Propolis-containing formulations in caries prevention - a systematic review and meta-analysis

Area of Science:

• Oral Health
• Microbiology
• Evidence-Based Dentistry

Background:

• Dental caries remains a significant global health issue.
• Propolis-containing formulations (PCFs) are increasingly explored for oral health benefits.
• Existing evidence on PCFs for caries prevention requires rigorous synthesis.

Purpose of the Study:

• To systematically review and meta-analyze the clinical efficacy of PCFs in preventing dental caries.
• To compare PCFs against negative controls and chlorhexidine (CHX).
• To assess outcomes including plaque index and microbial counts.

Main Methods:

• Systematic review and meta-analysis following PRISMA 2020 guidelines.
• Searched databases without language or date restrictions.
• Included randomized clinical trials (RCTs) and analyzed plaque index and microbial counts using random-effects models.

Main Results:

• PCFs significantly reduced plaque index compared to negative controls (SMD -1.11).
• No significant difference in plaque index was found between PCFs and CHX (SMD 0.46).
• PCFs reduced microbial counts versus negative controls (SMD -1.45) but not versus CHX (SMD 0.38).

Conclusions:

• PCFs show potential in reducing plaque and microbial load, suggesting a role in oral biofilm control.
• The certainty of evidence is very low due to high risk of bias and inconsistency.
• High-quality RCTs focusing on direct caries outcomes are necessary to establish the clinical efficacy of PCFs for caries prevention.