Effectiveness of probiotics in the prevention of carious lesions during treatment with fixed orthodontic appliances.
Abstract
The difficulty experienced by patients with fixed orthodontic appliances in maintaining adequate oral hygiene poses a risk for dental caries. The use of probiotics has been proposed as a means of prevention. The following systematic review aims to determine the effectiveness of probiotics in the prevention of dental caries during treatment with fixed orthodontic appliances. This review was carried out according to the PRISMA guidelines. A comprehensive electronic search was conducted in the Cochrane Library, EMBASE, PubMed and Google Scholar Beta databases. The inclusion criteria included randomized controlled clinical trials involving the use of probiotics, caries and patients under fixed orthodontic treatment. The methodological quality of the articles was evaluated according to risk of bias. Of the five included studies, three reported significant differences compared to the control group. Of the others, one article reported significant decrease in the final count of microorganisms compared to the beginning of treatment. Only one study reported no differences of any kind. It was estimated that the eligible studies were of moderate methodological quality and had an unclear risk of bias, without affecting key domains for the research. It is concluded that the daily consumption of probiotics can be effective in the prevention of carious lesions in patients under fixed orthodontic treatment. However, this should be interpreted with caution and corroborated by clinical trials of better methodological quality.References
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28. Yli-Knuuttila H, Snäll J, Kari K, Meurman JH. Colonization of Lactobacillus rhamnosus GG in the oral cavity. Oral Microbiol Immunol. 2006;21(2):129–31.
29. Legéňová K, Bujdáková H. [The role of Streptococcus mutans in the oral biofilm]. Epidemiol Mikrobiol Imunol. 2015;64(4):179–87.
30. Shukla C, Maurya R, Singh V, Tijare M. Evaluation of role of fixed orthodontics in changing oral ecological flora of opportunistic microbes in children and adolescent. J Indian Soc Pedod Prev Dent. 2017;35(1):34–40.
31. Shukla C, Maurya RK, Singh V, Tijare M. Evaluation of changes in Streptococcus mutans colonies in microflora of the Indian population with fixed orthodontics appliances. Dent Res J. 2016;13(4):309–14.
32. Parisotto TM, Steiner-Oliveira C, Silva CM, Rodrigues LK, Nobre-dos-Santos M. Early childhood caries and mutans streptococci: a systematic review. Oral Health Prev Dent. 2010;8(1):59–70.
33. Willmot D. White spot lesions after orthodontic treatment. Semin Orthod. 2008;14:209–19.
34. Wu CC, Lin CT, Wu CY, Peng WS, Lee MJ, Tsai YC. Inhibitory effect of Lactobacillus salivarius on Streptococcus mutans biofilm formation. Mol Oral Microbiol. 2015;30(1):16–26.
35. Lee SH, Kim YJ. A comparative study of the effect of probiotics on cariogenic biofilm model for preventing dental caries. Arch Microbiol. 2014;196(8):601–9.
36. Cagetti MG, Mastroberardino S, Milia E, Cocco F, Lingström P, Campus G. The use of probiotic strains in caries prevention: a systematic review. Nutrients. 2013;5(7):2530–50.
37. Chinnappa A, Konde H, Konde S, Raj S, Beena JP. Probiotics for future caries control: a short-term clinical study. Indian J Dent Res. 2013;24(5):547–9.
38. Iqbal MZ, Qadir MI, Hussain T, Janbaz KH, Khan YH, Ahmad B. Review: probiotics and their beneficial effects against various diseases. Pak J Pharm Sci. 2014;27(2):405–15.
39. Laleman I, Detailleur V, Slot DE, Slomka V, Quirynen M, Teughels W. Probiotics reduce mutans streptococci counts in humans: a systematic review and meta-analysis. Clin Oral Investig. 2014;18(6):1539–52.
