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REVIEW
Focus on Alternative and
Complementary Therapies
Volume 18(3) September 2013 118–125
© 2013 Royal Pharmaceutical Society
DOI 10.1111/fct.12034
ISSN 1465-3753
Role of propolis in dentistry: review of the literature
Divesh Sardana, KR InduShekar, Sheetal Manchanda, Bhavna Gupta Saraf,
Neha Sheoran
Abstract
Background Propolis (also called bee glue) is a resinous substance derived from bees. It has long been used in medicine
for its beneficial properties, including antimicrobial, anti-inflammatory, antidiabetic and local anaesthetic effects. In dentistry,
propolis has been used for the prevention of dental caries and periodontal diseases, as an interim transport medium for
avulsed teeth, and in endodontics, orthodontics and periodontics.
Objective To highlight the role of propolis in dentistry.
Methods A PubMed search was made using the keywords propolis, bee glue, antimicrobial, dental and herbs without
any limits on the date of publication. No specific inclusion or exclusion criteria were applied as the purpose of the review
was to make it as comprehensive as possible.
Discussion The role of propolis is discussed in various branches of dentistry, including: preventive dentistry, dental
traumatology, endodontics, periodontology, orthodontics and oral oncology.
Conclusion Although most research published in the dental literature on propolis is based on in-vitro studies or animal
studies, extrapolating the results of these present studies to clinical practice may be too early as these results may not be
necessarily replicated in human trials. In future, propolis may find a definitive role in one or more applications in dentistry;
however, clinical trials are necessary to isolate the individual components responsible for its beneficial effects and to study
them.
Keywords
Antimicrobial • bee glue • dental • interim-transport media • propolis
Introduction
Propolis (also called bee glue) is a resinous substance
derived from honey bees (Apis mellifera), and has long
been used in medicine for its beneficial properties.
The term ‘propolis’ is a Greek word meaning ‘in front
of the city’ (‘pro’ – in front and ‘polis’ – city), which
emphasises the protective role of propolis in bee
colonies. The medical literature is vast regarding the
potential benefits of propolis and its constituents,
with a range of effects reported to date including
anti-inflammatory,1antioxidant,2,3 anti-ulcer,4anti-
tumour,5antidiabetic,6,7 cardio-protective8and local-
anaesthetic effects.9The Greeks, Arabs, Romans and
Egyptians have long known about the medical prop-
erties of propolis, however the use of propolis in
dentistry is relatively new; but considering the effects
of propolis on infection, inflammation and carcino-
genesis, it may have more potential uses in the treat-
ment as well as the prevention of oral disease.
Propolis is mainly composed of plant resins and
exudates that are gathered by bees. Some wax, bee
secretions and pollen are added later by the bees to
give the final complex product, viz propolis. The
colour of the propolis may vary from yellowish-green
to dark brown depending on its source and age. Like
other waxes, it is hard and brittle when cold but
becomes soft and sticky when warmed.
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118
Several hundred compounds have been character-
ised in different propolis types; however, the main
chemical constituents of propolis are flavonoids,
various phenolic and aromatic compounds, amino
acids, minerals and vitamins A, E and B complex.
These constituents appear in various concentrations
depending on geographical location and botanical
origin. Howsoever the exact composition of propolis
from different botanical origins may vary, the biologi-
cal effects are similar. This may be because of similar
active ingredients in different types of propolis.
The purpose of this review is to highlight the role
of propolis in dentistry and to discuss any future
perspectives of this new ‘Api-herbal drug’.
Methods
Although propolis has been used in dentistry for
various indications, evidence from RCTs and control-
led clinical trials are lacking. Hence, no specific cri-
teria were applied a priori as to what articles would be
selected for this review. The purpose was to make this
review as comprehensive as possible, although only
articles indexed in PubMed were considered for inclu-
sion. A PubMed search was made using the keywords
propolis, bee glue, antimicrobial, dental and herbs
without any limits on the date of publication.
Discussion
Propolis has been widely used in dentistry; the earli-
est reference to its use was probably a medical book
named ‘The Carbadini’ published in the 13th century,
where its beneficial role had been suggested in tooth
decay. Since then, possibly due to its wide antimicro-
bial activity (including antibacterial, antifungal and
antiviral activity), propolis has been used for the
treatment and prevention of dental caries and peri-
odontal diseases, as an interim transport medium for
avulsed teeth, and for dental hypersensitivity and
denture and apthous stomatitis (Table 1).
