Clinical Oral Investigations

, Volume 23, Issue 1, pp 1–20 | Cite as

The effect of green tea as an adjunct to scaling and root planing in non-surgical periodontitis therapy: a systematic review

  • S. J. Gartenmann
  • Y. v. Weydlich
  • S. L. Steppacher
  • C. Heumann
  • T. Attin
  • Patrick R. SchmidlinEmail author



To provide a systematic overview on the efficacy of green tea catechin as an adjunct to scaling and root planing (SRP) in terms of probing pocket depth (PPD).

Materials and methods

A systematic literature search was performed using electronic databases in PubMed, Scopus, Medline, Cochrane, CINAHL, and Web of Science on randomized clinical trials up to January 2017. The research question was posed in accordance with PRISMA guidelines.


The search provided 234 studies. After analyzing the full texts, five studies were included, with four studies qualifying for meta-analysis. Mean PPD reduction was significantly higher (α = 0.05) when green tea catechin was used as an adjunct to SRP (test group) than with SRP alone (control group). The difference in the reduction was 0.74 mm [0.35–1.13; 95% CI].


The local application of green tea catechin as an adjunct to SRP may result in a beneficial reduction in PPD. Due to the highly heterogeneous data and some risk of bias, however, this data still needs to be interpreted with caution.

Clinical relevance

The finding suggests that green tea catechin may be a topical adjunct to SRP without negative side effects.


Green tea Local application Chronic periodontitis Non-surgical periodontal therapy Local delivery device 



The authors would like to acknowledge the work of Dr. Y. v. Weydlich for his support in the analysis of the data as part of his master thesis.


This study was funded by the authors only.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Ethical approval does not apply to a systematic review.

Informed consent

Informed consent does not apply to a systematic review.

Supplementary material

784_2018_2684_MOESM1_ESM.docx (15 kb)
ESM 1 (DOCX 14 kb)
784_2018_2684_MOESM2_ESM.docx (134 kb)
ESM 2 (DOCX 134 kb)


  1. 1.
    Page RC, Offenbacher S, Schroeder HE, Seymour GJ, Kornman KS (1997) Advances in the pathogenesis of periodontitis: summary of developments, clinical implications and future directions. Periodontology 2000 14:216–248CrossRefGoogle Scholar
  2. 2.
    Ebersole JL, Dawson D 3rd, Emecen-Huja P, Nagarajan R, Howard K, Grady ME et al (2017) The periodontal war: microbes and immunity. Periodontology 2000 75(1):52–115. CrossRefGoogle Scholar
  3. 3.
    Mombelli A, Schmid B, Rutar A, Lang NP (2000) Persistence patterns of Porphyromonas gingivalis, Prevotella intermedia/nigrescens, and Actinobacillus actinomyetemcomitans after mechanical therapy of periodontal disease. J Periodontol 71(1):14–21. CrossRefGoogle Scholar
  4. 4.
    Mailoa J, Lin GH, Khoshkam V, MacEachern M, Chan HL, Wang HL (2015) Long-term effect of four surgical periodontal therapies and one non-surgical therapy: a systematic review and meta-analysis. J Periodontol 86(10):1150–1158. CrossRefGoogle Scholar
  5. 5.
    Tonetti MS, Pini-Prato G, Cortellini P (1994) Principles and clinical applications of periodontal controlled drug delivery with tetracycline fibers. Int J Periodontics Restorative Dent 14(5):421–435Google Scholar
  6. 6.
    Haffajee AD, Torresyap G, Socransky SS (2007) Clinical changes following four different periodontal therapies for the treatment of chronic periodontitis: 1-year results. J Clin Periodontol 34(3):243–253. CrossRefGoogle Scholar
  7. 7.
    Mombelli A, Cionca N, Almaghlouth A (2011) Does adjunctive antimicrobial therapy reduce the perceived need for periodontal surgery? Periodontology 2000 55(1):205–216. CrossRefGoogle Scholar
  8. 8.
    Duarte Fde F, Lotufo RF, Pannuti CM (2008) Local delivery of chlorhexidine gluconate in patients with aggressive periodontitis. J Int Acad Periodontol 10(1):31–35Google Scholar
  9. 9.
    Heasman PA, Heasman L, Stacey F, McCracken GI (2001) Local delivery of chlorhexidine gluconate (PerioChip) in periodontal maintenance patients. J Clin Periodontol 28(1):90–95CrossRefGoogle Scholar
  10. 10.
    Kaner D, Bernimoulin JP, Hopfenmuller W, Kleber BM, Friedmann A (2007) Controlled-delivery chlorhexidine chip versus amoxicillin/metronidazole as adjunctive antimicrobial therapy for generalized aggressive periodontitis: a randomized controlled clinical trial. J Clin Periodontol 34(10):880–891. CrossRefGoogle Scholar
  11. 11.
    Bonito AJ, Lux L, Lohr KN (2005) Impact of local adjuncts to scaling and root planing in periodontal disease therapy: a systematic review. J Periodontol 76(8):1227–1236. CrossRefGoogle Scholar
  12. 12.
    Goodson JM, Holborow D, Dunn RL, Hogan P, Dunham S (1983) Monolithic tetracycline-containing fibers for controlled delivery to periodontal pockets. J Periodontol 54(10):575–579. CrossRefGoogle Scholar
  13. 13.
    Mombelli A, Lehmann B, Tonetti M, Lang NP (1997) Clinical response to local delivery of tetracycline in relation to overall and local periodontal conditions. J Clin Periodontol 24(7):470–477CrossRefGoogle Scholar
  14. 14.
    Oosterwaal PJ, Mikx FH, Renggli HH (1990) Clearance of a topically applied fluorescein gel from periodontal pockets. J Clin Periodontol 17(9):613–615CrossRefGoogle Scholar
  15. 15.
    Narotzki B, Reznick AZ, Aizenbud D, Levy Y (2012) Green tea: a promising natural product in oral health. Arch Oral Biol 57(5):429–435. CrossRefGoogle Scholar
  16. 16.
    McKay DL, Blumberg JB (2002) The role of tea in human health: an update. J Am Coll Nutr 21(1):1–13CrossRefGoogle Scholar
  17. 17.
    Cabrera C, Artacho R, Gimenez R (2006) Beneficial effects of green tea--a review. J Am Coll Nutr 25(2):79–99CrossRefGoogle Scholar
  18. 18.
    Kushiyama M, Shimazaki Y, Murakami M, Yamashita Y (2009) Relationship between intake of green tea and periodontal disease. J Periodontol 80(3):372–377. CrossRefGoogle Scholar
  19. 19.
    Okamoto M, Sugimoto A, Leung KP, Nakayama K, Kamaguchi A, Maeda N (2004) Inhibitory effect of green tea catechins on cysteine proteinases in Porphyromonas gingivalis. Oral Microbiol Immunol 19(2):118–120CrossRefGoogle Scholar
  20. 20.
    Okamoto M, Leung KP, Ansai T, Sugimoto A, Maeda N (2003) Inhibitory effects of green tea catechins on protein tyrosine phosphatase in Prevotella intermedia. Oral Microbiol Immunol 18(3):192–195CrossRefGoogle Scholar
  21. 21.
    Tijburg LB, Mattern T, Folts JD, Weisgerber UM, Katan MB (1997) Tea flavonoids and cardiovascular disease: a review. Crit Rev Food Sci Nutr 37(8):771–785. CrossRefGoogle Scholar
  22. 22.
    Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M et al (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 4:1. CrossRefGoogle Scholar
  23. 23.
    Miller SA, Forrest JL (2001) Enhancing your practice through evidence-based decision making: PICO, learning how to ask good questions. J Evid Based Dent Pract 1(2):136–141. CrossRefGoogle Scholar
  24. 24.
    DerSimonian RLN (1986) Meta-analysis in clinical trials. Control Clin Trials 7(3):177–188CrossRefGoogle Scholar
  25. 25.
    Graziani F, Figuero E, Herrera D (2012) Systematic review of quality of reporting, outcome measurements and methods to study efficacy of preventive and therapeutic approaches to peri-implant diseases. J Clin Periodontol 39(Suppl 12):224–244. CrossRefGoogle Scholar
  26. 26.
    Gadagi JS, Chava VK, Reddy VR (2013) Green tea extract as a local drug therapy on periodontitis patients with diabetes mellitus: a randomized case-control study. J Indian Soc Periodontol 17(2):198–203. CrossRefGoogle Scholar
  27. 27.
    Yuvaraja M, Reddy NR, Kumar PM, Ravi KS, Alqahtani N (2016) Thermoreversible gel for intrapocket delivery of green tea catechin as a local drug delivery system: an original research. J Adv Pharm Technol Res 7(4):139–143. CrossRefGoogle Scholar
  28. 28.
    Hirasawa M, Takada K, Makimura M, Otake S (2002) Improvement of periodontal status by green tea catechin using a local delivery system: a clinical pilot study. J Periodontal Res 37(6):433–438CrossRefGoogle Scholar
  29. 29.
    Kudva P, Tabasum ST, Shekhawat NK (2011) Effect of green tea catechin, a local drug delivery system as an adjunct to scaling and root planing in chronic periodontitis patients: a clinicomicrobiological study. J Indian Soc Periodontol 15(1):39–45. CrossRefGoogle Scholar
  30. 30.
    Funosas EMA, Pignolo M, Maestri L, Aromando RF, Scozzarro SM, Escovich L, Hermida PS (2005) Efficacy of green tea in the treatment of chronic periodontitis. Av Odontoestomatol 21(3):159–166CrossRefGoogle Scholar
  31. 31.
    Chava VK, Vedula BD (2013) Thermo-reversible green tea catechin gel for local application in chronic periodontitis: a 4-week clinical trial. J Periodontol 84(9):1290–1296. CrossRefGoogle Scholar
  32. 32.
    Hattarki SA, Pushpa SP, Bhat K (2013) Evaluation of the efficacy of green tea catechins as an adjunct to scaling and root planing in the management of chronic periodontitis using PCR analysis: a clinical and microbiological study. J Indian Soc Periodontol 17(2):204–209. CrossRefGoogle Scholar
  33. 33.
    Rattanasuwan K, Rassameemasmaung S, Sangalungkarn V, Komoltri C (2016) Clinical effect of locally delivered gel containing green tea extract as an adjunct to non-surgical periodontal treatment. Odontology 104(1):89–97. CrossRefGoogle Scholar
  34. 34.
    Mombelli A, Almaghlouth A, Cionca N, Courvoisier DS, Giannopoulou C (2015) Differential benefits of amoxicillin-metronidazole in different phases of periodontal therapy in a randomized controlled crossover clinical trial. J Periodontol 86(3):367–375. CrossRefGoogle Scholar
  35. 35.
    Herrera D, van Winkelhoff AJ, Dellemijn-Kippuw N, Winkel EG, Sanz M (2000) Beta-lactamase producing bacteria in the subgingival microflora of adult patients with periodontitis. A comparison between Spain and The Netherlands. J Clin Periodontol 27(7):520–525CrossRefGoogle Scholar
  36. 36.
    Hanes PJ, Purvis JP (2003) Local anti-infective therapy: pharmacological agents. A systematic review. Ann Periodontol 8(1):79–98. CrossRefGoogle Scholar
  37. 37.
    Matesanz-Perez P, Garcia-Gargallo M, Figuero E, Bascones-Martinez A, Sanz M, Herrera D (2013) A systematic review on the effects of local antimicrobials as adjuncts to subgingival debridement, compared with subgingival debridement alone, in the treatment of chronic periodontitis. J Clin Periodontol 40(3):227–241. CrossRefGoogle Scholar
  38. 38.
    Radafshar G, Ghotbizadeh M, Saadat F, Mirfarhadi N (2017) Effects of green tea (Camellia sinensis) mouthwash containing 1% tannin on dental plaque and chronic gingivitis: a double-blinded, randomized, controlled trial. J Investig Clin Dent 8(1).

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • S. J. Gartenmann
    • 1
  • Y. v. Weydlich
    • 2
  • S. L. Steppacher
    • 2
  • C. Heumann
    • 3
  • T. Attin
    • 1
  • Patrick R. Schmidlin
    • 1
    Email author
  1. 1.Clinic for Preventive Dentistry, Periodontology and Cardiology, Center of Dental MedicineUniversity of ZurichZurichSwitzerland
  2. 2.Private practiceWallisellen and St. GallenSwitzerland
  3. 3.Department of StatisticsLudwig-Maximilians-University MunichMunichGermany

Personalised recommendations