UWA Dental School, University of Western Australia, Nedlends, Western Australia, Australia.
Medilink Consultation Clinics, Karachi, Pakistan.
Aust Dent J. 2020 Mar;65(1):12-20. doi: 10.1111/adj.12733. Epub 2019 Nov 29.
To evaluate the efficacy of probiotics in the treatment of gingivitis.
MEDLINE, EMBASE and CENTRAL were searched up to May 2019. Randomized controlled clinical trials (RCTs) and/or controlled clinical trials were considered. Studies consisting of ≥10 patients per group clinically diagnosed with gingivitis were selected that compared the efficacy of probiotics in any form with placebo. The primary outcome measure was bleeding on probing (BOP) and gingival index (GI), while the secondary outcome measure was plaque index (PI). Forest plots were created reporting weighted mean difference (WMD) of outcomes with 95% confidence intervals (CI).
A total of 10 double-blind placebo-parallel RCTs were included. All studies showed that probiotic administration was effective in the treatment of gingivitis at follow-up. The mean percentage of BOP ranged from 11.87% to 21.7% in the probiotics group and from 15% to 33% in the placebo groups at follow-up, respectively. Considering the effects of Lactobacillus reuteri, the overall mean difference for GI (WMD = -0.48, 95% CI = -1.69 to 0.72, P = 0.42) and PI (WMD = 0.18, 95% CI = -0.23 to 0.61, P = 0.37) did not show any statistical significance between probiotic and placebo groups.
The outcomes of this review show weak evidence to support the use of probiotics in reducing inflammatory periodontal parameters in gingivitis. Significant heterogeneity and limited available data may reduce the impact of these conclusions.
评估益生菌治疗牙龈炎的疗效。
检索 MEDLINE、EMBASE 和 CENTRAL，检索时间截至 2019 年 5 月。纳入随机对照临床试验（RCT）和/或对照临床试验。选择纳入每组至少 10 例临床诊断为牙龈炎的患者，并比较任何形式的益生菌与安慰剂的疗效。主要结局指标为探诊出血（BOP）和牙龈指数（GI），次要结局指标为菌斑指数（PI）。创建森林图报告以 95%置信区间（CI）报告结局的加权均数差（WMD）。
共纳入 10 项双盲安慰剂平行 RCT。所有研究均表明，益生菌治疗在随访时对牙龈炎有效。在随访时，益生菌组的 BOP 平均百分比范围为 11.87%至 21.7%，而安慰剂组的 BOP 平均百分比范围为 15%至 33%。考虑到罗伊氏乳杆菌的作用，GI（WMD=-0.48，95%CI=-1.69 至 0.72，P=0.42）和 PI（WMD=0.18，95%CI=-0.23 至 0.61，P=0.37）的总体平均差异在益生菌组和安慰剂组之间没有统计学意义。
本综述的结果表明，益生菌在减轻牙龈炎的炎症牙周参数方面的证据较弱。显著的异质性和有限的可用数据可能会降低这些结论的影响。