Preventive dentistry
As an anti-caries agent
Apart from the numerous approaches already avail-
able for the prevention of dental caries (e.g. fluorides,
dietary counselling, povidone-iodine, probiotics,
caries vaccine), which affect one or more steps in the
caries process, propolis is a useful addition to this list
as it inhibits water-insoluble glucan synthesis and
affects acid production and the acid tolerance of
micro-organisms.10 Two mechanisms of action have
been associated with the anti-caries11 and anti-
plaque12 properties of propolis: the first is the anti-
microbial activity against cariogenic bacteria;13,14 the
second is the inhibition of glucosyltransferase
enzyme activity.15–18 However; the cariostatic effect of
propolis depends on its composition and, thus, the
region of collection of the propolis sample.19,20
Although propolis demonstrates in vitro inhibitory
activity against streptococcus and lactobacillus, long-
term clinical studies showing changes in decayed,
missing, filled teeth (DMFT) and decayed, missing,
filled surfaces (DMFS) are lacking. The exact dosage
and concentration of propolis that should be used
also needs to be conclusively determined. Propolis
has already been tested as an adjuvant to vaccines21
and hence, may have a future role in caries vaccina-
tion or as adjuvant therapy to other anti-caries
agents [e.g. fluorides, povidone-iodine, casein
phosphopeptide – amorphous calcium phosphate
(CPP-ACP)].
Dental trauma
Interim-transport media for avulsed teeth
Dental avulsion is a consequence of injury that
results in the complete displacement of a tooth from
its alveolar socket and damaging the adjacent
hard and soft periodontal tissues. Various interim
Table 1 Propolis and its role in dentistry
Composition (may vary
depending on
the source)
Flavonoids
Phenolic and aromatic
compounds
Amino acids
Minerals
Vitamins
Physical characteristics Colour: yellowish-green to dark
brown depending on source
and age
Hard and brittle when cold
Soft and sticky when warmed
Health-enhancing
benefits
Anti-inflammatory
Antioxidant
Anti-ulcer
Antidiabetic
Antibacterial
Antifungal
Antiviral
Anti-tumour
Cardio-protective
Dental uses Anti-caries agent
Interim transport media for
avulsed teeth
Anti-plaque agent
Anti-calculus agent
Intra-canal medicament
Intra-canal irrigant
Pulp capping agent
Adjunct to radiotherapy
Reduction of dentinal
hypersensitivity
Treatment of stomatitis
Anti-herpetic
Antifungal
Repair of oral wounds
Review 119
transport media for avulsed teeth have been used to
preserve the vitality of periodontal ligament (PDL)
cells; propolis is one of them. Propolis has been
found to be an effective storage media for periods of
6 h and above.22,23 However, the results do not appear
very promising for shorter periods of storage.
Propolis increases the metabolic activity and pro-
liferation of PDL cells and decreases apoptosis, sug-
gesting it has a beneficial role on the viability and
physiological health of periodontal ligament cells.24
Propolis has also been shown to inhibit external
root resorption similar to 2% acidulated-phosphate
sodium fluoride solution,25 although in another
study propolis caused time-dependent replacement
resorption similar to teeth maintained in saliva and
dry conditions.23 Lastly, propolis inhibits osteoclas-
togenesis and osteoclast activation in tissue culture
and may prove useful in future as a medicament to
reduce resorption associated with traumatic injuries
to the teeth.26
Various concentrations of propolis (either alone or
in combinations)27–29 with varied time periods have
been studied to determine its effectiveness in main-
taining PDL cell viability utilising different meth-
ods.30,31 Although found to be effective, the exact
concentration is yet to be conclusively determined.
Moreover, its ease of availability remains a question
when compared to other easily available and effective
media such as milk, coconut water and oral rehydra-
tion solution. Based on the data available for propolis
as an interim transport medium, it may be concluded
that propolis is an acceptable long-term storage
medium for avulsed teeth. However, long-term
human trials are necessary to term it the ‘best’ storage
medium for avulsed teeth.
