Effect of TCI188 Probiotic on Oral Health

• TCI188 Probiotic (Dietary supplement), also known as Pediococcus acidilactici TCI188: take two tablets per day
• Placebo (Dietary supplement): take two tablets per day

Primary outcomes

• The change of clinical oral measurements- Probing pocket depth (PPD) [before root planning, after taking chewable tablets for 6-8 weeks, and after finishing taking chewable tablets for 12 weeks]: The values of Probing pocket depth (PPD) was utilized to evaluate oral status.
• The change of clinical oral measurements- Bleeding on probing (BOP) [before root planning, after root planning, after taking chewable tablets for 6-8 weeks, and after finishing taking chewable tablets for 12 weeks]: The values of Bleeding on probing (BOP) was utilized to evaluate oral status.

Secondary outcomes

• The change of clinical oral measurements- Plaque index (PI) [before root planning, after taking chewable tablets for 6-8 weeks, and after finishing taking chewable tablets for 12 weeks]: The values of Plaque index (PI) was utilized to evaluate oral status.
• The change of clinical oral measurements- Clinical attachment level (CAL) [before root planning, after taking chewable tablets for 6-8 weeks, and after finishing taking chewable tablets for 12 weeks]: The values of Clinical attachment level (CAL) was utilized to evaluate oral status.
• The change of clinical oral measurements- Gingival index (GI) [before root planning, after taking chewable tablets for 6-8 weeks, and after finishing taking chewable tablets for 12 weeks]: The values of Gingival index (GI) was utilized to evaluate oral status.
• The change of inflammatory markers (IL-10, IL-1beta) of saliva [before root planning, after taking chewable tablets for 6-8 weeks, and after finishing taking chewable tablets for 12 weeks]: The levels of interleukin-10 (IL-10), interleukin-1beta (IL-1beta) in saliva were utilized to evaluate oral inflammation status.
• The change of oral microflora [before root planning, after root planning, after taking chewable tablets for 6-8 weeks, and after finishing taking chewable tablets for 12 weeks]: The relative abundance of Streptococcus mutans, Porphyromonas gingivalis, Streptococcus salivarius, Pediococcus acidilactici were utilized to evaluate the change of oral microflora.
• The change of liver function biomarkers (AST, ALT) of blood [before root planning, after root planning, after taking chewable tablets for 6-8 weeks, and after finishing taking chewable tablets for 12 weeks]: Fasting venous blood was sampled to measure liver function biomarkers- Aspartate Transaminase (AST), Alanine aminotransferase (ALT), Blood urea nitrogen (BUN), Creatinine, High-sensitivity CRP (Hs-CRP), Interleukin.
• The change of renal function biomarkers (BUN, CRE) of blood [before root planning, after root planning, after taking chewable tablets for 6-8 weeks, and after finishing taking chewable tablets for 12 weeks]: Fasting venous blood was sampled to measure renal function biomarkers- Blood urea nitrogen (BUN), Creatinine (CRE).
• The change of inflammatory biomarkers (Hs-CRP, IL-10, IL-1beta) of blood [before root planning, after root planning, after taking chewable tablets for 6-8 weeks, and after finishing taking chewable tablets for 12 weeks]: Fasting venous blood was sampled to measure inflammatory biomarkers- High-sensitivity CRP (Hs-CRP), Interleukin-10 (IL-10), Interleukin-1beta(IL-1beta).
• The change of Bad breath [before root planning, after root planning, after taking chewable tablets for 6-8 weeks, and after finishing taking chewable tablets for 12 weeks]: The Bad Breath Tester was utilized to measure Bad breath. The Bad breath detection level is 0\~5.

Sex: All, ages: 18 Years to 70 Years, accepts healthy volunteers

Inclusion Criteria:

* Male or female over 18 years old
* Participants suffer from severe periodontal disease throughout the mouth with symptoms at third and fourth stages, do not have immediate indications for the extraction of multiple teeth or complex denture stimulation, and have not undergone periodontal planing within one year.

Exclusion Criteria:

* Participants have had periodontal or antimicrobial treatment within the past 6 months
* Participants are smokers, pregnant or with systemic diseases
* Participants had probiotic supplements or with history of adverse reactions to lactose or fermented dairy products

• Chin-Wei Wang, Principal investigator, Taipei Medical University Hospital