Journal of Dental Research, Dental Clinics, Dental Prospects Review Propolis: A natural biomaterial for dental and oral health care 1 2 3,4 5 6 Zohaib Khurshid • Mustafa Naseem • Muhammad S. Zafar * • Shariq Najeeb • Sana Zohaib 1Department of Fixed Prosthodontics, College of Dentistry,King Faisal University, Hofuf, Saudi Arabia 2Department of Preventive dental Sciences, College of Dentistry, Dar-Al-Uloom University, Riyadh, Saudi Arabia 3Department of Restorative Dentistry, College of Dentistry, Taibah University, Madinah, Al Munawwarah, Saudi Arabia 4Adjunct Faculty, Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, Pakistan 5Private Dental Practitioner, Restorative Dental Sciences, Canada 6Department of Biomedical Engineering, King Faisal University, Al-Hofuf, Saudi Arabia *Corresponding Author; E-mail: [email protected] Received: 13 July 2017; Accepted: 14 August 2017 J Dent Res Dent Clin Dent Prospect 2017; 11(4):265-274 | doi: 10.15171/joddd.2017.046 This article is available from: http://joddd.tbzmed.ac.ir © 2017 Khurshid et al. This is an Open Access article published and distributed by Tabriz University of Medical Sciences under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract The field of health has always emphasized on the use of natural products for curing diseases. There is a wide variety of nat- ural products (such as silk, herbal tea, chitosan) used today in the biomedical application for treating a large array of sys- temic diseases. The natural product “propolis” is a non-toxic resinous material with beneficial properties such as antimi- crobial, anticancer, antifungal, antiviral and anti-inflammatory; hence it has gained the attention of researchers for its poten- tial for bio-dental applications. This study aims to explore the properties and chemistry of propolis in relation to its biomed- ical and dental applications. In addition, the status and scope of propolis for current and potential bio-dental applications have been discussed. This review provides an insight for the reader about the possible use of propolis in modern-day denti- stry. Key words: Antimicrobial, dentistry, natural biomaterials, oral health care, propolis, restorations. bees for building and preservation of their hives. It Introduction kills pathogens, shields the honeycomb from rain he field of health has always emphasized on the and due to its adhesive nature prevents foreign T use of natural products for curing diseases ra- guests from entering the hive (Figure 1).7 ther than depending on the conventional allopathic This naturally occurring substance has a wide medicine. There are varieties of natural products range of overlooked benefits. It is categorized into used today in the biomedical application in treating a twelve different types according to terrestrial loca- large array of systemic diseases. These may include tion and physiochemical properties. However, only natural silk,1,2 chitosan,3,4 herbal tea5 and miswak.6 three different types of botanical origin have been Propolis a non-toxic resinous natural substance exhi- identified.8 Propolis is considered the nucleus and biting antimicrobial, anticancer, antifungal, antiviral powerhouse of nutrients.9 This resinous lipophilic and anti-inflammatory properties has gained atten- material is sticky, soft and flexible when exposed to tion in both the dental and medical fields. This wax- wheat but hard and breakable when cold.8 Propolis cum resin substance comes from Greek word “pro” is primarily composed of resins (55‒60%). Waxes (meaning outer wall) and “polis” (meaning city). and fatty acids contribute around 30‒45% and ar o- This reflects the protective nature of the substance.7,8 matic oil and pollen about‒5%. 10 10 Other sub- Propolis is one of the natural substances made by stances may include minerals, vitamins and flavono- JODDD, Vol. 11, No. 4 Autumn 2017 266 Khurshid et al. Figure 1. A schematic representation of possible associations of propolis and bees. ids. The biological activity of propolis is mostly chrysin, galangin, pinocembrin, pinobaskin found in linked with flavonoids and hydroxycinnamic acid.11 a temperate climate. These are flavonoids without B- Research has revealed that it is difficult to standard- ring substituents. The major component of temperate ize the chemical constituents and flavonoid contents propolis is caffeic acid phenethyl ester (CAPE).14 of propolis as it is dependent on the environmental Similarly, the chemical composition of propolis ori- condition on the site of collection, on its origin and ginating from tropical regions includes prenylated type of plant pollen and species of bees that