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Clinical Oral Investigations Jul 2014Systematically review the available literature regarding the caries-preventive effect of probiotics. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Systematically review the available literature regarding the caries-preventive effect of probiotics.
DATA, SOURCES AND STUDY SELECTION
An electronic search was conducted in three databases (PubMed MEDLINE, ISI Web of Science and Cochrane Library) to identify all suitable studies. The outcomes had to be presented as the effect of probiotics on the incidence of caries or on the levels of mutans streptococci and/or Lactobacillus species. Human studies, written in English, with at least 15 participants, comparing a probiotic product with a placebo/no probiotic were included. Where possible, a meta-analysis was performed to obtain quantitative data.
RESULTS
Since only two articles presented useful data on the caries incidence, we focused on the surrogate endpoints: mutans streptococci and/or Lactobacillus counts. The meta-analysis showed that when the probiotic and control group are compared after treatment, significantly more patients in the probiotic group had low mutans streptococci (<10(5) CFU/ml) counts and significantly less patients had high (>10(6) CFU/ml) counts. Regarding the Lactobacillus counts, comparing the probiotic and control group at the end of the probiotic use, no significant differences could be observed, neither in low (<10(4) CFU/ml) nor in high Lactobacillus (>10(6) CFU/ml) counts.
CONCLUSIONS
Within the limitations of the available data, it may be concluded that probiotics decrease the mutans streptococci counts. This suggests that probiotics could have a positive effect in the prevention of caries.
CLINICAL RELEVANCE
There is insufficient evidence that probiotics can prevent caries, but they can reduce the mutans streptococci counts.
Topics: Adolescent; Adult; Aged; Child; Colony Count, Microbial; Humans; Lactobacillus; Middle Aged; Probiotics; Streptococcus mutans; Young Adult
PubMed: 24663813
DOI: 10.1007/s00784-014-1228-z -
Journal of Oral and Maxillofacial... Jan 2014The current recommendations for the treatment of bacterial salivary gland infections are mainly empirical. Therefore, an evidence-based literature review was conducted... (Review)
Review
PURPOSE
The current recommendations for the treatment of bacterial salivary gland infections are mainly empirical. Therefore, an evidence-based literature review was conducted to identify antibiotics with favorable pharmacokinetics in saliva and to establish recommendations for the antibiotic treatment of sialadenitis.
MATERIALS AND METHODS
The authors performed a systematic review of the pertinent literature published from 1985 to 2013. If the predefined inclusion criteria were met, the articles were screened for various variables: antibiotic type, mode of administration, type of examined saliva, peak salivary antibiotic concentrations, biochemical methodology, and minimal inhibitory concentrations of bacteria implicated in sialadenitis (Staphylococcus aureus, Viridans streptococci, various gram-negative strains, and anaerobes).
RESULTS
The review included 18 studies. The systematic analysis of the reported results concurred that intravenously administered cephalosporins achieve the highest concentrations in saliva, followed by orally administered cephalosporins and fluoroquinolones. These concentrations exceed the minimal inhibitory concentrations of the bacteria of interest. Phenoxymethylpenicillin and tetracyclines are not secreted in the saliva at bactericidal levels. The antibiotic peak salivary levels depended on the type of saliva examined (parotid vs submandibular vs minor salivary gland) and the biochemical method of measurement (high-performance liquid chromatography vs bioassay).
CONCLUSION
Cephalosporins and fluoroquinolones display superior pharmacokinetics in saliva and cover the spectrum of all bacteria implicated in sialadenitis. Within the limitations of this review, they can be recommended for the treatment of bacterial salivary gland infections.
Topics: Administration, Intravenous; Administration, Oral; Anti-Bacterial Agents; Cephalosporins; Evidence-Based Dentistry; Fluoroquinolones; Humans; Microbial Sensitivity Tests; Saliva; Sialadenitis
PubMed: 23992785
DOI: 10.1016/j.joms.2013.06.214 -
Nutrients Jul 2013This paper aims to provide a systematic review of the caries-prevention effect of probiotics in human. The hypothesis was that the administration of probiotic strains... (Review)
Review
This paper aims to provide a systematic review of the caries-prevention effect of probiotics in human. The hypothesis was that the administration of probiotic strains might play a role in caries lesion prevention and in the control of caries-related risk factors. The main relevant databases (Medline, Embase) were searched. Quality of the Randomized Clinical Trials (RCTs) was classified using the "Consolidated Standards of Reporting Trials" (CONSORT) checklist and the Impact Factor (IF) value of each journal was recorded. Sixty-six papers were identified, and 23 fulfilled the inclusion criteria. Only three studies had caries lesion development as outcome, all the others reported caries risk factors as interim evaluation. Using the CONSORT Score, the papers were coded as 4 excellent, 9 good and 10 poor. The mean IF value recorded was 1.438. Probiotics may play a role as antagonistic agent on mutans streptococci (MS), acidogenic/aciduric bacteria that contributes to the caries process. In two-thirds of the selected papers, probiotics have demonstrated the capacity to reduce MS counts in saliva and/or plaque in short-term. The effect of probiotics on the development of caries lesion seems encouraging, but to date, RCTs on this topic are insufficient to provide scientific clinical evidence.
