Propolis effects in periodontal disease seem to affect coronavirus disease: a meta-analysis

SALES-PERES, Silvia Helena de Carvalho; AZEVEDO-SILVA, Lucas José de; CASTILHO, Ana Virginia Santana Sampaio; CASTRO, Marcelo Salmazo; SALES-PERES, André de Carvalho; MACHADO, Maria Aparecida de Andrade Moreira

doi:10.1590/1807-3107bor-2023.vol37.0031

Silvia Helena de Carvalho SALES-PERES

Universidade de São Paulo – USP, Bauru School of Dentistry, Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru, SP, Brazil.

http://orcid.org/0000-0003-3811-7899

Lucas José de AZEVEDO-SILVA

Universidade de São Paulo – USP, Bauru School of Dentistry, Department of Prosthodontics and Periodontics, Bauru, SP, Brazil.

http://orcid.org/0000-0002-6636-8022

Ana Virginia Santana Sampaio CASTILHO

Universidade de São Paulo – USP, Bauru School of Dentistry, Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru, SP, Brazil.

http://orcid.org/0000-0003-0674-8522

Marcelo Salmazo CASTRO

Universidade de São Paulo – USP, Bauru School of Dentistry, Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru, SP, Brazil.

http://orcid.org/0000-0002-9601-9069

André de Carvalho SALES-PERES

Universidade Estadual de São Paulo – UNESP, Botucatu Medical School, Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Botucatu, SP, Brazil.

http://orcid.org/0000-0001-9477-8742

Maria Aparecida de Andrade Moreira MACHADO

Universidade de São Paulo – USP, Bauru School of Dentistry, Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru, SP, Brazil.

http://orcid.org/0000-0003-3778-7444

Corresponding Author: Silvia Helena de Carvalho Sales Peres E-mail: shcperes@usp.br,

Declaration of Interests: The authors certify that they have no commercial or associative interest that represents a conflict of interest in connection with the manuscript.

Study	Design	Total (group)	Age (range)	Intervention	Control	Quality assessment
El-Sharkawy et al., 2016²⁴24.El-Sharkawy HM, Anees MM, Van Dyke TE. Propolis improves periodontal status and glycemic control in patients with type 2 Diabetes Mellitus and chronic periodontitis: a randomized clinical trial. J Periodontol. 2016 Dec;87(12):1418-26. https://doi.org/10.1902/jop.2016.150694 https://doi.org/10.1902/jop.2016.150694...	Randomized Clinical Trial	Patients with Moderate to severe chronic periodontitis	38–63	Scaling and root planning + capsule 400 mg propolis	Scaling and root planning + capsule placebo	2 (JADAD)
	Randomized Clinical Trial	50 (n=24;26)	38–63	Scaling and root planning + capsule 400 mg propolis	Scaling and root planning + capsule placebo	2 (JADAD)
Kirti et al., 2017²⁵25.Kirti S, Khuller N, Bansal P, Singh P. To assess the clinical and microbiological effects of subgingival irrigation with propolis extract and chlorhexidine as an adjunct to scaling and root planing in patients affected with chronic periodontitis: a comparative study. J Pharm Biomed Sci. 2017;7(11):387-99. https://doi.org/10.20936/jpbms/171104 https://doi.org/10.20936/jpbms/171104...	Randomized Clinical Trial	Patients with Chronic Periodontitis	30–55	Scaling and root planning followed by subgingival irrigation with Propolis Platinum	Scaling and root planning followed by subgingival irrigation with Normal Saline	5 (JADAD)
	Randomized Clinical Trial	45 (n=15)	30–55	Scaling and root planning followed by subgingival irrigation with PerioGard®		5 (JADAD)
Kumar et al., 2015²⁶26.Kumar A, Sunkara MS, Pantareddy I, Sudhakar S. Comparison of plaque inhibiting efficacies of aloe vera and propolis tooth gels: a randomized PCR atudy. J Clin Diagn Res. 2015 Sep;9(9):ZC01-03. https://doi.org/10.7860/JCDR/2015/13185.6413 https://doi.org/10.7860/JCDR/2015/13185....	Randomized Clinical Trial	Patients with Chronic Periodontitis	35–55	Commercial toothpaste with propolis	Commercial toothpaste with aloe-vera	3 (JADAD)
	Randomized Clinical Trial	40 (n=20)	35–55	Commercial toothpaste with propolis	Commercial toothpaste with aloe-vera	3 (JADAD)
Nakao et al., 2020²⁷27.Nakao R, Senpuku H, Ohnishi M, Takai H, Ogata Y. Effect of topical administration of propolis in chronic periodontitis. Odontology. 2020 Oct;108(4):704-14. https://doi.org/10.1007/s10266-020-00500-4 https://doi.org/10.1007/s10266-020-00500...	Randomized Clinical Trial	Patients with Chronic Periodontitis	–	Propolis	Placebo	5 (JADAD)
				Curry leaf
		24 (n=6)		Minocycline	1% ethanol
Pundir et al., 2017²⁸28.Pundir AJ, Vishwanath A, Pundir S, Swati M, Banchhor S, Jabee S. One-stage full mouth disinfection using 20% propolis hydroalcoholic solution: a clinico-microbiologic study. Contemp Clin Dent. 2017 Jul-Sep;8(3):416-20. https://doi.org/10.4103/ccd.ccd_544_17 https://doi.org/10.4103/ccd.ccd_544_17...	Randomized Clinical Trial	Patients with Chronic Periodontitis	25–55	20% propolis hydroalcoholic solution, 24 h after scaling and root planning	Scaling and root planning	4 (JADAD)

