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Effectiveness of probiotic mouthwash on full crown anterior teeth prosthesis plaque accumulation and gingival inflammation in 20-30-year-olds

British Dental Journal (2025)Cite this article

Abstract

Background Periodontal diseases are common and can lead to severe dental complications, with bacterial infections at their core. Dental restorations, such as crowns, can exacerbate these conditions by facilitating bacterial accumulation. Traditional therapies, including mechanical debridement and antimicrobial agents, may not fully address oral microbiome dysbiosis, potentially leading to recurrent infections and antibiotic resistance.

Objective This study evaluated the effectiveness of a probiotic mouthwash in reducing plaque accumulation and gingival inflammation in patients with full crown anterior teeth prostheses, focusing on the impact on the oral microbiome and inflammatory markers.

Methods A randomised, double-blind, placebo-controlled trial of 30 patients with gingivitis and 30 periodontally healthy individuals was conducted. The participants used either a probiotic or placebo mouthwash for one month. Clinical assessments, including the bleeding index (BI), plaque index (PLI) and gingival index (GI), were conducted at baseline and post-treatment. Gingival crevicular fluid was collected to measure interleukin-6 (IL-6), interleukin-1 beta (IL-1β), and tumour necrosis factor-alpha (TNF-α) by enzyme-linked immunosorbent assays. Microbial diversity was analysed using quantitative polymerase chain reaction analysis and sequencing.

Results Probiotic mouthwash use significantly decreased BI, PLI and GI values compared to the control group. Decreases in IL-6, IL-1β, and TNF-α levels in the gingival crevicular fluid were also observed. Microbial analysis showed an improved oral microbiome health index and reduced levels of periodontal pathogens.

Conclusion The probiotic mouthwash significantly improved gingival health and modulated the oral microbiome, suggesting its potential as an adjunct to standard periodontal treatments for patients with dental prostheses.

Key points

  • Probiotic mouthwash effectively reduced plaque accumulation and gingival inflammation in patients with anterior crown prostheses.

  • Probiotic intervention led to significant reductions in pro-inflammatory cytokines (IL-6, IL-1β and TNF-α) in gingival crevicular fluid.

  • Oral microbiota diversity improved, with decreased periodontal pathogens and increased microbial homeostasis.

  • This non-antibiotic intervention provides a promising adjunctive strategy for maintaining periodontal health in restorative patients.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou 310000, China

    Yi Zhou, Ying Wang & Shuli Deng

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  1. Yi Zhou
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  2. Ying Wang
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  3. Shuli Deng
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Contributions

YZ and YW contributed equally to the study design, data collection, and manuscript drafting. SD supervised the research process, provided critical revisions to the manuscript, and approved the final version for submission. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Shuli Deng.

Ethics declarations

The authors declare no conflicts of interest. Ethical approval for this study was granted by the Biomedical Ethics Committee of the Stomatology Hospital, Zhejiang University School of Medicine (Approval No. 2023.080). All participants provided written informed consent before enrolment.

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Zhou, Y., Wang, Y. & Deng, S. Effectiveness of probiotic mouthwash on full crown anterior teeth prosthesis plaque accumulation and gingival inflammation in 20-30-year-olds. Br Dent J (2025). https://doi.org/10.1038/s41415-025-8886-x

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  • DOI: https://doi.org/10.1038/s41415-025-8886-x

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