Division of Orthodontics and Dentofacial Orthopedics Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Ave, Rochester, NY, 14620, USA.
Probiotics Antimicrob Proteins. 2020 Dec;12(4):1349-1359. doi: 10.1007/s12602-020-09683-2.
The aim was to assess the role of probiotics in oral health maintenance among patients undergoing fixed orthodontic therapy (OT). An unrestricted search of indexed databases was performed until April 2020 using the following Mesh-terms: (1) probiotic and (2) orthodontic. Randomized controlled clinical trials (RCTs) evaluating the influence of probiotic therapy (PT) towards oral health maintenance/improvement in patients undergoing fixed OT were included. Data screening, selection, and extraction were performed; and the risk of bias was assessed using the Cochrane Collaboration's tool. All evaluations were performed by 2 independent researchers; and disagreements were resolved via discussion. Nine RCTs were included. Eight studies reported that PT improves oral health in patients undergoing fixed OT. Seven studies showed that PT reduces the counts of oral pathogenic bacteria in the oral biofilm and/or saliva. One study reported that PT reduces halitosis in patients undergoing fixed OT. One study found that PT reduces the scores of plaque index (PI) and gingival index (GI); and one study reported that PT has no significant influence on PI and GI in patients undergoing fixed OT. One study reported that PT does not prevent the formation of white spot lesions during fixed OT. Three and 6 studies had a moderate and low risk of bias, respectively. A power analysis was performed in 4 studies. In conclusion, probiotics exhibit antimicrobial activity against oral pathogenic bacteria; however, due to the limitations of the studies assessed, further well-designed RCTs are needed.
目的是评估益生菌在接受固定正畸治疗（OT）的患者口腔健康维持中的作用。使用以下 Mesh 术语对索引数据库进行了无限制搜索，直到 2020 年 4 月：（1）益生菌和（2）正畸。纳入了评估益生菌治疗（PT）对接受固定 OT 的患者口腔健康维持/改善影响的随机对照临床试验（RCT）。进行了数据筛选、选择和提取；并使用 Cochrane 协作工具评估偏倚风险。所有评估均由 2 位独立研究人员进行；并通过讨论解决了分歧。纳入了 9 项 RCT。8 项研究报告称 PT 改善了接受固定 OT 的患者的口腔健康。7 项研究表明 PT 减少了口腔生物膜和/或唾液中口腔致病菌的数量。一项研究报告称 PT 减少了接受固定 OT 的患者的口臭。一项研究发现 PT 降低了菌斑指数（PI）和牙龈指数（GI）的评分；一项研究报告称 PT 对接受固定 OT 的患者的 PI 和 GI 没有显著影响。一项研究报告称 PT 不能预防固定 OT 期间白色斑点病变的形成。3 项和 6 项研究分别具有中度和低度偏倚风险。对 4 项研究进行了功效分析。总之，益生菌对口腔致病菌具有抗菌活性；然而，由于评估研究的局限性，需要进一步进行精心设计的 RCT。
