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Article

Evaluation of the Effectiveness of a Postbiotic in Home Care Maintenance in Patients Affected by Peri-Implant Mucositis

by
Silvia Sabatini
1,2,*,
Carlos Perez-Albacete Martinez
3,
Jessica Bassignani
4,
Carolina Maiorani
5,
Andrea Butera
5 and
Andrea Scribante
5,6,*
1
Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, 41124 Modena, Italy
2
Health Sciences PhD Program, Universidad Catòlica de Murcia UCAM, Campus de Ios Jerònimos N. 135, 30107 Guadalupe, Murcia, Spain
3
Tissue Regeneration and Repair Group, Biomaterials and Tissue Engineering, Faculty of Health Sciences, UCAM-Universidad Catòlica San Antonio de Murcia, 30107 Guadalupe, Murcia, Spain
4
EIMS (European Institute for Medical Studies), HEI (Higher Education Institution), St George’s Business Complex, Elija Zammit Street, STJ3150 St. Julian’s, Malta
5
Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
6
Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
*
Authors to whom correspondence should be addressed.
Appl. Sci. 2025, 15(18), 10135; https://doi.org/10.3390/app151810135 (registering DOI)
Submission received: 7 August 2025 / Revised: 15 September 2025 / Accepted: 16 September 2025 / Published: 17 September 2025
(This article belongs to the Special Issue State-of-the-Art Peri Implant Therapy)
Browse Figure
Versions Notes

Abstract

Peri-implant mucositis is an inflammatory condition that affects the peri-implant mucosa, without bone involvement. Peri-implant mucositis can include erythema, swelling, and bleeding, and the mucosa can be painful even with the traditional oral hygiene procedures. Peri-implant mucositis is always a reversible condition but, if left untreated, it can degenerate into peri-implantitis. Although biofilm control is considered the gold-standard therapy, some adjunctive therapies can be employed. The aim of this study is to investigate the efficacy of postbiotics in peri-implant mucositis management. Forty patients in good systemic health with at least one implant diagnosed with peri-implant mucositis were enrolled in this case–control study. The control group received professional biofilm removal and home care instructions, while the test group was also asked to use a postbiotic gel. Clinical indices of inflammation, such as probing pocket depth (PPD), plaque index (PI), bleeding on probing (BoP), erythema, pain, suppuration and swelling, were collected at four timepoints during observation and analyzed at both the patient and site levels. After one year, clinical indices statistically significantly improved in both groups compared to baseline. The test group showed greater reductions. PPD was statistically significantly lower at the site level in the test group than in the control group. The results of this study confirm that biofilm control is an effective therapy for peri-implant mucositis. Our findings showed that postbiotics used as an adjunctive in home therapy have been effective in managing clinical indices in patients with peri-implant mucositis.

1. Introduction

Dental implants are an accepted therapy worldwide for teeth replacement. A titanium implant can be inserted into either the maxilla or the mandible using different surgical protocols [1], and it serves as the foundation for various fixed or removable prosthetic devices [2].
Five-year survival rates are very high for implants supporting fixed prostheses (97.1%) [3] and implant-retained overdentures (95–100%) [4]. However, survival rates alone are not a comprehensive measure of implant success as they do not account for pathological conditions affecting the peri-implant tissues.
Despite the use of accurate surgical techniques [1] and prosthetic design [2], patients treated with dental implants may still develop peri-implant mucositis or peri-implantitis. Peri-implant mucositis is a reversible inflammatory condition confined to the peri-implant soft tissues. It is often characterized by erythema, swelling, bleeding on probing and discomfort during hygiene procedures. If left untreated, it may progress to peri-implantitis, which is associated with inflammatory bone loss [5]. The prevalence of peri-implant mucositis ranges from 43% [6] to 46.83% [7], while peri-implantitis affects between 19.83% [7] and 22% [6] of implant patients.
Given the high incidence of peri-implant diseases, it has been suggested that their prevention should begin before implant placement. This is known as primordial prevention and includes the risk factor control, such as diabetes, smoke, previous periodontal disease and poor oral hygiene conditions [8,9].
Plaque accumulation appears to be the etiological agent for the development of peri-implant mucositis and peri-implantitis [5], and therefore oral biofilm control, both professional and home care, is the goal of the therapies [8].
Professional biofilm and calculus removal can be performed using air polishing devices, ultrasonic scalers with specific inserts, titanium manual scalers and curettes [10,11,12].
Home hygiene procedures should include powered or manual toothbrushes [13] and additional interdental devices and additional chemical agents.
Among these, chlorhexidine is the most extensively researched antiseptic for periodontal care. It is widely used in peri-implant maintenance [14,15,16] although there is limited evidence to support its efficacy in this context [14]. Furthermore, its known disadvantages—such as staining teeth, altering taste, and limited stability after opening—have prompted the exploration of alternative agents [17].
Several different chemical aids have been introduced to manage implant patients and treat peri-implant alterations, such as essential oils, ozonated oils, probiotics [18], prebiotics and, more recently, postbiotics [19].
Within the current scientific framework, probiotics are defined as live microorganisms that benefit the host when consumed in sufficient quantities. Prebiotics, on the other hand, are indigestible substances that selectively promote the growth or activity of beneficial microorganisms. Paraprobiotics are defined as inactivated microbial cells that can have a positive effect on host health despite being non-viable [20].
Postbiotics are bioactive compounds that support health in a direct or indirect way, they are produced during a fermentation process by microorganism metabolic activity [20,21,22,23,24,25,26,27]. It is interesting to notice that bacterial viability is not required for postbiotic efficacy [28]. Inactivated microbial cells, microbial metabolites, cell wall components, and complex molecules from the bacterial extracellular matrix can be considered as postbiotics.
Little or nothing is known about postbiotics in peri-implant disease management.
The main purpose of this project is to investigate the efficacy of postbiotics in peri-implant disease management.
The null hypothesis is that the adjunctive use of a postbiotic gel does not result in a greater reduction in peri-implant clinical inflammation indices (e.g., PPD, BoP, and erythema) compared to mechanical debridement and standard home oral hygiene alone.

