A review of the traditional and modern uses of Salvadora persica L. (Miswak): Toothbrush tree of Prophet Muhammad

Salvadora persica leaves: phytochemical profile and in vitro-inhibitory activity on inflammatory mediators implicated in periodontal disease

CONTEXT

Virtually all parts of Salvadora persica L. (Salvadoraceae) are used in traditional medicine. The twigs and leaves are used for oral health, but leaves are far less investigated.

OBJECTIVE

This study assesses the oral health-promoting potential of S. persica leaves with emphasis on anti-inflammatory and antiproliferative effects and provides an in depth-characterization of their metabolite profile.

MATERIALS AND METHODS

Hot-water and methanolic S. persica leaf extracts (1, 10, and 100 µg/mL) and their major constituents (5, 10, and 50 µM), were subjected to cellular assays on IL-8 and TNFα release in LPS-stimulated human neutrophils, NO-release in LPS/IFNγ stimulated mouse macrophages, and proliferation of HNO97 human tongue carcinoma cells. Metabolite profiling was performed by UHPLC-HRMS analysis. Major constituents were isolated and structurally elucidated.

RESULTS AND DISCUSSION

Both extracts showed pronounced anti-inflammatory activity in LPS-stimulated neutrophils. Major identified compound classes were flavonoid glycosides, the glucosinolate glucotropaeolin, phenyl- and benzylglycoside sulfates, and megastigmane glycosylsulfates, the latter ones identified for the first time in S. persica. Glucotropaeolin strongly inhibited the release of IL-8 and TNF-α (13.3 ± 2.0 and 22.7 ± 2.6% of the release of stimulated control cells at 50 µM), while some flavonoids and 3-(3'-O-sulfo-β-d-glucopyranosyloxy)-7,8-dihydro-β-ionone, a newly isolated megastigmane glycosylsulfate, were moderately active. Benzylisothiocyanate, which is likely formed from glucotropaeolin during traditional application of S. persica, showed considerable antiproliferative activity (IC50 in HNO97 cells: 10.19 ± 0.72 µM) besides strongly inhibiting IL-8 and TNFα release.

CONCLUSIONS

Glucotropaeolin and benzylisothiocyanate are likely implicated in the oral health-promoting effects of S. persica leaves. The chemistry and pharmacology of the newly identified megastigmane glycosylsulfates should be further evaluated.

Syringin: a naturally occurring compound with medicinal properties

Syringin, a phenylpropanoid glycoside, is widely distributed in various plants, such as Acanthopanax senticosus (Rupr. et Maxim.) Harms, Syringa reticulata (BL) Hara var. mandshurica (Maxim.) Hara, and Ilex rotunda Thumb. It serves as the main ingredient in numerous listed medicines, health products, and foods with immunomodulatory, anti-tumor, antihyperglycemic, and antihyperlipidemic effects. This review aims to systematically summarize syringin, including its physicochemical properties, plant sources, extraction and separation methods, total synthesis approaches, pharmacological activities, drug safety profiles, and preparations and applications. It will also cover the pharmacokinetics of syringin, followed by suggestions for future application prospects. The information on syringin was obtained from internationally recognized scientific databases through the Internet (PubMed, CNKI, Google Scholar, Baidu Scholar, Web of Science, Medline Plus, ACS Elsevier, and Flora of China) and libraries. Syringin, extraction and separation, pharmacological activities, preparations and applications, and pharmacokinetics were chosen as the keywords. According to statistics, syringin can be found in 23 families more than 60 genera, and over 100 species of plants. As a key component in many Chinese herbal medicines, syringin holds significant research value due to its unique sinapyl alcohol structure. Its diverse pharmacological effects include immunomodulatory activity, tumor suppression, hypoglycemic action, and hypolipidemic effects. Additionally, it has been shown to provide neuroprotection, liver protection, radiation protection, cardioprotection, and bone protection. Related preparations such as Aidi injection, compound cantharidin capsule, and Tanreqing injection have been widely used in clinical settings. Other studies on syringin such as extraction and isolation, total synthesis, safety profile assessment, and pharmacokinetics have also made progress. It is crucial for medical research to deeply explore its mechanism of action, especially regarding immunity and tumor therapy. Meanwhile, more robust support is needed to improve the utilization of plant resources and to develop extraction means adapted to the needs of industrial biochemistry to further promote economic development while protecting people's health.

Effectiveness of Salvadora persica toothbrush and Salvadora persica chewing stick in plaque and gingivitis control: a randomized control trial

BACKGROUND

The values of plant-based products have taken on an expanding relevance in dentistry. Salvadora persica chewing stick (miswak) has been practiced for centuries and is recommended by the World Health Organization as a customary oral hygiene tool. The therapeutic effects of S. persica chewing stick are contributed by its mechanical cleansing action, active chemicals released, or the combination of these two actions. However, the S. persica chewing stick in its natural form can be difficult to maneuver in certain parts of the mouth. This concern has inspired the innovation of the S. persica toothbrush that is designed to merge the ease of use of a toothbrush with the beneficial natural properties of S. persica preserved in its bristle. The present study aimed to compare the clinical effectiveness between S. persica toothbrush, S. persica chewing stick and the standard toothbrush in plaque and gingivitis control.

METHODS

In this single-blinded and parallel randomized controlled trial, 78 participants were randomly divided into three groups to either use (i) S. persica toothbrush (MTB); (ii) S. persica chewing stick (MCS); or (iii) standard toothbrush (STB) in a standardized manner for three weeks. Plaque Index (PI) and Periodontal Inflamed Surface Area (PISA) values, measuring plaque levels and severity of gingivitis, respectively, were evaluated at baseline, one- and three-week post-interventions.

RESULTS

The MCS group showed a significant improvement in the mean PISA values of the anterior teeth compared to the MTB and STB groups (MCS: from 16.35 ± 10.03 to 3.41 ± 1.14; MTB: from 25.20 ± 14.01 to 3.57 ± 1.19; STB: from 26.54 ± 8.64 to 6.17 ± 0.86; p < .050). All three groups reported significant improvements (p < .001) in the plaque levels and the severity of gingivitis from baseline to three weeks after the intervention.

CONCLUSIONS

Following correct techniques, S. persica toothbrush and chewing sticks are as effective as the standard toothbrush in plaque control and gingival health, which represent the reputed anti-plaque and anti-gingivitis properties of S. persica.

