Table 4.
Plant-Derived Compounds and Periodontal Diseases.
| Nutrient(s) | Type of Study | Methodology | Follow-Up Period | Clinical Outcomes | Subclinical Outcomes | Author(s) and Year |
|---|---|---|---|---|---|---|
| Oligomeric proanthocyanidin nutritional supplement | RCT | N = 20 dental students followed a 21-day protocol of experimental gingivitis and randomly either received oligomeric proanthocyanidin nutritional supplements treatment consisting of 90 mg exocian cran 408 and 120 mg of vitamin C (test) or placebo capsules (control). Oral hygiene was not performed for 21 days. | 21 days | Silness and Löe index and gingival bleeding index were significantly lower in the test group compared to the control. Plaque index was significantly higher in the test group. | GCF levels of IL-6 were significantly lower in the test group (22.15 ± 15.14 pg/mL) compared to the control one (69.40 ± 50.10 pg/mL) (p = 0.011). | R.M Diaz Sanchez et al., 2017 [58] |
| Encapsulated fruit, vegetable, and berry juice | RCT | A total of 60 nonsmoking subjects with periodontitis were randomized into 3 groups: Daily supplementation with capsules with fruit/vegetable (FV) juice powder, fruit/vegetable/berry (FVB) juice powder, and placebo (control) for 2 months after SRP. | 8 months | PPD, CAL, and BOP at 2 months were improved in all groups, with additional improvement in the FV group compared to the placebo one (p < 0.03). FV groups showed better BOP % and plaque scores when compared to control at 5 months (p < 0.05). No differences between FV and FVB groups. | Adherence/β-carotene plasma levels were significantly higher in both FV and FVB groups compared to control (p < 0.001). GCF volume was significantly reduced in both supplement groups (FV, FVB), compared to control. | Chapple et al., 2012 [59] |
| Cranberry functional beverage | RCT | 50 gingivitis patients were randomized into two groups: The test group received a daily 750 mL of cranberry functional beverage (CFB) for 8 weeks, while the control group was given the same amount of water, both combined with nonsurgical periodontal therapy. | 8 Weeks | Significant reduction in GI and PI scores in the test group compared to control, but no differences in BOP scores between the two groups. | Saliva and serum levels of total anti-oxidant status, malonyldialdehyde, and IL-1β were not significantly different between comparison groups. Number of Streptococcus mutans were reduced in the test group but not in the control. | Wozniewicz et al., 2018 [26] |
| Resveratrol | RCT | Patients with aggressive periodontitis (N = 160) were randomized into 4 groups: high dose of resveratrol (RV) (RV 500 mg/d), middle-dose (RV 250 mg/day), low-dose (RV 125mg/d), and placebo capsules (oral administration). No periodontal therapy was provided. | 8 weeks | Significant improvement was observed in the CAL, BI, OHI-S, and PPD in test groups compared to placebo group (p < 0.01). High-dose and middle-dose RV groups showed significant differences compared to low-dose RV group. However, the difference between high-dose and middle-dose RV groups was not statistically significant (p > 0.05). | RV supplementation reduced inflammatory markers and endotoxin in serum and GCF compared to placebo capsules. No difference was found between different RV doses. | Qiang, Zhang et al., 2021 [60] |
| Resveratrol | RCT | Patients with periodontitis and diabetes mellitus type II (N = 43) were randomized into receiving either resveratrol capsules (480 mg of resveratrol) or placebo capsules daily. Nonsurgical periodontal treatment was also provided to all patients. | 4 weeks | PPD were significantly lower in the test compared to the control groups after intervention (2.35 ± 0.6 mm and 3.38 ± 0.5 mm, respectively). | Mean serum levels of fasting insulin and insulin resistance: lower in the test group compared to the control (p < 0.05). No difference in serum fasting blood glucose levels and triglycerides between two groups. | Zare Javid et al., 2017 [61] |
| Green Tea | RCT | Chronic periodontitis patients (N = 30) were randomized into two groups; all participants received SRP. The test group consumed green herbal tea while the control group did not consume anything. | 6 weeks | Greater reduction in PPD and BI in the test group compared to the control. PI difference was not significant among the two groups. | N/A | F.Taleghani et al., 2018 [62] |
