Eficácia e segurança da própolis no tratamento de doenças periodontais: revisão sistemática e meta-análise

Abstract

Periodontal diseases (PD) have traditionally been associated with the development of certain systemic conditions. The possible treatment of PD with natural agents has been the subject of great interest in recent years, due to the increasing bacterial resistance to antibiotic therapy. Propolis is a natural substance which has proven useful for treating periodontal disease. This systematic review and meta-analysis gather evidence of the efficacy and safety of propolis intervention in PD. CINAHL, Central Register of Controlled Trials (CENTRAL), Embase, LILACS, PubMed, SciELO, Scopus, and Web of Science databases were searched for studies. This systematic review has a protocol registered in PROSPERO (CRD42021273137). 1,884 records were obtained from the searches, of which 12 met the eligibility requirements. The results demonstrated the efficacy and safety for all dental formulations containing propolis. Toothpaste was the most effective in removing biofilm, with improvement in gingival inflammation. However, the most accessible formulation was mouthwash, highlighting its use in patients with motor difficulties. Subgingival irrigation of the hydro-alcoholic solution of propolis is the method of choice in the clinic to reduce inflammation and microorganisms responsible for periodontitis, according to the results observed in the meta-analysis regarding the parameters gingival index (GI), pocket probing depth (PPD), and clinical attachment index (CAL). The different pharmaceutical forms containing propolis showed efficacy and safety in the treatment of PD. In this meta-analysis, it was possible to prove the efficacy of the treatment by subgingival irrigation in the parameters GI, PPD, and CAL. New perspectives for standardizing clinical protocols for the diagnosis of periodontal diseases, for better clinical evidence.