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Evaluation of Salvadora persica L. and green tea anti-plaque effect: a randomized controlled crossover clinical trial

Abdulbaqi HR, Himratul-Aznita WH, Baharuddin NA

BMC Complement Altern Med, 2016 Dec 01;16(1):493.
PMID: 27903262

BACKGROUND: In the author's earlier in vitro investigation, a combination of 0.25 mg/ml green tea and 7.82 mg/ml Salvadora persica L. aqueous extracts was found to exhibit significant synergistic anti-bacterial and anti-adherence effects against primary plaque colonizers biofilm. A clinical trial was needed to support these preliminary in vitro results and to investigate its efficacy as a mouthwash in the control of dental plaque.
METHODS: A 24 h plaque re-growth, double-blinded, randomized crossover trial was carried out. Participants (n = 14) randomly rinsed with test formulation, 0.12% chlorhexidine (control) and placebo mouthwashes for 24 h. A week before the trial, all participants received scaling, polishing and oral hygiene education. On the trial day, the participants received polishing at baseline and rinsed with 15 ml of randomly allocated mouthwash twice daily without oral hygiene measures. After 24 h, plaque index was scored and then the participants entered a 6-days washout period with regular oral hygiene measures. The same protocol was repeated for the next 2 mouthwashes.
RESULTS: The results were expressed as mean (±SD) plaque index. The test mouthwash (0.931 ± 0.372) significantly reduced plaque accumulation when compared with placebo (1.440 ± 0.498, p 0.0167).
CONCLUSIONS: The test mouthwash has an anti-plaque effect for a 24 h period. Longer-term clinical studies are highly encouraged to investigate its anti-plaque effect for longer periods.
TRIAL REGISTRATION: This study was registered in ClinicalTrials.gov as NCT02624336 in December 3, 2015.

Matched MeSH terms: Dental Plaque/drug therapy*
The effectiveness of pure Stichopus horrens extract toothpaste in reducing plaque-induced gingivitis following orthodontic bonding: A triple-blinded randomized controlled trial

Bakar NA, Jayah NI, Mohamed NR, Ali SM, Nasir SH, Hashim R, et al.

J World Fed Orthod, 2020 03;9(1):3-8.
PMID: 32672665 DOI: 10.1016/j.ejwf.2019.11.004

INTRODUCTION: Gingivitis is one of the commonest problems faced by patients with fixed appliances (FA) as there is close relation between the appliances to gingival sulcus. Stichopus horrens (SH) is a sea cucumber from the Indo-Pacific that has medical healing properties which have been traditionally used.
OBJECTIVE: To assess the effects of toothpaste containing aqueous SH extract on plaque-induced gingivitis following orthodontic bond-up and to identify the optimal concentration of SH.
METHODS: A single-centred; triple-blinded randomized controlled trial conducted in 40 patients with FA. Participants were randomly assigned to one of the four groups with toothpaste which has concentration of SH extract of 0%, 3%, 6% or 9%. The statistician, the participants and the researchers involved in data collection were kept blinded from the allocation. Gingival Index (GI) and Bleeding on Probing (BOP) for each group were taken at day 0,7,14 and 30.
RESULTS: 9% of SH-containing toothpaste (SHCT) showed most substantial result as there were significance difference of GI (P = 0.020) from Day 7 to 14 and from Day 0 to 14 (P = 0.020). There was also significance difference of BOP from Day 0 to 14 (P = 0.022) and from Day 0 to 30 (P = 0.027). Significant difference was seen in 3% of SHCT group with the decrease of GI (P = 0.004) from Day 1 to 14. There were no significant difference noted for 0% and 6% SHCT.
CONCLUSION: The 9% SHCT is the most effective concentration to reduce both the gingival inflammation (up to day 14) and bleeding on probing (up to day 30).