TRIAL REGISTRATION

This clinical trial was prospectively registered in ClinicalTrials.gov with registration NCT04650685 (25/11/2020).

The effect of Salvadora persica ethanolic extract on oral tissue healing in rats: An in vivo study

Introduction

Invasive surgical procedures in the oral cavity inevitably cause trauma to the soft and hard tissues. The healing process in the oral cavity tissue occurs in a complex manner involving different types of cells, maturation process, and the time of healing. Salvadora persica (miswak) has been found to exert various positive effects on the oral cavity, including antimicrobial, anti-gingivitis, anti-cariogenic, gingival healing, and teeth whitening properties. This study aims to investigate the potential of miswak as an adjunctive therapy in promoting wound healing.

Materials and methods

30 live Sprague-Dawley rats were used in this study. The rats' mandibular first molar tooth was extracted, and an incision wound was made on the tongue. The extraction socket and incision wound were irrigated using normal saline and different concentrations of locally processed miswak plant extracts (0.05%, 10%, and 20%) for 7 days. The rats were sacrificed for gross examination of the tooth socket and tongue healing. Both soft tissue and alveolar bone were examined microscopically.

Results

Complete closure of the incision wound was observed on all rats' tongues; miswak groups showed better wound healing than control and placebo groups in the oral mucosa overlying the alveolar bones. 0.05% and 20% miswak extracts showed prominent wound healing effects in the sagittal sections of the tongue, with moderate formation of connective tissue under the wound site and notable wound contraction. The 20% miswak extract group showed the highest percentage of healed oral mucosa on the alveolar bone and higher bone deposition at the alveolar base.

Conclusion

A concentration of 20% miswak extract enhances the initial phase of wound healing both in oral soft and hard tissues. Miswak extract at this concentration was not toxic to the tissues and had potential therapeutic effects in oral tissue healing.

Effect of Alkaline Treatment on Mechanical and Thermal Properties of Miswak (Salvadora persica) Fiber-Reinforced Polylactic Acid

This study examines the effects of alkaline treatment on the mechanical and thermal properties of miswak fiber-reinforced polylactic acid. The treatment was performed with three distinct concentrations of sodium hydroxide (NaOH): 1 wt %, 2 wt %, and 3 wt %. The difficulties of interaction between the surface of the fiber and the matrix, which led to this treatment, is caused by miswak fiber's hydrophilic character, which impedes its ability to bind with hydrophobic polylactic acid. FTIR, tensile, TGA, and DMA measurements were used to characterize the composite samples. A scanning electron microscope (SEM) was used to examine the microstructures of many broken samples. The treatment is not yet especially effective in enhancing interfacial bonding, as seen by the uneven tensile strength data. The effect of the treated fiber surface significantly improves the tensile strength of miswak fiber-reinforced PLA composites. Tensile strength improves by 18.01%, 6.48%, and 14.50%, respectively, for 1 wt %, 2 wt %, and 3 wt %. Only 2 wt %-treated fiber exhibits an increase of 0.7% in tensile modulus. The modulus decreases by 4.15 % at 1 wt % and by 19.7% at 3 wt %, respectively. The TGA curve for alkali-treated fiber composites demonstrates a slight increase in thermal stability when compared to untreated fiber composites at high temperatures. For DMA, the composites with surface treatment have higher storage moduli than the composite with untreated miswak fiber, especially for the PLA reinforced with 2 wt % alkali miswak fiber, proving the effectiveness of the treatment.

Valorization and characterization of bio-oil from Salvadora persica seed for air pollutant adsorption

Salvadora persica (SP) is an important medicinal plant. Numerous articles have been conducted on the leaf, the roots, and the stem of the plant, but there is little information about the seed. Thus, the present work tries to identify the chemical composition of SP seed bio-oil and investigates its use as an adsorbent for cyclohexane removal. This study extracted bio-oil from seeds using different polar and non-polar organic solvents. Two techniques have been used to determine the chemical composition of the bio-oil extracted: FTIR and GC-MS. Results show that the extracted bio-oil presented 13 new major organic bio-compounds in n-hexane and ethanol SP seed extracts. Moreover, the analytical results showed that the two extracts are complex and contained thiocyanic acid, benzene, 3-pyridine carboxaldehyde, benzyl nitrile, ethyl tridecanoate, ethyl oleate, and dodecanoic acid ethyl ester. Additionally, each technique of analysis showed that the extracted bio-oils from SP seeds are rich in non-polar compounds. Indeed, the major fatty acids obtained are pentadecylic acid, myristic acid, lauric acid, oleic acid, margaric acid, and tricosanoic acid. This work provides guidelines for identifying these compounds, among others, and offers a platform for using SP seeds as a herbal alternative for various chemical, industrial, and medical applications. Furthermore, the capacity of SP extracts for air pollution treatment, namely, the removal of cyclohexane in batch mode, was investigated. Results showed that cyclohexane adsorption could be a chemical process involving both monolayer and multilayer adsorption mechanisms. The pores and the grooves on the surface of the SP bio-oil extract helped in adsorbing the cyclohexane with an outstanding maximum removal capacity of about 674.23 mg/g and 735.75 mg/g, respectively, for the ethanol and hexane SP extracts, which is superior to many other recent adsorbents.

Persicaline, an alkaloid from Salvadora persica, inhibits proliferation and induces apoptosis and cell-cycle arrest in MCF-7 cells

Cancer is the second largest cause of mortality worldwide. Many natural bioactive chemicals generated from plants have favorable impacts on health, including cancer chemoprevention, compared to their manufactured counterparts. Persicaline, a novel sulfur-containing imidazoline alkaloid derived from Salvadora persica, has been shown to display promising antioxidant activity. In this study, the antiproliferative activity of persicaline was tested against different cancer cells using (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide assay. The cell death mode and cell-cycle arrest were examined using flow cytometry analysis. In addition, the proapoptotic and molecular mechanism effects of persicaline against mammary MCF-7 cell line were explored. Furthermore, the impact of persicaline on apoptotic genes markers, generation of reactive oxygen species (ROS), and mitochondrial membrane potential were monitored. It was found that persicaline inhibits cell proliferation in a dose-dependent manner. Persicaline-treated MCF-7 cells also showed initiation of apoptotic events and G1 cell-cycle arrest. In addition, persicaline treatment led to an increase in ROS generation, Bax and caspase upregulation while the Bcl-2 was downregulated. Hence, for the first time, this study showed that persicaline causes G1 phase arrest and apoptosis induction in MCF-7 cells. Increased proapoptotic genes and ROS levels were required for the antiproliferative and apoptotic effects of persicaline.

