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Relationship Between Intake of Green Tea and Periodontal Disease

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Green tea is a very popular beverage, and in vitro studies have shown that green tea polyphenols inhibit the growth and cellular adherence of periodontal pathogens and their production of virulence factors. We investigated the epidemiologic relationship between the intake of green tea and periodontal disease. We analyzed 940 Japanese men aged 49 to 59 years as part of a comprehensive health examination. Probing depth (PD), clinical attachment loss (AL), and bleeding on probing (BOP) were used as the periodontal parameters. We examined the relationship between the intake of green tea and periodontal parameters. The intake of green tea was defined as the number of cups per day in a self-administered questionnaire. The intake of green tea was inversely correlated with the mean PD, mean clinical AL, and BOP. In multivariate linear regression models, every one cup/day increment in green tea intake was associated with a 0.023-mm decrease in the mean PD (P <0.05), a 0.028-mm decrease in the mean clinical AL (P <0.05), and a 0.63% decrease in BOP (P <0.05), after adjusting for other confounding variables. There was a modest inverse association between the intake of green tea and periodontal disease.
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Relationship Between Intake of Green
Tea and Periodontal Disease
Mitoshi Kushiyama,* Yoshihiro Shimazaki,* Masatoshi Murakami,* and Yoshihisa Yamashita*
Background: Green tea is a very popular beverage, and in
vitro studies have shown that green tea polyphenols inhibit
the growth and cellular adherence of periodontal pathogens
and their production of virulence factors. We investigated the
epidemiologic relationship between the intake of green tea
and periodontal disease.
Methods: We analyzed 940 Japanese men aged 49 to
59 years as part of a comprehensive health examination.
Probing depth (PD), clinical attachment loss (AL), and bleed-
ing on probing (BOP) were used as the periodontal parameters.
We examined the relationship between the intake of green tea
and periodontal parameters. The intake of green tea was de-
fined as the number of cups per day in a self-administered
questionnaire.
Results: The intake of green tea was inversely correlated
with the mean PD, mean clinical AL, and BOP. In multivariate
linear regression models, every one cup/day increment in
green tea intake was associated with a 0.023-mm decrease
in the mean PD (P<0.05), a 0.028-mm decrease in the
mean clinical AL (P<0.05), and a 0.63% decrease in BOP
(P<0.05), after adjusting for other confounding variables.
Conclusion: There was a modest inverse association be-
tween the intake of green tea and periodontal disease. J Peri-
odontol 2009;80:372-377.
KEY WORDS
Epidemiology; green tea; periodontal disease; periodontitis.
Periodontal disease is a chronic dis-
ease that is prevalent in adults.
The incidence and progression of
periodontal disease is related causally to
periodontal pathogens,
1,2
as well as to
various host and environmental fac-
tors.
3,4
Eating habits and nutritional
intake affect periodontal disease. Many
studies have reported that consumption
of vitamin C and calcium is linked to
periodontal disease
5,6
and that the con-
sumption of whole-grain and lactic acid
foods has a prophylactic effect on peri-
odontal disease.
7-9
Green tea is a popular drink, and the in-
take of greentea and its components,such
as catechin, had a preventive effect
against cancer development and cardio-
vascular disease in experimental and
epidemiologic studies.
10,11
Several in vi-
tro studies have suggested that green tea
catechins, such as (-)-epigallocatechin
gallate (EGCg), inhibit periodontal path-
ogens
12-14
and the destruction of peri-
odontal tissue.
15,16
A pilot clinical
study
12
showed that periodontal treatment
withtheslow-releaselocaldeliveryofcate-
chin improved periodontal status. How-
ever, it is not clear whether the daily
intake of green tea has a beneficial effect
on periodontal health. Therefore, we exam-
ined the epidemiologic relationship be-
tween the daily intake of green tea and
periodontal disease through a compre-
hensive health examination in middle-
aged Japanese men.
* Department of Preventive Dentistry, Kyushu University Faculty of Dental Science,
Fukuoka, Japan.
doi: 10.1902/jop.2009.080510
Volume 80 Number 3
372
MATERIALS AND METHODS
Study Population
More than 95% of the men enlisted in the Self-Defense
Force in Fukuoka, Japan, attended a comprehensive
health examination that included a 5-day admission
to the Self-Defense Force Fukuoka Hospital in the 5
years before retirement. The examination was con-
ducted for preretirement healthcare for the subjects.
We examined a total of 1,123 men aged 49 to 59 years
between January 2000 and March 2002. Of these, 940
subjects who had 20 teeth and all of the data required
for analysis were studied to ensure an adequate as-
sessment of periodontal condition. The subjects pro-
vided oral consent to participate in this study. The
study was conducted in accordance with the Helsinki
Declaration, and the design and procedures were ap-
proved by the Self-Defense Force, Fukuoka Hospital,
and the Ground Staff Office.
