Russian MedicineRussian MedicineРоссийский медицинский журнал0869-21062412-9100Eco-Vector69883210.17816/medjrf698832LICURCReviewsНаучные обзорыReview ArticleOral microbiota in periodontitis and its modulation using probiotics: a reviewМикробиота полости рта при пародонтите и возможности её коррекции с использованием пробиотиков: обзорhttps://orcid.org/0009-0003-6609-4644UzaevIbragim Sh.УзаевИбрагим Шамсудинович
Russian Federation
uzai.Ib2002@yandex.ruhttps://orcid.org/0009-0001-4525-1124AyubovMikail B.АюбовМикаил Балаудинович
Russian Federation
ayubowmikail@gmail.comhttps://orcid.org/0009-0004-9309-265XMadievDeni A.МадиевДени Асланбекович
Russian Federation
madievdeni001@icloud.comhttps://orcid.org/0009-0007-7711-5980ShapaevShamad S.ШапаевШамад Сулейманович
Russian Federation
shamadshapaev@mail.ruhttps://orcid.org/0009-0003-4237-5548GebekovIlyas M.ГебековИльяс Магомедгаджиевич
Russian Federation
genekovilas5@gmail.comhttps://orcid.org/0009-0007-1232-567XRazakovAbdula S.РазаковАбдула Саитович
Russian Federation
razakov.abdula@bk.ruhttps://orcid.org/0009-0007-0289-5783ZubayraevDeni I.ЗубайраевДени Илесович
Russian Federation
denizubair00@icloud.comhttps://orcid.org/0009-0005-1920-8041KusievaMarha B.КусиеваМарха Бекбулатовна
Russian Federation
kusieva2001@bk.ruNoth-Ossetian State Medical AcademyСеверо-Осетинская государственная медицинская академия27032026120520263221962031712202519022026Copyright ©; 2026, Eco-VectorCopyright ©; 2026, Эко-Вектор2026Eco-VectorЭко-Векторhttps://eco-vector.com/for_authors.php#07https://medjrf.com/0869-2106/article/view/698832

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.

Пародонтит остаётся одной из наиболее частых причин утраты зубов, при этом нарушение микробного равновесия в полости рта рассматривается как ключевое звено его патогенеза. В последние годы возрастает интерес к микробиоте как терапевтической мишени, что обусловливает актуальность анализа современных подходов, направленных на восстановление её баланса и снижение воспалительной активности.

Целью настоящего обзора литературы стала оценка эффективности пробиотиков, пребиотиков и других средств, влияющих на микробиоту полости рта при пародонтите. Анализ публикаций 2020–2025 гг., включающих клинические исследования и обзоры, показал, что применение пробиотиков (Lactobacillus reuteri, L. salivarius, Bifidobacterium spp.) и пребиотиков (инулин) способствует снижению глубины пародонтальных карманов, уменьшению кровоточивости дёсен, нормализации микробного состава и снижению концентрации провоспалительных цитокинов. Наиболее выраженный клинический эффект наблюдается при сочетании данных средств с традиционной механической обработкой корней зубов.

Полученные данные свидетельствуют о том, что модуляция микробиоты полости рта является эффективным и безопасным адъювантным направлением терапии пародонтита. Представленный обзор систематизирует современные сведения о применении пробиотиков и пребиотиков в стоматологии и определяет перспективные направления дальнейших клинических исследований, направленных на оптимизацию лечебных протоколов.

