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CompletedNCT04398511Updated May 21, 2020

L Brevis for Traumatic Oral Lesions in Orthodontic Patients

A Phase 2 interventional study of L brevis and Placebo in Orthodontic Appliance Complication, Oral Mucositis and Bacterium; Agent, sponsored by Universidade de Passo Fundo. Completed at 1 site in Brazil. Open to participants aged 14 Years to 60 Years. Per ClinicalTrials.gov, last updated 2020-05-21.

Sponsored by Universidade de Passo Fundo · Phase 2, Interventional, and Prevention

From the registry’s dates

  • Registered 1 year 4 months after the study started (first participant enrolled Jan 2019, registered May 2020).
Phase
Phase 2
Study type
Interventional
Enrollment
20
Allocation
Randomized
Ages
14 Years to 60 Years
Sex
All
01

Study summary

Introduction: Traumatic oral lesions are common in the beginning of the orthodontic treatment, and pathogenic oral bacteria might be involved. We tested whether the probiotic Lactobacillus brevis CD2 (L brevis) is benefic in this condition. Methods: In a double-blind clinical trial, 20 patients were randomized to 21 days course of lozenges containing L brevis CD2 (4 billion colony-forming units after breakfast, lunch and dinner) or placebo, starting on the day of installation of the fixed orthodontic appliance. Main outcomes were days without oral lesions and oral pain score [ranging between 0 (no pain) and 10 (maximum)]. Oral health related quality of life was measured by OHIP-14 before and after treatments.

Read the detailed description

Study protocol After signing the informed consent form, the patients underwent an oral examination and answered about clinical information, oral pain scale, and the OHIP-14 questionnaire. The pain scale was graded between 0 (no pain) and 10 (maximum), Likert standard. There was also a drawing for the distribution of coded treatments, through a number taken by the patient from a manila envelope. After the orthodontic appliance installation session, each patient was instructed to use the coded treatment for the next 21 days, two gums after breakfast, after lunch and after dinner, totalizing 12 billion UFC of L brevis or placebo per day. The patient was provided with a diary to note the daily appearance of lesions and their evolution during the 21-day period, as well as the occurrence of any new symptoms (potential adverse effect), in addition to proof of the commitment assumed by the use of the tablets. After 21 days, each patient was reexamined by the author of the study, who collected the diaries and obtained information regarding the oral examination, oral pain scale, data on adherence to treatment and self-completion of the OHIP-14.

Statistical analysis Quantitative data are described with mean and standard deviation (or standard error of the mean) or median and range, while qualitative data are displayed with absolute and relative frequencies. Student's t-test was used for comparison of quantitative data between groups, Wilcoxon-Mann-Whitney (WMW) test being employed when the assumptions for that test were not met. Exact chi-square and Fisher´s exact test (FET) were used for categorical data. Treatment effect on OHIP-14 was analyzed using a Generalize Estimating Equations (GEE) model with Poisson distribution and log link, the predictors being treatment, time (beginning and end of treatment) and interaction treatment*time. The analyses were performed with softwares GraphPrism version 4.0 and SPSS® (IBM SPSS statistics v18). Sample size was estimated using WinPEPI v11.65. The P value indicative of significance was \< 0.05. Because the final outcome was prevention or mitigation (not maintenance or augmentation) of undesirable symptoms, one-tailed tests were used for comparisons between groups respect to days without oral lesions, oral pain and OHIP-14 scores.

02

Conditions studied

  • Orthodontic Appliance Complication
  • Oral Mucositis
  • Bacterium; Agent

Keywords

  • Fixed orthodontic appliance
  • Lactobacillus brevis CD2
  • Oral pain
  • Traumatic oral lesions
03

In context

Mucositis

488 studies on the registry are indexed under Mucositis; 70 are open to participants now.

This study's enrollment of 20 is below the median of 50 across 394 interventional studies indexed under Mucositis.

Browse Mucositis studies →

Lead sponsor

Universidade de Passo Fundo is the lead sponsor of 13 studies on the registry; none are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
14 Years to 60 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • need for orthodontic treatment with fixed appliance

Exclusion criteria

Exclusion Criteria:

  • Oral lesions
  • Uncompensated systemic diseases
  • Regular use of corticoids, antibiotics, immuno regulators and antidepressive agents
05

Study design

Phase
Phase 2
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Outcomes assessor)
Enrollment
20 participants (actual)

Study arms

  • Experimental
    L brevis

    Lactobacillus brevis CD2 in lozenges containing 4 billion CFU. Patients used a lozenge 15 min after breakfast, lunch and dinner, during 21 days, starting in the day of installation of the orthodontic appliance.

    Drug: L brevis

  • Placebo comparator
    Placebo

    Placebo in lozenges, identical to those of L brevis. Patients used a lozenge 15 min after breakfast, lunch and dinner, during 21 days, starting in the day of installation of the orthodontic appliance.

    Drug: Placebo

Interventions

  • DrugL brevis

    Lactobacillus brevis CD2 lozenges (4 billion CFU) after breakfast, lunch and dinner for 21 days.

