Influence of propolis on hygiene, gingival condition, and oral microflora in patients with cleft lip and palate treated with fixed orthodontic appliances

Oral flora and functional dysbiosis of cleft lip and palate patients: A scoping review

AIMS

This scoping review aimed to conduct an assessment of the current literature on specific ecological changes in the oral microbiota of individuals living with cleft lip and/or palate.

METHODS

All studies that assess oral microbiota and ecological changes distinct of individuals living with cleft lip and/or palate were included. Ovid MEDLINE and EMBASE databases were used, using planned search keywords. Included articles were grouped into cohort, cross-sectional, case-control, and retrospective reviews.

RESULTS

A total of 164 eligible title articles were recognized. Of these, 32 full-text studies were included in the present review. All the included articles were published between 1992 and 2022. These studies were two retrospective studies, two review studies, and the remaining (n = 28) were observational studies.

CONCLUSION

The oral flora of cleft lip and/or palate patients has been shown in scientific studies to have an increased frequency of potentially pathogenic fungal and bacterial colonization, particularly Candida species, Staphylococcus aureus, Lactobacili and Streptococci mutans. This may influence oral diseases and post-operative repair complications, potentially necessitating further surgical intervention.

Mouthwash Effects on the Oral Microbiome: Are They Good, Bad, or Balanced?

This narrative review describes the oral microbiome, and its role in oral health and disease, before considering the impact of commonly used over-the-counter (OTC) mouthwashes on oral bacteria, viruses, bacteriophages, and fungi that make up these microbial communities in different niches of the mouth. Whilst certain mouthwashes have proven antimicrobial actions and clinical effectiveness supported by robust evidence, this review reports more recent metagenomics evidence, suggesting that mouthwashes such as chlorhexidine may cause "dysbiosis," whereby certain species of bacteria are killed, leaving others, sometimes unwanted, to predominate. There is little known about the effects of mouthwashes on fungi and viruses in the context of the oral microbiome (virome) in vivo, despite evidence that they "kill" certain viral pathogens ex vivo. Evidence for mouthwashes, much like antibiotics, is also emerging with regards to antimicrobial resistance, and this should further be considered in the context of their widespread use by clinicians and patients. Therefore, considering the potential of currently available OTC mouthwashes to alter the oral microbiome, this article finally proposes that the ideal mouthwash, whilst combatting oral disease, should "balance" antimicrobial communities, especially those associated with health. Which antimicrobial mouthwash best fits this ideal remains uncertain.

Propolis and Diet Rich in Polyphenols as Cariostatic Agents Reducing Accumulation of Dental Plaque

Conducted studies indicate the relationship between oral health and systemic diseases. Moreover, the latest research indicated that cariogenic bacteria may severely influence the course of SARS-CoV-2 infection and increase risk of COVID-19 complications. This article aims to review various applications of propolis and pay attention to a healthy diet rich in polyphenols, which may allow the reduction of dental plaque accumulation. A literature review has been conducted from June until November 2021. It showed that propolis could be a useful agent in decreasing the accumulation of dental plaque. Moreover, a diet rich in polyphenols prevents cariogenic bacteria and reduces the accumulation of dental plaque. A reduction of a dental plaque may influence the risk of a severe course of COVID-19. Therefore, propolis and a diet rich in polyphenols may play an important role in prophylaxis of systemic diseases. Recently, it has been proven that oral infection may affect cardiovascular system, musculoskeletal system, respiratory system, nervous system, as well as may be a risk factor for diabetes mellitus. These aspects should stimulate clinicians to further research about polyphenols.

A double-blind randomized clinical trial of Brazilian red propolis dentifrice efficacy in orthodontic patients

PURPOSE

The objective was to evaluate the efficacy of a dentifrice containing Brazilian Red Propolis (BRP) against salivary Lactobacillus spp. and plaque formation.

METHODS

This was a randomized, double-blind clinical trial. Forty-two participants were randomized into two groups according to the dentifrice employed: G1 (fluoridated BRP dentifrice) and G2 (fluoridated common dentifrice). Saliva was collected and the visible plaque index (VPI) was recorded at the baseline (D0) and 4 weeks after day 0 (D28). Microbiological analysis was performed using two dilutions. Lactobacillus spp. isolates were identified and their abundance was expressed as log (CFU/mL).

