Sir John Walsh Research Institute and Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin 9010, New Zealand.
J Breath Res. 2019 May 31;13(3):036010. doi: 10.1088/1752-7163/ab1c81.
Orthodontic braces can impede oral hygiene and promote halitosis. The aim of the study was to investigate the effect of the oral probiotic Streptococcus salivarius M18 on oral hygiene indices and halitosis in patients wearing orthodontic braces. The study was a prospective, randomized, triple-blind, placebo-controlled trial. Patients undergoing fixed orthodontic treatment were randomly allocated to a probiotic group (n = 32) and a placebo group (n = 32). Patients consumed 2 lozenges d for one month. Assessments were taken at baseline, at the end of the intervention, and at a 3 month follow-up. The outcome measures were plaque index (PI), gingival index (GI) and halitosis-causing volatile sulfur compound (VSC) levels. The dental biofilms before and after the intervention were analyzed utilizing next-generation sequencing of bacterial 16S rRNA genes. PI and GI scores were not significantly influenced by the probiotic intervention (intervention × time: p > 0.05). The level of VSCs decreased significantly in both the probiotic group (VSC reduction = -8.5%, 95%CI = -7.4% to -9.1%, p = 0.015) and the placebo group (-6.5%, 95%CI = -6.0% to -7.4%, p = 0.039) after 1 month intervention. However, at the 3 month follow-up, the VSC levels in the placebo group returned to baseline levels whereas those in the probiotic group decreased further (-10.8%, 95%CI = -10.5% to -12.9%, p = 0.005). Time, but not treatment, was associated with the decrease in microbial community alpha diversity and a modest effect on beta diversity. Oral probiotic S. salivarius M18 reduced the level of halitosis in patients with orthodontic braces, but had minimal effects on PI, GI and dental biofilm microflora.
正畸矫治器会妨碍口腔卫生并导致口臭。本研究旨在探讨口腔益生菌唾液链球菌 M18 对佩戴正畸矫治器患者的口腔卫生指数和口臭的影响。该研究为前瞻性、随机、三盲、安慰剂对照试验。接受固定正畸治疗的患者被随机分配到益生菌组（n=32）和安慰剂组（n=32）。患者每天服用 2 片含漱剂，持续 1 个月。在基线、干预结束时和 3 个月随访时进行评估。主要结局指标为菌斑指数（PI）、牙龈指数（GI）和口臭挥发性硫化合物（VSC）水平。干预前后的牙菌斑生物膜利用细菌 16S rRNA 基因的下一代测序进行分析。益生菌干预对 PI 和 GI 评分没有显著影响（干预×时间：p＞0.05）。益生菌组（VSC 降低=8.5%，95%CI=7.4%至 9.1%，p=0.015）和安慰剂组（VSC 降低=6.5%，95%CI=6.0%至 7.4%，p=0.039）在干预 1 个月后 VSC 水平均显著降低。然而，在 3 个月随访时，安慰剂组的 VSC 水平恢复到基线水平，而益生菌组的 VSC 水平进一步降低（-10.8%，95%CI=-10.5%至-12.9%，p=0.005）。时间而不是治疗与微生物群落 alpha 多样性的降低有关，并且对 beta 多样性有适度影响。口腔益生菌唾液链球菌 M18 降低了正畸矫治器患者的口臭水平，但对 PI、GI 和牙菌斑微生物群几乎没有影响。
