J
Dcembre/December 2012, Vol..35, N140
Abstract
Periodontal diseases are among the most common infectious diseases that lead to the destruction of
periodontal tissues. Anaerobic gram-negative bacteria (Aggregatibacter actinomecetemcomitans,
Porphyromonas gingivalis, Fusobacterium nucleatum) isolated from periodontal lesions, have been
shown to be related to the onset and progression of periodontal disease. Given the incidence of periodontitis, increased resistance of oral bacteria to antibiotics and adverse effects of some antibacterial
agents currently used in dentistry, there is a need for alternative products that are safe and effective,
for prevention and treatment of these diseases. Essential oils considered traditional medicines are
viewed as good alternatives. In Morocco, a wide producer of essential oils, the high prevalence of
aggressive periodontitis, related to virulent periodontal bacteria isolated from pockets in Moroccan
adolescents and because of the reasons evoked above, the search of a new natural agent has become
a necessity. In this qualitative systematic review, the virulence and increased antibiotic resistance of
periopathogens, involved in periodontitis, will be exposed, justifying the use of alternative natural
agents such as essential oils-based. Studies that have investigated the efficacy of such plant-derived
medicines on periodontal pathogens will be described and discussed.
Keywords :
Biofilms,
periodontal,
pathogens,
essential oils
Rsum
Activit antibactrienne des huiles essentielles contre les pathognes parodontaux :
revue qualitative systmatique
Les maladies parodontales sont parmi les maladies infectieuses les plus communes, qui entranent la
destruction des tissus parodontaux. Aujourdhui, il est bien tabli que les bactries anarobies gram
ngatif (A ggregatibacter actinomecetemcomitans, Porphyromonas gingivalis, Fusobacterium
nucleatum), isoles partir des lsions parodontales, sont lies lapparition et la progression de la
maladie parodontale. Compte tenu de lincidence des parodontites, de la rsistance croissante des bactries orales aux antibiotiques et des effets secondaires de certains agents antibactriens frquemment
utiliss en dentisterie, la recherche dun nouvel agent thrapeutique alternatif, efficace et sur, pour la
prvention et le traitement de ces maladies, simpose. Les huiles essentielles, utilises en mdecine
traditionnelle, peuvent tre considres comme une bonne alternative thrapeutique.
Au Maroc, grand producteur dhuiles essentielles, en raison de la haute prvalence des parodontites
agressives causes par des bactries parodontales virulentes, isoles partir de poches parodontales
chez des adolescents marocains, et pour toutes les raisons voques ci-dessus, la recherche dun nouvel agent naturel est devenue une ncessit.
Dans cette revue de littrature de type qualitative systmatique, seront exposes, la virulence et la
rsistance accrue des pathognes parodontaux impliqus dans les parodontites, justifiant lutilisation
de tels agents base dhuiles essentielles. Seront galement dcrites et discutes, des tudes
dmontrant lefficacit de ces mdicaments base de plantes sur les bactries parodontopathognes.
Mots-cls :
Biofilms,
parodontal,
pathognes,
huiles essentielles
Antibacterial activity...
Introduction
39
Antibacterial activity...
40
Antibacterial activity...
clear.
Antibiotics have been and continue to be the
only effective treatment of periodontal infections caused by periodontal bacteria in biofilm.
However, sufficient evidence exists that antibiotic resistance has increased in the periodontal flora over the last decades (33). Recent
studies have found that periodontal micro-organisms, in patients with periodontal infections,
exhibit moderate susceptibilities to clindamycin,
metronidazol and amoxicillin (34, 35), probably
because of the widespread use of these antibiotics. Other earlier studies showed a resistance of periodontal flora to penicillin and tetracycline (36, 37).
For many years, it has been shown that organisms growing in biofilm are more resistant to
antimicrobial agents than the same species
growing in a planktonic state (13). There are
many factors that influence the increased resistance of organisms in biofilms to antibiotics,
such : types of species, antibiotic molecules,
biofilms growing in different habitat (27).
