# Study of the Antimicrobial Effect of an Ethanolic Extract of Propolis in Periodantal Disease
## 1 Introduction  
Periodontal disease encompasses gingivitis and periodontitis. Gingivitis, or inflammation of the gums which leads to bleeding gums, is considered an early form of periodontal disease. Periodontal disease is one of the most common chronic infections in the adult population [1]. Periodontitis develops over time with the accumulation of dental plaque, bacterial dysbiosis, periodontal pockets formation, gingival recession, tissue destruction and alveolar bone resorption, which can ultimately lead to tooth loss. Periodontal disease may contribute to the organism's overall inflammatory burden, worsening conditions such as diabetes mellitus and atherosclerosis [2] systemic inflammation being one of the main reasons for this association [3]. The immune response from the interaction between inflammatory cells and pathogenic bacteria like _P. gingivalis_, _T. forysythensis_, _P. Intermedia_, _B. forystl thus_ and _A. actinomycetemcomitans_ can be crucial for the development of inflammatory processes in the surrounding tissue of the teeth. All forms of periodontitis are treated by scaling and root planing (SRP) risk factor elimination or minimization, and daily home care and professional prophylaxis during the subsequent follow-up appointment with dentists. After clinical detection of periodontal bone adhesion and/or bone resorption, the goal of treatment is controlling inflammation and preventing disease progression and create the conditions that will help the patient to maintain healthy, functional and comfortable dentition in the long term [4] because when tissue and bone loss has occurred, it is permanent. Scaling and root planning can be limited by the inability to reach deep areas, making it difficult to eliminate all bacteria. Therefore, the use of antibacterial agents is recommended to reduce the use of surgical approaches to periodontal pockets [5]. This helps to achieve effective drug levels at points where systemic drug intake is minimal and the risk of antibiotic-resistant strains is low [6]. The clinical use of antibiotics and other antimicrobial agents, as adjuvants for the treatment of periodontitis, is really common [7]. Recently, special attention has been paid to natural therapies. There is considerable evidence that herbal products, essential oils, and purified phytochemicals have proved to be an abundant source of biologically active compounds [8]. Approximately 80% of the population of the developing countries still use traditional medicines for their health care [9]. There have been many reports of traditional plants for the treatment of periodontal diseases. They showed the ability to inhibit the growth of oral pathogens and decreased bacterial adhesion responsible for the formation of dental plaque. Traditional plants could be the first step in developing gingivitis reducing risk factors and contributing to the maintenance of oral health to avoid bacterial recolonisation [5; 10]. In this sense, [PERSON] et al. [11] suggested the efficacy of GTF (glucosyltransferaseense) inhibitors and ARBs (Angiotensin II receptor blocker) to prevent biofilm formation and periodontitis, respectively. Different _Lactobacillus_ species and the two-peptide bacteriocin PLNCS \(\alpha\beta\) on _P. gingivalis_ have been investigated to study possible effects on supporting the host immune system against invading pathogens; the probiotics tested represent valid support for SRP and benefit several clinical indexes [12]. There should be still many unknown substances that are useful for treating oral diseases in the natural kingdom. Spanish propolisis can be one of the natural substances used in periodontal disease because as previously reported [13]. Propolis is a non-toxic resinous substance produced by bees that has anti-inflammatory, antibacterial, antifungal, and antioxidant properties, among others [14; 15], which has attracted the attention of researchers, in medical and dental care.