Sys Rev Pharm 2021;12(2):414-419 A multifaceted review journal in the field of pharmacy Gambier Extract (Uncaria gambier Roxb.) as Herbal Treatment for the Oral Cavity: A Systematic Review Harun Achmada, Irene Edith Rieuwpassab, Arni Irawaty Djaisc, Eriska Riyantid, Risti Saptarini Primartid, Ainun Isnaeni Ilhame a. Department of Pediatric Dentistry, Faculty of Dentistry, Hasanuddin University, Indonesia b. Department of Oral Biology, Faculty of Dentistry, Hasanuddin University, Indonesia c. Department of Periodontology, Faculty of Dentistry, Hasanuddin University, Indonesia d. Department of Pediatric Dentistry, Faculty of Dentistry, Padjadjaran University, Indonesia e. Clinical Dental Student, Faculty of Dentistry, Hasanuddin University, Indonesia Email Correspondence: [email protected], [email protected] ABSTRACT Introduction: The disease of oral and dental that mostly Keywords: Gambier extract, Herbal Treatment, Oral cavity affects Indonesians is dental caries, followed by periodontal tissue disease in the second place. One of the causes is the Email Correspondence: [email protected], buildup of dental plaque. Dental plaque is a collection of [email protected] various kinds of microorganisms on the surface of the teeth. Gambier extract is a product of the gambier plant containing polyphenol compounds that have the potential to be antioxidants and antibacterials. Aim: The purpose of writing this systematic review is to determine the effect of gambier extract as a herbal treatment in the oral cavity. Method: In this review systematics, article searches are carried out on google schoolar. Study published 2015-2020. 118 articles were rated. 28 articles were screened, 80 articles were excluded, 25 full-text articles were assessed for eligibility and 10 full-text articles according to inclusion criteria. Results: There were 10 articles about gambier extract as an oral herbal treatment. Conclusion: Based on a systematic review study, Gambier extract has potential as an herbal treatment for oral health. 1. INTRODUCTION easily attach to these surfaces via adhesins (specific surface Oral and dental disease is the sixth highest health problem receptors). After attaching, the bacteria actively grow and that is often complained of by Indonesia.1 Basic Health synthesize the outer membrane components. 9 Research in 2018 states that the largest proportion of dental Primary colonization consists of aerobic and facultative problems in Indonesia are damaged/decayed/pain teeth anaerobic bacteria such as Gram-positive bacteria (45.3%).2 (Streptococcus sp.). Streptococcus mutans will produce The most common dental disease suffered by Indonesia is glucosyltransferase and fructosyltransferase enzymes and dental caries, followed by periodontal tissue disease in convert sucrose into extracellular polysaccharides in the second place.3 Indonesia is a country with higher caries form of glucans and fructants. Glucans are sticky so they compared to other developing countries, namely 73% support the attachment of bacteria to the initial colonization according to the 2013 Household Health Survey.4 of plaque formation.10 Over time, there has been a shift in Periodontal has a fairly high prevalence that affects humans the microflora from Gram-positive to Gram-negative almost all over the world and reaches 50% of the total adult organisms, and an increase in the heterogeneity of microbial population.5 Dental caries is a hard tissue disease species. Increased number of organisms in such subgingival caused by the activity of microorganisms in fermenting plaques Porphyromonas gingivalis, Prevotella intermedia, carbohydrates to form acid and lowering pH, marked by Fusobacterium nucleatum, Tannerella forsythia, Treponema demineralization of tooth hard tissue.6 Dental caries left too denticola, Fusobacterium nucleatum initiate periodontal long without treatment will continue to the supporting infection.9,11,12 tissues of the teeth. Periodontal disease is an inflammation One of the efforts to prevent dental and oral diseases is that occurs in the supporting tissues of the teeth, including through the development of natural treatments by utilizing the alveolar bones and periodontal ligaments.7 One of the extracts of gambier (Uncaria gambier Roxb.). Gambier is causes of several oral diseases such as caries and used traditionally to treat diarrhea, influenza, dysentery, periodontal disease is the buildup of dental plaque. Dental stomatitis, cough, sore throat, and gingivitis. Gambier plaque is a collection of various kinds of microorganisms on extract is a product of the gambier plant (Uncaria gambier the surface of the teeth. The thicker plaque on the teeth can roxb) containing functional compounds which are included prevent saliva from