		30 (n=15)
Sanghani et al., 2014²⁹29.Sanghani NN, Bm S, S S. Health from the hive: propolis as an adjuvant in the treatment of chronic periodontitis: a clinicomicrobiologic study. J Clin Diagn Res. 2014 Sep;8(9):ZC41-4. https://doi.org/10.7860/JCDR/2014/8817.4856 https://doi.org/10.7860/JCDR/2014/8817.4...	Randomized Clinical Trial	Patients with Chronic Periodontitis	25–50	Scaling and root planning followed by subgingival placement of Indian propolis	Scaling and root planning	4 (JADAD)

		40 (n=20)
Shohdy et al., 2020³⁰30.Shohdy AT, Gawish AS, Attia MS, Osman DA. Effect of adjunctive use of propolis gel with non surgical treatment in management of chronic periodontitis. Al-Azhar Dental J Girls. 2020;7(2):281-4. https://doi.org/10.21608/adjg.2020.7852.1110 https://doi.org/10.21608/adjg.2020.7852....	Randomized Clinical Trial	Patients with Chronic Periodontitis	-	Propolis and chitosan polymer gel	Non surgical therapy	3 (JADAD)
	Randomized Clinical Trial	30 (n=10)	-	Propolis and polyox polymer gel	Non surgical therapy	3 (JADAD)
Sparabombe et al., 2019³¹31.Sparabombe S, Monterubbianesi R, Tosco V, Orilisi G, Hosein A, Ferrante L, et al. Efficacy of an all-natural polyherbal mouthwash in patients with periodontitis: a single-blind randomized controlled trial. Front Physiol. 2019 May;10:632. https://doi.org/10.3389/fphys.2019.00632 https://doi.org/10.3389/fphys.2019.00632...	Randomized Clinical Trial		20–65	Mouthwash containing Propolis resin extract (1:3), Plantago lanceolata leaves extract (1:10), Salvia officinalis leaves extract (1:1) and 1.75% of essential oils from Salvia officinalis, Syzygium aromaticum buds, Mentha piperita leaves, Commiphora myrrha oleoresin and Pistacia lentiscus oleoresin	Aqueous mouthwash	3 (JADAD)
		Patients with severe or moderate periodontitis
		34 (n=17)
Sreedhar et al., 2017³²32.Sreedhar A, John P, Pai J, Baramappa R, Sikkander S. Efficacy of Propolis as an Adjunct to Scaling and Root planing in patients with chronic periodontitis: placebo controlled study: efficacy of propolis as an adjunct to scaling and root planing in patients with chronic periodontitis. Natl J Integr Res Med. 2018;8(4):17-22.	Randomized Clinical Trial	Patients with Chronic Periodontitis	35–53	Irrigation with 3mL of 30% Propolis solution per tooth	Irrigation with 3mL of distilled water per tooth	3 (JADAD)
	Randomized Clinical Trial	15 (split mouth)	35–53	Irrigation with 3mL of 30% Propolis solution per tooth	Irrigation with 3mL of distilled water per tooth	3 (JADAD)
Gebara et al., 2003³³33.Gebaraa EC, Pustiglioni AN, de Lima LA, Mayer MP. Propolis extract as an adjuvant to periodontal treatment. Oral Health Prev Dent. 2003;1(1):29-35.	Clinical trial	Patients with Chronic Periodontitis	25–57	Scaling and root planning + Irrigation with 3ml of a propolis hydro alcoholic solution (20% propolis extract)	Scaling and root planning	19 (MINORS)
	Clinical trial	20 (n=10)	25–57	Scaling and root planning + Irrigation with 3ml of a placebo solution (containing 14% ethanol-propolis	Scaling and root planning	19 (MINORS)

