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

Periodontal and microbiological evaluation in cleft lip/palate patients undergoing orthodontic treatment: A cross-sectional study

BACKGROUND

The present cross-sectional study was undertaken to evaluate the periodontal and microbiological parameters in patients with surgically repaired unilateral cleft lip and palate (UCLP) undergoing orthodontic correction in comparison to patients without any cleft or orthodontic treatment.

METHODS

A total of 120 patients, out of initial 148 patients, between the age group 6 and 18 years were enrolled and divided into four groups with 30 patients each: non-cleft patients without orthodontic treatment in Group 1, non-cleft patients undergoing fixed orthodontic treatment in Group 2, patients with UCLP without any orthodontic treatment in Group 3, and patients with UCLP undergoing fixed orthodontic treatment in Group 4. Periodontal parameters including plaque index (PI), gingival index (GI), gingival bleeding index (GBI), community periodontal index of treatment needs (CPITN) index, pocket probing depth (PD), and tooth mobility were measured in all the groups. The subgingival plaque samples of all the patients were subjected to microbial evaluation using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF-MS) for clinical diagnosis.

RESULTS

The periodontal parameters were significantly raised in Group 4, followed by Group 3 and Group 2 in comparison to Group 1 (p < 0.01), thereby suggesting poor periodontal health in patients with UCLP undergoing orthodontic treatment. Statistically significant differences (p < 0.01) in counts of micro-organisms among the groups were observed for P. gingivalis, P. intermedia, Veillonella, and Capnocytophaga, with the highest proportions in Group 4, indicating a deteriorating oral health in these patients.

CONCLUSION

Poor periodontal and microbial health in patients with UCLP undergoing orthodontic treatment indicates a need for reinforcement of oral hygiene practices among these patients.

Comparative effectiveness of Propolis with chlorhexidine mouthwash on gingivitis - a randomized controlled clinical study

BACKGROUND

To assess and compare the effectiveness of propolis mouthwash with chlorhexidine mouthwash in the reduction of plaque and gingivitis.

METHODS

A single centre, latin-square cross-over, double masked, randomized controlled clinical trial was conducted on 45 chronic generalized gingivitis subjects who were chosen from the dental clinic of MAHSA University, Malaysia. A total of 45 subjects were randomly assigned into one of the three different groups (n = 15 each) using a computer-generated random allocation sequence: Group A Propolis mouthwash; Group B Chlorhexidine mouthwash; and Group C Placebo mouthwash. Supragingival plaque and gingival inflammation were assessed by full mouth Plaque index (PI) and gingival index (GI) at baseline and after 21 days. The study was divided into three phases, each phase lasted for 21 days separated by a washout period of 15 days in between them. Groups A, B and C were treated with 0.2% Propolis, Chlorhexidine, and Placebo mouthwash, respectively, in phase I. The study subjects were instructed to use the assigned mouthwash twice daily for 1 min for 21 days. On day 22nd, the subjects were recalled for measurement of PI and GI. After phase I, mouthwash was crossed over as dictated by the Latin square design in phase II and III.

RESULTS

At baseline, intergroup comparison revealed no statistically significant difference between Groups A, B and C (p > 0.05). On day 21, one-way ANOVA revealed statistically significant difference between the three groups for PI (p < 0.001) and GI (p < 0.001). Bonferroni post-hoc test showed statistically significant difference between Propolis and Chlorhexidine mouthwash (P < 0.001), with higher reduction in the mean plaque and gingival scores in propolis group compared to chlorhexidine and placebo groups.

CONCLUSIONS

Propolis mouthwash demonstrated significant improvement in gingival health and plaque reduction. Thus, it could be used as an effective herbal mouthwash alternative to chlorhexidine mouthwash.

TRIAL REGISTRATION

The trial was retrospectively registered on 25/07/2019 at clinicaltrials.gov and its identifier is NCT04032548.

The benefits of propolis in periodontal therapy. A scoping review of preclinical and clinical studies

ETHNOPHARMACOLOGICAL RELEVANCE

The treatment of periodontal disease (PD) is aimed at adequate control of bacterial plaque. In many patients mechanical methods are unable to eliminate this plaque leading to the need for adjuvant chemical products. Propolis is a natural product that has demonstrated therapeutic properties and has shown to be effective as an anti-inflammatory and antibacterial agent in dentistry.

AIM OF THE STUDY

Considering the beneficial effects of propolis on various oral conditions, this study aimed to review, update and summarize the available evidence on the benefits of propolis in in vitro studies, animal models, and human clinical trials on non-surgical periodontal therapy.

MATERIALS AND METHODS

An electronic search in three databases was performed up to December 2021. The search strategy included the terms "propolis" and "periodontal disease" to identify relevant studies on the potential advantages of propolis in periodontal therapy in in vitro studies, animal models, and human clinical trials.

RESULTS

The search yielded 538 results, discarding 459 studies that did not clearly meet the inclusion criteria. A total of 42 studies were included: 18 in vitro, one animal, and 23 randomized clinical trials. In vitro studies have demonstrated that propolis has antimicrobial activity against periodontal pathogens and clinical studies have reported its use as an adjunct to non-surgical periodontal therapy. The clinical effects of propolis have been reported in conjunction with prophylaxis, polishing, and scaling and root planing (SRP). It has shown to have anti-plaque activity and improve gingival health. Propolis was found to be more effective in improving clinical parameters than conventional treatment (SRP alone) and demonstrated similar efficacy in treating chronic periodontitis compared to positive controls. Only one study reported an allergic reaction.

CONCLUSION

The evidence available on the benefits of propolis in in vitro studies, animal models, and clinical trials suggests that propolis could be a promising adjunct to conventional therapy of gingivitis and periodontitis. However, further studies are needed to determine its superiority to other therapies in the treatment of PD.

