{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T19:24:25Z","timestamp":1776626665445,"version":"3.51.2"},"reference-count":52,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,7,3]],"date-time":"2022-07-03T00:00:00Z","timestamp":1656806400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Gum hypertrophy is a very frequent condition linked to orthodontic treatment, especially in teenagers, and the same time, about 80% of young adults are affected by acne vulgaris, a chronic inflammatory skin disease, typically treated with antibacterial therapy. The use of probiotics has gained popularity in the medical field, and many studies have demonstrated its effectiveness, such as the positive effects of some bacterial strains belonging to Lactobacillus species. The aim of this study is to document the effect of Lactobacillus reuteri (L. reuteri) on facial skin that was randomly observed in two orthodontic patients. We present two case reports of a 14-year-old female patient and a 15-year-old male patient suffering from acne vulgaris who, during fixed orthodontic treatment, showed clinical signs of gingivitis with high values of Full Mouth Plaque Score (FMPS) and Bleeding on Probing (BOP). The patients were treated first with professional oral hygiene sessions and Scaling and Root Planing (SRP) procedures, and then with the administration of a formulate containing L. reuteri as a probiotic. The follow-up was made at four weeks. During the follow-up analysis, both patients showed a significant clinical remission for gum hypertrophy and skin acne vulgaris.<\/jats:p>","DOI":"10.3390\/microorganisms10071344","type":"journal-article","created":{"date-parts":[[2022,7,3]],"date-time":"2022-07-03T22:50:46Z","timestamp":1656888646000},"page":"1344","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Host Microbiota Balance in Teenagers with Gum Hypertrophy Concomitant with Acne Vulgaris: Role of Oral Hygiene Associated with Topical Probiotics"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7776-6598","authenticated-orcid":false,"given":"Giovanna","family":"Mosaico","sequence":"first","affiliation":[{"name":"Independent Researcher, 72100 Brindisi, Italy"},{"name":"Department of Surgical Science, Oral Biotechnology Laboratory, University of Cagliari, 09121 Cagliari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Artuso","sequence":"additional","affiliation":[{"name":"Independent Researcher, 20123 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mara","family":"Pinna","sequence":"additional","affiliation":[{"name":"Department of Surgical Science, Oral Biotechnology Laboratory, University of Cagliari, 09121 Cagliari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gloria","family":"Denotti","sequence":"additional","affiliation":[{"name":"Department of Surgical Science, Oral Biotechnology Laboratory, University of Cagliari, 09121 Cagliari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Germano","family":"Orr\u00f9","sequence":"additional","affiliation":[{"name":"Department of Surgical Science, Oral Biotechnology Laboratory, University of Cagliari, 09121 Cagliari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7962-2712","authenticated-orcid":false,"given":"Cinzia","family":"Casu","sequence":"additional","affiliation":[{"name":"Department of Surgical Science, Oral Biotechnology Laboratory, University of Cagliari, 09121 Cagliari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,3]]},"reference":[{"key":"ref_1","first-page":"595","article-title":"Relationship of Orthodontic Treatment and Periodontal Soft Tissue Health","volume":"36","author":"Zhao","year":"2018","journal-title":"West China J. Stomatol."},{"key":"ref_2","first-page":"823","article-title":"A histological analysis of gingival condition associated with orthodontic treatment","volume":"54","author":"Mezei","year":"2013","journal-title":"Rom. J. Morphol. Embryol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1902\/jop.2007.070028","article-title":"Clinical and Microbiologic Changes Associated With the Combined Use of a Powered Toothbrush and a Triclosan\/Copolymer Dentifrice: A 3-Year Prospective Study","volume":"78","author":"Bogren","year":"2007","journal-title":"J. Periodontol."},{"key":"ref_4","first-page":"5","article-title":"Studies on periodontitis and analyses of individuals at risk for periodontal diseases","volume":"180","author":"Jansson","year":"2006","journal-title":"Swed. Dent. J. Suppl."