***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Lactobacillus paracasei has been demonstrated to inhibit the growth of many pathogenic microbes such as Streptococcus mutans , in vitro . However , its clinical application remains unclear . Here , we examined whether a novel probiotic L. paracasei GMNL-33 may reduce the caries-associated salivary microbial counts in healthy adults . Seventy-eight subjects ( aged 20 to 26 ) had completed this double-blinded , r and omized , placebo-controlled study . A probiotic/test ( n = 42 ) and a control group ( n = 36 ) took a L. paracasei GMNL-33 and a placebo oral tablet three times per day for 2 weeks , respectively . Bacterial counts of salivary S. mutans , lactobacilli , and salivary buffer capacity were measured with chair-side kits at the beginning ( T1 ) , the completion ( T2 ) of medication , and 2 weeks after medication ( T3 ) . The results did not show differences in the counts of S. mutans and lactobacilli between probiotic and control groups at T1 , T2 , and T3 . Nevertheless , within the probiotic group , an interesting probiotic effect was noticed . Between T1 and T2 , no inhibitory effect against S. mutans was observed . However , a significant count reduction in the salivary S. mutans was detected between T2 and T3 ( p = 0.016 ) . Thus , a 2-week period of medication via oral administration route may be needed for L. paracasei GMNL-33 to be effective in the probiotic action Background Several studies have recently demonstrated that a post-treatment communication to explain the importance of an oral hygiene can improve the orthodontic patients ’ compliance over a period of 66 days . The main goal of this study is to evaluate the effects of a structured follow-up communication after orthodontic appliance application on oral hygiene compliance after 30–40 days . Methods Eighty-four orthodontic participants enrolled from patients who were beginning fixed orthodontic treatment at the Orthodontic Department , Gaslini Hospital , Genova , between July and October 2014 were r and omly assigned to one of three trial arms . Before the bonding , all patients underwent a session of oral hygiene aim ed at obtaining an plaque index of “ zero . ” At the following orthodontic appointment , the plaque index was calculated for each patient in order to assess oral hygiene compliance . The first group served as control and did not receive any post-procedure communication , the second group received a structured text message giving reassurance , and the third group received a structured telephone call . Participants were blinded to group assignment and were not made aware that the text message or the telephone call was part of the study . ( The research protocol was approved by the Italian Comitato Etico Regionale della Liguria-sezione 3^ c/o IRCCS-Istituto G. Gaslini 845/2014 , and it is not registered in the trial ’s register . ) Results Thirty patients were r and omly assigned to the control group , 28 participants to the text message group , and 26 to the telephone group . Participants who received a post-treatment communication  reported higher level of oral hygiene compliance than participants in the control group . The plaque index was 0.3 ( interquartile range ( Iqr ) , 0.60 ) and 0.75 ( Iqr , 1.30 ) , respectively , with a significant difference ( P = 0.0205 ) . Conclusions A follow-up procedure after orthodontic treatment may be an effective tool to increase oral hygiene compliance also over a short period BACKGROUND / OBJECTIVES The purpose of the study is to evaluate the effect of daily intake of lozenges containing probiotic bacteria on white spot lesion ( WSL ) formation as well as on salivary lactobacilli ( LB ) and mutans streptococci ( MS ) counts , in patients undergoing orthodontic treatment with fixed appliances . MATERIAL S/ METHODS A r and omized double-blind placebo-controlled study design with two parallel arms was employed . Patients ( n = 85 , mean age 15.9 years ) with maxillary braces on at least eight anterior teeth and a remaining treatment period of 7 - 24 months were finally enrolled and r and omly allocated to a test or placebo group . Subjects in the test group were instructed to take one probiotic lozenge containing two strains of Lactobacillus reuteri once daily . An identical lozenge without active bacteria was used in the placebo group . Dental plaque , WSL , and salivary MS and LB levels were recorded at baseline and immediately