Study	Properties	Components	Mechanism
Al Naggar et al., 2020³⁴34.Al Naggar Y, Giesy JP, Abdel-Daim MM, Javed Ansari M, Al-Kahtani SN, Yahya G. Fighting against the second wave of COVID-19: can honeybee products help protect against the pandemic? Saudi J Biol Sci. 2021 Mar;28(3):1519-27. https://doi.org/10.1016/j.sjbs.2020.12.031 https://doi.org/10.1016/j.sjbs.2020.12.0...	Antiviral Antiseptic Anti-inflammatory Antioxidant Immunomodulatory Anti-fungal Anti-bacterial	CAPE, artepilin C, chrysin, caempferol and quercetin	It strengthens the cell wall and leaves the internal environment aseptic, interfering with viral maturation and replication; and mitigating the exaggerated inflammatory response, especially the cytokine storm associated with COVID-19 infection.
Bachevski et al., 2020³⁵35.Bachevski D, Damevska K, Simeonovski V, Dimova M. Back to the basics: propolis and COVID-19. Dermatol Ther. 2020 Jul;33(4):e13780. https://doi.org/10.1111/dth.13780 https://doi.org/10.1111/dth.13780...	Antiviral	CAPE, quercetin, kaempferol, artepelin C and chrysin	Propolis acts on enveloped viruses. CAPE acts on PAK1 and can be useful in stopping / inhibiting coronavirus-induced fibrosis in the lungs.
Berretta et al., 2020⁷7.Berretta AA, Silveira MA, Cóndor Capcha JM, De Jong D. Propolis and its potential against SARS-CoV-2 infection mechanisms and COVID-19 disease: Running title: Propolis against SARS-CoV-2 infection and COVID-19. Biomed Pharmacother. 2020 Nov;131:110622. https://doi.org/10.1016/j.biopha.2020.110622 https://doi.org/10.1016/j.biopha.2020.11...	Antiviral Anti-inflammatory Immunomodulatory Antioxidant Anticancer	Phytochemicals of propolis such as caffeic acid, quercetin and myricetin	Inhibitory effect on ACE2, TMPRSS2 and PAK1 signaling pathways. Immunoregulation of pro-inflammatory cytokines, including reduction of IL-6, IL-1 beta and TNF-α, proving antiviral activity to COVID-19.
Fiorini et al., 2021³⁶36.Fiorini AC, Scorza CA, Almeida AG, Fonseca M, Finsterer J, Fonseca F, et al. Antiviral activity of Brazilian green propolis extract against SARS-CoV-2 (Severe Acute Respiratory Syndrome - Coronavirus 2) infection: case report and review. Clinics. 2021;76e2357. https://doi.org/10.6061/clinics/2021/e2357 https://doi.org/10.6061/clinics/2021/e23...	Antiviral	Quercetin	Potential to inhibit the functional activity of ACE-2 receptor in SARS-CoV-2
Keflie and Biesalski, 2020³⁷37.Keflie TS, Biesalski HK. Micronutrients and bioactive substances: their potential roles in combating COVID-19. Nutrition. 2021 Apr;84:111103. https://doi.org/10.1016/j.nut.2020.111103 https://doi.org/10.1016/j.nut.2020.11110...	Antiviral Anti-inflammatory	Bioactive substancies	Promising effects in interrupting transmission, reducing susceptibility and improving the severity of SARS-CoV, MERS-CoV and other viral infections.
Khayrani et al., 2021³⁸38.Khayrani AC, Irdiani R, Aditama R, Pratami DK, Lischer K, Ansari MJ, et al. Evaluating the potency of Sulawesi propolis compounds as ACE-2 inhibitors through molecular docking for COVID-19 drug discovery preliminary study. J King Saud Univ Sci. 2021 Mar;33(2):101297. https://doi.org/10.1016/j.jksus.2020.101297 https://doi.org/10.1016/j.jksus.2020.101...	Antiviral	Glicosperin A, broussoflavonol F, sulabiroinas A, (2S) -5,7-dihydroxy-4’-methoxy-8-prenylflavanone and isorhamnetina.	Inhibition of the converting activity of angiotensin-2 (ACE-2), a SARS-CoV-2 receptor in the human body, preventing replication of the virus.