periodontitisoral microbiotaprobioticsprebioticsreviewпародонтитмикробиота полости ртапробиотикипребиотикиобзор литературыZanatta CAR, Fritz PC, Comelli EM, Ward WE. Intervention with inulin prior to and during sanative therapy to further support periodontal health: study protocol for a randomized controlled trial. Trials. 2021;22(1):527. doi: 10.1186/s13063-021-05504-1 EDN: NRGJFUMensi M, Caselli E, D’accolti M, et al. Efficacy of the additional use of subgingival air-polishing with erythritol powder in the treatment of periodontitis patients: a randomized controlled clinical trial. Part II: effect on sub-gingival microbiome. Clin Oral Investig. 2023;27(6):2547–2563. doi: 10.1007/s00784-022-04811-4 EDN: IMIOLZNĘdzi-GÓra M, WrÓblewska M, GÓrska R. The effect of lactobacillus salivarius sgl03 on clinical and microbiological parameters in periodontal patients. Pol J Microbiol. 2020;69(4):441–451. doi: 10.33073/pjm-2020-047Şahin T, Akca G, Özmeriç N. The role of probiotics for preventing dysbiosis in periodontal disease: a randomized controlled trial. Turk J Med Sci. 2023;54(1):357–365. doi: 10.55730/1300-0144.5798 EDN: URVAIZSeidel CL, Gerlach RG, Weider M, et al. Influence of probiotics on the periodontium, the oral microbiota and the immune response during orthodontic treatment in adolescent and adult patients (ProMB Trial): study protocol for a prospective, double-blind, controlled, randomized clinical trial. BMC Oral Health. 2022;22(1):148. doi: 10.1186/s12903-022-02180-8 EDN: DSLSILGannenko AS, Miroshnichenko VV, Masimov AE. Application of bacteriophages in inflammatory periodontal disease treatment. Actual Problems in Dentistry. 2020;16(1):64–69. doi: 10.18481/2077-7566-2020-16-1-64-69 EDN: ILJRFHGerasimova LP, Kamilov FH, Ibragimova IF, et al. Modern methods of chronic periodontitis treatment (literature review). Actual Problems in Dentistry. 2024;20(4):28–39. doi: 10.18481/2077-7566-2024-20-4-28-39 EDN: AGHKARKang MS, Lee DS, Lee SA, et al. Effects of probiotic bacterium Weissella cibaria CMU on periodontal health and microbiota: a randomised, double-blind, placebo-controlled trial. BMC Oral Health. 2020;20(1):243. doi: 10.1186/s12903-020-01231-2 EDN: UFJEEQŽiemytė M, Lopez-Roldan A, Carda-Diéguez M, et al. Personalized antibiotic selection in periodontal treatment improves clinical and microbiological outputs. Front Cell Infect Microbiol. 2023;13:1307380. doi: 10.3389/fcimb.2023.1307380 EDN: DRALAYGonçalves MLL, Sobral APT, Gallo JMAS, et al. Antimicrobial photodynamic therapy with erythrosine and blue light on dental biofilm bacteria: study protocol for randomised clinical trial. BMJ Open. 2023;13(9):e075084. doi: 10.1136/bmjopen-2023-075084 EDN: MVATTJTaalab MR, Mahmoud SA, Moslemany RME, Abdelaziz DM. Intrapocket application of tea tree oil gel in the treatment of stage 2 periodontitis. BMC Oral Health. 2021;21(1):239. doi: 10.1186/s12903-021-01588-y EDN: CVEFKFTakesh T, Goshtasbi A, Lin K, et al. Better living through chemistry? A randomized, double-blind controlled study evaluating the efficacy of plaque control and gingival health impacts of a novel stannous fluoride-containing gel. J Periodontol. 2023;94(4):509–518. doi: 10.1002/jper.22-0254 EDN: AWWZJGGurina AV, Nagaeva MO, Zaitseva MV, et al. The role of oral microbiocenosis disorders in the formation of somatic and dental pathology. Actual Problems in Dentistry. 2022;18(2):15–22. doi: 10.18481/2077-7566-2022-18-2-15-22 EDN: GDAZFOYilmaz FÇ, Görgin NÇ. Yilmaz FÇ, Görgin NÇ. The role of probiotics and dietary interventions in the treatment of periodontitis: a pilot randomized controlled clinical trial. BMC Oral Health. 2025;25(1):1287. doi: 10.1186/s12903-025-06510-4 EDN: GSIICLArefnia B, Klymiuk I, Peikert SA, et al. Impact of antibiotics on the subgingival microbiome in advanced periodontitis: secondary analysis of a randomized controlled trial. Diagnostics (Basel). 2025;15(16):2012. doi: 10.3390/diagnostics15162012 EDN: IOCLOVKodzaeva ZS, Daurova FYu, Tomaeva DI, et al. Combined use of antimicrobial medication and physical therapeutic factors in periodontitis. Russian Journal of Dentistry. 2022;26(5):415–420. doi: 10.17816/dent.109158 EDN: GYCIMDLundtorp-Olsen C, Enevold C, Twetman S, Belstrøm D. Probiotics do not alter the long-term stability of the supragingival microbiota in healthy subjects: a randomized controlled trial. Pathogens. 2021;10(4):391. doi: 10.3390/pathogens10040391 EDN: WZXUOHKleine Bardenhorst S, Hagenfeld D, Matern J, et al. The role of the oral microbiota in the causal effect of adjunctive antibiotics on clinical outcomes in stage III-IV periodontitis patients. Microbiome. 2024;12(1):220. doi: 10.1186/s40168-024-01945-3 EDN: KSLDZMXu X, He L, Huo P, et al. Potential short-term shift in oral microbiota of patients with stage III-IV periodontitis and type 2 diabetes treated by non-surgical periodontal therapy. J Dent Sci. 2025;20(3):1470–1479. doi: 10.1016/j.Jds.2025.01.014 EDN: XZUWLFOmar YK, Rashidy MAE, Ahmed GB, Aboulela AG. Evaluation of leukocyte-platelet rich fibrin as an antibiotic slow-release biological device in the treatment of moderate periodontitis: a randomized controlled clinical trial. BMC Oral Health. 2024;24(1):1530. doi: 10.1186/s12903-024-05254-x EDN: EJTBRMSaberi Kakhki KCL, Harks I, Matern J, et al. Association of supragingival plaque management with subgingival microbiota is moderated by adjunctive antibiotics in stage III–IV periodontitis patients during periodontal therapy. J Oral Microbiol. 2025;17(1):2517043. doi: 10.1080/20002297.2025.2517043 EDN: AUJCLQBushueva E, Grigorjev S, Sablina S, et al. Clinical and microbiological characteristics of oral cavity in patients with periodontitis and hypothyroidism on the background of complex therapy with inclusion of synbiotic. Actual Problems in Dentistry. 2021;17(2):32–37. doi: 10.18481/2077-7566-20-17-2-32-37 EDN: VZWUTY