226 J Med Nus Vol. 26 No.4 Oktober- Desember 2005

EFFECT OF GREEN TEA TO IMPROVE PERIODONTAL TISSUESSTATUS ON DIABETES MELLITUS PATIENTS

Bahruddin Thalib1 dan Asmawati21 Department of Prosthodontic, Faculty of Dentistry, Hasanuddin University2 Department of Oral Biology, Faculty of Dentistry, Hasanuddin University

RINGKASANTeh hijau secara laboratoris telah terbuki memiliki anti bakteri dan efek enti radang. Penelitian ini nertujuan untukmelihat efek teh hijau terhadap perbaikan status jaringan periodontal pada penderita diabetes mellitus memilikipenyakit periodontal yang cukup parah. Penelitian dilakukan dengan jumlah sampel sebanyak 20 orang yangdibagi dalam 2 kelompok yaitu kelompok 1 sebanyak 10 orang yang meminum teh hijau dan kelompok 2 sebanyak10 orang sebagai placebo yang meminum air putih. Dilakukan pemeriksaan pretest dan post test di hari ke 15, 30,dan hari ke 45, dan di analisis secara statistik menggunakan friedman test (

227J Med Nus Vol. 26 No.4 Oktober- Desember 2005

men and women which later randomly divided into 2groups, test group and control group.

Periodontal tissue status examination conducted aspre test for both groups using CPITN index. Test groupswere given Green Tea 919 which instructed to drinktwice daily every after breakfast and dinner. Each 1 teabag (1gr) infused in 100cc hot water for 8-10 minutes.Green tea supply was given for 40 days.

Control group (placebo) were given 100cc bottledwater drink twice daily with the same drinking procedureas the test group.

Periodontal tissue status examination were againconducted (post test) on day 15, 30 and 45. Informationacquired with Periodontal Index examination on 10determined teeth for each subject. Results laterstatistically analyze using Friedman Test.

RESULT AND DISCUSSIONA. Result

Periodontal tissue status before treatment (pre test)on test group (PK) were seen quite similar with those incontrol group (PL) (see Table 1)

0

10

20

30

40

50

NORMAL GOOD MEDIUM BAD SEVERE

PRE TEST DERAJAT FREQUENCIES

(PK) (PL)NORMAL 0 0GOOD 0 0MEDIUM 19 19BAD 28 34SEVERE 46 47TOTAL 93 100

Table 1

Picture 1

Measurement result of periodontal status on diabeticsubject after green tea treatment on day 15 can be seenin Table 2. Green teas affects for improving periodontalstatus after drinking green tea for 15 days can be seenon Picture 2 (Purple represent test group (PK) and redrepresent control group (PL))

POST TEST 15 DERAJAT FREKUENSI

(PK) (PL)NORMAL 0 0GOOD 0 0MEDIUM 23 19BAD 46 25SEVERE 24 56TOTAL 93 100

0102030405060

NORM AL BAIK SEDANG BURUK PARAH

Measurement result of periodontal status on diabeticsubject after green tea treatment on day 30 can be seenin Table 3. Green teas affects for improving periodontalstatus after drinking green tea for 30 days can be seenon Picture 3 (Purple represent test group (PK) and redrepresent control group (PL))

POST TEST 30

DERAJAT FREKUENSI

(PK) (PL)NORMAL 0 0GOOD 0 0MEDIUM 25 19BAD 60 19SEVERE 6 62TOTAL 91 100

0

20

40

60

80

NORMAL GOOD MEDIUM BAD SEVERE

Table 2

Picture 2

Table 3

Picture 3

228 J Med Nus Vol. 26 No.4 Oktober- Desember 2005

Measurement result of periodontal status on diabeticsubject after green tea treatment on day 45 can be seenin Table 3. Green teas affects for improving periodontalstatus after drinking green tea for 45 days can be seenon Picture 3 (Purple represent test group (PK) and redrepresent control group (PL))

POST TEST 45 DERAJAT FREKUENSI

(PK) (PL)NORMAL 0 0GOOD 14 0MEDIUM 68 19BAD 11 25SEVERE 0 56TOTAL 93 100

0

20

40

60

80

NORM AL BAIK SEDANG BURUK PARAH

Picture 4

Table 4

Statistical analysis with Friedman Test using 0,05and 95% trust degree was conducted. Result showsthat there are significant periodontal status improvementson test group which given Green Tea 919 compared tocontrol group (placebo), especially on day 30 and 45.On day 15 other wise the difference is not significant.