Kumar et al., 2020³⁹39.Kumar V, Dhanjal JK, Kaul SC, Wadhwa R, Sundar D. Withanone and caffeic acid phenethyl ester are predicted to interact with main protease (Mpro) of SARS-CoV-2 and inhibit its activity. J Biomol Struct Dyn. 2021 Jul;39(11):3842-54. https://doi.org/10.1080/07391102.2020.1772108 https://doi.org/10.1080/07391102.2020.17...	Antiviral Antimicrobial	CAPE	Inhibition of TMPRSS2 (protein S activator of several strains of SARS-CoV) and reduction of the SARS-COV-2.
Kumar et al., 2021²2.Kumar V, Dhanjal JK, Bhargava P, Kaul A, Wang J, Zhang H, et al. Withanone and Withaferin-A are predicted to interact with transmembrane protease serine 2 (TMPRSS2) and block entry of SARS-CoV-2 into cells. J Biomol Struct Dyn. 2022 Jan;40(1):1-13. https://doi.org/10.1080/07391102.2020.1775704 https://doi.org/10.1080/07391102.2020.17...	Antiviral Antimicrobial	CAPE	CAPE is able to inhibit M^pro (highly conserved SARS-COV-2 protein), inhibiting the functional activity of the SARS-CoV-2 protease.
Lima et al., 2020⁴⁰40.Lima WG, Brito JC, Nizer WSC. Bee products as a source of promising therapeutic and chemoprophylaxis strategies against COVID-19 (SARS-CoV-2). Phytother Res. 2021 Feb;35(2):743-50. https://doi.org/10.1002/ptr.6872 https://doi.org/10.1002/ptr.6872...	Antiviral Immunomodulatory Anti-inflammatory Antioxidant	Phenolic compounds such as galangin, chrysin, p-cumaric acid, kaempferol and quercetin	Blocking / reducing the entry of the virus into host cells, with the ability to stimulate the immune system and antiviral effect in the treatment of COVID-19
Maruta and He, 2020⁸8.Maruta H, He H. PAK1-blockers: potential Therapeutics against COVID-19. Med Drug Discov. 2020 Jun;6:100039. https://doi.org/10.1016/j.medidd.2020.100039 https://doi.org/10.1016/j.medidd.2020.10...	Antiviral Antibacterial	CAPE and Artepelin C	PAK1 blockade. Propolis components have the capacity to stimulate the immune system, block coronavirus-induced fibrosis of the lungs and have an antiviral effect in the treatment of COVID-19.
Refaat et al., 2021⁴¹41.Refaat H, Mady FM, Sarhan HA, Rateb HS, Alaaeldin E. Optimization and evaluation of propolis liposomes as a promising therapeutic approach for COVID-19. Int J Pharm. 2021 Jan;592:120028. https://doi.org/10.1016/j.ijpharm.2020.120028 https://doi.org/10.1016/j.ijpharm.2020.1...	Antiviral	Flavonoid components of Egyptian propolis	The liposomal formula of propolis showed an inhibitory effect against the protease COVID-3CL and the protein spike, inhibiting viral replication.
Sahlan et al., 2021⁴²42.Sahlan M, Irdiani R, Flamandita D, Aditama R, Alfarraj S, Ansari MJ, et al. Molecular interaction analysis of Sulawesi propolis compounds with SARS-CoV-2 main protease as preliminary study for COVID-19 drug discovery. J King Saud Univ Sci. 2021 Jan;33(1):101234. https://doi.org/10.1016/j.jksus.2020.101234 https://doi.org/10.1016/j.jksus.2020.101...	Antiviral	Glicosperin A, broussoflavonol F, sulabiroinas A, (2S) -5,7-dihydroxy-4’-methoxy-8-prenylflavanone and isorhamnetina,	Propolis glycosperin A and broussoflavonol F can inhibit the enzyme activity of the main SARS-CoV-2 protease, blocking viral replication.
Shahinozzaman et al., 2020⁴³43.Shahinozzaman M, Basak B, Emran R, Rozario P, Obanda DN, Artepillin C. Artepillin C: a comprehensive review of its chemistry, bioavailability, and pharmacological properties. Fitoterapia. 2020 Nov;147:104775. https://doi.org/10.1016/j.fitote.2020.104775 https://doi.org/10.1016/j.fitote.2020.10...	Antioxidant	Artepillin C	Blocking PAK1 (COVID-19 protein kinase), has anti-inflammatory properties and can also increase immunity against COVID-19 by inhibiting PAK1
	Antiviral
	Anti-inflammatory
	Anticancer Immunomodulatory

