Comprehensive Diagnostic and Therapeutic Approaches to Oral Dysbiosis

Comprehensive Diagnostic and Therapeutic Approaches to Oral Dysbiosis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Comprehensive Diagnostic and Therapeutic Approaches to Oral Dysbiosis Jambilov Ravshan Sotvoldiyevich, Gafforov Sunatullo Amrulloyevich, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8455347/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Relevance. The study examines the quantitative and qualitative colonization of microorganisms in the oral cavity (OC) and its dependence on exogenous and endogenous factors, as well as the variability related to the design and number of removable dentures (RD). A microbial “landscape” — including the types, colonization levels, and quantity of microorganisms — was determined for clinically healthy adults to establish normative parameters for oral microflora. Objective. To diagnose dysbiotic conditions of the oral cavity, establish the normative microbial “landscape,” and substantiate the role of removable dentures in microbial colonization and composition. Materials and Methods. The study included 260 individuals (males and females aged 18–60 years). Group I (n=105) consisted of individuals diagnosed with various degrees of oral dysbiosis (61 males [58.09%], 44 females [41.9%]; mean age 44.6 years). Group II (n=96) included patients with oral dysbiosis of varying severity and the presence of removable dentures (41 males [43.15%], 54 females [56.84%]; mean age 49 years). Group III (n=60) served as the control group for determining the microbiological norm (27 males, 33 females; mean age 37 years). Results. In the clinically healthy adult population of Andijan City, the quantitative range of oral microflora was established as follows: Lactobacillus spp. 10³–10⁴, Streptococcus spp. 10⁵–10⁸, Str. pyogenes – absent, Leptotrichiaspp. 10²–10⁴, Staphylococcusspp. 10²–10⁴, Candida spp. 10²–10³, conditionally pathogenic Enterobacteriaceae10–10², Corynebacterium spp. <10², Bacteroides spp. <10³, Veillonella spp. 10³–10⁸, Fusobacterium spp. 10³–10⁴, Staphylococcus aureus– absent, Neisseria spp. 10⁵–10⁷. Dysbiotic states of the oral cavity were classified as follows: Grade I — reduction of resident microflora; Grade II — alteration of resident and conditionally pathogenic species composition; Grade III — predominance and proliferation of Candida spp. fungi. Conclusions. A classification of oral dysbiosis severity (Grade I–III) was developed and normative microbiological indices were established for the adult population of Andijan City. The microbial “landscape” of oral cavities with removable dentures was characterized. The obtained results substantiate the clinical and preventive significance of using Anethum graveolens leaf extract and decoction in orthopedic dental practice to enhance treatment outcomes and predict the effectiveness of therapeutic-preventive measures. Health sciences/Diseases Health sciences/Health care Health sciences/Medical research Biological sciences/Microbiology oral microbiocenosis pathogenic microbial spectrum removable dentures microbial resistance somatic pathologies oral cavity Figures Figure 1 Relevance It is well established that the oral cavity harbors between 300 and 400 species of microorganisms, with their quantitative concentration under normal conditions not exceeding 10²–10³ CFU/mL. Among these microorganisms, streptococci are predominant, accounting for 30–60% of the total oropharyngeal microflora, forming a specific “geographic specialization” within the oral ecosystem [ 1 – 3 ]. According to the World Health Organization (WHO), more than 20% of the global population develop various forms of candidiasis during their lifetime. Candida species rank fourth among pathogens isolated from the bloodstream—after Staphylococcus aureus, Streptococcus epidermidis, and Enterococcus spp.—and play a significant role in mortality associated with nosocomial septic conditions [ 4 – 6 ]. It has been reported that in the treatment of oral mucosal candidiasis, the development of specific and targeted antifungal drugs has shown high therapeutic efficacy. In addition, numerous studies have been devoted to counteracting microbial colonization in the oral cavity and restoring the balance of the normal microflora [ 7 – 9 ]. For example, considerable research has been conducted to evaluate the state and degree of dysbiosis both in the body and within the oral cavity. In recent years, there has been growing scientific interest in studying the impact of artificial dental prostheses (ADP ) —their types, designs, base materials, and their influence on the oral microbiocenosis—given their widespread use in the correction of dental defects [ 10 – 12 ]. This necessity arises from the current lack of a standardized definition of oral dysbiosis, the heterogeneous composition of the oral microbiota across different sites, and the absence of differentiated approaches to its diagnosis and treatment [ 13 – 15 ]. The purpose of the study. To develop a scientifically based framework for a rational approach to the diagnosis of oral cavity dysbiosis and the optimization of oral microflora composition aimed at improving the management and prevention of dental pathologies. Materials and methods The research was conducted in accordance with established ethical principles, taking into account the following factors: the study objectives, methodology, potential risks, availability of alternative treatment options, participants’ right to withdraw from the study at any stage, measures to mitigate possible harm, voluntary participation, and confidentiality of obtained data, as well as ensuring the safety of all participants [16-18]. Participants were selected based on the following inclusion criteria: men and women aged 18 to 60 years, free from systemic somatic pathologies, with no contraindications to the proposed treatment methods or medications, and no history of drug or alcohol dependency. A total of 155 individuals participated in the study, including 68 men and 87 women. The main group (MG) consisted of 95 individuals diagnosed with oral cavity dysbiosis, of whom 41 (43.15%) were men and 54 (56.84%) were women, with an average age of 49 years. According to the severity of dysbiosis, 22 participants (23.15%) had grade I, 36 (37.89%) had grade II, and 37 (38.94%) had grade III dysbiosis. The control group (CG) included 60 individuals (27 men and 33 women) with an average age of 37 years, who were somatically healthy, not registered for any chronic diseases, had no clinical complaints, and were free from periodontal and oral mucosal disorders. This group was used to determine the microbiological norms of the oral cavity. Ethics approval and consent to participate: The study protocol was reviewed and approved by the Local Ethics Committee of the Center for the Development of Professional Qualifications of Medical Workers under the Ministry of Health of the Republic of Uzbekistan with the participation of the Department of “Dentistry, Pediatric Dentistry and Orthodontics.” The decision approving the study was issued as Protocol No. 6 dated September 03, 2025. Prior to enrollment, all patients were provided with comprehensive information regarding the objectives, tasks, methods of the study, possible risks, and anticipated benefits. Written informed consent for participation in the study and the use of clinical data for scientific purposes was obtained from all participants, with strict adherence to confidentiality principles. The study did not cause any harmful physical or psychological effects on the participants. Personal data were coded and processed in anonymized form in accordance with medical confidentiality requirements. Clinical and functional data were recorded in a specially designed “Information Sheet” (questionnaire) , which included participants’ personal and demographic information , age , and dental status . The condition of the hard dental tissues was assessed using the CPI index — where (C) represents carious, (F) represents filled, and (E) represents extracted teeth. Oral hygiene was evaluated using the PHP (Podshadley and Haley) and Silness–Löe indices . The condition of the oral mucosa was examined by assessing the Dorsal Tongue Surface Index (DTSI) , which reflects swelling of the dorsal tongue surface , the expression of lingual papillae , and the presence of coating . The DTSI was graded as follows: 0 points – no visible changes; 1 point – coated dorsal surface of the tongue; 2 points – presence of coating and mild hyperkeratosis of filiform papillae; 3 points – dense coating and pronounced hyperkeratosis of filiform papillae [19, 20]. The microbiological composition of the oral cavity was assessed by cultural methods (smear inoculation and microbial cultivation) in the Bacteriological Laboratory . Biological material was collected on an empty stomach or 3–4 hours after a meal , without prior tooth brushing, medication intake, or mouth rinsing, using a sterile swab ( SORAP , Germany). To determine the total microbial contamination level (TMCL) , the sample was prepared in a 1:10 sodium chloride solution . The following culture media were used: Blood agar – for determining the total microbial contamination; Yellow-salt agar – for Lactobacillus species; Sabouraud medium – for Candida species; Endo medium – for Enterobacteriaceae ; Columbia agar – for anaerobic bacteria; Lacto-agar – for Lactobacillus isolation. Inoculation scheme: From 1:10 dilution – inoculation onto staphylococcal agar, Sabouraud medium, and Endo medium; From 1:100 dilution – inoculation onto Columbia agar, lacto-agar, and blood agar; From 1:1000 dilution – inoculation onto blood agar. Microscopic examination ( Biolam microscope) was carried out 48 hours after incubation . Microbial identification was performed as follows: Lactobacillus species ( L. casei, L. acidophilus, L. fermenti, L. salivarius ) – using the API 20 STREP test system ( bioMérieux Vitek, Inc. ); Streptococci ( Streptococcaceae, genus Streptococcus ) – using the API 20 STREP test system ( bioMérieux Vitek, Inc. ); Staphylococci ( Micrococcaceae, genus Staphylococcus ) – using the API Staph test system ( bioMérieux Vitek, Inc. ); Candida species – identified on Candiselect-4 chromogenic medium; Enterobacteria – using Diagnostic System plate tests; Anaerobic bacteria – identified using Anaerotest 23 ( Pliva Lachema ). Statistical analysis of the obtained results was performed using an IBM personal computer with a Pentium Dual-Core Inside processor , applying variation statistical methods described in several referenced publications. To correct dysbiotic conditions in the oral cavity, initial dental sanitation was performed, which included restoration of carious teeth, removal of dental calculus and plaque, and correction of dental arch defects. For orthopedic rehabilitation, patients in the main group (MG) were provided with artificial dental prostheses (ADPs) fabricated from metal–ceramic and zirconium-based materials using modern digital (3D) technology systems. As an adjunctive phytotherapeutic measure, the medicinal plant Anethum graveolens (dill) was used. Freshly harvested leaves were chewed for 3–4 minutes, 2–4 times daily, both before and after meals. An infusion was also prepared by steeping 50 g of dill in 1 liter of boiling water for 2 hours. The infusion was consumed 4–6 times per day, 50–70 mL per intake. The plant contains essential oils and phthalides, while its fruits are rich in essential oils, fatty acids, phthalides, furocoumarins, and hydroxycoumarins. The condition of participants’ hard dental tissues, periodontal tissues (PT), and oral mucosa (OM) was evaluated before treatment, and reassessed at 14, 60, and 90 days after the initiation of therapeutic and preventive interventions. Results and Their Analysis The initial microbiological assessment of the oral cavity in the control group (CG) revealed the following microbial titers : 10³–10⁴ (literature data: 10²–10³); <10³ (literature data: <10²); 10³–10⁴ (literature data: 10²–10³). A decrease in streptococcal