Periodontology
A large number of mouth rinses have been used for
their ability to disrupt the formation of plaque. In a
double-blind cross-over study, propolis was found to
be significantly more efficacious than placebo in
reducing the plaque index and the concentration of
insoluble polysachharide.12 Reduction of insoluble
polysaccharide by propolis may not only reduce the
bulk of plaque but also affect the cariogenic potential
of plaque.32 In rat models, propolis when adminis-
tered systemically reduced alveolar bone loss when
assessed by morphologic and histologic parameters.33
Sub-gingival irrigation with propolis extract as an
adjuvant to periodontal treatment was found to be
more effective than conventional treatment accord-
ing to both microbiological and clinical para-
meters34,35 and, hence, may be recommended in cases
of gingivitis and periodontitis. Propolis has also been
studied for its effectiveness in reducing malodour
production and found to be ineffective,36 but it still
may find a future role in toothpastes and mouth
rinses as an anti-calculus agent (due to its inhibitory
effect on both the rate of amorphous calcium
phosphate transformation to hydroxyapatite and the
induction time)37 and anti-plaque agent. However,
propolis may have a limited role when compared to
chlorhexidine (CHX) as an anti-plaque agent.38
Endodontics
Intra-canal medicament
Calcium hydroxide [Ca(OH)2] has remained a stand-
ard treatment against which intra-canal medica-
ments (ICMs) are compared.39,40 However, Ca(OH)2
has some disadvantages, like its longer time require-
ments for action41 and its inability to eliminate a
whole spectrum of micro-organisms.42 Propolis has
reportedly a greater inhibitory effect on Enterococcus
faecalis compared to Ca(OH)2, tri-antibiotic mixture,
ethanol and saline.43–45 However, in these studies the
methodologies differed in regard to antimicrobial
testing, duration of the study, strain of E. faecalis and
the concentration of propolis used. Although propo-
lis had better inhibitory activity against E. faecalis,
CHX and povidone iodine were found to be better
than propolis and Ca(OH)2.46 However, in another
study, Ca(OH)2paste containing propolis extract
was found to be better than Ca(OH)2alone against
polymicrobial cultures.47
Apart from the antimicrobial action of intra-canal
medicaments, another issue to be considered is the
peri-apical response of the ICM. Long-term studies on
peri-apical response of propolis are lacking, however,
when compared with corticosteroid–antibiotic paste,
it caused less peri-apical inflammation over a period
of 28 days in dogs’ teeth.48 As an ICM, both propolis
and Ca(OH)2have similar physical properties,49
although propolis has been reported to be 10 times
less cytotoxic to fibroblasts of the periodontal liga-
ment and dental pulp.50
Intra-canal irrigant
Propolis may be used as an intra-canal irrigant and
has been found to be effective in reducing endotox-
ins and inhibiting E. faecalis,Streptococcus aureus,
Candida albicans and E. coli.51–53
Pulp-capping agent/pulpotomy
Propolis has been used as a pulp-capping agent in
permanent teeth54 and as a pulpotomy agent in
primary teeth.55,56 It was found that teeth capped
with propolis form a hard tissue barrier. The probable
components of propolis responsible for the forma-
tion of the hard tissue barrier are the flavonoids,
which have been shown to cause less inflammation
and harder tissue formation than non-flavonoid
components.57 Flavonoids have anti-inflammatory
properties by virtue of their suppression of immune
cell activation, macrophage-derived nitric oxide and
cytokine production and neutrophil activation. Also,
Focus on Alternative and Complementary Therapies September 2013 18(3)120
flavonoids may inhibit bacterial growth in the pulp
chamber thereby reducing the host response to bac-
terial antigens.58
Orthodontics
Propolis solution was shown to have a positive effect
on bone formation during treatment with a device to
expand the palatine suture. An increased quantity of
osteoblasts and quicker bone remodelling was found
in preparations from rats that received propolis
during the treatment.59
Oral oncology
The radio-sensitising capacity of propolis was evalu-
ated in human head and neck squamous cell carci-
noma (HNSCC) cells and propolis was found to
enhance radio-sensitivity in one of the three HNSCC
lines and also reduced cell growth and clonogenic
survival.60 Hydro-alcoholic extract of green propolis
had a protective role against chemically induced
lingual carcinogenesis in rats61 and may be used as a
preventive agent or as adjunctive treatment for oral
cancers. Propolis may also have a role in reducing or
delaying radiation-induced mucositis.62
Miscellaneous
Dentin hypersensitivity
Dentin hypersensitivity has been defined as a short,
sharp pain arising from exposed dentin in response
to stimuli, typically thermal, evaporative, tactile,
osmotic or chemical, which cannot be ascribed to
any other form of dental pathology.63 Numerous
materials have been used to reduce dentin hypersen-
sitivity; propolis is one of them.64 When compared
with CPP-ACP F and sodium fluoride, topical appli-
cation of propolis was found to be most effective in
reducing hypersensitivity over a period of 90 days.65
The probable mechanism for the reduction in
hypersensitivity may be the occlusion of dentinal
tubules.66,67
Stomatitis
Systemic intake of propolis (500 mg/day) was found
to be effective in reducing the number of disease
outbreaks and improving the QoL of patients suffer-
ing from recurrent aphthous stomatitis.68
Antifungal
Candidiasis is a fungal infection commonly found in
denture wearers and immune-compromised patients.