pro- phenylpropanoids (e.g., artepillin C), whereas propo- duced it.10,12 Commercial availability of propolis is in lis found in Pacific and African regions contains ge- the form of lozenges, topically applied cream, mouth ranyl flavanones as the characteristic compounds rinses and toothpastes.8 The aim of this study is to (Figure 2).14,18 explore the properties and chemistry of propolis con- Properties of propolis in medicinal care cerning its biomedical and dental applications. In addition, status and scope of propolis for its contem- Propolis, having a wide variety of therapeutic advan- porary and potential future bio-dental applications tages, i.e. being cost-effective and biocompatible have been discussed . with the human cell, with no toxicity, limited allergic reaction and ready availability, can be used widely in Chemical unpredictability of propolis 19,20 medicinal care (Figure 3). The chemical variability of propolis is due to the dif- Antibacterial property of propolis ferent origin of plants, i.e. climatic and geographical whereabouts, flora at the site of collection and bee There is unequivocal evidence that propolis exhibits species.12,13 For the production of propolis, bees use secretions of different plants as well as substances discharged from wounds in plants, i.e. lipophilic ma- terials on leaves, leaf buds, resins, gums and matric- es.14,15 Therefore, there is a striking chemical varia- bility in propolis composition mostly from the tropi- cal regions. Kujumgiev et al16 compared the antibac- terial, antiviral, antifungal and anti-inflammatory properties of propolis from different origins and con- cluded that all showed significant properties, includ- ing impotant antiviral properties. Similarly, Popova et al17 reported the same findings compared to the biological activity of propolis with geographical ori- gin. The chemical constituents of propolis include Figure 2. The nomenclature and chemical structures of various constituents of propolis. JODDD, Vol. 11, No. 4 Autumn 2017 Propolis: A Natural Biomaterial for Oral Healthcare 267 remarkable antibacterial properties despite modifica- ron species were the most vulnerable yeasts. The tions in chemical structures and collection from dif- results reinforce the importance and the potential of ferent geographical regions. Proof suggests that this propolis extract as a treatment for onychomycosis.27 natural resin is effective against gram-positive rods The results of the study showed that all the yeasts in addition to Mycobacterium tuberculosis, with re- tested were inhibited by low concentrations of stricted activity against gram-negative bacilli.21 The propolis extract, including an isolate resistant to nys- ethanolic extract of propolis (EEP) shows high effi- tatin.28 Similarly, Ota et al studied antifungal activity cacy against the strains of bacteroides and Pepto- of propolis extract on 80 different strains of Candida streptococcus but exhibits less efficiency against the yeast and found the yeasts showed a clear antifungal strains of Clostridium, Eubacterium and Archnia.22 activity with the following order of sensitivity: C. Three antimicrobial compounds were discovered albicans>C. tropicalis>C. krusei>C. guilliermondii.29 from Brazilian propolis, mainly consisting of 3,5 di- Recently, Siquera et al assessed the fungistatic and prenyl-4-hydroxycinnamic acid, 3-prenyl-4- fungicidal activity of propolis against different spe- dihdrocinnamoloxycinnamic acid and 22-dimethyl 6- cies of Candida using fluconazole as control. It was carboxy-e-thenyl-2H-1-bezopyran, of which the ini- noted that propolis has fungistatic and fungicidal tial compound shows the highest activity against properties better than fluconazole.30 bacteria and is one of the major antimicrobial com- Antiviral activity of propolis pounds.22,23 Furthermore, EEP displayed synergism with certain antibiotics and demonstrated the capaci- Propolis extracts demonstrated high levels of antivir- ty to improve the actions of antifungals. There is a al activity against herpes simplex virus-1 (HSV-1). growing medical interest in the antimicrobial poten- Methods of antiviral action of propolis involved add- tial of propolis alone or in combination with certain ing propolis extract at different times during the viral antibiotics and antifungals.24 infection cycle. Both propolis extracts exhibited high anti-HSV-1 activity when the viruses were pre- Antifungal action of propolis 31,32 treated with these drugs prior to infection. Anti- Antifungals are used for the treatment and preven- HIV-1 activity was observed with propolis samples tion of fungal infections. Commonly, these antifun- from