D'Agostino Silvia, Dolci Marco
Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio, 66100 Chieti, Italy.
Microorganisms. 2025 May 20;13(5):1158. doi: 10.3390/microorganisms13051158.
This systematic review critically evaluates the efficacy of enzyme- and protein-containing toothpastes in augmenting saliva's inherent protective mechanisms. Adhering to PRISMA guidelines and having been registered under PROSPERO (CRD42024558854), a comprehensive literature search was conducted across PubMed, Web of Science, and Scopus, employing a PICO-structured query with the MeSH terms "enzymes", "proteins", and "toothpaste". The inclusion criteria were restricted to in vivo human studies, published in English within the last 10 years, assessing the gingival effects of these toothpastes. Risk of bias was assessed using the Cochrane RoB 2.0 for randomized controlled trials (RCTs) and ROBINS-I for non-randomized controlled trials (N-RCTs). From an initial pool of 62 articles, three studies met the inclusion criteria: two RCTs exhibiting low to medium risk of bias and one N-RCT with low risk of bias. The analysis suggests that enzyme- and protein-enriched toothpastes may contribute to improved gingival health following 12 weeks and 12 months of use. However, the hypothesized effect against extrinsic black stains was not substantiated within the selected studies. These findings, while promising, are constrained by the limited number of included studies, necessitating further investigations to validate these observations and explore the broader implications of enzyme- and protein-based oral care formulations.
本系统评价批判性地评估了含酶和含蛋白质牙膏增强唾液固有保护机制的功效。遵循PRISMA指南并已在PROSPERO（CRD42024558854）注册，通过使用带有医学主题词“酶”、“蛋白质”和“牙膏”的PICO结构化查询，在PubMed、科学网和Scopus上进行了全面的文献检索。纳入标准仅限于过去10年内以英文发表的人体体内研究，评估这些牙膏对牙龈的影响。使用Cochrane RoB 2.0评估随机对照试验（RCT）的偏倚风险，使用ROBINS-I评估非随机对照试验（N-RCT）的偏倚风险。从最初的62篇文章中，有三项研究符合纳入标准：两项RCT显示出低至中度的偏倚风险，一项N-RCT显示出低偏倚风险。分析表明，使用12周和12个月后，富含酶和蛋白质的牙膏可能有助于改善牙龈健康。然而，在所选研究中，针对外源性黑斑的假设效果并未得到证实。这些发现虽然很有前景，但受到纳入研究数量有限的限制，需要进一步调查以验证这些观察结果，并探索基于酶和蛋白质的口腔护理配方的更广泛影响。
