正畸患者固定矫治器佩戴中，白色斑点病变发展过程中的预处理口腔微生物组分析及唾液 Stephan 曲线动力学：一项初步研究。

Pre-treatment oral microbiome analysis and salivary Stephan curve kinetics in white spot lesion development in orthodontic patients wearing fixed appliances. A pilot study.

机构信息

School of Dentistry, University of Alberta, Edmonton, AB, T6G 2E1, Canada.

Division of Periodontology, School of Dentistry, University of Alberta, Edmonton, AB, T6G 2E1, Canada.

出版信息

BMC Oral Health. 2023 Apr 24;23(1):239. doi: 10.1186/s12903-023-02917-z.

DOI:10.1186/s12903-023-02917-z

PMID:37095478

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10127078/

Abstract

BACKGROUND

White spot lesions (WSLs) are a formidable challenge during orthodontic treatment, affecting patients regardless of oral hygiene. Multifactorial in nature, amongst potential contributors to their development are the microbiome and salivary pH. The aim of our pilot study is to determine if pre-treatment differences in salivary Stephan curve kinetics and salivary microbiome features correlate with WSL development in orthodontic patients with fixed appliances. We hypothesize that non-oral hygiene determined differences in saliva could be predictive of WSL formation in this patient population through analysis of salivary Stephan curve kinetics, and that these differences would further manifest as changes in the oral microbiome.

METHODS

In this prospective cohort study, twenty patients with initial simplified oral hygiene index scores of "good" that were planning to undergo orthodontic treatment with self-ligating fixed appliances for at least 12 months were enrolled. At pre-treatment stage, saliva was collected for microbiome analysis, and at 15-minute intervals after a sucrose rinse over 45 min for Stephan curve kinetics.

RESULTS

50% of patients developed a mean 5.7 (SEM: 1.2) WSLs. There were no differences in saliva microbiome species richness, Shannon alpha diversity or beta diversity between the groups. Capnocytophaga sputigena exclusively and Prevotella melaninogenica predominantly were found in WSL patients, while Streptococcus australis was negatively correlated with WSL development. Streptococcus mitis and Streptococcus anginosus were primarily present in healthy patients. There was no evidence to support the primary hypothesis.

CONCLUSIONS

While there were no differences in salivary pH or restitution kinetics following a sucrose challenge and no global microbial differences in WSL developers, our data showed change in salivary pH at 5 min associated with an abundance of acid-producing bacteria in saliva. The results suggest salivary pH modulation as a management strategy to inhibit the abundance of caries initiators. Our study may have uncovered the earliest predecessors to WSL/caries development.

摘要

背景

白点病（WSL）是正畸治疗中的一个难题，无论患者的口腔卫生状况如何，都会受到影响。这种疾病具有多因素特性，其潜在的发病因素包括微生物组和唾液 pH 值。本研究旨在确定正畸固定矫治患者中，治疗前唾液 Stephan 曲线动力学和唾液微生物组特征的差异是否与 WSL 的发展相关。我们假设，通过分析唾液 Stephan 曲线动力学，非口腔卫生决定的唾液差异可能对该患者群体中 WSL 的形成具有预测性，并且这些差异将进一步表现为口腔微生物组的变化。

方法

在这项前瞻性队列研究中，纳入了 20 名初始简化口腔卫生指数评分“良好”、计划接受自锁固定矫治器治疗至少 12 个月的患者。在治疗前阶段，收集唾液进行微生物组分析，并在 45 分钟内每隔 15 分钟用蔗糖冲洗一次，以进行 Stephan 曲线动力学分析。

结果

50%的患者出现了平均 5.7（SEM：1.2）个 WSL。两组间的唾液微生物组物种丰富度、Shannon 多样性或β多样性均无差异。WSL 患者中仅发现 Capnocytophaga sputigena 和 Prevotella melaninogenica 占主导地位，而 Streptococcus australis 与 WSL 的发展呈负相关。Streptococcus mitis 和 Streptococcus anginosus 主要存在于健康患者中。这一结果不支持主要假设。