Green Synthesis of Silver Nanoparticles Using Salvadora persica and Caccinia macranthera Extracts: Cytotoxicity Analysis and Antimicrobial Activity Against Antibiotic-Resistant Bacteria.

Silver nanoparticles (AgNPs) have gained great interest because of their specific and distinct properties. Chemically synthesized AgNPs (cAgNPs) are often unsuitable for medical applications due to requiring toxic and hazardous solvents. Thus, green synthesis of AgNPs (gAgNPs) using safe and nontoxic substances has attracted particular focus. The current study investigated the potential of Salvadora persica and Caccinia macranthera extracts in the synthesis of CmNPs and SpNPs, respectively. Aqueous extracts of Salvadora persica and Caccinia macranthera were prepared and taken as reducing and stabilizing agents through gAgNPs synthesis. The antimicrobial effects of gAgNPs against susceptible and antibiotic-resistant bacterial strains and their toxicity effects on L929 fibroblast normal cells were evaluated. TEM images and particle size distribution analysis showed that the CmNPs and SpNPs have average sizes of 14.8 nm and 39.4 nm, respectively. The XRD confirms the crystalline nature and purity of both CmNPs and SpNPs. FTIR results demonstrate the involvement of the biologically active substances of both plant extracts in the green synthesis of AgNPs. According to MIC and MBC results, higher antimicrobial effects were seen for CmNPs with a smaller size than SpNPs. In addition, CmNPs and SpNPs were much less cytotoxic when examined against a normal cell relative to cAgNPs. Based on high efficacy in controlling antibiotic-resistant pathogens without detrimental adverse effects, CmNPs may have the capacity to be used in medicine as imaging, drug carrier, and antibacterial and anticancer agents.

Evaluation of Chemical, Biochemical and Anti-Microbial Effects of Salvadora persica and Moringa oleifera Extract to Produce Organic Disinfectant Products.

Oral hygiene is one of the most influential and important issues in people's health. People have been using herbal components to maintain their oral hygiene for centuries. Oral cancer develops in the oral cavity, and its origin always lies in the growth of malignant epithelial tissue cells. Due to the spread of this cancer in Iran, we intend to measure the antibacterial effects of the combination of Salvadora persica and Moringa oleifera extracts. Cariogenic bacteria are one leading cause of oral cancer. We used this extract in mouthwash, toothpaste, and chewing gum, and we expect that it would reduce cell proliferation and be used in prevention and treatment. The new organic mouthwash, chewing gum, and toothpaste were designed and prepared using M. oleifera oil, S. persica, M. oleifera extract, the powder of S. persica wood, and M. oleifera leaves. With the use of herbal compounds in the preparation of these products, the quantity of essential chemical ingredients in the prepared samples was decreased. We examined the quality and stability of mouthwash, toothpaste, and chewing gum that indicated the standard level of each substance. Furthermore, we evaluated the antibacterial effects of our products, which indicated that our products can significantly reduce the total bacterial count. For the first time, a combination of S. persica and M. oleifera extract replaced chemicals in mouthwash, toothpaste, and chewing gum. Natural herbal ingredients with antimicrobial activity are effective in maintaining low bacterial counts in the mouth, and as a result, improving oral hygiene and health.

Antimicrobial Efficacy of Glass Ionomer Cement in Incorporation with Biogenic Zingiber officinale Capped Silver-Nanobiotic, Chlorhexidine Diacetate and Lyophilized Miswak.

In the present study, Zingiber officinale is used for the synthesis of Zingiber officinale capped silver nanoparticles (ZOE-AgNPs) and compares the antimicrobial efficacy and compressive strength of conventional glass ionomer cement (GIC) combined with ZOE-AgNPs, lyophilized miswak, and chlorhexidine diacetate (CHX) against oral microbes. Five groups of the disc-shaped GIC specimens were prepared. Group A: lyophilized miswak and GIC combination, Group B: ZOE-AgNPs and GIC combinations, Group C: CHX and GIC combination, Group D: ZOE-AgNPs + CHX + GIC; Group E: Conventional GIC. Results confirmed the successful formation of ZOE-AgNPs that was monitored by UV-Vis sharp absorption spectra at 415 nm. The X-ray diffractometer (XRD) and transmission electron microscope (TEM) results revealed the formation of ZOE-AgNPs with a mean size 10.5-14.12 nm. The peaks of the Fourier transform infrared spectroscopy (FTIR) were appearing the involvement of ZOE components onto the surface of ZOE-AgNPs which played as bioreducing, and stabilizing agents. At a 24-h, one-week and three-week intervals, Group D showed the significantly highest mean inhibitory zones compared to Group A, Group B, and Group C. At microbe-level comparison, Streptococcus mutans and Staphylococcus aureus were inhibited significantly by all the specimens tested except group E when compared to Candida albicans. Group D specimens showed slightly higher (45.8 ± 5.4) mean compressive strength in comparison with other groups. The combination of GIC with ZOE-AgNPs and chlorhexidine together enhanced its antimicrobial efficacy and compressive strength compared to GIC with ZOE-AgNPs or lyophilized miswak or chlorhexidine combination alone. The present study revealed that The combination of GIC with active components of ZOE-AgNPs and chlorhexidine paves the way to lead its effective nano-dental materials applications.