RESULTS

For the first dilution, the counts of Lactobacillus spp. in G1 was 1.15 ± 0.41 at D0 and 0.68 ± 0.15 at D28 (P < 0.05) and in G2 it was 1.33 ± 0.52 at D0 and 1.84 ± 0.39 at D28 (P < 0.05). For the second dilution, the corresponding values in G1 and G2 were 0.87 ± 0.34 and 0.64 ± 0.37, respectively (P = 0.1547), and 1.54 ± 0.47 and 1.62 ± 0.37, respectively (P = 0.9999). The corresponding VPI values for G1 and G2 were 38.10 ± 17.95 and 20.60 ± 16.44, respectively (P < 0.05), and 38.38 ± 19.65 and 27.40 ± 14.63, respectively (P = 0.03).

CONCLUSION

The dentifrice containing BRP showed antimicrobial activity against Lactobacillus spp. and decreased the VPI for up to 4 weeks.

Effectiveness of propolis in maintaining oral health: a scoping review

BACKGROUND

Research has revealed that periodontal diseases are caused by inflammation that results from a dysbiosis of the oral microbiome where oral bacteria multiply into larger communities referred to as dental biofilm. To help control this overgrowth of bacteria, a variety of toothpastes, dentifrices, and mouthwashes have been developed. Although not as common in North American toothpastes, propolis as an active ingredient in dentifrices has begun to emerge, as laboratory studies have suggested it has anti-inflammatory, immunomodulatory, antioxidant, antimicrobial, and antidiabetic properties. The purpose of this scoping review was to explore the literature on the effectiveness of propolis in maintaining oral health.

METHODS

This review used the following criteria: Population: studies involving healthy humans; Intervention: propolis in the form of toothpaste, dentifrice, and mouthwash; Comparison: fluoride, chlorohexidine, and placebo; Outcomes: plaque and gingival indices, improvement in oral hygiene, and inhibition of bacteria. Relevant research articles were selected from Web of Science, PubMed, MEDLINE, and Scopus databases using the search parameter "propolis[tw] AND (toothpaste*[tw] OR dentifrice*[tw] OR mouthwash*[tw])". Only original articles published after 2009 and written in the English language were included.

RESULTS

A total of 19 original papers met the criteria and showed varying levels of success achieved with the use of propolis. It was responsible for a significant lowering of specific plaque and gingival indices, inhibited the growth of bacteria, reduced oral flora diversity, and consistently improved periodontal condition, oral hygiene, and oral health.

CONCLUSION

Propolis may play a role in initiating, sustaining, and maintaining oral health as its desirable properties have the potential to improve various oral hygiene related indices.

Dynamic Change in Oral Microbiota of Children With Cleft Lip and Palate After Alveolar Bone Grafting

To investigate the longitudinal influence of alveolar bone grafting on the oral microbiota of children with cleft lip and palate (CLP).

Twenty-eight children with nonsyndromic CLP were recruited and underwent secondary alveolar bone grafting at the first time. Unstimulated saliva and plaque samples were collected from the subjects preoperatively and at 2 days, 1 month, and 3 months postoperatively. The v3-v4 hypervariable regions of the 16S rRNA gene from bacterial DNA were sequenced using the Illumina MiSeq sequencing platform.

The alpha diversity of the saliva and plaque microbiota was significantly decreased at 2 days postoperatively and then increased at 1 and 3 months postoperatively. The saliva and plaque microbiota compositions at 2 days postoperatively differed from those at the other time points, and the microbiota compositions at 1 and 3 months postoperatively showed a gradual shift toward the preoperative composition. The saliva, but not plaque, microbiota composition 3 months postoperatively was similar to that preoperatively.

The effect of secondary alveolar bone grafting on the plaque microbiota in children with CLP lasted longer than the saliva microbiota. Alveolar bone grafting altered the saliva microbiota in children with CLP within 3 months postoperatively.

