{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:23:20Z","timestamp":1787840600073,"version":"build-2784847793"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["J Int Soc Prev Community Dent"],"published-print":{"date-parts":[[2026,1]]},"abstract":"\n A\n bstract<\/jats:sc>\n <\/jats:title>\n \n Aim:<\/jats:title>\n \n Periodontal disease remains a prevalent chronic condition worldwide, and interest has grown in natural adjunctive agents such as\n Commiphora myrrh<\/jats:italic>\n for their potential antimicrobial and healing properties. This systematic review evaluated the antimicrobial and clinical effects of myrrh in managing periodontal disease, gingival healing, and pathogen reduction across\n in vitro<\/jats:italic>\n , animal, and clinical studies.\n <\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n A comprehensive search of major databases (2010\u20132025) was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, including randomized controlled trials (RCTs),\n in vitro<\/jats:italic>\n , and animal studies. Primary outcomes were gingival and plaque indices, healing parameters (swelling, redness), and antimicrobial efficacy. Risk of bias was assessed using the Cochrane RoB 2, Systematic Review Center for Laboratory Animal Experimentation, and Quality Assessment Tool for\n in vitro<\/jats:italic>\n Studies of Dental Materials, with meta-analyses performed for eligible RCTs, and certainty of evidence rated using the Grading of Recommendations Assessment, Development, and Evaluation approach.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Fifteen studies met the inclusion criteria: six\n in vitro<\/jats:italic>\n , one animal study, and eight RCTs.\n In vitro<\/jats:italic>\n studies consistently demonstrated strong antimicrobial effects of myrrh, particularly in its essential oil form, against periodontal pathogens and\n Staphylococcus aureus<\/jats:italic>\n . The animal study indicated enhanced early wound healing, but also dose-dependent toxicity with prolonged use. Meta-analysis of RCTs revealed a small yet statistically significant reduction in plaque, whereas effects on gingival inflammation and healing were not significant. Reported adverse effects were minimal.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n \n Myrrh shows promising potential as an adjunct in periodontal therapy, supported by\n in vitro<\/jats:italic>\n and preclinical findings; however, further well-designed, standardized clinical trials and translational animal studies are essential to confirm its efficacy.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jispcd.jispcd_160_25","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T07:00:11Z","timestamp":1772089211000},"page":"1-19","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Myrrh in the Management of Periodontal Disease and Gingival Healing: A Systematic Review and Meta-Analysis"],"prefix":"10.4103","volume":"16","author":[{"given":"Rabab A.","family":"Alnakhli","sequence":"first","affiliation":[{"name":"Department of Dentistry, Royal Commission Medical Center, Yanbu, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saeed S.","family":"Alqalaleef","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Royal Commission Medical Center, Yanbu, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinan M.","family":"Alesawi","sequence":"additional","affiliation":[{"name":"Applied College, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moneera H.","family":"Aljedaie","sequence":"additional","affiliation":[{"name":"Department of Dental Health, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rinad T.","family":"Alqunaian","sequence":"additional","affiliation":[{"name":"Department of Dental Health, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yousef E.","family":"Shokri","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Royal Commission Medical Center, Yanbu, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid A.","family":"Alghumayti","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Royal Commission Medical Center, Yanbu, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Turki A.","family":"Bakhsh","sequence":"additional","affiliation":[{"name":"Advanced Technology Dental Research Laboratory, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia"},{"name":"Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia"},{"name":"Department of Cariology and Operative Dentistry, Tokyo Medical and Dental University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"CIT0001-20260420","first-page":"72","article-title":"Prevalence of periodontal disease, its association with systemic diseases and prevention","volume":"11","author":"Nazir","year":"2017","journal-title":"Int J Health Sci (Qassim)"},{"key":"CIT0003-20260420","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.sdentj.2023.11.022","article-title":"Prevalence of periodontitis in Saudi Arabia: A systematic review and meta-analysis","volume":"36","author":"Hakeem","year":"2023","journal-title":"Saudi Dent J"},{"key":"CIT0005-20260420","doi-asserted-by":"crossref","first-page":"3480","DOI":"10.4103\/jfmpc.jfmpc_759_19","article-title":"Red complex: Polymicrobial conglomerate in oral flora: A review","volume":"8","author":"Mohanty","year":"2019","journal-title":"J Family Med Prim Care"},{"key":"CIT0006-20260420","doi-asserted-by":"crossref","first-page":"11613","DOI":"10.1038\/s41598-023-38599-4","article-title":"Antimicrobial resistance and virulence of subgingival staphylococci isolated from periodontal health and diseases","volume":"13","author":"Colombo","year":"2023","journal-title":"Sci Rep"},{"key":"CIT0007-20260420","first-page":"35","article-title":"Antibiotic susceptibility of staphylococcus aureus isolates in oral mucosa and pockets of patients with gingivitis-periodontitis","volume":"24","author":"Cuesta","year":"2011","journal-title":"Acta