by Jim English
Advanced gum disease involves a significant loss of alveolar bone, the portion of the jaw that attaches to, and anchors, teeth. If left untreated, alveolar bone loss can result in increased loosening and eventual loss of teeth. Advanced gum disease also contributes to a host of additional health problems from increased exposure to bacterial colonies that thrive in the mouth, teeth and gums. These disorders include heart disease and heart attack, stroke, atherosclerosis, prostate swelling, mouth and throat cancer, diabetes, rheumatoid arthritis and osteoporosis.
Loss of alveolar jaw bone is a localized form of osteoporosis, and supplements that support bone and gum growth can aid in restoring healthy alveolar bone to firmly anchor the teeth to prevent tooth loss and aid in chewing.
Over the centuries traditional doctors in China developed a number of herbal formulas to promote bone healing in fractures. Referred to as “bone-knitting herbs,” these specialized formulas were given to speed up bone healing in fractures resulting from farm work, martial arts training, wars and construction work.
Modern research has identified the physiological actions by which traditional bone-knitting herbs work to rebuild bone tissues. Over time a large body of contemporary research has focused on one particular herb that is particularly effective at restoring bone loss arising from periodontal disease. The herb, Drynaria fortunei, is referred to in China as GuSuiBu, literally meaning “mend broken bones.”
Early scientific research on Drynaria focused on its ability to rebuild healthy bone to reverse the effects of osteoporosis. Bone building, called remodeling, requires maintaining a careful balancing act between the destruction of weak, old bone (resorption) and the manufacturing of new, healthy bone (regeneration). When old bone is broken down at a faster rate than new bone is created, the result is osteoporosis. (8,12,13)
Drynaria has been shown to improve bone rebuilding in several examples of excessive bone loss.
- Inhibiting osteoclast function: Osteoclasts are specialized cells that break down old bone to provide a space for healthy new bone. This is a normal, healthy process unless it outpaces the body’s ability to create new bone tissue. Drynaria has been shown to support healthy osteoclast function without entirely halting it, as bisphosphonate drugs do. (3,15,17,18,20,21,22,30,33)
- Stimulating osteoblast function: Osteoblasts are specialized cells within bones that deposit new, healthy bone in the spaces created by osteoclasts. When osteoblasts can’t keep up with the pace of bone resorption, loss of bone tissue accelerates, resulting in osteoporosis. Drynaria has been shown in multiple studies to stimulate osteoblasts to produce more healthy bone tissue. (7,12,18,22,25,26,28,30,32,34,36,39)
- Osteogenesis [mesenchymal cells]: Osteogenesis is the process by which mesenchymal cells in bone marrow differentiate to become new osteoblast cells capable of producing new bone tissue. Not only is it necessary to stimulate osteoblasts to produce bone, but to also stimulate bone marrow to produce new osteoblast cells to replace those lost to disease or apoptosis, the process of natural cell death. Several studies have shown that Drynaria stimulates osteogenesis to provide bones with an adequate supply of new osteoblasts. (1,2,4,5)
- Loss of Ovaries: Accelerated bone loss in recently menopausal women is associated with the loss of ovarian function. Extracts of Drynaria have been shown to provide an anti-osteoporotic effects in female mammals following the loss of ovaries. (1,40)
Drynaria’s Role in Gum Disease and Alveolar bone growth
Impressed with the growing body of studies supporting Drynaria’s role in rebuilding healthy bone, researchers began to examine its application in periodontal disease, where bacterial proliferation and inflammation contribute to the destruction of gum tissues and underlying alveolar bone. They have come up with some very exciting findings.
One group of dental researchers conducted an animal study to see if Drynaria could counter the alveolar bone resorption effects caused by E. Coli bacteria. Their study showed that the extract suppressed bone resorption and promoted bone regeneration. (29)
Other recent studies have shown positive effects on improving alveolar bone remodeling. In a paper published in 2011, scientists with the Department of Oral Medicine, School of Medicine in Hangzhou investigated Drynaria to see if it could reduce alveolar bone loss in rats by stimulating the proliferation and differentiation of osteoblasts. They observed a remarkable decrease in the number of osteoclasts (bone dissolving cells) in the Drynaria-treated group as compared to the control animals.
Significantly, the scientists reported that enhanced differentiation of osteoblastic cells resulted in the growth of new, non-calcified bone-like matrix attached to the root furcation (the base of a tooth where two or more roots meet) by the osteoblasts. In their summary the scientists concluded that Drynaria could be a supplementary medicine for periodontal therapy based on its ability to reduce alveolar bone resorption while support the bone-building effects of osteoblasts. (8)
More recently, in 2012, researchers with the Department of Orthodontics of Shandong University evaluated the bone remodeling effects Drynaria on orthodontic tooth movement (OTM) in female SPF Wistar rats. They found that Drynaria effectively increased the number of osteoblasts and reduced the number of osteoclasts, providing an overall osteogenic effect. (4)
The periodontal ligament is a structure within the gums that helps bind the teeth to the underlying alveolar bone. However, this ligament also produces cells that become bone tissue, so it’s importance in dental health is extremely significant. The dental department of a research hospital in China used an electron microscope to reveal that naringin, one of the active ingredients in Drynaria, actively stimulates protein synthesis and metabolism of human periodontal ligament cells. (17)
These same researchers had previously shown that naringin can promote proliferation and differentiation of human periodontal ligament cells by enhancing alkaline phosphatase (ALP) activity. Alkaline phosphatase activity is an important osteoblast function in building bone. (21)
Similar research at a different hospital also concluded that naringen could promote growth of new human periodontal ligament cells via alkaline phosphatase activity. (10)
The unique actions of Drynaria and its extracts on the periodontal ligament are very important directions of research for natural dental health. Because the periodontal ligament not only serves as structural support for the teeth, but also as a source for regenerating bone tissue, reversing destruction of these ligaments during gum loss is central to halting and repairing periodontal disease. (17,19,21,41)
Additional Health Benefits of Drynaria
- Rheumatoid bone loss: During rheumatoid arthritis, bone is lost due to inflammation. One study has shown that the total flavonoid active ingredients in Drynaria can prevent and treat osteoporosis in rheumatoid arthritis. (12)
- Diabetes and osteoporosis: Researchers throughout the world have identified strong links between diabetes and osteoporosis. One study in China revealed the ability of the total flavonoid content of Drynaria rhizomes to promote osteogenic differentiation of bone marrow cells into bone-building osteoblast cells at different concentrations of exposure to glucose. The study also revealed that Drynaria counters this damage at the highest concentrations of glucose and concludes that the flavonoids may help as a therapy for diabetic osteoporosis. (14)
- Diabetes and periodontitis: There is substantial interaction between diabetes and periodontal problems. Other research supports additional contributions of Drynaria to gum health due to an ability to ameliorate damage from high blood sugar. (5,23)
Isolation and study of active fractions
Medical researchers, of course, also began to identify which active ingredients within Drynaria are responsible for activating healthy physiological actions in bone remodeling. This form of research on medicinal herbs is common in China in attempts to develop new drugs from isolated ingredients. And to improve extraction techniques to standardize herbal products in a way that concentrates identified active ingredients. In the case of Drynaria, however, as research has continued, scientists have noted a wide-variety of active ingredients. (1,2,3,9,10,11,12,13,14,16.22.24,25,26,36)
Since multiple active ingredients in each herb contribute some type of positive physiological stimulus, this supports the argument that using concentrated extracts of the entire herbal part is much better than just a single ingredient molecule.
This promotes safe use of the herb, too. Many active fractions contribute and there is not an excessive concentration of a single ingredient as is the common case with drug medications. A single active fraction does not address all of the factors contributing to any disorder, while at the same time single fractions are the cause of most, if not all, medication side effects.
This same argument speaks for building complex, sophisticated herb formulas, whereby all of the herbs and their active ingredients contribute to the therapeutic efficacy and safety of the remedy.
Drynaria for Dental Health
Periodontal disease, a chronic inflammatory disorder that results in the loss of bone tissues and teeth, affects one out of every two adults aged 30 and over, according to the Centers for Disease Control and Prevention (CDC). A recent study, titled Prevalence of Periodontitis in Adults in the United States: 2009 and 2010, estimates that over 47 percent, or almost 65 million American adults, have mild, moderate or severe periodontitis, the more advanced form of periodontal disease. And for adults 65 and older, the rate of periodontal disease exceeds to 70 percent.
In addition to the pain, misery and embarrassment associated with losing one’s teeth, new research shows a positive link between periodontal disease and increased incidence of other chronic inflammatory disorders, including diabetes, cardiovascular disease, prostatitis and rheumatoid arthritis.
Based on a significant body of contemporary research, Drynaria rhizome has been shown to aid in halting and reversing the destructive loss of gums and alveolar bone that are the hallmark of periodontal disease. Drynaria has also been shown to promote the growth of alveolar bone and the periodontal ligament to aid in restoring and maintaining dental health.
Combined with other herbs in a synergistically balanced formula, (GingiPhase® for example), dyrnaria can aid in supporting optimal periodontal health while addressing a wide range of disorders known to interact with, and contribute to, periodontal disease.
1. Drynaria fortunei-derived total flavonoid fraction and isolated compounds exert oestrogen-like protective effects in bone. Wong KC, Pang WY, Wang XL, Mok SK, Lai WP, Chow HK, Leung PC, Yao XS, Wong MS. Br J Nutr. 2013 Aug;110(3):475-85. doi: 10.1017/S0007114512005405. Epub 2013 Jan 10.
2. Population pharmacokinetics of naringin in total flavonoids of Drynaria fortunei (Kunze) J. Sm. in Chinese women with primary osteoporosis. Wang JN, Jiang JJ, Xie YM, Wei X, Li JP, Duan JL, Xiong X. Chin J Integr Med. 2012 Dec;18(12):925-33. doi: 10.1007/s11655-012-1296-0. Epub 2012 Dec 13.
3. Effects of total flavonoids from Drynaria fortunei on the proliferation and osteogenic differentiation of rat dental pulp stem cells. Huang XF, Yuan SJ, Yang C. Mol Med Rep. 2012 Sep;6(3):547-52. doi: 10.3892/mmr.2012.974. Epub 2012 Jun 29.
4. Effects of traditional Chinese medicine on bone remodeling during orthodontic tooth movement. Wang Y, Wang XX, Zhang LN, Jin SM, Zhang J. J Ethnopharmacol. 2012 Jun 1;141(2):642-6. doi: 10.1016/j.jep.2011.09.003. Epub 2011 Sep 10.
5. Effects of total flavonoids in Drynaria fortunei on osteoblasts differentiation and the expression of ERK1/2 and p38 MAPK after treatment by high glucose in vitro. Zhu XF, Wang TC, Zhang RH, Sun SY, Wang PP, Yang L, Han L, Jin L. Zhong Yao Cai. 2012 Mar;35(3):424-9.
6. Metabonomic study on the anti-osteoporosis effect of Rhizoma Drynariae and its action mechanism using ultra-performance liquid chromatography-tandem mass spectrometry. Liu X, Zhang S, Lu X, Zheng S, Li F, Xiong Z. J Ethnopharmacol. 2012 Jan 6;139(1):311-7. Epub 2011 Nov 20.
7. Nanoparticles prepared from the water extract of Gusuibu (Drynaria fortunei J. Sm.) protects osteoblasts against insults and promotes cell maturation. Hsu CK, Liao MH, Tai YT, Liu SH, Ou KL, Fang HW, Lee IJ, Chen RM. Int J Nanomedicine. 2011;6:1405-13. Epub 2011 Jul 6.
8. Osteogenic effect of Drynariae rhizoma extracts and Naringin on MC3T3-E1 cells and an induced rat alveolar bone resorption model. Chen LL, Lei LH, Ding PH, Tang Q, Wu YM. Arch Oral Biol. 2011 Dec;56(12):1655-62. Epub 2011 Jul 20.
9. Comparison of neoeriocitrin and naringin on proliferation and osteogenic differentiation in MC3T3-E1. Li L, Zeng Z, Cai G. Phytomedicine. 2011 Aug 15;18(11):985-9. Epub 2011 Jul 7.
10. Interventional value of total flavonoids from Rhizoma Drynariae on Cathepsin K, a potential target of osteoporosis. Shi XL, Liu K, Wu LG. Chin J Integr Med. 2011 Jul;17(7):556-60. Epub 2011 Jul 3.
11. Osteogenic effects of flavonoid aglycones from an osteoprotective fraction of Drynaria fortunei–an in vitro efficacy study. Wang X, Zhen L, Zhang G, Wong MS, Qin L, Yao X. Phytomedicine. 2011 Jul 15;18(10):868-72. Epub 2011 Mar 5.
