Efficacy of mangosteen as local drug delivery for improving periodontal health in adults with periodontitis: a systematic review and meta-analysis of randomized controlled trials

Konathala S.V. Ramesh; Koruprolu Ramalaxmi; Naga V.S.G. Sruthima; Pasupuleti Swetha; Budumuru Anil; Mettapalli PhaniKumar; Gurindapalli Nissi; Chennamsetti Sahithiprabha

doi:10.1515/jcim-2024-0463

Article

Efficacy of mangosteen as local drug delivery for improving periodontal health in adults with periodontitis: a systematic review and meta-analysis of randomized controlled trials

Konathala S.V. Ramesh , Koruprolu Ramalaxmi , Naga V.S.G. Sruthima , Pasupuleti Swetha , Budumuru Anil , Mettapalli PhaniKumar , Gurindapalli Nissi and Chennamsetti Sahithiprabha

Published/Copyright: May 5, 2025

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From the journal Journal of Complementary and Integrative Medicine Volume 22 Issue 4

Abstract

Mangosteen (Garcinia mangostana L.) has garnered attention for its diverse health benefits, including antibacterial, antioxidant, anti-proliferative, anti-carcinogenic, and anti-inflammatory properties. These therapeutic effects play a central role in the pathophysiology of many conditions. Periodontal disease, a chronic inflammatory disorder of the tooth-supporting structures, is primarily caused by biofilm-forming bacteria. This systematic review focuses on the effectiveness of mangosteen in local drug delivery (LDD) for the management of periodontitis. An electronic search was conducted across multiple databases, including PubMed, LILACS, Web of Science, and Scopus. Cohen’s Kappa coefficient was used to evaluate inter-rater agreement, and the risk of bias was assessed. A random-effects model and heterogeneity were examined using I² statistics, while funnel plots were used to detect publication bias. Clinical outcomes, including periodontal pocket depth (PPD) and clinical attachment level (CAL), were extracted from RCTs comparing mangosteen LDD to placebo or conventional therapies. The analysis revealed a significant reduction in PPD (effect size = −1.08, 95 % CI: −1.40, −0.77) and CAL (effect size = −0.96, 95 % CI: −1.80, −0.13) in the mangosteen-treated group. These findings suggest that mangosteen gel as an LDD can offer substantial clinical benefits by reducing PPD and CAL, thereby improving overall periodontal health.

Keywords: local drug delivery; mangosteen; periodontal attachment loss; periodontal pocket depth

Corresponding author: Dr. Konathala S.V. Ramesh, MDS, Associate Professor, Department of Periodontics and Implantology, 77203 Vishnu Dental College , Bhimavaram, Andhra Pradesh, India, E-mail: ksv006@gmail.com

Research ethics: Not applicable.
Informed consent: Not applicable.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Use of Large Language Models, AI and Machine Learning Tools: None declared.
Conflict of interests: The authors state no conflict of interest.
Research funding: None declared.
Data availability: All data generated or analyzed during this study are included in this published article.
Trial registration: PROSPERO registration link https://www.crd.york.ac.uk/PROSPERO/view/CRD42024618658.

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Received: 2024-12-20

Accepted: 2025-04-03

Published Online: 2025-05-05

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Articles in the same Issue

https://doi.org/10.1515/jcim-2024-0463

Keywords for this article

local drug delivery; mangosteen; periodontal attachment loss; periodontal pocket depth