Topics: Dental Caries; Humans; Probiotics; Randomized Controlled Trials as Topic; Risk Factors; Saliva; Streptococcus mutans
PubMed: 23857225
DOI: 10.3390/nu5072530 -
International Journal of Paediatric... Jul 2013Early childhood caries (ECC) describes dental caries affecting children aged 0-71 months. Current research suggests ECC has important aetiological bases during the first... (Review)
Review
BACKGROUND
Early childhood caries (ECC) describes dental caries affecting children aged 0-71 months. Current research suggests ECC has important aetiological bases during the first year of life. Gaps in knowledge about disease progression prevent the effective and early identification of 'at risk' children.
AIM
To conduct a systematic review of research studies focusing on (a) acquisition and colonization of oral bacteria and ECC and (b) risk and/or protective factors in infants aged 0-12 months.
DESIGN
Ovid Medline and Embase databases (1996-2011) were searched for RCT, longitudinal, cross-sectional and qualitative studies. Two investigators undertook a quality assessment for risk of bias.
RESULTS
Inclusion criteria were met for (a) by four papers and for (b) by 13 papers; five papers were rated medium or high quality. Bacterial acquisition/colonization and modifying factor interrelationships were identified, but their role in the caries process was not clarified. Key risk indicators were infant feeding practices (nine papers), maternal circumstances and oral health (6) and infant-related oral health behaviours (4).
CONCLUSION
This review confirmed that factors occurring during the first year of life affect ECC experience. Despite heterogeneity, findings indicated maternal factors influence bacterial acquisition, whereas colonization was mediated by oral health behaviours and practices and feeding habits.
Topics: Dental Caries; Dental Caries Susceptibility; Disease Progression; Feeding Methods; Humans; Infant; Risk Factors; Streptococcus mutans
PubMed: 22925469
DOI: 10.1111/j.1365-263X.2012.01260.x -
Oral Health & Preventive Dentistry 2010The aim of the present study was to undertake a systematic review to investigate whether mutans streptococci levels are a strong risk indicator/factor for ECC, based on... (Review)
Review
PURPOSE
The aim of the present study was to undertake a systematic review to investigate whether mutans streptococci levels are a strong risk indicator/factor for ECC, based on the current quality of the literature regarding the relationship between early childhood caries (ECC) and these microorganisms.
MATERIALS AND METHODS
The authors searched PubMed, Scopus and Cochrane Library databases for papers from 1951 to 2007. The minimal inclusion requirements were assessment of preschool children reporting mutans streptococci counts, mainly in saliva and biofilm samples, and caries assessment. Since the heterogeneity of the studies did not allow a meta-analysis (chi(2) test), a qualitative analysis was conducted.
RESULTS
The electronic search yielded 120 articles, but only 16 scientific papers were critically appraised. Of the 16 scientific papers included in the review, only one cross-sectional study achieved a high value of evidence.
CONCLUSIONS
It was concluded that mutans streptococci levels are a strong risk indicator for ECC. However, further well designed longitudinal studies with high evidence values are required to confirm mutans streptococci levels as a significant ECC risk factor.
Topics: Chi-Square Distribution; Child, Preschool; Dental Caries; Dental Plaque; Humans; Infant; Risk Factors; Saliva; Streptococcus mutans
PubMed: 20480056
DOI: No ID Found -
Journal of Dentistry May 2007The current study undertakes a systematic review of the literature in order to assess how long different formulations (solutions, gels and varnishes) of chlorhexidine... (Review)
Review
OBJECTIVES
The current study undertakes a systematic review of the literature in order to assess how long different formulations (solutions, gels and varnishes) of chlorhexidine (CHX) reduce the level of mutans streptococci (MS) in the oral cavity.
SOURCES
A search of the PUBMED and LILACS databases was conducted through October 2005.
STUDY SELECTION
Clinical studies evaluating the effects of CHX solutions, gels, or varnishes on MS levels were targeted (n=52).
CONCLUSIONS
The studies varied greatly in quantity of mouthwash solution used in rinsing, length of rinsing, and treatment frequency and period. CHX mouthwash solution had short-term effect on salivary MS. Most of studies evaluating CHX gel and varnish used a concentration of 1%. The 1% CHX gel showed a significant reduction through intensive treatment (3-4 daily applications over 2 days) or through daily application for 10 and 14 days. It cannot be asserted that 1% CHX varnish provides better results when applied intensively as compared to applications conducted at intervals of 1 or more months. Treatment using 1% CHX varnish displays large variations in the level and length of decreased MS levels. Despite variability in results, 40% CHX varnish has a greater effect on the period of decreased MS levels than does 1% CHX varnish. Studies did not show a statistically significant difference between the gel and the varnish. The effects of CHX treatment must be monitored, given sharp individual variability in response to this treatment.
