Clinical and antioxidant efficacy of 4% mangosteen gel as a local drug delivery in the treatment of chronic periodontitis: A placebo-controlled, split-mouth trial.

Abstract

Currently, the knowledge on the clinical effect of 4% mangosteen gel as a local drug delivery, adjunctive to non-surgical periodontal therapy, on the gingival crevicular fluid (GCF) total antioxidant capacity (TAOC) levels in chronic periodontitis patients is limited. The aim of the study was to evaluate and compare the efficacy of 4% mangosteen gel and a placebo gel as an adjunct to scaling and root planing (SRP) on clinical and biochemical parameters in chronic periodontitis patients. A total of 50 test sites from 25 patients with Stage II Grade B periodontitis were randomly divided into 2 groups. The experimental group was treated with SRP followed by a single subgingival application of 4% mangosteen gel, while the control group was treated with SRP followed by a single subgingival application of a placebo gel. Clinical parameters, including the plaque index (PI), the gingival bleeding index (GBI), the probing depth (PD), the relative attachment level (RAL), as well as biochemical parameters, i.e., the GCF TAOC levels, were evaluated using an ABTS (2,2'-Azino-bis-3-ethylbenzothiazoline-6-sulfonic acid) antioxidant assay kit at baseline (D0) and at 3 months (D3). The full-mouth PI and GBI values were significantly lower at D3 in comparison with D3. The experimental sites showed a significantly greater reduction in the PD and RAL scores as compared to control, and the GCF TAOC levels revealed a substantial rise throughout the study period, reversing from negative values at D0 to positive values at D3 in the experimental group. Traditional SRP with the adjunctive local delivery of 4% mangosteen gel demonstrated an added benefit in improving clinical and biochemical parameters, and thereby encouraging the use of the mangosteen gel in clinical practice for the management of moderate chronic periodontitis.