Salvadora persica mediated synthesis of silver nanoparticles and their antimicrobial efficacy.

Silver nanoparticles (AgNPs) exhibit strong antimicrobial properties against many pathogens. Traditionally employed chemical methods for AgNPs synthesis are toxic for the environment. Here, we report a quicker, simpler, and environmentally benign process to synthesize AgNPs by using an aqueous 'root extract' of Salvadora persica (Sp) plant as a reducing agent. The synthesized Salvadora persica nano particles (SpNPs) showed significantly higher antimicrobial efficacy compared to earlier reported studies. We characterized SpNPs using UV-Vis spectroscopy, Fourier Transform Infrared Spectroscopy (FTIR), Transmission Electron Microscopy (TEM), Field Emission Scanning Electron Microscopy (FE-SEM), Dynamic Light Scattering (DLS) and X-ray powder diffraction (P-XRD). UV-Vis spectrum showed the highest absorbance at 420 nm. FTIR analysis depicts presence of bond stretching including OH- (3300 cm-1), C=N- (2100 cm-1) and NH- (1630 cm-1) which are attributed in the involvement of phenolics, proteins or nitrogenous compounds in reduction and stabilization of AgNPs. TEM, FE-SEM and DLS analysis revealed the spherical and rod nature of SpNPs and an average size of particles as 37.5 nm. XRD analysis showed the presence of the cubic structure of Ag which confirmed the synthesis of silver nanoparticles. To demonstrate antimicrobial efficacy, we evaluated SpNPs antimicrobial activity against two bacterial pathogens (Escherichia coli (ATCC 11229) and Staphylococcus epidermidis (ATCC 12228)). SpNPs showed a significantly high inhibition for both pathogens and minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were found to be 0.39 µg/mL and 0.78 µg/mL for E. coli while 0.19 µg/mL and 0.39 µg/mL for S. epidermidis respectively. Further, Syto 16 staining of bacterial cells provided a supplemental confirmation of the antimicrobial efficacy as the bacterial cells treated with SpNPs stop to fluoresce compared to the untreated bacterial cells. Our highly potent SpNPs will likely have a great potential for many antimicrobial applications including wound healing, water purification, air filtering and other biomedical applications.

Shear Bond Strength and Film Thickness of a Naturally Antimicrobial Modified Dental Luting Cement.

Although several natural plants and mixtures have been known and used over the centuries for their antibacterial activity, few have been thoroughly explored in the field of dentistry. Thus, the aim of this study was to enhance the antimicrobial activity of a conventional glass ionomer cement (GIC) with natural plant extracts. The effect of this alteration on the bond strength and film thickness of glass ionomer cement was evaluated and related to an 0.5% chlorohexidine modified GIC. Olive leaves (Olea europaea), Fig tree (Ficus carica), and the leaves and roots of Miswak (Salvadora persica) were used to prepare an alcoholic extract mixture. The prepared extract mixture after the evaporation of the solvent was used to modify a freeze-dried glass ionomer cement at three different extracts: water mass ratios 1:2, 1:1, and 2:1. An 0.5% chlorhexidine diacetate powder was added to a conventional GIC for the preparation of a positive control group (CHX-GIC) for comparison. The bond strength to dentine was assessed using a material-testing machine at a cross head speed of 0.5 mm/min. Failure mode was analyzed using a stereomicroscope at 12× magnification. The cement film thickness was evaluated in accordance with ISO standard 9917-1. The minimum number of samples in each group was n = 10. Statistical analysis was performed using a Kruskal-Wallis test followed by Dunn's post hoc test for pairwise comparison. There was a statistically insignificant difference between the median shear bond strength (p = 0.046) of the control group (M = 3.4 MPa), and each of the CHX-GIC (M = 1.7 MPa), and the three plant modified groups of 1:2, 1:1, 2:1 (M = 5.1, 3.2, and 4.3 MPa, respectively). The CHX-GIC group showed statistically significant lower median values compared to the three plant-modified groups. Mixed and cohesive failure modes were predominant among all the tested groups. All the tested groups (p < 0.001) met the ISO standard of having less than 25 µm film thickness, with the 2:1 group (M = 24 µm) being statistically the highest among all the other groups. The plant extracts did not alter either the shear bond strength or the film thickness of the GIC and thus might represent a promising additive to GICs.

