Introduction: The effectiveness of nonsurgical periodontal treatment is related to patient- and tooth-related factors. To overcome the limitations of the conventional approach, probiotics are one of the adjunct therapies that have been studied.Objectives: This umbrella review answered the focused question: in adult patients with periodontal diseases or peri-implant diseases, does the use of probiotic therapy as an adjuvant to nonsurgical periodontal treatment when compared with nonsurgical periodontal treatment alone affect treatment effectiveness and clinical disease parameters?Methods: A systematic electronic search to identify systematic reviews according to PICOS criteria, defined a priori, was used, and 5 electronic databases were searched (Medline, LILACS, Cochrane Central Registry of Controlled Trials, Google Scholar, and DANS EASY). Included systematic reviews were rated using quality assessment tools by 2 independent reviewers.Results: Thirty systematic reviews were identified evaluating the effectiveness of probiotics in periodontal and peri-implant disease treatment. A quantitative analysis of the results was not possible due to the high heterogeneity of clinical data. Seventeen of 31 reviews reported clinically relevant benefits of probiotic therapy as an adjuvant to scaling and root planning. Twenty-two reviews had a low risk of bias, 7 had a moderate risk, and 2 had a high risk.Conclusion: The evidence from the available studies is conflicting, which means that no definitive conclusions can be made about the effectiveness of probiotic therapy as an adjuvant to nonsurgical periodontal treatment. High-quality primary research studies are needed that control for known confounding variables.Knowledge Transfer Statement: This umbrella review provides some evidence regarding the efficacy of probiotics as an adjunct to nonsurgical periodontal therapy, despite some equivocal findings. However, short-term probiotic use alongside therapy appears to be advantageous; there is currently no evidence supporting their long-term benefits. We have also identified that probiotic research is primarily constrained by its origins in gastrointestinal applications, resulting in a lack of approved probiotics for dental use. This review highlights the need for extensive clinical research to ascertain their effectiveness in the oral environment. Nevertheless, the utilization of probiotics alongside periodontal treatment seems safe, with no reported adverse effects in patients. Thus, further clinical validations in oral health care settings are crucial.

Gut microbiota has been identified as a unique endocrine organ linked to the development of cardiovascular disease and other illnesses, especially deteriorated in overweight and obese postmenopausal women. The object of this systematic review and meta-analysis aimed to assess the effects of oral supplementation with probiotics for overweight and obese postmenopausal women. We performed a systematic search for randomized controlled trials (RCTs) from inception to April 2022 in MEDLINE, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov. We also performed a hand search by reviewing reference lists to identify trials. The risk of bias in individual studies was assessed with the Cochrane risk of bias tool for randomized trials (RoB). Two reviewers independently selected studies and collected data. There were 6 studies from 5 RCTs with 281 participants in this systematic review. Compared with the placebo, the probiotics supplementation group had reductions in insulin (MD - 4.20 IU/L (95% CI - 8.11 to - 0.30 IU/L), I-2 = 54%), HOMA-IR (MD - 1.25 (95% CI - 2.49 to - 0.01), I-2 = 50%), and TNF-alpha (MD - 0.12 pg/mL (95% CI - 0.22 to - 0.01 pg/mL), I-2 = 44%). Improvements were also shown in body adiposity and lipid profile, but these effects were nonsignificant. In addition to body adiposity and cardiovascular risk markers, one trial showed the administration of probiotics also had an effect on iron metabolism. In conclusion, probiotics have a potential benefit on glucose metabolism and inflammatory process in overweight and obese postmenopausal women, but this effect is mild. It demonstrates that oral probiotics supplementation can be a complementary treatment for improving the fitness of postmenopausal women with overweight and obesity.

Purpose Accumulating evidence showed that probiotics therapy might be effective in treating diarrhea-predominant irritable bowel syndrome (IBS-D). This study aimed to evaluate the effectiveness and safety of probiotics therapy for the treatment of IBS-D. Methods We performed a comprehensive literature search in eight electronic databases, and gray literature from inception to August 4, 2021. Randomized controlled trials (RCTs) of probiotics therapy for the treatment of IBS-D were included and the quality was assessed using the risk of bias tool recommended by the Cochrane Handbook version 5.1.0. RevMan 5.4 software was used to perform the meta-analysis on the outcomes of IBS-D symptoms, abdominal pain, quality of life, and abdominal distension. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of evidence. Results Ten RCTs evaluating 943 patients were identified. Only one study had unclear risk of bias, while nine studies had a high risk of bias. The meta-analysis results showed that, compared to the placebo, probiotics therapy significantly decreased the score of IBS-D symptoms (SMD = - 0.55, 95% CI: [- 0.83, - 0.27], P < 0.05), abdominal pain (SMD = - 0.43, 95% CI: [- 0.57, - 0.29], P < 0.05), and abdominal distension (SMD = - 0.45, 95%CI: [- 0.81, - 0.09], P < 0.05). There was no statistical difference in the quality of life. However, all the certainty of evidence was very low. Conclusion Very low certainty evidence showed that probiotics might be an effective treatment for improving the IBS-D symptoms, abdominal pain, and abdominal distension, in adult IBS-D patients. However, these conclusions should be supported by high-quality evidence.

