Effectiveness of Propolis in the Treatment of Periodontal Disease: Updated Systematic Review with Meta-Analysis

Abstract

In recent times, the use of natural products has gained momentum, either as a treatment or as adjuvants for other drugs in the treatment of different conditions. Propolis is a natural substance produced by bees which has proven useful for treating periodontal disease. This systematic review and meta-analysis gather evidence of the effectiveness of propolis in this kind of condition. The MEDLINE, CENTRAL, PubMed, EMBASE and Web of Science databases were searched for scientific articles to identify the findings published up to October 2020. The MeSH phrases used in the search were: “periodontal diseases AND propolis treatment”; “gingivitis AND propolis treatment”; “periodontitis AND propolis treatment”; “propolis treatment AND oral health”; “propolis AND oxidative stress AND periodontitis”. The Boolean operator “AND” was used to combine the searches. Randomized trials where propolis was used in the treatment of different periodontal conditions were included. Non-randomized clinical studies were systematically reviewed and 224 studies were detected, eight of which met the criteria for inclusion in the meta-analysis. Only three of these were selected for quantitative synthesis. In conclusion, propolis is safe to use and can improve the results of periodontal disease treatment, reducing probing pocket depth compared with treatment with a placebo (difference in means, fixed effects −0.67 [95% CI: −0.84, −0.50]).

Effects of Antioxidant in Adjunct with Periodontal Therapy in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

“…Similarly, the biological effect of propolis probably resulted from a combination of its known antibacterial [ 64 , 65 ], anti-inflammatory, and antioxidant properties [ 66 ]. In addition, topical application of propolis as an adjuvant to SRP was more effective than SRP alone, with regard to both microbiological [ 67 ] and clinical parameters [ 45 ]. The clinical improvement in Aloe vera-supplemented SRP can be attributed to its antibacterial [ 68 ] and anti-inflammatory [ 69 ] effects on periodontal bacteria, which consequently accelerate collagen synthesis and promote wound healing [ 70 ].…”

“…An extensive literature search was performed using the PubMed, Cochrane Library, and Web of Science databases to summarize the currently available knowledge and answer the aforementioned clinical question by isolating randomized controlled trials (RCTs) investigating the effects of antioxidants with periodontal treatment in patients with diabetes prior to 6 April 2021. The search terms related to antioxidants were set according to the previous studies [ 43 , 44 , 45 , 46 , 47 , 48 ]. The search terms used in PubMed are listed below:…”

Clinical and Immunological Efficacy of Mangosteen and Propolis Extracted Complex in Patients with Gingivitis: A Multi-Centered Randomized Controlled Clinical Trial

“…Propolis is a viscous substance produced by bees that exhibits antimicrobial, anti-inflammatory, and antioxidant properties [ 13 , 14 ]. Propolis is well-documented in the scientific literature and is known to be non-toxic [ 15 ]. Propolis comprises over 200 ingredients, including flavonoids, cinnamic acids, caffeic acids, and caffeic acid phenethyl ester [ 16 ].…”

“…Propolis comprises over 200 ingredients, including flavonoids, cinnamic acids, caffeic acids, and caffeic acid phenethyl ester [ 16 ]. A meta-analysis on the effectiveness of propolis treatment for periodontitis has shown that it reduced probing pocket depth as compared with placebo [ 15 ]. Propolis has been locally delivered in various forms, such as mouthwash, toothpaste, irrigation, and subgingival gel [ 15 ], and has been reported to reduce plaque formation and exhibit antimicrobial effects against some key periodontal pathogens [ 17 , 18 , 19 ].…”

“…A meta-analysis on the effectiveness of propolis treatment for periodontitis has shown that it reduced probing pocket depth as compared with placebo [ 15 ]. Propolis has been locally delivered in various forms, such as mouthwash, toothpaste, irrigation, and subgingival gel [ 15 ], and has been reported to reduce plaque formation and exhibit antimicrobial effects against some key periodontal pathogens [ 17 , 18 , 19 ]. Furthermore, propolis has been studied extensively for its anti-oxidative property [ 14 ], which could be beneficial for treatment of periodontitis, as reduction in oxidative stress may decrease secretion of pro-inflammatory cytokines and prevent alveolar bone loss.…”