Periodontitis is a chronic inflammatory disease driven by a dysbiotic oral microbiome and an altered host immune response, leading to progressive destruction of the periodontal supporting tissue. Although non-surgical periodontal therapy remains the cornerstone of treatment, residual inflammation and microbial recolonization are frequently observed. In recent years, probiotics have emerged as a potential adjunctive approach aimed at modulating the oral microbiome and host response. Aim of the study. The aim of this study was to evaluate the effectiveness of probiotics as an adjunct to non-surgical periodontal therapy in improving clinical and microbiological outcomes in patients with periodontal diseases. Methods. A systematic search was conducted in PubMed for RCTs published between 2020 and 2025 investigating probiotics as adjuvant therapy in patients with gingivitis or chronic periodontitis. Inclusion criteria: human studies, clinical outcomes measured (PD, CAL, BOP, PI), and follow-up ≥4 weeks. Fifteen relevant studies were selected for detailed analysis. Results. The analyzed studies have shown that adjunctive probiotic therapy resulted in additional improvements in periodontal clinical parameters, particularly probing pocket depth reduction, clinical attachment gain, and decreased bleeding indices, compared to conventional therapy alone. Beneficial shifts in the periodontal microbiota were also reported. Conclusions. Probiotics appear to be a promising adjunctive strategy in the non-surgical management of periodontal diseases. While current evidence supports their beneficial clinical effects, standardized protocols and long-term studies are required before definitive clinical recommendations can be established.

DOI: https://doi.org/10.62838/ASMJ.2026.1.02