contamination was observed—from 10⁸–10¹⁴ to 10²–10⁵. Based on these findings, the following normative indicators were established as characteristic for the adult population of Andijan city : Lactobacillus spp. — 10¹³–10¹⁴ CFU; Streptococcus spp. — 10⁵–10⁸ CFU; Streptococcus pyogenes — 0; Staphylococcus aureus — 0; Staphylococcus spp. — 10⁴–10⁶ CFU; Candida spp. — 10¹²–10¹³ CFU; Conditionally pathogenic Enterobacteriaceae — 10²–10⁴ CFU; Corynebacterium spp. — <10² CFU; Bacteroides spp. — <10⁴ CFU; Veillonella spp. — 10¹²–10¹⁶ CFU; Fusobacterium spp. — 10⁴–10⁶ CFU; Leptotrichia spp. — 10⁴–10⁶ CFU; Neisseria spp. — 10⁶–10⁸ CFU. Based on the obtained data, the severity of oral dysbiosis was categorized as follows: Grade I dysbiosis: Slight decrease in Lactobacillus titers with the presence of 2–3 types of pathogenic microorganisms . This stage is characterized by noticeable changes in the counts of Lactobacillus and Corynebacterium , while other rod-shaped microorganisms ( Bacteroides, Fusobacterium, Leptotrichia ), coccal flora ( Streptococcus , nonpathogenic Staphylococcus , Veillonella , Neisseria ), and Candida spp. may fluctuate. However, titers of conditionally pathogenic microorganisms ( Enterobacteriaceae , Streptococcus pyogenes , Staphylococcus aureus ) remain within normal limits. Grade II dysbiosis: Noticeable quantitative shifts are observed in nonpathogenic Staphylococcus , Corynebacterium , Bacteroides , Fusobacterium , and Leptotrichia species—both increases and decreases may occur. Titers of Lactobacillus , Veillonella , Neisseria , and Streptococcus significantly decline, while counts of Staphylococcus aureus and Enterobacteriaceae increase, and Candida spp. remain within normal values. Grade III dysbiosis: Marked reduction in the titers of Lactobacillus , Streptococcus , Veillonella , and Neisseria species, accompanied by pronounced changes in Bacteroides and Corynebacterium populations. The counts of Staphylococcus aureus , nonpathogenic Staphylococcus , Enterobacteriaceae , Fusobacterium , Leptotrichia , and Candida spp. increase substantially, with Candida spp. often forming fungal associations at this stage. The clinical condition of the oral cavity in the study participants was evaluated using the oral mucosa and dorsal tongue surface index (DTSI), CFE (carious, filled, and extracted teeth), periodontal tissue (PT) status, and oral hygiene indices (PHP and Silness–Löe). A negative change in DTSI was observed, characterized by the presence of coating and hypertrophy of filiform papillae, particularly pronounced in participants with Grade III (severe) dysbiosis ( p < 0.05). Similarly, CFE, PT status, and oral hygiene indices (PHP and Silness–Löe) exhibited comparable clinical manifestations, indicating a consistent association between the severity of dysbiosis and deterioration in both dental and periodontal health (Table 1). Table 1 . Description of the relationship between clinical–dental assessment indices and the degree of dysbiosis, M ± t, p (Control group, M ± t) Observed group: M/G (n = 95) CFE Hygienic indices CPI scores DTSI, scores РНР, scores Silness–Löe, scores 1 I-grade n=22 13,44±0,46 0,98±0,04 1,21±0,04 1,88±0,05 1,32±0,11 2 II-grade n=36 13,54±0,42 1,04±0,04 1,34±0,06 1,84±0,16 1,56±0,12 3 III-grade n=37 19,8±0,26 2,04±0,08 2,04± 0,05 2,98±0,24 1,91±0,23 C/G n=60 8,50±0,48 0,54±0,02 0,12±0,01 0,11±0,02 0,24±0,06 Note: CFE - carious, filled, and extracted teeth, DTSI - dorsal tongue surface index. The results presented in the table demonstrate the following trends: Caries intensity was classified as “moderate” in Grade I dysbiosis , “high” in Grade II , “very high” in Grade III , and “low” in the control group (CG) . The Silness–Löe index indicated mild gingivitis in Grade I dysbiosis ( p < 0.001), and moderate gingivitis in Grades II and III . Periodontal tissue inflammation (periodontitis) was observed as mild in Grade I dysbiosis , and moderate in Grades II and III . Oral hygiene was generally assessed as satisfactory in all participants of the main group (MG), whereas it was considered good in the control group (CG). These results indicate a clear correlation between dysbiosis severity and the intensity of dental and periodontal pathology , as well as oral hygiene status. The significance of various adverse factors in the development of oral dysbiosis was observed in the main group (MG) among patients with artificial dental prostheses (ADPs) . This condition is illustrated in Figure 1 . It has been reported in several studies that dental diseases develop against the background of intermediate dysbiosis , and that microecological disturbances occur not only in the oral cavity but also in the upper gastrointestinal tract (UGT) . In this context, dysbiotic changes in these systems are synchronous , and according to specialists, the number and diversity of bacteria in the OC correlate with those in the intestines within the same sample. This suggests that intermediate oral dysbiosis may be a consequence of intestinal dysbiosis , serving as a confirming factor of systemic microbial imbalance (Table 2, 3). Table 2. Frequency and composition (%) of artificial dental prostheses (ADPs) in relation to dysbiosis severity and somatic pathology. Observation group (n = 95) Frequency and composition of diseases, % URT GIT CVS 1-gr. (n=22) Up to 3 dental crowns 2/9,1 2/9,1 1 /4,5 More than 3 dental crowns 2/13,6 4/18,2 1 /4,5 More than 2 types of materials 2/9,1 5/22,7 1 /4,5 Total for Group I 6/27,3 11/50,0 3/13,6 2-gr. (n=36) Up to 3 dental crowns 2/5,5 2 /5,5 1 / 2,7 More than 3 dental crowns 4/11,1 5/13,9 2/5,5 More than 2 types of materials 5/13,9 10/27,8 2/ 5,5 Total for Group I I 11/30,5 17/47,2 5/13,9 3-gr. (n=37) Up to 3 dental crowns 4/10,8 5/13,5 2/5,5,3 More than 3 dental crowns 5/13,5 7/18,9 2/8,1 More than 2 types of materials 4/10,8 11/29,7 2/8,1 Total for Group I II 13/35,1 23/62,1 6/16,2 Total number of prostheses 30/31,6 51/53,7 14/14,7 Note: URT – Upper Respiratory Tract; GIT – Gastrointestinal Tract; CVS – Cardiovascular System. Table 3. Comparative characteristics of oral clinical-functional parameters in groups with various prosthetic constructions, M ± t, p Disbiotic conditions associated with gastrointestinal pathologies can impair not only the oral cavity but also the overall functioning of the digestive system. In subgroups with gastrointestinal disorders, cardiovascular diseases, and upper respiratory tract conditions, the average caries intensity, oral hygiene status, and severity of periodontitis progression were found to be nearly identical. As previously mentioned, the therapeutic-preventive interventions conducted in the main group involving 95 patients were evaluated at −14, 60, and 90 days. Analysis of Table 4 demonstrates a positive shift in the oral microbiota following the applied treatment measures. Table 4. Microbiological characteristics of the oral cavity under therapeutic-preventive intervention Microflora Observation period Isolation rate, % Significance Non-physiological range Significance Physiological range Lactobacillus spp. Before treatment 100 0 * Р 1-2 <0,001 55,8 Р 1-2 <0,001 58,7 ** Р 2-3 <0,001 24,6 Р 2-3 <0,001 68,4 *** Р 3-4 <0,001 3,13 Р 3-4 <0,001 74,8 Р 1-4 <0,0001 Р 1-4 <0,0001 Streptococcus spp. Before treatment 58,0 20.6 * Р 1-2 <0,05 30,4 Р 1-2 <0,05 64,6 ** Р 2-3 <0,05 14,4 Р 2-3 <0,05 76,8 *** Р 3-4 <0,05 2,8 Р 3-4 <0,05 82,4 Р 1-4 <0,01 Р 1-4 0,05 34,6 Р 1-2 >0,05 48,4 ** Р 2-3 >0,05 12,2 Р 2-3 >0,05 56,2 *** Р 3-4 >0,05 0 Р 3-4 >0,05 64,8 Р 1-4 >0,005 Р 1-4 >0,005 Enterobacteriaceae Before treatment 46,8 33,6 * Р 1-2 <0,05 20,4 Р 1-2 <0,05 42,8 ** Р 2-3 <0,05 12,4 Р 2-3 <0,05 68,2 *** Р 3-4 <0,05 4,2 Р 3-4 <0,05 78,7 Р 1-4 <0,005 Р 1-4 <0,005 Corynebacterium spp. Before treatment 58,9 18,6 * Р 1-2 <0,001 40,2 Р 1-2 <0,001 44,6 ** Р 2-3 <0,001 13,4 Р 2-3 <0,001 56,4 *** Р 3-4 < 0,001 2,2 Р 3-4 <0,001 92,5 Р 1-4 <0,001 Р 1-4 <0,001 Bacteroides spp. Before treatment 84 22 * Р 1-2 < 0,01 60,8 Р 1-2 < 0,01 40,6 ** Р 2-3 < 0,01 24,4 Р 2-3 < 0,01 85,4 *** Р 3-4 < 0,01 4,2 Р 3-4 < 0,01 79,9 Р 1-4 < 0,001 Р 1-4 0,05 12,4 Р 1-2 >0,05 76,4 ** Р 2-3 >0,05 4,2 Р 2-3 >0,05 84,4 *** Р 3-4 >0,05 0 Р 3-4 >0,05 89,6 Р 1-4 >0,005 Р 1-4 >0,005 Leptotrichia spp. Before treatment 37,5 55,8 * Р 1-2 < 0,01 28,4 Р 1-2 < 0,01 84,4 ** Р 2-3 < 0,01 11,2 Р 2-3 < 0,01 98,4 *** Р 3-4 < 0,01 0,6 Р 3-4 < 0,01 99,0 Р 1-4 < 0,01 Р 1-4 < 0,01 Note: *- after 14 days; **- after 60 days; ***- after 90 days; P 2 – reliability of data from the first subgroup compared to the second subgroup; P 3 – reliability of data from the first subgroup compared to the third subgroup; P 2–3 – reliability of data from the second subgroup compared to the third subgroup; P 1–4 – reliability of data from the first subgroup compared to the fourth subgroup; P 3–4 – reliability of data from the second subgroup compared to the fourth subgroup. In the first subgroup, normalization of Lactobacillus (p < 0.05), Streptococcus (p < 0.05), conditionally pathogenic Enterobacteriaceae (p < 0.05), Corynebacterium (p < 0.05), Bacteroides (p < 0.05), and Leptotrichia (p < 0.01) was observed. Among participants, 66.6% achieved complete recovery, while 23.7% showed no change in microbiological composition. Thus, in Grade I dysbiosis, treatment with Anethum graveolens (dill) improved oral hygiene, reduced periodontal inflammation, and allowed normalization of the oral microbiocenosis in 67% of cases. In the second subgroup, normalization of the oral microbiocenosis occurred in 13.3% of cases, and in the third subgroup in 53.3% of cases. Improvement was observed in 46.7% of participants in the second subgroup and 20.9% in the third subgroup. However, Grade II dysbiosis persisted in 40.9% of cases in the second subgroup and 26.7% in the third subgroup ( p < 0.05). After the therapeutic-preventive intervention, normalization was observed in Staphylococcus aureus, Staphylococcus spp., Candida spp., conditionally pathogenic Enterobacteriaceae, Bacteroides (p < 0.05), and Corynebacterium. Other microbiological indicators showed no significant changes. Thus, for all degrees of dysbiosis, the use of Anethum graveolens (dill) and its decoction, in combination with the placement of ceramo-metal and ceramo-ceramic prostheses in the dental arches, was observed to improve the oral microbiocenosis by up to 70%. Analysis. It is well established that the human microbiota plays both protective and pathogenic roles . Therefore, maintaining a balanced microbial landscape in the oral cavity is crucial for preventing complications of dental diseases and, in certain cases, has significant therapeutic value. In line with the perspectives of numerous international and local authors , we support the use of the term “dysbiosis” to describe quantitative changes in protozoa, fungi, and viruses . Based on the objectives of our study, we also constructed a reference profile of the oral microbial landscape in healthy individuals. In all participants of the study, the oral cavity microflora was analyzed using laboratory microbiological methods, and the obtained data were compared with published literature. Subsequently, we aimed to define microbiological and clinical criteria for dysbiosis according to its severity. For this purpose, 60 individuals who visited the Andijan City Dental Polyclinic for oral sanitation were included. Their dental status was assessed, and during the clinical examination, caries intensity, periodontal tissue status, oral hygiene, and Silness–Löe indices were recorded. Analysis of the OC in healthy respondents demonstrated that the tongue dorsal surface index (TDSI) increased significantly with worsening dysbiosis from Grade I to Grade III ( p < 0.05; p < 0.025). Similarly, dental indices including CPI, PHR, Silness–Löe, and PT status showed the same trend. Additionally, the presence and construction type of dental prostheses (ADPs) were examined in relation to the state of oral microbiocenosis, while the impact of URT, and CVS pathologies on OC dysbiosis was also assessed. When treating Grade III dysbiosis, a positive correlation was