Formulation and assessment of biological properties of garcinia indica fruit extract mouthrinse as an adjunct to oral hygiene regimen: an in vitro analysis
DOI:
https://doi.org/10.1590/1678-7757-2023-0291Keywords:
Garcinia indica, Fruit extract, Mouthrinse, Turmeric mouthrinse, Gingivitis, Cytotoxicity, Staining, SubstantivityAbstract
The prevalence of gingivitis is substantial within the general population, necessitating rigorous oral hygiene maintenance. Objective: This study assessed a Garcinia indica (GI) fruit extract-based mouthrinse, comparing it to a 0.1% turmeric mouthrinse and a 0.2% Chlorhexidine (CHX) mouthrinse. The evaluation encompassed substantivity, staining potential, antimicrobial efficacy and cytocompatibility. Methodology: The study employed 182 tooth sections. For antimicrobial analysis, 64 extracted human teeth coated with a polymicrobial biofilm were divided into four groups, each receiving an experimental mouthrinse or serving as a control group with distilled water. Microbial reduction was assessed through colony forming units (CFU). Substantivity was evaluated on 54 human tooth sections using a UV spectrophotometer, while staining potential was examined on 64 tooth sections. Cytocompatibility was tested using colorimetric assay to determine non-toxic levels of 0.2% GI fruit extract, 0.1% Turmeric, and 0.2% CHX. Results: Data were analysed with one-way ANOVA (α=0.05). Cell viability was highly significant (p<0.001) in the 0.2% GI group (64.1±0.29) compared to 0.1% Turmeric (40.2±0.34) and 0.2% CHX (10.95±1.40). For antimicrobial activity, both 0.2% GI (20.18±4.81) and 0.2% CHX (28.22±5.41) exhibited no significant difference (P>0.05) at end of 12 hours. However, 0.1% Turmeric showed minimal CFU reduction (P<0.001). Substantivity results at 360 minutes indicated statistically significant higher mean release rate in 0.1%Turmeric (12.47±5.84 ) when compared to 0.2% GI (5.02±3.04) and 0.2% CHX (4.13±2.25) (p<0.001). The overall discoloration changes (∆E) were more prominent in the 0.2% CHX group (18.65±8.3) compared to 0.2% GI (7.61±2.4) and 0.1% Turmeric (7.32±4.9) (P<0.001). Conclusion: This study supports 0.2% GI and 0.1% Turmeric mouth rinses as potential natural alternatives to chemical mouth rinses. These findings highlight viability of these natural supplements in oral healthcare.
Downloads
References
Murakami S,Mealey BL, Mariotti A, Chapple ILC. Dental plaque-induced gingival conditions. J Periodontol. 2018:89(1)S17-S27. doi:10.1002/JPER.17-0095
Osso D, Kanani N. Antiseptic mouth rinses: an update on comparative effectiveness, risks and recommendations. J Dent Hyg. 2013;87(1):10-8.
Langa GP, Muniz FW, Costa RD, Silveira TM, Rösing CK. The effect of cetylpyridinium chloride mouthrinse as adjunct to toothbrushing compared to placebo on interproximal plaque and gingival inflammation- a systematic review with meta-analyses. Clinical Oral Investig. 2021;25:745-57. doi: 10.1007/s00784-020-03661-2.
