Gingivitis crónica y otros campos de interferencia en pacientes con artritis del hombro

Introducción: La odontología holística es parte de la medicina biológica o neurofocal, dirigida a la prevención, el diagnóstico y el tratamiento relacionados con las enfermedades del sistema estomatognático en correlación con otras estructuras anatómicas, a fin de tratar al paciente de manera integral, en cuerpo, mente y alma. Objetivo: Identificar la presencia de gingivitis crónica y de otros campos de interferencia en pacientes con artritis del hombro. Métodos: Se realizó un estudio observacional, descriptivo y transversal de 24 pacientes con artritis del hombro, pertenecientes al área de salud del Policlínico Docente Carlos Juan Finlay en Santiago de Cuba, quienes fueron atendidos en la Clínica Estomatológica Provincial Docente Mártires del Moncada, desde noviembre del 2021 hasta mayo del 2022. Resultados: En la serie predominaron el sexo femenino (62,5 %) y el grupo etario de 35-59 años (75,0 %). De igual modo, la mayoría de los pacientes padecía gingivitis crónica (87,5 %), en tanto, los otros campos de interferencia mayormente hallados fueron la placa dentobacteriana (100 %) y la caries dental (58,3 %), que figuraron en todos los molares según el holograma del microsistema de dientes alemán. Conclusiones: Los campos de interferencia identificados con más frecuencia en la casuística fueron la gingivitis crónica grave, la placa dentobacteriana y la caries dental, los cuales estuvieron asociados a la artritis del hombro que aquejaba a los pacientes.

Introduction: Holistic dentistry is part of the biological or neurofocal medicine, directed to the prevention, diagnosis and treatment related to the diseases of the stomatognatic system in correlation with other anatomical structures, in order to treat the patient in an integral way, in body, mind and soul. Objective: To identify the presence of chronic gingivitis and other interference fields in patients with shoulder arthritis. Methods: An observational, descriptive and cross-sectional study of 24 patients with shoulder arthritis was carried out, who belonged to the health area of Carlos Juan Finlay Teaching Polyclinic in Santiago de Cuba. They were assisted in Mártires del Moncada Teaching Provincial Stomatological Clinic, from November, 2021 to May, 2022. Results: In the series there was a prevalence of the female sex (62.5%) and the 35-59 age group (75.0%). In a same way, most of the patients suffered from chronic gingivitis (87.5%), as long as the other mostly found interference fields were the dentobacterial plaque (100%) and dental cavity (58.3%) that were in all the molars according to the hologram of the German teeth microsystem. Conclusions: Severe chronic gingivitis, dentobacterial plaque and dental cavity were the most frequently identified interference fields in the case material, which were associated to the shoulder arthritis in patients.

Ayurvedic and herbal plaque control agents in gingivitis: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Since the effectiveness of ayurvedic and herbal plaque control agents in reducing plaque in gingivitis is inconsistent across multiple trials, we conducted a study to evaluate their overall effect on dental plaque index (PI), gingival index, and bacterial colony counts (CC) of debris in gingivitis patients. MATERIALS AND METHODS: We searched major electronic biomedical databases (PubMed/Medline, CAM-QUEST®, EBSCOhost, Google Scholar, EMBASE, Scopus, and Cochrane Central Register of Controlled Trials) from August 2004 to August 2021 for randomized control trials on gingivitis using ayurvedic, herbal plaque control agents, and oil pulling therapy as interventions. We grouped comparable outcome parameters of similar products and estimated the standard mean difference (SMD) for pooled effect size with 95% confidence intervals (CI) using RevMan 5.4.1 software. Risk-of-bias (ROB) assessment followed the Cochrane Collaboration's recommended approach. RESULTS: We found 554 articles of 2,806 patients after searching of which 41 randomized clinical trials were considered for meta-analysis. Ayurvedic plaque control agents (Plaque index (PI): SMD = -0.52, 95% CI (-0.94, -0.11); CC: SMD = -1.70, 95% CI (-5.06, 1.67)), (Oil pulling therapy: PI: SMD = -0.38, 95% CI (-1.45, 0.68); CC: SMD = -1.04, 95% CI (-2.20, 0.11)), (Herbal plaque control agents: PI: SMD = -0.58, 95% CI (-1.55, 0.39)), (Triphala: PI: SMD = -0.65, 95% CI (-1.32, 0.03)) were found as good as control. Significant reduction in the gingival index and bacterial colony count was also seen. CONCLUSIONS: In addition to conventional dental care, ayurvedic and herbal plaque control agents may help in plaque reduction, gingival inflammation, and bacterial growth. They are safe and may be recommended in community dentistry practices.(PROSPERO registration number: CRD42021274656).

