国际口腔医学杂志

国际口腔医学杂志 ›› 2020, Vol. 47 ›› Issue (5): 515-521.doi: 10.7518/gjkq.2020080

• 口腔微生态专栏 • 上一篇    下一篇

益生菌制剂在牙周病防治中的应用进展

郏乐铭1(),贾小玥2,杨燃2,周学东1,徐欣1()   

  1. 1.口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院牙体牙髓病科 成都 610041
    2.口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院儿童口腔科 成都 610041
  • 收稿日期:2020-01-05 修回日期:2020-04-02 出版日期:2020-09-01 发布日期:2020-09-16
  • 通讯作者: 徐欣
  • 作者简介:郏乐铭,硕士,Email: leming401@163.com
  • 基金资助:
    国家自然科学基金(81870754);国家自然科学基金(81800989);四川省科技厅资助项目(2018SZ0121)

Progress on the application of probiotics in the management of periodontal diseases

Jia Leming1(),Jia Xiaoyue2,Yang Ran2,Zhou Xuedong1,Xu Xin1()   

  1. 1.State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
    2.State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2020-01-05 Revised:2020-04-02 Online:2020-09-01 Published:2020-09-16
  • Contact: Xin Xu
  • Supported by:
    National Natural Science Foundation of China(81870754);National Natural Science Foundation of China(81800989);Program Funded by Science and Technology Department of Sichuan Province(2018SZ0121)

RichHTML

32

PDF (PC)

324

摘要：

牙周病是发生于牙周支持组织的常见口腔慢性感染性疾病,我国80%~90%的成年人罹患不同程度的牙周疾患。牙周病病因复杂,牙周微生态失衡及宿主免疫应答反应是导致牙周病发生发展的重要原因。牙周病的基础治疗以机械去除牙结石和牙菌斑为主,可以辅助全身及局部用药。近年来,由于口腔病原菌的频繁定植及口腔耐药菌的出现,许多针对牙周微生态调节及免疫调节的药物应运而生。益生菌制剂常用于调节肠道菌群失衡疾病,在治疗口腔感染性疾病中也展现出较好的应用前景。本文对益生菌制剂在牙周病治疗中的应用进展进行综述,为规范益生菌制剂在辅助治疗牙周病中的应用提供参考。

关键词: 牙周病, 益生菌制剂, 口腔微生态, 牙周微生态

Abstract:

Periodontal diseases, which can seriously damage the structures that surround the teeth, including gums, perio-dontal ligament, and alveolar bone, are the major causes of tooth loss among adults. Approximately 80%-90% of adults in China are suffering from different degrees of periodontal diseases. The etiology of periodontal diseases is complicated, but periodontal micro dysbiosis and abnormal host immune response are recognized as the important causes of these diseases. The basic treatment of these diseases includes the mechanical removal of calculus and plaque and systemic and topical medications. Several drugs that modulate periodontal microbial ecology and immune abnormality have emerged because of the re-colonization of oral pathogens and the incidence of antibacterial resistance. Probiotics have been used to address intestinal microbial dysbiosis, and their application in the treatment of oral infectious diseases has also been suggested. This article reviewed the progress on the research and application of probiotics in the treatment of periodontal diseases to provide a new paradigm for the ecological management of these diseases.

Key words: periodontal diseases, probiotics, oral microecology, periodontal microecology

中图分类号: 

  • R781.4

表 1

中国卫生健康委员会批准应用于人体的益生菌分类"

菌属 菌种名称
乳杆菌属 德氏乳杆菌（Lactobacillus delbrueckii）、短乳杆菌（Latobacillus brevis）、嗜酸乳杆菌（Lactobacillus acidophilus）、保加
利亚乳杆菌（Lactobacillus bulgaricus）、干酪乳杆菌（Lactobacillus casei）、发酵乳杆菌（Lactobacillus fermentium）、植
物乳杆菌（Lactobacillus plantarum）、鼠李糖乳杆菌（Lactobacillus rhamnosus）等
双歧杆菌属 青春双歧杆菌（Bifidobacterium adolescentis）、长双歧杆菌（Bifidobacterium longum）、短双歧杆菌（Bifidobacterium
breve）、嗜热双歧杆菌（Bifidobacterium thermophilum）、乳双歧杆菌（Bifidobacterium lactis）等
肠球菌属 粪肠球菌（Enterococcus faecalis）、屎肠球菌（Enterococcus faecium）等
链球菌属 嗜热链球菌（Streptococcus thermophilus）
芽孢杆菌属 枯草芽孢杆菌（Bacillus subtilis）、蜡样芽孢杆菌（Bacillus cereus）、地衣芽孢杆菌（Bacillus licheniformis）、凝结芽孢杆
菌（Bacillus coagulans）
梭菌属 酪酸梭菌（Clostridium butyricum）
酵母菌属 布拉酵母菌（Saccharomyces boulardii）