Salvadora persica L. chewing stick and standard toothbrush as anti-plaque and anti-gingivitis tool: A systematic review and meta-analysis.

ETHNOPHARMACOLOGICAL RELEVANCE: Salvadora persica L. chewing stick, commonly known as miswak is still being used as an oral hygiene tool for plaque control and prevention against gingivitis. Various studies have reported on the therapeutics and prophylactic effects particularly on periodontal disease. This review aimed to evaluate the effectiveness of S. persica chewing stick compared to the standard toothbrush for anti-plaque and anti-gingivitis. MATERIAL AND METHODS: A PRISMA-compliant systematic search of literature was done from the MEDLINE, CENTRAL, Science Direct, PubMed and Google Scholar. Literature that fulfilled eligibility criteria was identified. Data measuring plaque score and bleeding score were extracted. Qualitative and random-effects meta-analyses were conducted. RESULTS: From 1736 titles and abstracts screened, eight articles were utilized for qualitative analysis, while five were selected for meta-analysis. The pooled effect estimates of SMD and 95% CI were -0.07 [-0.60 to 0.45] with an χ2 statistic of 0.32 (p = 0.0001), I2 = 80% as anti-plaque function and 95% CI were -2.07 [-4.05 to -0.10] with an χ2 statistic of 1.67 (p = 0.02), I2 = 82%. CONCLUSION: S. persica chewing stick is a tool that could control plaque, comparable to a standard toothbrush. Further, it has a better anti-gingivitis effect and can be used as an alternative.

HPLC/MSn Profiling and Healing Activity of a Muco-Adhesive Formula of Salvadora persica against Acetic Acid-Induced Oral Ulcer in Rats.

Salvadora persica L. (S. persica, Siwak) is an ethnic plant that is widely used for improving oral hygiene. This study aimed to provide a phytochemical profiling of S. persica ethyl acetate fraction (SPEAF) and to evaluate the healing activity of a muco-adhesive formula of the fraction against acetic acid-induced oral ulcers in rats. HPLC-ESI-QTOF-MS-MS analysis of SPEAF resulted in the tentative identification of 56 metabolites containing fatty acids (23%), urea derivatives (10.5%) and sulphur compounds (10%), in addition to several amides, polyphenols and organic acids (6.5%, 5% and 2%, respectively). For the first time, 19 compounds were identified from S. persica. In vitro and in vivo experiments indicated that the extract is non-toxic. SPEAF exhibited superior healing activities compared to both the negative and positive control groups on days 7 and 14 of tongue ulcer induction. This was confirmed by histopathological examinations of haematoxylin and eosin-stained (H&E) and Masson's trichrome-stained tongue sections. Moreover, SPEAF showed potent anti-inflammatory activities, as evidenced by the inhibited expression of interleukin-6 (IL-6) and tumour necrosis alpha (TNF-α). Moreover, SPEAF exhibited potent antioxidant activity, as it prevented malondialdehyde (MDA) accumulation, reduced glutathione (GSH) depletion and superoxide dismutase (SOD) exhaustion. SPEAF significantly enhanced hydroxyproline tongue content and upregulated collagen type I alpha 1 (Col1A1) mRNA expression. SPEAF also improved angiogenesis, as shown by the increased mRNA expression of the angiopoietin-1 (Ang-1). In conclusion, S. persica has a wide range of secondary metabolites and ameliorates acetic acid-induced tongue ulcers in rats. This can be attributed, at least partly, to its anti-inflammatory, antioxidant, procollagen and angiogenic activities. These findings provide support and validity for the use of S. persica as a traditional and conventional treatment for oral disorders.

Evaluation of the antimicrobial activity and compressive strength of a dental cement modified using plant extract mixture.

