Tay John Rong Hao, Ng Ethan, Lai Clement Wei Ming, Lim Lum Peng, Ong Marianne Meng Ann
Department of Restorative Dentistry, National Dental Centre Singapore, 5 Hospital Avenue, Singapore, 168938, Singapore.
Faculty of Dentistry, National University of Singapore, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore.
Clin Oral Investig. 2022 Jul;26(7):4687-4700. doi: 10.1007/s00784-022-04522-w. Epub 2022 May 10.
To evaluate the efficacy of probiotics in reducing halitosis of dental origin.
MEDLINE, EMBASE, and CENTRAL were searched up to and including June 2020. Randomised placebo-controlled, double-blinded clinical trials in systemically healthy adult patients who were given any form of probiotics to manage halitosis of dental origin were included. Primary outcome measures were organoleptic scores and volatile sulphur concentration levels. Secondary outcome measures were microbiologic parameters and quality of life (QOL).
Of the 301 potentially relevant articles, eight articles were selected for the review. The risk of bias assessment showed that two studies were of low risk of bias, four studies had some concerns, and two studies had a high risk of bias. The beneficial effect of probiotics could neither be confirmed in periodontally treated patients administered with up to 8 weeks of probiotics, nor in periodontitis patients who received both non-surgical periodontal therapy and adjunctive probiotics up to 90 days. Microbiological findings 1 month after probiotics administration and QOL measures showed no significant differences compared to control. Considerable heterogeneity was observed among probiotic administration protocols.
The available evidence suggests no convincing benefit for the use of probiotics in the management of halitosis. Standardised protocols on recruitment of halitosis subjects and organoleptic measurements are required for future studies on probiotics as an intervention.
The lack of well-conducted studies with a low risk of bias precludes any clinical recommendation. Further research is needed to verify the efficacy of probiotics in the management of intra-oral halitosis.
评估益生菌在减轻牙源性口臭方面的疗效。
检索截至2020年6月的MEDLINE、EMBASE和CENTRAL数据库。纳入全身健康的成年患者参与的随机安慰剂对照双盲临床试验，这些患者接受任何形式的益生菌治疗以管理牙源性口臭。主要结局指标为感官评分和挥发性硫化物浓度水平。次要结局指标为微生物学参数和生活质量（QOL）。
在301篇潜在相关文章中，8篇文章被选入综述。偏倚风险评估显示，两项研究偏倚风险低，四项研究存在一些问题，两项研究偏倚风险高。在接受长达8周益生菌治疗的牙周治疗患者中，以及在接受非手术牙周治疗和辅助益生菌治疗长达90天的牙周炎患者中，均未证实益生菌的有益效果。与对照组相比，服用益生菌1个月后的微生物学结果和生活质量测量结果无显著差异。在益生菌给药方案中观察到相当大的异质性。
现有证据表明，使用益生菌治疗口臭没有令人信服的益处。未来关于益生菌作为干预措施的研究需要标准化的口臭受试者招募方案和感官测量方法。
缺乏低偏倚风险的高质量研究排除了任何临床推荐。需要进一步研究以验证益生菌在治疗口腔内口臭方面的疗效。