Measurements
Oral examination was carried out by one dentist
trained to perform a clinical examination of oral health
status using a normal dental chair. Probing depth (PD)
and clinical attachment loss (AL) were measured
using a periodontal probe
at the mesio-buccal and
mid-buccal sites for all remaining teeth, except third
molars, following the method of the Third National
Health and Nutrition Examination Survey.
17
Gingival
bleeding on probing (BOP) was evaluated by calculat-
ing the percentage of teeth exhibiting gingival bleed-
ing within a few seconds of probing the periodontal
pockets. The examiner reliability of the periodontal
examination was verified by an intraexaminer calibra-
tion of volunteers; the percentage agreement (within
1 mm) ranged from 91.0% to 100% for PD and from
89.0% to 100% for clinical AL. The kappa value
ranged from 0.86 to 1.00 for PD and from 0.84 to
1.00 for clinical AL. The examiner was masked to
the answers of the questionnaire while conducting
the periodontal examination.
Each subject completed a self-administered ques-
tionnaire that assessed smoking history, alcohol in-
take, toothbrushing habits, and the daily intake of
green tea; an examiner checked the answers orally.
Smoking habit was quantified as the number of ciga-
rettes smoked per day multiplied by the number of
years smoked. The frequency of toothbrushing was
divided into five categories and coded as follows:
never =1; sometimes =2; once a day =3; twice a
day =4; and three or more times a day =5. We asked
about the habitual frequency of drinking green tea as
the number of cups per day and used it as a continu-
ous variable in the analysis.
Physicians examined each subject’s systemic con-
dition. A blood sample was collected from the antecu-
bital vein after an overnight fast to determine lipid and
glucose levels. The body mass index was defined as
the weight in kilograms divided by the square of the
height in meters. Body fat was defined using foot-to-
foot bioelectric impedance analysis using a body com-
position monitor.
Statistical Analysis
Weused the mean PD,mean clinicalAL, and BOP as de-
pendentvariablestoreflectperiodontaldisease.We cal-
culated the Spearman correlation coefficient among
each periodontal parameter, the intake of green tea,
andotherstudy variables.We used simple linear regres-
sion analysis to examine the relationship between the
intake of green tea and each periodontal parameter.
Stepwise multivariate linear regression analysis was
used to examinethe effect of each independent variable
on the periodontal parameters. The variables for which
the correlation coefficient was significant were entered
into the multivariate model. The statistical analyses
were performed using a software program.
§
RESULTS
The characteristics of the subjects were compared to
the data for men 50 to 59 years old from the National
Nutrition Survey of Japan, conducted in 2000 (Table
1).
18
Most of the data were similar; however, the
subjects’ systolic blood pressure and triglycerides
were slightly lower and the high-density lipoprotein
(HDL) cholesterol was slightly higher compared to
the results of the National Nutrition Survey. The per-
centage of smokers (current and past) was 81.5% in
this study and 76.7% in the National Nutrition Survey.
Table 1 shows the Spearman correlation coefficient
of the study variables. The intake of green tea, smok-
ing habit, number of teeth, and HDL cholesterol were
significantly correlated with all of the periodontal pa-
rameters. The frequency of toothbrushing was associ-
ated with the mean PD and BOP, and the body fat and
triglycerides were associated with BOP. The intake of
green tea was correlated with the frequency of tooth-
brushing and number of teeth. There was no signifi-
cant seasonal variation in mean green tea intake.
The simple linear regression analysis identified a
significant relationship between the intake of green
tea and each periodontal parameter (Table 2). Table
3 shows the results of the stepwise multivariate linear
regression to evaluate each independent variable in
relation to the periodontal parameters. The intake of
green tea was significantly inversely correlated with
all of the periodontal parameters. Every one cup/
day increment in green tea intake was associated with
a 0.023-mm decrease in mean PD (P<0.05), a 0.028-
mm decrease in mean clinical AL (P<0.05), and a
† PCPUNC15, Hu-Friedy, Chicago, IL.
‡ TBF-401, Tanita, Tokyo, Japan.
§ SPSS version 15.0, SPSS Japan, Tokyo, Japan.
J Periodontol March 2009 Kushiyama, Shimazaki, Murakami, Yamashita
373
0.63% decrease in BOP (P<0.05), after adjusting for
other confounding variables.
DISCUSSION
We conducted a comprehensive health examination
of males in their fifties and examined the relationship
between the daily intake of green tea and periodontal
disease. Most of the subjects in the Self-Defense Force
were men, and men in their fifties have a relatively
large number of existing teeth and a high prevalence
of periodontal disease. The daily intake of green tea
was significantly associated with indices of peri-
odontal disease, including PD, clinical AL, and BOP,
such that the more frequently the subjects drank
green tea, the better was their periodontal condition.
Bacterial biofilm development in the marginal
gingiva and periodontal pockets is important in the
pathogenesis of periodontal disease. Previous in vitro
studies showed that green tea catechin inhibits the
growth of Porphyromonas gingivalis,Prevotella inter-
media, and Prevotella nigrescens
12,14
and the adher-
ence of P. gingivalis onto human buccal epithelial
cells.
14
In addition, green tea catechins with the steric
structures of 3-galloyl radial, EGCg, (-)-epicatechin
gallate (ECg), and (-)-gallocatechin gallate, which
are the major tea polyphenols, inhibit the production
of toxic end metabolites of P. gingivalis.
19
These re-
ports of the inhibitory effects of catechin contained
in green tea on periodontal pathogens may provide
the basis for the beneficial effect of the daily intake
of green tea on periodontal health.
Periodontal disease is an infectious disease involv-
ing gingival inflammation and the destruction of peri-
odontal tissue. Periodontal pathogens, such as P.
gingivalis and Aggregatibacter actinomycetemcomi-
tans (previously Actinobacillus actinomycetemcomi-
tans), produce matrix metalloproteinases (MMPs)
and exhibit collagenase activity.
20
MMPs, such as
Table 1.
Characteristics of Variables and Spearman Correlation Coefficients
Spearman Correlation Coefficient
Mean SD
(range)
National Nutrition
Survey
18
Mean PD
Mean
Clinical AL BOP
Intake of
Green Tea
Age (years) 52.4 0.9 (49 to 59) (50 to 59) -0.04 -0.01 -0.03 0.03
PD (mm) 2.5 0.8 (1.0 to 7.0) 0.77* 0.69* -0.11*
Clinical AL (mm) 3.0 1.0 (0.7 to 8.2) 0.77* 0.50* -0.11*
BOP (%) 17.7 19.0 (0 to 100) 0.69* 0.50* -0.08
Intake of green tea (cups/day) 3.5 2.2 (0 to 12) -0.11* -0.11* -0.08
Smoking habit (pack-years) 23.3 17.7 (0 to 87.5) 0.24* 0.30* 0.14* -0.06
Alcohol intake (times/week) 4.4 2.7 (0 to 7) -0.01 -0.03 0.004 -0.04
Toothbrushing frequency (times/day) 3.8 0.8 (1 to 5) -0.13* -0.02 -0.15* 0.09*
Teeth (n) 26.3 2.9 (20 to 32) -0.22* -0.35* -0.12* 0.07
BMI (kg/m
2
) 23.8 2.6 (16.6 to 32.8) 23.6 3.0 0.05 -0.03 0.03 -0.01
Body fat (%) 21.5 4.4 (10.1 to 35.5) 0.06 -0.004 0.07
-0.01
Systolic blood pressure (mm Hg) 128.9 14.9 (90 to 220) 134.9 19.5 0.03 0.003 0.05 0.03
Diastolic blood pressure (mm Hg) 82.6 9.9 (46 to 126) 83.9 11.7 0.02 -0.05 0.04 -0.02
Total cholesterol (mg/dl) 205.5 33.1 (99 to 339) 204.0 36.6 0.01 -0.05 0.05 -0.02
HDL cholesterol (mg/dl) 57.5 15.9 (23 to 128) 54.1 15.6 -0.09* -0.11* -0.09
0.01
Triglycerides (mg/dl) 149.6 124.2 (31 to 1,753) 164.3 161.2 0.05 0.04 0.08
0.01
Fasting plasma glucose level (mg/dl) 102.1 19.2 (74 to 289) 101.7 29.9 0.04 0.04 0.05 -0.02
=not applicable.
*P<0.01.
P<0.05.
Intake of Green Tea and Periodontal Disease Volume 80 Number 3
374
collagenases and gelatinases, break down the colla-
gen and gelatin that make up the extracellular matrix
of periodontal tissue, and MMP activity plays an im-
portant role in the pathogenesis and progression of
periodontal disease. When periodontal pathogens
live on local periodontal tissue, fibroblasts and mac-
rophages produce several cytokines, including inter-
leukin-1 and -6 and tumor necrosis factor-alpha, as
mediators of the inflammatory response and immune
reaction.
21
These cytokines play a direct role in the
destruction of periodontal tissue and encourage
fibroblasts and macrophages in periodontal tissue
to enhance the production and activation of MMPs, re-
sulting in the progressive destruction of periodontal
tissue.
22
Astudy
13
showed that green tea catechin,
EGCg, and ECg inhibit the activity of P. gingivalis
derived collagenase. In addition, EGCg inhibited
osteoclast formation in a coculture of primary osteo-
blastic cells and bone marrow cells,
15
and it induced
the apoptotic cell death of osteoclast-like multinucle-
ated cells in a dose-dependent manner.
23
Previous
studies
10,11
suggested that green tea catechin has a
preventive effect against the development of cancer
and cardiovascular disease, and the effect has been
ascribed to the antioxidative mechanisms of cate-
chin.
24,25
Oxidative stress plays an important role
in the pathogenesis of periodontal disease, as well
as many other disorders,
26,27
and it is believed that
antioxidants can defend against inflammatory dis-
eases.
26
Vitamin C is a well-known antioxidant,
28
and reports
5,29
have shown a significant relationship
between vitamin C deficiency and periodontal break-
down. In addition, a recent animal study
30
showed
that the oral administration of vitamin C prevented
alveolar bone resorption by decreasing oxidative
damage to periodontal tissue. Therefore, similar
mechanisms might be involved in the effects of the in-
take of green tea.