observed between the improvement of all clinical-dental indices and the normalization of oral microbiocenosis, which was confirmed by statistical analysis. Conclusion In healthy adults, the normal quantitative ranges of the oral cavity (OC) microflora are as follows: Lactobacillus – 10³–10⁴ CFU; Streptococcus spp. – 10⁵–10⁸ CFU; Str. pyogenes – 0; Leptotrichia – 10²–10⁴ CFU; Staphylococcus spp. – 10²–10⁴ CFU; Candida spp. – 10²–10³ CFU; conditionally pathogenic Enterobacteriaceae – 10–10² CFU; Corynebacterium – <10² CFU; Bacteroides – <10³ CFU; Veillonella – 10³–10⁸ CFU; Fusobacterium – 10³–10⁴ CFU; Staph. aureus – 0; Neisseria – 10⁵–10⁷ CFU. Oral dysbiosis is classified by severity as follows: Grade I – reduction of resident microflora; Grade II – alterations in both resident and conditionally pathogenic microflora; Grade III – pronounced overgrowth of Candida spp. The severity of dysbiosis and deterioration of oral hygiene are influenced by carious lesions, periodontal pathologies, and the presence of dental prostheses (ADPs). In particular, ADPs made of various constructions and metal alloys, especially mixed-metal prostheses, negatively affect the oral microbiota through local immunological disruption. Moreover, pathologies of the upper respiratory tract (URT), gastrointestinal tract (GIT), and cardiovascular system (CVS) contribute to instability of oral hygiene. Restoration and continuous correction of the OC microbiocenosis can be effectively achieved by replacing conventional prosthetic constructions with zirconia and ceramo-metal prostheses, combined with oral rinsing using local Anethum graveolens (dill) decoction and chewing fresh dill leaves 2–3 times daily, which demonstrates positive microbiological and clinical outcomes. Declarations Ethics approval and consent to participate: The study protocol was reviewed and approved by the Local Ethics Committee of the Center for the Development of Professional Qualifications of Medical Workers under the Ministry of Health of the Republic of Uzbekistan with the participation of the Department of “Dentistry, Pediatric Dentistry and Orthodontics.” The decision approving the study was issued as Protocol No. 6 dated September 03, 2025. Prior to enrollment, all patients were provided with comprehensive information regarding the objectives, tasks, methods of the study, possible risks, and anticipated benefits. Written informed consent for participation in the study and the use of clinical data for scientific purposes was obtained from all participants, with strict adherence to confidentiality principles. The study did not cause any harmful physical or psychological effects on the participants. Personal data were coded and processed in anonymized form in accordance with medical confidentiality requirements. Availability of data and materials . All data used in this review are contained in publicly available publications listed in the references. The datasets analyzed during the current study are available from the corresponding author upon reasonable request. Competing Interests . The authors declare no actual or potential conflicts of interest related to the publication of this article. Funding. This study received no external funding. Authors’ contributions. All authors made a substantial contribution to the development of the study concept, conduct of the research, and preparation of the manuscript. All authors read and approved the final version prior to publication. The individual contributions were distributed as follows: Djambilov R.S. – conduct of the research; Gafforov S.A. – supervision of manuscript preparation; Sobirov A.A. – manuscript formatting; Usmonov B.A. – writing and formatting of the text; Ulugbekova D.R. – conduct of the research; Gafforova S.S. – text editing. Statement of Originality. This manuscript is original; it has not been published, and is not under consideration elsewhere. All information sources are properly cited. Data Availability. All data used in this review are contained in publicly available publications listed in the references. Additional materials are available on request. Submission and Peer Review. The manuscript was submitted to the journal on the authors’ own initiative. Clinical trial number : not applicable. References Alyousef, Y. M., Piotrowski, S., Alonaizan, F. A., et al. (2023). Oral microbiota analyses of paediatric Saudi population reveals signatures of dental caries. 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C., Langø, T., Remman, T., Sen, A. … (2023). AI‑Dentify: Deep learning for proximal caries detection on bitewing x‑ray – HUNT4 Oral Health Study. ArXiv Preprint . https://arxiv.org/abs/2310.00354 Zambrano‑Mila, J., et al. (2021). The Impact of Oral Microbiome Dysbiosis on the Aetiology, Pathogenesis, and Development of Oral Cancer. Cancers, 16 (17), 2997. https://doi.org/10.3390/cancers16172997 Chirkova, N. V., Vecherkina, Z. V., Shalimova, N. A., & Primacheva, N. V. (2023). Selection of a structural material for the basis of a removable prosthesis in patients with oral dysbiosis based on toxicological examination. Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny), 26 (1), 9–14. https://doi.org/10.18499/2070-9277-2023-26-1-9-14 Alijon, S., Sunnatullo, G., Nurmukhamet, R., Raykhon, P., Ravshanbek, J., Kalamkas, R., ... & Sevara, G. (2025). Justification for the physiological isolation of the torus based on the pain sensitivity of the oral mucosa. In BIO Web of Conferences (Vol. 152, p. 01008). EDP Sciences. https://doi.org/10.1051/bioconf/202515201008 Pervov, Y. Y., Bocharov, V. S., Kim, A. R., & Reva, G. V. (2024). Influence of dental prostheses materials on the condition of oral mucosa local homeostasis. Perm Medical Journal, 41 (5), 5–18. https://doi.org/10.17816/pmj4155-18 Hasnur Safii, S., Ahmad, N. A., et al. (2024). Denture microbiome shift and changes of salivary inflammatory markers following insertion of 3D printed removable partial PMMA denture: A pilot study. BMC Oral Health, 24 , Article 1216. https://doi.org/10.1186/s12903-024-05012-z Khairunnisa, Z., Tuygunov, N., Cahyanto, A., et al. (2024). Potential of microbial‑derived biosurfactants for oral applications – a systematic review. BMC Oral Health, 24 , Article 707. https://doi.org/10.1186/s12903-024-04479-0 Zhang, M., Zhao, Y., Umar, A., et al. (2024). Comparative analysis of microbial composition and functional characteristics in dental plaque and saliva of oral cancer patients. BMC Oral Health, 24 , Article 411. https://doi.org/10.1186/s12903-024-04181-1 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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04:00:17","extension":"xml","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":103801,"visible":true,"origin":"","legend":"","description":"","filename":"44717be21dcd4acda7006578d4286cfd1structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-8455347/v1/24f98b47dc6e29511629ee14.xml"},{"id":100748015,"identity":"60a4917d-b370-4ae2-b4da-690f727bf3fd","added_by":"auto","created_at":"2026-01-21 04:00:14","extension":"html","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":117597,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8455347/v1/70c626ed3ee5ad9c5876b1df.html"},{"id":100748060,"identity":"b7027def-66bf-416e-b914-d5605b8d7500","added_by":"auto","created_at":"2026-01-21 04:00:31","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":43516,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eDescription of identified somatic pathologies (%) in participants of the main group (MG).\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8455347/v1/e40ae819eb3974d2c7f4737b.png"},{"id":101752636,"identity":"77be76a1-2778-410d-b2c8-17423ef2f5ce","added_by":"auto","created_at":"2026-02-03 10:28:37","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2323598,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8455347/v1/e9a6d2d2-8b34-4e57-9e57-544cc3238f63.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eComprehensive Diagnostic and Therapeutic Approaches to Oral Dysbiosis\u003c/p\u003e","fulltext":[{"header":"Relevance","content":"\u003cp\u003eIt is well established that the oral cavity harbors between 300 and 400 species of microorganisms, with their quantitative concentration under normal conditions not exceeding 10\u0026sup2;\u0026ndash;10\u0026sup3; CFU/mL. Among these microorganisms, streptococci are predominant, accounting for 30\u0026ndash;60% of the total oropharyngeal microflora, forming a specific \u0026ldquo;geographic specialization\u0026rdquo; within the oral ecosystem [\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. According to the World Health Organization (WHO), more than 20% of the global population develop various forms of candidiasis during their lifetime. Candida species rank fourth among pathogens isolated from the bloodstream\u0026mdash;after Staphylococcus aureus, Streptococcus epidermidis, and Enterococcus spp.\u0026mdash;and play a significant role in mortality associated with nosocomial septic conditions [\u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. It has been reported that in the treatment of oral mucosal candidiasis, the development of specific and targeted antifungal drugs has shown high therapeutic efficacy. In addition, numerous studies have been devoted to counteracting microbial colonization in the oral cavity and restoring the balance of the normal microflora [\u003cspan additionalcitationids=\"CR8\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. For example, considerable research has been conducted to evaluate the state and degree of dysbiosis both in the body and within the oral cavity. In recent years, there has been growing scientific interest in studying the impact of artificial dental prostheses (ADP\u003cb\u003e)\u003c/b\u003e\u0026mdash;their types, designs, base materials, and their influence on the oral microbiocenosis\u0026mdash;given their widespread use in the correction of dental defects [\u003cspan additionalcitationids=\"CR11\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. This necessity arises from the current lack of a standardized definition of oral dysbiosis, the heterogeneous composition of the oral microbiota across different sites, and the absence of differentiated approaches to its diagnosis and treatment [\u003cspan additionalcitationids=\"CR14\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cb\u003eThe purpose of the study.\u003c/b\u003e To develop a scientifically based framework for a rational approach to the diagnosis of oral cavity dysbiosis and the optimization of oral microflora composition aimed at improving the management and prevention of dental pathologies.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cp\u003eThe research was conducted in accordance with established ethical principles, taking into account the following factors: the study objectives, methodology, potential risks, availability of alternative treatment options, participants\u0026rsquo; right to withdraw from the study at any stage, measures to mitigate possible harm, voluntary participation, and confidentiality of obtained data, as well as ensuring the safety of all participants [16-18]. Participants were selected based on the following inclusion criteria: men and women aged 18 to 60 years, free from systemic somatic pathologies, with no contraindications to the proposed treatment methods or medications, and no history of drug or alcohol dependency. A total of 155 individuals participated in the study, including 68 men and 87 women. The main group (MG) consisted of 95 individuals diagnosed with oral cavity dysbiosis, of whom 41 (43.15%) were men and 54 \u0026nbsp; \u0026nbsp;(56.84%) were women, with an average age of 49 years. According to the severity of dysbiosis, 22 participants (23.15%) had grade I, 36 (37.89%) had grade II, and 37 (38.94%) had grade III dysbiosis. The control group (CG) included 60 individuals (27 men and 33 women) with an average age of 37 years, who were somatically healthy, not registered for any chronic diseases, had no clinical complaints, and were free from periodontal and oral mucosal disorders. This group was used to determine the microbiological norms of the oral cavity.