2. Materials and Methods

2.1. Study Design and Patient Selection

This study has been conducted as a case–control study, with an equal number of participants.
The test group was treated with professional biofilm removal and home hygiene indications, including the adjunctive use of postbiotics (Biorepair Parodontgel intensive, Coswell, Funo (BO), Italy).
The control group received the same professional and home care protocol, without any adjunctive therapy. The Declaration of Helsinki was followed for ethical concerns. This study was approved by Unit Internal Review Board (registration number: 2023-097) and UCAM Ethics Committee (registration number: CE102305). The CONSORT statement was followed for the conduct and writing of this study.
Patients signed the informed consent prior to the start of the trial. Enrolment began in January 2024, and the entire study ended in March 2025.
Patients were recruited at the Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences of the University of Pavia (Pavia, Italy).
Inclusion criteria:
-
Age between 18 and 70 years old;
-
Good systemic health condition;
-
At least one implant suffering from mucositis.
Exclusion criteria:
-
Neurological or psychiatric disorders;
-
Pregnancy or breastfeeding;
-
Tumor therapy;
-
Taking antibiotics in the last six months;
-
Bisphosphonate therapy in the last twelve months;
-
Impossibility to follow the program.
Sample size calculation (Alpha = 0.05; Power = 85%) for two independent study groups and a continuous primary endpoint was calculated. Concerning the variable PPD (primary outcome), the expected difference between the means was supposed to be 0.21 with a standard deviation of 1.14 [19], requiring 20 patients for this study.
A detailed flow chart of the study design and patient allocation is presented in Figure 1.

2.2. Operating Protocol

Baseline (T0): Anamnestic data collection, informed consent signed by the patients, explanation of the protocol, clinical indices collection, complete professional hygiene session, allocation to the test or control group, and home hygiene indications:
T1:
Clinical indices collection, deplaquing session, and home hygiene indications;
T2:
Clinical indices collection, deplaquing session or complete professional hygiene session if necessary, and home hygiene indications;
T3:
Clinical indices collection, complete professional hygiene session if necessary, and home hygiene indications;
T4:
Final clinical indices collection, and complete professional hygiene session.

2.2.1. Professional Biofilm Removal

Professional biofilm removal for all implant sites included the use of fleecy thread with threader at both ends (Oral-B Super Floss, P&G, Cincinnati, OH, USA), periopolishing with glycine powder (Mectron Combi Touch, Mectron, Mectron S.p.A., Carasco, Italy, Mectron Prophylaxis Powder Sensitive + glycine powder, Mectron, Mectron S.p.A., Carasco, Italy), ultrasonic scaling with PEEK inserts (Mectron IC1 PEEK Implant-Cleaning Tip, Mectron, Mectron S.p.A., Carasco, Italy), and manual scaling with titanium curettes (PDT Wingrove Titanium Implant Instrument, PDT Dental/Paradise Dental Technologies, Missoula, MT, USA). Each patient received a complete professional hygiene session including airpolishing (Mectron Combi Touch, Mectron, Mectron S.p.A., Carasco, Italy) or polishing with bristles (Medium Nylon Prophylaxis Brush for Low-Speed Handpieces, various manufacturers) and polishing paste (Nupro Prophy Paste, Medium Grit unit-dose cups, Dentsply Sirona, Charlotte, NC, USA), ultrasonic scaling (Mectron Combi Touch, Mectron, Mectron S.p.A., Carasco, Italy), and manual scaling (PDT 23 Slim Posterior Scaler, PDT Dental Instruments, Missoula, MT, USA).