A tangible prospect for the treatment of gingivitis using a potentially probiotic strain Lactobacillus plantarum MK06 isolated from traditional dairy products: a triple blind randomized clinical trial.

BACKGROUND: Frequent bacterial plaque buildup at the gingival margin and crevice can provoke an inflammatory reaction in gingival tissues which manifests as gingivitis. Probiotics could serve as a beneficial complementary therapy for treating gingival inflammation. The main aim of this research was to investigate the effect of the Lactobacillus plantarum MK06 probiotic strain on the treatment of gingivitis. METHODS: Patients with gingivitis, who were referred to a private clinic and were systematically healthy, were included in this randomized, triple-blind, placebo-controlled trial. They were instructed to use either placebo or Lactobacillus plantarum suspensions for one minute two times a day after tooth-brushing for four weeks. Then, the clinical parameters of gingivitis, including plaque index (PI), gingival index (GI), bleeding on probing (BOP), and oral hygiene index (OHI-s), were measured in the first, second, and fourth weeks. A total of forty-two patients were randomly assigned to the experimental (n = 21) and control (n = 21) groups. The mean age of the experimental and control groups was 29.10 and 28.48, respectively. RESULTS: The mean scores of BOP, GI, PI, and OHI-s reduced over time in both the control and test groups. However, according to the Mann-Whitney test, the difference between the two groups was not significant at the same time intervals (P ≥ 0.05) and only GI showed a significant difference in the fourth week (GI-3, P = 0.006). Nevertheless, the experimental group experienced a higher overall reduction rate than the control group. The BOP, GI, PI, and OHI-s scores decreased by 0.081, 0.204, 0.186, and 0.172 times in the second week, respectively, resulting from the interaction of time and the intervention, which considerably diminished these indices. CONCLUSION: This study shows the potential of the probiotic Lactobacillus plantarum MK06 suspension as a promoting therapeutic adjuvant in the treatment of gingivitis.

Effectiveness of Herbal, Homeopathic and Conventional Dentifrices on Dental Caries - A Double-Blind Randomised Controlled Trial.

PURPOSE: To compare the effectiveness of ayurvedic, homeopathic and conventional dentifrices on plaque and saliva in terms of cariogenic bacteria, salivary pH, and plaque pH. MATERIALS AND METHODS: This double-blinded, parallel-group, randomised controlled trial was performed at Saveetha Dental College and Hospitals, Chennai, India. The participants comprised healthy adults possessing more than 20 permanent natural teeth and having a Decayed Missing and Filled Teeth (DMFT) score, plaque index score, and gingival index score less than or equal to 2. There were 3 intervention groups: 1: herbal dentifrice (Dabur Meswak); 2: homeopathic dentifrice (Gum Forte gel); 3: fluoride dentifrice (Colgate Total). The outcome measures were as follows: plaque and saliva samples were evaluated for pH; colony counts of Streptococcus mutans and Lactobacillus at baseline, 14 and 28 days of follow-up. One-way and repeated measures ANOVA, Wilcoxon signed-rank and Kruskal Wallis tests were used to compare the mean differences of plaque and salivary pH and plaque and salivary S. mutans and Lactobacillus counts at baseline, 14 and 28 days. RESULTS: The mean S. mutans and Lactobacillus counts in plaque and saliva decreased statistically significantly in all treatment groups at the 28-day follow-up. Mean plaque pH was not statistically significantly different at the 14-day follow-up (p-value = 0.16). On the 28th day, group 1 (7.64 ± 0.20) showed the highest increase in plaque pH followed by group 2 (7.39 ± 0.25) and group 3 (7.27 ± 0.19), which was found to be statistically significant. No statistically significant difference in mean salivary pH was observed between the three groups at the different time points. CONCLUSION: This study reveals that the herbal dentifrice tested here was effective in reducing cariogenic bacterial count and increasing the plaque pH, thereby warranting the usage of the same.

A Randomized Double-Blind Clinical Trial Evaluates the Efficacy of Alternative Herbal Mouthwashes.

INTRODUCTION: The removal of dental plaque is the primary step in achieving good oral hygiene. Mechanical plaque removal measures have questionable efficacy in inaccessible areas and proximal aspects of the oral cavity. Out of the several types of mouthwash available, chlorhexidine (CHX) is regarded as the gold standard, but considering its adverse effects, herbal alternatives are being sought after. So, the aim of the study was to evaluate the efficacy of alternative herbal mouthwashes. MATERIALS AND METHODS: In this randomized, double-blind study, 125 selected patients were divided into five groups. Group 1: negative control - distilled water (DW); group 2: positive control - hexidine mouthwash (ICPA, Gujarat, India); group 3: FeelFresh Herbal Mouthcare Gargle (Able Exports, Gujarat, India); group 4: HiOra mouthwash (Himalaya Wellness Company, Bengaluru, India); group 5: Colgate MaxFresh Fresh Tea mouthwash (Colgate-Palmolive, India). Plaque index (PI), gingival index (GI), and microbial count (CFU) were evaluated before and after the intervention. RESULTS: The difference among the three types of herbal mouthwash was statistically non-significant. The lowest PI, GI, and CFU values were obtained in the subjects of group 4. CONCLUSION:  Herbal mouthwashes are a promising alternative and are effective in maintaining oral hygiene.

