Study of the Antimicrobial Effect of an Ethanolic Extract of Propolis in Periodontal Disease

Abstract

Periodontal disease encompasses gingivitis and periodontitis and is one of the most common chronic infections in the adult population. This study aimed to evaluate the influence of Spanish propolis extract (EEP) on the effect of the clinical and microbiological parameters as an adjuvant to scaling and root planning in patients undergoing supportive periodontal therapy (SPT). Forty chronic periodontitis patients were randomly assigned into two groups for the treatment. In the control group (n = 20), the sites were treated by scaling and root planing followed by gingival irrigation with physiological saline and in the test group (n = 20), the sites were treated by scaling and root planing followed by subgingival placement of EEP. At baseline (BL), bleeding on probing positive (BOP+) sites with probing pocket (PPD) ≥ 4 mm were defined as study sites. Plaque index, PPD, BOP, clinical attachment level (CAL), and subgingival plaque were evaluated at BL and 1 month later. The results showed a significant clinical improvement (p < 0.05) in the PPD, CAL and BOP+ comparing them with BL and one month after the periodontal treatment and a significant reduction (p < 0.05) for Tannerella forsythensis, Porphyromonas gingivalis, Prevotella intermedia and Treponema denticola in both groups. In addition, the improvement of clinical parameters was observed with subgingival use of EEP and also statistically significant differences between groups were observed (p < 0.05) such as reductions of BOP+ % and reduced counts of T. forsythensis and P. gingivalis, considered as the “key pathogens” for the periodontal diseases. Our results suggest prophylactic and therapeutic potential for EEP against periodontal diseases, improving clinical parameters, reducing gingival bleeding and decreasing bacterial counts of T. forsythensis and P. gingivalis. The subgingival use of EEP represents a promising modality as an adjuvant in periodontal therapy to avoid microbial resistance and other adverse effects.

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

“…Antibacterial action of propolis is connected with the presence of flavonoids such as galangin, chrysin, pinobanksin, quercetin, naringenin, apigenin, tt-farnesol as well as phenolic acids like caffeic acid, benzoic acid, gallic acid, and cinnamic acid and bacarin or ursolic acid ( Table 1 ) [ 7 , 8 , 9 , 10 ]. A study conducted by Lisbona-Gonzales et al confirmed that the ethanolic extract of Spanish Propolis reduced bacterial counts of Tannerella forsythensis and Porphyromonas gingivalis [ 11 ].…”

“…has been confirmed by Dziedzic et al, and Elbaz and Elsayad. The mentioned strains turned out to be responsible for the biofilm formation [ 11 , 53 ].…”

“…Besides inhibiting oral pathogens growth, propolis decreases Streptococci adhesion to the teeth. The mentioned bacteria are known to be responsible for the formation of dental plaque [ 11 ]. According to Koo at al., Brazilian ethanol propolis extracts led to the reduction of the mentioned adherence of Streptococcus mutans and Streptococcus sobrinus as well as Streptococcus cricetus.…”

“…Besides fruits, herbs, and spices, a propolis is a rich source of polyphenols, which are responsible for antimicrobial and antiadherent action of the mentioned natural bee product. Moreover, it inhibits bacterial glucosyltransferase activity [ 11 , 87 ].…”

“…The main propolis components are polyphenols being responsible for a beneficial impact on the oral microflora as well as antibacterial and anti-inflammatory action. Among the active components responsible for the antibacterial action are: galangin, chrysin, pinobanksin, quercetin, naringenin, apigenin, tt-farnesol, artepillin C, and phenolic acids as well as ursolic acid and bacarin [ 7 , 8 , 9 , 10 , 11 ]. Caffeic acid phenetyl ester (CAPE) and galangin constitute the major components responsible for anti-inflammatory action [ 12 ].…”