表 2

完全或部分证实可应用于口腔感染性疾病防治的益生菌种类"

菌种或菌属名称 作用机制或应用领域
唾液链球菌K12 拮抗口腔病原菌[19]
罗伊氏乳杆菌 抑制口腔病原菌黏附[20]
（Lactobacillus reuteri）
唾液链球菌M18 作用于口腔黏膜上皮[21]
嗜酸乳杆菌LA-5 阻碍生物膜形成[21]
干酪乳杆菌LC-11 阻碍致龋生物膜形成[22,23]
副干酪乳杆菌 龋病治疗[23]
乳杆菌属 牙周病治疗[23]
双歧杆菌属 牙龈炎治疗[24]
鼠李糖乳杆菌 免疫调节[25]
乳双歧杆菌 提高对口腔感染的抵抗力[26]
[1] Krishnan K, Chen T, Paster BJ. A practical guide to the oral microbiome and its relation to health and disease[J]. Oral Dis, 2017,23(3):276-286.
doi: 10.1111/odi.12509 pmid: 27219464
[2] Leys EJ, Griffen AL, Beall C, et al. Isolation, classi-fication, and definition of oral microorganisms[M]. Washington: ASM Press, 2014: 71-74.
[3] 周学东, 施文元. 口腔微生态学[M]. 北京: 人民卫生出版社, 2013: 109-113.
Zhou XD, Shi WY. Oral microecology[M]. Beijing: People’s Medical Publishing House, 2013: 109-113.
[4] Theilade E. The non-specific theory in microbial etiology of inflammatory periodontal diseases[J]. J Clin Periodontol, 1986,13(10):905-911.
doi: 10.1111/j.1600-051x.1986.tb01425.x pmid: 3540019
[5] Marsh PD. Microbial ecology of dental plaque and its significance in health and disease[J]. Adv Dent Res, 1994,8(2):263-271.
doi: 10.1177/08959374940080022001 pmid: 7865085
[6] Pérez-Chaparro PJ, Gonçalves C, Figueiredo LC, et al. Newly identified pathogens associated with per-iodontitis: a systematic review[J]. J Dent Res, 2014,93(9):846-858.
doi: 10.1177/0022034514542468
[7] Richards AM, Abu Kwaik Y, Lamont RJ. Code blue: Acinetobacter baumannii, a nosocomial pathogen with a role in the oral cavity[J]. Mol Oral Microbiol, 2015,30(1):2-15.
doi: 10.1111/omi.12072 pmid: 25052812
[8] Albandar JM. Aggressive periodontitis: case defini-tion and diagnostic criteria[J]. Periodontol 2000, 2014,65(1):13-26.
doi: 10.1111/prd.12014
[9] Könönen E, Müller HP. Microbiology of aggressive periodontitis[J]. Periodontol 2000, 2014,65(1):46-78.
doi: 10.1111/prd.12016
[10] Vartoukian SR, Palmer RM, Wade WG. Diversity and morphology of members of the phylum “syner-gistetes” in periodontal health and disease[J]. Appl Environ Microbiol, 2009,75(11):3777-3786.
doi: 10.1128/AEM.02763-08 pmid: 19346352
[11] Lu HY, Zhao YB, Feng XH, et al. Microbiome in maintained periodontitis and its shift over a single maintenance interval of 3 months[J]. J Clin Perio-dontol, 2019,46(11):1094-1104.
[12] Kornman KS. Mapping the pathogenesis of perio-dontitis: a new look[J]. J Periodontol, 2008,79(8 Suppl):1560-1568.
doi: 10.1902/jop.2008.080213 pmid: 18673011
[13] Costalonga M, Herzberg MC. The oral microbiome and the immunobiology of periodontal disease and caries[J]. Immunol Lett, 2014,162(2 Pt A):22-38.
doi: 10.1016/j.imlet.2014.08.017 pmid: 25447398
[14] 王晖, 康迪, 周学东, 等. 微生态调节技术在感染性疾病预防中的应用[J]. 华西口腔医学杂志, 2018,36(5):564-567.
Wang H, Kang D, Zhou XD , et al. Prevention of in- fectious diseases through microecology modulation techniques[J]. West China J Stomatol, 2018,36(5):564-567.
