The Role of Probiotics in Oral Potentially Malignant Disorders: A Comprehensive Review

Oral potentially malignant disorders (OPMDS), including leukoplakia, oral lichen planus, erythroplakia, and oral submucous fibrosis, are associated with an elevated risk of malignant transformation. Emerging evidence suggests that probiotics may modulate oral microbiota and local immune responses, potentially reducing progression risk. This review aimed to critically evaluate current evidence on the role of probiotics in the management of OPMDS, focusing on clinical outcomes, mechanistic insights, and safety profiles. A comprehensive literature search was conducted in PubMed, Web of Science, and Scopus for studies published from ۲۰۰۵ to ۲۰۲۵. Search terms included "probiotics," "Lactobacillus," "Bifidobacterium," "oral premalignant," "oral leukoplakia," "oral lichen planus," and related terms. Eligible studies comprised human clinical trials (RCTS, cohort, case-control), observational studies, systematic reviews, and relevant in vitro or animal studies elucidating mechanisms. Data extracted included study design, sample size, OPMD type, probiotic species/formulation, dose, duration, clinical outcomes, biomarkers, microbiome alterations, and safety. Twenty-seven studies met inclusion criteria: ۱۲ human clinical studies, ۹ in vitro/animal studies, and ۶ systematic reviews. Clinical evidence indicated that probiotics, particularly Lactobacillus and Bifidobacterium strains, were associated with reductions in lesion size, decreased inflammatory markers, and modulation of oral microbiota. Mechanistic studies suggested enhancement of mucosal immune responses, competitive inhibition of pathogenic bacteria, and anti-inflammatory effects as potential pathways. No severe adverse effects were reported, and probiotics were generally well-tolerated. However, study heterogeneity, small sample sizes, and short follow-up periods limit definitive conclusions. Probiotics show promise as adjunctive therapy for OPMDS by modulating local immune and microbial environments. While preliminary clinical and mechanistic evidence is encouraging, large-scale, well-designed RCTs with standardized formulations are required to confirm efficacy, determine optimal dosing, and assess long-term outcomes.

کلیدواژه ها:

Probiotics ، Oral Potentially Malignant Disorders ، Oral Leukoplakia ، Oral Lichen Planus ، Microbiome