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Influências dos probióticos na saúde oral
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Abstract(s)
Contextualização: A cavidade oral é um ecossistema dinâmico, com mudanças ambientais e interações permanentes em que o microbioma comensal limita a colonização dos microrganismos patogénicos. A disbiose do microbioma oral está frequentemente associada a doenças orais de que são exemplos a cárie, a periodontite e a endodontite. Nestes casos pode ser necessário o recurso ao tratamento com antibióticos e/ou antissépticos. Infelizmente, tem-se observado um aumento da resistência bacteriana aos antibióticos e é necessário procurar alternativas a estes agentes. Os probióticos podem oferecer resultados encorajadores na prevenção, tratamento de doenças orais e manutenção da saúde oral. Objetivo: Esta revisão sistemática foi elaborada como objetivo de procurar obter comprovação científica, ou não, dos benefícios dos probióticos na saúde oral para definir a utilidade dos probióticos na prática da medicina dentária. Métodos: O método de pesquisa bibliográfica em bases de dados eletrónicas (PubMed, ClinicalTrials.gov, ScienceDirect, Google Scholar, B-on, SciELO) para identificação de estudos apoiou-se nos critérios PICOS. Foram incluídos ensaios clínicos randomizados em crianças, adultos e idosos em que a ingestão de probióticos foi comparada com placebo ou outra intervenção. Resultados: B. animalis subsp. lactis DN-173010 melhorou os parâmetros clínicos periodontais (P<0,001) no caso da saúde gengival. L. reuteri teve um efeito antimicrobiano (P=0,03) no caso da gengivite. B.animalis subsp. lactis HN019 e L. reuteri permitiram uma redução da PD no caso da periodontite crónica (P<0,05). L. paracasei SD1 permitiu uma redução da contagem de S. mutans (P=0,016). L. salivarius WB21 diminui os níveis de VCS (P=0,002), L. reuteri reduziu a contagem de Candida spp. (P<0,05). L. brevis CD2 contribuiu para atenuar a mucosite oral e melhorar a qualidade de vida de pacientes submetidos a quimio-radioterapia. Conclusão: Não obstante os resultados promissores obtidos nalguns estudos com alguns agentes probióticos orais, a tecnologia probiótica ainda é pouco utilizada a nível oral devido a falta de evidências científicas, heterogeneidade e disparidade nos resultados. Implicação: Para que os probióticos representam uma terapia inovadora, atraente e segura para prevenir, manter, controlar e tratar as condições orais diversas é necessário que ensaios clínicos randomizados de longo prazo com tamanho de amostra maior devem ser realizados, de modo a determinar os veículos mais apropriados, as estirpes mais eficazes e as dosagens e frequência de administração adequadas. Número de registo: N/A.
Background: The oral cavity is a dynamic ecosystem, with environmental changes and permanent interactions in which the commensal microbiome limits the colonization of pathogenic microorganisms. Dysbiosis of the oral microbiome is often associated with oral diseases such as caries, periodontitis and endodontitis. In these cases antibiotic and / or antiseptic treatment may be necessary. Unfortunately, there has been an increase in bacterial resistance to antibiotics and it is necessary to look for alternatives to these agents. Probiotics can offer encouraging results in the prevention, treatment of oral diseases and maintenance of oral health. Objective: This systematic review was designed to obtain scientific evidence of the benefits of probiotics in oral health in order to define the usefulness of probiotics in dental practice. Methods: The method of bibliographic search in electronic databases (PubMed, ClinicalTrials.gov, ScienceDirect, Google Scholar, B-on, SciELO) to identify studies was based on the PICOS criteria. Randomized clinical trials were included in children, adults and the elderly in which probiotic ingestion was compared with placebo or other intervention. Result: B. animalis subsp. lactis DN-173010 improved peridontal clinical criteria (P<0,001) in case of gengival health. L. reuteri had na antimicrobial effect (P=0,03) in case of gengivitis. B. animalis subsp. lactis HN019 and L. reuteri participated in the reduction of PD in cases of chronic periodontitis (P<0,05). L.paracasei SD1 participated in the reduction of the S. mutans count (P=0,016). L.salivarius WB21 reduced VCS levels (P=0,002), L. reuteri reduced the count of Candida spp. (P<0,05). L. brevis CD2 contributed to eased the oral mucositis and improve the quality of life of patients submitted to the chemo-radioterapy. Limitations: In the moment that the studies are heterogeneous, comparisons between trials are very limited, which make it difficult to perform meta-analysis. Conclusion: Notwithstanding the promising results obtained in some studies with some oral probiotic agents, probiotic technology is still poorly used at the oral level due to lack of scientific evidence, heterogeneity and disparity in results. Implication: For probiotics to represent an innovative, attractive and safe therapy to prevent, maintain, control and treat diverse oral conditions it is necessary that long-term randomized clinical trials with larger sample size should be performed in order to determine the vehicles most appropriate strains, the most effective strains and the appropriate dosages and frequency of administration. Registration number: N/A.
Background: The oral cavity is a dynamic ecosystem, with environmental changes and permanent interactions in which the commensal microbiome limits the colonization of pathogenic microorganisms. Dysbiosis of the oral microbiome is often associated with oral diseases such as caries, periodontitis and endodontitis. In these cases antibiotic and / or antiseptic treatment may be necessary. Unfortunately, there has been an increase in bacterial resistance to antibiotics and it is necessary to look for alternatives to these agents. Probiotics can offer encouraging results in the prevention, treatment of oral diseases and maintenance of oral health. Objective: This systematic review was designed to obtain scientific evidence of the benefits of probiotics in oral health in order to define the usefulness of probiotics in dental practice. Methods: The method of bibliographic search in electronic databases (PubMed, ClinicalTrials.gov, ScienceDirect, Google Scholar, B-on, SciELO) to identify studies was based on the PICOS criteria. Randomized clinical trials were included in children, adults and the elderly in which probiotic ingestion was compared with placebo or other intervention. Result: B. animalis subsp. lactis DN-173010 improved peridontal clinical criteria (P<0,001) in case of gengival health. L. reuteri had na antimicrobial effect (P=0,03) in case of gengivitis. B. animalis subsp. lactis HN019 and L. reuteri participated in the reduction of PD in cases of chronic periodontitis (P<0,05). L.paracasei SD1 participated in the reduction of the S. mutans count (P=0,016). L.salivarius WB21 reduced VCS levels (P=0,002), L. reuteri reduced the count of Candida spp. (P<0,05). L. brevis CD2 contributed to eased the oral mucositis and improve the quality of life of patients submitted to the chemo-radioterapy. Limitations: In the moment that the studies are heterogeneous, comparisons between trials are very limited, which make it difficult to perform meta-analysis. Conclusion: Notwithstanding the promising results obtained in some studies with some oral probiotic agents, probiotic technology is still poorly used at the oral level due to lack of scientific evidence, heterogeneity and disparity in results. Implication: For probiotics to represent an innovative, attractive and safe therapy to prevent, maintain, control and treat diverse oral conditions it is necessary that long-term randomized clinical trials with larger sample size should be performed in order to determine the vehicles most appropriate strains, the most effective strains and the appropriate dosages and frequency of administration. Registration number: N/A.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Probióticos Prática dentária Saúde oral Doenças orais Microbiota oral