Individual, familial and country-level factors associated with oral hygiene practices in children: an international survey

BACKGROUND

Maintaining good oral hygiene is key to preventing dental caries and periodontal disease. Children and adolescents with good oral hygiene behaviours are likely to grow into adults with the same behaviours. This study assessed the frequency of using various oral hygiene methods among children and adolescents from different countries and individual, familial and country-level factors associated with the use of these methods.

METHODS

A multi-country online survey collected data from caregivers of children in 2020-21 about children's use of oral hygiene methods including toothbrush, fluoridated toothpaste, mouthwash, dental floss and miswak using self-administered, close-ended questions. Adjusted multilevel logistic regression models were used to assess the relationship between each of the five oral hygiene methods (dependent variables) and the independent factors: sex, age, and history of dental visits (individual factors), mother's education and area of residence (familial factors) as well as country income and region (country-level factors).

RESULTS

A total of 4766 parents/caregivers were included from 20 countries (77.4% Eastern Mediterranean-region and 41.6% lower middle income countries). The most frequent oral hygiene methods were using toothbrush and toothpaste (90% and 60.3%). The use of oral hygiene methods differed by age, sex and history of dental visits as well as mother's education and area of residence (P < 0.05). In addition, children from low income countries had significantly lower odds of using mouthwashes and dental floss than those from high income countries (AOR = 0.55, 95% CI 0.31, 0.98 and AOR = 0.34, 95% CI 0.12, 0.97) whereas children from the European region had higher odds of using mouthwash (AOR = 2.82, 95% CI 1.27, 6.26) and those from the region of the Americas had higher odds of using dental floss (AOR = 3.84, 95% CI 1.28, 11.52) than those from the Eastern Mediterranean region.

CONCLUSIONS

The use of various oral hygiene methods is associated with individual, familial and country-level factors. Oral health promotion programs should be developed taking into account these influences.

Saudi Arabian Plants: A Powerful Weapon against a Plethora of Diseases

The kingdom of Saudi Arabia (SA) ranks fifth in Asia in terms of area. It features broad biodiversity, including interesting flora, and was the historical origin of Islam. It is endowed with a large variety of plants, including many herbs, shrubs, and trees. Many of these plants have a long history of use in traditional medicine. The aim of this review is to evaluate the present knowledge on the plants growing in SA regarding their pharmacological and biological activities and the identification of their bioactive compounds to determine which plants could be of interest for further studies. A systematic summary of the plants' history, distribution, various pharmacological activities, bioactive compounds, and clinical trials are presented in this paper to facilitate future exploration of their therapeutic potential. The literature was obtained from several scientific search engines, including Sci-Finder, PubMed, Web of Science, Google Scholar, Scopus, MDPI, Wiley publications, and Springer Link. Plant names and their synonyms were validated by 'The Plant List' on 1 October 2021. SA is home to approximately 2247 plant species, including native and introduced plants that belong to 142 families and 837 genera. It shares the flora of three continents, with many unique features due to its extreme climate and geographical and geological conditions. As plants remain the leading supplier of new therapeutic agents to treat various ailments, Saudi Arabian plants may play a significant role in the fight against cancer, inflammation, and antibiotic-resistant bacteria. To date, 102 active compounds have been identified in plants from different sites in SA. Plants from the western and southwestern regions have been evaluated for various biological activities, including antioxidant, anti-cancer, antimicrobial, antimalarial, anti-inflammatory, anti-glycation, and cytotoxic activities. The aerial parts of the plants, especially the leaves, have yielded most of the bioactive compounds. Most bioactivity tests involve in vitro assessments for the inhibition of the growth of tumour cell lines, and several compounds with in vitro antitumour activity have been reported. More in-depth studies to evaluate the mode of action of the compounds are necessary to pave the way for clinical trials. Ecological and taxonomical studies are needed to evaluate the flora of SA, and a plan for the conservation of wild plants should be implemented, including the management of the protection of endemic plants.

Physical, Mechanical, and Thermal Properties and Characterization of Natural Fiber Composites Reinforced Poly(Lactic Acid): Miswak (Salvadora Persica L.) Fibers

7000 years ago, miswak fiber (MF) was used as a toothbrush for oral care. However, since the emergence of plastic materials, it monopolized the oral care industry. The increment of plastic products also promotes accumulation of plastic wastes after its disposal. Thus, many researchers have turn to biodegradable products to reduce this problem. The aim of this study is to investigate the chemical, physical, and mechanical properties of MF as reinforcement in composites that are suitable to replace the toothbrush materials. The MF was reinforced in PLA composite with different weight percentage (0%, 10%, 20%, and 30%) and undergoes several types of testing. The chemical results show that there were high presence of cellulose in the fiber which could act as medium to transfer stress load equally from fiber to matrix. However, the results show low cellulosic contents in MF that affects the poor interfacial bonding between fiber and matrix. Physical properties shows a positive indication to be used as a toothbrush handle. As the fiber content increases, the density also increased. SEM micrographic illustrated the presence of voids as the cause for reduction in mechanical properties of composites. The mechanical results show the proposed material is comparable to the materials used in commercial applications. As for the thermal result, the TGA test melting point of the proposed composite material was comparable to the pure PLA, which means the proposed material can use similar processing temperature as PLA. DSC shows that Tg of PLA/MF composite is found to be similar to Tg in loss modulus of composites. DMA finding found that PLA/MF30 have the highest storage modulus 2062 MPa and the lowest tan δ 0.6 among PLA/MF composites. This concludes that there is a possibility of using these materials as an alternative in composites and increase the fiber strength by using pretreatments and/or compatibilizer.

