Non-Surgical Periodontal Therapy Improves Clinical Outcomes in Patients with Chronic Periodontitis Independent of the Use of Nigella Sativa Oil or Normal Saline Mouthwash; Randomized Controlled Trial

Abstract

OBJECTIVES: Chronic periodontitis (CP) is an inflammatory disease of microbial origin that harms the health of the oral tissues. The objective of this study was to analyze the effects of Nigella sativa oil mouthwash given for two weeks after non-surgical therapy in patients with CP. METHODOLOGY: This study was a parallel-arm randomized controlled trial that was conducted after ethical approval and registered with clinicaltrials.gov. The trial followed the guidelines of CONSORT and triple blinding was ensured. A total of fifty voluntary participants, after giving consent and being evaluated for clinical parameters of CP that included Periodontal Pocket Depth (PPD), CAL (Clinical Attachment Loss), PI (Plaque Index) and BoP (Bleeding on Probing) were divided into a control group and a treatment group. Both groups underwent scaling and root planning and were given normal saline solution or Nigella sativa oil respectively to be used as mouthwash daily for two weeks. The clinical parameters were recorded after two weeks and data was analyzed using SPSS (version 25.0). RESULTS: It was noted that a statistically significant change was found in the pre-treatment and post-treatment values of all CP parameters in both the groups after the use of normal saline and Nigella sativa oil mouthwash. No statistically significant results were obtained when clinical parameters were evaluated between the two groups. CONCLUSION: The clinical periodontal parameters of PI, CAL, PPD and BoP improved in both study groups two weeks following non-surgical periodontal therapy irrespective of the Nigella Sativa oil-based mouthwash or normal saline-based mouthwash used. It is suggested that either both types of mouthwashes had a beneficial effect or sub-gingival ultrasonic instrumentation itself was enough for improvement of periodontal health irrespective of the mouthwash used. KEYWORDS: Nigella sativa, Chronic periodontitis, Normal Saline, Oral Health, Dental, Non-surgical Periodontal Therapy

Clinical Effectiveness of Herbal Oral Care Products in Periodontitis Patients: A Systematic Review

“…All included studies were published between 2003 and 2022 [ 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 ] and the majority of them were randomized clinical trials [ 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 54 , 55 , 56 , 58 , 59 , 60 , 61 , 62 , 63 , 64 ] and conducted in India [ 43 , 45 , 46 , 47 , 48 , 51 , 52 , 53 , 55 , 63 , 64 ], while the rest of them were from Iran [ 44 , 49 , 59 ], Iraq […”

“…None of the included eligible investigations tested herbal gels. Various herbal products were tested in the included investigations including 1% Matricaria chamomilla [ 43 ], triphala ( Emblica officinalis , Terminalia chebula , and Terminalia belerica ) [ 45 , 52 , 53 ], Saussurea lappa extracts [ 46 ], 4% Ocimums anctrum [ 47 ], green tea [ 48 , 49 , 50 ], Nigella sativa [ 54 ], liquorice [ 57 ], Stuckenia striata [ 59 ], lemongrass oil [ 63 ], red ginseng [ 64 ], or combinations of different herbs [ 44 , 51 , 55 , 56 , 58 , 60 , 61 , 62 ].…”

“…SRP was completed in conjunction with the use of herbal products in 13 studies [ 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 52 , 53 , 54 , 55 , 57 ], whereas the rest of them performed SRP prior to the initiation of the study [ 51 , 56 ], or included SPD only [ 57 , 58 , 60 , 62 , 63 , 64 ], or no treatment [ 59 , 61 ]. All examined patients were diagnosed with chronic periodontitis.…”

“…The severity and extend of the disease varied between the studies. Five studies included patients with “generalized chronic periodontitis” [ 43 , 45 , 53 , 55 , 64 ], while “chronic periodontitis” was reported in the inclusion criteria of eleven included investigations [ 44 , 46 , 47 , 51 , 52 , 54 , 56 , 57 , 59 , 60 , 61 ]. Other diagnoses included “mild to moderate periodontitis” [ 48 ], “generalized moderate chronic periodontitis” [ 49 ], “localised mild to moderate chronic periodontitis” [ 50 ], “slight and moderate chronic periodontitis” [ 58 ], “moderate or severe periodontitis” [ 62 ], “generalized severe periodontitis” [ 63 ].…”

“…CHX showed better clinical outcomes than herbal products in two investigations [ 44 , 56 ]. No differences between saline and Nigella sativa used as mouthwash were detected in a study [ 54 ].…”