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Background: The aim of this systematic review was to evaluate the therapeutic potential of probiotics in patients with halitosis and to assess whether probiotics can also be implemented as a preventative tool in oral health. Secondary objectives included the effect of probiotics on oral-health-related quality of life, as well as their safety. Materials and methods: An electronic literature search in Medline (PubMed), Scopus, Web of Science, and the Cochrane library was carried out for the identification and selection of relevant randomized controlled trials. Eligibility was based on inclusion criteria, which included RCTs published after 2013, and the outcome variables were volatile sulfur compound (VSC) levels, organoleptic scores, plaque, or saliva samples to assess cariogenic bacteria counts and/or pH levels. Results: Out of 192 identified records, 16 randomized controlled trials were included. Ten of those studied the effects of probiotics on halitosis and the other six analyzed the effect of probiotics on oral health parameters, such as cariogenic bacteria counts, pH levels, and salivary flow and quality. A total of 921 patients were evaluated. The risk of bias was assessed using the Cochrane risk-of-bias assessment tool version 2. Conclusions: Probiotics exhibit the potential for oral health management by reducing VSC levels, improving saliva quality, and enhancing oral-health-related quality of life. Combining probiotics with tongue scraping may sustain VSC reduction, while symbiotics show potential in reducing tongue coating. However, different bacterial strains have been used in the included studies; hence, the conclusions cannot be generalized, being one of the main limitations of this review. Future research should explore the probiotics’ potential to persist in the oral cavity post-treatment and employ standardized methodologies for conclusive efficacy assessment.

Background: the purpose of this systematic review was to assess the clinical and radiographic effect of subgingival-administered statins as an adjunct periodontal treatment in patients with periodontitis. Methods: Electronic literature searches in Medline/PubMed and the Cochrane Library were conducted to identify all relevant articles. Eligibility was based on inclusion criteria which included Randomized Controlled Trials (RCTs) published after 2010, where the periodontal variables were assessed before and after periodontal treatment in combination with a statin administration. The risk of bias was assessed with the ROBINS-2 tool. The outcome variables were probing depth, clinical attachment level, bleeding on probing, and bone fill in systematically healthy patients, patients with type 2 diabetes, and smokers. Results: Out of 119 potentially eligible articles, 18 randomized controlled trials were included with a total of 1171 participants. The data retrieved from the meta-analysis showed the positive effect that statins have as an adjunctive periodontal disease treatment. When comparing the different types of statins, the PD reduction in the Simvastatin group was significantly higher than the Atorvastatin group at 6 months and at 9 months, while no differences between statins were found for the rest of the outcomes. Over 66% of the articles presented an overall risk of bias with some concerns, making this a limitation of this present RCT. Conclusions: The adjunct administration of statins has proven to have a positive effect on the periodontium by improving both clinical and radiographic parameters by a considerable margin.