The Effects of Salvia officinalis Gel as an Adjunct to Scaling and Root Planning in Patients with Periodontitis (Clinical and Immunological Study)

Abstract

Background: Phytotherapy is the usage of herbal species with medicinal properties for the management of various diseases. Gingivitis and periodontitis are diseases that involve the role of both the bacteria and the host immune response. Over the years, various researches have shown the importance of herbal products in the management of periodontal diseases. Aims of the study: To evaluate the efficacy of locally applied Salvia officinalis gel as adjunctive in the treatment of chronic periodontitis. Subjects and methods: Fourteen patients (10 males and 4 females) with chronic periodontitis were enrolled in the present study with total number of twenty-eight periodontal pockets utilizing a split mouth design, the pockets were divided into two groups, the test group which was treated with scaling and root planning procedure and the application of the S. officinalis gel, and the control group that treated with scaling and root planning only. Plaque index (PI) and gingival index (GI) were recorded for each site. Gingival crevicular fluid (GCF) was collected from each site by using PerioCol paper strips. The concentration of the transforming growth factor beta-1 in the gingival crevicular fluid was quantified by a high sensitivity enzyme-linked immunosorbent assay. Results: The test group demonstrated a significant reduction in GI at 1-week and 1-month after the treatment comparing to baseline (1.14 vs. 1.64, p = 0.003, and 1.21 vs. 1.64, p = 0.028, respectively), while no significant reduction in the PI at recall visits comparing to baseline. The control group demonstrated no significant reduction in PI and GI at recall visits, comparing to baseline. Both the test and control groups demonstrated no significant reduction in the transforming growth factor-beta 1 concentration in the gingival crevicular fluid at one week after the treatment comparing to baseline, while at one month after the treatment only the test group demonstrated a significant reduction comparing to baseline (3.91 vs. 9.62, p = 0.044). Conclusion: The findings of the present study indicated that the S. officinalis gel has a potential anti-inflammatory role in the treatment of chronic periodontitis by monitoring both the clinical and immunological parameters.