Department of Medicine and Medical Specialties, Faculty of Health Sciences, University of Alcalá de Henares, Madrid, Spain.
Department of Surgery, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, Salamanca, Spain.
Front Immunol. 2024 Apr 15;15:1371072. doi: 10.3389/fimmu.2024.1371072. eCollection 2024.
Peri-implant diseases (peri-implant mucositis and peri-implantitis) are pathologies of an infectious-inflammatory nature of the mucosa around dental implants. Probiotics are microorganisms that regulate host immunomodulation and have shown positive results in the treatment of peri-implant diseases. The objective of the systematic review and meta-analysis was to evaluate the efficacy of probiotics in the treatment of peri-implant oral diseases.
According to the PRISMA guidelines, the research question was established: Are probiotics able to favorably modify clinical and immunological biomarkers determinants of peri-implant pathologies? and an electronic search of the databases MEDLINE/PubMed, Embase, Cochrane Central, Web of Science, (until December 2023) was performed. Inclusion criteria were established for intervention studies (RCTs), according to the PICOs strategy in subjects with peri-implant pathology (participants), treated with probiotics (intervention) compared to patients with conventional treatment or placebo (control) and evaluating the response to treatment (outcomes). Results- 1723 studies were obtained and 10 were selected. Risk of bias was assessed using the Cochrane Risk of Bias Tool and methodological quality using the Joanna Briggs Institute for RCTs. Two meta-analyses were performed, one to evaluate probiotics in mucositis and one for peri-implantitis. All subgroups were homogeneous (I0%), except in the analysis of IL-6 in mucositis (I65%). The overall effect was favorable to the experimental group in both pathologies. The analysis of the studies grouped in peri-implantitis showed a tendency to significance (p=0.09).
The use of probiotics, as basic or complementary treatment of peri-implant diseases, showed a statistically significant trend, but well-designed studies are warranted to validate the efficacy of these products in peri-implant pathologies.
种植体周围疾病（种植体周围黏膜炎和种植体周围炎）是一种发生于种植体周围黏膜的感染性炎症性疾病。益生菌是一种调节宿主免疫调节的微生物，已被证明在治疗种植体周围疾病方面具有积极效果。本系统评价和荟萃分析的目的是评估益生菌治疗种植体周围口腔疾病的疗效。
根据 PRISMA 指南，确立了研究问题：益生菌是否能够有利地改变种植体周围疾病的临床和免疫生物标志物决定因素？并对 MEDLINE/PubMed、Embase、Cochrane 中央、Web of Science 数据库（截至 2023 年 12 月）进行了电子检索。纳入标准为干预研究（RCT），根据 PICO 策略，将患有种植体周围疾病（参与者）的受试者分为益生菌（干预）组与接受常规治疗或安慰剂（对照组）的患者，并评估治疗反应（结局）。结果：共获得 1723 项研究，最终纳入 10 项。使用 Cochrane 偏倚风险工具评估偏倚风险，使用 Joanna Briggs 研究所的 RCT 方法评估方法学质量。进行了两项荟萃分析，一项用于评估黏膜炎中的益生菌，另一项用于评估种植体周围炎。除黏膜炎中 IL-6 的分析（I65%）外，所有亚组均具有同质性（I0%）。两种疾病中，实验组的总体效果均有利于实验组。在分组为种植体周围炎的研究分析中，显示出有统计学意义的趋势（p=0.09）。
作为种植体周围疾病的基本或补充治疗，使用益生菌显示出具有统计学意义的趋势，但需要进行设计良好的研究来验证这些产品在种植体周围疾病中的疗效。
