Associação dos sorotipos de streptococcus mutans com a ocorrência e severidade da cárie dentária: uma revisão sistemática

Abstract

One of the main microorganisms related to dental caries, Streptococcus mutans, has four known serotypes (c, e, f and k). However, knowledge about the distribution of different S. mutans serotypes, including their association with dental caries, remains scarce. The objective of this study was to carry out a systematic review in order to answer the following question: “Are serotypes e, f and k of S. mutans more associated with the occurrence and severity of dental caries when compared to serotype c of S. mutans?” This review was reported in accordance with PRISMA recommendations and its protocol was registered on the PROSPERO platform (CRD42021251 176). The bibliographic search was carried out in the PubMed, Embase, Scopus and W eb of Science databases, without restrictions on year of publication or language. Observational studies (cross-sectional, case-control and cohort) are included. Randomized and non-randomized clinical trials selected for eligibility only baseline data were extracted for the present study . Reviews, letters, books, conference summaries, opinion articles, case reports, case series, animal studies and in vitro studies were excluded from the selection of studies.Study selection, data extraction and risk of bias assessment were carried out independently by two reviewers, and, in case of discrepancies, a third reviewer was consulted. For assessing risk of bias, Joanna Briggs Institute tool, for cross-sectional studies, and Newcastle-Ottawa tool, for cohort studies, were used. Of the 4778 studies retrieved from the databases, 13 studies (1 1 cross-sectional and two cohorts) were included. The studies included were conducted in ten countries, involving between 10 and 499 individuals aged between 5 months and 78 years. The Polymerase Chain Reaction was the most used identification method for identifying serotypes. The samples evaluated were collected from dental plaque, saliva, softened material taken from cavitated carious lesions and softened dentin from decayed teeth. All articles identified serotype c as the most frequently detected, with a range of 45.7% to 98%. Serotypes e, f and k showed a lower occurrence. Serotype c was the most commonly detected among individuals in the groups with dental caries. In individuals from the caries-free groups, the serotypes identified were c, e and f. Regarding the severity of dental caries, six studies associated serotype c with higher DMFT rates, two associated serotype e with a greater risk of caries, five studies did not find a relationship between serotype and caries severity and one did not verify this relationship. As for serotypes f and k, no study found a statistical association with the severity of dental caries. Five cross-sectional studies presented a moderate risk of bias, and six were assessed as having a low risk of bias. The two cohort studies were adequate in the dimensions assessed. It was concluded that serotype c had a higher occurrence than serotypes e, f and k. Most studies associated serotype c with a greater severity of dental caries. Serotypes e, f and k are not more associated with a greater occurrence and severity of dental caries when compared to serotype c of S. mutans.