Evaluation of Anti-plaque and Anti-gingivitis Efficacy of Two Commercially Available Herbal and Non-herbal Toothpastes.

BACKGROUND:  Plaque-associated oral disease affects a considerable portion of the population and is considered one of the major causes of tooth loss. The presence of plaque may be the reason for dental caries, gingivitis, periodontal problems, and halitosis. Many mechanical aids are used to control plaque, including toothbrushes, dental floss, mouth rinses, and dentifrices, and the most effective method of controlling gingivitis is supragingival plaque control. AIM AND OBJECTIVE: To evaluate and compare the anti-plaque and anti-gingivitis efficacy of commercially available herbal toothpaste (Meswak) and non-herbal toothpaste (Pepsodent). MATERIALS AND METHOD: 50 subjects aged between 10 and 15 years with a full complement of dentition were included in the study. The two toothpastes were provided to the subjects in plain white tubes by the investigator. Subjects were instructed to brush their teeth twice daily using the given toothpaste for 21 days. Plaque and gingival scores on days 0, 7, and 21 were recorded, and the data were subjected to statistical analysis. RESULT: At the end of the 21-day study, there was a statistically significant difference between the groups for plaque and gingival scores. CONCLUSION: The plaque and gingival scores were significantly reduced throughout the study in both groups. In comparison, the herbal dentifrices show more effectiveness in reducing plaque and gingival scores, but no statistically significant difference was seen between the two groups.

Comparison of the plaque regrowth inhibition effects of oil pulling therapy with sesame oil or coconut oil using 4-day plaque regrowth study model: A randomized crossover clinical trial.

OBJECTIVES: The aim of this study was to compare the plaque-inhibiting effects of oil pulling therapy with sesame oil or coconut oil using 4-day plaque regrowth study model. METHODS: This clinical observer-masked, randomized, crossover designed study involved 24 participants. The participants received professional prophylaxis in the preparatory period and after that subjects started to use the allocated mouthrinse (coconut oil or sesame oil). On day 5, periodontal clinical parameters including plaque index (PI), gingival index (GI), stain index (SI) and bleeding on probing (BOP) were recorded. Subjects underwent a 14-day wash out period and then used the other mouthrinse for 4 days. RESULTS: Oil pulling therapy with coconut oil or sesame oil exhibited similar plaque regrowth inhibition (PI = 1.60 ± 0.28 and 1.49 ± 0.22, for oil pulling with coconut oil and sesame oil, respectively) and tooth staining (SI = 0.20 ± 0.11 and 0.21 ± 0.09, for oil pulling with coconut oil and sesame oil, respectively.) In addition, GI and BOP were similar in both groups (GI = 0.61 ± 0.19 and 0.69 ± 0.16; BOP = 0.09 ± 0.24 and 0.03 ± 0.03 for oil pulling with coconut oil and sesame oil, respectively). CONCLUSIONS: Oil pulling therapy with coconut or sesame oil showed similar results in terms of plaque regrowth inhibition and tooth staining. According to the present results, both coconut oil and sesame oil can be used for oil pulling therapy with the aim of plaque regrowth inhibition.

A systematic review and meta-analysis on the comparative effectiveness of Salvadora persica - extract mouthwash with chlorhexidine gluconate in periodontal health.