Slower rate of growth of bacterial species in
biofilm makes them less susceptible to many
antibiotics (38, 39). It appears to be one
important mechanism of resistance. Also, other
parameters, such: nutritional status, temperature, pH and prior exposure to subeffective
Table 1 : Studies showing antimicrobial activity (MIC) of some essential oils on periodontal pathogens
Essential oil
Periopathogens Tested
Minimum Inhibitory
Concentrations (MIC)
Satureja hortensis L.
<0,125 l/ml
Salvia fruticosa M.
8 l/ml
Lavandula stoechas L.
4 l/ml
Myrtus communis L.
Aa
Pg
Pm
Tf
Fn
Pi
Pn
Aa, Pg, Pm, Tf, Fn, Pi, Pn
2-1 l/ml
0,25-2 l/ml
0,5-2 l/ml
0,25 l/ml
0,25-0,5 l/ml
2 l/ml
1-2 l/ml
4 l/ml
Juniperus communis L.
sarriette commune *
Studies
Gursoy et al 2009 (44)
41
Antibacterial activity...
Table 1 : Suite
Periopathogens Tested
Minimum Inhibitory
Concentrations (MIC)
Menthol, eucalyptol
En
16/128 g/ml
Thymol
Tf
Prevotella species
Pg, fusobacterium species
campylobacter species
256/512 g/ml
Pg
1 mg/ml
A a, Fn, Pi, Pg
Essential oil of
Artemisia feddei
Aa
Fn
Pi
Pg
0,8 mg/ml
0,025 mg/ml
0,025 mg/ml
0,1 mg/ml
Linalool-rich essential
Croton cajucara *
Pg
31,2 g/ml
Aa, Fn, Pg
0,03%
Aa
Pg
Fn
0,25-0,5 %
0,13- 0,25 %
Aa
Pg
Fn
0,50%
0,25-0,5 %
0,13- 0,25 %
Aa
0,50%
Pg
0,5- 1 %
Fn
0,50%
Aa
0,50%
Pg
0,5- 1 %
Fn
0,50%
0,003- 2%
Essential oil
Listerine
Citrus oil
Essential oil of
Cryptomeria japonica
Melaleuca alternifolia
42
Studies
Haffajee AD. et coll 2008
(45)
0,06%
Antibacterial activity...
Table 1 : Suite
Periopathogens Tested
Minimum Inhibitory
Concentrations (MIC)
Aa, Pg
0,11%
Pa
0,20%
Fn
> 0,6 %
Peppermint oil
0,1- 0,3 %
Sage oil
0,06-0,2 %
Thymol
0,02-0,03 %
Eugenol
0,05-0,14 %
Essential oil
Australian tea tree oil
Studies
Shapiro et al 1994 (53)
*: plant family, : commercial product, Aa : Aggregatibacter actinomycetemcomitans, Fn: Fusobacterium nucleatum, Pi: Prevotella intermedia,
Ec: Eikenella corrodens, En: Eubacterium nodatum, Tf: Tannerella forsythia, Pg: Porphyromonas gingivalis, Pa: Peptostreptococcus
anaerobius, Pb: Prevotella buccae, Pn: Prevotella nigrescens, Sa: Selenomas artemidis, Td: Treponema denticola, Tv: Treponema vincentil,
Cap: capnocytophaga
43
Antibacterial activity...
References
Conclusion
As demonstrated by examples in this review,
there is considerable evidence that essential
oils have strong antibacterial activity against
periodontal pathogens. However, numerous
factors can modify this efficacy, including the
complexity of subgingival biofilm, the constituents and doses used of essential oils and the
method of administration of the antiseptic
agent (mouthrinse, subgingival irrigation).
Therefore, in order to develop these natural
products into solutions or gels for subgingival
irrigation, further studies are required to establish whether they offer therapeutic or preventive benefits for periodontitis. In particular,
studies with adequate statistical power, blinding, standardization of purified compounds, and
quality control would be for great value.
Today, Listerine is the only commercial essential oil-based product recognized and the most
studied (81-85). However, its antibacterial
activity on periodontal bacteria is controversial.
Thus, our research team is currently investigating a novel antiseptic agent containing Moroccan essential oils by testing their activity on
periodontal pathogens in vitro and in vivo.
44
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