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Butera, A., Gallo, S., Pascadopoli, M., Luraghi, G., and Scribante, A. (2021). Ozonized Water Administration in Peri-Implant Mucositis Sites: A Randomized Clinical Trial. Appl. Sci., 11.","DOI":"10.3390\/app11177812"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1590\/2176-9451.19.2.046-055.oar","article-title":"The influence of orthodontic fixed appliances on the oral microbiota: A systematic review","volume":"19","author":"Freitas","year":"2014","journal-title":"Dent. Press J. Orthod."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"614","DOI":"10.2174\/1745017901814010614","article-title":"Orthodontic Fixed Appliance and Periodontal Status: An Updated Systematic Review","volume":"12","author":"Cerroni","year":"2018","journal-title":"Open Dent. J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"53","DOI":"10.3389\/fmicb.2016.00053","article-title":"Porphyromonas gingivalis: An Overview of Periodontopathic Pathogen below the Gum Line","volume":"7","author":"How","year":"2016","journal-title":"Front. Microbiol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Butera, A., Maiorani, C., Natoli, V., Bruni, A., Coscione, C., Magliano, G., Giacobbo, G., Morelli, A., Moressa, S., and Scribante, A. (2020). Bio-Inspired Systems in Nonsurgical Periodontal Therapy to Reduce Contaminated Aerosol during COVID-19: A Comprehensive and Bibliometric Review. J. Clin. Med., 9.","DOI":"10.3390\/jcm9123914"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Scribante, A., Butera, A., and Alovisi, M. (2022). Customized Minimally Invasive Protocols for the Clinical and Microbiological Management of the Oral Microbiota. Microorganisms, 10.","DOI":"10.3390\/microorganisms10040675"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/bjd.13462","article-title":"A global perspective on the epidemiology of acne","volume":"172","author":"Tan","year":"2015","journal-title":"Br. J. Dermatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1016\/j.jaad.2015.12.037","article-title":"Guidelines of care for the management of acne vulgaris","volume":"74","author":"Zaenglein","year":"2016","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.3389\/fphar.2018.01254","article-title":"Development of Rifampicin-Indocyanine Green-Loaded Perfluorocarbon Nanodroplets for Photo-Chemo-Probiotic Antimicrobial Therapy","volume":"9","author":"Hsiao","year":"2018","journal-title":"Front. Pharmacol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"371","DOI":"10.2147\/CCID.S69135","article-title":"Linking diet to acne metabolomics, inflammation, and comedogenesis: An update","volume":"8","author":"Melnik","year":"2015","journal-title":"Clin. Cosmet. Investig. Dermatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1111\/bjd.14409","article-title":"Skin expression of mammalian target of rapamycin and forkhead box transcription factor O1, and serum insulin-like growth factor-1 in patients with acne vulgaris and their relationship with diet","volume":"174","author":"Agamia","year":"2016","journal-title":"Br. J. Dermatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.jaad.2009.01.019","article-title":"New insights into the management of acne: An update from the Global Alliance to Improve Outcomes in Acne group","volume":"60","author":"Thiboutot","year":"2009","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1111\/jdv.13675","article-title":"A consensus-based practical and daily guide for the treatment of acne patients","volume":"30","author":"Gollnick","year":"2016","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/jdv.13190","article-title":"Understanding innate immunity and inflammation in acne: Implications for management","volume":"29","author":"Dreno","year":"2015","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1128\/CMR.00092-13","article-title":"Propionibacterium acnes: From Commensal to Opportunistic Biofilm-Associated Implant Pathogen","volume":"27","author":"Achermann","year":"2014","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1586\/eri.11.137","article-title":"Propionibacterium acnes: Infection beyond the skin","volume":"9","author":"Perry","year":"2011","journal-title":"Expert Rev. Anti-Infect. Ther."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.anaerobe.2016.08.005","article-title":"Evaluation of oral microbiota in undernourished and eutrophic children using checkerboard DNA-DNA hybridization","volume":"42","author":"Testa","year":"2016","journal-title":"Anaerobe"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.jaad.2017.09.078","article-title":"Practical management of acne for clinicians: An international consensus from the Global Alliance to Improve Outcomes in Acne","volume":"78","author":"Thiboutot","year":"2018","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2987","DOI":"10.1177\/0300060519847367","article-title":"Topical treatment of acne vulgaris: Efficiency, side effects, and adherence rate","volume":"47","year":"2019","journal-title":"J. Int. Med. Res."