Efetividade da própolis e produtos à base de própolis em terapia pulmonar conservadora: revisão sistemática e meta-análise

Abstract

This work aimed to analyze the scientific evidence regarding the effectiveness of propolis and propolis-based products in conservative pulp therapy. A systematic search was carried out in five databases, Medline via Pubmed, Scopus, Web of Science, Cochrane Library, Scielo and gray literature (ClinicalTrialsRegistry Platform), complemented by a manual search in the reference list of included studies. Randomized controlled clinical trials, in vitro and in vivo laboratory studies, and observational studies with a control group were included, without restrictions regarding language or year of publication. The outcomes of interest were biocompatibility, inflammatory response, pulp regeneration, dentin regeneration, clinical and radiographic success, antioxidant activity, antimicrobial activity and sealing capacity. The risk of bias of the studies was analyzed using the Cochrane RoB 2.0 instrument, the SYRCLE instrument for in vivo studies and the QUIN scale for in vitro studies. The certainty of the evidence was assessed considering clinical trials, using the GRADE approach. Results: 878 studies were identified, of which 35 were included in the review, of which 31 were analyzed qualitatively (in vivo studies, clinical trials and in vitro studies) and 4 were combined for quantitative analysis (in vivo studies) (meta-analysis). very low certainty of evidence, demonstrated that propolis presents biocompatibility, induces an inflammatory response in the dental pulp superior to calcium hydroxide (SMD = 1.11 [0.15, 2.06]) and promotes favorable results in relation to pulp and dentin regeneration. The meta-analysis, with moderate evidence, showed a difference in effect between propolis and MTA only after 9 months of observation, with better results for MTA (OR = 0.19; 95% CI: [0.04, 0.85]), no difference in effect in relation to radiographic success. The certainty of evidence was very low for antimicrobial, antioxidant activity and sealing capacity. Conclusion: The scientific evidence suggesting the effectiveness of propolis in pulp therapy as a pulp protection agent is very low. More methodologically similar studies are needed, with more significant samples and fewer methodological weaknesses.