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u003c/strong\u003e The study protocol was reviewed and approved by the Local Ethics Committee of the Center for the Development of Professional Qualifications of Medical Workers under the Ministry of Health of the Republic of Uzbekistan with the participation of the Department of \u0026ldquo;Dentistry, Pediatric Dentistry and Orthodontics.\u0026rdquo; The decision approving the study was issued as Protocol No. 6 dated September 03, 2025. Prior to enrollment, all patients were provided with comprehensive information regarding the objectives, tasks, methods of the study, possible risks, and anticipated benefits. Written informed consent for participation in the study and the use of clinical data for scientific purposes was obtained from all participants, with strict adherence to confidentiality principles. The study did not cause any harmful physical or psychological effects on the participants. Personal data were coded and processed in anonymized form in accordance with medical confidentiality requirements.\u003c/p\u003e\n\u003cp\u003eClinical and functional data were recorded in a specially designed \u003cstrong\u003e\u0026ldquo;Information Sheet\u0026rdquo; (questionnaire)\u003c/strong\u003e, which included participants\u0026rsquo; \u003cstrong\u003epersonal and demographic information\u003c/strong\u003e, \u003cstrong\u003eage\u003c/strong\u003e, and \u003cstrong\u003edental status\u003c/strong\u003e. The condition of the \u003cstrong\u003ehard dental tissues\u003c/strong\u003e was assessed using the \u003cstrong\u003eCPI index\u003c/strong\u003e \u0026mdash; where \u003cem\u003e(C)\u003c/em\u003e represents carious, \u003cem\u003e(F)\u003c/em\u003e represents filled, and \u003cem\u003e(E)\u003c/em\u003e represents extracted teeth. Oral hygiene was evaluated using the \u003cstrong\u003ePHP (Podshadley and Haley)\u003c/strong\u003e and \u003cstrong\u003eSilness\u0026ndash;L\u0026ouml;e indices\u003c/strong\u003e. The condition of the \u003cstrong\u003eoral mucosa\u003c/strong\u003e was examined by assessing the \u003cstrong\u003eDorsal Tongue Surface Index (DTSI)\u003c/strong\u003e, which reflects \u003cstrong\u003eswelling of the dorsal tongue surface\u003c/strong\u003e, \u003cstrong\u003ethe expression of lingual papillae\u003c/strong\u003e, and \u003cstrong\u003ethe presence of coating\u003c/strong\u003e. The DTSI was graded as follows: \u003cstrong\u003e0 points\u003c/strong\u003e \u0026ndash; no visible changes; \u003cstrong\u003e1 point\u003c/strong\u003e \u0026ndash; coated dorsal surface of the tongue; \u003cstrong\u003e2 points\u003c/strong\u003e \u0026ndash; presence of coating and mild hyperkeratosis of filiform papillae; \u003cstrong\u003e3 points\u003c/strong\u003e \u0026ndash; dense coating and pronounced hyperkeratosis of filiform papillae [19, 20].\u003c/p\u003e\n\u003cp\u003eThe microbiological composition of the oral cavity was assessed by \u003cstrong\u003ecultural methods\u003c/strong\u003e (smear inoculation and microbial cultivation) in the \u003cstrong\u003eBacteriological Laboratory\u003c/strong\u003e. Biological material was collected \u003cstrong\u003eon an empty stomach or 3\u0026ndash;4 hours after a meal\u003c/strong\u003e, without prior tooth brushing, medication intake, or mouth rinsing, using a sterile swab (\u003cem\u003eSORAP\u003c/em\u003e, Germany). To determine the \u003cstrong\u003etotal microbial contamination level (TMCL)\u003c/strong\u003e, the sample was prepared in a \u003cstrong\u003e1:10 sodium chloride solution\u003c/strong\u003e. The following culture media were used: \u003cstrong\u003eBlood agar\u003c/strong\u003e \u0026ndash; for determining the total microbial contamination; \u003cstrong\u003eYellow-salt agar\u003c/strong\u003e \u0026ndash; for \u003cem\u003eLactobacillus\u003c/em\u003e species; \u003cstrong\u003eSabouraud medium\u003c/strong\u003e \u0026ndash; for \u003cem\u003eCandida\u003c/em\u003e species; \u003cstrong\u003eEndo medium\u003c/strong\u003e \u0026ndash; for \u003cem\u003eEnterobacteriaceae\u003c/em\u003e; \u003cstrong\u003eColumbia agar\u003c/strong\u003e \u0026ndash; for anaerobic bacteria; \u003cstrong\u003eLacto-agar\u003c/strong\u003e \u0026ndash; for \u003cem\u003eLactobacillus\u003c/em\u003e isolation. \u003cstrong\u003eInoculation scheme:\u0026nbsp;\u003c/strong\u003eFrom \u003cstrong\u003e1:10 dilution\u003c/strong\u003e \u0026ndash; inoculation onto staphylococcal agar, Sabouraud medium, and Endo medium; From \u003cstrong\u003e1:100 dilution\u003c/strong\u003e \u0026ndash; inoculation onto Columbia agar, lacto-agar, and blood agar; From \u003cstrong\u003e1:1000 dilution\u003c/strong\u003e \u0026ndash; inoculation onto blood agar. Microscopic examination (\u003cem\u003eBiolam\u003c/em\u003e microscope) was carried out \u003cstrong\u003e48 hours after incubation\u003c/strong\u003e. Microbial identification was performed as follows: \u003cstrong\u003eLactobacillus species\u003c/strong\u003e (\u003cem\u003eL. casei, L. acidophilus, L. fermenti, L. salivarius\u003c/em\u003e) \u0026ndash; using the \u003cstrong\u003eAPI 20 STREP\u003c/strong\u003e test system (\u003cem\u003ebioM\u0026eacute;rieux Vitek, Inc.\u003c/em\u003e); \u003cstrong\u003eStreptococci\u003c/strong\u003e (\u003cem\u003eStreptococcaceae, genus Streptococcus\u003c/em\u003e) \u0026ndash; using the \u003cstrong\u003eAPI 20 STREP\u003c/strong\u003e test system (\u003cem\u003ebioM\u0026eacute;rieux Vitek, Inc.\u003c/em\u003e); \u003cstrong\u003eStaphylococci\u003c/strong\u003e (\u003cem\u003eMicrococcaceae, genus Staphylococcus\u003c/em\u003e) \u0026ndash; using the \u003cstrong\u003eAPI Staph\u003c/strong\u003e test system (\u003cem\u003ebioM\u0026eacute;rieux Vitek, Inc.\u003c/em\u003e); \u003cstrong\u003eCandida species\u003c/strong\u003e \u0026ndash; identified on \u003cstrong\u003eCandiselect-4\u003c/strong\u003e chromogenic medium; \u003cstrong\u003eEnterobacteria\u003c/strong\u003e \u0026ndash; using \u003cstrong\u003eDiagnostic System\u003c/strong\u003e plate tests; \u003cstrong\u003eAnaerobic bacteria\u003c/strong\u003e \u0026ndash; identified using \u003cstrong\u003eAnaerotest 23\u003c/strong\u003e (\u003cem\u003ePliva Lachema\u003c/em\u003e). Statistical analysis of the obtained results was performed using an \u003cstrong\u003eIBM personal computer\u003c/strong\u003e with a \u003cstrong\u003ePentium Dual-Core Inside processor\u003c/strong\u003e, applying \u003cstrong\u003evariation statistical methods\u003c/strong\u003e described in several referenced publications.\u003c/p\u003e\n\u003cp\u003eTo correct dysbiotic conditions in the oral cavity, initial dental sanitation was performed, which included restoration of carious teeth, removal of dental calculus and plaque, and correction of dental arch defects. For orthopedic rehabilitation, patients in the main group (MG) were provided with artificial dental prostheses (ADPs) fabricated from metal\u0026ndash;ceramic and zirconium-based materials using modern digital (3D) technology systems. As an adjunctive phytotherapeutic measure, the medicinal plant Anethum graveolens (dill) was used. Freshly harvested leaves were chewed for 3\u0026ndash;4 minutes, 2\u0026ndash;4 times daily, both before and after meals. An infusion was also prepared by steeping 50 g of dill in 1 liter of boiling water for 2 hours. The infusion was consumed 4\u0026ndash;6 times per day, 50\u0026ndash;70 mL per intake. The plant contains essential oils and phthalides, while its fruits are rich in essential oils, fatty acids, phthalides, furocoumarins, and hydroxycoumarins. The condition of participants\u0026rsquo; hard dental tissues, periodontal tissues (PT), and oral mucosa (OM) was evaluated before treatment, and reassessed at 14, 60, and 90 days after the initiation of therapeutic and preventive interventions.\u003c/p\u003e"},{"header":"Results and Their Analysis","content":"\u003cp\u003eThe initial microbiological assessment of the \u003cstrong\u003eoral cavity\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003ein the\u003cstrong\u003e\u0026nbsp;\u003cstrong\u003econtrol group (CG)\u003c/strong\u003e\u0026nbsp;\u003c/strong\u003erevealed the following\u003cstrong\u003e\u0026nbsp;\u003cstrong\u003emicrobial titers\u003c/strong\u003e\u003c/strong\u003e: 10\u0026sup3;\u0026ndash;10⁴ (literature data: 10\u0026sup2;\u0026ndash;10\u0026sup3;); \u0026lt;10\u0026sup3; (literature data: \u0026lt;10\u0026sup2;); 10\u0026sup3;\u0026ndash;10⁴ (literature data: 10\u0026sup2;\u0026ndash;10\u0026sup3;). A decrease in \u003cstrong\u003estreptococcal contamination\u003c/strong\u003e was observed\u0026mdash;from 10⁸\u0026ndash;10\u0026sup1;⁴ to 10\u0026sup2;\u0026ndash;10⁵. Based on these findings, the following \u003cstrong\u003enormative indicators\u003c/strong\u003e were established as characteristic for the \u003cstrong\u003eadult population of Andijan city\u003c/strong\u003e: \u003cem\u003eLactobacillus\u003c/em\u003e spp. \u0026mdash; 10\u0026sup1;\u0026sup3;\u0026ndash;10\u0026sup1;⁴ CFU; \u003cem\u003eStreptococcus\u003c/em\u003e spp. \u0026mdash; 10⁵\u0026ndash;10⁸ CFU; \u003cem\u003eStreptococcus pyogenes\u003c/em\u003e \u0026mdash; 0; \u003cem\u003eStaphylococcus aureus\u003c/em\u003e \u0026mdash; 0; \u003cem\u003eStaphylococcus\u003c/em\u003e spp. \u0026mdash; 10⁴\u0026ndash;10⁶ CFU; \u003cem\u003eCandida\u003c/em\u003e spp. \u0026mdash; 10\u0026sup1;\u0026sup2;\u0026ndash;10\u0026sup1;\u0026sup3; CFU; Conditionally pathogenic \u003cem\u003eEnterobacteriaceae\u003c/em\u003e \u0026mdash; 10\u0026sup2;\u0026ndash;10⁴ CFU; \u003cem\u003eCorynebacterium\u003c/em\u003e spp. \u0026mdash; \u0026lt;10\u0026sup2; CFU; \u003cem\u003eBacteroides\u003c/em\u003e spp. \u0026mdash; \u0026lt;10⁴ CFU; \u003cem\u003eVeillonella\u003c/em\u003e spp. \u0026mdash; 10\u0026sup1;\u0026sup2;\u0026ndash;10\u0026sup1;⁶ CFU; \u003cem\u003eFusobacterium\u003c/em\u003e spp. \u0026mdash; 10⁴\u0026ndash;10⁶ CFU; \u003cem\u003eLeptotrichia\u003c/em\u003e spp. \u0026mdash; 10⁴\u0026ndash;10⁶ CFU; \u003cem\u003eNeisseria\u003c/em\u003e spp. \u0026mdash; 10⁶\u0026ndash;10⁸ CFU. Based on the obtained data, \u003cstrong\u003ethe severity of oral dysbiosis\u003c/strong\u003e was categorized as follows: \u003cstrong\u003eGrade I dysbiosis:\u0026nbsp;\u003c/strong\u003eSlight decrease in \u003cem\u003eLactobacillus\u003c/em\u003e titers with the presence of \u003cstrong\u003e2\u0026ndash;3 types of pathogenic microorganisms\u003c/strong\u003e. This stage is characterized by noticeable changes in the counts of \u003cem\u003eLactobacillus\u003c/em\u003e and \u003cem\u003eCorynebacterium\u003c/em\u003e, while other rod-shaped microorganisms (\u003cem\u003eBacteroides, Fusobacterium, Leptotrichia\u003c/em\u003e), coccal flora (\u003cem\u003eStreptococcus\u003c/em\u003e\u003cem\u003e,\u0026nbsp;\u003c/em\u003enonpathogenic\u003cem\u003e\u0026nbsp;\u003cem\u003eStaphylococcus\u003c/em\u003e, \u003cem\u003eVeillonella\u003c/em\u003e, \u003cem\u003eNeisseria\u003c/em\u003e\u003c/em\u003e), and \u003cem\u003eCandida\u003c/em\u003e spp. may fluctuate. However, titers of \u003cstrong\u003econditionally pathogenic microorganisms\u003c/strong\u003e (\u003cem\u003eEnterobacteriaceae\u003c/em\u003e\u003cem\u003e, \u003cem\u003eStreptococcus pyogenes\u003c/em\u003e, \u003cem\u003eStaphylococcus aureus\u003c/em\u003e\u003c/em\u003e) remain within normal limits. \u003cstrong\u003eGrade II dysbiosis:\u0026nbsp;\u003c/strong\u003eNoticeable quantitative shifts are observed in nonpathogenic \u003cem\u003eStaphylococcus\u003c/em\u003e\u003cem\u003e, \u003cem\u003eCorynebacterium\u003c/em\u003e, \u003cem\u003eBacteroides\u003c/em\u003e, \u003cem\u003eFusobacterium\u003c/em\u003e\u003c/em\u003e, and\u0026nbsp;\u003cem\u003eLeptotrichia\u003c/em\u003e species\u0026mdash;both increases and decreases may occur.