Rölla G, Löe H, Schiøtt CR. Retention of chlorhexidine in the human oral cavity. Arch Oral Biol. 1971;16(9):1109-16. doi: 10.1016/0003-9969(71)90215-9
Haydari M, Bardakci AG, Koldsland OC, Aass AM, Sandvik L, Preus HR. Comparing the effect of 0.06% -, 0.12% and 0.2% chlorhexidine on plaque, bleeding and side effects in an experimental gingivitis model: a parallel group, double masked randomized clinical trial. BMC Oral Health. 2017;17(1):118. doi: 10.1186/s12903-017-0400-7
Flötra L, Gjermo P, Rölla G, Waerhaug J. Side effects of chlorhexidine mouth washes. Eur J Oral Sci. 1971;79(2):119-25. doi: 10.1111/j.1600-0722.1971.tb02001.x
Jones CG. Chlorhexidine: is it still the gold standard? Periodontol 2000. 1997;15:55-62. doi: 10.1111/j.1600-0757.1997.tb00105.x
Chye RM, Perrotti V, Piattelli A, Iaculli F, Quaranta A. Effectiveness of different commercial chlorhexidine-based mouthwashes after periodontal and implant surgery: a systematic review. Implant Dentistry. 2019;28(1):74-85. doi: 10.1097/ID.0000000000000854
Cortellini P, Labriola A, Zambelli R, Prato GP, Nieri M, Tonetti MS. Chlorhexidine with an anti discoloration system after periodontal flap surgery: a cross‐over, randomized, triple‐blind clinical trial. J Clin Periodontol. 2008;35(7):614‐ 20. doi: 10.1111/j.1600-051X.2008.01238.x
García‐Gargallo M, Zurlohe M, Montero E, Alonso B, Serrano J, Sanz M, et al. Evaluation of new chlorhexidine‐ and cetylpyridinium chloride‐based mouthrinse formulations adjunctive to scaling and root planing: pilot study. Int J Dent Hyg. 2017;15(4):269‐79. doi: 10.1111/idh.12254
James P, Worthington HV, Parnell C, Harding M, Lamont T, Cheung A, et al. Chlorhexidine mouthrinse as an adjunctive treatment for gingival health. Cochrane Database Syst Rev. 2017;3:CD008676. doi: 10.1002/14651858.CD008676.pub2
Wyganowska-Swiatkowska M, Kotwicka M, Urbaniak P, Nowak A, Skrzypczak-Jankun E, Jankun J. Clinical implications of the growth-suppressive effects of chlorhexidine at low and high concentrations on human gingival fibroblasts and changes in morphology. Int J Mol Med. 2016;37(6):1594-600. doi: 10.3892/ijmm.2016.2550
Chang YC, Huang FM, Tai KW, Chou MY. The effect of sodium hypochlorite and chlorhexidine on cultured human periodontal ligament cells. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;92(4):446-50. doi: 10.1067/moe.2001.116812
Lee TH, Hu CC, Lee SS, Chou MY, Chang YC. Cytotoxicity of chlorhexidine on human osteoblastic cells is related to intracellular glutathione levels. Int Endod J. 2010;43(5):430-5. doi: 10.1111/j.1365-2591.2010.01700.x
Kukreja BJ, Dodwad V. Herbal mouthwashes: gift of nature. Int J Pharma Bio Sci. 2012;3:46-52.
Nagpal M, Sood S. Role of curcumin in systemic and oral health: an overview. J Nat Sci Biol Med. 2013;4(1):3-7. doi: 10.4103%2F0976-9668.107253
Waghmare PF, Chaudhari AU, Karhadkar VM, Jamkhande AS. Comparative evaluation of turmeric and chlorhexidine gluconate mouthwash in prevention of plaque formation and gingivitis: a clinical and microbiological study. J Contemp Dent Pract. 2011;12(4):221-4. doi: 10.5005/jp-journals-10024-1038
Chatterjee A, Debnath K, Rao NK. A comparative evaluation of the efficacy of curcumin and chlorhexidine mouthrinses on clinical inflammatory parameters of gingivitis: a double-blinded randomized controlled clinical study. J Indian Soc Periodontol. 2017;21(2):132-7. doi: 10.4103/jisp.jisp_136_17
Mali AM, Behal R, Gilda SS. Comparative evaluation of 0.1% turmeric mouthwash with 0.2% chlorhexidine gluconate in prevention of plaque and gingivitis: a clinical and microbiological study. J Indian Soc Periodontol. 2012;16(3):386-91. doi: 10.4103/0972-124X.100917
Jagtap P, Bhise K, Prakya V. A phytopharmacological review on Garcinia indica. Int J Herb Med. 2015;3(4):2-7.
