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A periodontite é uma condição inflamatória multifatorial, caracterizada pela destruição dos tecidos de suporte dental, fortemente associada a disbiose microbiana. O uso de probióticos vem sendo investigado como adjuvante ao tratamento periodontal convencional, com o objetivo de restaurar o equilíbrio microbiano e modular a resposta inflamatória. Assim esta revisão sistemática teve como objetivo avaliar a eficácia do uso de probióticos como terapia complementar no tratamento da doença periodontal, com ênfase em parâmetros clínicos, microbiológicos e inflamatórios. Foram incluídos 19 estudos, publicados entre 2019–2025, que atendiam aos critérios de elegibilidade propostos. As intervenções utilizaram a aplicação de diferentes espécies probióticas, predominantemente Lactobacillus reuteri, administradas via oral ou local, associadas à raspagem e alisamento radicular (RAR). Os parâmetros analisados incluíram profundidade de sondagem (PPD), ganho de inserção clínica (CAL), índice de placa (IP), sangramento à sondagem (BOP), e níveis de agentes patogénicos periodontais e marcadores inflamatórios. Verificou-se que a maioria dos estudos demonstrou melhoria clínica significativa com o uso de probióticos, com reduções médias de até 1 mm na PPD e 0,5 mm de ganho em CAL. Adicionalmente, observou-se diminuição de agentes patogénicos como Porphyromonas gingivalis, Treponema forsythia e Aggregatibacter actinomycetemcomitans, bem como de citocinas inflamatórias. Contudo, a heterogeneidade metodológica, curta duração e falta de padronização entre os estudos limitam a robustez das evidências. Desta forma, o uso de probióticos, especialmente L. reuteri, mostra-se uma estratégia complementar segura e promissora para o tratamento da periodontite. Entretanto, ensaios clínicos adicionais, de maior duração e com maior rigor metodológico, são necessários para validar a sua aplicação clínica recorrente.
Periodontitis is a multifactorial inflammatory condition characterized by the destruction of tooth-supporting tissues, strongly associated with microbial dysbiosis. The use of probiotics has been investigated as an adjunct to conventional periodontal treatment, with the aim of restoring microbial balance and modulating the inflammatory response. Thus, this systematic review aimed to evaluate the efficacy of probiotics as a complementary therapy in the treatment of periodontal disease, with emphasis on clinical, microbiological, and inflammatory outcomes. Nineteen studies, published between 2019 2025, that met the proposed eligibility criteria were included. The interventions used different probiotic strains, predominantly Lactobacillus reuteri, administered orally or locally, associated with scaling and root planing (SRP). The outcomes analyzed included probing depth (PPD), clinical attachment gain (CAL), plaque index (PI), bleeding on probing (BOP), and levels of periodontal pathogens and inflammatory markers. It was found that most studies demonstrated significant clinical improvement with the use of probiotics, with mean reductions of up to 1 mm in PPD and 0.5 mm gain in CAL. Additionally, a decrease in pathogens such as Porphyromonas gingivalis, Treponema forsythia and Aggregatibacter actinomycetemcomitans, as well as inflammatory cytokines, was observed. However, methodological heterogeneity, short duration and lack of standardization among studies limit the robustness of the evidence. Thus, the use of probiotics, especially L. reuteri, shows itself to be a safe and promising complementary strategy for the treatment of periodontitis. However, additional clinical trials, of longer duration and with greater methodological rigor, are necessary to validate its recurrent clinical application.
Periodontitis is a multifactorial inflammatory condition characterized by the destruction of tooth-supporting tissues, strongly associated with microbial dysbiosis. The use of probiotics has been investigated as an adjunct to conventional periodontal treatment, with the aim of restoring microbial balance and modulating the inflammatory response. Thus, this systematic review aimed to evaluate the efficacy of probiotics as a complementary therapy in the treatment of periodontal disease, with emphasis on clinical, microbiological, and inflammatory outcomes. Nineteen studies, published between 2019 2025, that met the proposed eligibility criteria were included. The interventions used different probiotic strains, predominantly Lactobacillus reuteri, administered orally or locally, associated with scaling and root planing (SRP). The outcomes analyzed included probing depth (PPD), clinical attachment gain (CAL), plaque index (PI), bleeding on probing (BOP), and levels of periodontal pathogens and inflammatory markers. It was found that most studies demonstrated significant clinical improvement with the use of probiotics, with mean reductions of up to 1 mm in PPD and 0.5 mm gain in CAL. Additionally, a decrease in pathogens such as Porphyromonas gingivalis, Treponema forsythia and Aggregatibacter actinomycetemcomitans, as well as inflammatory cytokines, was observed. However, methodological heterogeneity, short duration and lack of standardization among studies limit the robustness of the evidence. Thus, the use of probiotics, especially L. reuteri, shows itself to be a safe and promising complementary strategy for the treatment of periodontitis. However, additional clinical trials, of longer duration and with greater methodological rigor, are necessary to validate its recurrent clinical application.
Descrição
Palavras-chave
Doença periodontal Probióticos Raspagem e alisamento radicular Tratamento periodontal Periodontal disease Probiotics Scaling and root planing Periodontal treatment