Evaluation of Indian Gooseberry/ Amla in the Management of Chronic Periodontitis

Evaluation of Amla (Emblica Officinalis) as an Adjunct to Non-surgical Periodontal Therapy in Patients With Chronic Periodontitis -A Clinical and Biochemical Study

This study aimed to evaluate the influence of amla (Emblica officinalis) on patients with chronic generalized periodontitis, using a single-blind, randomized controlled study design.

1. At baseline, all participants fulfilling the I/E criteria would be randomized into Arm I or II.
2. All participants in Arm I and II would undergo scaling and root planing (SRP).
3. After 1 month, Arm I participants would receive adjunct amla for 2 weeks, and Arm II participants would receive no treatment.
4. Both arms would be followed until the end of 6 months and evaluated for clinical and biochemical parameters.

The study is a randomized, single-blind, controlled trial, involving thirty chronic generalized periodontitis patients aged between 25 to 60 years. Participants fulfilling the Inclusion/ Exclusion criteria participants would be randomized to Arm I or II. They would be subjected to scaling and root planing (SRP). After 1 month, Arm I participants would be given amla for 2 weeks, while no adjunct therapy is planned for the participants in Arm II. Clinical parameters such as plaque index, gingival index, bleeding index, probing pocket depth, and clinical attachment loss would be assessed at baseline, 1, 3 and 6 months post-treatment. Biochemical parameters malondialdehyde (MDA) and glutathione (GTH) would be measured by spectrophotometry, while ELISA would be performed to assess the tumor necrosis factor-α (TNF- α), and C-reactive protein (CRP) in serum and saliva, at baseline and 6 months. Statistical analysis is proposed using SPSS or STATA 14 package.

Inclusion Criteria:

1. Patients who have at least 20 remaining teeth, with chronic generalized periodontitis, as defined as > 30 % sites involved (extent) and with moderate to severe involvement (severity) as characterized by > 2 interproximal sites with clinical attachment loss (CAL) > 4mm (not on the same tooth) AND/OR > 5 mm, probing depth (not on the same tooth) AND/OR > 2 interproximal sites with CAL > 6 mm AND 1 interproximal site with PD > 5mm.
2. Systemically healthy patients

Exclusion Criteria:

1. Medically compromised patients
2. Smokers
3. Pregnant and lactating women
4. Patients on cholesterol-lowering medication
5. Patients who had received any antimicrobial therapy in the past 2 months, on ongoing antimicrobial therapy, or would receive antimicrobials during the course of the study.
6. Patients who had undergone any periodontal surgery in the past 6 months
7. Patients with a high caries index
8. Patients with severe tooth hypersensitivity