Do Adjunctive Therapies with Natural Products Improve Periodontal Clinical Parameters After Non-Surgical Treatment? A Systematic Review and Meta-Analysis

Authors

• Rafael Scaf de Molon, Universidade Estadual Paulista "Júlio de Mesquita Filho"
• Joao Victor Soares Rodrigues, Universidade Estadual Paulista "Júlio de Mesquita Filho"
• Erica Dorigatti de Avila, Universidade Estadual Paulista "Júlio de Mesquita Filho"
• Davi da Silva Barbirato, Faculdade Pernambucana de Saúde (FPS)
• Joao Pedro Franco Moura, Universidade Estadual Paulista "Júlio de Mesquita Filho"
• Gabriele Vanzela Monteiro, Universidade Estadual Paulista "Júlio de Mesquita Filho"
• Marcos Vinicius Alves, Universidade Estadual Paulista "Júlio de Mesquita Filho"
• Leticia Helena Theodoro, Universidade Estadual Paulista "Júlio de Mesquita Filho"
• Rolando Vernal, Universidad de Chile
• Wim Teughels, KU Leuven– University Hospital Leuven

Document Type

Review

Publication Date

3-1-2026

Abstract

Periodontitis is a highly prevalent chronic inflammatory disease initiated by dysbiotic biofilms and sustained by an exaggerated host immune response, for which scaling and root planing (SRP) remains the cornerstone of therapy. However, mechanical debridement alone may be insufficient to fully resolve inflammation in complex cases and in susceptible patients. In this context, natural products and host modulatory strategies have emerged as potential adjunctive therapies owing to their antimicrobial, anti-inflammatory, antioxidant, and immunomodulatory properties. This systematic review and meta-analysis aimed to evaluate the effectiveness of natural products used as adjuncts to SRP on periodontal clinical outcomes. Comprehensive electronic searches were conducted in MEDLINE/PubMed, Scopus, Web of Science, Cochrane CENTRAL, Embase, SciELO, and Google Scholar through December 2025, and randomized controlled clinical trials were included. Ninety studies were eligible for qualitative synthesis, and thirty-three were incorporated into the meta-analysis. The interventions encompassed a broad spectrum of plant-derived, host-modulatory and nutraceutical compounds, including curcumin, resveratrol, propolis, Aloe vera, green tea catechins, and omega-3 fatty acids, administered via local, systemic, or rinse-based approaches. Meta-analytic findings demonstrated that adjunctive natural products significantly enhanced probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain compared with SRP alone, with additional improvements in gingival inflammation and bleeding outcomes; however, substantial heterogeneity was observed among studies. Overall, natural products provide measurable adjunctive benefits to SRP in the management of periodontitis, although further well-designed, standardized, and long-term randomized trials are necessary to support their routine clinical implementation.

Publication Title

International Journal of Molecular Sciences

ISSN

16616596

DOI

10.3390/ijms27052394

Recommended Citation

de Molon, Rafael Scaf; Rodrigues, Joao Victor Soares; de Avila, Erica Dorigatti; da Silva Barbirato, Davi; Franco Moura, Joao Pedro; Monteiro, Gabriele Vanzela; Alves, Marcos Vinicius; Theodoro, Leticia Helena; Vernal, Rolando; and Teughels, Wim, "Do Adjunctive Therapies with Natural Products Improve Periodontal Clinical Parameters After Non-Surgical Treatment? A Systematic Review and Meta-Analysis" (2026). Research Publications (2026 to 2030). 190.
https://knova.um.edu.my/research_publications_2026_2030/190

Volume

27

Issue

5