2.2.2. Home Oral Hygiene Protocol

Home oral hygiene procedures included the use of powered (Oral-B iO 6 Electric Toothbrush, P&G, Cincinnati, OH, USA) or manual toothbrush (GUM Technique Pro Compact Medium Toothbrush No. 528, GUM, Sunstar Suisse S.A., Etoy, Switzerland), toothpaste (Biorepair Peribioma Toothpaste, Biorepair, Coswell S.p.A., Funo di Argelato, Italy), interproximal brushes (GUM Trav-Ler Interdental Brush, GUM, Sunstar Suisse S.A., Etoy, Switzerland) or fleecy thread with threader at both ends (Oral-B Super Floss, P&G, Cincinnati, OH, USA) around implants and interproximal brushes (GUM Soft-Picks Pro or GUM Trav-Ler Interdental Brush, GUM, Sunstar Suisse S.A., Etoy, Switzerland) or floss (GUM Expanding Floss, GUM, Sunstar Suisse S.A., Etoy, Switzerland) in the interdental areas.
The test group was asked to use postbiotic gel (Biorepair Plus Parodontgel Intensive, Biorepair, Coswell S.p.A., Funo di Argelato, Italy) for fourteen days after the professional hygiene session and after each recall visit.
The control group was asked to follow the given home oral hygiene instructions, without any adjunctive therapy.
The gel and toothpaste used for this study are shown in Table 1.

2.2.3. Clinical Outcomes

The primary outcome was general inflammation reduction, evaluated for each site of intervention: erythema (presence/absence), swelling (presence/absence), bleeding (presence/absence), suppuration (presence/absence), pain (presence/absence), plaque accumulation (presence/absence), and probing pocket depth (recorded in millimeters).

2.2.4. Timepoints and Clinical Evaluations

Each index was detected at the baseline (T0), after one month (T1), after three months (T2), after six months (T3), and after one year (T4).

2.2.5. Randomization and Blinding

Considering a permuted block of 40 participants, the data analyst developed a randomization sequence using a block randomization table. It was not possible to blind clinician and patients to group allocation due to the type of products tested.

2.3. Statistical Analysis

Data were analyzed with R Software (R version 3.1.3, R Development Core Team, R Foundation for Statistical Computing, Wien, Austria). Descriptive statistics (mean, standard deviation, minimum, median, and maximum) were calculated for each group and variable. Data normality of the distributions were calculated with the Kolmogorov–Smirnov test. Subsequently, the Kruskal–Wallis was applied, followed by the post hoc Dunn test in case the results were significant.
Significance was predetermined as p < 0.05 for all the tests performed.

3. Results

A total of forty patients were enrolled, twenty in the test group and twenty in the control group. An equal number of men and women were enrolled. The test group consisted of nine males and eleven females with an average age of 52.8 years. The control group consisted of eleven men and nine women with an average age of 53.6 years. No patients dropped out of this study and no patients were excluded from the analysis.
Both groups showed improved their clinical indices after the professional hygiene session and following the home oral hygiene instructions.
The mean values obtained for each clinical variable are shown in the following sections at both the patient and site levels.
Variables include probing pocket depth (PPD), plaque index (PI), bleeding on probing (BoP), erythema, pain, suppuration, and swelling. Data are presented as the mean ± standard deviation (SD). Statistical analyses included intergroup comparisons (test vs. control) and intragroup comparisons (T0 vs. T4 within each group), using non-parametric tests (Kruskal–Wallis and Dunn post hoc), with a significance threshold of p < 0.05.

3.1. Patient-Level Outcomes

At baseline (T0), no statistically significant differences were found between the test and control groups for any of the assessed variables.
From T0 to T4 PPD, PI, BoP, suppuration and swelling were significantly reduced in both the control and test groups (p < 0.05). Erythema and pain showed a significant reduction only in the trial group.
At T4, no statistically significant differences were observed between groups for any variable at the patient level (all p > 0.05).
The Table 2 below summarizes the variation in clinical indices in both the control and test groups at each observation timepoint.
Table 2 shows the mean values of clinical indices with SD at baseline, T1, T2, T3 and T4 at the patient level for both groups.

3.2. Site-Level Outcomes

From T0 to T4, both groups showed statistically significant reductions in PPD, PI, BoP, erythema, suppuration, and swelling (p < 0.05). Pain and suppuration were significantly reduced only in the control group.
At T4, the mean PPD was significantly lower in the test group compared to the control group (p = 0.0116). The reduction in PPD from T0 to T4 was greater than 1 mm in both groups. This magnitude of change is generally considered to be clinically meaningful in the context of peri-implant mucositis managing.
All other variables at T4 showed no statistically significant differences between the groups (p > 0.9999).
Table 3 shows the mean values of clinical indices with SD at baseline, T1, T2, T3 and T4 at the site level for both groups.

4. Discussion

The efficacy of probiotics and postbiotics as an adjunctive therapy for patients with periodontitis, including smokers, has already been investigated and proven [29,30,31,32,33]. Similarly to observations in periodontal patients, our results support the efficacy of probiotics and postbiotics in managing peri-implant mucositis. Both treatment groups showed significant clinical improvement in nearly all indices after 12 months, confirming the effectiveness of non-surgical biofilm removal and structured home care as the current standard for peri-implant soft tissue management [8]. These findings are consistent with Maiorani et al. (2025) [12], who demonstrated comparable improvements in PPD, BoP, and PI using ultrasonic instrumentation and air polishing. This supports the reliability and versatility of mechanical decontamination protocols in peri-implant maintenance, regardless of prosthetic material.
Importantly, the test group treated with the adjunctive use of a postbiotic gel, demonstrated a statistically significant improvement in PPD at the site level compared to the control group at 12 months. This finding supports the hypothesis that certain adjunctive therapies may enhance local clinical outcomes beyond what is achieved with mechanical therapy alone.
Furthermore, erythema showed a statistically significant reduction in the test group at the patient level, while both groups improved at the site level. This enhanced clinical response may be partially attributed to the topical application of the postbiotic gel, which contains bioactive metabolites capable of modulating the local inflammatory environment. The gel’s formulation, designed to support mucosal trophism and exert a soothing effect on inflamed soft tissues, may have contributed to a more pronounced resolution of erythema in the test group. The gel also contains zinc-substituted hydroxyapatite microcrystals (microRepair®), zinc PCA, hyaluronic acid, lactoferrin, aloe vera extract and solidago virgaurea. These components may together promote soft tissue healing, enhance epithelial regeneration and contribute to rebalancing the local oral ecosystem by limiting biofilm accumulation and modulating inflammatory responses, all without the use of live bacterial cells.
It is also worth noting that, although they were only able to use the postbiotic gel in short cycles after each maintenance session, patients in the test group were able to comply with the regimen over the 12-month period. This suggests that long-term adherence to this regimen is feasible in clinical practice. However, the gel’s additional cost may limit its implementation, particularly for some patients.
The consistently positive trend observed across most variables in both groups highlights the robustness of the mechanical protocol, and at the same time suggests that adjunctive approaches, such as postbiotics, may contribute to further clinical improvement in selected parameters.
These findings are in line with recent evidence supporting the adjunctive use of biotic-based therapies in peri-implant mucositis. Sargolzaei et al. (2022) [34] evaluated the effect of a probiotic mouthwash used for 28 days after professional scaling and reported a statistically significant reduction in bleeding on probing. This supports the hypothesis that biotic agents, whether probiotic or postbiotic, may aid peri-implant mucosal healing through modulation of soft tissue inflammation, improving clinical signs such as bleeding and erythema. Alqahtani et al. (2021) [35] similarly demonstrated that adjunctive probiotic therapy, when compared to antibiotics or mechanical treatment alone, resulted in superior clinical outcomes. After 6 months of follow-up, the group receiving home-administered probiotics showed greater improvements in clinical indices, particularly bleeding on probing and probing depth, than the antibiotic or debridement-only groups. These findings further support the hypothesis that probiotic or postbiotic therapies, when used consistently after professional care, can enhance resolution of peri-implant inflammation more effectively than systemic pharmacologic interventions or non-surgical therapy alone.
In our study, both groups were instructed to use Biorepair® Peribioma Toothpaste, which contains probiotic-derived ingredients. These components can contribute to oral microbiota balance and support the host’s natural defense mechanisms, potentially reducing inflammation and microbial dysbiosis. This toothpaste was chosen as a chemical adjunct that would not interfere with the postbiotic gel applied in the test group, but rather support its intended mechanism of action without introducing antiseptic agents that could compromise microbial modulation.
The use of biotics, whether probiotics or postbiotics, may be particularly valuable for patients who do not respond adequately to mechanical debridement alone. Alternative bacterial therapies offer promising avenues within the framework of precision medicine, enabling peri-implant disease management to be customized based on individual risk profiles and systemic limitations. This approach is particularly relevant for patients who experience recurrent inflammation despite standard mechanical protocols or for whom systemic antibiotics and antiseptics are contraindicated due to underlying medical conditions, such as pregnant women [26]. In these instances, biotic therapies could provide a targeted, biologically compatible approach to improving soft tissue health and reducing the inflammatory burden, independent of traditional pharmacological agents [36].
Furthermore, probiotics or postbiotics may be particularly beneficial for pediatric and adolescent patients, for whom the use of systemic therapies or aggressive local antiseptics is generally discouraged [37,38,39]. In younger populations, minimizing exposure to agents associated with cytotoxicity, microbial resistance or mucosal irritation is essential to ensure long-term oral and systemic health. As postbiotics exert their action without requiring viable bacterial cells and without the side effects typically associated with conventional antiseptics (such as chlorhexidine), they may offer a safe and well-tolerated adjunct for controlling peri-implant inflammation in these age groups. The growing use of temporary or mini implants [40] in orthodontic and prosthetic procedures could justify exploring non-invasive, biocompatible agents such as postbiotics as part of supportive peri-implant maintenance strategies for young patients [41].
Biotic agents, including probiotics and postbiotics, have demonstrated their ability to positively impact oral health by modulating the local microbiota and inflammatory response [42]. Interestingly, even short-term colonization appears to be sufficient to induce significant clinical and biological changes in the peri-implant environment [43]. This opens up an interesting line of research aimed at improving the persistence and stability of probiotics on oral mucosal surfaces [44]. Enhancing their retention through optimized delivery vehicles or repeated applications may potentially amplify their therapeutic effect and contribute to more durable clinical outcomes in the management of peri-implant conditions and, more generally, oral health.
Recent hypotheses suggest that the mechanism of action of probiotics may extend beyond the local modulation of oral microbiota by directly inhibiting bacteria. Instead, they might also function as systemic metabolic regulators, influencing host responses at a broader level. This systemic effect could contribute to improvements in various oral health conditions, including not only biofilm-related diseases. This mechanism could affect halitosis, for which inflammatory and metabolic pathways are implicated. This broader biological impact would justify the use of biotic agents as modulators of host–microbe interactions, as well as localized antimicrobial adjuncts, with potential systemic and preventive relevance [45].
In light of our results, the null hypothesis that the adjunctive use of a postbiotic gel does not provide greater clinical benefits than mechanical debridement and standard home care can be partially rejected. Although both groups showed general clinical improvement, the test group demonstrated statistically significant reductions in probing pocket depth at the site level and in erythema at the patient level. These results imply that the addition of postbiotic therapy could lead to better outcomes for certain clinical parameters.
Our study presents several strengths, including a rigorous and standardized protocol for both professional and home care, meticulous data collection, and robust statistical analysis. One notable advantage is the 12-month follow-up period, which exceeds the duration commonly reported in similar studies, often limited to 3 to 6 months, allowing for a more meaningful evaluation of the treatment’s long-term effects.
However, the findings should be interpreted considering certain limitations. The primary constraint is the relatively small sample size, which may reduce the power to detect subtle differences for some clinical indices. Additionally, while the study design ensured internal validity, its generalizability may be limited by the single-center setting and the inclusion of systemically healthy, compliant patients, which may not fully represent the variability encountered in real-world clinical practice. Future studies should aim to replicate these findings in broader populations and assess long-term outcomes beyond one year.

5. Conclusions

The results of the present investigation showed that postbiotics used as at home adjunctive therapy may contribute in managing clinical indices in patients with peri-implant mucositis. The use of postbiotic gel proved to be a valuable adjuvant to professional and home oral hygiene, showing greater effectiveness in reducing PPD compared to oral hygiene measures alone. Further multicenter studies are encouraged to confirm these preliminary findings.

Author Contributions

Conceptualization, S.S. and A.S.; methodology, S.S. and A.B.; software, A.S.; validation, C.P.-A.M., J.B. and C.M.; formal analysis, A.S.; investigation, S.S.; resources, A.B.; data curation, C.M. and A.S.; writing—original draft preparation, S.S. and A.B.; writing—review and editing, S.S., C.P.-A.M. and A.S.; supervision, A.S.; project administration, S.S. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

This study was conducted in accordance with the Declaration of Helsinki and it was approved by Unit Internal Review Board (registration number: 2023-097) and UCAM Ethics Committee (registration number: CE102305). The CONSORT statement was followed for the conduct and writing of this study.

Informed Consent Statement

Informed consent was obtained from all subjects involved in this study. Written informed consent has been obtained from the patient(s) to publish this paper.

Data Availability Statement

The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Acknowledgments

Authors would like to thank Coswell, Funo (BO), Italy for providing the gel used in the test group.

Conflicts of Interest

The authors declare no conflicts of interest.