ETHNOPHARMACOLOGICAL RELEVANCE: Salvadora persica L., also known as miswak, is an indigenous plant most prevalent in the Middle Eastern, some Asian, and African countries. It has medicinal and prophylactics function for numerous illnesses, including periodontal disease. Various trials, apart from World Health Organization encouragement have contributed to the production and use of S. persica in extract form in the formulation of mouthwash. This systematic review and meta-analysis aimed to compare the clinical effect of Salvadora persica-extract mouthwash and chlorhexidine gluconate mouthwash for anti-plaque and anti-gingivitis functions. METHODS: Using the PRISMA 2020 Protocol, a systematic search of the publications was undertaken from the MEDLINE, CENTRAL, Science Direct, PubMed, and Google Scholars for randomized control trials published through 31st January 2022 to determine the effectiveness of Salvadora persica-extract mouthwash relative to chlorhexidine gluconate as anti-plaque and anti-gingivitis properties. RESULTS: A total of 1809 titles and abstracts were screened. Of these, twenty-two studies met the inclusion criteria for the systematic review while only sixteen were selected for meta-analysis. The overall effects of standardized mean difference and 95% CI were 0.89 [95% CI 0.09 to 1.69] with a χ2 statistic of 2.54, 15 degrees of freedom (p < 0.00001), I2 = 97% as anti-plaque function and 95% CI were 0.12 [95% CI -0.43 to 0.67] with a χ2 statistic of 0.68 with 10 degree of freedom (p < 0.00001), I2 = 89% as anti-gingivitis. CONCLUSION: This review suggests that Salvadora persica-extract mouthwash causes a significant reduction of plaque and gingival inflammation. While the improvement is inferior to chlorhexidine gluconate mouthwash, S. persica-extract mouthwash may be considered as a herbal alternative to the user pursuing periodontal care with natural ingredients.

Comparative Evaluation of the Phytochemical Analysis and Efficacy of Four Plant-derived Extracts against Streptococcus mutans: An In Vitro Study.

Introduction: Oral health is a loyal part of general health. As per the World Health Organization (WHO), dental caries is the most widespread noncommunicable disease and is a significant universal public health concern. The main causative organism associated with this disease is Streptococcus mutans (S. mutans). Various synthetic agents like chlorhexidine and fluorides are commercially available to prevent dental caries. However, these have side effects. Presently, research is engaged in the use of plant extracts to develop an effective and biocompatible material that may be used safely in the oral cavity. Methodology: Four plants were collected-Emblica officinalis, Vitis vinifera seeds, Psidium guajava (P. guajava) Linn leaves, and Acacia nilotica (A. nilotica), and extracts were prepared individually. These extracts were subjected to phytochemical analysis, and bacterial growth and fermentation were assessed. Result: The level of significance was set at p < 0.05. All the plant extracts inhibited S. mutans growth at all serial dilutions except P. guajava Linn and A. nilotica showing 55 CFU/mL and 5 CFU/mL, respectively in 1/1000 dilution only. The phytochemical analysis confirmed that all four plant extracts had alkaloids, carbohydrates, tannins, and flavonoids. Steroids and proteins are present in P. guajava Linn. Proanthocyanidins were present in Vitis vinifera. Saponins and Anthraquinones were present in A. nilotica exclusively. Conclusion: All the extracts were effective against S. mutans. These could be tried as herbal alternatives to conventional adjuncts. However, these results must be additionally evaluated for toxicity in animal models, and effectiveness must be assessed using in vivo studies on human subjects. How to cite this article: Kripalani KB, Thomas NA, Thimmaiah C, et al. Comparative Evaluation of the Phytochemical Analysis and Efficacy of Four Plant-derived Extracts against Streptococcus mutans: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(S-3):S258-S262.

Effect of hydroalcoholic extract of whole pomegranate fruit on cariogenic bacteria and its clinical effect on dental plaque formation in 8-10-year-old children.

Background: This study aimed to assess the effect of hydroalcoholic extract of the whole pomegranate fruit on Streptococcus mutans (S. mutans) and Lactobacillus acidophilus (L. acidophilus) and its clinical effect on dental plaque formation in 8-10-year-old children. Materials and Methods: This study was conducted in two phases of in vitro and clinical trial. In the in vitro phase, the antibacterial effect of 50%-50% hydroalcoholic extract of whole pomegranate fruit on S. mutans and L. acidophilus was assessed by the disc diffusion test. In the double-blind cross-over clinical trial phase, 14 children between 8 and 10 years were randomly assigned to two groups of 38% pomegranate mouthwash and 0.12% chlorhexidine (CHX) after assessing their baseline dental plaque by oral hygiene index-simplified (OHI-S). The children were asked not to use any other plaque control measure during the study. Their OHI-S score was measured again after 5 and 14 days using disclosing tablets. Data were analyzed by t-test and paired t-test at 0.05 level of significance. Results: The hydroalcoholic extract of pomegranate showed a positive antibacterial effect on S. mutans and L. acidophilus. However, its inhibitory effect was significantly lower than that of 0.12% CHX (P < 0.05). None of the tested mouthwashes inhibited plaque formation, but pomegranate mouthwash and CHX decreased the OHI-S score by 34% and 36%, respectively (P < 0.05), with no significant difference between them (P > 0.05). Conclusion: The whole pomegranate fruit hydroalcoholic extract showed significant inhibitory effects on S. mutans and L. acidophilus. Furthermore, 38% pomegranate mouthwash had a comparable efficacy to CHX in the reduction of dental plaque.

