Short-term clinical observations following local L8020 application in peri-implantitis with suppuration: a pilot study
Related Experiment Video
Updated: Nov 5, 2026
Adjunctive Diode Laser Therapy and Probiotic Lactobacillus Therapy in the Treatment of Periodontitis and Peri-Implant Disease
Published on: May 9, 2022
Yuhei Hashimoto1, Keisuke Yasuda1, Shinsuke Okada1
1Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
Objectives:
To evaluate feasibility, short-term safety, and preliminary clinical observations following local application of Lactobacillus rhamnosus KO3 (L8020) after standardized saline irrigation in patients with peri-implantitis presenting with suppuration.
Materials And Methods:
This prospective, single-arm, open-label pilot clinical study enrolled ten patients with peri-implantitis presenting with suppuration. After standardized irrigation of the peri-implant sulcus, L8020 was topically applied. Clinical examinations and submucosal microbiological sampling were performed at baseline and Day 7. The primary outcome was disappearance of suppuration at Day 7. The prespecified secondary outcome was change in the peri-implant microbial community; PPD was exploratory, and adverse events were monitored. Microbiome analyses included 16S rRNA V3-V4 sequencing, paired alpha-diversity analysis, Bray-Curtis beta-diversity analysis, taxonomic composition profiling, and exploratory paired differential-abundance testing.
Results:
Suppuration was absent in 7 of 10 implants (70%) at Day 7, whereas mean PPD remained unchanged (7.1 ± 1.9 mm at both time points). No significant changes were detected in five alpha-diversity indices. Bray-Curtis PCoA showed no distinct separation between baseline and Day 7, and a paired PERMANOVA using all 2^10 within-participant label permutations showed no difference in overall community structure (pseudo-F = 0.158; exact p = 0.883). Genus- and species-level taxonomic profiles showed no consistent community-wide shift, and no genus or species remained significant after paired Wilcoxon testing with Benjamini-Hochberg correction. No intervention-related adverse events were observed.
Conclusions:
The combined local procedure was feasible and well tolerated over 7 days. The disappearance of suppuration is a preliminary short-term observation and should not be interpreted as resolution of peri-implantitis or evidence of an L8020-specific therapeutic effect. The clinical observation occurred without a detectable major compositional shift in the peri-implant microbiota. Controlled studies with an irrigation-only comparator, larger samples, and longer follow-up are required.
Clinical Trial Registration:
https://jrct.mhlw.go.jp/latest-detail/jRCTs061230059, Japan Registry of Clinical Trials (jRCT) jRCTs061230059.