Limosilactobacillus reuteri Improves Healing Following Fully Impacted Tooth Extractions: Randomized Clinical Trial

Objectives: This randomized, double-blind, placebo-controlled clinical trial evaluated the effect of L. reuteri administration on postsurgical wound healing, pain levels, and patient-reported outcomes (PROs) following extraction of fully impacted teeth. Methods: Consecutive patients requiring surgical extractions were included and randomly allocated to either test (probiotic) or control group (placebo). Following oral hygiene procedures, patients began a daily probiotic/placebo intake 7 days before surgery until 14 days after surgery. Follow-up was performed at 3 (T3), 7 (T7), and 14 (T14) days postop. Wound healing, postoperative complications, pain, perceived functional impairment, and Oral Health Impact Profile-14 (OHIP-14) were registered. Results: A total of 128 patients (67 in the test group and 61 in the control group) were analyzed. Wound healing significantly improved in the test group at T3 and T7. Trismus was significantly milder in the test group at T3 and T14. No differences in pain were noted. The test group experienced reduced chewing impairment and difficulty in oral hygiene procedures, exhibited significantly lower scores of OHIP-14 at T14, and required a reduced number of anti-inflammatory medications in the first 7 days. Conclusions: Limosilactobacillus reuteri administration improved wound healing, reduced the severity of trismus, and was associated with improved PROs following impacted tooth extractions. Trial registration: The study protocol was registered in a clinical trials database (Clinicaltrials.gov) with registration number NCT04903925.