合生元和后生元补充剂对龋齿和牙周疾病的影响——一项综述
Effect of Synbiotic and Postbiotic Supplements on Dental Caries and Periodontal Diseases-A Comprehensive Review.
作者信息
Twetman Svante, Belstrøm Daniel
机构信息
Department of Odontology, Section for Clinical Oral Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Alle' 20, 2200 Copenhagen, Denmark.
出版信息
Int J Environ Res Public Health. 2025 Jan 8;22(1):72. doi: 10.3390/ijerph22010072.
Caries and periodontitis affect a significant part of the global population. Regular oral hygiene, sugar restriction, and fluoride exposure are the main avenues for the maintenance of oral health, but the adjunctive use of prebiotics and probiotic bacteria has gained attention over the past decades. The microbial and clinical effects of these biological interventions have been thoroughly covered in systematic reviews. However, the combination of prebiotics and probiotics (synbiotics) may boost the clinical benefits, and postbiotics, being inanimate microorganisms, can, when added to oral hygiene products, offer a sustainable option. The aim of this narrative review was to summarize clinical trials on the adjunctive use of synbiotics and postbiotics in the prevention and management of dental caries, gingivitis, and periodontitis. We searched two databases (PubMed and Google Scholar) for relevant literature, and we identified 17 relevant papers, five on dental caries and 12 with periodontal endpoints. We found emerging evidence of low certainty that lozenges/tablets containing synbiotics or postbiotics could reduce caries incidence in preschool and schoolchildren in comparison with standard preventive care. The effect on adult patients with plaque-induced gingivitis was less consistent. For adults with periodontitis, the adjunctive use of synbiotic and postbiotic products seemed to enhance the outcome of conventional scaling and root planning. In conclusion, both dental caries and periodontitis are non-communicable diseases, closely associated with an unbalanced oral biofilm, and the application of microbial modulators, including synbiotics and postbiotics, display promising beneficial effects and warrant further research.
龋齿和牙周炎影响着全球相当一部分人口。定期口腔卫生护理、限制糖分摄入以及接触氟化物是维持口腔健康的主要途径,但在过去几十年里,益生元与益生菌的辅助使用也受到了关注。这些生物干预措施的微生物学和临床效果已在系统评价中得到充分阐述。然而,益生元与益生菌的组合(合生元)可能会增强临床益处,而后生元作为无生命的微生物,添加到口腔卫生产品中时可提供一种可持续的选择。本叙述性综述的目的是总结关于合生元和后生元辅助用于预防和管理龋齿、牙龈炎和牙周炎的临床试验。我们在两个数据库(PubMed和谷歌学术)中搜索相关文献,共确定了17篇相关论文,其中5篇关于龋齿,12篇以牙周病为终点。我们发现,与标准预防护理相比,含有合生元或后生元的含片/片剂可降低学龄前儿童和学龄儿童龋齿发病率,但证据的确定性较低。对菌斑性牙龈炎成年患者的影响则不太一致。对于患有牙周炎的成年人,辅助使用合生元和后生元产品似乎能提高传统洗牙和根面平整的效果。总之,龋齿和牙周炎都是非传染性疾病,与口腔生物膜失衡密切相关,应用包括合生元和后生元在内的微生物调节剂显示出有前景的有益效果,值得进一步研究。