Efficacy of 3% Psidium guajava local drug delivery in the treatment of chronic periodontitis: A randomized controlled trial

Abstract

Aim: Herbal products are increasingly used as therapeutic agents in the prevention and management of periodontal diseases to preclude the side effects of antibiotics. A recent addition to the list is the leaves of P guajava, as they possess antimicrobial, anti-inflammatory, and antioxidant properties. This study evaluates the effects of the adjunctive use of 3% P. guajava local drug delivery in the management of chronic periodontitis. Materials and Methods: This was a split-mouth study involving contralateral sites in 15 patients (30 sites), who were randomly treated with either 3% P. guajava gel local drug delivery along with scaling and root planing (SRP) or SRP alone. The primary objective was to evaluate pocket probing depth (PPD), clinical attachment level (CAL), and colony counts of A.actenomycetemcomitans (Aa) and P.gingivalis (Pg); the secondary objective was to evaluate plaque, gingival, and bleeding scores. All parameters were assessed at baseline, one month and three months. The data were analyzed by using SPSS 18.5. Results: There was a significant overall improvement in clinical parameters over the study period. There was a statistically significant reduction in site-specific indices, PPD (2.74 ± 0.283), and gain in CAL (2.8 ± 0.152) in the test sites at three months. Microbiological analysis showed a significant reduction in the colony counts of Aa (17.4 ± 0.026) and Pg (22.7 ± 1.225) in the test sites at one and three months. (P < 0.001). Conclusion: Improvements in clinical and microbiological parameters showed that adjunctive use of locally delivered 3% P. guajava gel is effective in the management of chronic periodontitis.