目的:益生菌对正畸患者口腔健康维护的影响仍存在争议。该研究的目的是系统地回顾和评估益生菌对正畸治疗患者口腔健康和微生物组的影响。
方法:包括PubMed、WebofScience,科克伦图书馆,ClinicalTrials.gov,和ProQuest学位论文和论文全球数据库从成立到2022年6月进行了搜索。包括评估益生菌对正畸治疗患者临床和微生物结局影响的随机对照试验。
方法:进行数据筛选和收集,使用CochraneRoB2工具评估偏倚风险(RoB)。荟萃分析评估了益生菌对变形链球菌的影响(S.变形)和乳酸菌计数。荟萃分析的证据质量通过建议评估分级进行评估,开发和评估(等级)。
结果:总共确定了405条记录,其中15项研究纳入定性综合,4项纳入荟萃分析.所有纳入研究的患者均接受固定正畸矫治器治疗。关于临床结果的结果是有争议的;4/5的研究报告益生菌组的斑块没有显著变化(P>.05),和三分之二的研究报告牙龈指数没有显著变化(P>0.05)。关于微生物的结果,荟萃分析结果显示,益生菌显著增加了降低变形链球菌丰度至低于105CFU/ml的可能性(风险比:2.05[1.54,2.72],P<.001)并降低了将变形链球菌的丰度增加到超过106CFU/ml的可能性(风险比:0.48[0.28,0.83],P=.009)。然而,根据等级的证据质量是中等的。
结论:没有足够的证据来确定益生菌作为正畸治疗患者口腔健康补充剂的临床益处。然而,益生菌可能有助于减少正畸患者的唾液变形链球菌计数。
背景:PROSPERO(CRD42022366650)。
The effect of probiotics on oral health maintenance in orthodontic patients remains controversial. The aim of the study is to systematically review and assess the effects of probiotics on the oral health and microbiome of patients undergoing orthodontic treatment.
Databases including PubMed, Web of Science, Cochrane Library, ClinicalTrials.gov, and ProQuest Dissertations & Theses Global databases were searched from their inception until June 2022. Randomised controlled trials that assessed the effects of probiotics on clinical and microbial outcomes in patients undergoing orthodontic treatment were included.
Data screening and collection were performed, and the risk of bias (RoB) was assessed using the Cochrane RoB 2 tool. The meta-analysis evaluated the effects of probiotics on Streptococcus mutans (S. mutans) and Lactobacillus counts. The quality of the evidence from the meta-analyses was assessed with Grading of Recommendations Assessment, Development and Evaluation (GRADE).
A total of 405 records were identified, of which 15 studies were included in the qualitative synthesis and 4 in the meta-analysis. The patients in all the included studies were treated with fixed orthodontic appliances. Results regarding clinical outcomes were controversial; four out of five studies reported no significant changes in plaque in the probiotic group (P > .05), and two out of three studies reported no significant changes in the gingival index (P > .05). Regarding microbial outcomes, the meta-analysis results revealed that probiotics significantly increased the likelihood of reducing the abundance of S. mutans to below 105 CFU/ml (risk ratio: 2.05 [1.54, 2.72], P < .001) and reduced the likelihood of increasing the abundance of S. mutans to beyond 106 CFU/ml (risk ratio: 0.48 [0.28, 0.83], P = .009). However, the quality of evidence according to the GRADE was moderate.
There is insufficient evidence to determine the clinical benefits of probiotics as a supplement for the oral health of patients undergoing orthodontic treatment. However, probiotics may have benefits in reducing the salivary S. mutans counts in orthodontic patients.
PROSPERO (CRD42022366650).