40. Simark-Mattsson C, Emilson CG, Håkansson EG, Jacobsson C, Roos K, Holm S. Lactobacillus-mediated interference of mutans streptococci in caries-free vs. caries-active subjects. Eur J Oral Sci. 2007;115(4):308–14.
41. Ahmed A, Dachang W, Lei Z, Jianjun L, Juanjuan Q, Yi X. Effect of Lactobacillus species on Streptococcus mutans biofilm formation. Pak J Pharm Sci. 2014;27(5 Spec no):1523–8.
42. Haukioja A. Probiotics and oral health. Eur J Dent. 2010;4(3):348–55.
43. Maukonen J, Mättö J, Suihko ML, Saarela M. Intra-individual diversity and similarity of salivary and faecal microbiota. J Med Microbiol. 2008;57(Pt 12):1560–8.
44. Kour S, Verma VK, Sachan A, Singh K, Arora A, Kaur G. Role of Probiotics in Orthodontics. Rama Univ J Dent Sci. 2015;2(3):26–31.
45. Chaturvedi S, Jain U. Importance of Probiotics in Orthodontics. J Orofacial Res. 2015;5(3):99–103.
46. Hoorizad M, Mirhashemi route M, Rahpeyma R, Salehi M, Zavareian S. Effect of probiotic yoghurt on the salivary PH of orthodontic patients- A clinical trial study. J Res Dent Sci. 2013;10(3):155–9.
47. Reema SD, Lahiri PK, Roy SS. Review of casein phosphopeptides-amorphous calcium phosphate. Chin J Dent Res. 2014;17(1):7–14.
48. Cochrane NJ, Cai F, Huq NL, Burrow MF, Reynolds EC. New approaches to enhanced remineralization of tooth enamel. J Dent Res. 2010;89(11):1187–97.
49. Li J, Xie X, Wang Y, Yin W, Antoun JS, Farella M, Mei L. Long-term remineralizing effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on early caries lesions in vivo: a systematic review. J Dent. 2014;42(7):769–77.
50. Jiang S, Chen S, Zhang C, Zhao X, Huang X, Cai Z. Effect of the Biofilm Age and Starvation on Acid Tolerance of Biofilm Formed by Streptococcus mutans Isolated from Caries-Active and Caries-Free Adults. Int J Mol Sci. 2017;18(4):pii:E713.
51. Preshaw PM, Henne K, Taylor JJ, Valentine RA, Conrads G. Age-related changes in immune function (immune senescence) in caries and periodontal diseases: a systematic review. J Clin Periodontol. 2017;44(Suppl 18):S153–S177.
52. Lopatiene K, Borisovaite M, Lapenaite E. Prevention and Treatment of White Spot Lesions During and After Treatment with Fixed Orthodontic Appliances: a Systematic Literature Review. J Oral Maxillofac Res. 2016;7(2):e1.
53. O’Brien-Simpson NM, Burgess K, Lenzo JC, Brammar GC, Darby IB, Reynolds EC. Rapid Chair-Side Test for Detection of Porphyromonas gingivalis. J Dent Res. 2017;96(6):618–25.
54. Kuribayashi M, Kitasako Y, Matin K, Sadr A, Shida K, Tagami J. Intraoral pH measurement of carious lesions with qPCR of cariogenic bacteria to differentiate caries activity. J Dent. 2012;40(3):222–8.
2. Pithon MM, Sant’Anna LI, Baião FC, dos Santos RL, Coqueiro Rda S, Maia LC. Assessment of the effectiveness of mouthwashes in reducing cariogenic biofilm in orthodontic patients: a systematic review. J Dent. 2015;43(3):297–308.
3. Migliorati M, Isaia L, Cassaro A, Rivetti A, Silvestrini-Biavati F, Gastaldo L, Piccardo I, Dalessandri D, Silvestrini-Biavati A. Efficacy of professional hygiene and prophylaxis on preventing plaque increase in orthodontic patients with multibracket appliances: a systematic review. Eur J Orthod. 2015;37(3):297–307.