Periodontal disease severity is associated to pathogenic consortia comprising putative and candidate periodontal pathogens

Abstract Based on a holistic concept of polymicrobial etiology, we have hypothesized that putative and candidate periodontal pathogens are more frequently detected in consortia than alone in advanced forms of periodontal diseases (PD). Objective To correlate specific consortia of periodontal pathogens with clinical periodontal status and severity of periodontitis. Methodology Subgingival biofilm was obtained from individuals with periodontal health (113, PH), gingivitis (91, G), and periodontitis (209, P). Genomic DNA was purified and the species Aggregatibacter actinomycetemcomitans (Aa), Aa JP2-like strain, Porphyromonas gingivalis (Pg), Dialister pneumosintes (Dp), and Filifactor alocis (Fa) were detected by PCR. Configural frequency and logistic regression analyses were performed to correlate microbial consortia and PD. Results Aa + Pg in the presence of Dp (phi=0.240; χ2=11.9, p<0.01), as well as Aa JP2 + Dp + Fa (phi=0.186, χ2=4.6, p<0.05) were significantly more associated in advanced stages of P. The consortium Aa + Fa + Dp was strongly associated with deep pocketing and inflammation (p<0.001). The best predictors of disease severity (80% accuracy) included older age (OR 1.11 [95% CI 1.07 - 1.15], p<0.001), Black/African-American ancestry (OR 1.89 [95% CI 1.19 - 2.99], p=0.007), and high frequency of Aa + Pg + Dp (OR 3.04 [95% CI 1.49 - 6.22], p=0.002). Conclusion Specific microbial consortia of putative and novel periodontal pathogens, associated with demographic parameters, correlate with severe periodontitis, supporting the multifactorial nature of PD.

Clinical efficacy of green tea, aloe vera and chlorhexidine mouthwashes in the treatment of dental biofilm induced gingivitis: A multi-arm, double-blinded, randomized controlled clinical trial.

OBJECTIVE: This multi-arm, randomized, double-blinded, controlled clinical trial was designed to evaluate the clinical efficacy of 0.5% green tea (GT), 0.2% chlorhexidine (CHX) and aloe vera (AV) mouthwash as compared to the control (CNT) group (scaling and polishing alone with no mouthwash) in the management of dental biofilm induced gingivitis among 18-40-year-old patients. MATERIAL AND METHODS: Sixty patients with generalized dental biofilm-induced gingivitis were randomly allocated to four study groups (n = 15 each) for treatment, namely Group GT, Group CHX, Group AV and Group CNT after scaling and polishing were administered to all the patients. Plaque index (PI), gingival index (GI) and sulcular bleeding index (SBI) were recorded at baseline, 14th and 21st day. RESULTS: PI, GI and SBI at various time intervals (baseline, 14th and 21st day) showed high statistically significant differences within the group (p < 0.01). Among these, the maximum percentage change was found in the CHX group followed by GT when evaluated from baseline to 21st day. The least percentage change was found in the AV group for PI and GI while the CNT group showed the least percentage change for sulcular index when evaluated from 14th to 21st day. Inter-group results showed high statistically significant differences (p < 0.01) for PI and GI when evaluated between baseline to 14th day and baseline to 21st day. SBI also showed statistically significant differences (p < 0.05) when evaluated between baselines to 14th day and baseline to 21st day. CONCLUSION: Green tea mouthwash displayed a significant reduction in plaque index, gingival index and sulcular bleeding index. 0.5% green tea catechin has equivalent anti-plaque efficacy as 0.2% chlorhexidine gluconate and can be considered a potent alternative to prevent and treat gingival diseases.

Effect of a Novel Betel Leaf Dentifrice on Commonly Seen Oral Hygiene Parameters-A Randomized Clinical Crossover Study.

The use of herbal medicine in dentistry has grown exponentially over time. Currently, herbal medicine is considered an effective oral hygiene aid. The objective of the current study is to assess the anti-plaque efficiency and reduction of gingival bleeding of betel leaf and miswak (Salvadora persica) toothpaste. This randomized clinical cross-over pilot study enrolled 60 individuals with mild gingivitis. They were segregated into two groups by drawing lots. The study lasted 20 days and included a two-week washout period between miswak and betel leaf toothpaste. The gingival and plaque index were measured at specific time intervals during the research period. The results revealed that betel leaf and miswak herbal toothpaste significantly decreased plaque index. Nevertheless, betel leaf toothpaste caused a more significant reduction in gingival bleeding scores (p < 0.001) when compared to miswak (p = 0.007). No significant decrease in gingival and plaque index was seen when subjects were asked to return to their conventional chemical toothpaste. The current study concluded that betel leaf toothpaste displayed a more substantial decrease in gingival bleeding when compared to miswak toothpaste. Additionally, more studies should be done on the therapeutic benefits of betel leaf toothpaste.