    Also known as: Oral probiotic

  • DrugPlacebo

    Placebo lozenges after breakfast, lunch and dinner for 21 days.

06

What researchers measure

Primary outcomes

  1. Number of days without traumatic oral lesions

    Oral lesions (ulcers) due to fixed orthodontic appliance

    Time frame: First 21 days after appliance installation

  2. Oral pain scale

    Oral pain score measured by Likert scale between 0 (no pain) and 10 (maximum pain)

    Time frame: First 21 days after appliance installation

07

Study locations

1 site
  • Post-Graduate Program in Dentistry
    Passo Fundo, 99052-900, Brazil
08

References and documents

Publications

  • Rennick LA, Campbell PM, Naidu A, Taylor RW, Buschang PH. Effectiveness of a novel topical powder on the treatment of traumatic oral ulcers in orthodontic patients: A randomized controlled trial. Angle Orthod. 2016 May;86(3):351-7. doi: 10.2319/050415-303.1. Epub 2015 Sep 24. PubMed 26401826 ↗
  • Kluemper GT, Hiser DG, Rayens MK, Jay MJ. Efficacy of a wax containing benzocaine in the relief of oral mucosal pain caused by orthodontic appliances. Am J Orthod Dentofacial Orthop. 2002 Oct;122(4):359-65. doi: 10.1067/mod.2002.126405. PubMed 12411880 ↗
  • Bagatin CR, Andrucioli MCD, Ferreira JTL, Matsumoto MAN, da Silva RAB, da Silva LAB, Romano FL, Nelson-Filho P. Biofilm formation in Haas palatal expanders with and without use of an antimicrobial agent: an in situ study. Microsc Res Tech. 2017 May;80(5):471-477. doi: 10.1002/jemt.22817. Epub 2016 Dec 9. PubMed 27935660 ↗
  • Gizani S, Petsi G, Twetman S, Caroni C, Makou M, Papagianoulis L. Effect of the probiotic bacterium Lactobacillus reuteri on white spot lesion development in orthodontic patients. Eur J Orthod. 2016 Feb;38(1):85-89. doi: 10.1093/ejo/cjv015. Epub 2015 Apr 3. PubMed 25840585 ↗
  • Anusha RL, Umar D, Basheer B, Baroudi K. The magic of magic bugs in oral cavity: Probiotics. J Adv Pharm Technol Res. 2015 Apr-Jun;6(2):43-7. doi: 10.4103/2231-4040.154526. PubMed 25878972 ↗
  • Haukioja A. Probiotics and oral health. Eur J Dent. 2010 Jul;4(3):348-55. PubMed 20613927 ↗
  • Rastogi P, Saini H, Dixit J, Singhal R. Probiotics and oral health. Natl J Maxillofac Surg. 2011 Jan;2(1):6-9. doi: 10.4103/0975-5950.85845. PubMed 22442601 ↗
  • Riccia DN, Bizzini F, Perilli MG, Polimeni A, Trinchieri V, Amicosante G, Cifone MG. Anti-inflammatory effects of Lactobacillus brevis (CD2) on periodontal disease. Oral Dis. 2007 Jul;13(4):376-85. doi: 10.1111/j.1601-0825.2006.01291.x. PubMed 17577323 ↗
  • Sharma A, Rath GK, Chaudhary SP, Thakar A, Mohanti BK, Bahadur S. Lactobacillus brevis CD2 lozenges reduce radiation- and chemotherapy-induced mucositis in patients with head and neck cancer: a randomized double-blind placebo-controlled study. Eur J Cancer. 2012 Apr;48(6):875-81. doi: 10.1016/j.ejca.2011.06.010. Epub 2011 Jul 6. PubMed 21741230 ↗
  • Sharma A, Tilak T, Bakhshi S, Raina V, Kumar L, Chaudhary S, Sahoo R, Gupta R, Thulkar S. Lactobacillus brevis CD2 lozenges prevent oral mucositis in patients undergoing high dose chemotherapy followed by haematopoietic stem cell transplantation. ESMO Open. 2017 Feb 13;1(6):e000138. doi: 10.1136/esmoopen-2016-000138. eCollection 2016. PubMed 28848667 ↗
  • Lee JK, Kim SJ, Ko SH, Ouwehand AC, Ma DS. Modulation of the host response by probiotic Lactobacillus brevis CD2 in experimental gingivitis. Oral Dis. 2015 Sep;21(6):705-12. doi: 10.1111/odi.12332. Epub 2015 Apr 20. PubMed 25720615 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 21, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04398511
Lead sponsor
Universidade de Passo Fundo
Collaborators
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.
Responsible party
Fernando Fornari (Professor, Universidade de Passo Fundo) — Principal investigator
First posted
May 21, 2020
Start date
Jan 7, 2019
Primary completion
Nov 29, 2019
Completion
Dec 13, 2019
Last update
May 21, 2020

Study contacts

Fernando Fornari, Prof.
principal investigator · University of Passo Fundo

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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