Efectividad del té verde en el tratamiento de periodontitis crónica

Different applications forms of green tea (Camellia sinensis (L.) Kuntze) for the treatment of periodontitis: a systematic review and meta-analysis

BACKGROUND

Scaling and root planning (SRP) is the gold standard for non-surgical periodontal treatment. Green tea as a supporting alternative in non-surgical periodontal treatment has been suggested as a therapeutic option in the treatment of periodontitis.

OBJECTIVE

To analyse the comparative effectiveness of green tea (Camellia sinensis) in its different forms and applications for the treatment of periodontitis.

METHODS

We included randomized clinical trials evaluating green tea as an adjuvant therapeutic agent to scaling and root planning (SRP) in the treatment of periodontitis. For the meta-analysis, we calculated standardized mean difference (SMD) and 95%CI comparing green tea and control (only SRP). We subgrouped by types of application forms of green tea. The certainty of the evidence was assessed through GRADE.

RESULTS

Nine studies were included. The follow-up time of treatments varied from 21 days to 6 months. The subgroup meta-analysis showed that the green tea as sachet reduced probing bleeding (SMD = -0.71; 95%CI) and the gingival index (SMD = -0.78; 95%CI) compared to SRP with very low certainty of evidence. The sachet (SMD = -0.29; 95%CI) and dentifrice (SMD = -1.31; 95%CI) reduced plaque index with very low certainty compared to the control. All forms of application of green tea showed very low certainty of evidence (SMD = -0.27; 95% CI) in reducing the probing depth, as well as for the loss of clinical insertion (SMD = -0.42; 95% CI) with low certainty of evidence.

CONCLUSION

There was not a difference in the effectiveness of green tea isolated or in combination with SRP to reduce probing depth. Green tea adjunct to periodontal therapy showed very low certainty of effectiveness for the treatment of periodontal disease.

Local delivery natural products to treat periodontitis: a systematic review and meta-analysis

OBJECTIVES

This study aimed to answer the PICO question: in adults with periodontitis, does subgingival delivery of natural products (NP) after scaling and root planing (SRP) results in a better reduction of probing pocket depth (PPD) when compared with SRP alone or SRP plus placebo?

MATERIAL AND METHODS

A search for trials was carried out in eight databases. Two independent investigators performed all steps of this review. PPD reduction, clinical attachment level (CAL) gain, gingival inflammation, and biofilm accumulation reduction were investigated. We conducted meta-analyses where data could be pooled.

RESULTS

Searches yielded 4771 records, in which 27 trials fulfilled the eligibility. There was a large heterogeneity among trials (I² > 0.69, χ² < 0.000). Only four studies were at low risk of bias. The evidence quality was very low. The effectiveness of NP was demonstrated in a follow-up of 3-6 months considering PPD reduction (8 trials: 0.72 mm [95%CI: 0.23, 1.22]) and CAL gain (5 trials: 1.07 mm [95%CI: 0.36, 1.78]). A significant reduction in periodontal inflammation favors the use of NP. The biofilm accumulation reduction effect of NP was very weak or non-significant.

CONCLUSION

Although the high risk of bias and large heterogeneity of trials impose some restrictions on the validity of effect estimate, this review indicates that adjunctive NP better reduced the PPD when compared to SRP alone or SRP plus placebo in a follow-up of 3-6 months.

CLINICAL RELEVANCE

The evidence of non-responsive patients to conventional periodontal therapy highlights the need for therapeutic alternatives to treat periodontitis.

The effect of green tea as an adjunct to scaling and root planing in non-surgical periodontitis therapy: a systematic review

OBJECTIVE

To provide a systematic overview on the efficacy of green tea catechin as an adjunct to scaling and root planing (SRP) in terms of probing pocket depth (PPD).

MATERIALS AND METHODS

A systematic literature search was performed using electronic databases in PubMed, Scopus, Medline, Cochrane, CINAHL, and Web of Science on randomized clinical trials up to January 2017. The research question was posed in accordance with PRISMA guidelines.

RESULTS

The search provided 234 studies. After analyzing the full texts, five studies were included, with four studies qualifying for meta-analysis. Mean PPD reduction was significantly higher (α = 0.05) when green tea catechin was used as an adjunct to SRP (test group) than with SRP alone (control group). The difference in the reduction was 0.74 mm [0.35-1.13; 95% CI].

CONCLUSION

The local application of green tea catechin as an adjunct to SRP may result in a beneficial reduction in PPD. Due to the highly heterogeneous data and some risk of bias, however, this data still needs to be interpreted with caution.

CLINICAL RELEVANCE

The finding suggests that green tea catechin may be a topical adjunct to SRP without negative side effects.