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Applsci 15 10135 g001
Figure 1. Flow chart of this study.
Figure 1. Flow chart of this study.
Applsci 15 10135 g001
Table 1. Products used in this study.
Table 1. Products used in this study.
ProductManufacturerComposition
Biorepair Plus Parodontgel Intensive (gel)Coswell S.p.A., Funo di Argelato, ItalyAqua, Propylene Glycol, Peg-40 Hydrogenated Castor Oil, Xylitol, Xanthan Gum, Silica, Zinc Hydroxyapatite, Zinc PCA, Aloe Barbadensis Leaf Juice Powder, Lactobacillus Ferment, Sodium Hyaluronate, Lactoferrin, Solidago Virgaurea Extract, Aroma, Sodium Benzoate, Phenylpropanol, Benzyl Alcohol, Hydroxyacetophenone, Sodium Saccharin, O-Cymen-5-ol, Mannitol, Decylene Glycol, Sodium Myristoyl Sacrosinate, Sodium Methyl Cocoyl Taurate, Citric Acid, Potassium Sorbate, Phenoxyethanol, Linalool, Benzyl Benzoate, Limonene.
Biorepair Peribioma (toothpaste)Coswell S.p.A., Funo di Argelato, ItalyAqua, Zinc Hydroxyapatite, Sorbitol, Glycerin, Hydrated Silica, Silica, Cocamidopropyl Betaine, Cellulose Gum, Zinc PCA, Aroma, Pistacia Lentiscus (Mastic) Gum Oil, Ascorbic Acid, Tocopheryl Acetate, Retynyl Palmitate, Sodium Hyaluronate, Hamamelis Virginiana Leaf Extract, Spirulina Platensis Extract, Calendula Officinalis Flower Extract, Eucalyptus Globulus Leaf Oil, Bifidobacterium, Lactobacillus, Sodium Myristoyl Sarcosinate, Sodium Methyl Cocoyl Taurate, Phenoxyethanol, Benzyl Alcohol, Sodium Benzoate, Sodium Saccharin, Potassium Sorbate, Maltodextrin, Citric Acid, Helianthus Annuus Seed Oil, BHT, Limonene, Eugenol, CI 77891, CI 73360
Table 2. Analysis of clinical indices at the patient level, with means, standard deviation (SD), p value and intergroup differences.
Table 2. Analysis of clinical indices at the patient level, with means, standard deviation (SD), p value and intergroup differences.
ParameterControl Trial Intergroup Significance
T0T1T2T3T4T0T1T2T3T4
PPD5.94 (1.13)4.82 (0.76)4.70 (0.93)4.15 (0.77)3.93 (0.70)5.13 (0.91)4.34 (0.82)4.01 (0.67)3.82 (0.72)3.63 (0.78)T0 vs. T0 (p = 0.9999)
T1 vs. T1 (p = 0.9999)
T2 vs. T2 (p = 0.6459)
T3 vs. T3 (p = 0.9999)
T4 vs. T4 (p = 0.9999)
Intragroup significance T0 vs. T1
(p = 0.9999)		T0 vs. T2
(p = 0.4312)		T0 vs. T3
(p = 0.0007)		T0 vs. T4
(p = 0.0001)		 T0 vs. T1
(p = 0.3471)		T0 vs. T2
(p = 0.0057)		T0 vs. T3
(p = 0.0004)		T0 vs. T4
(p = 0.0001)
PI79.55 (17.40)48.20 (16.10)52.25 (15.07)53.50 (15.66)50.85 (13.77)76.00 (24.06)41.40 (18.01)42.25 (17.12)36.85 (15.33)33.15 (12.52)T0 vs. T0 (p = 0.9999)
T1 vs. T1 (p = 0.9999)
T2 vs. T2 (p = 0.9999)
T3 vs. T3 (p = 0.9999)
T4 vs. T4 (p = 0.1164)
Intragroup significance T0 vs. T1
(p = 0.0035)		T0 vs. T2
(p = 0.0568)		T0 vs. T3
(p = 0.0874)		T0 vs. T4
(p = 0.023)		 T0 vs. T1
(p = 0.0004)		T0 vs. T2
(p = 0.0015)		T0 vs. T3
(p = 0.0001)		T0 vs. T4
(p = 0.0001)
BoP54.23 (27.97)26.18 (17.93)21.94 (20.82)19.83 (18.97)20.74 (17.94)57.89 (29.34)22.08 (18.15)18.56 (18.73)17.80 (16.55)14.75 (12.95)T0 vs. T0 (p = 0.9999)
T1 vs. T1 (p = 0.9999)
T2 vs. T2 (p = 0.9999)
T3 vs. T3 (p = 0.9999)
T4 vs. T4 (p = 0.9999)
Intragroup significance T0 vs. T1
(p = 0.3321)		T0 vs. T2
(p = 0.0105)		T0 vs. T3
(p = 0.0025)		T0 vs. T4
(p = 0.0104)		 T0 vs. T1
(p = 0.0161)		T0 vs. T2
(p = 0.0003)		T0 vs. T3
(p = 0.0004)		T0 vs. T4
(p = 0.0001)
Erythema42.37 (23.40)29.77 (19.18)27.34 (16.82)23.50 (12.68)21.70 (12.42)36.01 (20.62)21.59 (10.41)18.74 (9.52)15.04 (8.52)12.96 (9.10)T0 vs. T0 (p = 0.9999)
T1 vs. T1 (p = 0.9999)
T2 vs. T2 (p = P0.9999)
T3 vs. T3 (p = 0.9999)
T4 vs. T4 (p = 0.9999)
Intragroup significance T0 vs. T1
(p = 0.9999)		T0 vs. T2
(p = 0.9999)		T0 vs. T3
(p = 0.3313)		T0 vs. T4
(p = 0.0762)		 T0 vs. T1
(p = 0.577)		T0 vs. T2
(p = 0.081)		T0 vs. T3
(p = 0.0016)		T0 vs. T4
(p = 0.0001)
Pain0.40 (0.50)0.20 (0.41)0.10 (0.31)0.10 (0.31)0.05 (0.22)0.50 (0.51)0.10 (0.31)0.05 (0.22)0.00 (0.00)0.00 (0.00)T0 vs. T0 (p = 0.9999)
T1 vs. T1 (p = 0.9999)
T2 vs. T2 (p = 0.9999)
T3 vs. T3 (p = 0.9999)
T4 vs. T4 (p = 0.9999)
Intragroup significance T0 vs. T1
(p = 0.9999)		T0 vs. T2
(p = 0.362)		T0 vs. T3
(p = 0.362)		T0 vs. T4
(p = 0.0895)		 T0 vs. T1
(p = 0.0184)		T0 vs. T2
(p = 0.0032)		T0 vs. T3
(p = 0.0005)		T0 vs. T4
(p = 0.0005)
Suppuration1.81 (2.15)0.00 (0.00)0.39 (1.21)0.00 (0.00)0.39 (1.21)2.23 (1.74)0.39 (1.21)0.19 (0.86)0.00 (0.00)0.00 (0.00)T0 vs. T0 (p = 0.9999)