Propolis has been found to inhibit C. albicans isolated
from HIV-seropositive individuals when compared to
nystatin in an in-vitro study,69 and also in denture
wearers, thus supporting its antifungal activity.70
Antiviral
Propolis may have a future role in the prophylaxis or
treatment of herpes simplex virus (HSV) infections of
the oral cavity. The anti-HSV effect of propolis was
tested in an in-vitro and in-vivo study71 and propolis
was found to have an inhibitory effect on viral infec-
tion probably owing to the prevention of virus
absorption into the host cells and/or inhibition of an
internal step(s) during the viral replication cycle,
thus preventing the appearance and development of
symptoms in vivo. In another study, Brazilian propolis
showed not only direct anti-HSV-1 activity but also
immunological activity against intradermal HSV-1
infection in mice.72
Repair of oral wounds
Propolis in aqueous alcohol solution exerted a small
analgesic and anti-inflammatory effect and also aided
repair of intra-buccal surgical wounds after sulculo-
plasty by modified Kazanjian technique.73 Topical
application of propolis hydro-alcoholic solution
was found to accelerate epithelial repair after tooth
extraction but had no effect on socket wound
healing.74
Role in dental materials
Arslan et al.75 evaluated the effect of five cavity disin-
fection agents: chlorhexidine, sodium hypochlorite,
propolis, ozone, and erbium chromium: yttrium-
scandium-gallium garnet (Er,Cr:YSGG) laser on bond
strengths of silorane-based resin composite. However,
no significant difference in mean bond strength was
observed between the groups. Troca et al.76 evaluated
the effect of adding green propolis on the mechanical
properties of glass ionomer cements (GICs). Water
sorption values of the experimental GICs were
increased compared to pure GIC; other mechanical
properties like diametral tensile strength and solubil-
ity were also affected, although the change in prop-
erties were dependent on the GIC material (i.e.
manufacturer). Silva et al.77 evaluated the effect of
nystatin, flucanazole and propolis on the roughness,
free energy and Knoop hardness number of poly-
methyl methacrylate (PMMA) resin (both heat
cured and microwave cured). There was a significant
increase in surface roughness and surface hardness of
PMMA samples treated with propolis compared to
antifungal agents. The increase in surface hardness in
the propolis-treated group was probably due to the
deposition of propolis over the roughened area,
which may have formed a barrier to C. albicans.
Side-effects
Propolis is considered to be a safe medicine; however,
like other honey-bee products, it may be responsible
for causing allergic reactions.78–80 As such, propolis
should be avoided by asthmatic patients, patients
allergic to bee stings and patients allergic to honey
products. Patch testing should be done to rule out
Review 121
allergy to propolis before prescribing it to a patient.
Future studies are needed to identify the individual
components of propolis responsible for causing aller-
gic reactions.
Conclusion
Although most of the dental literature published on
propolis is based on in-vitro studies or animal studies,
extrapolating the results of these present studies to
clinical practice may be too early as these results may
not be necessarily replicated in human trials. In
future, propolis may find a definitive role in one or
more applications in dentistry; however, clinical trials
are necessary to isolate the individual components
responsible for its beneficial effects and to study them.
Further research is also needed to determine its
optimal concentration, time of application, method
of preparation and effects on the oral cavity. Lastly,
allergy to propolis and its constituents should be
considered before prescribing the product to patients.
Conflict of interest None declared.
References
1 Paulino N, Teixeira C, Martins R et al. Evaluation of the
analgesic and anti-inflammatory effects of a Brazilian
green propolis. Planta Med 2006; 72: 899–906.
2 Sulaiman GM, Al Sammarrae KW, Ad’hiah AH et al.
Chemical characterization of Iraqi propolis samples
and assessing their antioxidant potentials. Food Chem
Toxicol 2011; 49: 2415–21.
3 Lee S, Kim KS, Park Y et al. In vivo anti-oxidant activi-
ties of tectochrysin. Arch Pharm Res 2003; 26: 43–6.
4 de Barros MP, Sousa JP, Bastos JK, de Andrade SF. Effect
of Brazilian green propolis on experimental gastric
ulcers in rats. J Ethnopharmacol 2007; 110: 567–71.
5 Szliszka E, Zydowicz G, Janoszka B et al. Ethanolic
extract of Brazilian green propolis sensitizes prostate
cancer cells to TRAIL-induced apoptosis. Int J Oncol
2011; 38: 941–53.
6 Wang NZ, Li D. Effect of combined propolis-ethanol-
extract and Shaoyao-Gancao-tang on blood sugar
levels in rabbits with alloxan induced experimental
diabetes. Asia Pac J Clin Nutr 2004; 13: S66.
7 Murata K, Yatsunami K, Fukuda E et al. Antihyperglyc-
emic effects of propolis mixed with mulberry leaf
extract on patients with type 2 diabetes. Altern Ther
Health Med 2004; 10 (3): 78–9.
8 Alyane M, Kebsa LB, Boussenane H et al. Cardioprotec-
tive effects and mechanism of action of polyphenols
extracted from propolis against doxorubicin toxicity.
Pak J Pharm Sci 2008; 3: 201–9.
9 Paintz M, Metzner J. On the local anaesthetic action of
propolis and some of its constituents. Pharmazie 1979;
34: 839–41.
10 Duarte S, Rosalen PL, Hayacibara MF et al. The influ-
ence of a novel propolis on mutans streptococci bio-
films and caries development in rats. Arch Oral Biol
2006; 51: 15–22.
11 Hayacibara MF, Koo H, Rosalen PL et al. In vitro and in
vivo effects of isolated fractions of Brazilian propolis
on caries development. J Ethnopharmacol 2005; 101:
110–15.
12 Koo H, Cury JA, Rosalen PL et al. Effect of a mouthrinse
containing selected propolis on 3-day dental plaque
accumulation and polysaccharide formation. Caries Res
2002; 36: 445–8.
13 Bertolini PF, Biondi Filho O, Pomilio A et al. Antimi-
crobial capacity of Aloe vera and propolis dentifrice
against Streptococcus mutans strains in toothbrushes: an
in vitro study. J Appl Oral Sci 2012; 20: 32–7.
14 Malhotra N, Rao SP, Acharya S, Vasudev B. Compara-
tive in vitro evaluation of efficacy of mouthrinses
against Streptococcus mutans, lactobacilli and Candida
albicans.Oral Health Prev Dent 2011; 9: 261–8.
15 Ikeno K, Ikeno T, Miyazawa C. Effects of propolis
on dental caries in rats. Caries Res 1991; 25: 347–
51.
16 Park YK, Koo MH, Abreu JA. Antimicrobial activity of
propolis on oral microorganisms. Curr Microbiol 1998;
36: 24–8.
17 Koo H, Gomes BP, Rosalen PL et al. In vitro antimicro-
bial activity of propolis and Arnica montana against
oral pathogens. Arch Oral Biol 2000; 45: 141–8.
18 Koo H, Vacca Smith AM, Bowen WH et al. Effects of
Apis mellifera propolis on the activities of streptococcal
glucosyltransferases in solution and adsorbed onto
saliva-coated hydroxyapatite. Caries Res 2000; 34: 418–
26.
19 Elbaz GA, Elsayad II. Comparison of the antimicrobial
effect of Egyptian propolis vs New Zealand propolis on
Streptococcus mutans and lactobacilli in saliva. Oral
Health Prev Dent 2012; 10: 155–60.
20 Koo H, Rosalen PL, Cury JA et al. Effect of Apis mellifera
propolis from two Brazilian regions on caries develop-
ment in desalivated rats. Caries Res 1999; 33: 393–
400.
21 Ashry el SH, Ahmad TA. The use of propolis as vaccine’s
adjuvant. Vaccine 2012; 31: 31–9.
22 Mori GG, Nunes DC, Castilho LR et al. Propolis as
storage media for avulsed teeth: microscopic and mor-
phometric analysis in rats. Dent Traumatol 2010; 26:
80–5.
23 Casaroto AR, Hidalgo MM, Sell AM et al. Study of the
effectiveness of propolis extract as a storage medium
for avulsed teeth. Dent Traumatol 2010; 26: 323–31.
24 Gjertsen AW, Stothz KA, Neiva KG, Pileggi R. Effect of
propolis on proliferation and apoptosis of periodontal
ligament fibroblasts. Oral Surg Oral Med Oral Pathol Oral
Radiol Endod 2011; 112: 843–8.
Focus on Alternative and Complementary Therapies September 2013 18(3)122
25 Gulinelli JL, Panzarini SR, Fattah CM et al. Effect of
root surface treatment with propolis and fluoride in
delayed tooth replantation in rats. Dent Traumatol
2008; 24: 651–7.
26 Pileggi R, Antony K, Johnson K et al. Propolis inhibits
osteoclast maturation. Dent Traumatol 2009; 25:
584–8.
27 Martin MP, Pileggi R. A quantitative analysis of propo-
lis: a promising new storage media following avulsion.
Dent Traumatol 2004; 20: 85–9.
28 Saxena P, Pant VA, Wadhwani KK et al. Potential of the
propolis as storage medium to preserve the viability of
cultured human periodontal ligament cells: an in vitro
study. Dent Traumatol 2011; 27: 102–8.
29 Ozan F, Polat ZA, Er K et al. Effect of propolis on sur-
vival of periodontal ligament cells: new storage media
for avulsed teeth. J Endod 2007; 33: 570–3.
30 Mahal NK, Singh N, Thomas AM, Kakkar N. Effect of
three different storage media on survival of periodon-
tal ligament cells using collagenase-dispase assay. Int
Endod J 2013; 46: 365–70.
31 Gopikrishna V, Baweja PS, Venkateshbabu N et al.
Comparison of coconut water, propolis, HBSS, and
milk on PDL cell survival. J Endod 2008; 34:
587–9.
32 Cury JA, Rebelo MAB, Del Bel Cury AA et al. Biochemi-
cal composition and cariogenicity of dental plaque
formed in the presence of sucrose or glucose and fruc-
tose in situ. Caries Res 2000; 34: 491–7.
33 Toker H, Ozan F, Ozer H et al. A morphometric and
histopathologic evaluation of the effects of propolis on
alveolar bone loss in experimental periodontitis in rats.
J Periodontol 2008; 79: 1089–94.
34 Coutinho A. Honeybee propolis extract in periodontal
treatment: a clinical and microbiological study of
propolis in periodontal treatment. Indian J Dent Res
2012; 23: 294.
35 Gebaraa EC, Pustiglioni AN, de Lima LA, Mayer MP.
Propolis extract as an adjuvant to periodontal treat-
ment. Oral Health Prev Dent 2003; 1: 29–35.
36 Sterer N, Rubinstein Y. Effect of various natural medici-
nals on salivary protein putrefaction and malodor pro-
duction. Quintessence Int 2006; 37: 653–8.
37 Hidaka S, Okamoto Y, Ishiyama K, Hashimoto K. Inhi-
bition of the formation of oral calcium phosphate pre-
cipitates: the possible effects of certain honeybee
products. J Periodontal Res 2008; 43: 450–8.
38 Murray MC, Worthington HV, Blinkhorn AS. A study
to investigate the effect of a propolis-containing
mouthrinse on the inhibition of de novo plaque for-
mation. J Clin Periodontol 1997; 24: 796–8.
39 Podbielski A, Spahr A, Haller B. Additive antimicrobial
activity of calcium hydroxide and chlorhexidine on
common endodontic bacterial pathogens. J Endod
2003; 29: 340–5.
40 Lynne RE, Liewehr FR, West LA et al. In vitro antimi-
crobial activity of various medication preparations on
E. faecalis in root canal dentin. J Endod 2003; 29: 187–
90.
41 Sjögren U, Figdor D, Spångberg L, Sundqvist G. The
antimicrobial effect of calcium hydroxide as a short-
term intracanal dressing. Int Endod J 1991; 24: 119–
25.
42 de Souza CA, Teles RP, Souto R et al. Endodontic
therapy associated with calcium hydroxide as an int-
racanal dressing: microbiologic evaluation by the
checkerboard DNA-DNA hybridization technique. J
Endod 2005; 31: 79–83.
43 Awawdeh L, Al-Beitawi M, Hammad M. Effectiveness of
propolis and calcium hydroxide as a short-term intra-
canal medicament against Enterococcus faecalis: a labo-
ratory study. Aust Endod J 2009; 35: 52–8.
44 Madhubala MM, Srinivasan N, Ahamed S. Comparative
evaluation of propolis and triantibiotic mixture as an
intracanal medicament against Enterococcus faecalis.J
Endod 2011; 37: 1287–9.
45 Kayaoglu G, Ömürlü H, Akca G et al. Antibacterial
activity of propolis versus conventional endodontic
disinfectants against Enterococcus faecalis in infected
dentinal tubules. J Endod 2011; 37: 376–81.
