Evaluation of morinda citrifolia ethanolic extract versus morinda citrifolia fresh fruit juice for tissue response and systemic toxicity in animal model.

Introduction: An ideal irrigant should exhibit good antimicrobial activity along with smear removal. Various plant extracts have been used for disinfection of the root canal system. The present study aims in evaluating the tissue response and systemic toxicity of ethanolic extract of Morinda citrifolia versus Morinda citrifolia fresh fruit juice in an animal model. Materials and Methods: A total 48 female adult wistar albino rats were randomly allocated into 4 groups as Group I- 3% sodium hypochlorite (n = 12), Group II- Saline (Control) (n = 12), Group III- ethanolic extract of Morinda citrifolia (n = 12), Group IV- Morinda citrifolia Fresh Fruit Juice (n = 12). A trough was made in the periapical bone, and the test sample was placed in the respective groups. The animals were euthanized for 7th day, 14th day and 30th day and the tissue specimen was prepared for histopathological evaluation, and serum analysis was done for oxidative stress markers, liver and renal function tests. Results: Serum analysis exhibited significant elevation of Alkaline Phosphatase (ALP), Glutathione Peroxidase (GPX) and Glutathione Reductase (GR) and histopathology showed a higher inflammatory response at 7th and 14th days in group II and group III (p < 0.05), as compared to the other groups. At the 30th day time interval, there was no statistically significant difference in serum analysis and inflammatory response, in all the four groups analysed (p > 0.05). Conclusion: Ethanolic extract of Morinda citrifolia was not biocompatible and more cytotoxic than a Morinda citrifolia fresh fruit juice. So, fresh fruit juice of Morinda citrifolia can be a preferred choice of natural root canal irrigant, with least possible cytotoxic effects as compared to the ethanolic extract.

Antibacterial efficacy of conventional versus herbal products on Streptococcus mutans in adult population- a systematic review & meta-analysis / Eficácia antibacteriana de produtos convencionais e fitoterápicos frente a Streptococcus mutans em adultos - uma revisão sistemática e meta-análise

Background: Dental caries is challenging infectious disease, which is wide spread and difficult to control. Although it's multifactorial, microorganisms especially cariogenic Streptococcus mutans plays a wide role in initiation and progression of dental caries. Objective: The present review mainly aimed to evaluate and assess the antibacterial efficacy of herbal versus conventional products on Streptococcus mutans. Data Sources: A search was execute in electronic database (i.e., PUBMED CENTRAL,COCHRANE, LILAC, SCIENCEDIRECT, GOOGLE SEARCH) using following search terms alone and in combination by means of PUBMED search builder from January 1990 up to July 2019. Study Eligibility Criteria: Studies were stipulate if they met the following criteria: In vivo studies comparing herbal and conventional products on anticariogenic or antibacterial activity on Streptococcus mutans were selected. Participants and Intervention: Adult patients aged from 18-65 years with dental caries undergoing intervention of herbal products. Study Appraisal and Synthesis Material and Methods: Out of 225 studies collected from databases, only 6 studies were included and other 6 were collected by hand search. Finally 12 included studies were analyzed out of which 5 studies were considered for meta-analysis. Results: The results unveil that natural products exerted virtually homogeneous antibacterial effect against Streptococcus mutans when compared with the counterpart. Limitations: Review was assessing on patients with dental caries and studies previously assessed did not mention about the caries risk. Prevalence varies based on caries risk assessments. Study was concentrating only on single species Streptococcus mutans. But ideally caries is multifactorial. Conclusion: Although natural products were effective, the present systematic review does not furnish concrete evidence to a show increased antibacterial efficacy of natural products as compared to conventional products. (AU)

Introdução: A cárie dentária é um desafio para as doenças infecciosas, que são amplamente disseminadas e de difícil controle. Embora seja multifatorial, os microrganismos cariogênicos, em especial o Streptococcus mutans, desempenham um amplo papel na iniciação e progressão da cárie dentária. Objetivo: A presente revisão teve como objetivo principal avaliar a eficácia antibacteriana de produtos fitoterápicos em comparação com produtos convencionais frente a Streptococcus mutans. Os dados foram obtidos através de uma pesquisa executada em um banco de dados eletrônico (PUBMEDCENTRAL, COCHRANE, LILAC, SCIENCEDIRECT, GOOGLE SEARCH) usando termos isoladamente ou associados, por meio do construtor de pesquisa PUBMED, de janeiro de 1990 a julho de 2019. Foram selecionados estudos que atendessem aos seguintes critérios de elegibilidade: estudos in vivo comparando produtos à base de plantas e produtos convencionais sobre a atividade anticariogênica ou antibacteriana de Streptococcus mutans. Os participantes envolvidos consistiam de pacientes adultos de 18 a 65 anos com cárie dentária submetidos a intervenção de produtos fitoterápicos. Material e métodos: de 225 estudos coletados de bancos de dados eletrônicos, apenas 6 estudos foram incluídos e outros 6 foram selecionados por pesquisa manual. Finalmente, 12 estudos incluídos foram analisados, dos quais 5 foram considerados para meta-análise. Resultados: Os resultados revelaram que os produtos naturais exerceram efeito antibacteriano homogêneo contra o Streptococcus mutans quando comparados com a contraparte. Limitações: A revisão avaliou pacientes com cárie dentária e os estudos prévios não mencionavam o risco de cárie. A prevalência varia com base nas avaliações de risco de cárie. O estudo se concentrou apenas em uma única espécie de Streptococcus mutans, mas a cárie dentária é de origem multifatorial. Conclusão: Embora os produtos naturais tenham sido eficazes, a presente revisão sistemática não fornece evidências concretas para mostrar um aumento da eficácia antibacteriana dos produtos naturais em comparação com os produtos convencionais.(AU)