Zhan L, Featherstone J D B, Lo J, Krupansky C, Hoang N, DenBesten P, Huynh T
Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, CA, USA.
Adv Dent Res. 2012 Sep;24(2):117-22. doi: 10.1177/0022034512449835.
The aim of the study was to investigate whether xylitol-wipe use in young children prevented caries by affecting bacterial virulence. In a double-blinded randomized controlled clinical trial, 44 mother-child pairs were randomized to xylitol-wipe or placebo-wipe groups. Salivary mutans streptococci levels were enumerated at baseline, 6 months, and one year. Ten mutans streptococci colonies were isolated and genotyped from each saliva sample. Genotype-colonization stability, xylitol sensitivity, and biofilm formation of these isolates were studied. Despite a significant reduction in new caries at one year in the xylitol-wipe group, no significant differences were found between the two groups in levels of mutans streptococci. Children in the xylitol-wipe group had significantly fewer retained genotypes (p = 0.06) and more transient genotypes of mutans streptococci (p = 0.05) than those in the placebo-wipe group. At one year, there was no significant difference in the prevalence of xylitol-resistant genotypes or in biofilm formation ability of mutans streptococci isolates between the two groups. The mechanism of the caries-preventive effect of xylitol-wipe use may be related to the stability of mutans streptococci colonization. Further studies with genomic characterization methods are needed to determine specific gene(s) that account for the caries-preventive effect of xylitol.
该研究的目的是调查幼儿使用木糖醇擦拭巾是否通过影响细菌毒力来预防龋齿。在一项双盲随机对照临床试验中，44对母婴被随机分为木糖醇擦拭巾组或安慰剂擦拭巾组。在基线、6个月和1年时对唾液变形链球菌水平进行计数。从每个唾液样本中分离出10个变形链球菌菌落并进行基因分型。研究了这些分离株的基因型 - 定植稳定性、木糖醇敏感性和生物膜形成。尽管木糖醇擦拭巾组在1年时新发龋齿显著减少，但两组之间变形链球菌水平没有显著差异。木糖醇擦拭巾组儿童的变形链球菌保留基因型显著较少（p = 0.06），而短暂基因型较多（p = 0.05），高于安慰剂擦拭巾组。1年时，两组之间木糖醇抗性基因型的患病率或变形链球菌分离株的生物膜形成能力没有显著差异。使用木糖醇擦拭巾预防龋齿的作用机制可能与变形链球菌定植的稳定性有关。需要进一步采用基因组表征方法进行研究，以确定导致木糖醇预防龋齿作用的特定基因。
