Crab shells and green tea leaves. Two materials that appear far removed from the field of dentistry have unexpectedly demonstrated great potential as agents for gingival wound healing. This is the key finding of a study published in Archives of Orofacial Sciences (2021) by a research team from Universitas Gadjah Mada, led by Dr. drg. Indra Bramanti, M.Sc., Sp.KGA(K), from the Department of Pediatric Dentistry, Faculty of Dentistry, Universitas Gadjah Mada.
The results were remarkable: green tea extract gel encapsulated in nano-chitosan significantly increased the number of fibroblasts during the proliferative phase of gingival wound healing, with effectiveness comparable to non-steroidal anti-inflammatory drugs (NSAIDs), which have long been considered a standard therapeutic option.
When Gingival Wounds Require More Than Just Time
Wounds in the oral cavity are not trivial. Their healing process occurs through three overlapping phases: inflammation, proliferation, and maturation. During the proliferative phase, fibroblasts become key players. These cells produce collagen, fibronectin, and extracellular matrix components that serve as the foundation for new tissue formation.
However, accelerating this phase is not an easy task. NSAIDs are effective, but their use carries potential risks, including gastrointestinal bleeding, prolonged bleeding time, and impaired kidney function. Therefore, the search for alternatives that are both effective and associated with fewer side effects has become increasingly important.
Green tea (Camellia sinensis) has long been recognized for its high flavonoid content, particularly epigallocatechin gallate (EGCG), which exhibits anti-inflammatory and antioxidant activities. However, the main challenge lies in the delivery system: how can these active compounds be ensured to reach the wound site, become properly absorbed, and function optimally?
The answer comes from chitosan, a polysaccharide extracted from crustacean shells such as crabs and shrimp. In nanoparticle form, chitosan can act as a “vehicle” that enables phenolic compounds to enter the bloodstream and cells more efficiently while protecting their active properties from degradation before reaching their target.
From the Laboratory to Gingival Tissue
The research team, consisting of Dr. drg. Indra Bramanti, M.Sc., Sp.KGA(K), together with Annisa Hidaratri Uningojati, Dilla Asriyani, Urfa Tabtila, Fathul Muin, and Bramanti Nadya Kausara, designed a true experimental study using a post-test-only control group design. The subjects were 24 three-month-old male Wistar rats. Gingival wounds were created on the mandibular labial gingiva using a 2 mm diameter punch biopsy.
Before conducting the in vivo experiment, the team first analyzed the flavonoid content of three types of green tea: Pekoe, Gun Powder, and Green Powder. The results showed that Pekoe tea had the highest flavonoid concentration, reaching 65.211 mg/L. This tea was subsequently encapsulated with nano-chitosan and formulated into a gel containing 20% active compounds. A particle size analyzer confirmed that 77% of the chitosan particles were within the nanoscale range.
For seven days, the four groups of rats received different treatments: Nano-chitosan green tea extract gel, Non-encapsulated green tea extract gel, Base gel as the negative control and Topical NSAID gel (Difflam) as the positive control. On days 5 and 7, gingival tissues were collected, prepared for histological examination using hematoxylin-eosin staining, and observed under a binocular microscope at 400× magnification.
The Numbers Speak for Themselves
The histological findings were highly convincing. On day 5, the average number of fibroblasts in the nano-chitosan green tea gel group reached 46.17 cells, significantly higher than the negative control group, which showed only 28.00 cells. On day 7, the number increased to 51.00 cells, while the negative control group reached only 32.50 cells.
More importantly, statistical analysis showed no significant difference between the nano-chitosan green tea group and the NSAID (Difflam) group on either observation day. This means that the effectiveness of this herbal gel was comparable to conventional anti-inflammatory medication that has been clinically used for many years.
“The administration of green tea extract gel which is encapsulated by nano-chitosan is effective in accelerating the healing of gingival wounds of male Wistar white rats as demonstrated by the increase in the number of fibroblasts.” — Bramanti et al., Archives of Orofacial Sciences, 2021
The biological mechanism behind this finding is also plausible. Flavonoids in green tea are known to stimulate the production of transforming growth factor-β (TGF-β), which promotes fibroblast migration and proliferation toward wound areas. Flavonoids also induce vascular endothelial growth factor (VEGF), which plays a role in new blood vessel formation. Nano-chitosan encapsulation strengthens this effect by ensuring that active compounds are delivered more efficiently and remain stable when reaching the target tissue.
Local Wisdom Awaiting Further Evidence
An interesting aspect of this research lies in its local context: the green tea used in the study was obtained from PT Pagilaran Yogyakarta, while chitosan was derived from crab shells, a material that is widely available in Indonesia. The study explicitly highlights the potential for developing this approach as a form of utilizing Indonesian local resources, with the hope that it may eventually be applied clinically in humans.
Of course, the journey from preclinical testing in animals to clinical application in humans remains long. Further studies are required, including toxicity assessments, pharmacokinetic studies, and rigorous phased clinical trials. Nevertheless, as an early proof of concept, this discovery opens a previously unexplored possibility: that crab shells and tea leaves — two abundant local resources — may hold the key to safer and more affordable wound-healing solutions.
The question now is no longer “Does it work?” but rather “How far can we take it?”
DOI Source: 10.21315/aos2021.16.s1.5
Authors: Nanda Ayu; drg. Achmad Zam Zam Aghasy, M.Kes.
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