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Background: Periodontitis is a chronic inflammatory disease of tooth and supporting tissues with clinical signs of bone and connective tissue loss and is mediated by a combination of periodontal pathogens and host defense systems. Currently the use of herbal products in dentistry is increasing due to their easy availability, low cost and lesser side effects. One such herbal plant is Morus alba which is known to possess medicinal properties. Therefore the present study was conducted to determine the clinical effectiveness of subgingivally delivered Morus alba gel incorporated into polaxamers vehicle for its controlled release on periodontal pocket in adjunct to scaling and root planing for treatment of moderate periodontitis patients.
Methods: one hundred eighty patients with chronic periodontitis having pocket depth of ≥5 mm in atleast two different teeth were treated by full-mouth scaling and root planning (SRP) and curettage. They were randomly assigned into one of the three groups with 60 in each group: Group 1: Chlorhexidine Sol-gel was applied at baseline, 15 and 30 days. Group 2: Morus alba Sol-gel was applied at baseline, 15 and 30 days. Grpup 3: Placebo gel was applied at baseline, 15 and 30 days. Plaque index (PI) (Silness and Loe), Gingival index (GI) (Loe and Silness), Community Periodontal index, Periodontal pocket depth and quantitative analysis (anaerobic culture) of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Tannerella forsythia were assessed at baseline and after 45 days.
Morus alba is invaluable member of the plant kingdom belonging to the family Moraceae and the genus Morus. It is extensively cultivated for leaf yield in sericulture. Morus alba have long been used in traditional medicine to improve eyesight, lower blood pressure, prevent diabetes, protect the liver, strengthen joints and treat fever. In particular, few studies on mulberry fruits have reported its biological activities such as antioxidative and anti-inflammatory activities. Even the root bark of has been traditionally used in Asian countries for medicinal purposes due to its anti-inflammatory, hypoglycemic, antibacterial activities. LD50 of extracts of Morus Alba leaves was found to be above 2000 mg/kg which is safe to be used in human beings. Therefore, in the present study the Morus alba leaves has been used in the gel preparation and its effectiveness is assessed against periodontal microorganisms.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 1 (Chlorhexidine gel) | Active Comparator | Non surgical periodontal treatment at baseline and 0.1 ml of 1% chlorhexidine gel administered in subsequent visits. |
|
| Group 2 (Morus alba gel) | Experimental | Non surgical periodontal treatment at baseline and 0.1 ml of 16% Morus alba gel administered in subsequent visits. |
|
| Group 3 (Placebo) | Placebo Comparator | Non surgical periodontal treatment at baseline and 0.1 ml of placebo gel administered in subsequent visits. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Chlorhexidine gel | Other | 0.1 ml of Chlorhexidine gel was administered into the periodontal pocket |
|
| Measure | Description | Time Frame |
|---|---|---|
| Reduction in the periodontal pocket depth | Measured by Probing pocket depth | 45 days |
| Measure | Description | Time Frame |
|---|---|---|
| Reduction in the Microbial count of periodontal pathogens | Reduction in Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Tannerella forsythia | 45 days |
| Reduction in Plaque deposition |
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Inclusion Criteria:
Exclusion Criteria:
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| ID | Term |
|---|---|
| D055113 | Chronic Periodontitis |
| ID | Term |
|---|---|
| D010518 | Periodontitis |
| D010510 | Periodontal Diseases |
| D009059 | Mouth Diseases |
| D009057 | Stomatognathic Diseases |
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| Morus alba gel | Other | 0.1 ml of Morus alba gel was administered into the periodontal pocket |
|
| Placebo | Other | 0.1 ml of Placebo gel was administered into the periodontal pocket |
|
Measured by Plquel index (Silness and Loe)
| 45 days |
| Reduction in gingival inflammation | Measured by Gingival index (Loe and Silness) | 45 days |
| D002908 |
| Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |