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Efeito do óleo essencial de Tea Tree no tratamento da gengivite
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Abstract(s)
Introdução: A gengivite é a doença periodontal mais prevalente, caracterizando-se como uma inflamação gengival provocada pela acumulação de biofilme bacteriano na margem gengival, sem perda de inserção periodontal. A clorohexidina (CHX) é amplamente reconhecida no controlo químico do biofilme bacteriano, devido ao seu largo espetro antimicrobiano e elevada substantividade. Contudo, o uso prolongado está associado a vários efeitos adversos. O óleo essencial de Tea Tree (TTO), extraído da planta Melaleuca alternifolia, possui propriedades antibacterianas, anti-inflamatórias, antifúngicas e cicatrizantes, mas a evidência clínica da sua eficácia na gengivite permanece limitada.
Objetivos: Avaliar a eficácia clínica e a tolerabilidade de um colutório com TTO no tratamento da gengivite, comparando-o com um colutório com CHX.
Materiais e métodos: Ensaio clínico randomizado, controlado e single-blind, com 30 participantes divididos aleatoriamente em dois grupos: grupo experimental (n=15), que utilizou colutório com TTO, e grupo controlo (n=15), com colutório com CHX. Foram realizadas medições do índice de placa (IP) e do índice gengival (IG), recolha de saliva para quantificação microbiológica e destartarização, antes e após 15 dias de uso diário do colutório atribuído. Ensaios in vitro prévios definiram a concentração ideal de TTO.
Resultados: Ambos os colutórios promoveram reduções significativas nos índices clínicos (IP e IG), sem diferenças estatisticamente significativas entre os grupos (p>0,05).
Em termos microbiológicos, embora maior no grupo de controlo, observou-se uma diminuição significativa da contagem de Streptococcaceae e de anaeróbios totais no grupo experimental (p<0,05). O grupo de controlo apresentou maior prevalência de efeitos adversos, como alteração do paladar, pigmentação dentária, ardor e língua pilosa negra. Laboratorialmente, ambos demonstraram eficácia na redução de Streptococcus mutans.
Conclusões: O colutório com TTO demonstrou eficácia comparável à CHX na redução da inflamação gengival e da placa bacteriana, com melhor tolerabilidade. Estudos futuros com maior amostra e seguimento mais prolongado são recomendados.
Introduction: Gingivitis is the most prevalent periodontal disease, characterised by gingival inflammation caused by bacterial biofilm accumulation at the gingival margin, without periodontal attachment loss. Chlorhexidine (CHX) is widely recognised for chemical bacterial biofilm control due to its broad-spectrum antimicrobial activity and high substantivity. However, prolonged use is associated with several adverse effects. Tea Tree Oil (TTO), extracted from Melaleuca alternifolia, has antibacterial, antiinflammatory, antifungal and healing properties, but clinical evidence supporting its efficacy in managing gingivitis remains limited. Objectives: To evaluate the clinical efficacy and tolerability of a TTO-based mouthwash in the treatment of plaque-induced gingivitis, compared with a CHX-based mouthwash. Materials and Methods: A randomised, controlled, single-blind clinical trial was conducted with 30 participants randomly assigned to two groups: the test group (n=15), who used the TTO mouthwash, and the control group (n=15), who used the CHX mouthwash. Clinical assessments included plaque index (PI), gingival index (GI), saliva collection for microbial quantification, and scaling, all performed before and after 15 days of daily mouthwash use. The optimal concentration of TTO was previously determined through in vitro testing. Results: Both mouthwashes led to significant reductions in clinical indices (PI and GI), with no statistically significant differences between groups (p>0.05). Microbiologically, although the reduction was greater in the control group, a significant decrease in Streptococcaceae and total anaerobes was observed in the test group (p<0.05). Control group reported more adverse effects, including taste alteration, tooth staining, burning sensation and black hairy tongue. In vitro, both formulations were effective in reducing Streptococcus mutans load. Conclusions: The TTO-based mouthwash proved non-inferior to CHX in reducing gingival inflammation and plaque, with a more favourable tolerability profile. Further trials with larger samples and longer follow-up are warranted.
Introduction: Gingivitis is the most prevalent periodontal disease, characterised by gingival inflammation caused by bacterial biofilm accumulation at the gingival margin, without periodontal attachment loss. Chlorhexidine (CHX) is widely recognised for chemical bacterial biofilm control due to its broad-spectrum antimicrobial activity and high substantivity. However, prolonged use is associated with several adverse effects. Tea Tree Oil (TTO), extracted from Melaleuca alternifolia, has antibacterial, antiinflammatory, antifungal and healing properties, but clinical evidence supporting its efficacy in managing gingivitis remains limited. Objectives: To evaluate the clinical efficacy and tolerability of a TTO-based mouthwash in the treatment of plaque-induced gingivitis, compared with a CHX-based mouthwash. Materials and Methods: A randomised, controlled, single-blind clinical trial was conducted with 30 participants randomly assigned to two groups: the test group (n=15), who used the TTO mouthwash, and the control group (n=15), who used the CHX mouthwash. Clinical assessments included plaque index (PI), gingival index (GI), saliva collection for microbial quantification, and scaling, all performed before and after 15 days of daily mouthwash use. The optimal concentration of TTO was previously determined through in vitro testing. Results: Both mouthwashes led to significant reductions in clinical indices (PI and GI), with no statistically significant differences between groups (p>0.05). Microbiologically, although the reduction was greater in the control group, a significant decrease in Streptococcaceae and total anaerobes was observed in the test group (p<0.05). Control group reported more adverse effects, including taste alteration, tooth staining, burning sensation and black hairy tongue. In vitro, both formulations were effective in reducing Streptococcus mutans load. Conclusions: The TTO-based mouthwash proved non-inferior to CHX in reducing gingival inflammation and plaque, with a more favourable tolerability profile. Further trials with larger samples and longer follow-up are warranted.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Tea-Tree Clorohexidina Gengivite Streptococcus mutans