Gatej Simona, Gully Neville, Gibson Rachel, Bartold P Mark
School of Dentistry, The University of Adelaide, Adelaide, SA, Australia.
School of Medicine, The University of Adelaide, Adelaide, SA, Australia; Division of Health Sciences, University of South Australia, Adelaide, SA, Australia.
J Int Acad Periodontol. 2017 Apr 1;19(2):42-50.
This review was designed to explore the use of probiotics in prevention or treatment of periodontitis.
A search was performed using MEDLINE and bibliographies from previous reviews in order to identify any randomised controlled animal and human probiotic interventions in periodontitis.
Five studies using probiotics in animal models of periodontitis and eight clinical studies using probiotics in patients with chronic periodontitis were analysed. The analysis of the animal models showed reduction in periodontal pathogens and bleeding on probing when probiotics were used in adjunction to mechanical debridement and significant increase in alveolar bone levels and bone density in the probiotic groups when compared with placebo. Some of the results of the clinical studies indicated decreased clinical parameters (gingival inflammation, bleeding on probing, plaque index) and decreased pro-inflammatory markers levels in saliva or gingival crevicular fluid in treated periodontitis patients when compared with controls or placebo. Other results included decreased periodontal pocket depth and clinical attachment loss for scaling and root planing plus probiotic treatment versus scaling and root planing alone or placebo and also reduction in Porphyromonas gingivalis numbers and the total viable count and proportion of obligate anaerobic bacteria.
Within the limitations of this review, the results are encouraging, supporting the notion that there is a place for probiotics in the treatment of periodontitis. Future independent studies are needed to investigate specific probiotic strains, doses, delivery methods, treatment schedules, mechanisms of action, safety and how to maintain the results of the probiotic interventions.
本综述旨在探讨益生菌在预防或治疗牙周炎中的应用。
利用MEDLINE和以往综述的参考文献进行检索，以确定在牙周炎中使用益生菌的任何随机对照动物和人体干预研究。
分析了五项在牙周炎动物模型中使用益生菌的研究以及八项在慢性牙周炎患者中使用益生菌的临床研究。动物模型分析显示，在机械清创的基础上联合使用益生菌时，牙周病原体减少，探诊出血减少；与安慰剂相比，益生菌组的牙槽骨水平和骨密度显著增加。一些临床研究结果表明，与对照组或安慰剂相比，接受治疗的牙周炎患者的临床参数（牙龈炎症、探诊出血、菌斑指数）降低，唾液或龈沟液中的促炎标志物水平降低。其他结果包括，与单独进行龈上洁治和根面平整或使用安慰剂相比，龈上洁治、根面平整联合益生菌治疗可使牙周袋深度和临床附着丧失减少，牙龈卟啉单胞菌数量、总活菌数以及专性厌氧菌比例降低。
在本综述的局限性范围内，结果令人鼓舞，支持了益生菌在牙周炎治疗中占有一席之地的观点。未来需要进行独立研究，以调查特定的益生菌菌株、剂量、给药方法、治疗方案、作用机制、安全性以及如何维持益生菌干预的效果。