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Ellis, S.R., Nguyen, M., Vaughn, A.R., Notay, M., Burney, W.A., Sandhu, S., and Sivamani, R.K. (2019). The Skin and Gut Microbiome and Its Role in Common Dermatologic Conditions. Microorganisms, 7.","DOI":"10.3390\/microorganisms7110550"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Stangeland, K.Z., Huldt-Nystr\u00f8m, T., Li, X., and Danielsen, K. (Tidsskrift for Den Norske Legeforening, 2019). Behandling av akne [Treatment of acne], Tidsskrift for Den Norske Legeforening.","DOI":"10.4045\/tidsskr.18.0946"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1016\/j.jaad.2016.06.057","article-title":"Duration of oral tetracycline-class antibiotic therapy and use of topical retinoids for the treatment of acne among general practitioners (GP): A retrospective cohort study","volume":"75","author":"Barbieri","year":"2016","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.jaad.2014.02.031","article-title":"A retrospective analysis of the duration of oral antibiotic therapy for the treatment of acne among adolescents: Investigating practice gaps and potential cost-savings","volume":"71","author":"Lee","year":"2014","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1016\/j.jaad.2015.01.048","article-title":"Duration of oral antibiotic therapy for the treatment of adult acne: A retrospective analysis investigating adherence to guideline recommendations and opportunities for cost-savings","volume":"72","author":"Straight","year":"2015","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/j.jaad.2017.04.016","article-title":"Trends in prescribing behavior of systemic agents used in the treatment of acne among dermatologists and nondermatologists: A retrospective analysis, 2004\u20132013","volume":"77","author":"Barbieri","year":"2017","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1001\/jamadermatol.2018.5221","article-title":"Association of Systemic Antibiotic Treatment of Acne With Skin Microbiota Characteristics","volume":"155","author":"Chien","year":"2019","journal-title":"JAMA Dermatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1007\/s40257-018-0345-x","article-title":"Emerging Therapies for Acne Vulgaris","volume":"19","author":"Trivedi","year":"2018","journal-title":"Am. J. Clin. Dermatol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Friedrich, A.D., Paz, M.L., Leoni, J., and Maglio, D.H.G. (2017). Message in a Bottle: Dialog between Intestine and Skin Modulated by Probiotics. Int. J. Mol. Sci., 18.","DOI":"10.3390\/ijms18061067"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1038\/nrgastro.2014.66","article-title":"Expert consensus document: The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic","volume":"11","author":"Hill","year":"2014","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1111\/jcpe.12545","article-title":"Clinical efficacy of probiotics as an adjunctive therapy to non-surgical periodontal treatment of chronic periodontitis: A systematic review and meta-analysis","volume":"43","author":"Davideau","year":"2016","journal-title":"J. Clin. Periodontol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1111\/jcpe.12387","article-title":"Clinical and microbiological effects of probiotic lozenges in the treatment of chronic periodontitis: A 1-year follow-up study","volume":"42","author":"Tekce","year":"2015","journal-title":"J. Clin. Periodontol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"5344","DOI":"10.3402\/jom.v2i0.5344","article-title":"Effect of the probiotic Lactobacilli reuteri (Prodentis) in the management of periodontal disease: A preliminary randomized clinical trial","volume":"2","author":"Vivekananda","year":"2010","journal-title":"J. Oral Microbiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1902\/jop.2015.140612","article-title":"Clinical and Biochemical Evaluation of Lozenges Containing Lactobacillus reuteri as an Adjunct to Non-Surgical Periodontal Therapy in Chronic Periodontitis","volume":"86","author":"Ince","year":"2015","journal-title":"J. Periodontol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1111\/jcpe.13198","article-title":"A dual-strain Lactobacilli reuteri probiotic improves the treatment of residual pockets: A randomized controlled clinical trial","volume":"47","author":"Laleman","year":"2020","journal-title":"J. Clin. Periodontol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Sinesi, A., Mosaico, G., Cont, M., Cefola, S., Mautarelli, G., and Casu, C. (2019). Gum Hypertrophy in Patients in Fixed Orthodontic Therapy Treated with Topical Probiotic Lactobacillus Reuteri: A Pilot Study. Proceedings, 35.","DOI":"10.3390\/proceedings2019035040"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"5","DOI":"10.7243\/2052-6180-3-5","article-title":"Probiotics in personal care products","volume":"3","author":"Huang","year":"2015","journal-title":"Microbiol. Discov."