Literature lacks sufficient data regarding addition of natural antibacterial agents to glass ionomer cement (GICs). Hence, the aim of the study was to increase the antimicrobial properties of GICs through its modification with mixture of plant extracts to be evaluated along with an 0.5% chlorohexidine-modified GIC (CHX-GIC) with regard to biological and compressive strength properties. Conventional GIC (freeze-dried version) and CHX were used. Alcoholic extract of Salvadora persica, Olea europaea, and Ficus carcia leaves were prepared using a Soxhlet extractor for 12 h. The plant extract mixture (PE) was added in three different proportions to the water used for preparation of the dental cement (Group 1:1 PE, 2:1 PE, and 1:2 PE). Specimens were then prepared and tested against the unmodified GIC (control) and the 0.5% CHX-GIC. Chemical analysis of the extract mixture was performed using Gas chromatography-mass spectrometry. Antimicrobial activity was evaluated using agar diffusion assay against Micrococcus luteus and Streptoccocus mutans. Compressive strength was evaluated according to ISO 9917-1:2007 using a Zwick testing machine at a crosshead speed of 0.5 mm/min. Antimicrobial activity against Streptoccocus mutans was significantly increased for all the extract-modified materials compared to the unmodified cement, and the highest concentration was comparable to the CHX-GIC mixture. The activity against Micrococcus luteus was also significantly increased, but only for the material with the highest extract concentration, and here the CHX-GIC group showed statistically the highest antimicrobial activity. Compressive strength results revealed that there was no statistically significant difference between the different mixtures and the control except for the highest tested concentration that showed the highest mean values. The plant extracts (PEs) enhanced the antimicrobial activity against S. mutans and also against M. luteus in the higher concentration while compressive strength was improved by addition of the PE at higher concentrations.

Possible healing effects of Salvadora persica extract (MISWAK) and laser therapy in a rabbit model of a caustic-induced tongue ulcers: histological, immunohistochemical and biochemical study.

Caustic ingestion is a potentially detrimental event that can cause serious devastating damage on contact with tissues. Local exposure is associated with severe pain, swelling and ulceration. Caustics-induced oral ulcers can be painful enough to compromise the patient's quality of life. Treatment of oral ulcers is crucial in clinical practice. Albeit, some ulcers do not respond adequately to the conventional treatment. The current study was conducted to evaluate the potential healing effects of topical Salvadora persica (SP) extract, low-level laser (LLL) and high-level laser (HLL) therapies in a rabbit model of caustic-induced tongue ulcers and explore the underlying mechanisms. Fifty male rabbits with a caustic induced tongue ulcers were included in the study. Rabbits were equally divided into four groups: positive control (ulcer) group, SP, LLL and HLL groups in addition to the negative control (healthy) group. All treatments were given thrice weekly for 14 days. Results showed that acetic acid-induced tongue ulcers caused extensive structural tongue damage secondary to overexpression of apoptotic BAX, pathological angiogenesis indicated by VEGF overexpression, marked collagen fibers deposition as well as upregulation of tissue pro-inflammatory TNF-α and upregulation of tissue anti-inflammatory IL-10. The healing potential of topical SP, LLL and HLL therapy are mostly comparable. In conclusion, acetic acid-induced extensive tongue damage. Topical SP extract, LLL and HLL are equally effective therapies against caustics-induced tongue ulcers. However, we recommend SP extract, owing to its safety, non-invasiveness, availability and low cost.

Comparative secondary metabolites profiling and biological activities of aerial, stem and root parts of Salvadora oleoides decne (Salvadoraceae).

In this study, different parts (aerial, stem and root) of Salvadora oleoides Decne were investigated in order to explore their phytochemical composition and biological potential. The bioactive contents were evaluated by conventional spectrophotometric methods. Additionally, the secondary metabolite compounds were identified by UHPLC-MS analysis. Biological potential was evaluated by determining antioxidant (DPPH, FRAP, and Phosphomolybdenum) and enzyme inhibitory (butrylcholinesterase and lipoxygenase) effects. Higher total bioactive contents were found in methanolic extracts which tend to correlate with higher radical scavenging and reducing potential of these extracts. LC/MS spectrum revealed the presence of 16 different secondary metabolites belonging to terpene, glucoside and sesquiterpenoid dervivatives. Glucocleomin and emotin A were the main compounds present in all three parts. The strongest butrylcholinesterase and lipoxygenase inhibitory activity was observed for root and stem DCM extracts. Demonstrated biological potential of S. oleoides plant can trace a new road map for developing newly designed bioactive pharmaceuticals.

