Microbiological Modulation Of The Oral-Gut Axis After Treatment With Or Without Systemic Use Of Probiotics In Patients With Periodontitis: A Randomized Controlled Clinical Study.

This study aims to evaluate whether the oral administration of probiotics, in combination with conventional periodontal treatment (deep cleaning of the tooth root surfaces), can improve oral health and influence the relationship between oral and gut bacteria in individuals with periodontitis. The study will include adults aged 30 years or older diagnosed with advanced periodontitis and receiving treatment at the School of Dentistry of Ribeirão Preto, University of São Paulo (FORP/USP). Individuals with systemic diseases that may interfere with the study outcomes, pregnant or breastfeeding women, smokers, recent former smokers, or individuals who have used antibiotics, probiotics, or certain medications within the previous six months will not be eligible to participate. Participants will be randomly assigned to two groups: one group will receive conventional periodontal treatment alone, while the other will receive the same treatment combined with probiotic supplementation. Before and after treatment, periodontal health will be assessed, including the presence of dental plaque, bleeding, periodontal pocket depth, and clinical attachment levels. Inflammatory substances present in gingival fluid will also be analyzed to evaluate the response to treatment. The findings of this study are expected to help clarify whether probiotics used as an adjunct to periodontal treatment can reduce inflammation and promote a more balanced relationship between oral and gut microorganisms, thereby contributing to improved periodontal health.