditis in adults (and other forms of se...
Major risk factors1) Immune compromise, including a debilitated state or malignancy2) Premature infantsMinor risk factors1...
   Probiotics represent an upcoming field of research, the    examination of the close relationships between oral health ...
   It still remains to be seen, the extent to which probiotics are    applicable to promoting oral health. Although the r...
      Report of a Joint FAO/WHO Expert Consultation on Evaluation of Health    and Nutritional Properties of Probiotics i...
PRESENTED BYAYSHA JABEEN.M.2007-2012 BATCHVIVEKANANDHA DENTAL COLLEGE FOR WO
Probiotics in periodontal health and disease
Probiotics in periodontal health and disease
Probiotics in periodontal health and disease
Probiotics in periodontal health and disease
Upcoming SlideShare
Loading in …5
×

Probiotics in periodontal health and disease

5,887 views

Published on

Published in: Health & Medicine, Technology
3 Comments
13 Likes
Statistics
Notes
No Downloads
Views
Total views
5,887
On SlideShare
0
From Embeds
0
Number of Embeds
4
Actions
Shares
0
Downloads
469
Comments
3
Likes
13
Embeds 0
No embeds

No notes for slide

Probiotics in periodontal health and disease

  1. 1.  Introduction History Definitions Mechanism of action Probiotics in periodontal health Risks during probiotic treatment Conclusion References
  2. 2.  Periodontitis Multifactorial Conventional treatment modalities Mechanical Debridement • Non surgical • Surgical Antibiotics Eliminate entire microflora
  3. 3. ANTIBIOTIC RESISTANCE AND  RECOLONIZATION BY Need for new treatment PATHOGENIC BACTERIA  paradigm
  4. 4.  Probiotics = „pro‟(for) and „bios‟( life) term coined by Lilley and Stillwell(1965) Concept of probiotics by Elie Metchnikoff in his book “prolongation of life”(1907) proposed a diet containing milk fermented by lactobacilli, which produce large amounts of lactic acid that could increase the life span of humans.
  5. 5. Probiotic Currently adopted definition By FAO /WHO Live microorganisms which when administered in adequate amounts confer a health benefit on the host
  6. 6. PrebioticA non-digestible food ingredient that confers benefits on thehost by selectively stimulating the growth and/or activity ofone bacterium or a group of bacteria in the colon, and thusimprove the host health
  7. 7. SynbioticThe term synbiotic is used when a product contains bothprobiotics and prebiotics. Because the word alludes tosynergism, this term should be reserved for products in whichthe prebiotic compound selectively favors the probioticcompound
  8. 8. ANTIBIOTICS VS PROBIOTICS Antibiotics Probiotics Favours good bacteriaPathogenic bacteria Good bacteria Pathogenic Bacteria
  9. 9. Lactobacillus species. L acidophilus L. casei L. crispatus L. delbrueckii subsp. L. fermentum L. Gasseri L. johnsonii L. paracasei L. plantarum L. reuteri L. rhamnosus
  10. 10. Bifidobacterium species B. bifidum B. breve B. Infantis B. longum B. lactis B. adolescentis
  11. 11. Others Lactococcus lactis subsp. Cremoris Enterococcus faecalum Streptococcus salivarius subsp.thermophilus S. diacetylactis S. Intermedius Yeasts and moulds (Saccharomyces boulardii,Aspergillus niger)
  12. 12.  Lactobacillus: enhance innate and acquired immunity inhibition of pro-inflammatory mediators production of enzymes to digest and metabolize proteins and carbohydrates. synthesis of vit. B and vit.K and facilitates breakdown of bile salts.
  13. 13.  Bifidobacterium metabolization of lactose, generate lactic ions from lactic acid and synthesize vitamins. ferment indigestible carbohydrates and produce beneficial short chain fatty acids.
  14. 14.  Streptococcus thermophilus and Lactobacillus bulgaricus metabolize lactose, improve lactose tolerance and antimicrobial activity
  15. 15.  Saccharomyces boulardii: secrete proteases and other substances that breakdown bacterial enterotoxins and inhibits their binding to intestinal receptors. They also help in immune function enhancement.
  16. 16. 1. Direct interaction2. Competitive exclusion3. Modulation of host immune response
  17. 17. Direct interaction: Probiotics interact directly with the disease-causing microbes, making it harder for them to cause the disease. Production of antimicrobial substances against periodonto pathogens
  18. 18. Competitive exclusion: Beneficial microbes directly compete with the disease developing microbes for nutrition or enterocyte adhesion sites.
  19. 19. Modulation of host immune response: Probiotics interact with and strengthen the immune system and help prevent disease. Modulation of host defenses including the innate as well as the acquired immune system
  20. 20.  Modulate host immunity both systemically and locally Stimulate dendritic cells (antigen presenting cells) Expression of Th1 and Th2 Modulate pathogen induced inflammation through „toll like receptors‟ on dendritic cells. Th1 response: Phagocytose intracellular pathogens Th2 response: Extracellular pathogens
  21. 21.  Glycoprotein-carbohydrate cell surface interaction mediate by interspecies interactions Apoptosis is yet another proposed mechanism. Probiotics stimulate apoptosis of tumor cells
  22. 22. Production of • Organic acidsantimicrobial • Hydrogen peroxide substances • Bacteriocins • Compete with pathogens for adhesion sitesBinding in Oral • Involvement in metabolism of Cavity substrates (competing with oral micro organisms for substrates available) • Stimulate non specific immunity Co-Immuno modulatory • Modulate humoral and cellular immune response
