{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:23:36Z","timestamp":1787840616294,"version":"build-2784847793"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The aim of the present systematic review and meta-analysis was to investigate the effect of Carica papaya on periodontal disease in the adult population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A systematic search was performed using the PubMed, Web of Science, Embase, and Cochrane library databases up to June 2021 using related keywords for randomized clinical trials that evaluated the effect of Carica papaya on gingival index (GI), plaque index (PI), and papilla bleeding index (PBI) in the intervention group compared to control group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of five eligible studies involving 206 participants were included in the systematic review and meta-analysis. GI score significantly decreased in the intervention group at the end of the treatment compared to the baseline (ES = \u22120.64; 95% CI = \u22120.85\u2013\u22120.42; I\n                      <jats:sup>2<\/jats:sup>\n                      = 90.4%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Furthermore, patients in the intervention group had significantly lower GI (weighted mean difference = \u22120.28; 95% CI = \u22120.45\u2013\u22120.10; I\n                      <jats:sup>2<\/jats:sup>\n                      = 98.2%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) and PI (weighted mean difference = \u22120.36; 95% CI = \u22120.59\u2013\u22120.14; I\n                      <jats:sup>2<\/jats:sup>\n                      = 99.3;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) scores compared with control individuals. However, no significant difference observed between the two groups regarding PBI score.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Despite study limitations, this systematic review and meta-analysis highlighted the effective role of oral care products containing Carica papaya for the treatment of periodontal diseases by improving indices like GI and PI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/abr.abr_223_24","type":"journal-article","created":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:00:25Z","timestamp":1756378825000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["The Effect of Carica Papaya on Periodontal Disease: A Systematic Review and Meta-Analysis"],"prefix":"10.4103","volume":"14","author":[{"given":"Zahra","family":"Saberi","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Medicine, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza","family":"Rahimi","sequence":"additional","affiliation":[{"name":"Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awat","family":"Feizi","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Golestannejad","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Medicine, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Saidi","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Medicine, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Jafari","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Medicine, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,8]]},"reference":[{"key":"R1-20250829","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/nrdp.2017.38","article-title":"Periodontal diseases","volume":"3","author":"Kinane","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"R2-20250829","first-page":"3","article-title":"Risk factors for periodontitis","volume":"7","author":"Van Dyke","year":"2005","journal-title":"J Int Acad Periodontol"},{"key":"R3-20250829","doi-asserted-by":"crossref","first-page":"2146160","DOI":"10.1155\/2020\/2146160","article-title":"Global prevalence of periodontal disease and lack of its surveillance","volume":"2020","author":"Nazir","year":"2020","journal-title":"ScientificWorldJournal"},{"key":"R5-20250829","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.3390\/ijms20061414","article-title":"Periodontal disease: A risk factor for diabetes and cardiovascular disease","volume":"20","author":"Liccardo","year":"2019","journal-title":"Int J Mol Sci"},{"key":"R6-20250829","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.disamonth.2018.09.011","article-title":"Effects of periodontal disease on systemic health","volume":"65","author":"Hegde","year":"2019","journal-title":"Dis Mon"},{"key":"R7-20250829","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1111\/jre.12436","article-title":"Impact of periodontal disease on quality of life: A systematic review","volume":"52","author":"Ferreira","year":"2017","journal-title":"J Periodontal Res"},{"key":"R8-20250829","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/jre.12805","article-title":"Periodontal disease and quality of life: Umbrella review of systematic