Efficacy of Pomegranate Peel Extract Mouthwash on Gingivitis and C-reactive protein

Authors

  • Nabila Abdul Aziz Hussein Kurdistan Higher Council of Medical Candidate, Duhok Training Center
  • Saeed Ali Mohammed Assistant Prof, Department of Periodontics, College of Dentistry, Duhok University Iraq

DOI:

https://doi.org/10.56056/amj.2024.284

Keywords:

Chlorhexidine, C-Reactive protein, Gingivitis, Pomegranate, saliva

Abstract

Background and objective: Gingivitis is characterized as the world’s most predominant inflammatory periodontal disease. Healthy mouth and teeth are obtained by brushing and uses mouthwash. And because of the side effects of chlorhexidine, pomegranate peel extract mouthwash used alternative which are thought to have anti-inflammatory effect.  The aim of this study is to prepare a herbal mouthwash and to evaluate the efficacy of pomegranate peel extract mouthwash on plaque index, gingival index, and C-reactive protein on moderate gingivitis patients.

Method: this study is a clinical crossover design study, which consists of 25 volunteers with moderate gingivitis, who visited Duhok Dental Training Center. This study started from December 2022 to March 2023. Plaque and gingival index with a sample of saliva for C-reactive protein measuring were taken as a baseline before each mouth wash and after that, the pomegranate peel extract mouthwash was used for two weeks, then three weeks wash out between them, then chlorhexidine mouth wash was used for two weeks (crossover method). All saliva samples were analyzed using (CRP ELISA Test).

Results: Twenty-five patients who used pomegranate peel extract mouthwash showed a significant reduction after two weeks used (CRP=162.28, GI=0.54, PI=0.82) and p value (<0.0001) in mean C-reactive protein, gingival index, and plaque index from baseline which was (CRP=669.78, GI=1.88, PI=2.11).

Conclusion: Pomegranate peel extract mouthwash had been shown effective against moderate gingivitis in adult patients with no systemic diseases through lowering in mean salivary C-reactive protein, gingival index, and plaque index.

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References

Arweiler N, L. Netuschil L, The oral microbiota. Adv. Exp. Med. Biol. 2016 ;902: 45 –60.

Uriarte SM., Edmisson JS., Jimenez E. Human neutrophils and oral microbiota: a constant tug - of - war between a harmonious and a discordant coexistence, Immunol. Rev. 2016; 282 –98.

Kote S, Kote S, Nagesh L. Effect of pomegranate juice on dental plaque microorganisms (Streptococci and lactobacilli). Anc Sci Life 2011; 31:49-51.

Malaiappan S, Abrahan C. Effect of pomegranate green tea mouth wash in orogranulocyte migratory rate in gingivitis patient. Biomed &Pharmacol. J. 2020.13(2);883-6.

Bhadbhade S, Acharya A, Rodrigues S, Thakur S. The antiplaque efficacy of pomegranate mouthwash. Quintessence Int. 2011; 42:29-36.

Umar D, Dilshad B, Farhan M, Ali A, Baroud K. The effect of pomegranate mouthrinse on Streptococcus mutans count and salivary pH: An in vivo study. J Adv Pharm Technol Res 2016; 7:13-6.

Siegrist BE, Gusberti FA, Brecx MC, Weber HP, Lang NP. Efficacy of supervised rinsing with chlorhexidine digluconate in comparison to phenolic and plant alkaloid compounds. J Periodont Res. 1986; 21:60–73.

Menezes SM, Corderio LN, Viana GS. Punica granatum (pomegranate) extract is active against dental plaque. J Herb Pharmacother. 2006; 6:79-92.

Nasreen J. Gayathri V. Preparation of Antibacterial Herbal Mouthwash against Oral Pathogens. INT.J.Curr.Microbial.App.Sci.2016 5(11): 205-21.

Bachoual R, Talmoudi W, Boussetta T, Braut F. El- Benna J. An aqueous pomegranate peel extract inhibits neutrophil myeloperoxidase in vitro and attenuates lung inflammation in mice. Food ChemToxicol.2011;49(6):1224-8.

Endo EH, Cortez DA, Ueda-Nakamura T, Nakamura CV and Dias Filho BP. Potent antifungal activity of extracts and pure compounds isolated from pomegranate peels and synergism with fluconazole against Candida albicans. Research in Microbiology.2010;161:534-540.

DiSilvestro RA, DiSilvestro DJ. DiSilvestro DJ. Pomegranate extract mouth rinsing effects on saliva measures relevant to gingivitis risk. Phytotherapy Research.2009;23:1123-1127.

Bhat S. S, Hegde K. S, Farha M. Effect of pomegranate extract mouth rinse on salivary pH and streptococcus mutans counts in children: An In Vivo Study. J Int Den Res.2014;4(1):12-19.

Sajjanl P, Laxminarayan N, Kar P, Sajjanar M. Chlorhexidine as antimicrobial agent in dentistry –A review. Oral Health Dent Manag.2016:15(2):93-100.

Jone CG. Chlorhexidine is it a gold standard Periodontology. 2000; 15:55-62.

Kritika J, Jayakumer ND , Varghese SS, Ssankari, M. Effecancy of herbal mouth wash compared to chlorhexidine in gingivitis –A Systemic Review .In J. Ethnobiology & Ethnomedicine 2014:1(1):1-12.

James B, Andrew M. Clin Biochem. Towards salivary C-reactive protein as a viable biomarker of systemic inflammation. Clinbiochem.2019;68:1-8.