Study	Evaluation	Results
El-Sharkawy et al., 2016²⁴24.El-Sharkawy HM, Anees MM, Van Dyke TE. Propolis improves periodontal status and glycemic control in patients with type 2 Diabetes Mellitus and chronic periodontitis: a randomized clinical trial. J Periodontol. 2016 Dec;87(12):1418-26. https://doi.org/10.1902/jop.2016.150694 https://doi.org/10.1902/jop.2016.150694...	Probing Depth (PD); Clinical attachment level (CAL); Eastman interdental bleeding index (EIBI); Gingival index (GI); Plaque Index (PI).	GI, PI, and EIBI: no statistically significant differences at 3 and 6 months between groups;
		PD and CAL: statistically improved results in propolis group when compared with control at 3 and 6 months.
Kirti et al., 2017²⁵25.Kirti S, Khuller N, Bansal P, Singh P. To assess the clinical and microbiological effects of subgingival irrigation with propolis extract and chlorhexidine as an adjunct to scaling and root planing in patients affected with chronic periodontitis: a comparative study. J Pharm Biomed Sci. 2017;7(11):387-99. https://doi.org/10.20936/jpbms/171104 https://doi.org/10.20936/jpbms/171104...	Pocket Probing Depth (PPD); Relative Attachment Level (RAL); Sulcular Blending Index (SBI); Plaque Index (PI); Gingival Index (GI)	Intragroup comparison: baseline to 6 weeks, statistically significant for all groups in all parameters;
		PI and GI: non-significant difference between groups;
		SBI and RAL: statistically significance was found when comparing propolis and Periogard groups with the control group;
		PPD: statistically significant difference with better results in propolis group compared to others;
		Microbial colony count: significantly higher percentage reduction in propolis group comparing to control. No difference between Propolis and Periogard group.
Kumar et al., 2015²⁶26.Kumar A, Sunkara MS, Pantareddy I, Sudhakar S. Comparison of plaque inhibiting efficacies of aloe vera and propolis tooth gels: a randomized PCR atudy. J Clin Diagn Res. 2015 Sep;9(9):ZC01-03. https://doi.org/10.7860/JCDR/2015/13185.6413 https://doi.org/10.7860/JCDR/2015/13185....	Plaque score (PS); Gingival score (GS); Bleeding score (BS); Probing pocket depth (PPD); Clinical attachment level (CAL)	PS, GS, BS, PPD and CAL: statistically significant reduction in Propolis when compared to Aloe-vera group;
		Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola: statistically significant reduction in propolis group.
Nakao et al., 2020²⁷27.Nakao R, Senpuku H, Ohnishi M, Takai H, Ogata Y. Effect of topical administration of propolis in chronic periodontitis. Odontology. 2020 Oct;108(4):704-14. https://doi.org/10.1007/s10266-020-00500-4 https://doi.org/10.1007/s10266-020-00500...	Plaque control record (PCR); Tooth mobility (TM); Probing pocket depth (PPD); Clinical attachment level (CAL); Bleeding on probing (BOP).	CAL: improved in the propolis and minocycline groups, as compared to the placebo, but with no statistically significant difference;
		PPD: statistically significant improvement in the propolis group as compared to the placebo;
		Bacterial number: decrease in the propolis group for P. gingivalis, T. forsythia and P. intermedia.
Pundir et al., 2017²⁸28.Pundir AJ, Vishwanath A, Pundir S, Swati M, Banchhor S, Jabee S. One-stage full mouth disinfection using 20% propolis hydroalcoholic solution: a clinico-microbiologic study. Contemp Clin Dent. 2017 Jul-Sep;8(3):416-20. https://doi.org/10.4103/ccd.ccd_544_17 https://doi.org/10.4103/ccd.ccd_544_17...	Gingival index (GI); Plaque index (PI); Modified sulcus bleeding index; Probing pocket depth (PPD); Clinical attachment level (CAL).	PI, GI, BOP, PPD, and CAL: statistically significant improvement in propolis group;