4. Zharmagambetova A, Tuleutayeva S, Akhmetova S, Zharmagambetov A. Microbiological aspects of the orthodontic treatment. Georgian Med News. 2017;(264):39–43.
5. Ata-Ali F, Ata-Ali J, Ferrer-Molina M, Cobo T, De Carlos F, Cobo J. Adverse effects of lingual and buccal orthodontic techniques: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop. 2016;149(6):820–9.
6. Khoroushi M, Kachuie M. Prevention and Treatment of White Spot Lesions in Orthodontic Patients. Contemp Clin Dent. 2017;8(1):11–9.
7. Zabokova-Bilbilova E, Popovska L, Kapusevska B, Stefanovska E. White spot lesions: prevention and management during the orthodontic treatment. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2014;35(2):161–8.
8. Sundararaj D, Venkatachalapathy S, Tandon A, Pereira A. Critical evaluation of incidence and prevalence of white spot lesions during fixed orthodontic appliance treatment: A meta-analysis. J Int Soc Prev Community Dent. 2015;5(6):433–9.
9. Morrier JJ. [White spot lesions and orthodontic treatment. Prevention and treatment]. Orthod Fr. 2014;85(3):235–44.
10. Meeran NA. Iatrogenic possibilities of orthodontic treatment and modalities of prevention. J Orthod Sci. 2013;2(3):73–86.
11. Benson PE, Parkin N, Dyer F, Millett DT, Furness S, Germain P. Fluorides for the prevention of early tooth decay (demineralised white lesions) during fixed brace treatment. Cochrane Database Syst Rev. 2013;12(12):CD003809.
12. Kim S, Katchooi M, Bayiri B, Sarikaya M, Korpak AM, Huang GJ. Predicting improvement of postorthodontic white spot lesions. Am J Orthod Dentofacial Orthop. 2016;149(5):625–33.
13. Giorgetti G, Brandimarte G, Fabiocchi F, Ricci S, Flamini P, Sandri G, Trotta MC, Elisei W, Penna A, Lecca PG, Picchio M, Tursi A. Interactions between Innate Immunity, Microbiota, and Probiotics. J Immunol Res. 2015;2015:501361.
14. Gungor OE, Kirzioglu Z, Kivanc M. Probiotics: can they be used to improve oral health? Benef Microbes. 2015;6(5):647–56.
15. Twetman S, Keller MK. Probiotics for caries prevention and control. Adv Dent Res. 2012;24(2):98–102.
16. Gruner D, Paris S, Schwendicke F. Probiotics for managing caries and periodontitis: Systematic review and meta-analysis. J Dent. 2016;48:16–25.
17. Flichy-Fernández AJ, Alegre-Domingo T, Peñarrocha-Oltra D, Peñarrocha-Diago M. Probiotic treatment in the oral cavity: an update. Med Oral Patol Oral Cir Bucal. 2010;15(5):e677–80.
18. Teanpaisan R, Piwat S, Dahlén G. Inhibitory effect of oral Lactobacillus against oral pathogens. Lett Appl Microbiol. 2011;53(4):452–9.
19. Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8(5):336–41.
20. Echevarria IM, Walker S. To make your case, start with a PICOT question. Nursing. 2014;44(2):18–9.
21. Cericato GO, Bittencourt MA, Paranhos LR. Validity of the assessment method of skeletal maturation by cervical vertebrae: a systematic review and meta-analysis. Dentomaxillofac Radiol. 2015;44(4):20140270.
22. Cildir SK, Germec D, Sandalli N, Ozdemir F, Arun T, Twetman S, Caglar E. Reduction of salivary mutans streptococci in orthodontic patients during daily consumption of yoghurt containing probiotic bacteria. Eur J Orthod. 2009;31(4):407–11.
