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Postbiotics and Dental Caries: A Systematic Review Publisher Pubmed



Heidari F1 ; Heboyan A2, 3, 4 ; Rokaya D5, 6 ; Fernandes GVO7 ; Heidari M8 ; Banakar M2, 9, 10 ; Zafar MS5, 6, 11
Authors
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Authors Affiliations
  1. 1. Department of Pediatric Dentistry, Faculty of Dentistry, Shahed University, Tehran, Iran
  2. 2. Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
  3. 3. Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
  4. 4. Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Clinical Sciences Department, College of Dentistry, Ajman University, Ajman, United Arab Emirates
  6. 6. Center of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
  7. 7. A. T. Still University – Missouri School of Dentistry & Oral Health, St. Louis, MO, United States
  8. 8. Student Research Committee, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
  9. 9. Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
  10. 10. Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  11. 11. School of Dentistry, University of Jordan, Amman, Jordan

Source: Clinical and Experimental Dental Research Published:2025


Abstract

Objective: This systematic review aimed to evaluate the current evidence regarding the impact of postbiotics on dental caries, focusing on the effectiveness of postbiotic interventions in caries prevention, mechanisms of action, optimal dosages, and administration protocols. Methods: A literature search was conducted across PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library. Eligible studies included randomized controlled trials, quasi-experimental, observational, and in vitro studies. The selection followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A qualitative synthesis was performed due to heterogeneity in study designs and outcomes. Results: Twenty-one studies were included (18 in vitro and three randomized controlled trials). Postbiotics derived from various Lactobacillus species demonstrated inhibitory effects on Streptococcus mutans growth, biofilm formation, and virulence gene expression. Proposed mechanisms include direct antimicrobial activity, inhibition of bacterial adhesion, disruption of biofilm formation, modulation of immune responses, and pH buffering. After postbiotic interventions, human trials showed reduced salivary S. mutans counts and increased salivary pH. Conclusions: Postbiotics offer a promising novel approach to dental caries prevention by targeting cariogenic bacteria and modulating the oral microbiome through multiple mechanisms. Compared to probiotics, postbiotics present additional advantages, including enhanced safety, stability, and ease of incorporation into oral care products. © 2025 The Author(s). Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.
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