Salvadora persica protects mouse intestine from eimeriosis / Salvadora persica protege o intestino do rato da eimeriose

Abstract Eimeriosis is a global poultry health problem. In the current study, we investigated the role of Salvadora persica leaf extracts (SE) against murine eimeriosis induced by Eimeria papillata. The infection induced an oocyst output of 6242 ± 731 oocysts/g feces. After treatment with 300 mg⁄kg SE, the oocysts expelled in feces decreased by approximately 3-fold. In addition, the total number of E. papillata in the parasitic stage decreased in the jejunum of mice after treatment with SE. In addition, SE significantly reduced the number of apoptotic cells by approximately 2-fold in the infected jejunum. SE ameliorated the changes in glutathione, malondialdehyde, and catalase due to E. papillata infection. Finally, SE regulated the cytokine genes, interleukin (IL)-1β, IL-6, interferon-γ, and tumor necrosis factor-α, and the apoptotic genes, B-cell lymphoma-2, Bax, and Caspase-3. SE protects the jejunum from E. papillata induced injury and may have potential therapeutic value as a food additive during eimeriosis.

Resumo A eimeriose é um problema global de saúde avícola. No presente estudo, investigou-se o papel dos extratos de folhas de Salvadora persica (SE) contra a eimeriose murina induzida por Eimeria papillata. A infecção induziu uma produção de oocistos de 6242 ± 731 oocistos/g de fezes. Após o tratamento com 300 mg⁄kg SE, os oocistos eliminados nas fezes diminuíram em aproximadamente 3 vezes. Além disso, o número total de E. papillata no estágio parasitário diminuiu nos jejunos de camundongos após o tratamento com SE. Da mesma forma, o SE reduziu significativamente o número de células apoptóticas em aproximadamente 2 vezes no jejuno infectado. O estudo mostrou que o SE melhorou as alterações na glutationa, malonaldeído e catalase devido à infecção por E. papillata. Finalmente, o SE regulou os genes das citocinas, interleucina (IL) -1β, IL-6, interferon-γ e fator de necrose tumoral α, e os genes apoptóticos, linfoma-2, Bax e Caspase-3. Assim, o SE protegeu os jejunos das lesões induzidas por E. papillata e pode ter potencial valor terapêutico como aditivo alimentar durante a eimeriose.

Salvadora persica protects mouse intestine from eimeriosis.

Eimeriosis is a global poultry health problem. In the current study, we investigated the role of Salvadora persica leaf extracts (SE) against murine eimeriosis induced by Eimeria papillata. The infection induced an oocyst output of 6242 ± 731 oocysts/g feces. After treatment with 300 mg/kg SE, the oocysts expelled in feces decreased by approximately 3-fold. In addition, the total number of E. papillata in the parasitic stage decreased in the jejunum of mice after treatment with SE. In addition, SE significantly reduced the number of apoptotic cells by approximately 2-fold in the infected jejunum. SE ameliorated the changes in glutathione, malondialdehyde, and catalase due to E. papillata infection. Finally, SE regulated the cytokine genes, interleukin (IL)-1ß, IL-6, interferon-γ, and tumor necrosis factor-α, and the apoptotic genes, B-cell lymphoma-2, Bax, and Caspase-3. SE protects the jejunum from E. papillata induced injury and may have potential therapeutic value as a food additive during eimeriosis.

Antibacterial activity of Salvadora persica against oral pathogenic bacterial isolates.

OBJECTIVE: The objective was to determine the antibacterial activity of Salvadora persica extract against bacteria isolated from dental plaque of patients. MATERIALS AND METHODS: Out of 40 different clinical specimens collected from patients suffering from plaque-induced gingivitis, 12 Staphylococcus aureus and 8 Streptococcus sp. isolates were recovered. The isolates were screened for their biofilm-forming capacity using tissue culture plate (TCP), tube method (TM), and congo red agar (CRA) method. Antibacterial activity of methanolic S. persica extract as well as of commercial antimicrobials against tested isolates was performed. High-performance liquid chromatography-mass spectrometry (HPLC-MS) and gas chromatography-MS (GC-MS) analysis were performed for S. persica crude extract and its volatile oil, respectively, to determine their constituents. RESULTS: Out of 20 isolates, 80%, 85%, and 90% showed positive results using TM, CRA, and TCP, respectively. The highest antimicrobial activity of methanolic S. persica extract was observed at 200 mg/ml. HPLC-MS analysis shows many polyphenols in S. persica extract such as Chrysin-8-c-ß-D-glucopyranoside, ferulic acid, gallic acid, and stigmasterol. Chemical composition of the essential oil of S. persica was determined by GC-MS yield; a mixture of monoterpene and hydrocarbons. The major compounds were butylated hydroxytoluene followed by benzene (isothiocyanatomethyl). CONCLUSION: Methanolic extract of S. persica had significant antibacterial effect against S. aureus and Streptococcus sp. isolates, and it may be gave a good alternative method for controlling oral pathogen.

