The aim of this study is to evaluate the effects of adjunctive synbiotic supplementation combined with non-surgical periodontal therapy in smokers with periodontitis. The main questions this study aims to answer are:
Does adjunctive synbiotic supplementation improve clinical periodontal parameters in smokers with periodontitis? Does adjunctive synbiotic supplementation affect immunological and microbiological parameters associated with periodontal disease?
Systemically healthy smokers and non-smokers diagnosed with generalized Stage III-IV Grade B/C periodontitis will be included in the study. Participants will first be divided into two main groups according to smoking status (smokers and non-smokers). These groups will then be further divided into two subgroups according to the use of synbiotic or placebo capsules. Therefore, the study will consist of four groups in total. The sample size of the study was determined as 92 participants, with 23 participants included in each group.
All participants will receive non-surgical periodontal therapy (NSPT) at baseline. In addition to NSPT, participants will use either synbiotic or placebo capsules once daily for 90 days.
To evaluate clinical periodontal, immunological, and microbiological parameters, periodontal measurements will be performed, and saliva and subgingival plaque samples will be collected. In addition, stool samples will be collected from participants to evaluate the effects of synbiotic supplementation on the gastrointestinal microbiota, and microbiota analyses will be performed.
All samples will be collected again and evaluated at the third month following non-surgical periodontal therapy.
Age between 18 and 65 years
Diagnosis of generalized Stage III/IV Grade B/C periodontitis
Willingness to participate in the study and provide informed consent
No periodontal treatment within the last 3 months
Failure to meet voluntary participation requirements
Presence of systemic diseases affecting the periodontium or immune response
Use of additional dietary supplements
Pregnancy or breastfeeding
Parallel
Synbiotic supplementation
Dietary supplementProduct Name: Bigflor Capsule Food Supplement Containing Probiotic Microorganisms Approval Number: 005400-08.02.2019 Manufacturer: Nuvita İlaç ve Kimya Sanayi Ticaret Anonim Şirketi Manufacturer Registration/Approval Number: TR-34-K-063184 Contents: Saccharomyces boulardii (5×10⁹ cfu/day) - 250 mg Probiotic Blend (3.5×10⁹ cfu/day) (Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium longum, Streptococcus thermophilus) - 22.5 mg Prebiotic (Inulin) - 25 mg
Placebo Administration
Other interventionThe use of a placebo in the control group
Changes in Probing Pocket Depth (PPD)
Evaluation of changes in probing pocket depth following non-surgical periodontal therapy combined with synbiotic or placebo supplementation in smokers and non-smokers with generalized Stage III-IV Grade B/C periodontitis.
Gain in Clinical Attachment Level (CAL)
Evaluation of changes in clinical attachment level following non-surgical periodontal therapy combined with synbiotic or placebo supplementation in smokers and non-smokers with generalized Stage III-IV Grade B/C periodontitis.
Quantitative Changes in Periodontal Pathogens
Assessment of quantitative changes in periodontal pathogens in subgingival plaque samples following non-surgical periodontal therapy combined with synbiotic or placebo supplementation.
Changes in IL-1β, IL-8, and 8-OHdG Levels
Evaluation of changes in inflammatory and oxidative stress biomarkers, including IL-1β, IL-8, and 8-OHdG levels, following non-surgical periodontal therapy combined with synbiotic or placebo supplementation.
Changes in Plaque Index
Assessment of changes in plaque index values following non-surgical periodontal therapy combined with synbiotic or placebo supplementation.
Changes in Bleeding on Probing
Assessment of changes in bleeding on probing values following non-surgical periodontal therapy combined with synbiotic or placebo supplementation.
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Biruni University
Lead sponsor
KU Leuven
Collaborator
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