\u003cbr\u003eTiters of \u003cem\u003eLactobacillus\u003c/em\u003e\u003cem\u003e, \u003cem\u003eVeillonella\u003c/em\u003e, \u003cem\u003eNeisseria\u003c/em\u003e\u003c/em\u003e, and \u003cem\u003eStreptococcus\u003c/em\u003e significantly decline, while \u003cstrong\u003ecounts of\u0026nbsp;\u003c/strong\u003e\u003cem\u003eStaphylococcus aureus\u003c/em\u003e\u003cstrong\u003e\u0026nbsp;and\u0026nbsp;\u003c/strong\u003e\u003cem\u003eEnterobacteriaceae\u003c/em\u003e increase, and \u003cem\u003eCandida\u003c/em\u003e spp. remain within normal values. \u003cstrong\u003eGrade III dysbiosis:\u0026nbsp;\u003c/strong\u003eMarked reduction in the titers of \u003cem\u003eLactobacillus\u003c/em\u003e\u003cem\u003e, \u003cem\u003eStreptococcus\u003c/em\u003e, \u003cem\u003eVeillonella\u003c/em\u003e\u003c/em\u003e, and \u003cem\u003eNeisseria\u003c/em\u003e species, accompanied by \u003cstrong\u003epronounced changes in\u0026nbsp;\u003c/strong\u003e\u003cem\u003eBacteroides\u003c/em\u003e\u003cstrong\u003e\u0026nbsp;and\u0026nbsp;\u003c/strong\u003e\u003cem\u003eCorynebacterium\u003c/em\u003e populations. The counts of \u003cem\u003eStaphylococcus aureus\u003c/em\u003e, nonpathogenic \u003cem\u003eStaphylococcus\u003c/em\u003e, \u003cem\u003eEnterobacteriaceae\u003c/em\u003e\u003cem\u003e, \u003cem\u003eFusobacterium\u003c/em\u003e, \u003cem\u003eLeptotrichia\u003c/em\u003e\u003c/em\u003e, and \u003cem\u003eCandida\u003c/em\u003e spp. increase substantially, with \u003cstrong\u003eCandida spp. often forming fungal associations\u003c/strong\u003e at this stage.\u003c/p\u003e\n\u003cp\u003eThe clinical condition of the oral cavity in the study participants was evaluated using the oral mucosa and dorsal tongue surface index (DTSI), CFE (carious, filled, and extracted teeth), periodontal tissue (PT) status, and oral hygiene indices (PHP and Silness\u0026ndash;L\u0026ouml;e). A negative change in DTSI was observed, characterized by the presence of coating and hypertrophy of filiform papillae, particularly pronounced in participants with Grade III (severe) dysbiosis (\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.05). Similarly, CFE, PT status, and oral hygiene indices (PHP and Silness\u0026ndash;L\u0026ouml;e) exhibited comparable clinical manifestations, indicating a consistent association between the severity of dysbiosis and deterioration in both dental and periodontal health (Table 1).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003cstrong\u003e.\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eDescription of the relationship between clinical\u0026ndash;dental assessment indices and the degree of dysbiosis, M \u0026plusmn; t, p (Control group, M \u0026plusmn; t)\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 132px;\"\u003e\u003cstrong\u003eObserved group:\u003c/strong\u003e\u003cstrong\u003e\u003cbr\u003e \u003cstrong\u003eM/G (n = 95)\u003c/strong\u003e\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 99px;\"\u003eCFE\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 184px;\"\u003eHygienic indices\u003cbr\u003e\u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 90px;\"\u003eCPI scores\u003cbr\u003e\u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 107px;\"\u003eDTSI, scores\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003eРНР,\u003cbr\u003escores\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003eSilness\u0026ndash;L\u0026ouml;e, scores\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e1\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003eI-grade n=22\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e13,44\u0026plusmn;0,46\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e0,98\u0026plusmn;0,04\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e1,21\u0026plusmn;0,04\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e1,88\u0026plusmn;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e1,32\u0026plusmn;0,11\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e2\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003eII-grade n=36\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e13,54\u0026plusmn;0,42\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e1,04\u0026plusmn;0,04\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e1,34\u0026plusmn;0,06\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e1,84\u0026plusmn;0,16\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e1,56\u0026plusmn;0,12\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003e3\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003eIII-grade n=37\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e19,8\u0026plusmn;0,26\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e2,04\u0026plusmn;0,08\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e2,04\u0026plusmn; 0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e2,98\u0026plusmn;0,24\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e1,91\u0026plusmn;0,23\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49px;\"\u003eC/G\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003en=60\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e8,50\u0026plusmn;0,48\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e0,54\u0026plusmn;0,02\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e0,12\u0026plusmn;0,01\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e0,11\u0026plusmn;0,02\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e0,24\u0026plusmn;0,06\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eNote:\u0026nbsp;\u003c/strong\u003eCFE - carious, filled, and extracted teeth, DTSI - dorsal tongue surface index. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe results presented in the table demonstrate the following trends: \u003cstrong\u003eCaries intensity\u003c/strong\u003e was classified as \u003cstrong\u003e\u0026ldquo;moderate\u0026rdquo;\u003c/strong\u003e in \u003cstrong\u003eGrade I dysbiosis\u003c/strong\u003e, \u003cstrong\u003e\u0026ldquo;high\u0026rdquo;\u003c/strong\u003e in \u003cstrong\u003eGrade II\u003c/strong\u003e, \u003cstrong\u003e\u0026ldquo;very high\u0026rdquo;\u003c/strong\u003e in \u003cstrong\u003eGrade III\u003c/strong\u003e, and \u003cstrong\u003e\u0026ldquo;low\u0026rdquo;\u003c/strong\u003e in the \u003cstrong\u003econtrol group (CG)\u003c/strong\u003e. The \u003cstrong\u003eSilness\u0026ndash;L\u0026ouml;e index\u003c/strong\u003e indicated \u003cstrong\u003emild gingivitis\u003c/strong\u003e in \u003cstrong\u003eGrade I dysbiosis\u003c/strong\u003e (\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001), and \u003cstrong\u003emoderate gingivitis\u003c/strong\u003e in \u003cstrong\u003eGrades II and III\u003c/strong\u003e. \u003cstrong\u003ePeriodontal tissue inflammation (periodontitis)\u003c/strong\u003e was observed as \u003cstrong\u003emild\u003c/strong\u003e in \u003cstrong\u003eGrade I dysbiosis\u003c/strong\u003e, and \u003cstrong\u003emoderate\u003c/strong\u003e in \u003cstrong\u003eGrades II and III\u003c/strong\u003e. \u003cstrong\u003eOral hygiene\u003c/strong\u003e was generally assessed as \u003cstrong\u003esatisfactory\u003c/strong\u003e in all participants of the main group (MG), whereas it was considered \u003cstrong\u003egood\u003c/strong\u003e in the control group (CG). These results indicate a clear correlation between \u003cstrong\u003edysbiosis severity\u003c/strong\u003e and the \u003cstrong\u003eintensity of dental and periodontal pathology\u003c/strong\u003e, as well as oral hygiene status.\u003c/p\u003e\n\u003cp\u003eThe significance of various adverse factors in the development of \u003cstrong\u003eoral dysbiosis\u003c/strong\u003e was observed in the \u003cstrong\u003emain group (MG)\u003c/strong\u003e among patients with \u003cstrong\u003eartificial dental prostheses (ADPs)\u003c/strong\u003e. This condition is illustrated in \u003cstrong\u003eFigure 1\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003eIt has been reported in several studies that \u003cstrong\u003edental diseases\u003c/strong\u003e develop against the background of \u003cstrong\u003eintermediate dysbiosis\u003c/strong\u003e, and that \u003cstrong\u003emicroecological disturbances\u003c/strong\u003e occur not only in the \u003cstrong\u003eoral cavity\u003c/strong\u003e but also in the \u003cstrong\u003eupper gastrointestinal tract (UGT)\u003c/strong\u003e. In this context, \u003cstrong\u003edysbiotic changes in these systems are synchronous\u003c/strong\u003e, and according to specialists, the \u003cstrong\u003enumber and diversity of bacteria in the OC correlate with those in the intestines\u003c/strong\u003e within the same sample. This suggests that \u003cstrong\u003eintermediate oral dysbiosis may be a consequence of intestinal dysbiosis\u003c/strong\u003e, serving as a confirming factor of systemic microbial imbalance (Table 2, 3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u003c/strong\u003e \u003cstrong\u003eFrequency and composition (%) of artificial dental prostheses (ADPs) in relation to dysbiosis severity and somatic pathology.\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"633\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 132px;\"\u003eObservation group (n = 95)\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 501px;\"\u003eFrequency and composition of diseases, %\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 257px;\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003eURT\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003eGIT\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003eCVS\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 132px;\"\u003e1-gr. (n=22)\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 257px;\"\u003e\u003cstrong\u003eUp to 3 dental crowns\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e2/9,1\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e2/9,1\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e1 /4,5\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 257px;\"\u003e\u003cstrong\u003eMore than 3 dental crowns\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e2/13,6\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e4/18,2\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e1 /4,5\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 257px;\"\u003e\u003cstrong\u003eMore than 2 types of materials\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e2/9,1\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e5/22,7\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e1 /4,5\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 257px;\"\u003e\u003cstrong\u003eTotal for Group I\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e6/27,3\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e11/50,0\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e3/13,6\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 132px;\"\u003e2-gr. (n=36)\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 257px;\"\u003e\u003cstrong\u003eUp to 3 dental crowns\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e2/5,5\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e2 /5,5\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e1 / 2,7\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 257px;\"\u003e\u003cstrong\u003eMore than 3 dental crowns\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e4/11,1\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e5/13,9\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e2/5,5\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 257px;\"\u003e\u003cstrong\u003eMore than 2 types of materials\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e5/13,9\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e10/27,8\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e2/ 5,5\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 257px;\"\u003e\u003cstrong\u003eTotal for Group I\u003c/strong\u003e\u003cstrong\u003eI\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e11/30,5\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e17/47,2\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e5/13,9\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 132px;\"\u003e3-gr. (n=37)\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 257px;\"\u003e\u003cstrong\u003eUp to 3 dental crowns\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e4/10,8\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e5/13,5\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e2/5,5,3\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 257px;\"\u003e\u003cstrong\u003eMore than 3 dental crowns\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e5/13,5\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e7/18,9\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e2/8,1\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 257px;\"\u003e\u003cstrong\u003eMore than 2 types of materials\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e4/10,8\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e11/29,7\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e2/8,1\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 257px;\"\u003e\u003cstrong\u003eTotal for Group I\u003c/strong\u003e\u003cstrong\u003eII\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e13/35,1\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e23/62,1\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e6/16,2\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 389px;\"\u003eTotal number of prostheses\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e30/31,6\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e51/53,7\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e14/14,7\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eNote:\u0026nbsp;\u003c/strong\u003eURT \u0026ndash; Upper Respiratory Tract; GIT \u0026ndash; Gastrointestinal Tract; CVS \u0026ndash; Cardiovascular System.