[15] 李兰娟. 医学微生态学[M]. 北京: 人民卫生出版社, 2014: 16, 282-285.
Li LJ. Medical microecology[M]. Beijing: People’s Medical Publishing House, 2014: 16, 282-285.
[16] Seminario-Amez M, López-López J, Estrugo-Devesa A, et al. Probiotics and oral health: a systematic re- view[J]. Med Oral Patol Oral Cir Bucal, 2017,22(3):e282-e288.
doi: 10.4317/medoral.21494 pmid: 28390121
[17] 李凤琴. 食品微生物菌种安全性评估研究进展[J]. 中国食品卫生杂志, 2018,30(6):667-672.
Li FQ . Progress on safety assessment of microbial food cultures[J]. Chin J Food Hyg, 2018,30(6):667-672.
[18] Joint FAO/WHO Expert Consultation. Health and nutritional properties of probiotics in food including powder milk with live latic acid bacteria[R]. Córdoba: FAO/ WHO, 2001.
[19] Masdea L, Kulik EM, Hauser-Gerspach I, et al. Anti-microbial activity of Streptococcus salivarius K12 on bacteria involved in oral malodour[J]. Arch Oral Biol, 2012,57(8):1041-1047.
doi: 10.1016/j.archoralbio.2012.02.011
[20] Jørgensen MR, Kragelund C, Jensen PØ, et al. Pro-biotic Lactobacillus reuteri has antifungal effects on oral Candida species in vitro[J]. J Oral Microbiol, 2017,9(1):1274582.
doi: 10.1080/20002297.2016.1274582 pmid: 28326154
[21] Manning J, Dunne EM, Wescombe PA, et al. Inves-tigation of Streptococcus salivarius-mediated inhibition of pneumococcal adherence to pharyngeal epithelial cells[J]. BMC Microbiol, 2016,16(1):225.
pmid: 27681377
[22] Chuang LC, Huang CS, Ou-Yang LW, et al. Probiotic Lactobacillus paracasei effect on cariogenic bacterial flora[J]. Clin Oral Investig, 2011,15(4):471-476.
pmid: 20502929
[23] Schwendicke F, Dörfer C, Kneist S, et al. Cariogenic effects of probiotic Lactobacillus rhamnosus GG in a dental biofilm model[J]. Caries Res, 2014,48(3):186-192.
doi: 10.1159/000355907
[24] Invernici MM, Salvador SL, Silva PHF, et al. Effects of Bifidobacterium probiotic on the treatment of chronic periodontitis: a randomized clinical trial[J]. J Clin Periodontol, 2018,45(10):1198-1210.
pmid: 30076613
[25] Fong FL, Shah NP, Kirjavainen P, et al. Mechanism of action of probiotic bacteria on intestinal and syste-mic immunities and antigen-presenting cells[J]. Int Rev Immunol, 2016,35(3):179-188.
pmid: 26606641
[26] Oliveira LF, Salvador SL, Silva PH, et al. Benefits of Bifidobacterium animalis subsp. lactis probiotic in experimental periodontitis[J]. J Periodontol, 2017,88(2):197-208.
doi: 10.1902/jop.2016.160217 pmid: 27660886
[27] Teughels W, Durukan A, Ozcelik O, et al. Clinical and microbiological effects of Lactobacillus reuteri probiotics in the treatment of chronic periodontitis: a randomized placebo-controlled study[J]. J Clin Pe-riodontol, 2013,40(11):1025-1035.
[28] Shah MP, Gujjari SK, Chandrasekhar VS. Evaluation of the effect of probiotic (inersan®) alone, combina-tion of probiotic with doxycycline and doxycycline alone on aggressive periodontitis—a clinical and microbiological study [J]. J Clin Diagn Res, 2013,7(3):595-600.