Smoking habit and the frequency of toothbrushing,
which are important lifestyle factors for periodontal
Ta b l e 3 .
Parameter Estimates From Stepwise Multivariate Linear Regression Models Evaluating
Each Independent Variable in Relation to Periodontal Parameters
Dependent Variable
Mean PD (mm)
Dependent Variable
Mean Clinical AL (mm)
Dependent Variable
BOP (%)
Independent Variables Coefficient SE PValue Coefficient SE PValue Coefficient SE PValue
Intake of green tea
(cups/day)
-0.023 0.011 0.037 -0.028 0.013 0.035 -0.63 0.27 0.021
Smoking habit
(pack-years)
0.008 0.001 <0.001 0.013 0.002 <0.001 0.096 0.035 0.006
Toothbrushing
frequency (times/day)
-0.072 0.031 0.021 -3.04 0.79 <0.001
Teeth (n) -0.056 0.008 <0.001 -0.12 0.011 <0.001 -0.65 0.21 0.002
Intercept 4.19 0.26 <0.001 6.01 0.29 <0.001 46.24 6.52 <0.001
R
2
for mean PD =0.103, for mean clinical AL =0.193, and for BOP =0.048.
Ta b l e 2 .
Parameter Estimates From Simple Linear Regression Models Evaluating Intake of Green
Tea in Relation to Periodontal Parameters
Dependent Variable
Mean PD (mm)
Dependent Variable
Mean Clinical AL (mm)
Dependent Variable
BOP (%)
Independent Variable Coefficient SE PValue Coefficient SE PValue Coefficient SE PValue
Intake of green tea (cups/day) -0.034 0.011 0.002 -0.046 0.015 0.002 -0.84 0.28 0.002
Intercept 2.65 0.047 <0.001 3.21 0.062 <0.001 20.70 1.14 <0.001
R
2
for mean PD =0.010, for mean clinical AL =0.010, and for BOP =0.010.
J Periodontol March 2009 Kushiyama, Shimazaki, Murakami, Yamashita
375
disease, were significantly associated with periodon-
tal parameters and were associated with the intake
of green tea in the bivariate analyses. However, when
we entered the green tea intake and these factors si-
multaneously as independent variables into a multi-
variate regression model whose dependent variable
was an index of periodontal disease, the intake of
green tea was significantly associated with each peri-
odontal parameter, independent of other variables.
This shows that the relationship between the intake
of green tea and periodontal disease is independent
of other confounding factors.
The correlation coefficients in this study were gen-
erally small, suggesting that it is difficult to explain
periodontal disease using only a few variables, be-
cause periodontitis is a multifactorial disease. The
sample size in our study was sufficiently large to show
the statistical significance of the relationship between
the intake of green tea and periodontal disease,
but the factors considered in this study were not suffi-
cient to account for periodontal disease. Although a
number of previous studies suggested that the intake
of food and nutrients, such as dairy products,
8,9
whole
grain,
7
fiber,
7
and vitamin C,
5
may affect the preva-
lence of periodontal disease, we did not examine the
intake of foods and supplements other than green
tea. Further studies including a dietary survey are
necessary to identify other important confounders that
explain the relationship between periodontal disease
and the explanatory variables. Our periodontal exam-
ination at the mesio-buccal and mid-buccal sites of
each tooth may have led to bias because we did not
examine the periodontal condition at six sites per
tooth. In some studies
31,32
that have examined the
reproducibility and validity of dietary questionnaires,
reasonable levels of reproducibility and validity were
observed for the intake of tea. Nevertheless, because
we did not assess the validity and reliability of our
self-administered questionnaire, a bias derived from
measurement errors may have affected the study re-
sults. The study design was based on a cross-sectional
model, so the results cannot establish whether the
regular intake of green tea has a beneficial effect on
periodontal disease. Longitudinal studies of the rela-
tionship between the continued intake of green tea
and periodontal disease are required to strengthen
the interrelation. In addition, because our study sub-
jects were males in their fifties, studies of both genders
and a wide range of ages are needed to generalize
the relationship between the intake of green tea and
periodontal disease.
CONCLUSIONS
The present study suggests that there is a modest in-
verse association between the daily intake of green
tea and periodontal disease. Drinking green tea at
meals and breaks is a relatively easy habit to main-
tain, and drinking green tea as frequently as possible
may help to maintain a healthy periodontium. However,
because the observed relationship between the daily
intake of green tea and periodontal disease was
weak, the application of concentrated green tea com-
ponents, such as catechin, may be expected to have
a more beneficial effect on the periodontal condition.
ACKNOWLEDGMENTS
This work was supported by Grants-in-Aid of Scientific
Research (19390541 and 20592458) from the Minis-
tryofEducation,Science,SportsandCultureofJapan,
Tokyo, Japan, and by the department budget of
Kyushu University, Faculty of Dental Science. The au-
thors report no conflicts of interest related to this study.
