The alveolar bone protective effects of natural products: A systematic review

This systematic review was carried out to identify which naturally-occurring agents and constituents isolated therefrom have effects in preventing bone loss in a ligature-induced periodontitis model.

Eight databases were systematically searched for studies of experimental periodontitis. The data were extracted, analyzed, and the treatment outcomes were given scores based on the level of bone destruction as compared to their untreated induced-periodontitis control.

294 articles were found, of which 15 met the inclusion criteria. The selected studies tested a multi-herbal formulation; extracts (leaves, barks or fruit) of different plant species; and propolis. The most usual dosing protocol consisted of 3-times-a-day, 11-day treatment. The combined gel of Myracrodruon urundeuva (5%) and Lippia sidoides (0.5%) was the most active treatment, reducing 45-65% bone loss in the region of molars as compared to 73.4% of doxycycline (gold-standard). Ginkgo biloba extract (28-56 mg/kg) and propolis (100-200 mg/kg) prevented bone destruction by 50% and 40-44%, respectively. The other tested samples showed intermediate/weak activity in modulating bone resorption.

The gel of M. urundeuva and L. sidoides, and G. biloba and propolis extracts showed strong alveolar bone protective effectiveness in induced-periodontitis in rats. Further translational research should bridge the gap between the rat study outcomes and the clinical efficacy and long-term toxicity of these formulations in humans. The compilation of the vast literature database presented herein may drive further in vivo and clinical studies with the selected efficacious formulations to subsidize their pharmaceutical application.