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Is there a role for herbal medicine in the treatment and management of periodontal disease?

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Accepted Manuscript

Title: Is there a role for herbal medicine in the treatment and management of periodontal disease?

Authors: Julija Milovanova-Palmer, Barbara Pendry

PII: S2210-8033(18)30014-9

DOI: https://doi.org/10.1016/j.hermed.2018.02.004

Reference: HERMED 215

To appear in:

Received date: 9-6-2017 Revised date: 28-1-2018 Accepted date: 25-2-2018

Please cite this article as: Milovanova-Palmer, Julija, Pendry, Barbara, Is there a role for herbal medicine in the treatment and management of periodontal disease?.Journal of Herbal Medicine https://doi.org/10.1016/j.hermed.2018.02.004

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TABLE 1. HERB SPECIES INDICATED FOR TREATMENT & MANAGEMENT OF PERIODONTAL DISEASE IN AT LEAST 3 DIFFERENT CONTEMPORARY HERBAL TEXTS

Herb species Alexan der & Straub-Bruce, 2014 Pizzor no & Murr ay, 2013 Brau n, 201 0 McInt yre, 2010 Yarn ell, 2009 Fish er, 200 9 Woo d, 200 8 & 200 9 Chevall ier, 2007 Hoffm an, 2003 Mill s & Bon e, 200 3 Barn es et al., 2002 Bark er, 2001 Wei ss, 200 1 Blumen tal, 2000 Mind ell, 2000 Tyl er, 199 9 Bartra m, 1995 Robi ns, 1995 Cou nt Achillea millefoli um

3

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3

Calendul a officinali s

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Centella

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Echinace a purpurea

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TABLE 2. SUMMARY OF IN VITRO STUDIES

Source plant Author Year

Supragingiva l micro-organisms tested

Subgingival

micro-organisms tested Other cells tested

Biochemical

s tested Review/Comments

Mangifera indica (mango), Anacardium occidentale (cashew)

Anand et al. 201 5

Streptococcu s mutans

Enterococcus faecalis, Staphylococcus aureus, Escherichia coli, Candida albicans

Coffea arabica, Coffea

canephora

Antonia et al. 201 0

Streptococcu

s mutans

Camellia sinensis (green tea)

Araghizadeh et al.

201 3

Streptococcu s mutans (20 strains)

Aggregatibacter actinomycetemcomitan

s, Porphyromonas gingivalis, Prevotella intermedia (20 strains each)

Minimal inhibitory concentration for S. mutans 6.25 mg/ml, whilst other micro-organisms was 12.5 mg/ml

Artemisia herba-alba (white wormwood), Opuntia focus-indica (Indian fig), Camellia sinensis (green tea), Phlomis

Arbia et al. 201 7

Porphyromonas

gingivalis, Prevotella intermedia

Minimal inhibitory concentration range 0.03 to 591 mg/ml, For P. gingivalis, A. herba alba and O. ficus-indica were most effective; for P. intermedia, O. ficus-indica and C. sinensis were most effective

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24 crinita

(Jerusalem sage)

Copaifera reticulata (copaiba)

Bardaji et al. 201 6

Streptococcu s mutans, S. salivarius, S. mitis

Fusobacterium

nucleatum, Prevotella nigrescens,

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Lactobacillus casei

Quercus

infectoria (gall oak)

Basri et al. 201 2

Streptococcu s mutans, S. salivarius

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Quercus galls used in traditional Indian medicine to treat toothache and gingivitis. Minimial inhibitory concentration 0.16 to 0.63 mg/ml in methanol or acetone extracts. Galls (plant cancers) effective against oral pathogens, S. Salivarius most susceptible.

Acacia nilotica (gum arabic tree), Murraya koenigi (curry tree), Psidium guajava (guava)

Chandrasheka r et al.

201 7

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Lactobacillus

acidophilus

Cymbopogon citrates (lemongrass), Plectrathus amboinicus (Mexican mint), Conyza

bonariensis (hairy fleabane)

Da Silva et al. 201 2

Streptococcu s mutans, S. salivarius, S. oralis

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De Oliveira et al.

201 3

Streptococcu s spp.

Porphyromonas gingivalis, Aggregatibacter actinomycetemcoitans, Prevotella intermedia

Candida spp., cultured mouse macrophage (cell viability and inflammation

response)

Minimal inhibitory concentrations (MIC) of S. mutans were 12.5 mg/ml for P. granatum. 3.13 mg/ml S. barbatimam, 25 mg/ml E. arvense, 100 mg/ml G. glabra

Salvadora persica (toothbrush tree)

Esfahani et al. 201 4

Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitan s

Aloe vera (aloe) Fani and Kohanteb

201 2

Streptococcu s mutans

Aggregatibacter actinomycetemcomitan

s, Porphyromonas gingivalis, Bacteroides fragilis

Aloe vera gel had MIC for S. mutans of 12.5 ug/ml, and for A.

actinomycetemcomitans, P. gingivalis and B. fragilis of 25-50

ug/ml (P<0.01) Psidium

cattleianum (cherry guava), Myracrodruon urundeuva (timber tree)

Gaetti-Jardim, Jr. et al.

201 1

Porphyromonas

gingivalis, Prevotella intermedia,

Fusobacterium nucleatum

Glycyrrhiza uralensis (Chinese liquorice)

Gafner et al. 201 1

Streptococcu s mutans, S. sobrinus

Porphyromonas

gingivalis, Prevotella intermedia,

Fusobacterium nucleatum

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phyromonas

18

gingivalis,

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herry guava

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26 Psacalium

decompositum (Indian plantain)

Garcio-Palencia et al.

201 6

Streptococcu s mutans

Porphyromonas

gingivalis, Prevotella intermedia

Geum urbanum

(wood avens) Granica

201

6

Polymorphonuclea

r lymphocytes

Morus alba

(mulberry) Gunjal et al.

201 5

Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitan s, Tannerella forsythia

Citrus sinensis

(orange) Hussain et al. 201 5

Prevotella intermedia, Porphyromonas

gingivalis, Aggregatibacter actinomyctemcomitans

Moringa oleifera (drumstick tree), Murraya

koenigii (curry tree), Psidium guajava (guava), Eclipta prostata (false daisy), Phyllanthus

fraternus (gulf leaf-flower)

John et al. 201 3

Streptococcu s mutans, S. salivarius, S. mitior, S. sanguinis, S. mitis, S. milleri

Pistacia lentiscus (mastic gum)

Karyagianni et al.

201 4

Porphyromonas

gingivalis, Prevotella intermedia,

Fusobacterium nucleatum

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