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Correspondence: Dr. Yoshihiro Shimazaki, Department
of Preventive Dentistry, Kyushu University Faculty of
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Submitted October 8, 2008; accepted for publication No-
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J Periodontol March 2009 Kushiyama, Shimazaki, Murakami, Yamashita
377
... Similar results were reported in a Japanese study where the PPD and CAL were inversely correlated with the intake of green tea. An increment in intake by one cup/day, improved the parameters significantly (23). However, there is no consensus on the dosage of green or oolong teas for periodontal health. ...
... However, there is no consensus on the dosage of green or oolong teas for periodontal health. The recommendations vary from less than 1 cup to 3-4 cups/day (12,23,24). Furthermore, excessive consumption of teas may elevate bone loss due to the effects of caffeine. ...
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Introduction: Oolong tea, a functional food, has numerous therapeutic benefits owing to the presence of bioactive polyphenols, theasinensins (TS) and catechins. The present study aimed to evaluate the influence of systemic administration of oolong tea as an adjunct to nonsurgical periodontal therapy (NSPT) in the management of chronic periodontitis (CP).Methods: A total of 60 subjects with mild to moderate CP were randomly divided into two groups of tests (n = 30) and the controls (n = 30). They underwent NSPT with adjunctive oolong tea supplementation in the test group only. At baseline, 1, and 3 months, their gingival index (GI), plaque index (PI), probing pocket depth (PPD), clinical attachment loss (CAL), percentage of sites with bleeding on probing (BOP), and lobene stain index (LSI) were recorded. Furthermore, the levels of glutathione peroxidase (GPx), total antioxidants (TAO), and malondialdehyde (MDA) were also estimated in gingival crevicular fluid (GCF), saliva and serum. Additionally, colony-forming units (CFUs) of selective supra and subgingival plaque bacteria were estimated in the plaque samples.Results: In both groups, at 1 month, the GI, PI, BOP, GPx, and TAO levels were improved with a reduction in the levels of MDA and CFU’s and no staining of teeth (P < 0.05). The results were maintained in the test group at 3-month recall visit.Conclusion: Adjunctive administration of oolong tea with NSPT reduced the local and systemic oxidative burden and rapidly resolved the inflammation in CP. This would be specifically beneficial in CP subjects with systemic conditions.
... Because tea polyphe-green tea intake was associated with a 0.023mm decrease in the mean PD (P<0.05), a 0.028-mm decrease in the mean CAL (P<0.05) and a 0.63% decrease in the BOP (P<0.05) 11. nols have been shown to have antimicrobial and deodorant effect,researchers investigated whether green tea powder reduces VSCs in mouth air,and compared its effectiveness with Tips for preparing Green tea should be handled tenderly, just as you would fresh green leafy vegetables. ...
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Periodontal diseases are the chronic inflammatory diseases of the periodontium, characterised by inflammatory destruction of gingival & periodontal ligament. Most of the periodontal diseases are of microbial etiology with environmental, systemic, and other fac�tors playing a secondary role. The destruction Key Words: green tea catechin. periodontium, inflammatory response. seen in periodontal disease is due to micro�organisms as well as host inflammatory response. Earlier it was thought that the nutri�tion habits & dietary habits do not have a role in periodontal disease. But now it is clear that the eating habits & nutrition affect the peri�odontal disease. Green tea is one of the com�Introduction Green tea is one of the most popular bev�erages in the world, and it has received consid�erable attention because of its many scientifi�cally proven beneficial effects on human monly ingested drinks in day-to-day routine. The effect of green tea on various lifestyle related disorders such as diabetes mellitus & health. Several epidermiological and experimental observations have confirmed that there is a obesity have been widely investigated.The ingredients close relationship between green tea consump�and the prevention of both cancer develop�ment and cardiovascular disease. These effects have been largely attributed to the most prevalent polyphenol contained in green tea,namely Epigallocatechingallate is known to induce apoptosis in various type of tumor cells,but has little or no effect on normal cells2.3. Recently, it has been reported that epigallocatechingal- late could induce the opoptotic cell death of osteoclasts4.Thus, it can prevent alveolar bone resorption by inhibiting osteoclast survival of tea like green epicatechin(EC),epigallocatechin(EGC), Epigallocatechingallate(EGCG),and epicate- chingallate(ECG) have also been studied for their preventive effects on cancer developmen- tal &and epidermiological studies have sug gested the inhibition of periodontal pathogens and destructive periodontal diseases by green tea. Epigallocatechin-3-gallate(EGCG).a major ngredient of green tea catechins (GTC),hasbeen reported toexert a variety of biological effects, including antioxidant ,antibacterial, antiinflammatory & anticarcinogenicactivities. Additionally, it has been reported that EGCG inhibits lipopolysaccharides(LPS)-induced inflammatory cytokine production. so there is a positive relationship between intake of green tea & periodontal parameters.
... Some studies have shown that drinking green tea was beneficial to oral health [72,73]. Moreover, Fournier-Larente J et al. further studied the effect of green tea on periodontal pathogens. ...
