# Propolis as Natural Product in the Oral Cavity Bacterial Infections Treatment: A Systematic Review
## 4 Results
### Antibacterial Activity of Propolis in Oral Cavity Bacterial Infections
#### 4.2.2 In Vivo Studies
The results were obtained based on the study of thirty patients who were classified into three groups: the I group (ten patients used placebo), the II group (10 patients used 3% Brazilian propolis ethanol extract), and the III group (ten patients used 0.12% chlorhexidine). At the day 10 time point, no significant differences were observed. Between the 10 and 15 time points, a significant reduction in _P. nigrescens_, _A. naslundii_, _F. periodonticum_, _P. intermedia_, _P. gingialis_, _T. denticola_, _C. ocheacea_, _A. nasalundii_, _A. isrelli_, and _T. forsytthia_ in the II group was observed. _P. acnes_ showed a significant significant increase in the II group. In the III group, the authors observed a significant reduction in _T. forsytthia_, _P. gingialis_, and _T. denticola_. In case of the I group, a significant increase in _A. naslundi_, _P. micra_, _S. orails_, _F. nucleatum ssp vincentii_, _P. acnes_, _E. nodatum_, and _S. anginosus_ was observed after 5 days of treatment. The total counts of organisms present on the tongue surface showed a significant decrease for the II and III groups [25]. Patients who had periodontal disease constituted the group studied by [PERSON] et al. [29]. The researchers evaluated the antimicrobial effects of a mouthwash with propolis and assessed how the propolis paste formulation affected dental healing after teeth extraction. The common staining of the mouth/tongue could be avoided when propolis and chlorhexidine were used as ingredients of the mouthwash. Moreover, propolis paste proved to be an alternative substance to be used after dental extraction for healing the socket. Additionally, this paste could control the inflammatory process more effectively over the experimental period. A decrease in CFU of _S. mutans_ and _Lactobacillus spp_. observed in propolis and chlorhexidine + propolis samples was recorded by researchers [29]. In another study, [PERSON] et al. [42] evaluated how Spanish propolis extract (EEP) affected the clinical and microbiological parameters when it was used as an adjuvant to scaling and root planning in supportive periodontal therapy (SPT) patients. The authors suggest that EEP used subgingivally could be a helpful adjuvant in periodontal therapy, since microbial resistance and other adverse effects could be eliminated. The results were obtained based on the study of forty patients who were classified into three groups: the I group (twenty patients who underwent scaling and root planning, after which physiological saline was used for gingival irrigation--the controls) and the II group (twenty patients who underwent scaling and root planing after which EEP was placed subgingivally). The researchers concluded that EEP could be used in prophylaxis and in the treatment of periodontal diseases. EEP would improve clinical parameters, reduce gingival bleeding, and decrease the number of _T. forsytthensis_ and _P. gingialis_[42]. [PERSON] et al. [107] researched the antimicrobial effect of Brazilian red propolis on _Lactobacillus spp_. The authors showed that Brazilian red propolis has antibacterial activity against the analyzed strains. The results were obtained based on the study of forty-two participants who were divided into three groups: the I group (fluoridated Brazilian red propolis denitrice) and the II group (fluoridated common denitrice). For the first dilution (1:10), the analysis of _Lactobacillus spp_. strains from patients' saliva showed a decrease in the count of the analyzed strain from 1.15 \(\pm\) 0.41 at day 0 to 0.68 \(\pm\) 0.15 on day 28 for the I group as well as an increase from 1.33 \(\pm\) 0.52 on day 0 to 1.84 \(\pm\) 0.39 at day 28 for the II group. For the second dilution (1:100), the corresponding values in G1 and G2 were 0.87 \(\pm\) 0.34 and 0.64 \(\pm\) 0.37 as well as 1.54 \(\pm\) 0.47 and 1.62 \(\pm\) 0.37, respectively [107]. [PERSON] et al. [108] selected a group of high caries risk patients for their study to research propolis and pomegranate mouthwashes in comparison with chlorhexidine mouthwash.