不同菌株益生菌作为牙周炎患者非手术牙周治疗辅助手段的临床、微生物学及免疫学短期、中期和长期效果。系统评价与荟萃分析

Clinical, microbiological and immunological short, medium and long-term effects of different strains of probiotics as an adjunct to non-surgical periodontal therapy in patients with periodontitis. Systematic review with meta-analysis.

作者信息

Ausenda Federico, Barbera Emanuele, Cotti Elisabetta, Romeo Eugenio, Natto Zuhair S, Valente Nicola Alberto

机构信息

Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan, Italy.

Department fo Periodontology, Tufts University School of Dental Medicine, Boston, MA, USA.

出版信息

Jpn Dent Sci Rev. 2023 Dec;59:62-103. doi: 10.1016/j.jdsr.2023.02.001. Epub 2023 Mar 4.

INTRODUCTION/OBJECTIVES: Probiotics have been proposed as adjuncts to non-surgical periodontal therapy (NSPT), however, the effect of their use remains unclear. The aim of this systematic review and meta-analysis was to analyze the evidence regarding the use of probiotics as an adjunct to NSPT in patients with periodontitis at a clinical, microbiological and immunological level.

DATA/SOURCES: A comprehensive search to identify clinical studies investigating the use of probiotics as an adjunct to NSPT in patients treated for periodontitis was performed. The data were grouped according to probiotic strain, frequency, form and duration of the probiotic intake.

STUDY SELECTION

A total of 25 articles were included, all articles analysed clinical parameters, 10 included also microbiological findings and only 4 had immunological findings. The difference in probing depth (PD) between the test and the control group was statistically significant in favour of the test group when the probiotics were in the form of lozenges, administered twice a day and when the strain was . In terms of Clinical Attachment Level (CAL) gain the difference was statistically significant in the short and in the medium term but not in the long term. Due to the heterogeneity of the data, it was not possible to compare trough a meta analysis the immunological and the microbiological findings that were therefore analysed only descriptively.

CONCLUSIONS

The use of probiotics as an adjunct to NSPT in patients with periodontitis appears to provide additional clinical benefits that depend on the duration, the frequency, the form and the strain of probiotic used.

CLINICAL SIGNIFICANCE

This review not only shows data on the efficacy of probiotics in non-surgical periodontal therapy, but provides important information on their effects over time and which forms of probiotic administration might be most clinically useful.

引言/目的：益生菌已被提议作为非手术牙周治疗（NSPT）的辅助手段，然而，其使用效果仍不明确。本系统评价和荟萃分析的目的是在临床、微生物学和免疫学水平上分析关于益生菌作为牙周炎患者NSPT辅助手段的证据。

数据/来源：进行了全面检索，以确定调查益生菌作为牙周炎患者NSPT辅助手段的临床研究。数据根据益生菌菌株、服用频率、形式和持续时间进行分组。

研究选择

共纳入25篇文章，所有文章均分析了临床参数，10篇还纳入了微生物学结果，只有4篇有免疫学结果。当益生菌为含片形式、每天服用两次且菌株为[具体菌株未给出]时，试验组和对照组之间的探诊深度（PD）差异具有统计学意义，有利于试验组。就临床附着水平（CAL）改善而言，短期和中期差异具有统计学意义，但长期无差异。由于数据的异质性，无法通过荟萃分析比较免疫学和微生物学结果，因此仅对其进行描述性分析。