46 Kandaswamy D, Venkateshbabu N, Gogulnath D,
Kindo AJ. Dentinal tubule disinfection with 2% chlor-
hexidine gel, propolis, Morinda citrifolia juice, 2%
povidone iodine and calcium hydroxide. Int Endod J
2010; 43: 419–23.
47 de Rezende GP, da Costa LR, Pimenta FC, Baroni DA. In
vitro antimicrobial activity of endodontic pastes with
propolis extracts and calcium hydroxide: a preliminary
study. Braz Dent J 2008; 19: 301–5.
48 Ramos IF, Biz MT, Paulino N et al. Histopathological
analysis of corticosteroid-antibiotic preparation and
propolis paste formulation as intracanal medication
after pulpectomy: an in vivo study. J Appl Oral Sci 2012;
20: 50–6.
49 Victorino FR, Bramante CM, Zapata RO et al. Removal
efficiency of propolis paste dressing from the root
canal. J Appl Oral Sci 2010; 18: 621–4.
50 Al-Shaher A, Wallace J, Agarwal S et al. Effect of propo-
lis on human fibroblasts from the pulp and periodontal
ligament. J Endod 2004; 30: 359–61.
51 Mattigatti S, Ratnakar P, Moturi S et al. Antimicrobial
effect of conventional root canal medicaments vs
propolis against Enterococcus faecalis, Staphylococcus
aureus and Candida albicans.J Contemp Dent Pract 2012;
13: 305–9.
52 Arslan S, Ozbilge H, Kaya EG, Er O. In vitro antimicro-
bial activity of propolis, BioPure MTAD, sodium
hypochlorite, and chlorhexidine on Enterococcus
faecalis and Candida albicans.Saudi Med J 2011; 32:
479–83.
Review 123
53 Valera MC, da Rosa JA, Maekawa LE et al. Action of
propolis and medications against Escherichia coli and
endotoxin in root canals. Oral Surg Oral Med Oral Pathol
Oral Radiol Endod 2010; 110: e70–4.
54 Parolia A, Kundabala M, Rao NN et al. A comparative
histological analysis of human pulp following direct
pulp capping with propolis, mineral trioxide aggregate
and Dycal. Aust Dent J 2010; 55: 59–64.
55 Ozório JE, Carvalho LF, de Oliveira DA et al. Standard-
ized propolis extract and calcium hydroxide as pul-
potomy agents in primary pig teeth. J Dent Child (Chic)
2012; 79: 53–8.
56 Lima RV, Esmeraldo MR, de Carvalho MG et al. Pulp
repair after pulpotomy using different pulp capping
agents: a comparative histologic analysis. Pediatr Dent
2011; 33: 14–18.
57 Sabir A, Tabbu CR, Agustiono P, Sosroseno W. Histo-
logical analysis of rat dental pulp tissue capped with
propolis. J Oral Sci 2005; 47: 135–8.
58 Burdock GA. Review of the biological properties and
toxicity of bee propolis (propolis). Food Chem Toxicol
1998; 36: 347–63.
59 Altan BA, Kara IM, Nalcaci R et al. Systemic propolis
stimulates new bone formation at the expanded suture.
Angle Orthod 2013; 83: 286–91.
60 Hehlgans S, Lange I, Eke I et al. Human head and neck
squamous cell carcinoma cell lines are differentially
radiosensitised by the honeybee product propolis. Int J
Radiat Biol 2011; 87: 243–53.
61 Cavalcante DR, Oliveira PS, Gois M et al. Effect of green
propolis on oral epithelial dysplasia in rats. Braz J
Otorhinolaryngol 2011; 77: 278–84.
62 Ghassemi L, Zabihi E, Mahdavi R et al. The effect
of ethanolic extract of propolis on radiation-
induced mucositis in rats. Saudi Med J 2010; 31:
622–6.
63 Addy M. Tooth brushing, tooth wear and dentine
hypersensitivity – are they related? Int Dent J 2005; 55:
261–7.
64 Mahmoud AS, Almas K, Dahlan AA. The effect of
propolis on dentinal hypersensitivity and level of sat-
isfaction among patients from a university hospital,
Riyadh, Saudi Arabia. Indian J Dental Res 1999; 10:
130–7.
65 Madhavan S, Nayak M, Shenoy A et al. Dentinal hyper-
sensitivity: a comparative clinical evaluation of CPP-
ACP F, sodium fluoride, propolis and placebo. J Conserv
Dent 2012; 15: 315–8.