Advantages of using toothpaste containing propolis and plant oils for gingivitis prevention and oral cavity hygiene in cleft lip/palate patients

BACKGROUND

The anti-inflammatory and antibacterial action of preparations used during oral hygiene procedures is particularly important in patients with oral cleft. Few reports have been published assessing the influence of natural products on the state of the oral cavity in patients with oral cleft. The aim of this study was to assess the effect of toothpaste containing Polish propolis and plant oils on oral cavity health in patients with oral cleft treated orthodontically.

MATERIALS AND METHODS

A total of 50 patients aged 9-16 years old (20 females, 23 males) were selected and randomly assigned into two groups. Group (A) received toothpaste with Polish propolis, tea tree oil, menthol, and rosemary oil. Group (B) received toothpaste without active ingredients (placebo). A baseline assessment was followed by an oral hygiene index (OHI, debris OHI-D, and calculus OHI-C component) and gingival bleeding index (GBI) after 35 days. The methodology of the oral condition assessment included the presence of cleft malformation as a dysmorphic of the anterior maxilla segment.

RESULTS

In group A, improvement in oral cavity hygiene assessed for incisors and molars was found (OHI-T p = 0.011). For the gingival condition, a decrease in the gingival bleeding index - total (GBI-T p = 0.002), as well as for the incisors (GBI-I p = 0.007) and molars (GBI-M p = 0.017) was found.

CONCLUSIONS

This research confirms the biological effectiveness of toothpaste with Polish propolis and plant oils. These results may be clinically useful for improving preventative oral care and for control of oral infectious diseases during orthodontic treatment in patients with oral cleft.

Salivary counts of Streptococcus mutans and Lactobacillus in patients with and without cleft lip and/or palate undergoing orthodontic treatment: A meta-analysis

OBJECTIVE

To conduct a systematic review with meta-analysis to assess if cleft lip and palate (CLP) patients undergoing orthodontic treatment have a higher colonization of Streptococcus mutans and Lactobacillus than patients without this condition.

METHODS

Five electronic databases were searched systematically. The inclusion criteria were as follows: randomized clinical trials, non-randomized, or quasi-randomized controlled trials, prospective and retrospective studies published until March, 2021; articles that evaluated S. mutans and Lactobacillus profile in patients with and without cleft lip and palate undergoing orthodontic treatment. The random-effect model was used to perform the analysis of all the data collected. Statistic heterogeneity was evaluated with I² test.

RESULTS

In this systematic review, 2 cohort studies were included. The data analysis from 160 patients revealed that patients without cleft lip and palate had 4.5 times more predisposition to oral colonization with S. mutans than CLP patients. No statistical significant difference was found between these patients for colonization with Lactobacillus.

CONCLUSIONS

Despite the limitations in the included studies, this systematic review suggested that CLP patients have a lower predisposition to oral colonization with S. mutans when compared to healthy patients.

The use of propolis in dentistry, oral health, and medicine: A review

BACKGROUND

Propolis is a resinous product that is collected from plants by bees to cover holes and crevices in their hives. Propolis has potent antibacterial, antiviral, anti-inflammatory, wound healing, and anticancer properties. Propolis has been used therapeutically by humans for centuries, including the treatment of dental caries and mouth infections.

HIGHLIGHT

This review article attempts to analyze the potential use of propolis in general dentistry and oral health management.

CONCLUSION

Propolis is potentially useful in dentistry and oral health management based on available in vitro, in vivo, and ex vivo studies, as well as human clinical trials.

Evidence-Based Studies and Perspectives of the Use of Brazilian Green and Red Propolis in Dentistry

This review analyzes the evidence and perspectives of dental use of the green and red propolis produced in Brazil by Apis mellifera L. Multiple applications of propolis were found considering its antibacterial, antifungal, anti-inflammatory, immunomodulatory, antiviral, and healing properties. Its therapeutic effects are mainly due to the presence of alcohols, aldehydes, aliphatic acids, aliphatic esters, amino acids, aromatic acids, aromatic esters, flavonoids, hydrocarbyl esters, ethers, fatty acids, ketones, terpenes, steroids, and sugars. Propolis has been mainly used in dentistry in the composition of dentifrices and mouthwashes. Studies have also demonstrated promising use against dentin hypersensitivity, root canal treatment, Candida albicans, and other microorganisms. Overall review of the literature presented here demonstrated that both Brazilian green and red propolis are effective for the problems of multiple etiologies that affect the oral cavity in different dental specialties.