23. Jose JE, Padmanabhan S, Chitharanjan AB. Systemic consumption of probiotic curd and use of probiotic toothpaste to reduce Streptococcus mutans in plaque around orthodontic brackets. Am J Orthod Dentofacial Orthop. 2013;144(1):67–72.
24. Ritthagol W, Saetang C, Teanpaisan R. Effect of Probiotics Containing Lactobacillus paracasei SD1 on Salivary Mutans Streptococci and Lactobacilli in Orthodontic Cleft Patients: A Double-Blinded, Randomized, Placebo-Controlled Study. Cleft Palate Craniofac J. 2014;51(3):257–63.
25. Pinto GS, Cenci MS, Azevedo MS, Epifanio M, Jones MH. Effect of yogurt containing Bifidobacterium animalis subsp . lactis DN-173010 probiotic on dental plaque and saliva in orthodontic patients. Caries Res. 2014;48(1):63–8.
26. Gizani S, Petsi G, Twetman S, Caroni C, Makou M, Papagianoulis L. Effect of the probiotic bacterium Lactobacillus reuteri on white spot lesion development in orthodontic patients. Eur J Orthod. 2016;38(1):85–9.
27. Meyer-Lueckel H, Paris S. When and How to Intervene in the Caries Process. Oper Dent. 2016;41(S7):S35–47. [PubMed]
28. Yli-Knuuttila H, Snäll J, Kari K, Meurman JH. Colonization of Lactobacillus rhamnosus GG in the oral cavity. Oral Microbiol Immunol. 2006;21(2):129–31.
29. Legéňová K, Bujdáková H. [The role of Streptococcus mutans in the oral biofilm]. Epidemiol Mikrobiol Imunol. 2015;64(4):179–87.
30. Shukla C, Maurya R, Singh V, Tijare M. Evaluation of role of fixed orthodontics in changing oral ecological flora of opportunistic microbes in children and adolescent. J Indian Soc Pedod Prev Dent. 2017;35(1):34–40.
31. Shukla C, Maurya RK, Singh V, Tijare M. Evaluation of changes in Streptococcus mutans colonies in microflora of the Indian population with fixed orthodontics appliances. Dent Res J. 2016;13(4):309–14.
32. Parisotto TM, Steiner-Oliveira C, Silva CM, Rodrigues LK, Nobre-dos-Santos M. Early childhood caries and mutans streptococci: a systematic review. Oral Health Prev Dent. 2010;8(1):59–70.
33. Willmot D. White spot lesions after orthodontic treatment. Semin Orthod. 2008;14:209–19.
34. Wu CC, Lin CT, Wu CY, Peng WS, Lee MJ, Tsai YC. Inhibitory effect of Lactobacillus salivarius on Streptococcus mutans biofilm formation. Mol Oral Microbiol. 2015;30(1):16–26.
35. Lee SH, Kim YJ. A comparative study of the effect of probiotics on cariogenic biofilm model for preventing dental caries. Arch Microbiol. 2014;196(8):601–9.
36. Cagetti MG, Mastroberardino S, Milia E, Cocco F, Lingström P, Campus G. The use of probiotic strains in caries prevention: a systematic review. Nutrients. 2013;5(7):2530–50.
37. Chinnappa A, Konde H, Konde S, Raj S, Beena JP. Probiotics for future caries control: a short-term clinical study. Indian J Dent Res. 2013;24(5):547–9.
38. Iqbal MZ, Qadir MI, Hussain T, Janbaz KH, Khan YH, Ahmad B. Review: probiotics and their beneficial effects against various diseases. Pak J Pharm Sci. 2014;27(2):405–15.
39. Laleman I, Detailleur V, Slot DE, Slomka V, Quirynen M, Teughels W. Probiotics reduce mutans streptococci counts in humans: a systematic review and meta-analysis. Clin Oral Investig. 2014;18(6):1539–52.
