Non-Cochrane · intervention · PM42317150
Natural Agents for the Improvement of Gingival Health: Systematic Review and Meta-Analysis of Randomized Clinical Trials.
Meyer Frederic, Mohammed Zubaida Selva, Deschner James, et al. · Oral health & preventive dentistry · 2026 · PubMed · doi:10.3290/j.ohpd.c_2697
Findings
Population People in clinical trials of oral care products for gingival health (gingivitis, periodontal patients)
1 finding
| Natural-ingredient toothpastes and gels (e.g., Aloe vera, Pudilan, hydroxyapatite, herbal extracts) | Control toothpastes and gels (placebo or active control) | Gingival health (bleeding on probing, or gingival index when BoP not reported) 12 weeks to 6 months · Clinical trials of toothpastes and gels | MD 0.63 [0.19, 1.07] GRADE not reported 10 studies |
Included primary studies 10
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Butera 2022 Home Oral Care of Periodontal Patients Using Antimicrobial Gel with Postbiotics, Lactoferrin, and Aloe Barbadensis Leaf Juice Powder vs.… PMID:35052995 | 2022 | this review only | Gingival health (bleeding on probing, or gingival index when BoP not reported) | not extracted yet |
| Cheng 2019 Evaluation of the effect of a toothpaste containing Pudilan extract on inhibiting plaques and reducing chronic gingivitis: A randomized,… DOI:10.1016/j.jep.2019.111870 | 2019 | this review only | Gingival health (bleeding on probing, or gingival index when BoP not reported) | not extracted yet |
| Figueiredo 2024 The Effect of a Nature-Based Gel on Gingival Inflammation and the Proteomic Profile of Crevicular Fluid: A Randomized Clinical Trial. PMID:39727530 | 2024 | this review only | Gingival health (bleeding on probing, or gingival index when BoP not reported) | not extracted yet |
| Harks 2016 Impact of the Daily Use of a Microcrystal Hydroxyapatite Dentifrice on De Novo Plaque Formation and Clinical/Microbiological Parameters of… DOI:10.1371/journal.pone.0160142 | 2016 | this review only | Gingival health (bleeding on probing, or gingival index when BoP not reported) | not extracted yet |
| Hellstrom 2014 The effect of a dentifrice containing Magnolia extract on established plaque and gingivitis in man: a six‐month clinical study DOI:10.1111/idh.12047 | 2013 | this review only | Gingival health (bleeding on probing, or gingival index when BoP not reported) | not extracted yet |
| Howshigan 2015 The effects of an Ayurvedic medicinal toothpaste on clinical, microbiological and oral hygiene parameters in patients with chronic… DOI:10.4038/cmj.v60i4.8219 | 2016 | this review only | Gingival health (bleeding on probing, or gingival index when BoP not reported) | not extracted yet |
| Namiranian 2012 The effect of a toothpaste containing aloe vera on established gingivitis. PMID:23421308 | 2012 | this review only | Gingival health (bleeding on probing, or gingival index when BoP not reported) | not extracted yet |
| Nandlal 2021 A randomized clinical study to examine the oral hygiene efficacy of a novel herbal toothpaste with zinc over a 6‐month period DOI:10.1111/idh.12505 | 2021 | this review only | Gingival health (bleeding on probing, or gingival index when BoP not reported) | not extracted yet |
| Pradeep 2012 Clinical and Microbiologic Effects of Commercially Available Dentifrice Containing Aloe Vera: A Randomized Controlled Clinical Trial DOI:10.1902/jop.2011.110371 | 2012 | this review only | Gingival health (bleeding on probing, or gingival index when BoP not reported) | not extracted yet |
| Vajrabhaya 2024 Efficacy of a Herbal Toothpaste During Active Periodontal Treatment: A Clinical Study. PMID:39727435 | 2024 | this review only | Gingival health (bleeding on probing, or gingival index when BoP not reported) | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients of all ages with mild to moderate periodontal conditions | Patients with gingivitis or periodontal conditions (n=10 RCTs) |
| Intervention | Oral care products (toothpastes, gels) containing natural agents, i.e., plant-derived or tooth-like (hydroxyapatite) | Toothpastes or gels with Aloe vera, hydroxyapatite, Pudilan, magnolia extract, propolis and herbal mixtures (n=10) |
| Comparison | Placebo or active control | Conventional, placebo, chlorhexidine gel, triclosan and stannous fluoride/amine fluoride toothpastes (n=10) |
| Outcomes | Improvement in gingival health measured as bleeding on probing (BoP) and gingival index (GI) | Gingival health by BoP or GI (n=10) |
| Study designs | Double-blind randomized clinical trials with at least two groups and duration of at least 12 weeks | RCTs (n=10) |
| Timing | Minimum 12 weeks | 3 to 6 months |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | No | No | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | No | No | yes |
| 6Data extraction in duplicate | No | No | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | No | Partial Yes | no |
| 9Risk of bias assessed satisfactorilycritical | RCT: No · NRSI: N/A | NRSI: N/A · RCT: No | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: No · NRSI: N/A | NRSI: N/A · RCT: No | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | No | No | yes |
| 14Heterogeneity explained | No | No | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |