Role of gut microbiome diversity in third molar postoperative healing

Abstract

Third molar extraction is one of the most frequently performed oral surgical procedures and may be followed by pain, swelling, infection, delayed soft-tissue healing, and alveolar osteitis. Increasing evidence suggests that microbial diversity and host–microbiome interactions play important roles in postoperative recovery. Although local oral microbiota have traditionally received greater attention, the gut microbiome may influence third molar healing through systemic immune regulation, inflammatory signaling, microbial metabolites, and interactions with the oral microbiome. Greater gut microbial diversity may support immune homeostasis and balanced inflammatory responses, whereas dysbiosis may contribute to excessive inflammation, impaired tissue repair, and increased susceptibility to postoperative complications. Microbiome-derived metabolites, particularly short-chain fatty acids, may further influence immune activity and wound-healing processes. Probiotics, dietary interventions, and microbiome-directed therapies therefore represent potential strategies for supporting postoperative recovery. However, the specific relationship between gut microbiome diversity and third molar healing remains insufficiently characterized, and current evidence is stronger for local oral microbial influences than for direct gut-mediated effects. Future investigations integrating gut microbiome profiling, oral microbial analysis, inflammatory biomarkers, and clinical healing outcomes may enable personalized risk assessment and microbiome-based postoperative interventions. Understanding this gut–oral connection could contribute to improved pain management, infection prevention, and tissue regeneration following third molar surgery.