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3.\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eComparative characteristics of oral clinical-functional parameters in groups with various prosthetic constructions, M \u0026plusmn; t, p\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cimg src=\"https://myfiles.space/user_files/58895_8739fc6c57c1c19a/58895_custom_files/img1768915878.png\" width=\"705\" height=\"569\"\u003e\u003c/p\u003e\n\u003cp\u003eDisbiotic conditions associated with gastrointestinal pathologies can impair not only the oral cavity but also the overall functioning of the digestive system. In subgroups with gastrointestinal disorders, cardiovascular diseases, and upper respiratory tract conditions, the average caries intensity, oral hygiene status, and severity of periodontitis progression were found to be nearly identical. As previously mentioned, the therapeutic-preventive interventions conducted in the main group involving 95 patients were evaluated at \u0026minus;14, 60, and 90 days. Analysis of Table 4 demonstrates a positive shift in the oral microbiota following the applied treatment measures.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4.\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eMicrobiological characteristics of the oral cavity under therapeutic-preventive intervention\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"641\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003eMicroflora\u003cbr\u003e\u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 93px;\"\u003eObservation period\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 404px;\"\u003eIsolation rate, %\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eSignificance\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003eNon-physiological range\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eSignificance\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003ePhysiological range\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 144px;\"\u003eLactobacillus spp.\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003eBefore treatment\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 206px;\"\u003e100\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003e0\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e*\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e1-2 \u0026nbsp; \u0026nbsp;\u003c/sub\u003e\u0026lt;0,001\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e55,8\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e1-2\u0026nbsp;\u003c/sub\u003e\u0026lt;0,001\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e58,7\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e**\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e2-3\u0026nbsp;\u003c/sub\u003e\u0026lt;0,001\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e24,6\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e2-3 \u0026nbsp;\u003c/sub\u003e\u0026lt;0,001\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e68,4\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e***\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e3-4\u0026nbsp;\u003c/sub\u003e\u0026lt;0,001\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e3,13\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e3-4\u0026nbsp;\u003c/sub\u003e\u0026lt;0,001\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e74,8\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 206px;\"\u003eР\u003csub\u003e1-4 \u0026nbsp;\u003c/sub\u003e\u0026lt;0,0001\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003eР\u003csub\u003e1-4 \u0026nbsp;\u003c/sub\u003e\u0026lt;0,0001\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003eStreptococcus spp.\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003eBefore treatment\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 206px;\"\u003e58,0\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003e20.6\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e*\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e1-2\u0026nbsp;\u003c/sub\u003e\u0026lt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e30,4\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e1-2\u0026nbsp;\u003c/sub\u003e\u0026lt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e64,6\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e**\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e2-3\u0026nbsp;\u003c/sub\u003e\u0026lt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e14,4\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e2-3\u0026nbsp;\u003c/sub\u003e\u0026lt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e76,8\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e***\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e3-4\u0026nbsp;\u003c/sub\u003e\u0026lt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e2,8\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e3-4\u0026nbsp;\u003c/sub\u003e\u0026lt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e82,4\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 206px;\"\u003eР\u003csub\u003e1-4 \u0026nbsp;\u0026lt;0,01\u003c/sub\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003eР\u003csub\u003e1-4 \u0026nbsp;\u0026lt;0,01\u003c/sub\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 144px;\"\u003eStaphylococcus spp.\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003eBefore treatment\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 206px;\"\u003e60,8\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003e24,6\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e*\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e1-2 \u0026nbsp;\u003c/sub\u003e\u0026gt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e34,6\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e1-2 \u0026nbsp;\u003c/sub\u003e\u0026gt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e48,4\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e**\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e2-3 \u0026nbsp;\u003c/sub\u003e\u0026gt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e12,2\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e2-3 \u0026nbsp;\u003c/sub\u003e\u0026gt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e56,2\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e***\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e3-4 \u0026nbsp;\u003c/sub\u003e\u0026gt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e0\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e3-4 \u0026nbsp;\u003c/sub\u003e\u0026gt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e64,8\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 206px;\"\u003eР\u003csub\u003e1-4 \u0026nbsp;\u003c/sub\u003e\u0026gt;0,005\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003eР\u003csub\u003e1-4 \u0026nbsp;\u003c/sub\u003e\u0026gt;0,005\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003e\u003cem\u003eEnterobacteriaceae\u003c/em\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003eBefore treatment\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 206px;\"\u003e46,8\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003e33,6\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e*\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e1-2 \u0026nbsp;\u003c/sub\u003e\u0026lt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e20,4\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e1-2 \u0026nbsp;\u003c/sub\u003e\u0026lt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e42,8\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e**\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e2-3 \u0026nbsp;\u003c/sub\u003e\u0026lt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e12,4\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e2-3 \u0026nbsp;\u003c/sub\u003e\u0026lt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e68,2\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e***\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e3-4 \u0026nbsp;\u003c/sub\u003e\u0026lt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e4,2\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e3-4 \u0026nbsp;\u003c/sub\u003e\u0026lt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e78,7\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 206px;\"\u003eР\u003csub\u003e1-4 \u0026nbsp;\u003c/sub\u003e\u0026lt;0,005\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003eР\u003csub\u003e1-4 \u0026nbsp;\u003c/sub\u003e\u0026lt;0,005\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 144px;\"\u003eCorynebacterium spp.\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003eBefore treatment\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 206px;\"\u003e58,9\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003e18,6\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e*\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e1-2 \u0026nbsp;\u003c/sub\u003e\u0026lt;0,001\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e40,2\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e1-2 \u0026nbsp;\u003c/sub\u003e\u0026lt;0,001\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e44,6\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e**\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e2-3 \u0026nbsp;\u003c/sub\u003e\u0026lt;0,001\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e13,4\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e2-3 \u0026nbsp;\u003c/sub\u003e\u0026lt;0,001\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e56,4\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e***\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e3-4\u0026nbsp;\u003c/sub\u003e\u0026lt;\u003csub\u003e\u0026nbsp;\u003c/sub\u003e0,001\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e2,2\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e3-4 \u0026nbsp;\u003c/sub\u003e\u0026lt;0,001\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e92,5\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 206px;\"\u003eР\u003csub\u003e1-4 \u0026nbsp;\u003c/sub\u003e\u0026lt;0,001\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003eР\u003csub\u003e1-4 \u0026nbsp;\u003c/sub\u003e\u0026lt;0,001\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 144px;\"\u003eBacteroides spp.