Fabrication and characterization of a titanium dioxide (TiO2) nanoparticles reinforced bio-nanocomposite containing Miswak (Salvadora persica L.) extract - the antimicrobial, thermo-physical and barrier properties.

Objective: The microbial, physico-chemical and optical corruptions threaten a variety of foods and drugs and consequently the human biological safety and its accessible resources. The humanbeing's tendency towards bio-based materials and natural plant-extracts led to an increase in the usage of antimicrobial biocomposites based on medicinal herbs. Miswak (Salvadora persica L.) extract (SPE) has been proved effective for its antimicrobial and other biological activities. Therefore, in this study, titanium dioxide (TiO2) nanoparticles (TONP) and SPE were applied to fabricate antimicrobial carboxymethyl cellulose (Na-CMC) based bio-nanocomposites which would simultaneously promote some thermo-physical and barrier properties. Methods: CMC-neat film (C1), CMC/TONP-2% (C2) and CMC/TONP-2% with 150, 300 and 450 mg/mL SPE (SPE150, SPE30 and SPE450, respectively) were fabricated. The physical and mechanical properties; elemental mapping analysis (MAP), X-ray diffraction (XRD), scanning electron microscopy (SEM), thermal gravimetric analysis (TGA-DTG); fourier transform infrared (FTIR), energy-dispersive X-ray (EDX) and UV-vis spectroscopies were done to further validate the results. Results: Addition of TONP (2%) improved the blocking of UV light at 280 nm while SPE-containing nanocomposites completely blocked it. FTIR, XRD and SEM confirmed the formation of homogeneous films and high miscibility of applied materials. TONP led to an increase in Young's modulus (YM) and stress at break (SB) while SPE decreased them and enhanced the elongation to break (EB) (flexibility) of the active nanocomposites. Compared to CMC-film, the thermo-gravimetric analysis (TGA-DTG) showed a higher thermal stability for CMC/TONP and CMC/TONP/SPE nanocomposites. The EDX spectroscopy and elemental mapping analysis (MAP) proved the existence and well-distributedness of Na, K, Cl, S, Ti, F and N elements in SPE-activated nanocomposites. The pure SPE and SPE-activated nanocomposites showed a favorable antimicrobial activity against both gram-positive (Staphylococcus aureus) and negative (Escherichia coli) bacteria. Conclusion: The CMC-TiO2-SPE nanocomposites were homogeneously produced. Combination of TiO2 nanoparticles and dose-dependent SPE led to an improvement of thermal stability, and high potential in antimicrobial and UV-barrier properties. These results can generally highlight the role of the fabricated antimicrobial bio-nanocomposites as a based for different applications especially in food/drug packaging or coating.

The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of chlorhexidine: a systematic review and meta-analysis.

BACKGROUND: The plant Salvadora persica (miswak) has a long history of use in oral hygiene. Associations between the use of Salvadora persica and decreased oral bacteria numbers and plaque scores have been reported. This systematic review and meta-analysis assessed the ability of Salvadora persica mouthrinses to reduce plaque/cariogenic bacteria, in comparison to that of chlorhexidine and/or placebo rinses. METHODS: A comprehensive literature search for clinical trials reporting the use of Salvadora persica rinses as an antibacterial and/or antiplaque agent in comparison with chlorhexidine and/or placebo rinses was conducted, with no restriction to language. MEDLINE-PubMed, Cochrane Central Register of Controlled Trials, Wiley Online Library, ScienceDirect, and Google Scholar databases were searched to include all articles published up to December 2018. Based on inclusion/exclusion criteria, data were extracted from the identified reports by two independent reviewers. The primary and secondary outcomes measured from the eligible studies were mean plaque scores and mean cariogenic bacterial counts, respectively. Risk of bias of these studies was assessed. A statistical test of homogeneity was used to determine if the results of the separate studies could be combined. Based on the chi-square test, an inconsistency coefficient was computed (I2 statistic). Sensitivity analyses using subgroups and homogeneity evaluation were conducted. RESULTS: A total of 1135 potentially eligible articles were identified, of which 19 were eventually included in the qualitative analysis whereas 18 were included in the quantitative meta-analysis. The meta-analysis showed that Salvadora persica rinses exhibited strong antiplaque effects (P < 0.00001, MD: 0.46, and 95% CI: 0.29 to 0.63). In addition, it had statistically significant anti-streptococcal (P < 0.0001, MD: -1.42, and 95% CI: -2.08 to - 0.76) and anti-lactobacilli effects (P < 0.00001, MD: -1.12, and 95% CI: -1.45 to - 0.79) when compared to placebo. However, its effects were inferior compared to those by chlorhexidine rinse (P = 0.04, MD: 0.19, and 95% CI: 0.01 to 0.37). Subgroup analyses yielded results similar to those prior to subgrouping. CONCLUSION: The use of Salvadora persica extract was associated with a significant reduction in the plaque score and cariogenic bacterial count. Although, this reduction was lower than that achieved with the gold standard chlorhexidine mouthwash, Salvadora persica-containing rinse could be considered as a suitable oral hygiene alternative for use in individuals of all ages, socioeconomic backgrounds, and health conditions especially as a long-term measure due to its efficacy, safety, availability, cost-effectiveness, and ease of use.