Biosynthesis and Analytical Characterization of Iron Oxide Nanobiocomposite for In-Depth Adsorption Strategy for the Removal of Toxic Metals from Drinking Water

The biosynthesis of the iron oxide nanoparticles was done using Ixoro coccinea leaf extract, followed by the fabrication of iron oxide nanobiocomposites (I-Fe3O4-NBC) using chitosan biopolymer. Furthermore, the synthesized I-Fe3O4-NPs and I-Fe3O4-NBC were characterized, and I-Fe3O4-NBC was applied to remove toxic metals (TMs: Cd, Ni, and Pb) from water. The characterization study confirmed that the nanostructure, porous, rough, crystalline structure, and different functional groups of chitosan and I-Fe3O4-NPs in I-Fe3O4-NBCs showed their feasibility for the application as excellent adsorbents for quantitative removal of TMs. The batch mode strategy as feasibility testing was done to optimize different adsorption parameters (pH, concentrations of TMs, dose of I-Fe3O4-NBC, contact time, and temperature) for maximum removal of TMs from water by Fe3O4-NBC. The maximum adsorption capacities using nanocomposites for Cd, Ni, and Pb were 66.0, 60.0, and 66.4 mg g-1, respectively. The adsorption process follows the Freundlich isotherm model by I-Fe3O4-NBC to remove Cd and Ni, while the Pb may be adsorption followed by multilayer surface coverage. The proposed adsorption process was best fitted to follow pseudo-second-order kinetics and showed an exothermic, favorable, and spontaneous nature. In addition, the I-Fe3O4-NBC was applied to adsorption TMs from surface water (%recovery > 95%). Thus, it can be concluded that the proposed nanocomposite is most efficient in removing TMs from drinking water up to recommended permissible limit.

Characterization of lignocellulosic S. persica fibre and its composites: a review

As the demand for renewable, cost-effective, and environmentally acceptable materials in a variety of applications has developed, natural fibres have become more popular as reinforcement in composite materials. Salvadora persica L. is the most common traditional source of chewing stick (miswak) advised by Prophet Muhammad. It is also known as Arak in Arabic and Peelu in Urdu. A lot of research has been done in the last few years to investigate if its traditional applications in dental care are still valid. For this review, a variety of databases (Science Direct, PubMed, Wiley Online Library, and Google Scholar), books and primary sources were examined, surveyed, and analysed. Miswak fibre qualities and attributes were addressed in this review study to evaluate if the fibre may be used as an alternative to natural fibre reinforcing in composites. The history and uses of the miswak tree, as well as the structure of the miswak tree, are presented first, followed by a discussion of fibre characterization, with a focus on fibre structure and composition. Finally, the effect of miswak on the physical, mechanical, and thermal properties of composites is discussed. Miswak fibre and its composites present considerable challenges and potential as a reinforcement or filler alternative in a variety of applications, including dentistry.

Salvadora persica extract attenuates cyclophosphamide-induced hepatorenal damage by modulating oxidative stress, inflammation and apoptosis in rats

OBJECTIVE

Salvadora persica (SP) is used as a food additive and is a common ingredient in folk medicine. This study investigates the antioxidant, anti-inflammatory, and beneficial effects of SP against cyclophosphamide (CYP) toxicity in rats.

METHODS

In a 10-day study, 32 male rats were equally allocated into 4 groups (8 rats/group) as follows: the normal control (NC group), normal rats that only received oral aqueous extract of SP (100 mg/[kg·d]; SP group), animals treated with intraperitoneal CYP injections (30 mg/[kg·d]; CYP group), and the CYP + SP group that concurrently received CYP with SP aqueous extract. Serum samples were collected to measure the liver and renal biochemical profiles, as well as antioxidant and oxidative stress markers and the concentrations of interleukin-1β (IL-1β), IL-6, IL-10, tumor necrosis factor-α (TNF-α), nuclear factor-κB (NF-κB) and adenosine 5'-monophosphate-activated protein kinase (AMPK). Hepatic and renal tissues were also harvested for histopathology and to measure apoptosis using the terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling technique, alongside tissue levels of oxidative stress markers.

RESULTS

Liver enzymes, total bilirubin, creatinine and urea, as well as serum IL-1β, IL-6, TNF-α and NF-κB increased significantly, whilst total protein, albumin, calcium, IL-10 and AMPK declined in serum of the CYP group relative to the NC group. The hepatorenal concentrations of glutathione, glutathione peroxidase and catalase declined markedly in the CYP group, whereas malondialdehyde, protein adducts, and apoptosis index increased compared with the NC group. By contrast, the hepatorenal biochemistry and apoptosis index of the SP group were comparable to the NC group. Interestingly, the CYP + SP group had significant improvements in the liver and renal biochemical parameters, enhanced anti-oxidative and anti-inflammatory effects, and marked declines in hepatic and renal apoptosis relative to the CYP group. Moreover, all monitored parameters were statistically indistinguishable between the CYP + SP group and the NC group.

CONCLUSION

This study suggests that the aqueous extract of SP could be a potential remedy against CYP-induced hepatorenal damage and may act by modulating the AMPK/NF-κB signaling pathway and promoting anti-oxidative and anti-inflammatory activities.

Salvadora persica’s Biological Properties and Applications in Different Dental Specialties: A Narrative Review

Salvadora persica is a tree that belongs to the salvadorecea family. It is also known as Miswak, which is a popular natural toothbrush that was used centuries ago in oral hygiene by Muslims in all parts of the world, especially in the Middle East. Numerous researchers highlighted the biological activity of this plant in medicine, dentistry, and pharmacology. The purpose of this article is to narratively review the biological properties of Salvadora persica. In addition, it expresses variant applications of this herb in different dental specialties. Materials and Methods. The search of the literature was based on PubMed, MEDLINE, and Google Scholar using keywords: Salvadora persica, S. persica, Miswak, Dentistry, and Dental. All relevant articles were reviewed to check if they would fit within the scope of this review, and then, the information was extracted. Results. Multiple biological effects of S. persica have been reported including antibacterial, antiviral, antifungal, antibiofilm, antioxidant, and even antiulcer effects. Dental effects were discussed and presented. Conclusion. The wide biological range of Salvadora persica's effects is promising for dental and nondental fields and allows for an expanded clinical application that has otherwise not been discussed in the literature.