after debonding . RESULTS The groups were balanced at baseline . The mean duration of the intervention was 17 months and the total dropout rate was 10 per cent . There were no differences in the incidence of WSL between the groups at debonding . The patients had generally a neglected oral hygiene , both at baseline and at the follow-up . The levels of salivary LB were significantly reduced in both groups ( P < 0.05 ) at the time of debonding compared with baseline , while no alterations of the MS counts were unveiled . LIMITATIONS WSL were scored from photos that may not fully mirror the clinical situation . Chair-side tests estimate the counts of selected bacteria in saliva and do not reflect the entire microbiota . The invention was implemented approximately 6 months after the onset of the fixed appliances and some lesions may have been present at bonding . CONCLUSIONS / CLINICAL IMPLICATION S Daily intake of probiotic lozenges did not seem to affect the development of WSL during orthodontic treatment with fixed appliances Abstract Objectives . The aim of this study was to assess the clinical effect of the administration of Lactobacillus reuteri Prodentis as a probiotic agent in the treatment of initial to moderate chronic periodontitis . Secondary objectives were to evaluate the patient ‘ compliance ' factor and to observe the potential side-effects of the probiotic agent . Material s and methods . Twenty systemically healthy , non-smoking subjects with initial-to-moderate chronic periodontitis were enrolled in this 1-month double-blind , placebo-controlled , r and omized clinical trial . Subjects were r and omly assigned to receive tablets containing Lactobacillus reuteri Prodentis or placebo once a day for 30 days . Clinical parameters were collected at baseline and 30 days post-treatment . Results . Periodontal clinical parameters were improved in the test group after a 30-day intervention . The test group demonstrated a statistically significant reduction ( p < 0.05 ) in all the periodontal parameters included in the study ( plaque index , bleeding on probing and pocket probing depths ) , while the control group treated with placebo did not show any statistically significant change in periodontal parameters . Conclusions . These data indicate that oral administration of Lactobacillus reuteri Prodentis improved the short-term clinical outcomes in non-smoking patients with initial-to-moderate chronic periodontitis Abstract Objectives : The aim of this study was to evaluate the effects of Lactobacilli reuteri ( Prodentis ) alone and in combination with scaling and root planing ( SRP ) in a double blind , r and omized , placebo-controlled clinical trial of volunteers with chronic periodontitis . Methods : Thirty , otherwise systemically healthy , chronic periodontitis patients ( 19 males and 11 females , aged between 34 and 50 years ) were included . The study period was 42 days . ‘ Split-mouth ’ design was used for the SRP , which was performed on day 0 ; two quadrants ( either right or left ) were treated with SRP whereas the remaining two quadrants were left untreated . The participants received a toothbrush , toothpaste , and brushing instructions . L. reuteri Prodentis lozenges ( 1 × 108 CFU DSM17938 + 1 × 108 CFU ATCC PTA 5289 ) or the corresponding placebo lozenges were taken twice daily from day 21 to day 42 . Statistical analysis was done for comparisons of clinical parameters ( Plaque Index ( PI ) , Gingival Index ( GI ) , Gingival Bleeding Index ( GBI ) , probing pocket depth ( PPD ) , clinical attachment level ( CAL ) ) and microbiological levels of the pathogens Aggregibacter actinomycetemcomitans ( Aa ) , Porphyromonas gingivalis ( Pg ) , and Prevotella intermedia ( Pi ) . All p-values less than 0.05 were considered significant . Assessment s were made on day 0 before SRP treatment , on day 21 before administration of the lozenges , and on day 42 . Results : At day 42 , the PI , GI , and GBI were significantly reduced by all treatment modalities . When ranked , the amount of PI , GI and GBI reduction by the different treatments was SRP + Prodentis > Prodentis > SRP + placebo > placebo ; all differences were statistically significant . For PPD and CAL , the best result was obtained with the SRP + Prodentis treatment . PPD was reduced from 5.08±0.75 to 3.78±0.61 mm ( p<0.001 ) and CAL from 3.93±0.93 to 2.85±0.74 mm ( p<0.001 ) . Prodentis , either alone or following SRP , reduced