neutralizing the acidic pH of the oral in the polyphenol compound in Gambier, especially cavity due to the metabolism of bacteria.8 Bacteria can catechins that have potential as antioxidants and 414 Systematic Reviews in Pharmacy Vol 12, Issue 2, Jan-Feb 2021 Gambier Extract (Uncaria gambier Roxb.) as Herbal Treatment for the Oral Cavity: A Systematic Review antibacterials.13,14,15,16 that present scientific articles in PDF format, such as: Based on several studies on gambier, its relation to the google scholar and PubMed. Results were identified from antibacterial properties conducted by Magdalena, et al. journal searches from 14-21 December 2020. The inclusion (2015) states that gambier extract has the ability to inhibit criteria of this systematic review were: 1) Articles published Escherichia coli bacteria at 100% extract concentration, from 2015-2020. 2) An article that examines gambier Salmonella typhimurium at 90% extract concentration, extract as a herbal treatment for the oral cavity. 3) Staphylococus aureus at 90% extract concentration and Scientific articles available online. This systematic review Bacillus cereus at an extract concentration of 80%.9 Lucida et excludes articles that do not discuss gambier extract as an al (2010) stated that the 7% gambier extract contained in oral herbal treatment and articles that are not accessible toothpaste has optimal antimicrobial power in inhibiting the for free. The data search was conducted systematically growth of S. mutans bacteria as the cause of dental plaque using the keywords "Gambier Extract" and "Oral Cavity formation.11 Based on the description above, the authors are Herbal Materials" in Indonesian and English. A manual interested in writing a systematic review of gambier extract search was also carried out on references from each journal as a herbal treatment in the oral cavity. relevant to this research. 2. SEARCH METHODS 3. RESULTS Sources of data in this study come from online databases Figure 1. The flow chart of the journal tracking to be synthesized After eliminating duplicated articles, the titles and abstracts of each article were analyzed resulting in an exclusion of 90 articles and 10 articles were then included in the analysis. 415 Systematic Reviews in Pharmacy Vol 12, Issue 2, Jan-Feb 2021 Gambier Extract (Uncaria gambier Roxb.) as Herbal Treatment for the Oral Cavity: A Systematic Review Table 1. Article on Gambier Extract as an Oral Herbal Treatment No. Authors Year Title Conclusion The number of bacterial colonies decreased Siti Rusdiana Puspa The Effect of Gambier Extractssignificantly after being given gambier extract ointment. 1. Dewi, Anna Pratiwi,2018 (Uncaria Gambier [Roxb.]) asSo, ethyl acetate gambier extract has an effect as an Theodorus17 Antiseptic on Gingival Wound in Rats antiseptic on the gingival mucosal wound of Wistar strain white rats depending on the dose. The combination of betel leaf (Piper betle L.) and areca Combination Antibacterial Activitynut (Areca catechu L.) and gambier (Uncaria gambier Test of Betel Leaf Extract and ArecaRoxb) can inhibit the growth of Streptococcus mutans. 2. Munira18 2020 Nut and Gambier againstThe difference in extract concentration in the Streptococcus mutans combination extract can affect the bacterial inhibition activity. Zola Efa Harnis, Aldrina Based on the results of this study, it can be concluded Gambier Mouthwash Formulation Ginting, Christica that Gambier mouthwash can inhibit the growth of 3. 2020 and Effectiveness Test against Illsanna, Bunga Rimnta Staphylococcus aureus bacteria at concentrations of Staphylococcus aureus Bacteria Barus, Linda Margata19 5%, 10%, and 15%. Potential of CombinationAntibacterial herbal toothpaste with the active Toothpaste Formulation withtreatment combination of ethanol extract of betel leaf, Ethanol Extract of Betel Leaf (Piperareca nut and gambier can inhibit the growth of one of 4. Rifdah Afifah Rahmat20 2020 Betle L.), Areca Nut (Areca Catechu),the dental plaque bacteria, namely Staphylococcus Gambier (Uncaria Gambier) inaureus. This combination has a synergistic effect which Inhibiting the Growth ofis characterized by the inhibition zone formed which is Staphylococcus Aureus Bacteria larger than the inhibition zone of each material. As much 60% gambier extract has the ability to reduce Siti Rusdiana Puspa Anticariogenic Effect of Gambiermicropores due to the presence of catechin Dewi, Muhammad (Uncaria Gambier [Roxb.]) Extract onantibacterial activity which can inhibit the activity of the 5. Totong Kamaluddin,2016 Enamel Tooth Surface Exposed byglucosyltransferase enzyme and inhibit the extracellular Theodorus, Rindit Streptococcus mutans glucan polysaccharides, thus preventing the attachment Pambayun21 of Streptococcus mutans