Biocompatibility and Antibacterial Action of Salvadora persica Extract as Intracanal Medication (In Vitro and Ex Vivo Experiment)

This study aimed to test the biocompatibility and antibacterial properties of Salvadora persica (S. persica) extract, a natural product, as an intracanal medication in comparison with calcium hydroxide (Metapaste, META BIOMED, Cheongju, Korea). The pH values of both materials were tested. The biocompatibility of S. persica extract and Metapaste was determined using light microscopy and MTT assays. The antibacterial action was tested using the zone of bacterial inhibition on four common bacterial species. In addition, intracanal medication was administered using 68 extracted single-rooted teeth contaminated with Enterococcus faecalis (E. faecalis), and the percentage reduction in colony count (% RCC) at 1, 3, and 7 days was measured. The extension of activity for both materials was assessed using histological sections and scanning electron microscopy. S. persica was found to be acidic in nature. Both materials showed significantly lower cell viability than the positive control cells on days 1 and 3 but not on day 7. S. persica showed better antibacterial effects against E. faecalis and S. mutans. S. persica extract showed 97.6%, 98.9%, and 99.3% RCC values at 1, 3, and 7 days, respectively, which are comparable to those of Metapaste. S. persica herbal extract is a promising material that can be utilized as an intracanal medication, but its use requires further research.

De-novo fabrication of sunlight irradiated silver nanoparticles and their efficacy against E. coli and S. epidermidis

Silver nanoparticles (AgNPs) gained significant attention due to their activity against microbial pathogens, cancer cells, and viral particles etc. Traditional fabrication methods require hazardous chemicals as reducing agents and their usage and disposal pose a significant hazard to environmental ecosystem. Here, a de novo, robust, cost effective and an eco-friendly method is reported to fabricate AgNPs irradiated with sunlight (SL) while using Salvadora persica root extract (SPE) as reducing agent. Sunlight (SL) irradiated S. persica silver nanoparticles (SpNPs) i.e., SL-SpNPs were characterized using multiple techniques and their antibacterial efficacy was evaluated. The SL-SpNPs were synthesized in 10 min. Field emission scanning electron microscopy (FE-SEM) and transmission electron microscopy (TEM) analysis revealed their spherical morphology with a size range of 4.5-39.7 nm, while surface plasmon resonance (SPR) peaked at 425 nm. Fourier transform infrared spectroscopy (FTIR) analysis suggested that the reduction of SL-SpNPs was due to the presence of phytochemicals in the SPE. Furthermore, X-ray powder diffraction (P-XRD) pattern depicted the crystal structure of SL-SpNPs, hence proving the presence of AgNPs. Further the antibacterial studies were carried out against Escherichia coli (ATCC 11229) and Staphylococcus epidermidis (ATCC 12228) using Kirby Bauer method. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) for E. coli were determined to be 1.5 μg/mL and 3.0 μg/mL respectively while MIC and MBC values for S. epidermidis were found to be 12.5 μg/mL and 25 μg/mL respectively. The solar irradiation-based fabrication method and resulting SL-SpNPs can find their utility in many biomedical and environmental applications.

Salvadora persica L.: Toothbrush tree with health benefits and industrial applications - An updated evidence-based review

Salvadora persica L. is also known as Arak (in Arabic) and Peelu (in Urdu). Its frequent use as a toothbrush (miswak) is highly recommended by Prophet Muhammad. With a long history in folk medicine for centuries, S. persica was used in oral hygiene, food, cosmetics, fuel, and even as a medicine. Previous phytochemical investigation of its different parts afforded different classes of secondary metabolites such as flavonoids, glycosides, sterols, terpenes, carbohydrates and alkaloids. Organic sulfur-containing compounds and elemental sulfur are also present. In addition, there is a huge research on its biological potentials and industrial applications. Many pharmacological activities were reported experimentally, including antimicrobial, antioxidant, analgesic, anthelmintic, anti-inflammatory, antiulcer, sedative, anticonvulsant, anti-osteoporosis, antidiabetic, hypo-lipidemic, in addition to wound-healing, antidepressant and antitumor activities. Recently, a possible activity against COVID-19 protease was documented by molecular docking. This review tries to provide a recent detailed documentation of folk and modern uses of S. persica, focusing on the possible relations between its chemical constituents, pharmacological properties, and industrial applications. Moreover, a brief about recent analytical and validation methods for the major antimicrobial component is reported.

Salvadora persica: Nature's Gift for Periodontal Health

Salvadora persica (SP) extract, displays very valuable biotherapeutic capacities such as antimicrobial, antioxidant, antiparasitic and anti-inflammatory effects. Numerous investigations have studied the pharmacologic actions of SP in oral disease therapies but its promising outcomes in periodontal health and treatment are not yet entirely described. The current study has been planned to analyze the reported effects of SP as a support to periodontal therapy to indorse regeneration and healing. In consort with clinical trials, in vitro investigations show the advantageous outcomes of SP adjunctive to periodontal treatment. Yet, comprehensive supplementary preclinical and clinical investigations at molecular and cellular levels are indispensable to reveal the exact therapeutic mechanisms of SP and its elements for periodontal health and therapy.

Bioactive phenolic components and antioxidant activities of water-based extracts and flavonoid-rich fractions from Salvadora persica L. leaves

Salvadora persica L. (Sp) has been widely used as folk medicine. This study aimed to identify and assess the significant phenolics' antioxidant activities in young (S1) and old (S2) leaves of Sp. Six flavonoids; isoquercitrin, kaempferol-3-neohesperidoside, myricetin-3-galactoside, apigenin-O-hexoside, isorhamnetin and isorhamnetin-3-neohesperidoside, were identified for the first time in Sp leaves using LC-ESI-QTOF MS/MS analysis. The flavonoid-rich fraction obtained after purification of S1 (S1TF7) has the highest TFC (358.88 ± 0.12 mg rutin equivalent/g) and TPC (180.82 ± 0.82 mg gallic acid equivalent/g) and exhibits significant (p < 0.05) free-radical scavenging activity in DPPH(IC_50% = 14.64 ± 0.29 µg/mL) and ABTS (IC_50% = 200.41 ± 1.85 µg/mL) assays which was similar to Butylated hydroxytoluene (BHT) as a positive control (IC_50% =12.94 ± 0.10 µg/mL and IC_50% = 190.47 ± 8.93 µg/mL, respectively). Also, S1TF7 inhibits Lipopolysaccharide (LPS)-stimulated ROS production in raw-cell-264.7 with no significant toxicity at 200 µg/mL (p > 0.05). The study concludes that S1TF7 can serve as a mean to prevent oxidative diseases, and it merits further pharmacological investigations.