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Objectives Green tea (Camellia sinensis) is a kind of unfermented tea that retains the natural substance in fresh leaves to a great extent. It is regarded as the second most popular drink in the world besides water. In this paper, the phytochemistry, pharmacology, and toxicology of green tea are reviewed systematically and comprehensively. Key findings Green tea has been demonstrated to be good for human health. Nowadays, multiple pharmacologically active components have been isolated and identified from green tea, including tea polyphenols, alkaloids, amino acids, polysaccharides, and volatile components. Recent studies have demonstrated that green tea shows versatile pharmacological activities, such as antioxidant, anticancer, hypoglycemic, antibacterial, antiviral, and neuroprotective. Studies on the toxic effects of green tea extract and its main ingredients have also raised concerns including hepatotoxicity and DNA damage. Summary Green tea can be used to assist the treatment of diabetes, Alzheimer’s disease, oral cancer, and dermatitis. Consequently, green tea has shown promising practical prospects in health care and disease prevention.
... Nutrients and certain bioactive compounds, such as polyphenols, have been identified as contributing factors to the relief of symptoms in and recovery from periodontitis [14]. Catechin compounds found in green tea, as its primary polyphenolic compounds, are believed to possess antioxidative, anti-inflammatory, and antimicrobial properties, which have been reported to positively impact the clinical parameters in patients with chronic periodontitis [15]. A meta-analysis study (2021) showed no difference in the effectiveness of green tea alone or in combination with SRP to reduce the depth of the pocket. ...
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Aim: Interleukin-1 beta (IL-1β) is one of the major biomarkers involved in the pathogenesis of chronic periodontitis. The aim of this study was to evaluate the changes in salivary IL-1β concentration in patients with chronic periodontitis following daily consumption of green tea. Methods and materials: Thirty patients with an average age of 45.8 years suffering from chronic periodontitis were randomly assigned into 2 groups (i.e., experimental and control groups). Besides receiving phase 1 periodontal treatment (scaling and root planning (SRP)), the experimental group drank green tea for a period of 6 weeks. To measure the concentration of salivary IL-1β, saliva samples were taken from both groups at 2 time points, i.e., prior to SRP (time point 1 (T0)) and after 6 weeks (time point 2 (T1)). The nonparametric Wilcoxon test was used to examine and compare the changes in the concentration of salivary IL-1β in each group relevant to the 2 time points (T0 and T1). Data were submitted to statistical analysis. Results: At the end of the study period, a significant reduction (P=0.0001) in the concentration of salivary IL-1β was observed in the experimental group (A). As for the control group (B), however, there was no significant change (P=0.307) in the concentration of salivary IL-1β after 6 weeks following phase 1 periodontal treatment. Conclusion: Green tea supplementation, in addition to SRP, may reduce salivary IL-1β levels in patients with chronic periodontitis for a period of 6 weeks.
... On the contrary, Kuvda and Hirsawa applied a direct delivery system by means of the implantation of drug strips into the depth of the pocket. Improvements in plaque and bleeding indices applying green tea mouth wash are in commitment with many previous researches [10][11][12][13][14][15][16][17] Intercamparisons for BI and PI did not reach a statistically significant level, yet changing trends were different between the study arms. Low achieved powers (PI: 0.11, BI: 07) indicate that larger sample size may magnify such small differences. ...
... Its activity against oral biofilm formation is mainly attributed to polyphenols [91,[94][95][96][97]. An epidemiologic study demonstrated that frequent consumption of green tea was positively correlated with good periodontal health [98]. Consistently, in vitro studies demonstrated polyphenol compounds present in green tea could significantly inhibit the growth, adherence, and biofilm formation of P. gingivalis, as well as suppress the activity of collagenase and matrix metalloproteinases [99][100][101][102]. ...
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Despite many discoveries over the past 20 years regarding the etiopathogenesis of periodontal and peri-implant diseases, as well as significant advances in our understanding of microbial biofilms, the incidence of these pathologies continues to rise. For this reason, it was clear that other strategies were needed to eliminate biofilms. In this review, the literature database was searched for studies on locally delivered synthetic agents that exhibit anti-biofilm properties and their potential use in the treatment of two important oral diseases: periodontitis and peri-implantitis.
Chapter
It has been established that periodontal diseases are related with the hyperactivity of neutrophils. Reactive oxygen species are produced mainly by neutrophils. In order to maintain the balance with reactive oxygen species, the need for antioxidants is increasing. As for supplements to the conventional periodontal therapy, different antioxidants have been applied in an attempt to provide new possibilities in the periodontal treatment. This chapter focused on recent studies that used different antioxidants as adjuncts to conventional periodontal treatments.
