The treatment and prevention of periodontitis is focused on the reduction and the elimination of pathogenic bacteria, especially A. actinomycetemaomitans and black pigmented bacteria such as P. gingivaLs. To prevern recurrent disease, the reeolonization of these bacteria should be inhibited in the periodontal pocket. Since tlr replacement therapy was introduced in periodontics by Hillman et al, Jeong et al reported that hydrogen peroxide-producing Lactobacillus acidophilus V-20 completely inhibited P. gingivalis and A. actinamycetemcomitans in vitro and mouth gargling with Lactobacillus acidophilus V-20 in periodontitis patients during the maintenance phase improved clinical condition and reduced the No, of P. gingivalis and A. actinomycetemcomitans at 4 weeks of treatment. Prior to replacement therapy with bacteria, dynamics a( microbial colonization should be considered.
This study was performed to evaluate the change in the viable cell number of Lactobacilli and P. gingivalis after oral administration of L. acidophilus V-20. In periodontal health, gargling increased the No. of Lactobacilli in saliva, buocal mucosa, supragingival plaque from the first week, which maintained for 2-3 weeks after gargling stop, and then returned to the undetectable baseline level at the ninth week. In the periodontal pocket of moderate periodontitis patients, daily irrigation for 1 week and weekly irrigation for subsequent 3 weeks decreased the viable cell number of P. gingivalis during the period of irrigation and increased the number of Lactobaci& which was maintained from the second to the seventh week. L. acidophilus V-20 was isolated for the first 2 weeks of oral administration, and the 3 different strains of Lactobacilli were isolated continuously for remaining period and identified as L. a&nentarius, L. case, subspecies casei and L. fructosus. The fast two LactohaaA strains completely inhibited P. gi4vzrhs in vitro and all the isolated Lactobacilli strains reduced the artificial plaque formation by 55-63%.
These results showed that mouth gargling or pocket irrigation with L. acidophilus V-20 increased the No. of intraoral Lactobacff and caused to decrease in the No. of P. gingivalis. This suggests that the replacement therapy by these Lactobaciff might be useful in the maintenance care of periodontal patients.
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