Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA.
Periodontol 2000. 2021 Oct;87(1):254-267. doi: 10.1111/prd.12382.
Dysbiosis of the oral microbiome is associated with a variety of oral and systemic diseases, including periodontal disease. Oral dysbiosis in periodontal disease leads to an exacerbated host immune response that induces progressive periodontal tissue destruction and ultimately tooth loss. To counter the disease-associated dysbiosis of the oral cavity, strategies have been proposed to reestablish a "healthy" microbiome via the use of probiotics. This study reviews the literature on the use of probiotics for modifying the oral microbial composition toward a beneficial state that might alleviate disease progression. Four in vitro and 10 preclinical studies were included in the analysis, and these studies explored the effects of probiotics on cultured biofilm growth and bacterial gene expressions, as well as modulation of the host response to inflammation. The current molecular findings on probiotics provide fundamental evidence for further clinical research for the use of probiotics in periodontal therapy. They also point out an important caveat: Changing the biofilm composition might alter the normal oral flora that is beneficial and/or critical for oral health.
口腔微生物组失调与多种口腔和全身疾病有关,包括牙周病。牙周病中的口腔微生物组失调会导致宿主免疫反应加剧,从而引起进行性牙周组织破坏,最终导致牙齿丧失。为了对抗与疾病相关的口腔微生物失调,人们提出了通过使用益生菌来重建“健康”微生物组的策略。本研究综述了使用益生菌来改变口腔微生物组成以达到有益状态从而缓解疾病进展的文献。分析中纳入了 4 项体外研究和 10 项临床前研究,这些研究探讨了益生菌对培养生物膜生长和细菌基因表达的影响,以及对宿主炎症反应的调节作用。目前关于益生菌的分子研究为进一步的临床研究提供了基础证据,以将益生菌应用于牙周病治疗。它们还指出了一个重要的警告:改变生物膜组成可能会改变对口腔健康有益和/或至关重要的正常口腔菌群。