12. Effects of Drynaria total flavonoids on apoptosis of osteoblasts mediated by tumor necrosis factor-α. Huang ZM, Ouyang GL, Xiao LB, Li NL, Gao HL, He Y, Huang Z, Huang XX. Zhong Xi Yi Jie He Xue Bao. 2011 Feb;9(2):173-8.
13. Effect of assembled flavones of Drynariae Rhizome on activity and calcium deposition of bone marrow stem cells of rabbit. Shu X, Hu X, Zhang L. Zhongguo Zhong Yao Za Zhi. 2010 Oct;35(20):2760-3.
14. Effects of drynaria total flavonoid on osteogenic differentiation of bone marrow mesenchymal stem cells at different glucose concentrations: experiment with rats. Shu XC, Zhu DH, Pang TJ, Sun L, Ye LH, Lu HY, Yin DC, Xie DH. Zhonghua Yi Xue Za Zhi. 2010 Oct 19;90(38):2708-12.
15. Anti-inflammatory and analgesic properties of Drynaria quercifolia (L.) J. Smith. Anuja GI, Latha PG, Suja SR, Shyamal S, Shine VJ, Sini S, Pradeep S, Shikha P, Rajasekharan S. J Ethnopharmacol. 2010 Nov 11;132(2):456-60. Epub 2010 Aug 21.
16. Phenylpropanoid and flavonoids from osteoprotective fraction of Drynaria fortunei. Wang XL, Wang NL, Gao H, Zhang G, Qin L, Wong MS, Yao XS. Nat Prod Res. 2010 Aug;24(13):1206-13.
17. Effect of Drynaria fortunei naringin on the total protein content and ultra-structure of human periodontal ligament cells. Jiang JQ, Cai W, Wang ZC, Ding Y, Li XY. Hua Xi Kou Qiang Yi Xue Za Zhi. 2010 Jun;28(3):330-3.
18. Drynaria fortunei J. Sm. promotes osteoblast maturation by inducing differentiation-related gene expression and protecting against oxidative stress-induced apoptotic insults. Hung TY, Chen TL, Liao MH, Ho WP, Liu DZ, Chuang WC, Chen RM. J Ethnopharmacol. 2010 Aug 19;131(1):70-7. Epub 2010 Jun 8.
19. Traditional Chinese medicine Drynaria fortunei J. Smith naringin promotes proliferation and differentiation of human periodontal ligament cells. Hu QY, Chen LL, Wang RF. Zhejiang Da Xue Xue Bao Yi Xue Ban. 2010 Jan;39(1):79-83.
20. Effect of a novel botanical agent Drynol Cibotin on human osteoblast cells and implications for osteoporosis: promotion of cell growth, calcium uptake and collagen production. Wegiel B, Persson JL. Phytother Res. 2009 Dec 1. [Epub ahead of print]
21. Effects of Drynaria fortunei naringin on proliferation, alkaline phosphatase activity of human periodontal ligament cells. Jiang JQ, Ding Y, Li XY, Cai W, Wang ZC. Hua Xi Kou Qiang Yi Xue Za Zhi. 2009 Oct;27(5):538-41.
22. Effects of total flavonoids from Rhizoma Drynariae medicated serum on proliferation, differentiation, cell cycle and apoptosis of osteoblasts in vitro. Zhang J, Li HP, Yang PL, Liu YH, Yang BH. Zhong Yao Cai. 2009 Jul;32(7):1090-3.
23. Promotion of bone formation by naringin in a titanium particle-induced diabetic murine calvarial osteolysis model. Zhou X, Zhang P, Zhang C, Zhu Z. J Orthop Res. 2010 Apr;28(4):451-6.
24. Effects of naringin on the proliferation and osteogenic differentiation of human bone mesenchymal stem cell. Zhang P, Dai KR, Yan SG, Yan WQ, Zhang C, Chen DQ, Xu B, Xu ZW. Eur J Pharmacol. 2009 Apr 1;607(1-3):1-5.
25. Effects of eleven flavonoids from the osteoprotective fraction of Drynaria fortunei (KUNZE) J. SM. on osteoblastic proliferation using an osteoblast-like cell line. Wang XL, Wang NL, Zhang Y, Gao H, Pang WY, Wong MS, Zhang G, Qin L, Yao XS. Chem Pharm Bull (Tokyo). 2008 Jan;56(1):46-51.
