The Effect of Local Application of Tea Tree Oil Adjunctive to Daily Oral Maintenance and Nonsurgical Periodontal Treatment: A Systematic Review and Meta-Analysis of Randomised Controlled Studies.

2024-06-12
Oral health & preventive dentistry 22
- Chenjiao Zhang
- Bowen Liu
- Jingchao Hu
- Li Zhao
- Han Zhao

PubMed: 38864380
DOI: 10.3290/j.ohpd.b5458585

Study Design

Type: Meta-Analysis
Methods: Three electronic databases were searched from 2003. Reference lists were manually searched. Randomised controlled trials reporting clinical outcomes of topical use of TTO as an adjunct to daily oral hygiene or SRP were included.

Purpose

To evaluate the efficacy of the adjunctive use of tea tree oil (TTO) for dental plaque control and nonsurgical periodontal treatment (NSPT).

Materials and methods

Three electronic databases were searched from 2003. The reference lists of the included articles and relevant reviews were also manually searched. Randomised controlled trials reporting the clinical outcomes of the topical use of TTO as an adjunct to daily oral hygiene or scaling and root planing (SRP) were included. Regarding the use of TTO as an adjunctive to daily oral hygiene, the primary outcome was plaque index (PI) reduction. Regarding the use of TTO as an adjunctive to SRP, probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain were the primary outcomes. The secondary outcomes were adverse events.

Results

Eleven studies were included for qualitative analysis, 9 studies were included for quantitative analysis, and 6 studies were included to examine the application of TTO mouthwash as an adjunctive to daily oral hygiene. In addition, three studies were included to analyse the subgingival use of TTO adjunctive to SRP at selected sites. The results indicated a nonsignificant improvement in PI reduction in the TTO mouthwash group compared with placebo. The incidence of adverse events was statistically significantly greater in the CHX group than in the TTO group. For subgingival use of TTO adjunctive to SRP, beneficial effects were observed in the TTO group compared with SRP alone in terms of PPD and CAL at both three and six months post-treatment. However, an unpleasant taste was reported in three out of four studies.

Conclusion

There is a lack of strong evidence to support the beneficial effects of TTO. Studies with larger sample sizes and standardised evaluation criteria are needed to further demonstrate the clinical relevance of TTO.

Research Insights

Tea Tree→Improved Clinical Attachment
For subgingival use of TTO adjunctive to SRP, beneficial effects were observed in the TTO group compared with SRP alone in terms of PPD and CAL at both three and six months post-treatment.
Effect
Beneficial
Effect size
Moderate
Dose
subgingival application (concentration not specified in abstract)
Tea Tree→Reduced Plaque Index
The results indicated a nonsignificant improvement in PI reduction in the TTO mouthwash group compared with placebo.
Effect
Neutral
Effect size
Small
Dose
mouthwash (concentration not specified in abstract)
Tea Tree→Reduced Probing Pocket Depth
For subgingival use of TTO adjunctive to SRP, beneficial effects were observed in the TTO group compared with SRP alone in terms of PPD and CAL at both three and six months post-treatment.
Effect
Beneficial
Effect size
Moderate
Dose
subgingival application (concentration not specified in abstract)

Adverse Events Reported

Tea Tree→Overall tolerability
The incidence of adverse events was statistically significantly greater in the CHX group than in the TTO group.
Finding
Reported
Magnitude
The incidence of adverse events was statistically significantly greater in the CHX group than in the TTO group.
Significant
Yes
Tea Tree→unpleasant taste
However, an unpleasant taste was reported in three out of four studies.
Finding
Reported
Magnitude
reported in three out of four studies