The Effectiveness of Herbal Versus Non-Herbal Mouthwash for Periodontal Health: A Literature Review.

Dental plaque is a biofilm of microorganisms that present naturally on the exposed tooth surface; it is the main etiological factor for many periodontal conditions and other oral health issues and its regular removal from the oral cavity can prevent many periodontal problems. Despite several experiments using herbal oral care products to reduce dental plaque or gingivitis, the findings remain inconclusive. We performed a systematic literature search on PubMed and Cochrane Library for randomized controlled trials (RCTs) dating from 2001 up to and including the year 2021. The keywords and Medical Subject Headings (MeSH) terms comprised combinations of the following: herbal, clove oil, peppermint oil, ginger, basil, ajwain, betel leaf extract, neem, lavender, non-herbal, chlorhexidine, fluorides, hydrogen fluoride, hydrogen fluoride, stannous fluoride, and mouthwashes. Each of the titles that the search elicited was screened and duplicates were removed from the gathered results. The full-text versions of the remaining articles were downloaded and examined by title and abstract. Handsearching was not carried out. We initially identified 21 studies; 14 studies, which did not fulfill the selection criteria, were excluded. All the included studies reported a reduction in plaque index (PI) and gingival index (GI) scores in both herbal and non-herbal groups. Two studies reported the superiority of the non-herbal mouthwash over the herbal one while five of the studies showed no significant difference in PI and GI scores between herbal and non-herbal mouthwash, implying equal efficacy of both, i.e., Triphala, aloe vera, tea tree, and polyherbal groups like Zingiber officinale, Rosmarinus officinalis, and Calendula officinalis, and chlorhexidine. Current research suggests that herbal mouthwashes are as effective as non-herbal mouthwashes for reducing dental plaque in the short term; however, the evidence is based on low-quality trials.

Propolis and Diet Rich in Polyphenols as Cariostatic Agents Reducing Accumulation of Dental Plaque.

Conducted studies indicate the relationship between oral health and systemic diseases. Moreover, the latest research indicated that cariogenic bacteria may severely influence the course of SARS-CoV-2 infection and increase risk of COVID-19 complications. This article aims to review various applications of propolis and pay attention to a healthy diet rich in polyphenols, which may allow the reduction of dental plaque accumulation. A literature review has been conducted from June until November 2021. It showed that propolis could be a useful agent in decreasing the accumulation of dental plaque. Moreover, a diet rich in polyphenols prevents cariogenic bacteria and reduces the accumulation of dental plaque. A reduction of a dental plaque may influence the risk of a severe course of COVID-19. Therefore, propolis and a diet rich in polyphenols may play an important role in prophylaxis of systemic diseases. Recently, it has been proven that oral infection may affect cardiovascular system, musculoskeletal system, respiratory system, nervous system, as well as may be a risk factor for diabetes mellitus. These aspects should stimulate clinicians to further research about polyphenols.

Efficacy of minocycline hydrochloride ointment combined with metronidazole film in the treatment of periodontitis and their effects on C-reactive protein and elastase levels in gingival crevicular fluid / 中国基层医药

Objective:To investigate the efficacy of minocycline hydrochloride ointment combined with metronidazole film in the treatment of periodontitis and their effects on C-reactive protein and elastase levels in the gingival crevicular fluid.Methods:76 patients with periodontitis who received treatment in Jiaxing Hospital of Traditional Chinese Medicine from May 2019 to January 2020 were included in this study. They were randomly allocated to undergo treatment with metronidazole film (control group, n = 38) or minocycline hydrochloride ointment plus metronidazole film (observation group, n = 38) for 4 weeks. We compared clinical efficacy, periodontal system examination indexes (gingival index, periodontal probing pocket depth, gingival bleeding index, plaque index, loss of attachment), gingival crevicular fluid biochemical markers (C-reactive protein, elastase in the pellet, elastase in the supernatant) measured before and after treatment, the incidence of adverse reactions, and the recurrence rate within half a year after treatment between the two groups. Results:The total response rate was significantly higher in the observation group than in the control group [97.37% (37/38) vs. 78.95% (30/38), χ2 = 6.17 , P < 0.05]. Gingival index, periodontal probing pocket depth, gingival bleeding index, plaque index, and loss of attachment measured after treatment were significantly lower in the observation group than in the control group (all P < 0.001). C-reactive protein, elastase in the pellet, and elastase in the supernatant measured after treatment were (5.31 ± 1.19) μg/L, (0.70 ± 0.20) Abs/mL, (0.48 ± 0.19) Abs/mL respectively in the observation group, which were significantly lower than those in the control group [(7.92 ± 1.27) μg/L, (1.15 ± 0.52) Abs/mL, (1.12 ± 0.31) Abs/mL, t = 9.24, 4.97, 10.85, all P < 0.001]. The recurrence rate within half a year in the observation group was significantly lower than that in the control group [2.63% (1/38) vs. 20% (6/38), χ2 = 3.93, P < 0.05]. There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Minocycline hydrochloride ointment combined with metronidazole film is safe and effective in the treatment of periodontitis. The combined therapy help downregulate the levels of C-reactive protein, elastase in the pellet, elastase in the supernatant of the gingival crevicular fluid, alleviate inflammation, improve the periodontal status, and reduce the recurrence rate.

