Mechanism and Clinical Translation of Probiotic Preparations in the Prevention and Treatment of Periodontal Diseases

© 2026 by the Author. Licensee Whioce Publishing, Singapore. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )

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Abstract

Periodontitis is a chronic infectious disease associated with oral microbial dysbiosis and characterized by excessive activation of host immune inflammation. It can lead to gingival inflammation, periodontal pocket formation, alveolar bone resorption, and even tooth loss, and is closely associated with systemic conditions such as diabetes and cardiovascular disease. Probiotics, as active microorganisms capable of regulating host microecology and immune function, demonstrate significant potential in the prevention and treatment of periodontal diseases. They exert protective effects by antagonizing pathogenic bacteria, restoring oral microbial homeostasis, inhibiting inflammatory responses, alleviating oxidative stress-induced damage, and promoting the repair of periodontal soft and hard tissues. The Nrf2-Keap1-ARE signaling pathway, a key regulator of antioxidant and anti-inflammatory responses in the body, is involved in the modulation of the periodontal microenvironment by probiotics and plays a crucial mediating role in inhibiting oxidative stress, resolving inflammation, and promoting osteogenic differentiation. Biomaterial carriers, represented by hydrogels, can enhance the retention and bioavailability of probiotics in the periodontal region, providing critical support for the clinical translation of probiotic preparations. This article systematically reviews the mechanisms of probiotics in periodontal diseases, elucidates the regulatory functions of the Nrf2-Keap1-ARE pathway, compares the application characteristics of different types of hydrogel carriers, and summarizes the current clinical applications, translational bottlenecks, and future directions of probiotic preparations, offering a theoretical basis for microecological regulation therapy and the development of novel formulations for periodontal diseases.

Keywords

Probiotics

Periodontitis

Oxidative stress

Nrf2-Keap1-ARE pathway

Hydrogel

Funding

The Development of a Novel Photocurable Injectable Probiotic Hydrogel and Its Application in the Treatment of Diabetic Periodontitis (Project No.: X2025157); Hebei Natural Science Foundation (Project No.: H2025209011); Science Research Project of Hebei Education Department (Project No.: BJ2026391)

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