Anti-biofilm and anti-inflammatory effect of a herbal nanoparticle mouthwash: a randomized crossover trial

Abstract

Laboratory evidence has demonstrated the antimicrobial effect of Melaleuca alternifolia (MEL) against oral microorganisms. This randomized, double-blind, crossover clinical trial, compared the anti-biofilm and anti-inflammatory effects of MEL nanoparticles with 0.12% chlorhexidine gluconate (CHX) on biofilm-free (BF) and biofilm-covered (BC) surfaces. Before each experimental period, the participants refrained from all oral hygiene practices for 72 hours. The 60 participants were randomly assigned to professional prophylaxis in two quadrants (Q1-Q3 or Q2-Q4), and rinsed with MEL or CHX for four days. The Quigley & Hein plaque index (QHPI), gingival crevicular fluid (GCF) volume, and participants' perceptions were assessed. CHX showed significantly lower mean QHPI on BF (2.65 ± 0.34 vs. 3.34 ± 0.33, p < 0.05) and BC surfaces (2.84 ± 0.37 vs. 3.37 ± 0.33, p < 0.05). Intragroup comparisons indicated reductions in GCF in all the groups, with significant differences only for CHX on BF surfaces (p < 0.05). Intergroup comparisons revealed no significant differences (p > 0.05). Based on individual perceptions, CHX had better taste and biofilm control, but resulted in a greater change in taste. Nevertheless, MEL demonstrated anti-inflammatory effects similar to those of CHX. Further clinical trials testing different protocols, concentrations and follow-up periods are required to establish its clinical application.

A Review of Nanomaterials and Technologies for Enhancing the Antibiofilm Activity of Natural Products and Phytochemicals

“…157 The results pointed to a moderate to weak antibiofilm capacity and inferior to the one of chlorhexidine (a well-known and often used antiseptic for oral applications) and robust anti-inflammatory activity. 157 On the other hand, in a study with 45 chronic periodontitis patients treated with a nanogel with 2% curcumin, the antibiofilm results were as good as the ones seen for 1% chlorhexidine gel against three periodontopathic bacteria. 158 Curcumin was also used in another CT in which aPDT was tested against S. mutans biofilms in situ.…”

“…Most of them focus on the treatment of oral biofilms and periodontitis. For example, an RCT with 60 participants assessed the effectiveness of a mouthwash containing nanostructured lipid carriers with Melaleuca alternifolia oil on biofilm control and anti-inflammatory activity . The results pointed to a moderate to weak antibiofilm capacity and inferior to the one of chlorhexidine (a well-known and often used antiseptic for oral applications) and robust anti-inflammatory activity .…”

“…For example, an RCT with 60 participants assessed the effectiveness of a mouthwash containing nanostructured lipid carriers with Melaleuca alternifolia oil on biofilm control and anti-inflammatory activity . The results pointed to a moderate to weak antibiofilm capacity and inferior to the one of chlorhexidine (a well-known and often used antiseptic for oral applications) and robust anti-inflammatory activity . On the other hand, in a study with 45 chronic periodontitis patients treated with a nanogel with 2% curcumin, the antibiofilm results were as good as the ones seen for 1% chlorhexidine gel against three periodontopathic bacteria .…”

Advances of nanomaterial applications in oral and maxillofacial tissue regeneration and disease treatment

“…The application of nanomaterials in these dentifrices is of growing interest in recent decades. Generally, the use of nanomaterials enhances the mineralization process of the enamel and/or dentine (Amaechi et al, 2019; Forsback, Areva, & Salonen, 2004; Jeong, Hong, Choi, & Kim, 2007; Lu, Zhang, Meng, Wei, & Zhou, 2006; Roveri et al, 2008; Tay & Pashley, 2008; Vollenweider et al, 2007; Zhao, Liu, Sun, & Zhang, 2011), control bacterial infections or plaque biofilm as part of brushing (Casarin et al, 2019; Johnson et al, 2020; Lu et al, 2006), or provide nanoscale minerals, such as calcium phosphate, to promote pH control. The nanomaterials containing dentifrices are listed in Table 3.…”

Are oral hygiene instructions with aid of plaque‐disclosing methods effective in improving self‐performed dental plaque control? A systematic review of randomized controlled trials

“…14 These agents are specific chemical substances used to stain masses of dental plaque and allow its visualization for clinical purposes, such as iodine, bismarck brown, erythrosine, gentian violet, malachite green, methylene blue, basic fuchsin 15 and two-tone solutions. 16 There is a large evidence related to PD agent use for professional detection of dental plaque in trials [17][18][19][20] and the ability to disclose the biofilm can also improve patient's education and motivation by guiding their self-performed oral hygiene. 21 Interventions to improve adherence to OHI are a milestone challenge for dentistry 10,11,13,22,23 and educate and influence patient's motivation is an important task for dental professionals.…”