Antecedents, Consequences, and the Role of Third Parties in the Trust Repair Process: Evidence Taken from Orthodontics

Orthodontic treatment has popularized in Taiwan. Healthcare institutions can be responsive in their coping strategies and determine whether third-party intervention should take place involving medical disputes related to orthodontics in order to repair patient trust. This study draws on orthodontic treatment to explore the effect of various trust repair strategies employed by healthcare institutions and third-party involvement positively affecting outcomes related to trust repair. Patients were recruited among those who have undergone orthodontic treatments, and 353 valid scenario-based questionnaires were collected through an online survey. Results revealed that: (1) the affective and informational repair strategies positively impacted trust repair while the functional repair strategy did not; (2) trust repair positively impacted patient satisfaction/word-of-mouth and mediated between repair strategies and satisfaction/word-of-mouth; and (3) third-party involvement moderated the relationship between trust repair and word-of-mouth. The findings suggest that rather than receiving monetary compensation, patients usually prefer that healthcare institutions acknowledge their fault, offer apologies, and engage in active communications to clarify the causes of medical dispute. Further, an objective third party should be involved to mediate the medical disputes to afford satisfaction all around.

Antimicrobial activity of a novel Spanish propolis against planktonic and sessile oral Streptococcus spp

Increased bacterial resistance to traditional antimicrobial agents has prompted the use of natural products with antimicrobial properties such as propolis, extensively employed since ancient times. However, the chemical composition of propolis extracts is extremely complex and has been shown to vary depending on the region and season of collection, due to variations in the flora from which the pharmacological substances are obtained, being therefore essential for their antimicrobial activity to be checked before use. For this purpose, we evaluate the in vitro antimicrobial and anti-biofilm activity of a new and promising Spanish ethanolic extract of propolis (SEEP) on Streptococcus mutans and Streptococcus sanguinis, responsible, as dominant 'pioneer' species, for dental plaque. Results reveal that S. sanguinis is more sensitive to SEEP, slowing and retarding its growth considerably with lower concentrations than those needed to produce the same effect in S. mutans. SEEP presents concentration- and time-dependent killing activity and, furthermore, some of the subinhibitory concentrations employed increased biofilm formation even when bacterial growth decreased. Mono and dual-species biofilms were also inhibited by SEEP. Findings obtained clearly show the relevance of using biofilm and subinhibitory concentration models to determine optimal treatment concentrations.

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.

In Vitro Activity of Propolis on Oral Microorganisms and Biofilms

Natural products are being discussed as alternatives to commonly used chemicals in antimicrobial therapy. The study aimed to investigate the antimicrobial activity of propolis against microbial species associated with caries, periodontal disease, and Candida infections. Two commercially available ethanolic extracts of Brazilian and one of European propolis (EEP) were used. The minimal inhibitory concentrations (MIC) of propolis and controls against eight microbial strains were determined. Scanning and transmission electron microscopy (SEM and TEM) images visualized the effect of propolis on microorganisms. Subsequently, the activity on three different multi-species biofilms (both formation and existing biofilms) was assessed. All MIC values of the Brazilian EEPs were low against the tested oral species (≤0.1 mg/mL–3.13 mg/mL propolis (Candida albicans)). The European EEP had slightly higher MICs than the Brazilian EEPs. The SEM and TEM images suggest an interaction of propolis with the microbial cell wall. The European EEP exhibited the strongest effect on retarding biofilm formation, whereas the Brazilian EEPs were highly active against preformed biofilms (100 mg/mL propolis of both EEPs reduced colony forming unit counts always by more than 6 log10). The antimicrobial and anti-biofilm activities point to the potential of propolis as an adjunct in oral health care products.

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.

Periodontal health during orthodontic treatment with clear aligners and fixed appliances: A meta-analysis

BACKGROUND

Clear aligners have become increasingly popular because of their esthetics and comfort. The authors' aim in this systematic review was to compare periodontal health in patients undergoing orthodontic treatment with clear aligners with that of those undergoing orthodontic treatment with fixed appliances.

TYPES OF STUDIES REVIEWED

The authors systematically searched the PubMed, Web of Science, Cochrane Library, and Embase databases to collect related studies. After extracting data and assessing quality, the authors performed a meta-analysis and trial sequential analysis. The authors used the Grading of Recommendations Assessment, Development and Evaluation system to assess the quality of the evidence.

RESULTS

The authors included 9 studies in the quantitative synthesis analysis. Clear aligners were better for periodontal health, including plaque index (mean difference [MD], -0.53; 95% confidence interval [CI], -0.85 to -0.20; P = .001), gingival index (MD, -0.27; 95% CI, -0.37 to -0.17; P < .001), and probing depth (MD, -0.35; 95% CI, -0.67 to -0.03; P = .03), than were fixed appliances. However, the trial sequential analysis outcome indicated a false-positive meta-analysis result for probing depth. The authors downgraded the level of the evidence because of the risk of bias and inconsistency.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

Clear aligners were better for periodontal health than fixed appliances and might be recommended for patients at high risk of developing gingivitis. However, high-quality studies still are required.

Beneficial effects of specific natural substances on oral health

Substances that are consumed daily or occasionally may influence an individual’s oral health. Some substances, such as alcohol, tobacco, and areca nut, adversely affect the oral region. However, some other substances, such as honey and green tea, which have antimicrobial properties, and berries, which have anticarcinogenic potential, exhibit beneficial effects on oral health. The effectiveness of synthetic drugs in maintaining oral health cannot be ignored; however, the benefits of synthetic drugs are associated with adverse effects and high costs. By contrast, the medicinal use of natural substances is associated with safety, affordability, and long-term benefits. In this paper, we review various natural substances that are potentially beneficial to oral health.

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.