Lim SH, Lee HS, Lee CH, Choi CI. Pharmacological activity of Garcinia indica (Kokum): an updated review. Pharmaceuticals. 2021;14(12):1338. doi: 10.3390/ph14121338
Pasha C, Sayeed S, Ali S, Khan Z. Antisalmonella activity of selected medicinal plants. Turk J Biol. 2009;33(1):59-64. doi: 10.3906/biy-0804-3
Sushma B, Murali R, Shamala A, Yalamalli M, Kashyap B. Antibacterial activity of herbal extracts against oral bacteria: an in vitrostudy. IOSR J Dent Med Sci. 2020;19(6):22-9. doi: 10.9790/0853-1906072229
Varghese J, Ramenzoni LL, Shenoy P, Nayak UY, Nayak N, Attin T, et al. In vitro evaluation of substantivity, staining potential, and biofilm reduction of guava leaf extract mouth rinse in combination with its anti-inflammatory effect on human gingival epithelial keratinocytes. Materials (Basel). 2019;12(23):3903. doi: 10.3390/ma12233903
Guggenheim B, Giertsen ES, Schüpbach P, Shapiro S. Validation of an in vitro biofilm model of supragingival plaque. J Dent Res. 2001;80(1):363-70. doi: 10.1177/00220345010800011201
Freitas CS, Diniz HF, Gomes JB, Sinisterra RD, Cortés ME. Evaluation of the substantivity of chlorhexidine in association with sodium fluoride in vitro. Pesqui Odontol Bras. 2003;17(1):78-81. doi: 10.1590/S1517-74912003000100015
Jenkins S, Addy M, Newcombe R. Comparison of two commercially available chlorhexidine mouthrinses: II. Effects on plaque reformation, gingivitis, and tooth staining. Clin Prev Dent. 1989;11(6):12-16.
Addy M, Moran J, Newcombe R, Warren P. The comparative tea staining potential of phenolic, chlorhexidine and anti‐adhesive mouthrinses. J Clin Periodontol. 1995;22(12):923-8. doi: 10.1111/j.1600-051x.1995.tb01796.x
Mosmann T. Rapid colorimetric assay for cellular growth and survival: application to proliferation and cytotoxicity assays. J Immunol Methods. 1983;65(1-2):55-63. doi: 10.1016/0022-1759(83)90303-4
Nainegali BS, Iyyaswami R, Belur PD. Simultaneous extraction of four different bioactive compounds from garcinia indica and their enrichment using aqueous two-phase systems. Food Bioprod Process. 2019;114:185-95. doi: 10.1016/j.fbp.2019.01.002
Sutar RL, Mane SP, Ghosh JS. Antimicrobial activity of extracts of dried kokum (Garcinia indica C). Int Food Res J. 2012;19(3):1207-10.
Nagendra K, Kusum R, Ramachandran HD. Anti microbial, antifungal and anti oxidant activity of ethanolic extracts of Garcinia indica fruit. Int J Curr Microbiol Appl Sci. 2014;3(9):800-4.