Flavonoids of Salvadora persica L. (meswak) and its liposomal formulation as a potential inhibitor of SARS-CoV-2

Several studies are now underway as a worldwide response for the containment of the COVID-19 outbreak; unfortunately, none of them have resulted in an effective treatment. Salvadora persica L. (Salvadoraceae), commonly known as meswak, is one of the popular plants used by Muslims as an oral hygiene tool. It is documented that the meswak possesses antiviral activity, but no report discusses its use for coronavirus treatment. Herein, a mixture of 11 flavonoids prepared from the aqueous plant extract and its liposomal formulation were shown to inhibit SARS-CoV-2 in an in vitro A549 cell line culture and a RT-PCR test almost as well as the FDA-approved anti-COVID-19 agent, remdesivir. Encapsulation within liposomal formulation led to a highly significant increase in the percentage of inhibition of viral replication from 38.09 ± 0.83 to 85.56 ± 1.12% in a flavonoid mixture and its liposomal preparation, respectively, and this figure approached that obtained for remdesivir (91.20 ± 1.71%). Preliminary tests were also performed, including a total flavonoid assay, a molecular docking study, a 3CL-protease inhibition assay and a cytotoxicity study. It was worthy to find a cheap, readily available, safe natural source for promising anti-SARS-CoV-2 agents, that leak their phytochemicals into the aqueous saliva during regular use as a brushing agent.

Salvadora persica mediated synthesis of silver nanoparticles and their antimicrobial efficacy

Silver nanoparticles (AgNPs) exhibit strong antimicrobial properties against many pathogens. Traditionally employed chemical methods for AgNPs synthesis are toxic for the environment. Here, we report a quicker, simpler, and environmentally benign process to synthesize AgNPs by using an aqueous 'root extract' of Salvadora persica (Sp) plant as a reducing agent. The synthesized Salvadora persica nano particles (SpNPs) showed significantly higher antimicrobial efficacy compared to earlier reported studies. We characterized SpNPs using UV-Vis spectroscopy, Fourier Transform Infrared Spectroscopy (FTIR), Transmission Electron Microscopy (TEM), Field Emission Scanning Electron Microscopy (FE-SEM), Dynamic Light Scattering (DLS) and X-ray powder diffraction (P-XRD). UV-Vis spectrum showed the highest absorbance at 420 nm. FTIR analysis depicts presence of bond stretching including OH- (3300 cm-1), C=N- (2100 cm-1) and NH- (1630 cm-1) which are attributed in the involvement of phenolics, proteins or nitrogenous compounds in reduction and stabilization of AgNPs. TEM, FE-SEM and DLS analysis revealed the spherical and rod nature of SpNPs and an average size of particles as 37.5 nm. XRD analysis showed the presence of the cubic structure of Ag which confirmed the synthesis of silver nanoparticles. To demonstrate antimicrobial efficacy, we evaluated SpNPs antimicrobial activity against two bacterial pathogens (Escherichia coli (ATCC 11229) and Staphylococcus epidermidis (ATCC 12228)). SpNPs showed a significantly high inhibition for both pathogens and minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were found to be 0.39 µg/mL and 0.78 µg/mL for E. coli while 0.19 µg/mL and 0.39 µg/mL for S. epidermidis respectively. Further, Syto 16 staining of bacterial cells provided a supplemental confirmation of the antimicrobial efficacy as the bacterial cells treated with SpNPs stop to fluoresce compared to the untreated bacterial cells. Our highly potent SpNPs will likely have a great potential for many antimicrobial applications including wound healing, water purification, air filtering and other biomedical applications.

Ethnoveterinary for food-producing animals and related food safety issues: A comprehensive overview about terpenes

Alternatives to the use of conventional veterinary drugs in food-producing animals have gained attention, such as the use of natural products (NPs), mainly to soften the risks to the animal, the environment, and consumer's health. Although NPs have consistent advantages over conventional drugs, they cannot be considered risk free under food safety matters. In this way, this document presents a comprehensive overview of the importance of considering both the pharmacological and toxicological properties of the constituents of a NP from plants intending the standardization and regulation of its use in food-producing animals. Terpenes are the most diverse class of natural substances present in NP of vegetal origin with a broad range of biological activities that can be explored in veterinary science; however, certain plants and terpenes also have significant toxic effects, a fact that can harm the health of animals and consequently generate economic losses and risks for humans. In this context, this review gathered scientific data of vegetal species of importance to ethnoveterinary for food-producing animals, which produce terpenes, its biological effects, and their implications on food safety issues for consumers. For this, more than 300 documents were selected from different online scientific databases. The present data and discussion may contribute to the rational commercial exploration of this class of NPs in veterinary medicine.

Unraveling the metabolome composition and its implication for Salvadora persica L. use as dental brush via a multiplex approach of NMR and LC-MS metabolomics

Salvadora persica L. (toothbrush tree, Miswak) is well recognized in most Middle Eastern and African countries for its potential role in dental care, albeit the underlying mechanism for its effectiveness is still not fully understood. A comparative MS and NMR metabolomics approach was employed to investigate the major primary and secondary metabolites composition of S. persica in context of its organ type viz., root or stem to rationalize for its use as a tooth brush. NMR metabolomics revealed its enrichment in nitrogenous compounds including proline-betaines i.e., 4-hydroxy-stachydrine and stachydrine reported for the first time in S. persica. LC/MS metabolomics identified flavonoids (8), benzylurea derivatives (5), butanediamides (3), phenolic acids (8) and 5 sulfur compounds, with 21 constituents reported for the first time in S. persica. Principal component analysis (PCA) and hierarchical cluster analysis (HCA) of either NMR or LC/MS dataset clearly separated stem from root specimens based on nitrogenous compounds abundance in roots and is justifying for its preference as toothbrush versus stems. The presence of betaines at high levels in S. persica (9-12 μg/mg dry weight) offers novel insights into its functioning as an osmoprotectant that maintains the hydration of oral mucosa. Additionally, the previously described anti-inflammatory activity of stachydrine along with the antimicrobial effects of sulfonated flavonoids, benzylisothiocynate and ellagic acid derivatives are likely contributors to S. persica oral hygiene health benefits. Among root samples, variation in sugars and organic acids levels were the main discriminatory criterion. This study provides the first standardization of S. persica extract using qNMR for further inclusion in nutraceuticals.