Aa , Pi , and Pg by 1 log10 unit ( p<0.01 ) . The SRP + placebo combination did not significantly affect the levels of the pathogens . Conclusion : The present r and omized controlled trial confirms the plaque inhibition , anti-inflammatory , and antimicrobial effects of L. reuteri Prodentis . L. reuteri Prodentis probiotic can be recommended during non-surgical therapy and the maintenance phase of periodontal treatment . Considering the beneficial effects of probiotics , this therapy could serve as a useful adjunct or alternative to periodontal treatment when SRP might be contraindicated . Further studies are required in this direction Dental caries is the most common chronic disease of childhood . Cariogram is a well-recognized algorithm-based software program based on different caries-related risk factors and intended to aid clinicians in performing more objective and consistent dental caries risk assessment s. This type of approach precedes the diagnosis of caries and allows the dentist to identify at-risk patients and then take appropriate preventive measures before caries develop further . One of the etiological factors favoring the development of dental caries is the mutans streptococci . These acidogenic dental plaque inhabitants can be effectively antagonized by the activity of bacteriocins released by the probiotic Streptococcus salivarius M18 ( salivarius M18 ) . Moreover , salivarius M18 after colonizing the human oral mucosa produces the enzymes dextranase and urease that are able to counteract plaque formation and saliva acidity , respectively . Seventy-six subjects at high risk of dental caries were r and omized and then either treated or not treated for 90 days with an oral formulation containing the oral probiotic salivarius M18 ( Carioblis ® ) . The results indicate that the use of salivarius M18 increases the chances of avoiding new dental caries development in children , and its application could be proposed as a new tool in the dentist ’s armory to be adopted in subjects considered at high risk on the basis of their Cariogram outcome Aim : To assess how consumption of yogurt containing Bifidobacteriumanimalis subsp . lactis DN-173010 probiotic for a period of 2 weeks affects salivary and dental plaque levels of mutans streptococci and lactobacilli in patients undergoing orthodontic treatment . Methods : A crossover , double-blind , r and omized and placebo-controlled clinical trial was performed with 26 volunteers . The study was divided into four periods . During periods 2 and 4 , the volunteers ingested yogurt containing probiotic or control yogurt daily for 2 weeks . Periods 1 and 3 were a 1-week run-in period and 4-week washout period , respectively . Saliva and dental plaque sample s were collected from each participant at the end of each period . Mutans streptococci , lactobacilli , and total cultivable microorganisms were counted . Values were compared between groups and across periods with the Wilcoxon 's test . Results : There was no difference between the yogurt containing probiotic and the control yogurt for any of the studied variables ( all p > 0.05 ) . A reduction in counts of total cultivable microorganisms was observed in dental plaque sample s after ingestion of either yogurts ( both p < 0.05 vs. baseline ) , but not in saliva ( p < 0.05 ) . Conclusion : Daily ingestion of yogurt with or without B. animalis subsp . lactis for a period of 2 weeks was beneficial in reducing total microbial counts in dental plaque . Therefore , no additional benefits were achieved by the use of the tested probiotic strain AIM This r and omized clinical study was design ed to evaluate the effect of probiotic intervention using lactobacilli on the periodontal condition of volunteers without severe periodontitis . MATERIAL AND METHODS Freeze-dried Lactobacillus salivarius WB21 (WB21)-containing tablets or a placebo were given to volunteers in a double-blind r and omized study . A total of 66 volunteers were finally enrolled and r and omly assigned to receive tablets containing WB21 ( 6.7 x 10(8 ) CFU ) with xylitol or xylitol alone ( placebo ) three times a day for 8 weeks . Periodontal clinical parameters and whole saliva sample s were obtained at baseline ( BL ) , 4 weeks , and the end of the interventional period 
    Output:
    
Supplementation of orthodontic patients with probiotics did not affect the development of inflammation in the gingivae and decalcification in the enamel .