Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

44 questions · 44 findings · 3 reviews

No studies found 13 · 29.5%GRADE not reported 3 · 6.8%Very low 7 · 15.9%Low 8 · 18.2%Moderate 9 · 20.5%High 4 · 9.1%

Surfactants vs control

Early all‐cause mortality (≤ 3 months) Reported at: 28 days; and 90 days. Time point not reported in 4 studies · adults with acute respiratory distress syndrome

It is very uncertain whether surfactants changes early all‐cause mortality (≤ 3 months) Reported at: 28 days; and 90… compared with control (very low certainty).

1 finding from 1 review

Postbiotics from Lactobacillus spp. (cell-free supernatants, biosurfactants, lipoteichoic acid, bacterial lysates) vs No prior SDF application (untreated dentin control)

Downregulation of S. mutans virulence/biofilm gene expression (gtfB, gtfC, ftf) · Cariogenic bacteria (mainly Streptococcus mutans reference strains) and oral biofilms in vitro

Postbiotics reduce expression of S. mutans biofilm/virulence genes (gtfB, gtfC, ftf) in vitro (ungraded narrative synthesis).

1 finding from 1 review
  • Postbiotics and Dental Caries: A Systematic Review. 2025 All outcomes
    Exposure 24 h to 7 days · Laboratory (in vitro)
    Postbiotics downregulated expression of S. mutans virulence and exopolysaccharide-synthesis genes (e.g., gtfB, gtfC, gtfD, ftf) in 10 in vitro studies; no pooled estimate.
    8 studies
    GRADE not reported

Postbiotics from Lactobacillus spp. (cell-free supernatants, biosurfactants, lipoteichoic acid, bacterial lysates) vs No prior SDF application (untreated dentin control)

Proposed inhibition of S. mutans adhesion to tooth surface (mechanism; direct adherence endpoint confirmed only in Ahn 2018) · Cariogenic bacteria (mainly Streptococcus mutans reference strains) and oral biofilms in vitro

Postbiotics inhibit S. mutans adhesion to tooth surfaces in vitro (ungraded narrative synthesis).

1 finding from 1 review
  • Postbiotics and Dental Caries: A Systematic Review. 2025 All outcomes
    Exposure 24 h to 7 days · Laboratory (in vitro)
    Postbiotics (mainly biosurfactants and lipoteichoic acid) interfered with S. mutans adhesion to tooth/hydroxyapatite surfaces in 5 in vitro studies; no pooled estimate.
    5 studies
    GRADE not reported

Postbiotics from Lactobacillus spp. (cell-free supernatants, biosurfactants, lipoteichoic acid, bacterial lysates) vs No prior SDF application (untreated dentin control)

Reduced enamel demineralization · Cariogenic bacteria (mainly Streptococcus mutans reference strains) and oral biofilms in vitro

A single in vitro study found postbiotics reduce enamel demineralization (ungraded).

1 finding from 1 review
  • Postbiotics and Dental Caries: A Systematic Review. 2025 All outcomes
    Exposure 24 h to 7 days · Laboratory (in vitro)
    One in vitro multispecies-biofilm study reported that a postbiotic (L. reuteri cell-free supernatant) reduced enamel demineralization, indicating a protective effect against caries; no pooled estimate.
    1 study
    GRADE not reported

Bovine lung lavage surfactant extract vs modified bovine minced lung surfactant extract

Mortality before hospital discharge · Preterm infants for prevention of RDS

Bovine lung lavage surfactant extract showed no clear difference in mortality prior to discharge (from any cause) compared with modified bovine minced lung surfactant extract (moderate certainty).

1 finding from 1 review

Bovine lung lavage surfactant extract vs modified bovine minced lung surfactant extract

Death or oxygen requirement at 36 weeks' postmenstrual age · Preterm infants for treatment of RDS

Bovine lung lavage surfactant extract showed no clear difference in death or oxygen requirement at 36 weeks' postmenstrual age compared with modified bovine minced lung surfactant extract (high certainty).

1 finding from 1 review

Bovine lung lavage surfactant extract vs modified bovine minced lung surfactant extract

Pneumothorax · Preterm infants for treatment of RDS

Bovine lung lavage surfactant extract showed no clear difference in pneumothorax compared with modified bovine minced lung surfactant extract (low certainty).

1 finding from 1 review

Bovine lung lavage surfactant extract vs modified bovine minced lung surfactant extract

Pulmonary hemorrhage · Preterm infants for treatment of RDS

Bovine lung lavage surfactant extract showed no clear difference in pulmonary hemorrhage compared with modified bovine minced lung surfactant extract (moderate certainty).

1 finding from 1 review

Bovine lung lavage surfactant extract vs modified bovine minced lung surfactant extract

Severe intraventricular hemorrhage in infants who received neuroimaging · Preterm infants for treatment of RDS

Bovine lung lavage surfactant extract showed no clear difference in severe IVH in infants receiving neuroimaging compared with modified bovine minced lung surfactant extract (moderate certainty).

1 finding from 1 review

Bovine lung lavage surfactant extract vs porcine minced lung surfactant extract

Mortality before hospital discharge · Preterm infants for treatment of RDS

Bovine lung lavage surfactant extract showed no clear difference in mortality prior to discharge compared with porcine minced lung surfactant extract (low certainty).

1 finding from 1 review

Bovine lung lavage surfactant extract vs porcine minced lung surfactant extract

Oxygen requirement at 36 weeks' postmenstrual age · Preterm infants for treatment of RDS

Bovine lung lavage surfactant extract showed no clear difference in oxygen requirement at 36 weeks' postmenstrual age compared with porcine minced lung surfactant extract (low certainty).

1 finding from 1 review