Antibacterial activity of plant species used for oral health against Porphyromonas gingivalis

Porphyromonas gingivalis is the keystone pathogen of periodontitis, a chronic inflammatory disease which causes tooth loss and deterioration of gingiva. Medicinal plants have been traditionally used for oral hygiene and health and might play a role as antibacterial agents against oral pathogens. In this work, we aimed to evaluate the antibacterial activity of plants used for oral hygiene or symptoms of periodontitis against P. gingivalis. We first reviewed the literature to identify plant species used for oral hygiene or symptoms of periodontitis. Then, we cross-checked this species list with our in-house library of plant extracts to select extracts for testing. Antibacterial activity tests were then performed for each plant extract against P. gingivalis, and their cytotoxicity was assessed on HaCaT cells. The selectivity index (SI) was then calculated. A total of 416 plant species belonging to 110 families and 305 genera were documented through our literature search, and 158 plant species were noted as being used by North American Native peoples Once cross-checked with the extracts contained in our library of natural products, 30 matches were identified and 21 were defined as high priority. Of the 109 extracts from 21 plant species selected and tested, 21 extracts from 11 plants had higher than 90% inhibition on P. gingivalis at 64 μg/mL and were further selected for MIC (Minimum Inhibitory Concentration) assays. Out of 21 plant extracts, 13 extracts (7 plant species) had a SI > 10. Pistacia lentiscus fruits showed the best MIC with value of 8 μg/mL, followed by Zanthoxylum armatum fruits/seeds with a MIC of 16 μg/mL. P. lentiscus fruits also showed the highest SI of 256. Most of the extracts tested present promising antibacterial activity and low cytotoxicity. Further testing for biofilm eradication and examination of activity against other dental pathogens and oral commensals should be performed to confirm the potential of these extracts as antibacterial agents. Future work will focus on application of a bioassay-guided fractionation approach to isolating and identifying the most active natural products in the top performing extracts. This study can serve as a basis for their future development as ingredients for oral hygiene products.

Phytochemical, Cytotoxic, and Antimicrobial Evaluation of the Fruits of Miswak Plant, Salvadora persica L

Salvadora persica L. (Salvadoraceae) is an evergreen shrub growing in the Middle East, Africa, and Southern Asia. It is traditionally known as “miswak” and used as toothbrushes and for the treatment of toothache, gum diseases, boils, chest infection, gonorrhea, headache, spleen troubles, stomachache, and ulcers. To the best of our knowledge, this is the first study aimed at conducting phytochemical, cytotoxic, and antimicrobial investigations of the fruits (berries) of S. persica collected from the Jazan region of Saudi Arabia. Analysis of the ethanol extract of S. persica fruits using GC-MS showed the presence of six esters (20.71%), seven alkanes (15.47%), tetracosamethyl-cyclododecasiloxane (9.91%), eicosamethyl-cyclodecasiloxane (7.27%), and 1-monolinoleoylglycerol (5.17%). The predominant constituents were acetyl dasycarpidan-1-methanol (10.47%), tetracosamethyl-cyclododecasiloxane (9.91%), eicosamethyl-cyclodecasiloxane (7.27%), and 1-monolinoleoylglycerol (5.17%). The petroleum ether extract of the fruits contained mainly eicosamethyl-cyclodecasiloxane (23.81%), 1-monolinoleoylglycerol (11.78%), (Z,Z,Z)-9,12,15-octadecatrienoic acid ethyl ester derivative (10.56%), and tetracosamethyl-cyclododecasiloxane (9.91%). The cytotoxic properties of the ethanol extract were investigated by MTT assay against the breast MCF7, ovary A2780, and colon HT29 cells. The fruit extract of S. persica was selective against the ovarian and colon cancer cells compared to normal fibroblast cells (MRC5) as it showed IC50 values 17.50, 8.35, and 5.12, against MCF7, A2780, and HT29 cells, respectively. Interestingly, the fruit extract was also found to possess selective antimicrobial activity for Streptococcus mutans isolates with minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values of 3.12 and 6.25 mg/mL, respectively. Interestingly, it was found to be ineffective against other Gram-positive as well as Gram-negative microorganisms. This study provides insight into the bioactive components present in the fruits of the plant that can be utilized for its cytotoxic and antimicrobial properties.

Miswak and oral health: An evidence-based review

Poor oral health has been associated with several chronic and systemic disease. Currently, the most common method of teeth cleaning is the use of a toothbrush together with dentifrices. However, natural chewing stick such as S. persica miswak is still used in many developing countries due to their low cost and availability. The present review aims to summarize the evidences on effectiveness of miswak in promoting oral health. The search was performed using Medline via Ebscohost, Scopus and Google Scholar database to obtain relevant articles published between 2010 to May 2020 using the following set of keywords 1) Miswak OR Salvadora OR persica AND 2) dental OR caries OR plaque OR oral OR orthodontics. Isolated microbial inhibition studies were excluded from the review due to its well-established wealth of literature. Miswak was administered as ten different forms, namely mouthwash, toothpaste, chewing stick, essential oil, aqueous extract, ethanol extract, probiotic spray, dental varnish, dental cement or chewing gum. All studies reported a positive effect of miswak as an anti-plaque, anti-gingivitis, anti-cariogenic, promotion of gingival wound healing, whitening properties, orthodontic chain preservation, and biocompatibility with oral cells. Miswak in its different forms demonstrated positive effect towards oral health maintenance and management.

Antibiotic and Antibiofilm Activities of Salvadora persica L. Essential Oils against Streptococcus mutans: A Detailed Comparative Study with Chlorhexidine Digluconate

The use of organic components from plants as an alternative antimicrobial agent is becoming popular due to the development of drug-resistance in various pathogens. Essential oils from fresh (MF-1) and dried (MD-1) roots of Salvadora persica L. were extracted and benzyl isothiocynate was determined as their chief constituent using GC-MS and GC-FID. The antibiofilm and antimicrobial activities of MD-1 and MF-1 against Streptococcus mutans a dental caries causing bacteria were determined using multiple assays. These activities were compared with chlorhexidine digluconate (CHX) and clove oil, well known antimicrobial agents for oral hygiene. Essential oils demonstrated IC₅₀ values (10–11 µg/mL) comparable to that of CHX, showed a significant reduction (82 ± 7–87 ± 6%) of the biofilm formation at a very low concentration. These results were supported by RT-PCR studies showing change in the expression levels of AtlE, gtfB, ymcA and sodA genes involved in autolysis, biofilm formation and oxidative stress, respectively. The results presented in this study show the robust bactericidal and antibiofilm activity of MD-1 and MF-1 against S. mutans which is comparable to Chlorhexidine digluconate. Our results suggest that these essential oils can be as effective as CHX and hence can serve as a good alternative antimicrobial agent for oral hygiene.