Wetter J, Löhneysen S, Cobar F, Kristenson M, Garvin P, Sjöwall C. Pronounced Diurnal Pattern of Salivary C-Reactive Protein (CRP) With Modest Associations to Circulating CRP Levels. FrontImmunol.2021;11:607166.

Ammar A, Turki M, Chtourou H, Hammouda O, Trabelsi K, Kallel C, et al. Pomegranate supplementation accelerates recovery of muscle damage and soreness and inflammatory markers after a weightlifting training session. PLOS one.2016;11(10): e0160305.

Costa J, Cantor M, Neave H. Symposium review: Precision technologies for dairy calves and management applications. J. Dairy Sci. 2021; 104:1203–1219. doi: 10.3168/jds.2019-17885. 32713704/

Akowuah GA, Ismail Z, Norhayati I, Sadikun A. The effects of different extraction solvents of varying polarities on polyphenols of Orthosiphon stamineus and evaluation of the free radical-scavenging activity. Food Chem. 2005; 93:311–317. doi: 10.1016/j.foodchem.2004.09.028/

Silness J, Loe H. Periodontal disease in pregnancy IIColrrelation with oral hygiene and periodontalcondition. Acta Odont Scand 1964; 22:121-35.

Sastravaha G, Yotnuengnit P, Booncong P, Sangtherapitikul P. Adjunctive periodontal treatment with Centellaasiatica and Punicagranatum extracts. A preliminary study. J Int Acad Periodontol. 2003;15(5):106.

Aggarwal BB, Shishodia S. Suppression of the nuclear factor kappaB activation pathway by spice derived phytochemicals: Reasoning for seasoning. Ann N Y AcadSci; 1030:434 41 (2004).

Leo H, Schiott C. The effect of mouthrinse and topical application of chlorhexidine on the development of dental plaque and gingivitis. J Periodontol Res 1970; 5:79-83.

Cascaes AM, Clark VL, Barros AJ. Effectiveness of motivational interviewing at improving oral health: a systematic review. Rev Saude Publica 2014; 48(1):142-53.

Zannatta FB, Antoniazzi RP, Rosing CK. Staining and calculus formation after 0.12% chlorhexidine rinses in plaque-free and plaque covered surfaces: a randomized trial. J Appl Oral Sci 2010; 18(5):515–21.

Ghazi S, Baban D, Aziz S. A clinical trial evaluates the effect of pomegranate extract as a mouth wash for gingivitis in type 2 diabetic patientsShayma 24EDJ Vol.3 No.1 Jun 2020.

Ahuja S, Dodwad V, Kukreja BJ, Mehra P, Kukreja P. A comparative evaluation of efficacy of Punica granatum and chlorhexidine on plaque and gingivitis. J Int Clin Dent Res Organ 2011; 3(1):29-3.

de Medeiros Nóbrega D , Santos R, Soares R. , Alves P, Medeiros A , Pereira J. randomized, controlled clinical trial on the clinical and microbiological efficacy of Punica granatum Linn mouthwash. Pesquisa Brasileira em Odontopediatria e Clínica Integrada. 2015;15 doi: 10.4034/pboci.2015.151.32/

Deepak C , Samuel S . Effectiveness of pomegranate mouthrinse in reducing bacterial plaque, gingival inflammation and total salivary proteins over a period of 90 days: a double-blind randomized trial. J Int Acad Periodotol . 2018;20:110–114.

Samira E, Sayyedeh A, Razieh A, Amirhossein S .Therapeutic Effects of Punica granatum (Pomegranate): An Updated Review of Clinical Trials Published online 2021 . doi: 10.1155/2021/5297162/

Rahimabadi MS, Fani M, Rostami M, Zarshenas MM, Shams M. A traditional mouthwash (Punica granatum var pleniflora) for controlling gingivitis of diabetic patients. J Evid Based Complementary Altern Med 2017; 22(1):59–67.

RameshKS, ShaminSF. Role of pomegranate in dentistry. Int J Res Ayurveda Pharm 2012;3: 648-9.

Kocaka MM, Ozcanb Z, Kocakb S, Topuzc O, Ertend H. Comparison of the efficacy of three different mouth rinse solutions in decreasing the level of streptococcus mutants in saliva. Eur J of Dent 2009; 3:57-61.

Hassan SA, Metwalli NE. Aly MA, Ibrahim GG. Comparison of the efficacy of mouth rinses Camellia Sinensis extract, guava leaves extract and sodium fluoride solution, on streptococcus mutans and lactobacillus in children. AlAzhar J Dent Sci. 2017; 20:376-82.

Loe H and Silness J. Periodontal diseases in pregnancy 1. Prevalence and severity. Acta odont Scand 1963; 21:533-37.

Akhater S, Ismail T, Fraternale D, Sestili P. Pomegranate peel and peel extract. J foodchem 2014 ;174:417-425.

Christodoulides N, Mohanty S, Miller CS, Langub MC, Floriano PN, Dharshan P, et al. Application of microchip assay system for the measurement of C- reactive protein in human saliva. Lap Chip 2005; 5:261-9.

Bhadbahad S.J, Acharya A.B, Rodrigues S.V, Thakur S.L. The antiplaque efficacy of pomegranate mouth rinse. Quintessence Int.2011;42(1):29-36.

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Published

2024-09-09

How to Cite

Hussein, N. A. A. ., & Mohammed, S. A. . (2024). Efficacy of Pomegranate Peel Extract Mouthwash on Gingivitis and C-reactive protein. AMJ (Advanced Medical Journal) , 9(3), 116-124. https://doi.org/10.56056/amj.2024.284

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