66 Almas K, Mahmoud A, Dahlan A. A comparative study
of propolis and saline application on human dentin: a
SEM study. Indian J Dental Res 2001; 12: 21–7.
67 Sales-Peres SH, Carvalho FN, Marsicano JA et al. Effect
of propolis gel on the in vitro reduction of dentin
permeability. J Appl Oral Sci 2011; 19: 318–23.
68 Samet N, Laurent C, Susarla SM, Samet-Rubinsteen N.
The effect of bee propolis on recurrent aphthous sto-
matitis: a pilot study. Clin Oral Invest 2007; 11: 143–7.
69 Martins RS, Péreira ES Jr, Lima SM et al. Effect of com-
mercial ethanol propolis extract on the in vitro growth
of Candida albicans collected from HIV-seropositive
and HIV-seronegative Brazilian patients with oral can-
didiasis. J Oral Sci 2002; 44: 41–8.
70 Santos VR, Pimenta FJ, Aguiar MC et al. Oral candidia-
sis treatment with Brazilian ethanol propolis extract.
Phytother Res 2005; 19: 652–4.
71 Huleihel M, Isanu V. Anti-herpes simplex virus effect of
an aqueous extract of propolis. Isr Med Assoc J 2002; 4:
923–7.
72 Shimizu T, Takeshita T, Takamori Y et al. Efficacy of
Brazilian propolis against herpes simplex virus type 1
infection in mice and their modes of antiherpetic effi-
cacies. Evid Based Complement Alternat Med 2011; 2011:
976196.
73 Magro-Filho O, de Carvalho AC. Topical effect of
propolis in the repair of sulcoplasties by the modified
Kazanjian technique: cytological and clinical evalua-
tion. J Nihon Univ Sch Dent 1994; 36: 102–11.
74 Magro-Filho O, de Carvalho AC. Application of propo-
lis to dental sockets and skin wounds. J Nihon Univ Sch
Dent 1990; 32: 4–13.
75 Arslan S, Yazici AR, Gorucu J et al. Effects of different
cavity disinfectants on shear bond strength of a
silorane-based resin composite. J Contemp Dent Pract
2011; 12: 279–86.
76 Troca VB, Fernandes KB, Terrile AE et al. Effect of green
propolis addition to physical mechanical properties of
glass ionomer cements. J Appl Oral Sci 2011; 19: 100–5.
77 Da Silva WJ, Rached RN, Rosalen PL, Del bel Cury AA.
Effects of nystatin, fluconazole and propolis on
poly(methyl methacrylate) resin surface. Braz Dent J
2008; 19: 190–6.
78 Brailo V, Boras VV, Alajbeg I, Juras V. Delayed contact
sensitivity on the lips and oral mucosa due to propolis-
case report. Med Oral Patol Oral Cir Bucal 2006; 11:
E303–4.
79 Budimir V, Brailo V, Alajbeg I et al. Allergic contact
cheilitis and perioral dermatitis caused by propolis:
case report. Acta Dermatovenerol Croat 2012; 20: 187–
90.
80 Hay KD, Greig DE. Propolis allergy: a cause of oral
mucositis with ulceration. Oral Surg Oral Med Oral
Pathol 1990; 70: 584–6.
Focus on Alternative and Complementary Therapies September 2013 18(3)124
Divesh Sardana, BDS, MDS, Senior Lecturer, Department
of Pedodontics and Preventive Dentistry, Sudha Rustagi
College of Dental Sciences and Research, Faridabad
121002, India.
E-mail: doc_divesh@yahoo.co.in
KR InduShekar, BDS, MDS, Professor and Head, Depart-
ment of Pedodontics and Preventive Dentistry, Sudha Rustagi
College of Dental Sciences and Research, Faridabad
121002, India.
E-mail: indushekar66@yahoo.co.in
Sheetal Manchanda, BDS, Private Practitioner, NexGen
Dental Solutions, Gurgaon 122002, India.
E-mail: manchanda_sheetal@yahoo.co.in
Bhavna Gupta Saraf, BDS, MDS, Associate Professor,
Department of Pedodontics and Preventive Dentistry, Sudha
Rustagi College of Dental Sciences and Research, Faridabad
121002, India.
E-mail: guptabhavna2000@yahoo.com
Neha Sheoran, BDS, MDS, Senior Lecturer, Department of
Pedodontics and Preventive Dentistry, Sudha Rustagi College
of Dental Sciences and Research, Faridabad 121002, India.
E-mail: sheoran.neha@yahoo.co.in
Review 125
