Weighing up the potential of "superfoods" compounds of green tea or turmeric as adjuncts in comparison to established therapeutical approaches for periodontal disease

Objective: Aim of this study was to critically appraise clinical evidence on the potential benefits of adjunctive use of superfoods green tea and turmeric as mouthrinse or local delivery agents in the treatment of periodontal disease.

Materials and methods: Electronic searches were performed in four databases for randomized trials from inception to February 2024 assessing the supplemental use of superfoods green tea and turmeric for gingivitis/periodontitis treatment. After duplicate study selection, data extraction, and risk-of-bias assessment with the RoB 2 tool, random-effects meta-analyses of Mean Differences (MD) or Standardized Mean Differences (SMD) with their 95% confidence intervals (CI) were performed.

Results: Nineteen studies (814 patients) were included, with 11 on gingivitis and 8 on periodontitis patients. No benefits were seen from the use of mouthwashes containing green tea extract or turmeric for gingivitis treatment, while green tea was associated with smaller Gingival Index (GI) reductions than chlorhexidine (5 studies; MD = 0.08; 95% CI = 0.01 to 0.14; P = 0.01). As far as periodontitis treatment is concerned, local supplementation with turmeric showed no benefits, whereas local supplementation with green tea extract was associated with improved treatment outcomes in terms of probing depth (4 studies; MD=-0.79; 95% CI=-1.29 to -0.29 mm; P = 0.002) and GI (3 studies; MD=-0.53; 95% CI=-1.01 to -0.05; P = 0.02) than the control group. However, the strength of evidence was moderate to very low due to bias, imprecision, and inconsistency.

Conclusion: Limited evidence indicates that supplemental use of green tea extract is associated with improved periodontal treatment outcomes. However, the strength of evidence is weak and further research is needed.

Clinical relevance: Green tea extract could be a natural adjunct to enhance periodontal treatment, without the potential side-effects of other adjuncts like chlorhexidine.