Maxillofacial Unit, Halland Hospital, 30185 Halmstad, Sweden.
Department of Clinical Microbiology, Halland Hospital, 30185 Halmstad, Sweden.
Benef Microbes. 2019 Jul 10;10(6):653-659. doi: 10.3920/BM2018.0168. Epub 2019 Jun 3.
We investigated the effect of probiotic supplements on oral wound healing, swelling, pain and discomfort after surgical removal of mandibular third molars. A second aim was to evaluate if the intervention could influence the concentrations of oxytocin in saliva. Sixty-four consecutive volunteers (18-34 years) were enrolled to a double-blind randomised placebo-controlled trial with two parallel arms. Following surgery, the patients were asked to take three lozenges per day containing two strains of (DSM 17938 and ATCC PTA 5289) or placebo for two weeks. The clinical healing and extra-oral swelling were scored two weeks post-operatively. Samples of wound exudate were cultivated for the presence of and β-haemolytic streptococci. Salivary oxytocin concentrations were analysed from pre- and post-surgery samples using ELISA technique. Compliance and the subjective perception of swelling, pain and discomfort were reported daily through visual analogue scales in a logbook. All patients except three completed the protocol and the postoperative course was uneventful in most cases. Minor extra-oral swellings were noted in five patients, but none required antibiotic treatment. At the 2-week follow-up, there were no significant differences in clinical wound healing index, extra-oral swelling, bacterial growth or salivary oxytocin levels between the groups. The self-reported data unveiled, however, a significantly reduced sense of swelling, in particular during the second week after surgery in the probiotic test group (<0.05). Likewise, significantly fewer nights with disturbed sleep and fewer days with sick-leave from work were reported among the participants in the test group (<0.05). No differences were found in the post-operative use of analgesics. In conclusion, we found no significant influence of probiotic supplements on objective wound healing after surgical extraction of impacted mandibular third molars. However, since the patients' perceived significant post-operative ameliorations, further studies are needed to explore the patient's value of the intervention.
我们研究了益生菌补充剂对下颌第三磨牙拔除术后口腔伤口愈合、肿胀、疼痛和不适的影响。第二个目的是评估干预是否会影响唾液中催产素的浓度。64 名连续志愿者（18-34 岁）被纳入一项双盲随机安慰剂对照试验，分为两组。手术后，患者被要求每天服用 3 片含两种 （DSM 17938 和 ATCC PTA 5289）或安慰剂的含片，持续两周。术后两周对临床愈合和口腔外肿胀进行评分。采集伤口渗出物样本培养 和β-溶血性链球菌。使用 ELISA 技术分析术前和术后样本中的唾液催产素浓度。通过日志中的视觉模拟量表，每天报告依从性以及肿胀、疼痛和不适的主观感觉。除 3 名患者外，所有患者均完成了方案，大多数情况下术后过程均无异常。5 名患者出现轻微的口腔外肿胀，但均无需抗生素治疗。在 2 周随访时，两组间临床伤口愈合指数、口腔外肿胀、细菌生长或唾液催产素水平均无显著差异。然而，自我报告的数据显示，在益生菌试验组中，肿胀感在第二周明显减轻，特别是在手术后（<0.05）。同样，在试验组中，睡眠受到干扰的夜晚和因病缺勤的天数明显减少（<0.05）。术后使用镇痛药无差异。总之，我们发现益生菌补充剂对下颌第三磨牙拔除术后客观伤口愈合无显著影响。然而，由于患者术后感知到明显的改善，需要进一步研究以探讨干预措施对患者的价值。