\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003eBefore treatment\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 206px;\"\u003e84\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003e22\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e*\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e1-2\u0026nbsp;\u003c/sub\u003e\u0026lt;\u003csub\u003e\u0026nbsp;\u003c/sub\u003e0,01\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e60,8\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e1-2\u0026nbsp;\u003c/sub\u003e\u0026lt;\u003csub\u003e\u0026nbsp;\u003c/sub\u003e0,01\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e40,6\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e**\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e2-3\u0026nbsp;\u003c/sub\u003e\u0026lt;\u003csub\u003e\u0026nbsp;\u003c/sub\u003e0,01\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e24,4\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e2-3\u0026nbsp;\u003c/sub\u003e\u0026lt;\u003csub\u003e\u0026nbsp;\u003c/sub\u003e0,01\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e85,4\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e***\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e3-4\u0026nbsp;\u003c/sub\u003e\u0026lt;\u003csub\u003e\u0026nbsp;\u003c/sub\u003e0,01\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e4,2\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e3-4\u0026nbsp;\u003c/sub\u003e\u0026lt;\u003csub\u003e\u0026nbsp;\u003c/sub\u003e0,01\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e79,9\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 206px;\"\u003eР\u003csub\u003e1-4\u0026nbsp;\u003c/sub\u003e\u0026lt;\u003csub\u003e\u0026nbsp;\u003c/sub\u003e0,001\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003eР\u003csub\u003e1-4\u0026nbsp;\u003c/sub\u003e\u0026lt;\u003csub\u003e\u0026nbsp;\u003c/sub\u003e0,001\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 144px;\"\u003eFusobacterium spp.\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003eBefore treatment\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 206px;\"\u003e48,4\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003e56,4\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e*\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e1-2 \u0026nbsp;\u0026nbsp;\u003c/sub\u003e\u0026gt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e12,4\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e1-2 \u0026nbsp;\u0026nbsp;\u003c/sub\u003e\u0026gt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e76,4\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e**\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e2-3 \u0026nbsp;\u0026nbsp;\u003c/sub\u003e\u0026gt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e4,2\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e2-3 \u0026nbsp;\u0026nbsp;\u003c/sub\u003e\u0026gt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e84,4\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 144px;\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e***\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e3-4 \u0026nbsp;\u0026nbsp;\u003c/sub\u003e\u0026gt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e0\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e3-4 \u0026nbsp;\u0026nbsp;\u003c/sub\u003e\u0026gt;0,05\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e89,6\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 206px;\"\u003eР\u003csub\u003e1-4 \u0026nbsp;\u0026nbsp;\u003c/sub\u003e\u0026gt;0,005\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003eР\u003csub\u003e1-4 \u0026nbsp;\u0026nbsp;\u003c/sub\u003e\u0026gt;0,005\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 144px;\"\u003eLeptotrichia spp.\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003eBefore treatment\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 206px;\"\u003e37,5\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003e55,8\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e*\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e1-2\u0026nbsp;\u003c/sub\u003e\u0026lt;\u003csub\u003e\u0026nbsp;\u003c/sub\u003e0,01\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e28,4\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e1-2\u0026nbsp;\u003c/sub\u003e\u0026lt;\u003csub\u003e\u0026nbsp;\u003c/sub\u003e0,01\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e84,4\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e**\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e2-3\u0026nbsp;\u003c/sub\u003e\u0026lt;\u003csub\u003e\u0026nbsp;\u003c/sub\u003e0,01\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e11,2\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e2-3\u0026nbsp;\u003c/sub\u003e\u0026lt;\u003csub\u003e\u0026nbsp;\u003c/sub\u003e0,01\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e98,4\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u003cstrong\u003e***\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003eР\u003csub\u003e3-4\u0026nbsp;\u003c/sub\u003e\u0026lt;\u003csub\u003e\u0026nbsp;\u003c/sub\u003e0,01\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e0,6\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003eР\u003csub\u003e3-4\u0026nbsp;\u003c/sub\u003e\u0026lt;\u003csub\u003e\u0026nbsp;\u003c/sub\u003e0,01\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e99,0\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 206px;\"\u003eР\u003csub\u003e1-4\u0026nbsp;\u003c/sub\u003e\u0026lt;\u003csub\u003e\u0026nbsp;\u003c/sub\u003e0,01\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003eР\u003csub\u003e1-4\u0026nbsp;\u003c/sub\u003e\u0026lt;\u003csub\u003e\u0026nbsp;\u003c/sub\u003e0,01\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eNote:\u0026nbsp;\u003c/strong\u003e*- after 14 days; **- after 60 days; ***- after 90 days; \u003cstrong\u003eP\u003csub\u003e2\u003c/sub\u003e\u003c/strong\u003e \u0026ndash; reliability of data from the first subgroup compared to the second subgroup; \u003cstrong\u003eP\u003csub\u003e3\u003c/sub\u003e\u003c/strong\u003e \u0026ndash; reliability of data from the first subgroup compared to the third subgroup; \u003cstrong\u003eP\u003csub\u003e2\u0026ndash;3\u003c/sub\u003e\u003c/strong\u003e\u003csub\u003e\u0026nbsp;\u003c/sub\u003e\u0026ndash; reliability of data from the second subgroup compared to the third subgroup; \u003cstrong\u003eP\u003csub\u003e1\u0026ndash;4\u003c/sub\u003e\u003c/strong\u003e\u003csub\u003e\u0026nbsp;\u003c/sub\u003e\u0026ndash; reliability of data from the first subgroup compared to the fourth subgroup;\u003cbr\u003e\u003cstrong\u003eP\u003csub\u003e3\u0026ndash;4\u003c/sub\u003e\u003c/strong\u003e\u003csub\u003e\u0026nbsp;\u003c/sub\u003e\u0026ndash; reliability of data from the second subgroup compared to the fourth subgroup.\u003c/p\u003e\n\u003cp\u003eIn the first subgroup, normalization of Lactobacillus (p \u0026lt; 0.05), Streptococcus (p \u0026lt; 0.05), conditionally pathogenic Enterobacteriaceae (p \u0026lt; 0.05), Corynebacterium (p \u0026lt; 0.05), Bacteroides (p \u0026lt; 0.05), and Leptotrichia (p \u0026lt; 0.01) was observed. Among participants, 66.6% achieved complete recovery, while 23.7% showed no change in microbiological composition. Thus, in Grade I dysbiosis, treatment with Anethum graveolens (dill) improved oral hygiene, reduced periodontal inflammation, and allowed normalization of the oral microbiocenosis in 67% of cases. In the second subgroup, normalization of the oral microbiocenosis occurred in 13.3% of cases, and in the third subgroup in 53.3% of cases. Improvement was observed in 46.7% of participants in the second subgroup and 20.9% in the third subgroup. However, Grade II dysbiosis persisted in 40.9% of cases in the second subgroup and 26.7% in the third subgroup (\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.05).\u003c/p\u003e\n\u003cp\u003eAfter the therapeutic-preventive intervention, normalization was observed in Staphylococcus aureus, Staphylococcus spp., Candida spp., conditionally pathogenic Enterobacteriaceae, Bacteroides (p \u0026lt; 0.05), and Corynebacterium. Other microbiological indicators showed no significant changes. Thus, for all degrees of dysbiosis, the use of Anethum graveolens (dill) and its decoction, in combination with the placement of ceramo-metal and ceramo-ceramic prostheses in the dental arches, was observed to improve the oral microbiocenosis by up to 70%.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAnalysis.\u0026nbsp;\u003c/strong\u003eIt is well established that the human microbiota plays both \u003cstrong\u003eprotective and pathogenic roles\u003c/strong\u003e. Therefore, maintaining a \u003cstrong\u003ebalanced microbial landscape in the oral cavity\u003c/strong\u003e is crucial for preventing complications of dental diseases and, in certain cases, has significant therapeutic value. In line with the perspectives of numerous \u003cstrong\u003einternational and local authors\u003c/strong\u003e, we support the use of the term \u003cstrong\u003e\u0026ldquo;dysbiosis\u0026rdquo;\u003c/strong\u003e to describe quantitative changes in \u003cstrong\u003eprotozoa, fungi, and viruses\u003c/strong\u003e. Based on the objectives of our study, we also constructed a \u003cstrong\u003ereference profile of the oral microbial landscape\u003c/strong\u003e in healthy individuals.\u003c/p\u003e\n\u003cp\u003eIn all participants of the study, the oral cavity microflora was analyzed using laboratory microbiological methods, and the obtained data were compared with published literature. Subsequently, we aimed to define microbiological and clinical criteria for dysbiosis according to its severity. For this purpose, 60 individuals who visited the Andijan City Dental Polyclinic for oral sanitation were included. Their dental status was assessed, and during the clinical examination, caries intensity, periodontal tissue status, oral hygiene, and Silness\u0026ndash;L\u0026ouml;e indices were recorded. Analysis of the OC in healthy respondents demonstrated that the tongue dorsal surface index (TDSI) increased significantly with worsening dysbiosis from Grade I to Grade III (\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.05; \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.025). Similarly, dental indices including CPI, PHR, Silness\u0026ndash;L\u0026ouml;e, and PT status showed the same trend. Additionally, the presence and construction type of dental prostheses (ADPs) were examined in relation to the state of oral microbiocenosis, while the impact of URT, and CVS pathologies on OC dysbiosis was also assessed. When treating Grade III dysbiosis, a positive correlation was observed between the improvement of all clinical-dental indices and the normalization of oral microbiocenosis, which was confirmed by statistical analysis.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn healthy adults, the normal quantitative ranges of the oral cavity (OC) microflora are as follows: Lactobacillus \u0026ndash; 10\u0026sup3;\u0026ndash;10⁴ CFU; Streptococcus spp. \u0026ndash; 10⁵\u0026ndash;10⁸ CFU; Str. pyogenes \u0026ndash; 0; Leptotrichia \u0026ndash; 10\u0026sup2;\u0026ndash;10⁴ CFU; Staphylococcus spp. \u0026ndash; 10\u0026sup2;\u0026ndash;10⁴ CFU; Candida spp. \u0026ndash; 10\u0026sup2;\u0026ndash;10\u0026sup3; CFU; conditionally pathogenic Enterobacteriaceae \u0026ndash; 10\u0026ndash;10\u0026sup2; CFU; Corynebacterium \u0026ndash; \u0026lt;10\u0026sup2; CFU; Bacteroides \u0026ndash; \u0026lt;10\u0026sup3; CFU; Veillonella \u0026ndash; 10\u0026sup3;\u0026ndash;10⁸ CFU; Fusobacterium \u0026ndash; 10\u0026sup3;\u0026ndash;10⁴ CFU; Staph. aureus \u0026ndash; 0; Neisseria \u0026ndash; 10⁵\u0026ndash;10⁷ CFU.\u003c/p\u003e\n\u003cp\u003eOral dysbiosis is classified by severity as follows: Grade I \u0026ndash; reduction of resident microflora; Grade II \u0026ndash; alterations in both resident and conditionally pathogenic microflora; Grade III \u0026ndash; pronounced overgrowth of Candida spp.\u0026nbsp;The severity of dysbiosis and deterioration of oral hygiene are influenced by carious lesions, periodontal pathologies, and the presence of dental prostheses (ADPs). In particular, ADPs made of various constructions and metal alloys, especially mixed-metal prostheses, negatively affect the oral microbiota through local immunological disruption. Moreover, pathologies of the upper respiratory tract (URT), gastrointestinal tract (GIT), and cardiovascular system (CVS) contribute to instability of oral hygiene.