40. Simark-Mattsson C, Emilson CG, Håkansson EG, Jacobsson C, Roos K, Holm S. Lactobacillus-mediated interference of mutans streptococci in caries-free vs. caries-active subjects. Eur J Oral Sci. 2007;115(4):308–14.
41. Ahmed A, Dachang W, Lei Z, Jianjun L, Juanjuan Q, Yi X. Effect of Lactobacillus species on Streptococcus mutans biofilm formation. Pak J Pharm Sci. 2014;27(5 Spec no):1523–8.
42. Haukioja A. Probiotics and oral health. Eur J Dent. 2010;4(3):348–55.
43. Maukonen J, Mättö J, Suihko ML, Saarela M. Intra-individual diversity and similarity of salivary and faecal microbiota. J Med Microbiol. 2008;57(Pt 12):1560–8.
44. Kour S, Verma VK, Sachan A, Singh K, Arora A, Kaur G. Role of Probiotics in Orthodontics. Rama Univ J Dent Sci. 2015;2(3):26–31.
45. Chaturvedi S, Jain U. Importance of Probiotics in Orthodontics. J Orofacial Res. 2015;5(3):99–103.
46. Hoorizad M, Mirhashemi route M, Rahpeyma R, Salehi M, Zavareian S. Effect of probiotic yoghurt on the salivary PH of orthodontic patients- A clinical trial study. J Res Dent Sci. 2013;10(3):155–9.
47. Reema SD, Lahiri PK, Roy SS. Review of casein phosphopeptides-amorphous calcium phosphate. Chin J Dent Res. 2014;17(1):7–14.
48. Cochrane NJ, Cai F, Huq NL, Burrow MF, Reynolds EC. New approaches to enhanced remineralization of tooth enamel. J Dent Res. 2010;89(11):1187–97.
49. Li J, Xie X, Wang Y, Yin W, Antoun JS, Farella M, Mei L. Long-term remineralizing effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on early caries lesions in vivo: a systematic review. J Dent. 2014;42(7):769–77.
50. Jiang S, Chen S, Zhang C, Zhao X, Huang X, Cai Z. Effect of the Biofilm Age and Starvation on Acid Tolerance of Biofilm Formed by Streptococcus mutans Isolated from Caries-Active and Caries-Free Adults. Int J Mol Sci. 2017;18(4):pii:E713.
51. Preshaw PM, Henne K, Taylor JJ, Valentine RA, Conrads G. Age-related changes in immune function (immune senescence) in caries and periodontal diseases: a systematic review. J Clin Periodontol. 2017;44(Suppl 18):S153–S177.
52. Lopatiene K, Borisovaite M, Lapenaite E. Prevention and Treatment of White Spot Lesions During and After Treatment with Fixed Orthodontic Appliances: a Systematic Literature Review. J Oral Maxillofac Res. 2016;7(2):e1.
53. O’Brien-Simpson NM, Burgess K, Lenzo JC, Brammar GC, Darby IB, Reynolds EC. Rapid Chair-Side Test for Detection of Porphyromonas gingivalis. J Dent Res. 2017;96(6):618–25.
54. Kuribayashi M, Kitasako Y, Matin K, Sadr A, Shida K, Tagami J. Intraoral pH measurement of carious lesions with qPCR of cariogenic bacteria to differentiate caries activity. J Dent. 2012;40(3):222–8.
Published
2017-07-28
How to Cite
CONTRERAS, Paula et al.
Effectiveness of probiotics in the prevention of carious lesions during treatment with fixed orthodontic appliances..
Journal of Oral Research, [S.l.], v. 6, n. 7, p. 186-192, july 2017.
ISSN 0719-2479.
Available at: <https://joralres.com/index.php/JOralRes/article/view/joralres.2017.053>. Date accessed: 18 apr. 2024.
doi: https://doi.org/10.17126/joralres.2017.053.
Issue
Section
Reviews
Keywords
probiotics; caries; orthodontics.
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