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Reactive oxygen species (ROS) are free radical molecules obtained from biotransformation of molecular oxygen. Oxidative stress is referred as oxidative damage produced by free radicals, and has been associated with many diseases including periodontitis. Periodontitis is a chronic inflammatory disease resulting in loss of attachment and bone loss. There is over production of ROS in periodontitis, imbalance between free radicals and antioxidants locally result in destruction of periodontal tissues. Flavonoids are naturally occurring compounds known for various actions, such as, anti-inflammatory, antioxidant properties. The objective of this review is to provide an outline on the biological actions of flavonoids and their beneficial effects on periodontal tissues.
Chapter
The paper aims to review the current clinical evidence of various herbal agents as an adjunct treatment in the management of chronic periodontitis patients. Gingivitis and periodontitis are two common infectious inflammatory diseases of the supporting tissues of the teeth and have a multifactorial etiology. An important concern about chronic periodontitis is its association with certain systemic disease. New treatment strategies for controlling the adverse effects of chronic periodontitis have been extensively assessed and practiced in sub-clinical and clinical studies. It has been shown that the phytochemical agents have various therapeutic properties such as anti-inflammatory and antibacterial effects which can be beneficial for the treatment of periodontitis. The findings of this review support the adjunctive use of herbal agents in the management of chronic periodontitis. Heterogeneity and limited data may reduce the impact of these conclusions. Future long-term randomized controlled trials evaluating the clinical efficacy of adjunctive herbal therapy to scaling and root planing are needed.
Article
Green tea has protective effects against various diseases such as malignancies, cardiovascular and metabolic disorders. Green tea has been suggested to promote periodontal health by reducing inflammation, preventing the resorption of bones and restricting the growth of certain periodontal-related bacteria. Green tea has antioxidant, carcinogenic, antimicrobial and non-inflammatory properties. This traditional drink is also used to treat systemic chronic diseases, including carcinoma. Recent studies have shown that host immuno-inflammatory reactions, in addition to microbial activity, are more likely to destroy oral tissues. In such cases, green tea is considered to be a natural preventive and curative agent. The potential benefits of green tea and its polyphenols in oral health is capturing the interest of the researchers; hence, this review discusses the therapeutic effects of green tea in the prevention of periodontal and oral diseases.
Article
Abstract Periodontitis is generally considered to be a consequence of an unfavourable host-parasite interaction in which bacteria are the determinants of disease. An intense search continues for the bacteria, specific or non-specfic, that are responsible for periodontitis and various forms of the periodontal diseases have been associated with, and are widely believed to be caused by, specific bacterial groups. However, the distribution of periodontopathic bacteria is far wider than the distribution of periodontitis, indicating that the association between bacteria and periodontitis is weak. This paper proposes a paradigm for the etiology of generalized periodontitis in which ‘host’ factors are not only those triggered by bacteria (the agent) but are also those personal factors that influence the outcome of the host/parasite relationship. The personal factors that diminish the efficiency of host defence may include psycho-social stress from the social environment, factors from the lifestyle such as diet, smoking and alcoholism and systemic factors such as intercurrent disease or deficiencies within the immune inflammatory system. A model is described in which the interaction of personal factors with the social environment provides the potential for the initiation of periodontitis. Biological variation is significant and the combination of factors that cause generalized periodontitis or any other chronic disease in one individual may not result in dental or any other chronic disease in another.
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(-)-Epigallocatechin gallate (EGCG), the main polyphenolic constituent of green tea, inhibits tumor promotion and chemical carcinogenesis in animal experimental systems. Here we report that the peroral administration of EGCG inhibited metastasis of B16 melanoma cell lines, such as B16-F10 and BL6, in both experimental and spontaneous systems.
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The antioxidants in the aqueous phase of human plasma include ceruloplasmin, albumin (the protein itself and possibly also albumin-bound bilirubin), ascorbic acid, transferrin, haptoglobin, and hemopexin. Assays that attempt to answer the question "what is the most important antioxidant?" are compared, it being concluded that the answer is different depending on the nature of the prooxidant stress imposed in the assay.
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To evaluate factors that affect the reproducibility of a semi-quantitative food frequency questionnaire used in a large prospective study we compared an extended 99-item questionnaire with a shorter, 61-item form completed by 1497 women with an interval of nine months between. Correlation coefficients for individual items assessed by the two questionnaires were highest for beverages (Spearman r = 0.70). For other foods, coefficients ranged from 0.60 to 0.70 for items eaten frequently (or habitually), to values between 0.34 and 0.45 for foods, such as sweet potatoes and ready made pie, that were eaten less frequently. For food items, the correlation between mean frequency of consumption and the reproducibility coefficient (Spearman r) was 0.51 (p less than 0.01), formally confirming that the reproducibility of measurements was positively associated with frequency of use. Pearson correlation coefficients for calorie-adjusted intakes of nutrients between the two questionnaires ranged from 0.40 for trans-fatty acids to 0.71 for vitamin E (including supplements). These correlation coefficients did not vary materially between subjects in different categories of smoking status or tertiles of age or relative weight. Moderate alcohol use had minimal effect on correlation coefficients, but reproducibility was slightly reduced among heavier drinkers. These data indicate that this self-administered dietary questionnaire can provide reproducible information about individual food and nutrient intakes which is not altered materially by age and a number of important health habits.