T1 vs. T1 (p = 0.9999)
T2 vs. T2 (p = 0.9999)
T3 vs. T3 (p = 0.9999)
T4 vs. T4 (p = 0.9999)
Intragroup significance T0 vs. T1
(p = 0.0009)		T0 vs. T2
(p = 0.0392)		T0 vs. T3
(p = 0.0009)		T0 vs. T4
(p = 0.0392)		 T0 vs. T1
(p = 0.0001)		T0 vs. T2
(p = 0.0001)		T0 vs. T3
(p = 0.0001)		T0 vs. T4
(p = 0.0001)
Swelling3.26 (2.20)0.98 (1.77)0.65 (1.59)0.85 (1.75)0.65 (1.59)3.63 (3.04)0.24 (1.05)0.43 (1.32)0.24 (1.05)0.00 (0.00)T0 vs. T0 (p = 0.9999)
T1 vs. T1 (p = 0.9999)
T2 vs. T2 (p = 0.9999)
T3 vs. T3 (p = 0.9999)
T4 vs. T4 (p = 0.9999)
Intragroup significance T0 vs. T1
(p = 0.0095)		T0 vs. T2
(p = 0.0008)		T0 vs. T3
(p = 0.004)		T0 vs. T4
(p = 0.0008)		 T0 vs. T1
(p = 0.0001)		T0 vs. T2
(p = 0.0004)		T0 vs. T3
(p = 0.0001)		T0 vs. T4
(p = 0.0001)
Table 3. Analysis of clinical indices at the site level, with means, standard deviation (SD), p value and intergroup difference.
Table 3. Analysis of clinical indices at the site level, with means, standard deviation (SD), p value and intergroup difference.
ParameterControl Trial Intergroup Significance
T0T1T2T3T4T0T1T2T3T4
PPD6.29 (1.11)5.32 (0.93)5.08 (0.90)4.67 (1.06)4.45 (1.08)5.57 (0.94)4.56 (0.88)4.18 (0.77)4.17 (0.67)3.91 (0.67)T0 vs. T0 (p = 0.4478)
T1 vs. T1 (p = 0.0008)
T2 vs. T2 (p = 0.0001)
T3 vs. T3 (p = 0.0431)
T4 vs. T4 (p = 0.0116)
Intragroup significance T0 vs. T1
(p = 0.0092)		T0 vs. T2
(p = 0.0001)		T0 vs. T3
(p = 0.0001)		T0 vs. T4
(p = 0.0001)		 T0 vs. T1
(p = 0.0001)		T0 vs. T2
(p = 0.0001)		T0 vs. T3
(p = 0.0001)		T0 vs. T4
(p = 0.0001)
PI1.00 (0.00)0.92 (0.28)0.48 (0.51)0.28 (0.46)0.12 (0.33)1.00 (0.00)0.39 (0.49)0.47 (0.51)0.25 (0.44)0.00 (0.00)T0 vs. T0 (p = 0.9999)
T1 vs. T1 (p = 0.0021)
T2 vs. T2 (p = 0.9999)
T3 vs. T3 (p = 0.9999)
T4 vs. T4 (p = 0.9999)
Intragroup significance T0 vs. T1
(p = 0.9999)		T0 vs. T2
(p = 0.0107)		T0 vs. T3
(p = 0.0001)		T0 vs. T4
(p = 0.0001)		 T0 vs. T1
(p = 0.0001)		T0 vs. T2
(p = 0.0003)		T0 vs. T3
(p = 0.0001)		T0 vs. T4
(p = 0.0001)
BoP0.88 (0.33)0.36 (0.49)0.20 (0.41)0.08 (0.28)0.08 (0.28)0.67 (0.48)0.17 (0.38)0.19 (0.40)0.00 (0.00)0.03 (0.17)T0 vs. T0 (p = 0.9999)
T1 vs. T1 (p = 0.9999)
T2 vs. T2 (p = 0.9999)
T3 vs. T3 (p = 0.9999)
T4 vs. T4 (p = 0.9999)
Intragroup significance T0 vs. T1
(p = 0.0012)		T0 vs. T2
(p = 0.0001)		T0 vs. T3
(p = 0.0001)		T0 vs. T4
(p = 0.0001)		 T0 vs. T1
(p = 0.0001)		T0 vs. T2
(p = 0.0002)		T0 vs. T3
(p = 0.0001)		T0 vs. T4
(p = 0.0001)
Erythema0.83 (0.38)0.33 (0.48)0.20 (0.41)0.13 (0.35)0.13 (0.35)0.52 (0.51)0.06 (0.25)0.10 (0.30)0.10 (0.30)0.03 (0.18)T0 vs. T0 (p = 0.1764)
T1 vs. T1 (p = 0.6527)
T2 vs. T2 (p = 0.9999)
T3 vs. T3 (p = 0.9999)
T4 vs. T4 (p = 0.9999)
Intragroup significance T0 vs. T1
(p = 0.0003)		T0 vs. T2
(p = 0.0001)		T0 vs. T3
(p = 0.0001)		T0 vs. T4
(p = 0.0001)		 T0 vs. T1
(p = 0.0016)		T0 vs. T2
(p = 0.0054)		T0 vs. T3
(p = 0.0054)		T0 vs. T4
(p = 0.0004)
Pain0.68 (0.48)0.21 (0.42)0.11 (0.31)0.07 (0.26)0.04 (0.19)0.23 (0.43)0.03 (0.18)0.03 (0.18)0.00 (0.00)0.00 (0.00)T0 vs. T0 (p = 0.0001)
T1 vs. T1 (p = 0.9999)
T2 vs. T2 (p = 0.9999)
T3 vs. T3 (p = 0.9999)
T4 vs. T4 (p = 0.9999)
Intragroup significance T0 vs. T1
(p = 0.0001)		T0 vs. T2
(p = 0.0001)		T0 vs. T3
(p = 0.0001)		T0 vs. T4
(p = 0.0001)		 T0 vs. T1
(p = 0.9999)		T0 vs. T2
(p = 0.9999)		T0 vs. T3
(p = 0.4001)		T0 vs. T4
(p = 0.4001)
Suppuration0.70 (0.47)0.22 (0.42)0.19 (0.40)0.00 (0.00)0.07 (0.27)0.30 (0.47)0.07 (0.25)0.03 (0.18)0.00 (0.00)0.00 (0.00)T0 vs. T0 (p = 0.0012)
T1 vs. T1 (p = 0.9999)
T2 vs. T2 (p = 0.9999)
T3 vs. T3 (p = 0.9999)
T4 vs. T4 (p = 0.9999)
Intragroup significance T0 vs. T1
(p = 0.0001)		T0 vs. T2
(p = 0.0001)		T0 vs. T3
(p = 0.0001)		T0 vs. T4
(p = 0.0001)		 T0 vs. T1
(p = 0.5641)		T0 vs. T2
(p = 0.1946)		T0 vs. T3
(p = 0.0597)		T0 vs. T4
(p = 0.0597)
Swelling0.80 (0.41)0.32 (0.480.16 (0.37)0.12 (0.33)0.08 (0.28)0.52 (0.51)0.00 (0.00)0.03 (0.18)0.00 (0.00)0.00 (0.00)T0 vs. T0 (p = 0.3977)
T1 vs. T1 (p = 0.1271)
T2 vs. T2 (p = 0.9999)
T3 vs. T3 (p = 0.9999)
T4 vs. T4 (p = 0.9999)
Intragroup significance T0 vs. T1
(p = 0.0008)		T0 vs. T2
(p = 0.0001)		T0 vs. T3
(p = 0.0001)		T0 vs. T4
(p = 0.0001)		 T0 vs. T1
(p = 0.0001)		T0 vs. T2
(p = 0.0001)		T0 vs. T3
(p = 0.0001)		T0 vs. T4
(p = 0.0001)
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MDPI and ACS Style

