Adjunctive use of modified Yunu-Jian in the non-surgical treatment of male smokers with chronic periodontitis: a randomized double-blind, placebo-controlled clinical trial

Abstract

BackgroundYunu-Jian (YJ) is a Chinese medicine (CM) heat purging formula, which is used to reduce wei huo (stomach-heat, SH) and enrich shen yin (kidney-yin, KY). This formula is also commonly used to manage diabetes mellitus and gum/oral inflammation. The activity of YJ can be modified or refined by the addition of other CM herbs and/or minor changes to one of its five key ingredients. The aim of this study was to evaluate the adjunctive use of modified YJ (mYJ) or YJ containing additional osteoblast-stimulating and inflammation-modulating CM herbs in the non-surgical periodontal treatment of smokers with chronic periodontitis in a randomized, double-blind, prospective, placebo-controlled study.MethodsHealthy adult male smokers with untreated chronic periodontitis who showed CM syndrome of SH and KY deficiency (KYD) whilst attending a dental teaching hospital from October to December, 2005, were invited to participate in a randomized double-blind, placebo-controlled clinical trial. The trial itself involved the once-daily oral administration of a placebo or mYJ for 3 months as an adjunct to non-surgical periodontal therapy. Several periodontal parameters, including radiographic alveolar bone density, were measured by computer-assisted densitometric image analysis (CADIA) on selected sites, and CM signs of SH and KYD were followed from their baseline values to various time points up to 12 months or the end of study.ResultsTwenty-five smokers (consumed 25.0 ± 15.3 smoking-pack years, ranged 7.5–80; aged 46.3 ± 6.8 years) with periodontitis and SH and KYD were recruited (Placebo, n = 14; mYJ, n = 11). All of the participants showed good tolerance towards the CM recipe. All of the periodontal parameters had improved after 12-month follow-up, and no statistically significant differences were detected between the control group and test group, except for the higher CADIA values observed compared with the baseline at 12 months for test sites (P = 0.025). 4/3/3 test vs 14/13/13 control participants had persisting SH and KYD at 6, 9 and 12 months (P < 0.001), respectively.ConclusionsThe adjunctive use of mYJ preserved the post-treatment increases in the radiographic alveolar bone density at the study sites and led to an overall improvement in SH and KYD compared with the controls.Trial registration HKU Clinical Trial Register, HKCTR-1848 (www.hkuctr.com/Study/Show/3acbf983831244d29d50b543540bf6e9)Electronic supplementary materialThe online version of this article (doi:10.1186/s13020-016-0111-z) contains supplementary material, which is available to authorized users.

Self-Reported Gum Bleeding, Perception, Knowledge, and Behavior in Working-Age Hong Kong Chinese—A Cross-Sectional Study

“…Our cohort, as previously reported [7], was somewhat confused about gum bleeding, since a large proportion of those who reported gum bleeding over the past 12 months believed that it was associated with the consumption of heaty food. As observed in an earlier study [11], although the present cohort appeared to have strong traditional/conventional Chinese oral health beliefs, none recognized the fact that the TCM concept of gum bleeding also embraces good oral home care, in addition to maintaining 'yin-yang'-a balance of body and lifestyle [14,39,40]. The association of poor self-reported general health with gingival bleeding was also reported in a Finnish study [41].…”

The Effect of Tobacco Smoking on Musculoskeletal Health: A Systematic Review

“…Smoking is one of the greatest risks for periodontitis and is associated with poor periodontal parameters; such finding provides evidence that the treatment used Simvastatin besides SRP in smokers suffering from chronic periodontitis was more effective in reducing the negative effect of smoking on the periodontal parameter than the treatment using only SRP. The second RCT found the treatment using modified YJ (mYJ) Chinese medicinal herbs in a nonsurgical treatment for smokers suffering from periodontitis was associated with higher computer-assisted densitometry values than the treatment using original YJ Chinese medicinal herbs with nonsurgical treatments (P = 0.025) [ 110 ]. Also, this finding provides evidence that the use of mYJ Chinese medicinal herbs in a nonsurgical treatment was effective in reducing the negative effect of smoking on the periodontal parameter as evidenced by the increases in radiographic alveolar bone density.…”

Efficacy and Safety of Modified Yunu-Jian in Patients with Periodontitis: A Meta-Analysis

“…In this study, the used methods were described in detail, which included the sequence generation, blinding, and allocation concealment. The results, visualized as graphs, revealed that mYJ might be capable of increasing the radiographic alveolar bone density and lead to an overall improvement in stomach-heat and kidney-yin [ 11 ]. Clinically, several studies have shown that mYJ can significantly reduce the symptoms of patients suffering from periodontitis and achieve remarkable efficacy [ 11 – 14 ]; however, there is no statistical support for this conclusion.…”

“…The results, visualized as graphs, revealed that mYJ might be capable of increasing the radiographic alveolar bone density and lead to an overall improvement in stomach-heat and kidney-yin [ 11 ]. Clinically, several studies have shown that mYJ can significantly reduce the symptoms of patients suffering from periodontitis and achieve remarkable efficacy [ 11 – 14 ]; however, there is no statistical support for this conclusion. In this study, we conducted a systematic review and meta-analysis to evaluate the efficacy and safety of mYJ for treating periodontitis and provide a reference for its clinical use.…”