Activity of preparations from Spilanthes oleracea, propolis, Nigella sativa, and black garlic on different microorganisms involved in oral diseases and on total human salivary bacteria: A pilot study

Due to continuous rise in antibiotic resistance, there is a need for alternative treatment options to reduce the levels of oral pathogens for the maintenance of oral as well as overall health. The aim of this study was to evaluate the in vitro antibacterial potential of tinctures of Spilanthes oleracea and propolis, Nigella seed oil, and an ethanolic extract of black garlic on microorganisms involved in oral diseases. Both the minimum inhibitory concentration assay and the minimum bactericidal/fungicidal concentration assay were used in this study. Inhibition effects against total human salivary bacteria were also determined. Our results show that all of the preparations tested had potent antimicrobial activities. When measured 10 min after exposure, even low concentrations of the propolis tincture were found to have killed more than 99% of salivary bacteria, whereas Spilanthes tincture and black garlic extract killed more than 90% and Nigella seed oil more than 60% of the pathogens. This suggests that all preparations are promising candidates for the use in oral health care products and that all have the potential to control biofilm associated infections.

The Influence of Toothpaste Containing Australian Melaleuca alternifolia Oil and Ethanolic Extract of Polish Propolis on Oral Hygiene and Microbiome in Patients Requiring Conservative Procedures

The study was based on the use of a toothpaste with antiphlogistic activity, containing Australian Melaleuca alternifolia oil (tea tree oil—TTO) and ethanolic extract of Polish propolis (EEP). Fifty-one patients with varying conditions of the gingiva were divided into two groups. The study group received the toothpaste with TTO and EEP, while the control group received the same toothpaste but without TTO and EEP. Approximal plaque index (API), simplified oral hygiene index (OHI-s) and modified sulcus bleeding index (mSBI) were assessed in three subsequent stages. During each examination, swabs were employed for microbiological inoculation. During the period of use of toothpastes with TTO and EEP, a significant reduction of the API was observed, as assessed upon the control visit after 7 days and after 28 days, compared to baseline. A statistically significant reduction of mSBI was observed after 7 and 28 days of using the toothpaste with TTO and EEP, as compared to the value upon the initial visit. Statistically significant differences in the OHI-s value were observed in the study group, which was using the active toothpaste. The use of a toothpaste containing TTO and EEP helps to maintain microbiome balance. The observed stabilisation of bacterial microflora confirms the beneficial activity of toothpaste containing EEP and TTO compared to the control group, where the lack of these substances contributed to the emergence of qualitative and quantitative changes in oral microbiome.

A Comparative Study of Oral Microbiota in Infants with Complete Cleft Lip and Palate or Cleft Soft Palate

Few reports have been published on the early microbiota in infants with various types of cleft palate. We assessed the formation of the oral microbiota in infants with complete cleft lip and palate (CLP n = 30) or cleft soft palate (CSP n = 25) in the neonatal period (T1 time) and again in the gum pad stage (T2 time). Culture swabs from the tongue, palate, and/or cleft margin at T1 and T2 were taken. We analysed the prevalence of the given bacterial species (the percentage) and the proportions in which the palate and tongue were colonised by each microorganism. At T1, Streptococcus mitis (S. mitis) were the most frequently detected in subjects with CLP or CSP (63% and 60%, resp.). A significantly higher frequency of methicillin-sensitive Staphylococcus aureus (S. aureus MSSA) was observed in CLP compared to the CSP group. At T2, significantly higher percentages of S. mitis, S. aureus MSSA, Staphylococcus epidermidis, and members of the Enterobacteriaceae family were noted in CLP infants compared to the CSP. S. mitis and Streptococcus sanguinis appeared with the greatest frequency on the tongue, whereas Streptococcus salivarius was predominant on the palate. The development of the microbiota in CLP subjects was characterised by a significant increase in the prevalence of pathogenic bacteria.