  23. 23.  Produce antioxidants- neutralize free electrons that are needed for mineral formation. Break down putrescense odours by fixating the toxic gases ( volatile sulphur compounds) and change them into gases needed for metabolism
  24. 24.  High cell viability, resistant to low pH and acids Ability to persist Adhesion to cancel the flushing agent Able to interact or to send signals to immune cells Should be of human origin Should be non pathogenic Resistance to processing Influence local metabolic activity
  25. 25.  Plaque modification, altering anaerobic organisms colonization,altering pocket depth, improving clinical attatchment. The application of selected beneficial bacteria, as an adjunct to scaling and root planing, would also inhibit the periodonto- pathogen recolonization of periodontal pockets and thus achieve and maintain periodontal health. Probiotics can mimic response similar to a pathogen but without periodontal destruction
  26. 26.  Protect epithelium barrier by maintaining tight junction protein expression Lactobacillus paracasei and Lactobacillus rhamnosus had a high capacity to antagonize important oral pathogens, including Streptococcus mutans and Porphyromonas gingivalis. Weissella cibaria, a gram positive facultative anaerobic lactic acid bacterium that has been isolated from humans, is present in fermented foods and is considered a potential probiotic agent. -.
  27. 27.  W. cibaria secretes a significant quantity of hydrogen peroxide as well as bacteriocin that acts against gram positive bacteria. This bacterial species has the capacity to coaggregate with Fusobacterium nucleatum and to adhere to epithelial cells. These properties could enable W. cibaria to effectively colonize the oral cavity and limit the proliferation of pathogenic bacteria
  28. 28. The antiplaque activity of the Probiotic mouth rinse:. reduces the adhesion of bacteria to the tooth surface inhibits the growth and proliferation of microorganisms on the tooth surface inhibits the formation of the intercellular plaque matrix, modifies plaque biochemistry to reduce the formation of cytotoxic product modifies plaque ecology to a less pathogenic flora.
  29. 29.  A decrease in gingival bleeding and reduced gingivitis has been observed by Krasse et al with the application of L. reuteri Inhibits the growth of P. gingivalis and Prevotella intermedia.
  30. 30.  Probiotics are provided into the food items in one of four basic ways:(i) as a culture concentrate added to beverages.(e.g. fruit juice)(ii) inoculated into pre-biotic fibres which promote the growth of probiotic bacteria(iii) inoculated into milk and milk-based foods (e.g. milk drinks, yoghurt, cheese, kefir, bio-drinks)
  31. 31.  As lyophilized, dried cells packaged as dietary supplements (tablets, chewing gums, straws). The archetypical probiotic food is yoghurt and daily consumption of dairy products seems to be the most natural way to ingest probiotic bacteria
  32. 32. LOZENGES
  33. 33. Yoghurt
  34. 34. Probiotic MintsChewing gums
  35. 35. Sepsis Lactobacillus species are a rare but well-recognized cause of endocarditis in adults (and other forms of sepsis in children) in the absence of probiotic supplementation. Several reports have directly linked cases of Lactobacillus and other bacterial sepsis to the ingestion of probiotic supplements.Deleterious metabolic activitiesImmune deviation or excessive immune stimulation
  36. 36. Major risk factors1) Immune compromise, including a debilitated state or malignancy2) Premature infantsMinor risk factors1) CVC2) Impaired intestinal epithelial barrier, eg, diarrheal illness, intestinal inflammation3) Administration of probiotic by jejunostomy4)Probiotics with properties of high mucosal adhesion or knownpathogenicity5) Cardiac valvular disease (Lactobacillus probiotics only)
  37. 37.  Probiotics represent an upcoming field of research, the examination of the close relationships between oral health and our daily diet. It is a natural way of maintaining health and protecting oral tissues from disease, and datas suggest that the potential benefits increase with an early childhood start.
  38. 38.  It still remains to be seen, the extent to which probiotics are applicable to promoting oral health. Although the results of past studies are encouraging, still much needs to be done for identification of the probiotics that are best suited to oral use, as well as the most appropriate vehicles for its delivery. The application of probiotic strategies may, in near future provide an end to many infections occurring in oral cavity.
  39. 39.  Report of a Joint FAO/WHO Expert Consultation on Evaluation of Health and Nutritional Properties of Probiotics in Food Including Powder Milk with Live Lactic Acid Bacteria (October 2001) Retrieved 2009-11-04 Jürgen Schrezenmeir and Michael de Vrese Am J Clin Nutr February 2001 vol. 73 no. 2 361S-364S Deepa D,D.S.Mehta Is the role of probiotics friendly in the treatment of periodontal diseases? JISP Vol 13 Issue 1 Jan-Apr 2009 30-31 Anirban Chatterjee,Hirak Bhattacharya,Abhishek Kandwal Probiotics in periodontal health and disease JISP Vol 15 2011 23-24 Gupta G Probiotics and periodontal health Journal of medicine and life Kedar Saraf, MC Shashikanth, Tulasi Priya, Nishat Sultana, Nallan CSK Chaitanya JAPI • august 2010 • VOL. 58 488-492 Robert J Boyle, Roy M Robins-Browne, and Mimi LK Tang The American Journal of Clinical Nutrition V Shivakumar, S Pavithrapriyadharshoni, V Gopinath n Journal of Multidisciplinary Dentistry, Vol. 1, Issue 6, September-October 2011 316-320
  40. 40. PRESENTED BYAYSHA JABEEN.M.2007-2012 BATCHVIVEKANANDHA DENTAL COLLEGE FOR WO

×