Analysis of Plant Origin Antibiotics against Oral Bacterial Infections Using In Vitro and In Silico Techniques and Characterization of Active Constituents.

The pervasiveness of oral bacterial infections in diabetic patients is a serious health concern that may produce severe complications. We investigated 26 Ayurvedic medicinal plants traditionally used for treatment of the oral bacterial infections with the aim to look for new promising drug leads that can be further employed for herbal formulation design. The plants were grouped into three categories based on traditional usage. All plant extracts were examined for antibacterial, antibiofilm and antiquorum-sensing properties. The plants with significant activities including Juglans regia, Syzygium aromaticum, Eruca sativa, Myristica fragrans, Punica granatum and Azadirachta indica were further analyzed using HPLC-DAD-QToF and GC-MS. In silico and in vitro activity was evaluated for selected constituents. Finally, it could be concluded that eugenol and 2-phenylethylisothiocyanate are major contributors towards inhibition of bacterial biofilms and quorum sensing.

The Influence of Propolis on Dental Plaque Reduction and the Correlation between Dental Plaque and Severity of COVID-19 Complications-A Literature Review.

Current studies suggest that cariogenic bacteria in dental plaque influence the severity of COVID-19 complications since the oral cavity is a reservoir for respiratory pathogens potentially responsible for the development of hospital-acquired pneumonia. This article focuses on the association between dental plaque and COVID-19 concerning the influence of altered oral biofilm on the risk of increased severity of SARS-CoV-2 infection. Moreover, it concentrates on the usefulness of propolis, with its apitherapeutic antibacterial properties, for treating oral bacterial infections co-occurring with SARS-CoV-2 infection. A review of the literature on PubMed, Cochrane Library and Medline between 2000 and 2021 revealed 56 published articles indicating that a link between dental plaque and COVID-19 complications was probable. Furthermore, they indicated that propolis may minimize COVID-19 severity by reducing dental plaque accumulation. The possibility that improved oral health could reduce the risk of COVID-19 complications should be of interest to scientists.

Development of a herbal mouthwash containing a mixture of essential oils and plant extracts and in vitro testing of its antimicrobial efficiency against the planktonic and biofilm-enclosed cariogenic bacterium Streptococcus mutans.

A herbal mouthwash containing essential oils of holy basil and mountain tea, extracts of St John's wort and European goldenrod (Bucovia™) and cetylpyridinium chloride, was developed and in vitro tested for its efficiency against biofilm formation by Streptococcus mutans, together with its eradicating activity against already preformed (48 h with saccharose) streptococcal biofilm. The minimum inhibitory (MIC) and bactericidal concentrations (MBC) of the final formulation, as well as of its individual components, were initially determined. The results revealed that the mouthwash needed to be applied at two-times its MIC (0.63% v.v-1) to completely inhibit biofilm formation by S. mutans, which was otherwise capable of developing a robust biofilm on the tested surface. Once fully developed, the matrix of the biofilm was found to contain a significant amount of exopolysaccharides protecting the cells, being impossible to eradicate even when exposed to pure mouthwash for 15 min, highlighting the great recalcitrance of biofilm-embedded S. mutans.

Eficácia de óleos vegetais no controle do biofilme dental: revisão integrativa / Efficacy of vegetable oils in control of dental biofilm: integrative review / Eficacia de los aceites vegetales en el control de biofilm dental: revision integrativa

