使用牙膏对龈下微生物群的影响：一项初步随机临床试验。

Impact of toothpaste use on the subgingival microbiome: a pilot randomized clinical trial.

作者信息

Iniesta Margarita, Vasconcelos Viviane, Laciar Florencia, Matesanz Paula, Sanz Mariano, Herrera David

机构信息

ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, School of Dentistry, Complutense University of Madrid, Plaza Ramón y Cajal S/N (Ciudad Universitaria), 28040, Madrid, Spain.

Department of Dental Clinic Specialties, School of Dentistry, Section of Graduate Periodontology, Complutense University of Madrid, Madrid, Spain.

出版信息

BMC Oral Health. 2025 May 30;25(1):854. doi: 10.1186/s12903-025-06159-z.

DOI:10.1186/s12903-025-06159-z

PMID:40448072

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12125941/

Abstract

BACKGROUND

The subgingival microbiome plays a key role in the gingivitis development, but the impact of toothbrushing with toothpaste on the subgingival microbial composition is not well understood. Therefore, this study aimed to evaluate the microbiological safety and subgingival impact of a toothpaste containing CPC and cymenol, compared to a fluoride-based toothpaste, and assessed overall subgingival microbiome changes after 6 weeks of routine toothbrushing in patients with gingival inflammation.

METHODS

A 6-week randomized clinical trial was conducted in patients with gingival inflammation allocated to the use of either a toothpaste with cetylpyridinium chloride and cymenol or a toothpaste with sodium monofluorophosphate. Subgingival samples were collected at baseline and after 6 weeks and processed using high-throughput sequencing technology (Miseq®). Diversity metrics were calculated and the microbiome composition was analyzed using PERMANOVA, ANOSIM and PERMDISP.

RESULTS

A total of 116 samples from 60 patients were analyzed. No significant changes in diversity were observed in either group after 6 weeks. Among taxa with > 1% abundance, the toothpaste with cetylpyridinium chloride and cymenol exhibited a higher reduction in Aggregatibacter (p = 0.023) and a significant decrease in Fusobacterium nucleatum (p = 0.030), while the toothpaste with sodium monofluorophosphate showed a significant increase in the phylum Firmicutes (p = 0.033). The relative abundance of Porphyromonas gingivalis, Prevotella intermedia and Tannerella forsythia were not affected by either toothpaste (p > 0.05).

CONCLUSIONS

The daily use of a CPC/cymenol toothpaste was microbiologically safe, with no negative effects on the composition of the subgingival microbiome in patients with gingival inflammation, when compared to a fluoride-based toothpaste. The overall composition of the subgingival microbiome was not significantly affected by the daily use of either toothpaste after 6 weeks. In both groups, the observed changes affected mainly the low-abundance taxa.

TRIAL REGISTRATION

Registration Number: ISRCTN17497809; Registration Date: 12/07/2023 (ISRCTN.org).

摘要

背景

龈下微生物群在牙龈炎的发展中起关键作用，但含牙膏刷牙对龈下微生物组成的影响尚不清楚。因此，本研究旨在评估与含氟牙膏相比，含西吡氯铵和对异丙基甲苯酚的牙膏的微生物安全性和对龈下的影响，并评估牙龈炎症患者在常规刷牙6周后龈下微生物群的总体变化。

方法

对患有牙龈炎症的患者进行了一项为期6周的随机临床试验，这些患者被分配使用含十六烷基氯化吡啶和对异丙基甲苯酚的牙膏或含单氟磷酸钠的牙膏。在基线和6周后采集龈下样本，并使用高通量测序技术（Miseq®）进行处理。计算多样性指标，并使用PERMANOVA、ANOSIM和PERMDISP分析微生物群组成。

结果

共分析了来自60名患者的116个样本。6周后两组的多样性均未观察到显著变化。在丰度>1%的分类群中，含十六烷基氯化吡啶和对异丙基甲苯酚的牙膏对伴放线聚集杆菌的减少幅度更大（p = 0.023），具核梭杆菌显著减少（p = 0.030），而含单氟磷酸钠的牙膏在厚壁菌门中显著增加（p = 0.033）。牙龈卟啉单胞菌、中间普氏菌和福赛坦纳菌的相对丰度不受任何一种牙膏的影响（p>0.05）。