Plants mentioned in the Islamic Scriptures (Holy Qur'ân and Ahadith): Traditional uses and medicinal importance in contemporary times

ETHNOPHARMACOLOGICAL RELEVANCE

Over the past thousand years, Islamic physicians have collected cultural, philosophical, sociological and historical backgrounds for understanding diseases and medications. The Prophet Mohammed (Peace Be Upon Him (PBUH) said: "There is no disease that Allah has created, except that Allah also has created its cure." Therefore, Islamic scholars are encouraged to explore and use both traditional and modern forms of medicine.

AIM OF THE STUDY

(1) To identify some of the medicinal plants mentioned in the Holy Qur'ân and Ahadith textbooks of the period 700-1500 AD; (2) to compare them with presently used traditional medicines; (3) to evaluate their value based on modern research; and (4) to investigate the contributions of Islamic scholars to the development of the scientific branches, particularly medicine.

MATERIALS AND METHODS

A literature search was performed relating to 12 medicinal plants mentioned in the Holy Qur'ân and Ahadith using textbooks, Al-Azhar scholars, published articles, the plant list website (http://www.theplantlist.org/), the medicinal plant names services website (http://mpns.kew.org/mpns-portal/) and web databases (PubMed, Science Direct, and Google Scholar).

RESULTS AND DISCUSSION

The Islamic Golden Age was a step towards modern medicine, with unique insights and multi-disciplinary aspects. Traditional Islamic Medicine has had a significant impact on the development of various medical, scientific and educational activities. Innumerable Muslim and non-Muslim physicians have built on the strong foundation of Traditional Islamic Medicine by translating the described natural remedies and effects. The influences of different ancient cultures on the traditional uses of natural products were also documented in Islamic Scriptures in the last part of the second millennium. The divine teachings of Islam combine natural and practical healing and incorporate inherited science and technology.

CONCLUSION

In this review, we discuss Traditional Islamic Medicine with reference to both medical recommendations mentioned in the Holy Qur'ân and Prophetic Traditional Medicine (al-Tibb al-Nabawi). Although the molecular mechanisms and functions of some of the listed medicinal plants and their derivatives have been intensively studied, some traditional remedies have yet to be translated into clinical applications.

Comparing Caries Experience between Azadirachta indica Chewing Stick Users and Toothbrush Users among 35-44-Year-Old Rural Population of Southern India

Objectives

To compare the caries experience between Azadirachta indica chewing stick users and toothbrush users among 35-44-year-old rural population in Southern India.

Materials and Methods

This ex post facto research was conducted in the rural parts of two sub-administrative areas of a district in the Southern Indian state of Andhra Pradesh. The sample size for the study was determined to be 400, with 200 subjects in each group. Subjects following indigenous oral hygiene methods were identified using an interviewer-administered questionnaire. After obtaining 200 subjects using A. indica chewing sticks, age, gender, and socioeconomic status matched controls using toothbrush were identified. American Dental Association type III examination was carried out to record caries experience (decayed missing filled teeth (DMFT) Index) after obtaining informed consent and thus obtained data were subjected to statistical analysis using the Statistical Package for the Social Sciences (SPSS) software, version 20.

Results

It was observed that the caries experience was more in toothbrush users compared to subjects following indigenous methods (DMFT, 4.38 ± 1.93 vs. 3.54 ± 1.02). Similar results were obtained when the decay component of DMFT index was exclusively compared. No significant difference in the plaque scores and the mean number of filled, missing teeth was observed between the two groups.

Conclusion

Though conclusive results cannot be drawn from this study about the positive influence of indigenous methods on caries experience, the results emphasize the cardinal need to more thoroughly understand the potential benefits of indigenous methods before dismissing them as retrogressive approaches.

Use of Oral Cleaning Devices and Their Perceived Benefits among Malaysians in Kuala Lumpur and Johor Bahru: An Exploratory Structured Approach

Background and Objectives

Various devices have been used to maintain oral hygiene. These include toothbrush and toothpaste, mouthwash, dental floss, miswak, and toothpick. This study attempts to investigate the use of various oral cleaning devices and their perceived benefits among Malaysians.

Methods

A quantitative cross-sectional study conducted in two different cities of Malaysia. A convenience sampling approach was adopted. A total of 787 participants agreed to participate in the current research. A validated questionnaire translated into national language was used for data collection.

Statistical Analysis Used

Data analysis was performed using Statistical Package for Social Sciences version 20.

Results

About 302 respondents were in the age range of 18 - 25 years old (38.4%). There were marginally more females (55.7%) than males (44.3%). Although 99.9% of the participants used a toothbrush, a significant majority (n = 590, 75%) used more than a single device to maintain their oral hygiene. Only 311 respondents knew that toothpicks were inappropriate to use to remove food between teeth and gums, while a majority (n = 592, 75.2%) did not realize that some mouthwashes can stain the teeth. Less than half (42.1%) knew that improper use of miswak might harm the teeth.

Conclusions

Although their oral hygiene behaviors are relatively at a higher level, their perceived oral health benefits did not compare well.

Persicaline, A New Antioxidant Sulphur-Containing Imidazoline Alkaloid from Salvadora persica Roots

Salvadora persica L. is a popular chewing stick commonly known as “miswak”. During our ongoing research activities on the chemical constituents of Salvadora persica roots, which is a new sulphur-containing imidazoline alkaloid 1,3-Dibenzyl-4-(1,2,3,4-tetrahydroxy-butyl)-1,3-dihydro-imidazole-2-thione, persicaline, (1) along with five known compounds (2–6) are identified. Compounds (2, 3) were reported for the first time from the family Salvadoraeceae. The structure of the new compound was established by extensive spectroscopic data and HR-MS. The antioxidant activities of the fractions and isolates were evaluated using different in vitro methods, such as DPPH, superoxide anion and nitric oxide radicals scavenging assays. Compound (1) showed a promising antioxidant activity with IC₅₀ 0.1, 0.08, and 0.09 µM in the three assays, respectively, comparable to ascorbic acid.