Introdução:A terapia de bochecho com óleos vegetais é uma cultura tradicional na Índia com intuito de prevenir afecções bucais, como cárie e doença periodontal. Atualmente, com as mudanças nos padrões alimentares da sociedade, tem-se empregado com maior valor o uso de óleos naturais, já que estudos demonstram sua importância para saúde.Objetivo:Esta revisão integrativa teve como objetivo selecionar evidências que mostrassem a utilização de óleos vegetais, com ação antimicrobiana, no controle do biofilme dental. Metodologia:O levantamento bibliográfico foi realizado nos meses de julho e agosto de 2020, por meio de pesquisa por via eletrônica, consultando-se o banco de dados Pubmed e SciELO (Scientific Electronic Library Online). Foram utilizados os descritores: Óleos vegetais, agentes antimicrobianos, Placa dental, Odontologia preventiva e Odontologia, os descritores foram usados separadamente e em cruzamento com o operador boleano AND. Utilizou-se os seguintes critérios de inclusão: Estudos clínicos, artigos completos e disponíveis gratuitamente, publicados no período de 2010 a 2020 em português e/ou inglês, e indexados nas bases de dados já citadas. Foram excluídos os trabalhos de conclusão de curso, dissertações, teses, livros e capítulos de livros, além de artigos duplicados e que não abordaram o tema do estudo.Resultados:Atenderam os critérios da pesquisa 04 estudos do tipo clínico randomizado, os quais mostraram eficiência dos óleos vegetais utilizados no controle do biofilme dental. A realização de pesquisas envolvendo e motivando a industrialização de produtos naturaiscontribui para a Política Nacional de Práticas Integrativas e Complementares.Conclusões:Os artigos analisados mostraram eficácia na utilização de óleos vegetais no controle do biofilme dental, sendo esses aplicados clinicamente,não mostrando prejuízo aos participantes e indicados como coadjuvante na manutenção da saúde bucal (AU).

Introduction:Mouthwash therapy with vegetable oils is a traditional culture in India with the aim of preventing oral diseases, such as caries and periodontal disease. Currently, with the changes in the dietary patterns of society, the use of natural oils has been used with greater value, since studies demonstrate its importance for health.Objective:This integrative review aimed to select evidence that showed the use of vegetable oils, with antimicrobial action, in the control of dental biofilm. Methodology:Thebibliographic survey was carried out in July and August 2020, through electronic research, consulting the Pubmed and SciELO database (Scientific Electronic Library Online). The descriptors were used: Vegetable oils, antimicrobial agents, dental plaque, preventive dentistry and dentistry, the descriptors were used separately and in cross-section with the Boolean operator AND. The following inclusion criteria were used: Clinical studies, complete and freely available articles, published between 2010 and 2020in Portuguese and / or English, and indexed in the databases already cited. Course completion papers, dissertations, theses, books and book chapters were excluded, as well as duplicate articles that did not address the subject of the study. Results:Four studies of randomized clinical type met the research criteria, which showed efficiency of vegetable oils used in the control of dental biofilm. Conducting research involving and motivating the industrialization of natural products contributes to the National Policy on Integrative and Complementary Practices.Conclusions:The analyzed articles showed efficacy in the use of vegetable oils in the control of dental biofilm, which were applied clinically without showing any harm to the participants and indicatedas an adjunct in maintaining oral health (AU).

Introducción: La terapia de enjuague bucal con aceites vegetales es una cultura tradicional en India con el objetivo de prevenir enfermedades bucales, como caries y enfermedad periodontal. Actualmente, con los cambios en los patrones dietéticos de la sociedad, se ha utilizado con mayor valor el uso de aceites naturales, ya que los estudios demuestran su importancia para la salud. Objetivo: Esta revisión integradora tuvo como objetivo seleccionar evidencias que mostraran el uso de aceites vegetales, con acción antimicrobiana, en el control del biofilm dental.Metodología: El relevamiento bibliográfico se realizó en julio y agosto de 2020, mediante investigación electrónica, consultando la base de datos Pubmed y SciELO (Scientific Electronic Library Online). Se utilizaron los descriptores: Aceites vegetales, agentes antimicrobianos, placa dental, odontología preventiva y odontología, los descriptores se utilizaron por separado y en corte transversal con el operador booleano AND. Se utilizaron los siguientes criterios de inclusión: Estudios clínicos, artículos completos y de libre acceso, publicados entre 2010 y 2020 en portugués y / o inglés, e indexados en las bases de datos ya citadas. Se excluyeron trabajos de finalización de curso, disertaciones, tesis, libros y capítulosde libros, así como artículos duplicados que no abordaran el tema de estudio. Resultados: Cuatro estudios de tipo clínico aleatorizado cumplieron con los criterios de investigación, los cuales mostraron la eficiencia de los aceites vegetales utilizados enel control del biofilm dental. Realizar investigaciones que involucren y motiven la industrialización de productos naturales contribuye a la Política Nacional de Prácticas Integrativas y Complementarias.Conclusiones: Los artículos analizados mostraron eficacia en el uso de aceites vegetales en el control del biofilm dental, los cuales fueron aplicados clínicamente sin mostrar daño a los participantes e indicados como coadyuvante en el mantenimiento de la salud bucal (AU).