Traditional Medicinal Plant Extracts and Natural Products with Activity against Oral Bacteria: Potential Application in the Prevention and Treatment of Oral Diseases

Diabetes mellitus and Alzheimer's disease: Understanding disease mechanisms, their correlation, and promising dual activity of selected herbs

ETHNOPHARMACOLOGICAL RELEVANCE

This review explores the link between Type 2 Diabetes Mellitus (T2DM) and diabetes-induced Alzheimer's disease (AD). It emphasizes the shared pathophysiological links and mechanisms between the two conditions, focusing on reduced insulin levels and receptors, impaired glucose metabolism, insulin resistance, mitochondrial dysfunction, and oxidative damage in AD-affected brains-paralleling aspects of T2DM. The review suggests AD as a "diabetes of the brain," supported by cognitive enhancement through antidiabetic interventions. It focuses on the traditionally used Indian herbs as a means to manage both conditions while addressing developmental challenges.

AIM OF THE STUDY

This study explores the DM-AD connection, reviewing medicinal herbs with protective potential for both ailments, considering traditional uses and developmental challenges.

MATERIALS AND METHODS

Studied research, reviews, and ethnobotanical and scientific data from electronic databases and traditional books.

RESULTS

The study analyzes the pathophysiological links between DM and AD, emphasizing their interconnected factors. Eight Ayurvedic plants with dual protective effects against T2DM and AD are thoroughly reviewed with preclinical/clinical evidence. Historical context, phytoconstituents, and traditional applications are explored. Innovative formulations using these plants are examined. Challenges stemming from phytoconstituents' physicochemical properties are highlighted, prompting novel formulation development, including nanotechnology-based delivery systems. The study uncovers obstacles in formulating treatments for these diseases.

CONCLUSION

The review showcases the dual potential of chosen medicinal herbs against both diseases, along with their traditional applications, endorsing their use. It addresses formulation obstacles, proposing innovative delivery technologies for herbal therapies, while acknowledging their constraints. The review suggests the need for heightened investment and research in this area.

Comprehensive in vitro and in vivo evaluation of therapeutic potential of Bacopa-derived asiatic acid against a human oral pathogen Streptococcus mutans

Dental caries is a common human oral disease worldwide, caused by an acid-producing bacteria Streptococcus mutans. The use of synthetic drugs and antibiotics to prevent dental caries has been increasing, but this can lead to severe side effects. To solve this issue, developing and developed countries have resorted to herbal medicines as an alternative to synthetic drugs for the treatment and prevention of dental caries. Therefore, there is an urgent need for plant-derived products to treat such diseases. Bacopa monnieri, a well-documented medicinal plant, contains 52 phytocompounds, including the pentacyclic triterpenoid metabolite known as asiatic acid (ASTA). Hence, this study aimed to demonstrate, for the first time, the antibacterial activity of phytocompound ASTA against S. mutans. The findings revealed that ASTA significantly inhibited the growth of S. mutans and the production of virulence factors such as acidurity, acidogenicity, and eDNA synthesis. Molecular docking analysis evaluated the potential activity of ASTA against S. mutans virulence genes, including VicR and GtfC. Furthermore, toxicity assessment of ASTA in human buccal epithelial cells was performed, and no morphological changes were observed. An in vivo analysis using Danio rerio (zebrafish) confirmed that the ASTA treatment significantly increased the survival rates of infected fish by hindering the intestinal colonization of S. mutans. Furthermore, the disease protection potential of ASTA against the pathognomonic symptom of S. mutans infection was proven by the histopathological examination of the gills, gut, and kidney. Overall, these findings suggest that ASTA may be a promising therapeutic and alternative drug for the treatment and prevention of oral infection imposed by S. mutans.

Investigating the antimicrobial and anti-inflammatory effects of Lactobacillus and Bifidobacterium spp. on cariogenic and periodontitis pathogens

Background

The use of probiotics is emerging as an innovative approach to managing oral health issues and mediating the immune system. The current study assessed the in vitro impacts of non-orally isolated probiotics on periodontitis and tooth decay pathogens.