reviews","volume":"56","author":"Wong","year":"2021","journal-title":"J Periodontal Res"},{"key":"R9-20250829","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1111\/j.1600-0757.2006.00192.x","article-title":"Microbiological goals of periodontal therapy","volume":"42","author":"Teles","year":"2006","journal-title":"Periodontol 2000"},{"key":"R10-20250829","first-page":"69","article-title":"Evidence-based update on diagnosis and management of gingivitis and periodontitis","volume":"63","author":"Kumar","year":"2019","journal-title":"Dent Clin"},{"key":"R11-20250829","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1128\/CMR.14.4.727-752.2001","article-title":"Periodontal disease as a specific, albeit chronic, infection: Diagnosis and treatment","volume":"14","author":"Loesche","year":"2001","journal-title":"Clin Microbiol Rev"},{"key":"R12-20250829","first-page":"37","article-title":"Antibiotics in the treatment of periodontal diseases: Microbiological basis and clinical applications","volume":"19","author":"Feres","year":"2008","journal-title":"Ann R Australas Coll Dent Surg"},{"issue":"Suppl 1","key":"R13-20250829","doi-asserted-by":"crossref","first-page":"S7","DOI":"10.15171\/jlms.2017.s2","article-title":"The effect of photodynamic therapy in the treatment of chronic periodontitis: A review of literature","volume":"8","author":"Meimandi","year":"2017","journal-title":"J Lasers Med Sci"},{"key":"R14-20250829","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1111\/prd.12121","article-title":"Antibiotics\/antimicrobials: Systemic and local administration in the therapy of mild to moderately advanced periodontitis","volume":"71","author":"Jepsen","year":"2016","journal-title":"Periodontol 2000"},{"key":"R15-20250829","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.hermed.2018.02.004","article-title":"Is there a role for herbal medicine in the treatment and management of periodontal disease?","volume":"12","author":"Milovanova-Palmer","year":"2018","journal-title":"J Herb Med"},{"key":"R16-20250829","doi-asserted-by":"crossref","first-page":"590","DOI":"10.3109\/1547691X.2016.1149528","article-title":"Anti-inflammatory and immunomodulatory properties of Carica papaya","volume":"13","author":"Pandey","year":"2016","journal-title":"J Immunotoxicol"},{"key":"R17-20250829","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1007\/s10787-008-7008-0","article-title":"Anti-inflammatory activities of ethanolic extract of Carica papaya leaves","volume":"16","author":"Owoyele","year":"2008","journal-title":"Inflammopharmacology"},{"key":"R18-20250829","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1007\/s40199-020-00348-7","article-title":"Therapeutic application of Carica papaya leaf extract in the management of human diseases","volume":"28","author":"Singh","year":"2020","journal-title":"DARU J Pharm Sci"},{"key":"R19-20250829","first-page":"61","article-title":"Expression of Il-1\u03b2 in periodontitis post oral administration of papaya seed extract","volume":"13","author":"Pusporini","year":"2020","journal-title":"J Int Dent Med Res"},{"key":"R20-20250829","first-page":"22","article-title":"The effect of papaya seed ethanol extract in vivo on the number of osteoblasts cells of periodontitis-induced rats","volume":"24","author":"Pusporini","year":"2019","journal-title":"Tradit Med J"},{"key":"R21-20250829","first-page":"96","article-title":"Anti-inflammatory role of papaya seed extracts in inhibiting osteoclastogenesis of rats with Periodontitis","volume":"4","author":"Pusporini","year":"2018","journal-title":"Majalah Kedokt Gigi Indones"},{"key":"R22-20250829","doi-asserted-by":"crossref","first-page":"2660","DOI":"10.3390\/ijerph15122660","article-title":"Effect of a toothpaste\/mouthwash containing Carica papaya leaf extract on interdental gingival bleeding: A randomized controlled trial","volume":"15","author":"Saliasi","year":"2018","journal-title":"Int J Environ Res Public Health"},{"key":"R23-20250829","doi-asserted-by":"crossref","first-page":"35","DOI":"10.4103\/INJO.INJO_28_19","article-title":"Efficacy of Carica papaya seed extract on periodontitis: A clinico-microbiological study","volume":"7","author":"Rangaraju","year":"2019","journal-title":"Int J Oral Care Res"},{"key":"R24-20250829","doi-asserted-by":"crossref","first-page":"9379840","DOI":"10.1155\/2016\/9379840","article-title":"Effects of standardised fermented papaya gel on clinical symptoms, inflammatory cytokines, and nitric oxide metabolites in patients with chronic periodontitis: An open randomised clinical study","volume":"2016","author":"Kharaeva","year":"2016","journal-title":"Mediators Inflamm"},{"key":"R25-20250829","first-page":"203","article-title":"Efficacy of papain-arginine gel on gingivitis treatment caused by orthodontic appliances","volume":"829","author":"Jessica","year":"2020","journal-title":"Key