Sabatini, S.; Perez-Albacete Martinez, C.; Bassignani, J.; Maiorani, C.; Butera, A.; Scribante, A. Evaluation of the Effectiveness of a Postbiotic in Home Care Maintenance in Patients Affected by Peri-Implant Mucositis. Appl. Sci. 2025, 15, 10135. https://doi.org/10.3390/app151810135

AMA Style

Sabatini S, Perez-Albacete Martinez C, Bassignani J, Maiorani C, Butera A, Scribante A. Evaluation of the Effectiveness of a Postbiotic in Home Care Maintenance in Patients Affected by Peri-Implant Mucositis. Applied Sciences. 2025; 15(18):10135. https://doi.org/10.3390/app151810135

Chicago/Turabian Style

Sabatini, Silvia, Carlos Perez-Albacete Martinez, Jessica Bassignani, Carolina Maiorani, Andrea Butera, and Andrea Scribante. 2025. "Evaluation of the Effectiveness of a Postbiotic in Home Care Maintenance in Patients Affected by Peri-Implant Mucositis" Applied Sciences 15, no. 18: 10135. https://doi.org/10.3390/app151810135

APA Style

Sabatini, S., Perez-Albacete Martinez, C., Bassignani, J., Maiorani, C., Butera, A., & Scribante, A. (2025). Evaluation of the Effectiveness of a Postbiotic in Home Care Maintenance in Patients Affected by Peri-Implant Mucositis. Applied Sciences, 15(18), 10135. https://doi.org/10.3390/app151810135

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