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Lee, G.R., Maarouf, M., Hendricks, A.J., Lee, D.E., and Shi, V.Y. (2019). Topical probiotics: The unknowns behind their rising popularity. Dermatol. Online J., 25.","DOI":"10.5070\/D3255044062"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2331","DOI":"10.1080\/10408398.2013.834874","article-title":"Probiotic Lactic Acid Bacteria and Skin Health","volume":"56","author":"Jeong","year":"2016","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1583","DOI":"10.4014\/jmb.1406.06038","article-title":"Oral Administration of Lactobacillus plantarum HY7714 Protects Hairless Mouse Against Ultraviolet B-Induced Photoaging","volume":"24","author":"Kim","year":"2014","journal-title":"J. Microbiol. Biotechnol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2160","DOI":"10.4014\/jmb.1509.09021","article-title":"Clinical Evidence of Effects of Lactobacillus plantarum HY7714 on Skin Aging: A Randomized, Double Blind, Placebo-Controlled Study","volume":"25","author":"Lee","year":"2015","journal-title":"J. Microbiol. Biotechnol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.4014\/jmb.1306.06026","article-title":"Lactobacillus sakei Lipoteichoic Acid Inhibits MMP-1 Induced by UVA in Normal Dermal Fibroblasts of Human","volume":"23","author":"You","year":"2013","journal-title":"J. Microbiol. Biotechnol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"185","DOI":"10.3920\/BM2012.0060","article-title":"Acne vulgaris, probiotics and the gut-brain-skin axis: From anecdote to translational medicine","volume":"5","author":"Bowe","year":"2014","journal-title":"Benef. Microbes"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.ijwd.2015.02.001","article-title":"The effect of probiotics on immune regulation, acne, and photoaging","volume":"1","author":"Kober","year":"2015","journal-title":"Int. J. Womens Dermatol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"114","DOI":"10.2310\/7750.2012.12026","article-title":"Prospective, Randomized, Open-Label Trial Comparing the Safety, Efficacy, and Tolerability of an Acne Treatment Regimen with and without a Probiotic Supplement and Minocycline in Subjects with Mild to Moderate Acne","volume":"17","author":"Jung","year":"2013","journal-title":"J. Cutan. Med. Surg."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.3389\/fmicb.2018.01459","article-title":"The Gut Microbiome as a Major Regulator of the Gut-Skin Axis","volume":"9","author":"Salem","year":"2018","journal-title":"Front. Microbiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1111\/exd.13950","article-title":"Lactobacillus reuteri DSM 17938\u2014A comparative study on the effect of probiotics and lysates on human skin","volume":"28","author":"Khmaladze","year":"2019","journal-title":"Exp. Dermatol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1007\/s12275-012-1286-3","article-title":"Effect of Lactobacillus reuteri on the proliferation of Propionibacterium acnes and Staphylococcus epidermidis","volume":"50","author":"Kang","year":"2012","journal-title":"J. Microbiol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"7585486","DOI":"10.1155\/2019\/7585486","article-title":"Efficacy of Using Probiotics with Antagonistic Activity against Pathogens of Wound Infections: An Integrative Review of Literature","volume":"2019","author":"Fijan","year":"2019","journal-title":"BioMed Res. Int."}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/10\/7\/1344\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:42:17Z","timestamp":1760139737000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/10\/7\/1344"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,3]]},"references-count":52,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["microorganisms10071344"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms10071344","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,3]]}}}