B. DiscussionOn this experiment, Green Tea 919 as one of a well

known brand were used, packed in infuse tea bags thatis very practical in use and provide a maximum teaconcentrate. Periodontal status measurement weredone with CPITN index. Subjects divided into 2 groups:

1. Test Group, having green tea2. Control Group (placebo), having plain water

Sample amount were 20 subjects (10 treatment and10 control). Samples taken were diabetic mellitus type IIbecause its higher incidence (95% from diabetic mellitussubjects of all type), while age group were determinedabove 35 years old with considerations of the diseasenature which often occur after in this age group.

Clinical manifestation of diabetic mellitus patient inoral cavity is periodontal tissue damages. It has beenreported that periodontal severity and its frequency ishigher in patient with diabetic mellitus.8

From experiments sample studies, we found thatseverity of periodontal disease occurred in diabeticmellitus patient using CPITN index is quite high (Table1). Diabetic mellitus patients with high glucoseconcentration in blood become vulnerable to infections.Diabetes mellitus is one of risk factor of having a severeperiodontal disease.9 Matthews also found thatperiodontitis often more severe, develop more fast andwith higher prevalence in diabetic mellitus patients.10

Other studies by Handayani suggested that greentea leaves infuse shows anti inflammation affect onoedema made on wistar mouse. It was also suggestedthat certain concentration of green teas extract havebacteriostatic and bactericidal properties.11,12

Result of this experimental studies shows thattreatment of green tea after day 15, 30, and 45 giving animprovement signs, while in control group the periodontalstatus became more severe (Table 2,3 and 4). Chemicalmajor composition of green tea are catechins (polifenol)30% which believed to had a powerful biologic activity.13Otake in his study suggested that polyfenol contains orcathechin in green tea have inhibitors properties towardsStreptococcus mutans.14 Study by Sakanaka 1991 danOiwa dkk 1993 also suggested that polyfenol containsin green tea can prevent periodontal disease.15

CONCLUSION AND SUGGESTIONA. ConclusionThis experiment concludes:

1. Green tea 919 has clinical affects periodontaldisease in a diabetic mellitus subjects.

2. Periodontal status improvement with green teais quite significant.

B. SuggestionNeed to conduct another experiment with bigger

amount of samples so that the result can representwidely.

R E F E R E N C E1. Sakanaka, S., Sato, S., Kim, M., Yamamoto T., (1991). Effect

Of Green Tea Polyphenols On Glucan Sintesis and CellulerAdherence Of Cariogenic Sterptococci.

2. Fujiki, H (1995). Green Tea as a Cancer Preventive Materialin Humans. First International Conference on East-WestPerspective On Functional Food. ILSI. Singapore.

3. Teranishi and Hornstein (1995). Special issue on Tea. In :Food Reviews International, vol 11 no 3.

4. Research On Periodontal Complications Of DiabetesMellitus. National Institute Of Health NIH Guid, Vol 23 : no 27Juli 1994. Available at : http://www.ninds.nih.gov/patient/diabetes. Tanggal akses 16 maret 2003.

5. Diabetes and Periodontal Desease : A Two-Way Street.AAP Patient page, vol 3. no.2. September/Oktober 2002.Available at : http : //www.perio.org. tanggal akses13 Maret 2003.

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6. PUKO (2003). A Parallel Randomized, Placebo ControlledStudy On Hypoglykemic Effect Of Tea 919 In Type 2Diabetic Patients. Clinical Trial Protocol. Pusat Uji Klinik ObatFKUI-RSU Ciptomangunkusumo, Jakarta.

7. Singgih Santoso (2003). SPSS Ver. 10, Mengolah datastatistik secara profesional. 434 46.

8. Lalla RV, DAmbrosio JA, 2001. Dental managementconsideration for the patient with diabetes mellitus, JADA,132:1425 32

9. Grossi SG, Genco, RJ (1998). Periodontal Disease andDiabetes Mellitus: A Two-Way Relationship, Ann Periodontal,Juli 3(1): 51 61.

10. Mattehus, DC (2002). Teh Relationship Between Diabetesand Periodontal Desease. J Canada Dental Association,vol.68: no 63.

11. Handayani J dan Ruspiata (2000). Efek anti radang ekstrakteh hijau (Camelia sinensis) terhadap udem buatan padatikus putih jantan galur wistar, MI KGI, 2 (4): 63 6.

12. Horiba N, dkk A pilot Studi of Japanese Green tea as amedicaman: anti bacterial and bacterisidal effect, J. Endod:17(3): 122 4.

13. Price W dan Spitzer JC, 1993. Variation in the amounth afindividual flavonoid in a range of green tea food Chem. 47:271 - 6

14. Otake S, (1991). Anti caries effect of polifenolic compoundsfrom japanese green tea, J Caries Res. 25(6): 438 - 43

15. Oiwa. T, dkk. 1993. Effect of tea polifenols againts humandental plaque formation, Jap.J Pediatric Dent 31: 247 51