\u003c/p\u003e\n\u003cp\u003eRestoration and continuous correction of the OC microbiocenosis can be effectively achieved by replacing conventional prosthetic constructions with zirconia and ceramo-metal prostheses, combined with oral rinsing using local Anethum graveolens (dill) decoction and chewing fresh dill leaves 2\u0026ndash;3 times daily, which demonstrates positive microbiological and clinical outcomes.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u003c/strong\u003e The study protocol was reviewed and approved by the Local Ethics Committee of the Center for the Development of Professional Qualifications of Medical Workers under the Ministry of Health of the Republic of Uzbekistan with the participation of the Department of \u0026ldquo;Dentistry, Pediatric Dentistry and Orthodontics.\u0026rdquo; The decision approving the study was issued as Protocol No. 6 dated September 03, 2025. Prior to enrollment, all patients were provided with comprehensive information regarding the objectives, tasks, methods of the study, possible risks, and anticipated benefits. Written informed consent for participation in the study and the use of clinical data for scientific purposes was obtained from all participants, with strict adherence to confidentiality principles. The study did not cause any harmful physical or psychological effects on the participants. Personal data were coded and processed in anonymized form in accordance with medical confidentiality requirements.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003cstrong\u003e.\u0026nbsp;\u003c/strong\u003eAll data used in this review are contained in publicly available publications listed in the references. The datasets analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003cstrong\u003e.\u0026nbsp;\u003c/strong\u003eThe authors declare no actual or potential conflicts of interest related to the publication of this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding.\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eThis study received no external funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions.\u0026nbsp;\u003c/strong\u003eAll authors made a substantial contribution to the development of the study concept, conduct of the research, and preparation of the manuscript. All authors read and approved the final version prior to publication. The individual contributions were distributed as follows:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDjambilov R.S.\u003c/strong\u003e \u0026ndash; conduct of the research;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eGafforov S.A.\u003c/strong\u003e \u0026ndash; supervision of manuscript preparation;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSobirov A.A.\u003c/strong\u003e \u0026ndash; manuscript formatting;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eUsmonov B.A.\u003c/strong\u003e \u0026ndash; writing and formatting of the text;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eUlugbekova D.R.\u003c/strong\u003e \u0026ndash; conduct of the research;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eGafforova S.S.\u003c/strong\u003e \u0026ndash; text editing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatement of Originality.\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eThis manuscript is original; it has not been published, and is not under consideration elsewhere. All information sources are properly cited.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability.\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eAll data used in this review are contained in publicly available publications listed in the references. Additional materials are available on request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSubmission and Peer Review.\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eThe manuscript was submitted to the journal on the authors\u0026rsquo; own initiative.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e: not applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAlyousef, Y. M., Piotrowski, S., Alonaizan, F. A., et al. (2023). 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Comparative analysis of the oral cavity microflora state in various degrees of inflammatory conditions of periodontal tissues using comprehensive studies. \u003cem\u003eInternational Journal of Innovative Research and Scientific Studies\u003c/em\u003e, 1161-1168. https://doi.org/10.53894/ijirss.v8i2.5420 \u003c/li\u003e\n\u003cli\u003eZheng, H., Xie, T., Li, S., et al. (2021). Analysis of oral microbial dysbiosis associated with early childhood caries. \u003cem\u003eBMC Oral Health, 21\u003c/em\u003e, 181. https://doi.org/10.1186/s12903-021-01543-x\u003c/li\u003e\n\u003cli\u003eKo‑Dentures Review Group. (2024). Dentures and the oral microbiome: Unraveling the hidden impact on edentulous and partially edentulous patients \u0026ndash; a systematic review and meta‑analysis. \u003cem\u003e[Journal]\u003c/em\u003e. (2024). https://pubmed.ncbi.nlm.nih.gov/40442493/\u003c/li\u003e\n\u003cli\u003eBenzina, D., \u0026amp; Al Kawas, S. (2023). Dysbiosis of Subgingival Microbiome and Relation to Periodontal Disease in Association with Obesity and Overweight. \u003cem\u003eNutrients, 15\u003c/em\u003e(4), 826. https://doi.org/10.3390/nu15040826\u003c/li\u003e\n\u003cli\u003eP\u0026eacute;rez de Frutos, J., Holden Helland, R., Desai, S., Nymoen, L. C., Lang\u0026oslash;, T., Remman, T., Sen, A. \u0026hellip; (2023). AI‑Dentify: Deep learning for proximal caries detection on bitewing x‑ray \u0026ndash; HUNT4 Oral Health Study. \u003cem\u003eArXiv Preprint\u003c/em\u003e. https://arxiv.org/abs/2310.00354\u003c/li\u003e\n\u003cli\u003eZambrano‑Mila, J., et al. (2021). The Impact of Oral Microbiome Dysbiosis on the Aetiology, Pathogenesis, and Development of Oral Cancer. \u003cem\u003eCancers, 16\u003c/em\u003e(17), 2997. https://doi.org/10.3390/cancers16172997\u003c/li\u003e\n\u003cli\u003eChirkova, N. V., Vecherkina, Z. V., Shalimova, N. A., \u0026amp; Primacheva, N. V. (2023). Selection of a structural material for the basis of a removable prosthesis in patients with oral dysbiosis based on toxicological examination. \u003cem\u003eApplied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny), 26\u003c/em\u003e(1), 9\u0026ndash;14. https://doi.org/10.18499/2070-9277-2023-26-1-9-14\u003c/li\u003e\n\u003cli\u003eAlijon, S., Sunnatullo, G., Nurmukhamet, R., Raykhon, P., Ravshanbek, J., Kalamkas, R., ... \u0026amp; Sevara, G. (2025). Justification for the physiological isolation of the torus based on the pain sensitivity of the oral mucosa. In \u003cem\u003eBIO Web of Conferences\u003c/em\u003e (Vol. 152, p. 01008). EDP Sciences. https://doi.org/10.1051/bioconf/202515201008\u003c/li\u003e\n\u003cli\u003ePervov, Y. Y., Bocharov, V. S., Kim, A. R., \u0026amp; Reva, G. V. (2024). Influence of dental prostheses materials on the condition of oral mucosa local homeostasis. \u003cem\u003ePerm Medical Journal, 41\u003c/em\u003e(5), 5\u0026ndash;18. https://doi.org/10.17816/pmj4155-18\u003c/li\u003e\n\u003cli\u003eHasnur Safii, S., Ahmad, N. A., et al. (2024). Denture microbiome shift and changes of salivary inflammatory markers following insertion of 3D printed removable partial PMMA denture: A pilot study. \u003cem\u003eBMC Oral Health, 24\u003c/em\u003e, Article 1216. https://doi.org/10.1186/s12903-024-05012-z\u003c/li\u003e\n\u003cli\u003eKhairunnisa, Z., Tuygunov, N., Cahyanto, A., et al. (2024). Potential of microbial‑derived biosurfactants for oral applications \u0026ndash; a systematic review. \u003cem\u003eBMC Oral Health, 24\u003c/em\u003e, Article 707. https://doi.org/10.1186/s12903-024-04479-0\u003c/li\u003e\n\u003cli\u003eZhang, M., Zhao, Y., Umar, A., et al. (2024). Comparative analysis of microbial composition and functional characteristics in dental plaque and saliva of oral cancer patients. \u003cem\u003eBMC Oral Health, 24\u003c/em\u003e, Article 411. https://doi.org/10.1186/s12903-024-04181-1 \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"oral microbiocenosis, pathogenic microbial spectrum, removable dentures, microbial resistance, somatic pathologies, oral cavity","lastPublishedDoi":"10.21203/rs.3.rs-8455347/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8455347/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eRelevance.\u003c/strong\u003e The study examines the quantitative and qualitative colonization of microorganisms in the oral cavity (OC) and its dependence on exogenous and endogenous factors, as well as the variability related to the design and number of removable dentures (RD). A microbial “landscape” — including the types, colonization levels, and quantity of microorganisms — was determined for clinically healthy adults to establish normative parameters for oral microflora.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective.\u003c/strong\u003e To diagnose dysbiotic conditions of the oral cavity, establish the normative microbial “landscape,” and substantiate the role of removable dentures in microbial colonization and composition.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMaterials and Methods.\u003c/strong\u003e The study included 260 individuals (males and females aged 18–60 years). Group I (n=105) consisted of individuals diagnosed with various degrees of oral dysbiosis (61 males [58.09%], 44 females [41.9%]; mean age 44.6 years). Group II (n=96) included patients with oral dysbiosis of varying severity and the presence of removable dentures (41 males [43.15%], 54 females [56.84%]; mean age 49 years). Group III (n=60) served as the control group for determining the microbiological norm (27 males, 33 females; mean age 37 years).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults.\u003c/strong\u003e In the clinically healthy adult population of Andijan City, the quantitative range of oral microflora was established as follows: Lactobacillus spp. 10³–10⁴, Streptococcus spp. 10⁵–10⁸, Str. pyogenes – absent, Leptotrichiaspp. 10²–10⁴, Staphylococcusspp. 10²–10⁴, Candida spp. 10²–10³, conditionally pathogenic Enterobacteriaceae10–10², Corynebacterium spp. \u0026lt;10², Bacteroides spp. \u0026lt;10³, Veillonella spp. 10³–10⁸, Fusobacterium spp. 10³–10⁴, Staphylococcus aureus– absent, Neisseria spp. 10⁵–10⁷. Dysbiotic states of the oral cavity were classified as follows: Grade I — reduction of resident microflora; Grade II — alteration of resident and conditionally pathogenic species composition; Grade III — predominance and proliferation of Candida spp. fungi.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions.\u003c/strong\u003e A classification of oral dysbiosis severity (Grade I–III) was developed and normative microbiological indices were established for the adult population of Andijan City. The microbial “landscape” of oral cavities with removable dentures was characterized. The obtained results substantiate the clinical and preventive significance of using Anethum graveolens leaf extract and decoction in orthopedic dental practice to enhance treatment outcomes and predict the effectiveness of therapeutic-preventive measures.\u003c/p\u003e","manuscriptTitle":"Comprehensive Diagnostic and Therapeutic Approaches to Oral Dysbiosis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-21 03:58:03","doi":"10.21203/rs.3.rs-8455347/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"963bbf01-1cb8-4d1c-94f2-09f4bed35f8d","owner":[],"postedDate":"January 21st, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":61439108,"name":"Health sciences/Diseases"},{"id":61439109,"name":"Health sciences/Health care"},{"id":61439110,"name":"Health sciences/Medical research"},{"id":61439111,"name":"Biological sciences/Microbiology"}],"tags":[],"updatedAt":"2026-01-30T21:09:15+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-21 03:58:03","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8455347","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8455347","identity":"rs-8455347","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}