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Collagenolytic activity was assessed in a variety of microorganisms with particular emphasis on members of the indigenous oral flora. Organisms were grown in complete and peptide depleted basal anaerobic broth. Cell sonicates and media preparations were assayed for collagenolytic activity using 14C-labelled collagen in solution and as fibrils. Assay reaction products were evaluated by acrylamide gel electrophoresis. All tested species of Bacteroides, including B. gingivalis, B, melaninogenicus ss. melaninogenicus and intermedius, B. capillus, B. oris, B. thetaiotaomicron, and B. fragilis produced collagenase which was primarily associated with the cell fraction. Collagenolytic activity was also observed in both media and cell sonicates of Actinobacillus actinomycetemcomitans, Strain 511. The Bacteroides and Actinobacillus enzymes were heat labile, inhibited by EDTA and human serum. Enzyme activity appeared to be enhanced when these organisms were grown in peptide depleted medium. Collagenase production by tested species of Bacteroides and A. actinomycetemcomitans (511) was unique among other members of the oral microflora including species of Fusobacterium, Actinomyces, Capnocylophaga, and Selenomonas, which did not demonstrate collagenolytic activity under the same cultural conditions.
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Periodontal diseases comprise a heterogeneous group of infections that are difficult to distinguish on a clinical basis alone. The purpose of the present investigation was to group periodontitis subjects according to their elevated serum antibody levels to specific subgingival species. A total of 119 subjects (19-70 years) with evidence of prior periodontal destruction were monitored at 2-month intervals (maximum 8 visits), prior to therapy, using clinical parameters measured at 6 sites per tooth. The probing attachment level was measured twice at each visit, and an increase of > 2.5mm at a site was used to define subjects with progressing disease. Serum samples were obtained from each subject at each visit and the level of antibody determined by enzyme-linked immunosorbent assay to 12 subgingival species. Subgingival plaque samples were taken from the mesial aspect of all teeth in each subject at each visit, and the levels of 14 different subgingival species were determined using a colony-lift method and DNA probes. Subjects were grouped by cluster analysis of their elevated antibody levels using a simple matching coefficient. Ninety-two subjects fell into 9 clusters with 100% similarity; 29 subjects in one cluster group exhibited elevated antibody to none of the test species. Seven subjects in a second cluster group showed elevated antibody to Bacteroides forsythus. Subjects in the other 7 clusters showed elevated antibody to Actinobacillus actinomycetemcomitans serotype a only or in combination with B. forsythus, A. actinomycetemcomitans serotype b, Prevotella intermedia or Porphyromonas gingivalis.(ABSTRACT TRUNCATED AT 250 WORDS)
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Few food frequency questionnaires have been evaluated for their ability to assess intakes of individual foods that may be related to disease independently of their nutrient content. The reproducibility and validity of food intake measurements by a 131-item semiquantitative food frequency questionnaire were evaluated in a sample of 127 men from the Health Professionals Follow-up Study, a large longitudinal study of diet and disease. Each subject completed two questionnaires 1 year apart and two 1-week diet records 6 months apart during the intervening year. Pearson correlations assessing reproducibility between food intakes from the two questionnaires ranged from .31 for pie to .92 for coffee (mean = .59). Validity was measured by comparing food intakes from the second questionnaire with those from the diet records. Pearson correlations corrected for within-person weekly variation in diet record data ranged from .17 for other nuts to .95 for bananas (mean = .63). Large within-person variation precluded the calculation of accurate validity correlations for 29 foods. As we previously observed in women, the foods most often overreported were fruits and vegetables, and meats and dairy products were most often underreported. With few exceptions, reasonable levels of reproducibility and validity were observed for intake of individual foods in this extensive food frequency questionnaire.
Article
A major purpose of this study was to examine inhibitory effect of the catechin derivatives from Japanese green tea Camellia sinensis on collagenase activity. The crude tea catechins, which contain (+)-catechin (C), (-)-epicatechin (EC), (+)-gallocatechin (GC), (-)-epigallocatechin (EGC), (-)-epicatechin gallate (ECg), and (-)-epigallocatechin gallate (EGCg), were tested for their ability to inhibit the prokaryotic and eukaryotic cell derived collagenase activities. Among the tea catechins tested, ECg and EGCg showed the most potent inhibitory effect on collagenase activity when an optimal concentration of tea catechins (100 micrograms/ml) was added to reaction mixture containing collagenase and collagen. Preincubation of collagenase with tea catechins reduced the collagenase activity as well. In contrast to ECg and EGCg, the other four tea catechins (C, EC, EGC, and GC) did not show any collagenase inhibitory effect. Our results suggest that the steric structure of 3-galloyl radical is important for the inhibition of collagenase activity. The collagenase activity in the gingival crevicular fluid from highly progressive adult periodontitis was completely inhibited by the addition of tea catechins. These results demonstrated that tea catechins containing galloyl radical possess the ability to inhibit both eukaryotic and prokaryotic cell derived collagenase.