| Green tea | RCT | Mild to moderate chronic periodontitis patients (N = 120) received SRP and were randomized to consume either green tea sachets (test) or placebo cellulose sachets (control). Patients were asked to drink two cups per day. | 3 months | GI, PI, BoP, and PPD reduction was significantly lower in the test group compared to the control. CAL gain was significantly higher in the test group (2.01 + 0.65 mm) compared to control (1.60 + 0.54 mm) (p < 0.001). | GCF antioxidant levels significantly increased in the test group (p < 0.001) | Chopra et al., 2016 [63] |
| Chicory leaf extract capsules | RCT | Chronic periodontitis patients (N = 40) received SRP and were randomized to receive either chicory leaf capsules (2 g) or placebo capsules (containing 1 g wheat flour) daily. | 8 weeks | PPD showed a significant reduction in test group compared to control group. | Total antioxidant capacity (TAC) and uric acid levels in plasma increased significantly in the intervention group compared to control, while lipid (LDL-C, HDL-C, TC, TG) levels decreased. | Babaei et al., 2018 [64] |
| Bilberries | RCT | (N = 24) subjects with gingivitis were divided into placebo and two test groups who either consumed 250 g or 500 g of bilberries daily. | 1 week | The mean reduction in BOP before and after intervention was 31% in the placebo group, 41% for those who consumed 250 g, and 59% for 500 g of bilberries/day. | Significant reduction in IL-1β, IL-6, and VEGF in GCF samples in the test group that consumed 500 g bilberries. | Cecilia Widén et al., 2015 [65] |
| Coffee consumption | Cohort | N = 1152 males, periodontal status recorded, including radiographical bone loss scores, PPD, BOP, calculus, and plaque, and self-reported coffee intake assessments (from 1968 up to 1998). | 30 years | Moderate-to-severe alveolar bone loss decreased as coffee consumption increased. | N/A | Nathan Ng et al., 2014 [66] |
| Propolis | RTC | 104 patients with gingivitis and incipient periodontitis were randomized into 2 groups: Test group ingested a capsule containing propolis daily for 8 weeks, while the control group received a placebo capsule. SRP was provided to all patients at the end of the study (8 weeks). | 8 weeks | Test group showed significant improvement in gingival index after 4 and 8 weeks of treatment compared to control group. | In the test group, IL-6 was reduced and MMP-9 increased after 8 weeks. | Jin-Young Park et al., 2021 [67] |
| Propolis | RTC | 50 patients with periodontitis and type 2 diabetes mellitus received initial SRP and were divided into 2 groups. Test group received 400 mg of propolis orally 1x/day for 6 months, while the control group received placebo capsules. | 3 and 6 months | Test group showed significantly higher PPD reduction and CAL gain after 3 and 6 months of treatment. | Test group showed significant reduction in HbA1C after treatment. | El-Sharkawy et al., 2016 [68] |
| Curcumin (turmeric) | RTC | 76 patients with moderate/severe periodontitis were randomized into 2 groups: Test group received curcumin capsules (200 mg) and control group received 400 mg of mefenamic acid after surgical periodontal therapy (open-flap debridement). All patients received antibiotic treatment as well. Patients’ pain was assessed using the numerical rating scale and verbal rating scale after 24, 48, and 72 h. | 7 days | Curcumin did not result in any significant differences in postoperative pain and discomfort in patients compared to mefenamic acid. | N/A | Mansour Al Askar et al., 2022 [69] |
Abbreviations: RCT: Randomized controlled trial; PPD: Probing pocket depth; CAL: Clinical attachment level; SRP: Scaling and root planing; OHI-S: Oral hygiene index—simplified; GCF: Gingival crevicular fluid; BOP: Bleeding on probing; GI: Gingival index; PI: Plaque index; RV: Resveratrol; IL: Interleukin; TC: Total cholesterol; TG: Triglycerides; LDL-C: Low-density lipoprotein cholesterol; HDL-C: High-density lipoprotein cholesterol; VEGF: Vascular endothelial growth factor; N/A: Not available.