The antimicrobial bio-nanocomposite containing non-hydrolyzed cellulose nanofiber (CNF) and Miswak (Salvadora persica L.) extract.

Miswak (Salvadora persica L.) root extract (SPE) is known for its high antimicrobial and antioxidant activities. In this study, antimicrobial nanocomposites were prepared based on carboxymethyl cellulose (CMC), cellulose nano-fiber (CNF) and SPE. Scanning electron microscopy (SEM) was used distribution of CNF in CMC matrix and energy-dispersive X-ray (EDX) spectroscopy proved the existence of minerals and sulfur-containing compounds in SEP-activated nanocomposite. X-ray diffraction (XRD) and Fourier transform infrared (FTIR) spectroscopy were used for CNF and SPE effects on structure of resulted nanocomposite. Incorporation of CNF increased the ultimate tensile strength (UTS) and decreased the elongation at break point (EB) while adding of 200 and 400 mg/ml caused increase of EB without decrease of UTS. Thermal gravimetric analysis (TGA) showed that SPE improved the heat stability of the nanocomposites. The pure SPE and SPE-activated nanocomposites showed good antibacterial effect against both Staphylococcus aureus (gram positive) and Escherichia coli (gram negative) bacteria.

Alterations in lipid peroxidation, lipid profile, insulin sensitivity, and hepatic histopathological changes in diabetic rats following the treatment with Salvadora persica.

We examined the effects of various partitions of Salvadora persica extract on lipid profile (LP), lipid peroxidation, and insulin sensitivity (IS) of diabetic rats. The rats were divided into normal control, diabetic control (DC), standard, sham, and test groups. The test groups were treated with an oral dose of 200, 400, and 600 mg/kg of crude, aqueous, and ethyl acetate partition of S. persica extract. After 21 days of experiment, the fasting blood glucose (FBS), LPs, lipid peroxidation, IS, liver enzymes levels, liver histopathology, and body weight alteration were evaluated. A significant decrease in FBS and lipid profile (except HDL) were observed in rats treated with various dose of extract compared with the DC rats ( P < 0.05). Treating diabetic rats with various extracts of S. persica meaningfully decreased the level of malondialdehyde ( P < 0.05). Animals treated with various dose of aqueous extract showed better results ( P < 0.01). On the basis of used indirect indexes to determine IS, all partitions of extracts showed anti-insulin resistance effects in diabetic rats. On the basis of our statistical analyzing, treating diabetic rats with all of the three extracts of S. persica decreased the elevated levels of alanine phosphatase, aspartate aminotransferase, and alanine transferase. Also, pathological changes in the liver tissue were reduced following treatment with the S. persica. In conclusion, our results give evidence that the S. persica extract, especially aqueous partition, has a healing effect on diabetes and can be considered as an alternative therapy for this disease.

Chemical effects of chewing sticks made of Salvadora persica.

