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了解口腔微生物群在幼儿龋齿发生和发展中的预测潜力。

Understanding the Predictive Potential of the Oral Microbiome in the Development and Progression of Early Childhood Caries.

作者信息

Duque Cristiane, Chrisostomo Daniela Alvim, Souza Amanda Caselato Andolfatto, de Almeida Braga Gabriela Pacheco, Dos Santos Vanessa Rodrigues, Caiaffa Karina Sampaio, Pereira Jesse Augusto, de Oliveira Warlley Campos, de Aguiar Ribeiro Apoena, Parisotto Thaís Manzano

机构信息

Department of Preventive and Restorative Dentistry, Araçatuba Dental School, State University of São Paulo (UNESP), Araçatuba, Brazil.

Division of Diagnostic Sciences, University of North Carolina at Chapel Hill - Adams School of Dentistry, Chapel Hill, North Carolina, United State.

出版信息

Curr Pediatr Rev. 2023;19(2):121-138. doi: 10.2174/1573396318666220811124848.

Abstract

BACKGROUND

Early childhood caries (ECC) is the most common chronic disease in young children and a public health problem worldwide. It is characterized by the presence of atypical and fast progressive caries lesions. The aggressive form of ECC, severe early childhood caries (S-ECC), can lead to the destruction of the whole crown of most of the deciduous teeth and cause pain and sepsis, affecting the child's quality of life. Although the multifactorial etiology of ECC is known, including social, environmental, behavioral, and genetic determinants, there is a consensus that this disease is driven by an imbalance between the oral microbiome and host, or dysbiosis, mediated by high sugar consumption and poor oral hygiene. Knowledge of the microbiome in healthy and caries status is crucial for risk monitoring, prevention, and development of therapies to revert dysbiosis and restore oral health. Molecular biology tools, including next-generation sequencing methods and proteomic approaches, have led to the discovery of new species and microbial biomarkers that could reveal potential risk profiles for the development of ECC and new targets for anti-caries therapies. This narrative review summarized some general aspects of ECC, such as definition, epidemiology, and etiology, the influence of oral microbiota in the development and progression of ECC based on the current evidence from genomics, transcriptomic, proteomic, and metabolomic studies and the effect of antimicrobial intervention on oral microbiota associated with ECC.

CONCLUSION

The evaluation of genetic and proteomic markers represents a promising approach to predict the risk of ECC before its clinical manifestation and plan efficient therapeutic interventions for ECC in its initial stages, avoiding irreversible dental cavitation.

摘要

背景

幼儿龋(ECC)是幼儿中最常见的慢性疾病,也是全球范围内的一个公共卫生问题。其特征是存在非典型且进展迅速的龋损病变。ECC的侵袭性形式,即重度幼儿龋(S-ECC),可导致大多数乳牙的整个牙冠被破坏,并引起疼痛和败血症,影响儿童的生活质量。尽管已知ECC的多因素病因,包括社会、环境、行为和遗传决定因素,但人们一致认为,这种疾病是由高糖摄入和不良口腔卫生介导的口腔微生物群与宿主之间的失衡,即生态失调所驱动的。了解健康和患龋状态下的微生物群对于风险监测、预防以及开发恢复生态失调和恢复口腔健康的治疗方法至关重要。分子生物学工具,包括下一代测序方法和蛋白质组学方法,已导致发现新的物种和微生物生物标志物,这些标志物可以揭示ECC发生的潜在风险特征以及抗龋治疗的新靶点。本叙述性综述总结了ECC的一些一般方面,如定义、流行病学和病因,基于基因组学、转录组学、蛋白质组学和代谢组学研究的当前证据,口腔微生物群在ECC发生和发展中的影响,以及抗菌干预对与ECC相关的口腔微生物群的作用。

结论

评估遗传和蛋白质组学标志物是一种有前景的方法,可在ECC临床表现之前预测其风险,并为ECC的初始阶段制定有效的治疗干预措施,避免不可逆的牙体龋坏。

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