Microbiological Analyses of Subgingival Flora in Response to Probiotic Adjuncts to Non-surgical Periodontal Therapy: A Scoping Review.

2026-01-02
Cureus 18(1)

PubMed: 41635337
DOI: 10.7759/cureus.100604

Study Design

Type: Review
Population: nine eligible studies that employed culture-based techniques, PCR/qPCR, DNA-DNA hybridization, and 16S rRNA sequencing of subgingival plaque samples
Methods: This scoping review aimed to map the subgingival microbiological analysis methods used in randomized controlled trials evaluating probiotics as adjuncts to non-surgical periodontal therapy (NSPT) and to summarize the microbial and clinical outcomes reported. A comprehensive search of PubMed, Scopus, and Web of Science from January 2008 to October 2025 identified nine eligible studies

This scoping review aimed to map the subgingival microbiological analysis methods used in randomized controlled trials evaluating probiotics as adjuncts to non-surgical periodontal therapy (NSPT) and to summarize the microbial and clinical outcomes reported. A comprehensive search of PubMed, Scopus, and Web of Science from January 2008 to October 2025 identified nine eligible studies that employed culture-based techniques, PCR/qPCR, DNA-DNA hybridization, and 16S rRNA sequencing of subgingival plaque samples. Evidence suggests that probiotics may provide short-term, strain-dependent modulation of the microbiota, characterized by transient reductions in key periodontal pathogens and early improvements in inflammatory parameters. However, substantial heterogeneity in microbiological methods limits direct comparison across studies and contributes to uncertainty regarding long-term ecological and clinical effects. While probiotics appear to offer supportive benefits during the early healing phase following NSPT, persistent microbial stability, durable colonization, and sustained clinical advantages have not been conclusively demonstrated. Given the limited use of high-resolution sequencing techniques and marked methodological variability, current evidence remains insufficient to support routine clinical application. Future studies incorporating standardized ecological endpoints, extended follow-up periods, and advanced molecular analyses are essential to clarify the true clinical relevance of probiotic adjuncts in periodontal therapy.

Research Insights

Supplement	Dose	Health Outcome	Effect Type	Effect Size	Source
Bifidobacterium lactis BI-04	—	No Conclusive Long-Term Clinical Benefit	Neutral	Small	View source persistent microbial stability, durable colonization, and sustained clinical advantages have not been conclusively demonstrated.
Bifidobacterium lactis BI-04	—	Reduced Inflammatory Markers	Beneficial	Small	View source Evidence suggests that probiotics may provide short-term, strain-dependent modulation of the microbiota, characterized by transient reductions in key periodontal pathogens and early improvements in inflammatory parameters.
Bifidobacterium lactis BI-04	—	Reduced Periodontal Pathogens	Beneficial	Small	View source Evidence suggests that probiotics may provide short-term, strain-dependent modulation of the microbiota, characterized by transient reductions in key periodontal pathogens and early improvements in inflammatory parameters.
Lactobacillus reuteri ATCC PTA 5289	—	Reduced Inflammatory Markers	Beneficial	Small	View source Evidence suggests that probiotics may provide short-term, strain-dependent modulation of the microbiota, characterized by transient reductions in key periodontal pathogens and early improvements in inflammatory parameters.
Lactobacillus reuteri ATCC PTA 5289	—	Reduced Periodontal Pathogen Burden	Beneficial	Small	View source Evidence suggests that probiotics may provide short-term, strain-dependent modulation of the microbiota, characterized by transient reductions in key periodontal pathogens and early improvements in inflammatory parameters.