Popovici Vlad Andrei, Gulei Ioana, Ganu Narcisa, Solomon Sorina Mihaela
ABSTRACT
Introduction: This review aims to evaluate and compare the therapeutic efficacy and safety of probiotics and antibiotics in the treatment of periodontal disease, emphasizing their biological mechanisms, clinical outcomes and potential applications in evidence-based practice. Materials and Methods: Data were extracted from scientific databases (PubMed, Web of Science, Google Scholar) using keywords such as “probiotics,” “antibiotics,” “periodontitis,” and “periodontal therapy.” Both experimental and clinical studies were included. Results: Thirty studies were analyzed. Both probiotics and antibiotics significantly improved clinical parameters such as probing pocket depth (PPD), clinical attachment level (CAL), and bleeding on probing (BOP). Probiotics showed additional benefits through immunomodulation, reduction of pro-inflammatory cytokines, and restoration of microbial homeostasis, while antibiotics provided faster antibacterial effects, but with increased risks of resistance and dysbiosis. Conclusions: Probiotics demonstrate comparable or superior effects to antibiotics as adjunctive therapy in periodontitis. Their long-term safety and ability to modulate the oral microbiome emphasize their potential as future therapeutic agents in periodontal management.
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