Serrano J, Escribano M, Roldán S, Martín C, Herrera D. Efficacy of adjunctive anti-plaque chemical agents in managing gingivitis: a systematic review and meta-analysis. J Clin Periodontol. 2015;42(16):S106-38. doi: 10.1111/jcpe.12331
Weijden FA, Sluijs E, Ciancio SG, Slot DE. Can chemical mouthwash agents achieve plaque/gingivitis control? Dent Cli North Am. 2015;59(4):799-829. doi: 10.1016/j.cden.2015.06.002
Nagappan N, Ejaj MM, D’cruz TM, Subbiah GK, Tajuddin R, Subbiah K. An in vitro study to determine the antibacterial activity of Chlorhexidine and herbal mouthrinses against Enterococcus faecalis. J Pharm Bioallied Sci. 2022;14(1):S995-S9. doi: 10.4103/jpbs.jpbs_819_21
Schönbächler N, Thurnheer T, Paque´ PN, Attin T, Karygianni L. In vitro versus in situ biofilms for evaluating the antimicrobial effectiveness of herbal mouthrinses. Front Cell Infect Microbiol. 2023;13:1130255. doi: 10.3389/fcimb.2023.1130255
Bomdyal RS, Shah MU, Doshi YS, Shah VA, Khirade SP. Antibacterial activity of curcumin (turmeric) against periopathogens- an in vitro evaluation. J Adv Clin Res. 2017;4:175-80. doi: 10.15713/ins.jcri.188
Reda B, Hollemeyer K, Trautmann S, Hannig M, Volmer DA. Determination of chlorhexidine retention in different oral sites using matrix-assisted laser desorption/ionization-time of flight mass spectrometry. Arch Oral Biol. 2020;110:104623. doi: 10.1016/j.archoralbio.2019.104623
Quintas V, Prada-López I, Donos N, Suárez-Quintanilla D, Tomás I. In situ neutralisation of the antibacterial effect of 0.2% Chlorhexidine on salivary microbiota: quantification of substantivity. Arch Oral Biol. 2015;60(8):1109-16. doi: 10.1016/j.archoralbio.2015.04.002
Naiktari RS, Dharmadhikari C, Gurav AN, Kakade S. Determining the antibacterial substantivity of Triphala mouthwash and comparing it with 0.2% chlorhexidine gluconate after a single oral rinse: a crossover clinical trial. J Ind Soc Periodontol. 2018;22(6):498-502. doi: 10.4103/jisp.jisp_265_18. PMID: 30631228
Mauland EK, Preus HR, Aass AM. Comparison of commercially available 0.2% chlorhexidine mouthwash with and without anti‐discoloration system: a blinded, crossover clinical trial. J Clin Periodontol. 2020;47(12):1522-7. doi: 10.1111/jcpe.13382
Bagis B, Baltacioglu E, Özcan M, Ustaomer S. Evaluation of chlorhexidine gluconate mouth rinse-induced staining using a digital colorimeter: an in vivo study. Quint Int. 2011:42(3):213-23.
Avula B, Wang YH, Smillie TJ, Khan IA. Quantitative determination of curcuminoids from roots of Curcuma longa, Curcuma species and dietary supplements by UPLC-UV-MS method. Planta Medica. 2009;75:68-72. doi: 10.1055/s-2009-1216506
Prayitno S, Addy M. An in vitro study of factors affecting the development of staining associated with the use of chlorhexidine. J Perio Res. 1979;14(5):397-402. doi: 10.1111/j.1600-0765.1979.tb00237.x
Müller HD, Eick S, Moritz A, Lussi A, Gruber R. Cytotoxicity and antimicrobial activity of oral rinses in vitro. Biomed Res Int. 2017;2017:4019723. doi: 10.1155/2017/4019723
Liu JX, Werner J, Kirsch T, Zuckerman JD, Virk MS. Cytotoxicity evaluation of chlorhexidine gluconate on human fibroblasts, myoblasts, and osteoblasts. J Bone Jt Infect. 2018;10;3(4):165-72. doi: 10.7150/jbji.26355
Sukumaran SK, Vadakkekuttical RJ, Kanakath H. Comparative evaluation of the effect of curcumin and chlorhexidine on human fibroblast viability and migration: an in vitro study. J Indian Soc Periodontol. 2020;24(2):109-16. doi: 10.4103/jisp.jisp_173_19
Mandroli PS, Prabhakar AR, Bhat K, Krishnamurthy S, Bogar C. An in vitro evaluation of cytotoxicity of curcumin against human periodontal ligament fibroblasts. Ayu. 2019;40(3):192-5. doi: 10.4103%2Fayu.AYU_294_18
Coelho AS, Laranjo M, Gonçalves AC, Paula A, Paulo S, Abrantes AM, et al. Cytotoxic effects of a chlorhexidine mouthwash and of an enzymatic mouthwash on human gingival fibroblasts. Odontol. 2020;108:260-70. doi: 10.1007/s10266-019-00465-z
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Journal of Applied Oral Science
This work is licensed under a Creative Commons Attribution 4.0 International License.
Todo o conteúdo do periódico, exceto onde está identificado, está licenciado sob uma Licença Creative Commons do tipo atribuição CC-BY.
