Advanced Therapies Journal

Advanced Therapies Journal

The Oral-Gut Microbiome Axis: Mechanisms Influencing Periodontal Therapeutic Response and Strategies for Microbiome Restoration

Reviewers

Authors
Hasti Soleimani Ghara-Veran
Setayesh Soleimani Ghara-Veran
Biotechnology Research Center, ZistYar Sanat Technology Development Group, Science and Technology Park, Tarbiat Modares University, Tehran, Iran.
10.22034/atj.2026.253121
Abstract
The oral-gut axis represents a bidirectional relationship between oral and intestinal microbial communities and plays an important role in the development and progression of periodontal diseases. Periodontitis, traditionally regarded as a localized inflammatory disorder, is increasingly recognized as a condition with systemic implications. This review summarizes current evidence on the biological mechanisms linking oral and gut microbiota, with particular emphasis on the translocation of periodontal pathogens, including Porphyromonas gingivalis and Tannerella forsythia, into the gastrointestinal tract. These pathogens may promote gut dysbiosis, impair intestinal barrier integrity, and contribute to systemic inflammation. Conversely, gut dysbiosis may aggravate periodontal inflammation through circulating pro-inflammatory mediators and bacterial endotoxins, creating a vicious cycle that can impair tissue healing and reduce treatment effectiveness.Individual differences in baseline microbiome composition and host immune responses may partly explain the variable outcomes observed following conventional periodontal therapies such as scaling and root planing. Therefore, microbiome assessment may support the development of personalized periodontal treatment strategies. Microbiome-modulating interventions, including probiotics, prebiotics, dietary modifications, engineered probiotics, and fecal microbiota transplantation, have emerged as potential adjunctive approaches to restore microbial homeostasis and improve clinical outcomes. Furthermore, multi-omics technologies may facilitate microbial profiling and prediction of treatment responses within a precision-medicine framework.Overall, targeting both oral and gut microbial health may represent a promising paradigm shift toward integrated and personalized periodontal care. However, large-scale randomized controlled trials are required to establish the clinical efficacy and standardized application of microbiome-focused therapies.
Keywords
Oral-Gut Axis, Periodontal Disease, Microbiome Dysbiosis, Probiotics
Antimicrobial Stewardship
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  • Receive Date 29 May 2026
  • Revise Date 28 July 2026
  • Accept Date 22 August 2026