Center of Dental Research, Member of the interdisciplinary team for the care of patients with CLP, Faculty of Dentistry, Pontificia Universidad Javeriana, Bogotá, DC, Colombia.
Pediatric Dentistry, Faculty of Dentistry, Pontificia Universidad Javeriana, Bogotá, DC, Colombia.
Clin Oral Investig. 2024 Apr 8;28(5):245. doi: 10.1007/s00784-024-05624-3.
OBJECTIVE: To identify the characteristics of the oral microbiota and the relationship of the dental caries and periodontal status in patients aged 0 to 18 years with non-syndromic cleft lip and palate (CLP). MATERIALS AND METHODS: A systematic review of the literature was carried out. Five databases were consulted, including publications in English, Spanish and Portuguese. The evaluations of the quality of the observational studies and the experimental studies were carried out with the Newcastle-Ottawa scale and CONSORT guidelines, respectively. The risk of bias of the studies was determined using Rev Manager 5.4, and 5 publications were meta-analyzed. RESULTS: The cariogenic microbiota of children and adolescents with cleft lip and palate was similar to that of children without clefts, although with higher counts of Streptococcus mutans and Lactobacillus spp. The periodontopathogenic microbiota was related to the presence of Campylobacter spp, Fusobacterium spp, Fusobacterium nucleatum, Prevotella intermedia/nigrescens, Parvimonas micra and Porphyromonas gingivalis, considered microorganisms with high pathogenic capacity. Heterogeneity was shown in relation to the microbiota and the type of fissure, presenting numerous microorganisms associated with the pre- and post-surgical condition (cheilorrhaphy and palatorrhaphy) such as Staphylococcus aureus, Streptococcus beta hemolyticus, Klebsiella pneumoniae and Klebsiella oxytoca, Moraxella catarrhalis, Candida spp, Candida albicans, Candida krusei and Candida tropicalis. The meta-analysis revealed that patients with cleft lip and palate were 2.03 times more likely to have caries than the control group (p<0.005). CONCLUSION: In the microbiota, there was a great diversity of microorganisms that can vary according to the type of fissure and surgical interventions predisposing patients to a greater probability of dental caries, it is important to take into account the technique used to describe the oral microbiota in order to be able to compare the different studies. CLINICAL RELEVANCE: Studying the microbiota and the relationship of dental caries and periodontal status in children and adolescents with cleft lip and palate can facilitate the comprehensive care of patients with these conditions.
目的:确定非综合征性唇腭裂(CLP)0-18 岁患者口腔微生物群的特征,以及龋齿和牙周状况的关系。
材料和方法:进行了系统的文献回顾。检索了五个数据库,包括英文、西班牙文和葡萄牙文的出版物。使用纽卡斯尔-渥太华量表和 CONSORT 指南分别评估观察性研究和实验研究的质量。使用 RevMan 5.4 确定研究的偏倚风险,并对 5 篇文献进行了荟萃分析。
结果:唇腭裂患儿的致龋微生物群与无腭裂患儿相似,但变形链球菌和乳酸杆菌的数量较高。牙周病微生物群与弯曲杆菌、梭杆菌属、核梭杆菌、中间普氏菌/黑普氏菌、小韦荣球菌和牙龈卟啉单胞菌的存在有关,这些被认为是具有高致病性的微生物。关于微生物群和裂隙类型,存在异质性,有许多与术前和术后条件(唇裂修复术和腭裂修复术)相关的微生物,如金黄色葡萄球菌、β 溶血性链球菌、肺炎克雷伯菌和产酸克雷伯菌、卡他莫拉菌、假丝酵母菌属、白色假丝酵母菌、近平滑假丝酵母菌和热带假丝酵母菌。荟萃分析显示,唇腭裂患者发生龋齿的可能性是对照组的 2.03 倍(p<0.005)。
结论:在微生物群中,存在着多样性的微生物,它们可以根据裂隙的类型和手术干预而变化,使患者更容易发生龋齿,因此,重要的是要考虑用于描述口腔微生物群的技术,以便能够比较不同的研究。
临床意义:研究唇腭裂患儿的微生物群以及龋齿和牙周状况的关系,可以促进对这些患者的全面护理。
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