根面龋微生态管理策略的研究进展  

Research progress on the microecological strategies of root caries management

作　　者：伍丽静 陶奕伟 曾博 蔡艳玲 WU Lijing;TAO Yiwei;ZENG Bo;CAI Yanling(Hospital of Stomatology,Guanghua School of Stomatology,Sun Yat-sen University,Guangdong Provincial Key Laboratory of Stomatology,Guangzhou 510055,China;Department of Stomatology,Shan-tou University Medical College,Shantou 515063,China;Clinic of Stomatology,Shantou University Medical College,Shantou 515041,China)

机构地区：[1]中山大学附属口腔医院,光华口腔医学院,广东省口腔医学重点实验室,广东广州510055 [2]汕头大学医学院口腔医学系,广东汕头515063 [3]汕头大学医学院口腔门诊部,广东汕头515041

出　　处：《口腔疾病防治》2025年第3期244-251,共8页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金项目(81800960,82201041);广州市科技计划项目(202201011112);广州市临床重大技术项目(2023P⁃ZD07)。

摘　　要：根面龋是一种常见的慢性口腔疾病,全球平均患病率为41.5%,具有发病率高、治疗率低、再治疗率高的特点。根面龋主要由核心微生物群诱导的生态失调引起,有多种危险因素,包括牙龈萎缩、根面暴露和唾液功能障碍。传统的预防措施和治疗方法(如氟化物、矿化剂和修复材料)未能恢复或维持口腔菌群平衡。近期研究表明,益生菌、益生元、合生元、抗菌肽等微生态制剂可调节口腔微生物组成使其从失衡的致龋状态向健康状态转化,降低产酸菌的产酸量,同时促进产碱菌生成过氧化氢、氨等碱化胞外环境,并抑制菌斑生物膜的形成、下调胞外多糖浓度、减弱细菌间的黏附和聚集等致龋因素,有望在根面龋的防治领域发挥重要作用。因此,本文通过对口腔益生菌(寡发酵链球菌、口腔链球菌无龋亚种、唾液链球菌)、益生元(精氨酸、硝酸盐、合成化合物)、合生元和抗菌肽(没食子酸-多菌素I和LH12)进行综述,为微生态调节管理根面龋提供证据和指导。Root caries is a prevalent chronic oral disease with an average global prevalence of 41.5%,characterized by high incidence,low rate of treatment,and high rate of retreatment.Root caries is primarily caused by core microbi-ome-induced dysbiosis and has multiple risk factors,including gingival recession,root surface exposure,and salivary dysfunction.The traditional preventive measures and treatments such as fluoride,mineralizing agents,and restorative materials,are unable to restore or maintain oral microecological homeostasis.Recent studies have demonstrated that pro-biotics,prebiotics,synbiotics,and antimicrobial peptides may prevent and treat root caries by reversing dysbiosis.In ad-dition,these biotherapeutics can reduce acid production by acidiferous bacteria,promote alkali production(hydrogen peroxide and ammonia)by alkali-producing bacteria,inhibit biofilm formation,decrease extracellular polysaccharide production,and suppress microbial adhesion and aggregation.It is expected to play an important role in the prevention and control of root caries.This article aims to review oral probiotics(Streptococcus oligofermentans,Streptococcus oralis subsp.dentisani,and Streptococcus salivarius),prebiotics(arginine,nitrates,and synthetic compounds),synbiotics,and antimicrobial peptides(gallic acid-polyphemusin I and LH12)to provide evidence and guidance for root caries manage-ment through microecological modulation.

关 键 词：根面龋 牙菌斑微生态 核心微生物群 变异链球菌 乳杆菌 益生菌 益生元 合生元 抗菌肽 精氨酸 龋病管理 

分 类 号：R78[医药卫生—口腔医学]