		Aggregatibacter actinomycetemcomitans, Prevotella intermedia and P. gingivalis: statistically significantly greater reduction in the test group when compared with the control group.
Sanghani et al., 2014²⁹29.Sanghani NN, Bm S, S S. Health from the hive: propolis as an adjuvant in the treatment of chronic periodontitis: a clinicomicrobiologic study. J Clin Diagn Res. 2014 Sep;8(9):ZC41-4. https://doi.org/10.7860/JCDR/2014/8817.4856 https://doi.org/10.7860/JCDR/2014/8817.4...	Gingival index (GI); Sulcus bleeding Index (SBI); Probing pocket depth (PPD); Clinical attachment level (CAL)	GI, SBI, PPD and CAL: statistically significant decrease in propolis group;
		Microbial count of P. gingivalis, P. intermedia and Fusobacterium nucleatum: Decrease for both propolis and control groups.
Shohdy et al., 2020³⁰30.Shohdy AT, Gawish AS, Attia MS, Osman DA. Effect of adjunctive use of propolis gel with non surgical treatment in management of chronic periodontitis. Al-Azhar Dental J Girls. 2020;7(2):281-4. https://doi.org/10.21608/adjg.2020.7852.1110 https://doi.org/10.21608/adjg.2020.7852....	Plaque index (PI); Probing pocket depth (PPD); Clinical attachment level (CAL)	PI and CAL: statistically significant difference between baseline and final follow-up for both treatment groups with propolis.
		PPD: no difference in groups for the overall results.
Sparabombe et al., 2019³¹31.Sparabombe S, Monterubbianesi R, Tosco V, Orilisi G, Hosein A, Ferrante L, et al. Efficacy of an all-natural polyherbal mouthwash in patients with periodontitis: a single-blind randomized controlled trial. Front Physiol. 2019 May;10:632. https://doi.org/10.3389/fphys.2019.00632 https://doi.org/10.3389/fphys.2019.00632...	Full mouth bleeding score (FMBS); Full mouth plaque score (FMPS); Probing depth (PD); Clinical attachment level (CAL).	FMBS and FMPS: propolis showed a significant decrease comparing with the control group;
		PD and CAL: no significant difference between groups.
Sreedhar et al., 2017³²32.Sreedhar A, John P, Pai J, Baramappa R, Sikkander S. Efficacy of Propolis as an Adjunct to Scaling and Root planing in patients with chronic periodontitis: placebo controlled study: efficacy of propolis as an adjunct to scaling and root planing in patients with chronic periodontitis. Natl J Integr Res Med. 2018;8(4):17-22.	Plaque Index (PI); Modified Gingival Index (MGI); Blending on Probing (BOP); Pocket probing depth (PPD); Clinical attachment level (CAL).	PI and MGI: slight improvement in propolis group compared to placebo group;
		BOP, PPD and CAL: significant decrease in propolis comparing with placebo group;
Gebara et al., 2003²³23.Sales-Peres SH, de Azevedo-Silva LJ, Bonato RC, Sales-Peres MC, Pinto AC, Santiago Junior JF. Coronavirus (SARS-CoV-2) and the risk of obesity for critically illness and ICU admitted: meta-analysis of the epidemiological evidence. Obes Res Clin Pract. 2020 Sep - Oct;14(5):389-97. https://doi.org/10.1016/j.orcp.2020.07.007 https://doi.org/10.1016/j.orcp.2020.07.0...	Plaque index (PI); Gingival index (GI); Pocket probing depth (PPD); Bleeding upon probing (BOP); Clinical attachment level (CAL)	Viable counts of anaerobic bacteria and P. gingivalis: significant decrease in propolis group compared with others;
		PPD: significant decrease was observed in propolis group compared with others;
		GI, PI and CAL: no significant difference between groups.

[1] Corresponding Author: Silvia Helena de Carvalho Sales Peres E-mail: shcperes@usp.br,

Brasil

Brasil

Propolis effects in periodontal disease seem to affect coronavirus disease: a meta-analysis

Abstract