Topics: Anti-Infective Agents, Local; Chlorhexidine; Dentifrices; Gels; Humans; Mouth; Mouthwashes; Paint; Solutions; Streptococcus mutans
PubMed: 17391828
DOI: 10.1016/j.jdent.2007.01.007 -
Caries Research 2006Research suggests that mutans streptococci play an important role in cariogenesis in children but the usefulness of bacterial testing in risk assessment is unknown. Our... (Review)
Review
Research suggests that mutans streptococci play an important role in cariogenesis in children but the usefulness of bacterial testing in risk assessment is unknown. Our objective was to summarize the literature assessing the association of mutans streptococci and dental caries in preschool children, (Pre)Medline (1966-2003), Embase (1980-2003), the Cochrane Register of Controlled Trials (2003, issue 3), and reference lists of included studies were searched. All abstracts found by the electronic searches (n = 981) were independently scrutinized by 2 reviewers. Minimal requirements for inclusion were assessment of preschool children without caries at baseline, reporting of mutans streptococci present in saliva or plaque at baseline and assessment of caries presence after a minimum of 6 months of follow-up. Participants' details, test methods, methodological characteristics and findings were extracted by one reviewer and cross-checked by another. Homogeneity was tested using chi2 tests. Results of plaque and saliva testing were pooled separately using a fixed effects model. Methodological quality of reports was low. Out of 9 studies included, data from 3 reports on plaque test assessment alone (n = 300) and from 4 reports on saliva test assessment alone (n = 451) were available for pooled analysis. The pooled risk ratio (95% CI) was 3.85 (2.48-5.96) in studies using plaque tests and 2.11 (1.47-3.02) in those using saliva testing. Presence of mutans streptococci, both in plaque or saliva of young caries-free children, appears to be associated with a considerable increase in caries risk. Lack of adjustment for potential confounders in the original studies, however, limits the extent to which interpretations for practice can be made.
Topics: Child, Preschool; Confounding Factors, Epidemiologic; Dental Caries; Dental Plaque; Humans; Predictive Value of Tests; Prevalence; Risk Assessment; Risk Factors; Saliva; Streptococcus mutans
PubMed: 16946603
DOI: 10.1159/000094280 -
Community Dental Health Mar 2004To conduct a systematic review of the literature on risk factors for dental caries in deciduous teeth of children aged six years and under, to give a scientific... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To conduct a systematic review of the literature on risk factors for dental caries in deciduous teeth of children aged six years and under, to give a scientific framework for the international collaborative studies on inequalities in childhood caries.
METHOD
Accepted guidelines were followed. Studies were identified by electronic searching and reviewed on the basis of key words, title and abstract by two reviewers to assess whether inclusion criteria were met. Copies of all articles were obtained and assessed for quality according to the study design.
RESULTS
1029 papers were identified from the electronic search, 260 met the prima facie inclusion criteria. 183 were excluded once full copies of these papers were obtained. Of the 77 studies included, 43 were cross sectional, 19 cohort studies, 8 case control studies and 7 interventional studies. Few obtained the highest quality scores. 106 risk factors were significantly related to the prevalence or incidence of caries.
CONCLUSION
There is a shortage of high quality studies using the optimum study design, i.e. a longitudinal study. The evidence suggests that children are most likely to develop caries if Streptococcus Muttans is acquired at an early age, although this may be partly compensated by other factors such as good oral hygiene and a non-cariogenic diet. Diet and oral hygiene may interact so that if there is a balance of 'good' habits by way of maintaining good plaque control and 'bad' habits by way of having a cariogenic diet, the development of caries may be controlled.
Topics: Child; Child, Preschool; Dental Caries; Dental Caries Susceptibility; Diet; Humans; Oral Hygiene; Risk Factors; Streptococcus mutans; Tooth, Deciduous
PubMed: 15072476
DOI: No ID Found -
Archives of Gynecology and Obstetrics Oct 2003Infectious endocarditis is a rare life-threatening complication of pregnancy. We report a pregnancy complicated by a 3.5-cm infected vegetation of the tricuspid valve... (Review)
Review
INTRODUCTION
Infectious endocarditis is a rare life-threatening complication of pregnancy. We report a pregnancy complicated by a 3.5-cm infected vegetation of the tricuspid valve initially presenting as unilateral hip pain as well as systematic review of this entity.
SOURCES
A MEDLINE review of the English language literature from 1965 to present using the search terms 'endocarditis', 'pregnancy' and 'infection' as well as review of references was performed.
RESULTS
Sixty-eight cases of infectious endocarditis complicating pregnancy were identified. The calculated maternal and fetal mortality rates were 22.1% and 14.7% respectively.
CONCLUSIONS
With persistent symptomatic lesions, delivery should be considered without regard to measures of fetal lung maturity because of high fetal mortality rates.
Topics: Adult; Bacteremia; Cesarean Section; Chest Pain; Endocarditis, Bacterial; Female; Fetal Death; Gestational Age; Heart Septal Defects, Ventricular; Humans; MEDLINE; Male; Maternal Mortality; Oxygen; Pregnancy; Pregnancy Complications, Infectious; Streptococcal Infections; Tachycardia; Tricuspid Valve; Viridans Streptococci
PubMed: 12728325
DOI: 10.1007/s00404-003-0485-x