The Efficacy of 5% Propolis Gel in the Treatment of Primary Herpetic Gingivostomatitis in Children and Its Effect on Salivary IFN-γ Levels: A Parallel Randomized Controlled Pilot Trial

Abstract This pilot trial was designed to investigate the efficacy of propolis-based gel in the treatment of primary herpetic gingivostomatitis in children and assessed salivary IFN-γ levels before and after treatment to reflect the anti-inflammatory action of propolis, as IFN-γ is one of the principle cytokines involved in the disease pathogenesis. A total of 60 patients were randomized using a computer-generated sequence and allocated into the two study groups: intervention group treated with 5% propolis gel and placebo group treated with placebo mucoadhesive gel. Both were applied on the oral lesion two to three times daily for 1 week. At follow-up visit after 7 days, the following parameters were measured; severity of clinical lesions, pain assessment using visual analog scale, salivary IFN-γ levels using ELISA, as well as eating and drinking ability. Results revealed a statistically significant difference in pain scores, clinical severity scores, and the ability to eat and drink between the propolis and placebo groups on the 7th day of treatment (p ≤ 0.001, each). Furthermore, values for salivary IFN-γ showed statistically significant differences between the propolis and placebo groups on the 7th day of treatment (p ≤ 0.001). Moreover, in the propolis group, there were statistically significant differences in all clinical parameters, including pain scores, clinical severity scores, and the ability to eat and drink, as well as IFN-γ levels before and after treatment (p ≤ 0.001, p ≤ 0.001, 0.014, and p ≤ 0.001, respectively). In the placebo group, although there was a statistically significant reduction in pain scores, the ability to eat and drink, and salivary IFN-γ level before and after treatment (p ≤0.001 and p = 0.033 and 0.013, respectively), but there was no statistically significant difference in scores of clinical severities before and after treatment (p = 0.099). Propolis showed promising therapeutic effects that could avoid the mishaps of the currently used medications for the management of primary herpetic gingivostomatitis in children.