Green tea extract as a local drug therapy on periodontitis patients with diabetes mellitus: A randomized case-control study

Abstract

Background:The green tea extract is a naturally occurring product having beneficial effects that counteract with the pathobiological features of periodontitis and diabetes mellitus. Hence, the present study was aimed at incorporation of green tea extract into hydroxylpropyl methylcellulose and investigates its efficacy in chronic periodontitis patients associated with and without diabetes mellitus.Materials and Methods:For the in vitro study, formulation of green tea strips and placebo strips, and analysis of drug release pattern from the green tea strips at different time intervals were performed. For the in vivo study, 50 patients (20-65 years), including 25 systemically healthy patients with chronic periodontitis (group 1) and 25 diabetic patients with chronic periodontitis (group 2) were enrolled. In each patient, test and control sites were identified for the placement of green tea and placebo strips, respectively. Gingival Index (GI), Probing Pocket Depth (PPD), and Clinical Attachment Level (CAL) were examined at baseline, first, second, third, and fourth weeks. Microbiological analysis for Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans was performed at baseline and fourth week.Results:The in vitro study showed 10.67% green tea release at 30 min; thereafter, a slow release was noted till 120 min.In vivo study:Both groups showed significant reduction in GI scores at the test sites. Group 1 showed significant (P < 0.001) PPD reduction at different time intervals at the test sites. However, group 2 showed significant reduction from baseline (5.30 ± 0.70) to fourth week (3.5 ± 0.97). Statistically significant gain in CAL at the test sites was observed both in group 1 (1.33 mm) and group 2 (1.43 mm). The prevalence of P. gingivalis in group 1 test sites was significantly reduced from baseline (75%) to fourth week (25%).Conclusions:Local drug delivery using green tea extract could be used as an adjunct in the treatment of chronic periodontitis in diabetic and non-diabetic individuals.

Excessive Consumption of Green Tea as a Risk Factor for Periodontal Disease among Korean Adults

“…Various methods have been applied for the delivery of the green tea extracts. Green tea extract was incorporated into hydroxylpropyl methylcellulose [ 22 , 23 ]. This system showed a bactericidal effect against Gram-negative anaerobic rods and was effective in improving periodontal status.…”

“…Adjunctive local drug therapy with thermo-reversible sustained-release green tea gel has been shown to reduce inflammation and pockets of the clinical trial in patients with chronic periodontitis [ 24 ]. It has been suggested that local drug delivery using green tea extract could be used as an adjunct in the treatment of chronic periodontitis [ 22 , 25 , 26 ]. Green tea has been added to dentifrice in previous studies [ 27 , 28 ].…”

Impact of local drug delivery and natural agents as new target strategies against periodontitis: new challenges for personalized therapeutic approach

“…Gadagi et al 179 2013 decided to do a clinical trial testing green tea strips in patients with and without diabetes with periodontitis. They were randomly placed in strips with a placebo and with green tea in periodontal pockets.…”

Potential applications of medicinal herbs and phytochemicals in oral and dental health: Status quo and future perspectives

“…Curcumin's analgesic, anti‐inflammatory, antimicrobial, and anticarcinogenic effects have made it a mainstay in the natural system of medicine for thousands of years (Behal et al, 2011; Khezri et al, 2021; Samiei et al, 2021; Sharifi et al, 2019). Several recent studies have revealed that Curcuma extract is an effective supplement for root planning and scaling (Gadagi et al, 2013). Recent research has shown that this medication's gel and powder forms were shown to be equally effective (Pradeep et al, 2012).…”