Engineering Materials"},{"key":"R26-20250829","doi-asserted-by":"crossref","first-page":"100","DOI":"10.4103\/0976-500X.72352","article-title":"CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials","volume":"1","author":"Schulz","year":"2010","journal-title":"J Pharmacol Pharmacother"},{"key":"R27-20250829","first-page":"e649","article-title":"Anti-plaque and anti-gingivitis effect of Papain, Bromelain, Miswak and Neem containing dentifrice: A randomized controlled trial","volume":"9","author":"Tadikonda","year":"2017","journal-title":"J Clin Exp Dent"},{"key":"R28-20250829","article-title":"Pengaruh Berkumur Ekstrak Daun Pepaya (Carica papaya L.) 2, 5% Terhadap Akumulasi Plak Dan Status Gingiva Pada Penderita Gingivitis Kategori Sedang","author":"Ardyanti","year":"2017","journal-title":"Universitas Gadjah Mada"},{"key":"R29-20250829","article-title":"Pengaruh berkumur dengan larutan ekstrak biji pepaya (carica papaya l.) 10% terhadap skor plak gigi pada penderita gingivitis","author":"Rohman","year":"2016","journal-title":"Universitas Gadjah Mada"},{"key":"R30-20250829","doi-asserted-by":"crossref","first-page":"203","DOI":"10.4028\/www.scientific.net\/KEM.829.203","article-title":"Efficacy of papain-arginine gel on gingivitis treatment caused by orthodontic appliances","volume":"829","author":"Regina","year":"2020","journal-title":"Key Eng Mater"},{"key":"R31-20250829","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1111\/j.1600-051X.2012.01883.x","article-title":"Effect of a chlorhexidine mouthrinse on plaque, gingival inflammation and staining in gingivitis patients: A systematic review","volume":"39","author":"Van Strydonck","year":"2012","journal-title":"J Clin Periodontol"},{"key":"R32-20250829","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1590\/S1678-77572010000500015","article-title":"Staining and calculus formation after 0.12% chlorhexidine rinses in plaque-free and plaque covered surfaces: A randomized trial","volume":"18","author":"Zanatta","year":"2010","journal-title":"J Appl Oral Sci"},{"key":"R33-20250829","doi-asserted-by":"crossref","first-page":"45794","DOI":"10.1155\/2007\/45794","article-title":"Proinflammatory and oxidative stress markers in patients with periodontal disease","volume":"2007","author":"Borges","year":"2007","journal-title":"Mediators Inflamm"},{"key":"R34-20250829","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1111\/prd.12342","article-title":"Periodontitis is an inflammatory disease of oxidative stress: We should treat it that way","volume":"84","author":"Sczepanik","year":"2020","journal-title":"Periodontol 2000"},{"key":"R35-20250829","doi-asserted-by":"crossref","first-page":"439","DOI":"10.3389\/fphys.2017.00439","article-title":"The role of reactive oxygen species and autophagy in periodontitis and their potential linkage","volume":"8","author":"Liu","year":"2017","journal-title":"Front Physiol"},{"key":"R36-20250829","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S2222-1808(14)60617-4","article-title":"A review on medicinal properties of Carica papaya Linn","volume":"5","author":"Vij","year":"2015","journal-title":"Asian Pac J Trop Dis"},{"key":"R37-20250829","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13065-016-0149-0","article-title":"Compositional difference in antioxidant and antibacterial activity of all parts of the Carica papaya using different solvents","volume":"10","author":"Asghar","year":"2016","journal-title":"Chem Cent J"},{"key":"R38-20250829","first-page":"037","article-title":"Studies on the antibacterial activity of root extracts of Carica papaya L","volume":"1","author":"Doughari","year":"2007","journal-title":"Afr J Microbiol Res"},{"key":"R39-20250829","first-page":"473","article-title":"Antibacterial activity of leaves and stem extract of Carica papaya L","volume":"2","author":"Nirosha","year":"2013","journal-title":"Int J Adv Pharm Biol Chem"},{"key":"R40-20250829","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s43088-020-00048-w","article-title":"Antioxidant, antibacterial activity, and phytochemical characterization of Carica papaya flowers","volume":"9","author":"Dwivedi","year":"2020","journal-title":"Beni Suef Univ J Basic Appl Sci"}],"container-title":["Advanced Biomedical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/abr.abr_223_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:25:58Z","timestamp":1787837158000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/abr.abr_223_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/abr.abr_223_24","relation":{},"ISSN":["2277-9175"],"issn-type":[{"value":"2277-9175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]},"assertion":[{"value":"2024-04-14","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-03","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}