pmid: 23634432
[29] Riccia DN, Bizzini F, Perilli MG, et al. Anti-inflam-matory effects of Lactobacillus brevis (CD2) on pe-riodontal disease[J]. Oral Dis, 2007,13(4):376-385.
pmid: 17577323
[30] Vicario M, Santos A, Violant D, et al. Clinical changes in periodontal subjects with the probiotic Lactoba-cillus reuteri prodentis: a preliminary randomized clinical trial[J]. Acta Odontol Scand, 2013,71(3/4):813-819.
doi: 10.3109/00016357.2012.734404
[31] Shimauchi H, Mayanagi G, Nakaya S, et al. Im-provement of periodontal condition by probiotics with Lactobacillus salivarius WB21: a randomized, double-blind, placebo-controlled study[J]. J Clin Periodontol, 2008,35(10):897-905.
doi: 10.1111/j.1600-051X.2008.01306.x pmid: 18727656
[32] Lauritano D, Carinci F, Palmieri A, et al. Reuterinos® as adjuvant for peri-implant treatment: a pilot study [J]. Int J Immunopathol Pharmacol, 2019,33:2058738419827745.
pmid: 30791748
[33] Mayanagi G, Kimura M, Nakaya S, et al. Probiotic effects of orally administered Lactobacillus salivarius WB21-containing tablets on periodontopathic bacteria: a double-blinded, placebo-controlled, randomized clinical trial[J]. J Clin Periodontol, 2009,36(6):506-513.
pmid: 19453574
[34] Kõll-Klais P, Mändar R, Leibur E, et al. Oral lacto-bacilli in chronic periodontitis and periodontal health: species composition and antimicrobial activity[J]. Oral Microbiol Immunol, 2005,20(6):354-361.
doi: 10.1111/j.1399-302X.2005.00239.x pmid: 16238595
[35] Krasse P, Carlsson B, Dahl C, et al. Decreased gum bleeding and reduced gingivitis by the probiotic Lactobacillus reuteri[J]. Swed Dent J, 2006,30(2):55-60.
pmid: 16878680
[36] Schmitter T, Fiebich BL, Fischer JT, et al. Ex vivo anti-inflammatory effects of probiotics for perio-dontal health[J]. J Oral Microbiol, 2018,10(1):1502027.
pmid: 30057719
[37] Hallström H, Lindgren S, Yucel-Lindberg T, et al. Effect of probiotic lozenges on inflammatory reac-tions and oral biofilm during experimental gingivitis[J]. Acta Odontol Scand, 2013,71(3/4):828-833.
doi: 10.3109/00016357.2012.734406
[38] Twetman S, Derawi B, Keller M, et al. Short-term effect of chewing gums containing probiotic Lacto-bacillus reuteri on the levels of inflammatory me-diators in gingival crevicular fluid[J]. Acta Odontol Scand, 2009,67(1):19-24.
doi: 10.1080/00016350802516170 pmid: 18985460
[39] İnce G, Gürsoy H, İpçi ŞD, et al. Clinical and bio-chemical evaluation of lozenges containing Lacto-bacillus reuteri as an adjunct to non-surgical perio-dontal therapy in chronic periodontitis[J]. J Perio-dontol, 2015,86(6):746-754.
[40] Morales A, Carvajal P, Silva N, et al. Clinical effects of Lactobacillus rhamnosus in non-surgical treatment of chronic periodontitis: a randomized placebo-con-trolled trial with 1-year follow-up[J]. J Periodontol, 2016,87(8):944-952.
