Gizani Sotiria, Petsi Georgia, Twetman Svante, Caroni Crys, Makou Margarita, Papagianoulis Lisa
*Department of Paediatric Dentistry, Dental School, National and Kapodistrian University of Athens, Greece,
*Department of Paediatric Dentistry, Dental School, National and Kapodistrian University of Athens, Greece.
Eur J Orthod. 2016 Feb;38(1):85-89. doi: 10.1093/ejo/cjv015. Epub 2015 Apr 3.
BACKGROUND/OBJECTIVES: The purpose of the study is to evaluate the effect of daily intake of lozenges containing probiotic bacteria on white spot lesion (WSL) formation as well as on salivary lactobacilli (LB) and mutans streptococci (MS) counts, in patients undergoing orthodontic treatment with fixed appliances.
MATERIALS/METHODS: A randomized double-blind placebo-controlled study design with two parallel arms was employed. Patients (n = 85, mean age 15.9 years) with maxillary braces on at least eight anterior teeth and a remaining treatment period of 7-24 months were finally enrolled and randomly allocated to a test or placebo group. Subjects in the test group were instructed to take one probiotic lozenge containing two strains of Lactobacillus reuteri once daily. An identical lozenge without active bacteria was used in the placebo group. Dental plaque, WSL, and salivary MS and LB levels were recorded at baseline and immediately after debonding.
The groups were balanced at baseline. The mean duration of the intervention was 17 months and the total dropout rate was 10 per cent. There were no differences in the incidence of WSL between the groups at debonding. The patients had generally a neglected oral hygiene, both at baseline and at the follow-up. The levels of salivary LB were significantly reduced in both groups (P < 0.05) at the time of debonding compared with baseline, while no alterations of the MS counts were unveiled.
WSL were scored from photos that may not fully mirror the clinical situation. Chair-side tests estimate the counts of selected bacteria in saliva and do not reflect the entire microbiota. The invention was implemented approximately 6 months after the onset of the fixed appliances and some lesions may have been present at bonding.
CONCLUSIONS/CLINICAL IMPLICATIONS: Daily intake of probiotic lozenges did not seem to affect the development of WSL during orthodontic treatment with fixed appliances.
背景/目的：本研究旨在评估每日摄入含益生菌含片对接受固定矫治器正畸治疗患者白斑病变（WSL）形成以及唾液中乳酸杆菌（LB）和变形链球菌（MS）计数的影响。
材料/方法：采用随机双盲安慰剂对照研究设计，设有两个平行组。最终纳入至少8颗上前牙佩戴上颌矫治器且剩余治疗期为7 - 24个月的患者（n = 85，平均年龄15.9岁），并将其随机分配至试验组或安慰剂组。试验组受试者被指示每日服用1片含两株罗伊氏乳杆菌的益生菌含片。安慰剂组使用不含活性细菌的相同含片。在基线期和拆除矫治器后即刻记录牙菌斑、WSL以及唾液中MS和LB水平。
两组在基线期均衡。干预的平均持续时间为17个月，总脱落率为10%。拆除矫治器时两组间WSL的发生率无差异。患者在基线期和随访时口腔卫生状况普遍较差。与基线期相比，拆除矫治器时两组唾液中LB水平均显著降低（P < 0.05），而MS计数无变化。
WSL通过照片评分，可能无法完全反映临床情况。椅旁检测估计唾液中特定细菌的计数，不能反映整个微生物群。本研究在固定矫治器佩戴约6个月后实施，一些病变可能在粘接时就已存在。
结论/临床意义：在使用固定矫治器进行正畸治疗期间，每日摄入益生菌含片似乎并未影响WSL的发展。