Background: Gestational diabetes mellitus was associated with increased risks of complications during pregnancy and delivery. The efficacy of probiotics for preventing atopic disease among overweight and obese pregnant women has not been a unified conclusion. Therefore, we aimed to determine the efficacy and safety of probiotics supplementation for overweight and obese pregnant women. Methods: We searched the Cochrane Library, Embase, PubMed, and Web of Science for randomized controlled trials from the earliest publication date available to September 23, 2020, regardless of language or publication status. Two reviewers independently extracted data with a standardized form. When disagreements arose, a third investigator was consulted. Data was pooled using the generic inverse variance method and expressed as mean differences and relative risk with 95% confidence interval (CI). Heterogeneity was measured and quantified by I-2 statistic. Results: There were no significant differences between probiotics and placebo on GDM (RR = 1.03; 95% CI, 0.81-1.30; P = 0.821; I-2 = 38.7%, P = 0.180), excess gestational weight gain (RR = 0.92; 95% CI, 0.79 -1.06; P = 0.223; I-2 = 91.2%, P = 0.001) and neonatal birth weight (WMD = 28.47; 95% CI, -34.80-91.73; P = 0.383; I-2 = 4.5%, P = 0.381). In addition, probiotics might increase the risk of preeclampsia including superimposed (RR = 1.91; 95% CI, 1.03-3.55; P = 0.001; I-2 = 0.0%, P = 0.994). Conclusions: Probiotics had no better efficacy for prevention of atopic disease in overweight or obese pregnant women. In contrast, excessive probiotics supplementation might increase the risk of preeclampsia. More data will be necessary to determine the prevention efficacy of probiotics with consideration of real-world and other epidemiological settings. (C) 2022 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

To perform a systematic review and meta-analysis to evaluate the effectiveness and safety of probiotics in the treatment of constipation-predominant irritable bowel syndrome (IBS-C), we searched for randomized controlled trials (RCTs) comparing probiotic care versus placebos for patients with IBS-C in five comprehensive databases (March 2022). The risk of bias was assessed using the Cochrane Collaboration Risk of Bias Tool. RevMan 5.3 was used to perform a meta-analysis on stool consistency, abdominal pain, bloating, quality of life (QoL), fecal Bifidobacterium and Lactobacillus counts, and adverse events. The GRADE approach was used to evaluate the certainty of the evidence. Ten RCTs involving 757 patients were included. Only three studies were rated as having a low risk of bias. The meta-analysis results show that, compared to the placebo, probiotics significantly improved stool consistency (MD = 0.72, 95% CI (0.18, 1.26), p 0.05). The low-to-very low certainty evidence suggests that probiotics might improve the stool consistency of patients with IBS-C and increase the number of Bifidobacteria and Lactobacilli in feces with good safety. However, more high-quality studies with large samples are needed to verify the findings.

Probiotic and prebiotic products have shown potential health benefits, including for the prevention of adverse pregnancy outcomes. The incidence of adverse effects in pregnant people and their infants associated with probiotic/prebiotic/synbiotic intake, however, remains unclear. The objectives of this study were to evaluate the evidence on adverse effects of maternal probiotic, prebiotic, and/or synbiotic supplementation during pregnancy and lactation and interpret the findings to help inform clinical decision-making and care of this population. A systematic review was conducted following PRISMA guidelines. Scientific databases were searched using pre-determined terms, and risk of bias assessments were conducted to determine study quality. Inclusion criteria were English language studies, human studies, access to full-text, and probiotic/prebiotic/synbiotic supplementation to the mother and not the infant. In total, 11/100 eligible studies reported adverse effects and were eligible for inclusion in quantitative analysis, and data were visualised in a GOfER diagram. Probiotic and prebiotic products are safe for use during pregnancy and lactation. One study reported increased risk of vaginal discharge and changes in stool consistency (relative risk [95% CI]: 3.67 [1.04, 13.0]) when administering Lactobacillus rhamnosus and L. reuteri. Adverse effects associated with probiotic and prebiotic use do not pose any serious health concerns to mother or infant. Our findings and knowledge translation visualisations provide healthcare professionals and consumers with information to make evidence-informed decisions about the use of pre- and probiotics.