Oral Health of Patients Treated with Acrylic Partial Dentures Using a Toothpaste Containing Bee Product

This study was carried out to investigate the influence of a propolis and tee tree oil-containing hygienic agent on selected oral health parameters, oral microflora, and the condition of periodontal health. Thirty-seven patients who underwent oral rehabilitation with a removable acrylic denture were selected and randomly assigned into two groups: study group (A) which received a newly formulated propolis and tee tree oil-containing toothpaste or a control group (C) without an active ingredient. API, S-OHI, and mSBI were assessed in three subsequent stages. During each examination swabs were employed for microbiological inoculation: in the study group after 4 weeks use of the active toothpaste showed a decrease in the number of isolated microorganisms. In the control group, after 4 weeks use of the toothpaste without active ingredients resulted in increase in the number of the isolated microorganisms. Improvements in hygiene and the condition of periodontium were observed in patients using active toothpastes. In the study group the oral flora diversity was reduced by the decrease in the number of cultured microorganism species, while in the control group an increase in the number of cultured microorganisms and their species was observed.

Effects of Brazilian Propolis on Dental Plaque and Gingiva in Patients with Oral Cleft Malformation Treated with Multibracket and Removable Appliances: A Comparative Study

Orthodontic appliances modify the local environment of the oral cavity, increase the accumulation of dental plaque, and affect the condition of the gingiva. The aim of this study is assessment of Brazilian propolis toothpaste's effect on plaque index (PLI) and gingival index (GI) in patients with CL/CLP treated using orthodontic appliances in the 35-day study period. The study population included 96 patients of an Orthodontic Outpatient Clinic, ACSiMS in Bytom. All the patients participated in the active phase of orthodontic treatment using buccal multibracket appliances or removable appliances. During the first examination, each patient was randomly qualified to the propolis group or control group. A statistically significant decrease in GI and PLI in the entire propolis group (P < 0.01) was shown during repeated examination. Insignificant change in GI was in the entire control group during the repeated examination compared to the baseline. Similar result was obtained in patients treated with multibracket and removable appliances. The orthodontic appliance type did not affect the final dental plaque amount and gingival condition in patients using the propolis toothpaste. These results may be clinically useful to improve prevention and control oral infectious diseases during orthodontic treatment patients with oral cleft.

The Influence of Ethanolic Extract of Brazilian Green Propolis Gel on Hygiene and Oral Microbiota in Patients after Mandible Fractures

Maintenance of proper oral hygiene by dental plaque elimination is one of the most important factors affecting the healing process in postoperative oral wounds. Propolis is a substance produced by bees. Ethanolic extract of propolis has bactericidal, fungicidal, anti-inflammatory, and antioxidative properties. Moreover, it can scavenge free radicals. The purpose of this paper is to demonstrate the efficacy of a gel containing 3% of ethanolic extract of Brazilian green propolis (EEP-B) when used for maintaining oral hygiene in patients with postoperative oral mucosal wounds. The hygiene was assessed using API, OHI, and SBI followed by microbiological examinations. The patients were divided into two groups. Group 1 consisted of those who used a gel containing EEP-B for oral hygiene, and group 2 consisted of those who used a gel without EEP-B. Although improved oral hygiene was noted in both groups, the improvement was markedly greater in the group using gel containing EEP-B. Summing up the results of microbiological examinations, EEP-B has beneficial effect on mouth microflora in postoperative period. Propolis preparations used for oral hygiene allow eliminating microorganisms of pathogenic character and physiological flora microorganisms considered as being opportunistic, with no harmful influence on physiological microflora in oral ecosystem.

Propolis in dentistry and oral cancer management

Propolis, known as bee glue, is a wax-cum-resin substance, which is created out of a mix of buds from some trees with the substance secreted from the bee's glands. Its diverse chemical content is responsible for many valuable properties. Multiple applications of propolis have been studied and described in detail for centuries. However, currently available information on propolis is scarce. A literature search in the PubMed database was performed for English language articles, using the search terms propolis, oral health, dentistry, and oral cancer; no restrictions were used for publication dates. The aim of the article was to review propolis and its applications in dentistry including oral cancer.