Odontol Latinoam"},{"key":"CIT0008-20260420","doi-asserted-by":"crossref","DOI":"10.1080\/20002297.2023.2213111","article-title":"Newly identified pathogens in periodontitis: Evidence from an association and an elimination study","volume":"15","author":"Veras","year":"2023","journal-title":"J Oral 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Dent"},{"key":"CIT0012-20260420","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/1471-2288-14-43","article-title":"SYRCLE\u2019s risk of bias tool for animal studies","volume":"14","author":"Hooijmans","year":"2014","journal-title":"BMC Med Res Methodol"},{"key":"CIT0013-20260420","first-page":"l48","article-title":"RoB 2: A revised tool for assessing risk of bias in randomized trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"CIT0014-20260420","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1002\/jrsm.1411","article-title":"Risk-of-bias VISualization (robvis): An R package and Shiny web app for visualizing risk-of-bias assessments","volume":"12","author":"McGuinness","year":"2021","journal-title":"Res Synth Methods"},{"key":"CIT0015-20260420","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1136\/bmj.39500.677199.AE","article-title":"Grading quality of evidence and strength of recommendations for diagnostic tests and strategies","volume":"336","author":"Sch\u00fcnemann","year":"2008","journal-title":"BMJ"},{"key":"CIT0019-20260420","doi-asserted-by":"crossref","first-page":"1685","DOI":"10.3855\/jidc.14904","article-title":"Synergistic antibacterial activity of herbal extracts with antibiotics on bacteria responsible for periodontitis","volume":"15","author":"Saquib","year":"2021","journal-title":"J Infect Dev Ctries"},{"key":"CIT0020-20260420","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1016\/j.sdentj.2021.09.009","article-title":"Myrrh mixed with silver nanoparticles demonstrates superior antimicrobial activity against porphyromonas gingivalis compared to myrrh and silver nanoparticles alone","volume":"33","author":"ALHarthi","year":"2021","journal-title":"Saudi Dent J"},{"key":"CIT0021-20260420","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s13568-020-0958-3","article-title":"Bactericidal activity of myrrh extracts and two dosage forms against standard 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against stationary phase Staphylococcus aureus","volume":"20","author":"Xiao","year":"2020","journal-title":"BMC Complement Med Ther"},{"key":"CIT0025-20260420","doi-asserted-by":"crossref","first-page":"53","DOI":"10.2147\/CCIDE.S24064","article-title":"Effects of myrrh on intra-oral mucosal wounds compared with tetracycline- and chlorhexidine-based mouthwashes","volume":"3","author":"Al-Mobeeriek","year":"2011","journal-title":"Clin Cosmet Investig Dent"},{"key":"CIT0026-20260420","first-page":"92","article-title":"Efficacy of myrrh mouth rinse vs. chlorhexidine mouth rinse in maintaining the soft tissue health around dental implants: A comparative study","volume":"27","author":"Al-Zarea","year":"2020","journal-title":"Int J Med Sci"},{"key":"CIT0027-20260420","first-page":"32","article-title":"The anti-plaque effect of miswak and myrrh mouthwashes versus chlorhexidine in the treatment of chronic gingivitis: A comparative clinical 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RAW264.7 macrophages","volume":"63","author":"Cheng","year":"2011","journal-title":"J Pharm Pharmacol"},{"key":"CIT0037-20260420","first-page":"1","article-title":"Myrrh inhibits LPS-induced inflammatory response and protects from cecal ligation and puncture-induced sepsis","volume":"2012","author":"Kim","year":"2011","journal-title":"eCAM"},{"key":"CIT0038-20260420","doi-asserted-by":"crossref","first-page":"13668","DOI":"10.1038\/srep13668","article-title":"Frankincense and myrrh suppress inflammation via regulation of the metabolic profiling and the MAPK signaling pathway","volume":"5","author":"Su","year":"2015","journal-title":"Sci Rep"},{"key":"CIT0039-20260420","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1111\/j.1600-0536.1998.tb05867.x","article-title":"Allergic contact dermatitis from myrrh, a topical herbal medicine used to promote healing","volume":"39","author":"Al\u2010Suwaidan","year":"1998","journal-title":"Contact Dermatitis"},{"key":"CIT0040-20260420","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1111\/j.1600-0536.1999.tb06143.x","article-title":"Allergic contact dermatitis from myrrh","volume":"41","author":"Gallo","year":"1999","journal-title":"Contact Dermatitis"},{"key":"CIT0041-20260420","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1111\/cod.13144","article-title":"Patch test diagnosis of non\u2010immediate cutaneous reaction to myrrh following oral intake of a traditional Chinese medicine decoction","volume":"80","author":"Xu","year":"2018","journal-title":"Contact Dermatitis"},{"key":"CIT0042-20260420","doi-asserted-by":"crossref","first-page":"257","DOI":"10.5935\/1518-0557.20160050","article-title":"Risks of myrrh usage in pregnancy","volume":"20","author":"Al-Jaroudi","year":"2016","journal-title":"JBRA Assist Reprod"}],"container-title":["Journal of International Society of Preventive and Community Dentistry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jispcd.jispcd_160_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:25:42Z","timestamp":1787837142000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jispcd.jispcd_160_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":37,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/jispcd.jispcd_160_25","relation":{},"ISSN":["2231-0762","2250-1002"],"issn-type":[{"value":"2231-0762","type":"print"},{"value":"2250-1002","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-09-18","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-19","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}