26. Stimulative activity of Drynaria fortunei (Kunze) J. Sm. extracts and two of its flavonoids on the proliferation of osteoblastic like cells. Li F, Meng F, Xiong Z, Li Y, Liu R, Liu H. Pharmazie. 2006 Nov;61(11):962-5.
27. Systemic effect of crude extract from rhizome of Drynaria fortunei on bone formation in mice. Wong RW, Rabie AB. Phytother Res. 2006 Apr;20(4):313-5.
28. Effects of traditional chinese medicine Drynaria fortunei smith on promoting the proliferation, differentiation and calcification of mouse osteoblastic MC3T3-E1 cells. Tang Q, Chen LL, Yan J. Zhongguo Zhong Yao Za Zhi. 2004 Feb;29(2):164-8.
29. Therapeutic effect of aqueous-extract from a traditional Chinese medical herb Drynaria fortunei on rat experimental model of alveolar bone resorption. Chen LL, Tang Q, Yan J. Zhongguo Zhong Yao Za Zhi. 2004 Jun;29(6):549-53.
30. The effect of Gu-Sui-Bu (Drynaria fortunei) on bone cell activity. Sun JS, Thériault BL, Anderson GI. Am J Chin Med. 2004;32(5):737-53.
31. Effects of Drynariae rhizoma on the proliferation of human bone cells and the immunomodulatory activity. Jeong JC, Lee BT, Yoon CH, Kim HM, Kim CH. Pharmacol Res. 2005 Feb;51(2):125-36.
32. Stimulative effects of Drynariae Rhizoma extracts on the proliferation and differentiation of osteoblastic MC3T3-E1 cells. Jeong JC, Lee JW, Yoon CH, Lee YC, Chung KH, Kim MG, Kim CH. J Ethnopharmacol. 2005 Jan 15;96(3):489-95. Epub 2004 Nov 14.
33. Inhibitory activity of Drynariae rhizoma extracts on cathepsin having bone resorption activity. Jeong JC, Yoon CH, Jeong CW, Lee YC, Chang YC, Kim CH. Immunopharmacol Immunotoxicol. 2004 Aug;26(3):373-85.
34. Drynariae Rhizoma promotes osteoblast differentiation and mineralization in MC3T3-E1 cells through regulation of bone morphogenetic protein-2, alkaline phosphatase, type I collagen and collagenase-1. Jeong JC, Lee JW, Yoon CH, Kim HM, Kim CH. Toxicol In Vitro. 2004 Dec;18(6):829-34.
35. Antiosteoporotic activity of the water extract of Dioscorea spongiosa. Yin J, Tezuka Y, Kouda K, Tran QL, Miyahara T, Chen Y, Kadota S. Biol Pharm Bull. 2004 Apr;27(4):583-6.
36. Proliferative effects of flavan-3-ols and propelargonidins from rhizomes of Drynaria fortunei on MCF-7 and osteoblastic cells. Chang EJ, Lee WJ, Cho SH, Choi SW. Arch Pharm Res. 2003 Aug;26(8):620-30.
37. The effect of Chinese medicine on bone cell activities. Lin CY, Sun JS, Sheu SY, Lin FH, Wang YJ, Chen LT. Am J Chin Med. 2002;30(2-3):271-85.
38. The effect of Gu-Sui-Bu (Drynaria fortunei J. Sm) on bone cell activities. Sun JS, Lin CY, Dong GC, Sheu SY, Lin FH, Chen LT, Wang YJ. Biomaterials. 2002 Aug;23(16):3377-85.
39. Cytotoxic and antioxidant effects of the water extract of the traditional Chinese herb gusuibu (Drynaria fortunei) on rat osteoblasts. Liu HC, Chen RM, Jian WC, Lin YL. J Formos Med Assoc. 2001 Jun;100(6):383-8.
40. Study of morphologic effects of 4 Chinese herbs by bone histomorphometry in ovariectomized rats. Ma Z, Wang R, Qiu M. Zhonghua Fu Chan Ke Za Zhi. 1999 Feb;34(2):82-5.
41. Effects of Lycium barbarum L and Drynaria fortunei J Smith on in vitro attachment and growth of human gingival fibroblasts on root surfaces. Liu B. Zhonghua Kou Qiang Yi Xue Za Zhi. 1992 May;27(3):159-61, 190.