Oral microbiota in periodontitis and its modulation using probiotics: a review

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Abstract

Periodontitis remains one of the leading causes of tooth loss, with disruption of microbial balance in the oral cavity considered a key mechanism in its pathogenesis. In recent years, growing interest has focused on the oral microbiota as a therapeutic target, highlighting the relevance of analyzing current approaches aimed at restoring microbial balance and reducing inflammatory activity.

The review aimed to evaluate the effectiveness of probiotics, prebiotics, and other microbiota-modulating interventions in periodontitis. An analysis of publications from 2020 to 2025, including clinical studies and reviews, demonstrated that the use of probiotics (Lactobacillus reuteri, L. salivarius, Bifidobacterium spp.) and prebiotics (inulin) is associated with a reduction in periodontal pocket depth, decreased gingival bleeding, normalization of microbial composition, and reduced levels of proinflammatory cytokines. The most pronounced clinical effect was observed when these agents were combined with conventional mechanical debridement of root surfaces.

The available evidence indicates that modulation of the oral microbiota represents an effective and safe adjunctive approach in the treatment of periodontitis. This review systematizes current data on the use of probiotics and prebiotics in dentistry and identifies promising directions for future clinical research aimed at optimizing treatment protocols.

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About the authors

Ibragim Sh. Uzaev

Noth-Ossetian State Medical Academy

Author for correspondence.
Email: uzai.Ib2002@yandex.ru
ORCID iD: 0009-0003-6609-4644
Russian Federation, Vladikavkaz

Mikail B. Ayubov

Noth-Ossetian State Medical Academy

Email: ayubowmikail@gmail.com
ORCID iD: 0009-0001-4525-1124
Russian Federation, Vladikavkaz

Deni A. Madiev

Noth-Ossetian State Medical Academy

Email: madievdeni001@icloud.com
ORCID iD: 0009-0004-9309-265X
Russian Federation, Vladikavkaz

Shamad S. Shapaev

Noth-Ossetian State Medical Academy

Email: shamadshapaev@mail.ru
ORCID iD: 0009-0007-7711-5980
Russian Federation, Vladikavkaz

Ilyas M. Gebekov

Noth-Ossetian State Medical Academy

Email: genekovilas5@gmail.com
ORCID iD: 0009-0003-4237-5548
Russian Federation, Vladikavkaz

Abdula S. Razakov

Noth-Ossetian State Medical Academy

Email: razakov.abdula@bk.ru
ORCID iD: 0009-0007-1232-567X
Russian Federation, Vladikavkaz

Deni I. Zubayraev

Noth-Ossetian State Medical Academy

Email: denizubair00@icloud.com
ORCID iD: 0009-0007-0289-5783
Russian Federation, Vladikavkaz

Marha B. Kusieva

Noth-Ossetian State Medical Academy

Email: kusieva2001@bk.ru
ORCID iD: 0009-0005-1920-8041
Russian Federation, Vladikavkaz

References

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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