Matched MeSH terms: Dental Plaque/drug therapy*
The effect of selected plant extracts on the development of single-species dental biofilms

Abdul Rahim ZH, Shaikh S, Hasnor Wan Ismail WN, Wan Harun WH, Razak FA

J Coll Physicians Surg Pak, 2014 Nov;24(11):796-801.
PMID: 25404435 DOI: 11.2014/JCPSP.796801

To determine the effect of a mixture of plant extracts on the adherence and retention of bacteria in dental biofilm.

Matched MeSH terms: Dental Plaque/drug therapy
Long-term clinical effect of adjunctive antimicrobial photodynamic therapy in periodontal treatment: a randomized clinical trial

Alwaeli HA, Al-Khateeb SN, Al-Sadi A

Lasers Med Sci, 2015 Feb;30(2):801-7.
PMID: 24037036 DOI: 10.1007/s10103-013-1426-y

Mechanical removal of microbial biofilm dental plaque from tooth surfaces is important for treatment of periodontal diseases. However, the effectiveness of conventional scaling and root planing (SRP) is affected by the local conditions and residual bacteria which may affect the healing process. We performed a randomized clinical trial to test our hypothesis that adjunctive antimicrobial photodynamic therapy (aPDT) plus SRP has significant effect compared with SRP alone, which can last for 1 year. The study included 136 sites in 16 patients with previously untreated chronic periodontitis, at least one premolar and one molar in every quadrant (minimum, four teeth/quadrant) and at least one tooth with attachment loss of ≥4 mm in every quadrant. In all patients, two randomly assigned quadrants were treated with SRP and the other two were treated with SRP + aPDT. The clinical parameters of probing pocket depth (PPD), bleeding on probing (BOP), and clinical attachment level (CAL) were evaluated at baseline and after 3, 6, and 12 months. There were no significant differences between the two groups at baseline. PPD and BOP showed significant reduction, and CAL showed significant gain from baseline for all three time points in both groups. In addition, there were significantly greater reduction and gain for SRP + aPDT than for SRP at all three time points. No adverse effects of aPDT were observed. These data demonstrate significant improvement in all evaluated clinical parameters for at least 1 year and suggest that aPDT as an adjunctive therapy to SRP represents a promising therapeutic concept for persistent periodontitis.

Matched MeSH terms: Dental Plaque/drug therapy
Efficacy of 'Gamadent' toothpaste on the healing of gingival tissues: a preliminary report

Taiyeb-Ali TB, Zainuddin SL, Swaminathan D, Yaacob H

J Oral Sci, 2003 Sep;45(3):153-9.
PMID: 14650580

The aim of this randomised, parallel, double-blind study, in which 28 adult patients diagnosed with chronic gingivitis or early stages of chronic periodontitis were recruited, was to evaluate the efficacy of 'Gamadent' toothpaste compared to a placebo toothpaste. 'Gamadent' toothpaste has all the basic constituents of a toothpaste with the addition of a sea cucumber extract (SCE) of the species Stichopus sp. 1 to improve the healing potential of tissues. The placebo has the same basic constituents minus the extract. Out of the 28 patients, 14 were placed in the test group who used the 'Gamadent' toothpaste, and 14 patients were placed in the control group (2 control subjects defaulted and were excluded), who brushed using the placebo toothpaste. The longitudinal study was carried out over a period of 3 months with assessments made at baseline, 1 month, 2 months and 3 months after conventional therapy at the baseline visit. The clinical parameters used during the trial were Plaque Index (PI), Gingival Index (GI), Papilla Bleeding Index (PBI) and Probing Pocket Depth (PPD). A predetermined number of sites on a molar, premolar, canine and an incisor were examined and evaluated in each quadrant. After the baseline assessment, the patients had full mouth scaling and debridement as well as oral hygiene instructions. Patients were instructed to brush their teeth twice a day with the toothbrush provided (Oral-B plus, size 35) and toothpaste (test or control), using the Bass technique. At the 1-month assessment, there were significant mean reductions to baseline mean values in PI (P < 0.005) and GI (P < 0.001) in the test group as compared to the control group. At the end of the 2-month interval, significant reductions were observed in PI, PBI and PPD (P < 0.001). By the end of 3 months, there were significant differences in the mean reduction of all the parameters i.e. PI, PBI, GI and PPD (P < 0.001), between the test and control sites. In conclusion, 'Gamadent' toothpaste provided noteworthy benefits, producing statistically significant improvement in all clinical parameters compared to the placebo during the healing phase after conventional initial therapy.

Matched MeSH terms: Dental Plaque/drug therapy*
Anti-plaque effect of a synergistic combination of green tea and Salvadora persica L. against primary colonizers of dental plaque

Abdulbaqi HR, Himratul-Aznita WH, Baharuddin NA

Arch Oral Biol, 2016 Oct;70:117-124.
PMID: 27343694 DOI: 10.1016/j.archoralbio.2016.06.011

OBJECTIVE: Green tea (Gt), leafs of Camellia sinensis var. assamica, is widely consumed as healthy beverage since thousands of years in Asian countries. Chewing sticks (miswak) of Salvadora persica L. (Sp) are traditionally used as natural brush to ensure oral health in developing countries. Both Gt and Sp extracts were reported to have anti-bacterial activity against many dental plaque bacteria. However, their combination has never been tested to have anti-bacterial and anti-adherence effect against primary dental plaque colonizers, playing an initial role in the dental plaque development, which was investigated in this study.
METHODS: Two-fold serial micro-dilution method was used to measure minimal inhibitory concentration (MIC) of aqueous extracts of Gt, Sp and their combinations. Adsorption to hexadecane was used to determine the cell surface hydrophobicity (CSH) of bacterial cells. Glass beads were used to mimic the hard tissue surfaces, and were coated with saliva to develop experimental pellicles for the adhesion of the primary colonizing bacteria.
RESULTS: Gt aqueous extracts exhibited better anti-plaque effect than Sp aqueous extracts. Their combination, equivalent to 1/4 and 1/2 of MIC values of Gt and Sp extracts respectively, showed synergistic anti-plaque properties with fractional inhibitory concentration (FIC) equal to 0.75. This combination was found to significantly reduce CSH (p<0.05) and lower the adherence ability (p<0.003) towards experimental pellicles.
CONCLUSION: Combination between Gt and Sp aqueous extracts exhibited synergistic anti-plaque activity, and could be used as a useful active agent to produce oral health care products.

Matched MeSH terms: Dental Plaque/drug therapy
Fulltext A quaternary ammonium silane antimicrobial triggers bacterial membrane and biofilm destruction

Daood U, Matinlinna JP, Pichika MR, Mak KK, Nagendrababu V, Fawzy AS

Sci Rep, 2020 07 03;10(1):10970.
PMID: 32620785 DOI: 10.1038/s41598-020-67616-z

To study the antimicrobial effects of quaternary ammonium silane (QAS) exposure on Streptococcus mutans and Lactobacillus acidophilus bacterial biofilms at different concentrations. Streptococcus mutans and Lactobacillus acidophilus biofilms were cultured on dentine disks, and incubated for bacterial adhesion for 3-days. Disks were treated with disinfectant (experimental QAS or control) and returned to culture for four days. Small-molecule drug discovery-suite was used to analyze QAS/Sortase-A active site. Cleavage of a synthetic fluorescent peptide substrate, was used to analyze inhibition of Sortase-A. Raman spectroscopy was performed and biofilms stained for confocal laser scanning microscopy (CLSM). Dentine disks that contained treated dual-species biofilms were examined using scanning electron microscopy (SEM). Analysis of DAPI within biofilms was performed using CLSM. Fatty acids in bacterial membranes were assessed with succinic-dehydrogenase assay along with time-kill assay. Sortase-A protein underwent conformational change due to QAS molecule during simulation, showing fluctuating alpha and beta strands. Spectroscopy revealed low carbohydrate intensities in 1% and 2% QAS. SEM images demonstrated absence of bacterial colonies after treatment. DAPI staining decreased with 1% QAS (p

Matched MeSH terms: Dental Plaque/drug therapy