Abstract
BackgroundThe control of biofilm adherence on tooth surface has always been the keystone of periodontal therapeutic systems. However, prevalence of gingivitis suggest inadequacy of self-performed oral hygiene measures and need for adjunctive aid for mechanical plaque control. Oral rinses containing chlorhexidine, has been widely used however, with certain limitations. Herbal products have been used widely reflecting its action as alternative and complementary remedy. Hence, the purpose of the present study was to evaluate the antimicrobial and antioxidant efficacy of a Guava leaf extract based mouthrinse in patients with chronic generalized gingivitis as an adjunct to oral prophylaxis.MethodsSixty subjects (n = 20) in compliance with the inclusion criteria were randomly assigned to one of the 3 study groups i.e. Group A- 0.15%Guava mouth rinse, Group B- 0.2% Chlorhexidine (CHX) mouth rinse, Group C- Distilled water (placebo). All the participants received professional oral prophylaxis and were dispensed with experimental mouth rinses and instructed to use for period of 30 days. Clinical parameters such as gingival index, plaque index along with microbial colony forming units using plaque samples and antioxidant levels in saliva were estimated at baseline, 30 and 90 days’ time intervals.ResultsAll 3 groups showed gradual reduction in GI, PI and microbial counts. Considering the mean scores of recorded parameters at the scheduled time intervals, notable changes were observed between chlorhexidine and guava mouth rinse compared to placebo group. Although there was improvement in the antioxidant status in all study participants, yet there was no statistically significant difference observed.ConclusionGuava mouth rinse can be used as an empirical adjunct to professional oral prophylaxis owing to its multifactorial properties and favourable acceptance. However, long term studies need to be conducted to validate its use for an extended period of time.Trial registrationThe clinical trial has been prospectively registered on 17th February 2017 by the Clinical Trials Registry-India (CTRI/2017/02/007898).
Highlights
The control of biofilm adherence on tooth surface has always been the keystone of periodontal therapeutic systems
Chronic gingivitis is widely accepted as the preliminary phase to a destructive process which gradually results in the loss of both soft and hard tissues surrounding the teeth
Taking into account the antioxidant status, the current study demonstrated statistically significant improvement in all test groups at the recall visits, which probably could be attributed to the professional prophylaxis rendered at baseline and reinforcement of oral hygiene instructions at recall intervals
Summary
The control of biofilm adherence on tooth surface has always been the keystone of periodontal therapeutic systems. Prevalence of gingivitis suggest inadequacy of self-performed oral hygiene measures and need for adjunctive aid for mechanical plaque control. Chlorhexidine (CHX) mouthrinse have been universal since decades, owing to its varied side-effects (mainly staining and taste alteration), these are not recommended for a long term use [3]. This extended disproportionate use of synthetic antimicrobials and compounds have resulted in creating resistance and degrading its benefits. Various randomized clinical trials [4,5,6] have been conducted and proven to exhibit the use of phytochemicals as an alternative therapy for management of systemic and dental diseases
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