Effect of Subgingivally Delivered 10% Emblica officinalis Gel as an Adjunct to Scaling and Root Planing in the Treatment of Chronic Periodontitis - A Randomized Placebo-controlled Clinical Trial

Abstract

Emblica officinalis fruit possesses varied medicinal properties including cytoprotective antimicrobial, antioxidant, antiresorptive and antiinflammatory activity. The present study aimed to investigate the effect of subgingival application of indigenously prepared E. officinalis (Amla) sustained-release gel adjunctive to scaling and root planing (SRP) on chronic periodontitis. Forty-six patients (528 sites) were randomly assigned to control group (23;264): SRP +placebo gel and test group (23;264): SRP + 10% E. officinalis gel application. Periodontal parameters: plaque index, gingival index, probing pocket depth (PPD), clinical attachment level (CAL) and modified sulcus bleeding index (mSBI) were assessed at baseline, 2 and 3-month post-therapy. Forty patients (470 sites) completed the trial. When test and control sites were compared, significantly more reduction in mean PPD, mSBI, number of sites with PPD = 5-6 mm, PPD ≥ 7 mm, CAL ≥ 6 mm and greater CAL gain were achieved in test sites at 2- and 3-month post-therapy (p < 0.05). Locally delivered 10% E. officinalis sustained-release gel used as an adjunct to SRP may be more effective in reducing inflammation and periodontal destruction in patients with chronic periodontitis when compared with SRP alone. Copyright © 2016 John Wiley & Sons, Ltd.

Efficacy of local phytotherapy in the nonsurgical treatment of periodontal disease: A systematic review

“…Initially, 164 patients with chronic periodontitis were enrolled, and 154 (93.9%) completed the follow‐up. Just 1 study included smokers and 6 others excluded them …”

“…Three studies were considered to have an unclear risk of bias, and 4 studies were judged to have high risk of bias (Table ).…”

“…Besides 1 paper did not use clinical attachment level gain as clinical outcome, all included studies showed that periodontal treatment in association with local phytotherapic delivery promoted a significant PPD reduction and 6 of them showed clinical attachment level gain . One study showed that the test group presented a significant greater BOP change than control group; however, there were no differences between groups as regards PI and GI . Another study found a greater reduction in PI and GI on the test group .…”

“…Conventional periodontal treatment consists of oral hygiene instruction and scaling and root planing (SRP). However, some patients do not respond favorably to conventional therapy and therapeutic agents may be necessary …”

“…Some papers have studied the effects of plants as adjuncts to periodontal treatment . Still, it is necessary to review systematically the evidence regarding their efficacy, in periodontal treatment.…”