ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Green Tea Extract Helps to Improve the Clinical Outcome of Non-Surgical Therapy (Scaling and Root Planing [SRP]) in the Treatment of Patients with Chronic Periodontitis
Clinical Question In patients with chronic periodontitis does the delivery of green tea extract to the gingiva decrease bacteria and inflammation?
Clinical Bottom Line Local delivery of green tea extract to the gingiva of patients with chronic periodontitis was shown to shorten healing time and decrease bacterial count. Patients with chronic periodontitis also exhibited high counts of P. gingivalis, and green tea extract specifically decreased the count of this organism in the oral cavity. The local delivery of this extract into the periodontal pocket is within the capability of a general dentist and likely to be an attractive alternative to the average patient.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 23869126Gadagi/201350 patients with chronic periodontitis (25 with diabetes, 25 systemically healthy).Randomized Split Mouth Study
Key resultsIn each patient, test and control sites were identified for placement of green tea and placebo strips. Baseline microbiological analysis for Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, then again in the fourth week of treatment. group 1 (healthy patients) showed significant reduction (P<.001) in Gingival Index scores at test sites, as did group 2 (diabetic patients). Clinical Attachment Level was improved by 1.33mm in group 1 and by 1.43mm in group 2. Prevalence of P. gingivalis in group 1 test sites was significantly reduced from baseline (75%) to fourth week (25%). Furthermore, in group 2 test sites, Probing Pocket Depth (PPD) was decreased from over 5mm to less then 4mm which was statistically significant (P<.001).
#2) 23631500Zhao/2013In vitroLaboratory Study
Key resultsFour different tea extracts (green, white, oolong, and black) were tested for their effects on the growth and adherence of P. gingivalis, the activity of host and bacterial proteases, and cytokine secretion by oral epithelia cells. All extracts exhibited a comparable dose-dependent antibacterial activity against P. gingivalis (green tea by 21%). Green tea inhibited P. gingivalis collagenase activity by 57% and stimulated epithelial cell proliferation.
#3) 23121459Chava/201330 patients with 2 contralateral sites per patient Split mouth study
Key resultsThermo-reversible green tea gel and placebo gel was placed in 2 contralateral sites in 30 patients with chronic periodontitis. In the test site the probing depth (PD), gingival index (GI), and relative clinical attachment level (rCAL) all decreased significantly (p<.0001) by the fourth week.
Evidence Search "periodontitis"[All Fields]green[All Fields] AND ("tea"[MeSH Terms] OR "tea"[All Fields]) AND ("periodontitis"[MeSH Terms]
Comments on
The Evidence
Validity: This is a review of three different studies. Between the two studies, 80 people were studied and followed for several months after the studies, which is a sufficient follow-up. The completion rate of the studies was about 80%; the data was not based on recall bias of the patients and there were no competing interests mentioned. In the first split mouth study, it is difficult to verify if treatment on one side of the mouth effected results on the other side of the arch. A more controlled study is necessary to verify if results can be replicated. Perspective: The evidence of these studies seems to be good quality. However, because this topic is relatively new in dental research, more evidence studies should be done to confirm its validity.
Applicability The individuals in the two clinical studies are fairly representative of patients in an average dental practice, and this is a treatment that is easily applied in a dental practice setting. A general dentist or periodontist may locally apply green tea extract to the periodontal pocket as a supplement to non-surgical therapy. It is also likely that patients with chronic periodontitis will accept the combination of SRP and administration of green tea extract.
Specialty/Discipline (General Dentistry) (Periodontics)
Keywords Green tea, chronic periodontitis
ID# 2661
Date of submission: 04/01/2014spacer
E-mail mcgillc@livemail.uthscsa.edu
Author Casey McGill
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Georgiana S. Gross, MPH
Faculty mentor/Co-author e-mail grossg@uthscsa.edu
Basic Science Rationale
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