OBJECTIVE: The chewing sticks are widely used in many regions of Asia and Africa as a traditional tool to maintain oral hygiene. Salvadora persica L. (S. persica), also known as Arak or Miswak, a member of the salvadoraceae family. Chewing sticks, made up from S. persica, have chemical antibacterial properties and mechanical effects. The study aimed to investigate possible chemical effects of S. persica on dental plaque, sub-gingival microbiota and gingival inflammation. In order to achieve this, we inactivated some sticks through boiling to be used as inactive, but mechanically comparable control sticks. METHODS: In a double-blinded crossover trial, 24 patients with mild-to-moderate periodontitis were randomly allocated to use either fresh activated Miswak or inactivated Miswak for 3-week period. Plaque index (PI), gingival index (GI), visual plaque index (VPI) and bleeding on probing (BOP) were evaluated before and immediately following the experimental period. Sub-gingival plaque samples were analysed using DNA-DNA hybridization technique. The study was repeated with the participants switching the type of Miswak they used after a 7-week of "washout" period. RESULTS: There were no significant differences in the microflora after using active and inactive Miswak. Sixteen species of bacteria showed an increase (P < 0.05) after the usage of inactive Miswak, as compared to pretreatment values. No species showed a similar change after the use of active Miswak. There were no significant differences between active and inactive Miswak regarding the registered clinical variables. CONCLUSION: This study has not shown any clinical effect of the chemically active Miswak, but there was a tendency towards an effect on the microflora.

Effectiveness of root-bark extract from Salvadora persica against the growth of certain molecularly identified pathogenic bacteria.

The acetone extract from root-bark of Salvadora persica L. (Salvadoraceae), is assayed for its antibacterial activity against some bacterial pathogens. By GC/MS analysis, the main chemical components of the acetone extract were found to be benzylisothiocyanate (39.4%), and benzyl nitrile (benzeneacetonitrile) (37.9%). According the extract concentrations used, the measured inhibition zones observed were between from 13.6 to 18.6 mm, 15.3-23 mm, 13.3-18.3 mm, 13.3-18.3 mm, and 12.3-19 mm, against the isolated plant bacterial pathogens namely Agrobacterium tumefaciens, Pectobacterium atrosepticum, Enterobacter cloacae, Dickeya solani and Ralstonia solanacearum, respectively, whilst it was between 8 and 12 mm, 8-9.6 mm, 8-11.6 mm, and 8-10.3 mm against Bacillus subtilis, Sarcina lutea, Escherichia coli and Staphylococcus aureus, respectively. The minimum inhibitory concentration values of the extract were between 16 and 32 µg/mL against the growth of plant bacterial, and from 1000 to 2000 µg/mL against the growth of the human bacteria. In conclusion, the acetone extract of root-bark of S. persica showed strong antibacterial activity against the plant pathogens and some activity against the human pathogens were reported. The results suggested that using the acetone extract from root-bark of S. persica as bioactive agent against the growth of the studied plant bacterial pathogens.

A review of the traditional and modern uses of Salvadora persica L. (Miswak): Toothbrush tree of Prophet Muhammad.

ETHNOPHARMACOLOGICAL RELEVANCE: Salvadora persica L., also known as Arak (in Arabic) and Peelu (in Urdu), is the most common traditional source of tooth or chewing stick (miswak) highly recommended by Prophet Muhammad. To date, extensive studies have probed primarily into the validation of its traditional uses in oral care. Nonetheless, there is still a dearth of updated compilation and critical analysis of other potential ethnopharmacological properties of S. persica. This review therefore aims to provide an up-to-date detailed structured description of the traditional uses of S. persica and a critical analysis of its modern uses, highlighting its phytochemistry, pharmacological properties, and bioapplications. MATERIALS AND METHODS: Various databases (Science Direct, PubMed, Wiley Online Library, and Google Scholar), books, and relevant primary sources were probed, surveyed, analysed, and included in this review. The literature cited in this review dated from 1979 to 2017. RESULTS: S. persica was found to possess a plethora of bioactive compounds and broad pharmacological properties, including antimicrobial, antioxidant, enzyme inhibitory activity, antiulcer, anticonvulsant, sedative, analgesic, anti-inflammatory, hypoglycemic, hypolipidemic, antiosteoporosis, and antitumor activities. Studies also revealed the potential use of S. persica as a natural food preservative and a novel functional food ingredient. In addition, improvement in growth and reproductive performances have been observed by the introduction of S. persica in animal feed. Lastly, S. persica has also been used in the green synthesis of nanoparticles showing potential biotechnological applications. CONCLUSION: S. persica showed a wide scope of application and its uses have been extended far beyond the initial traditional uses of its roots, stems, and twigs in oral care. We found a number of other ethnopharmacological uses and potential bioapplications of different parts of S. persica that warrants further investigations. Though widely studied using several in vitro and in vivo models, and tested clinically for oral hygiene mainly, several gaps and research priorities have been identified which needs to be addressed in future.