pmid: 26944407
[41] Tyagi AM, Yu MC, Darby TM, et al. The microbial metabolite butyrate stimulates bone formation via T regulatory cell-mediated regulation of WNT10B expression[J]. Immunity, 2018, 49(6): 1116- 1131.e7.
pmid: 30446387
[42] Sima C, van Dyke TE. Therapeutic targets for mana-gement of periodontitis and diabetes[J]. Curr Pharm Des, 2016,22(15):2216-2237.
doi: 10.2174/1381612822666160216150338 pmid: 26881443
[43] Penoni DC, Fidalgo TK, Torres SR, et al. Bone density and clinical periodontal attachment in postmeno-pausal women: a systematic review and meta-analysis[J]. J Dent Res, 2017,96(3):261-269.
pmid: 28048966
[44] 张灼阳, 刘畅, 郭晓奎. 益生菌的安全性[J]. 微生物学报, 2008,48(2):257-261.
Zhang ZY, Liu C, Guo XK . Safety of probiotics—a review[J]. Acta Microbiol Sin, 2008,48(2):257-261.
[45] 郭淑娟, 刘倩, 丁一. 牙周病和植体周病国际新分类简介[J]. 国际口腔医学杂志, 2019,46(2):125-134.
Guo SJ, Liu Q, Ding Y . A brief introduction of the new classification scheme for periodontal and peri-implant diseases and conditions[J]. Int J Stomatol, 2019,46(2):125-134.
[1] 古丽其合热·阿布来提,秦旭,朱光勋. 线粒体自噬在牙周炎发生发展过程中的研究进展[J]. 国际口腔医学杂志, 2024, 51(1): 68-73.
[2] 成益凡,秦旭,姜鸣,朱光勋. 牙周病中固有淋巴细胞的研究进展[J]. 国际口腔医学杂志, 2023, 50(1): 32-36.
[3] 李伟光,吴亚菲,郭淑娟. 无机纳米粒子在牙周病诊疗中的研究进展[J]. 国际口腔医学杂志, 2022, 49(6): 724-730.
[4] 李归平,秦旭,朱光勋. 腺苷酸活化蛋白激酶在牙周病发生发展中的研究进展[J]. 国际口腔医学杂志, 2022, 49(3): 343-348.
[5] 穆新月,刘树泰. 动机性访谈在牙周病患者临床管理中的应用进展[J]. 国际口腔医学杂志, 2022, 49(1): 94-99.
[6] 白皓亮,杨禾,赵蕾. 牙周病风险评估及预后判断工具的研究进展[J]. 国际口腔医学杂志, 2021, 48(6): 696-702.
[7] 周万航,李嫣斐,许日聪,万启军. 牙周非手术治疗对慢性肾脏病危险因素及全身炎症水平影响的Meta分析[J]. 国际口腔医学杂志, 2021, 48(5): 528-535.
[8] 沈忆芬,刘超,汤颖,顾永春. 电子烟暴露对牙周健康影响的研究进展[J]. 国际口腔医学杂志, 2021, 48(3): 347-353.
[9] 秦小茹,刘梦圆. 牙周病和心肌梗死发生风险相关性队列研究的Meta分析[J]. 国际口腔医学杂志, 2021, 48(2): 165-172.
[10] 张琳琳,杜毅. 畸形舌侧沟的治疗进展[J]. 国际口腔医学杂志, 2020, 47(4): 458-462.
[11] 刘琳,周婕妤,吴亚菲,赵蕾. 益生菌生态调节在牙周病防治中的应用[J]. 国际口腔医学杂志, 2020, 47(2): 131-137.
[12] 程国平,丁一,郭淑娟. 静电纺丝纤维作为牙周药物传递系统的研究进展[J]. 国际口腔医学杂志, 2019, 46(5): 565-570.
[13] 胡竹林,赵诣,李茵. 口腔龈沟液生物标志物的检测分析现状及临床应用前景展望[J]. 国际口腔医学杂志, 2019, 46(3): 308-315.
[14] 郭淑娟, 刘倩, 丁一. 牙周病和植体周病国际新分类简介[J]. 国际口腔医学杂志, 2019, 46(2): 125-134.
[15] 闫凯娴,李纾. 非牙周病性龈病损[J]. 国际口腔医学杂志, 2019, 46(2): 177-185.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] 王昆润. 二甲亚砜和双氯芬酸并用治疗根尖周炎[J]. 国际口腔医学杂志, 1999, 26(06): .
[2] 汤庆奋,王学侠. 17β-雌二醇对人类阴道和口腔颊粘膜的渗透性[J]. 国际口腔医学杂志, 1999, 26(06): .
[3] 潘劲松. 颈总动脉指压和颈内动脉球囊阻断试验在大脑血液动力学中的不同影响[J]. 国际口腔医学杂志, 1999, 26(05): .
[4] 王昆润. 后牙冠根斜形牙折的治疗[J]. 国际口腔医学杂志, 1999, 26(05): .
[5] 杨锦波. 嵌合体防龋疫苗的研究进展[J]. 国际口腔医学杂志, 1999, 26(05): .
[6] 王昆润. 下颔骨成形术用网状钛板固定植骨块[J]. 国际口腔医学杂志, 1999, 26(04): .
[7] 汪月月,郭莉莉. 口腔机能与老化—痴呆危险因素流行病学研究[J]. 国际口腔医学杂志, 1999, 26(04): .
[8] 丁刚. 应用硬组织代用品种植体行丰颏术[J]. 国际口腔医学杂志, 1999, 26(04): .
[9] 田磊. 局部应用脂多糖后结合上皮反应性增生的变化[J]. 国际口腔医学杂志, 1999, 26(04): .
[10] 戴青. 口腔念珠菌病的新分类[J]. 国际口腔医学杂志, 1999, 26(04): .