Methods

Briefly, the persistence of probiotics in exposure to oral cavity enzymes, hydrogen peroxide, and saliva samples was examined. It was also investigated the biofilm formation and aggregation ability of probiotics, the adherence of probiotics in human gingival fibroblast cell (HGFC) lines and molar teeth samples, and the potential of probiotics to co-aggregate with oral pathogens. Additionally, the current study evaluated the effects of live probiotics on virulence gene expression, biofilm production of main oral pathogens, and changes in inflammation markers.

Results

The probiotics remained alive when exposed to enzymes in the oral cavity, hydrogen peroxide, and saliva at baseline, 1, 3, and 5 h after incubation at 37°C (p-value <0.05). Probiotics demonstrated to produce biofilm and aggregation, as well as adherence to HGFCs and maxillary molars (p-value >0.05). They showed significant co-aggregation with oral pathogens, which were recorded as 65.57% for B. bifidum 1001 with S. mutans, 50.06% for B. bifidum 1005 with P. gingivalis, 35.6% for L. plantarum 156 with F. nucleatum, and 18.7% for B. longum 1044 with A. actinomycetemcomitans after 8 h of incubation. A balance between pro-inflammatory and anti-inflammatory cytokines, along with inhibition of biofilm formation and changes in virulence gene transcripts, were observed. However, most of these changes were not statistically significant (p-value >0.05).

Conclusion

This study demonstrated the direct link between adhesiveness, aggregation, and biofilm formation with probiotic antibacterial activity. In addition to the careful selection of suitable probiotic strains, the concentration and origin of probiotic isolates should be considered.

Ethno-Dentistry of Medicinal Plants Used in North Waziristan, Pakistan

OBJECTIVE

This study aimed at recording therapeutic plant species used by inhabitants to treat dental disorders in the district of North Waziristan, Pakistan. The indigenous people of the studied area are dependent on medicinal plants for their basic health care needs including dental care.

METHODS

Ethnomedicinal data were collected using a semi-structured questionnaires, and in addition 130 local informants were interviewed. The collected data were evaluated using various quantitative indices, including use value (UV), relative frequency of citation (RFC), fidelity level (FL%), and Jaccard Index (JI).

RESULTS

A total of 69 plants belonging to 48 plant families used in dental disorders were identified. The Lamiaceae was the leading family that shared 7 species, followed by Solanaceae (4 spp).The dominant life form used was herbs (47.83%), folowed by leaves (43.90%) in preparing remedies for different dental disorders. Decoction was the most common mode of preparation (34.21%), followed by pastes (21.05%). The highest RFC (0.36) was reported for Bergenia ciliata, followed by Salvadora oleoides (0.35). The majority of the plants (36 spp) were utilised as herbal medicine to treat toothache, followed by 13 species for periodontal (gum) infections, 11 species used for teeth cleaning, and 9 species for halitosis (bad breath).

CONCLUSIONS

This study is the first-ever record of ethnomedicinal applications for the treatment of dental diseases from Pakistan. Some of the forgeoing hebal medications should be further evalauted for the development of pahrmaceutical bio-products for the treatment of dental disorders.

Moderated mediation role of ethnicity on natural skin care products purchasing intention model among multicultural consumers

The trends for sustainable lifestyle and marketing motivated natural product consumption, such as natural skin care products (NSCPs). Different personal, environmental, and sociocultural factors influence purchase intention (PI) for NSCPs. However, there is a lack of evidence on the role of consumers' ethnicity in the PI model. The present study investigated the moderated mediation role of ethnicity in the relationship between related factors, including environmental concern, subjective norms, health factor, Halal certificate, packaging design, past experience factor, price factor, and PI mediated by personal attitude. A web-based survey was utilized to capture quantitative data from a random sample of 330 multicultural consumer group participants. The results of the study indicated that consumers' ethnicity substantially moderated the mediation effect of personal attitude in the relationships between subjective norms, health factor, Halal certificate, packaging design, past experience factor, price factor, and PI in the model. The findings contributed to understanding of the factors that influenced the PI of consumers from diverse sociocultural contexts in the market for natural products. It contributed directly to natural product marketing and industry.

Romanian Wild-Growing Chelidonium majus-An Emerging Approach to a Potential Antimicrobial Engineering Carrier System Based on AuNPs: In Vitro Investigation and Evaluation

Novel nanotechnology based on herbal products aspires to be a high-performing therapeutic platform. This study reports the development of an original engineering carrier system that jointly combines the pharmacological action of Chelidonium majus and AuNPs, with unique properties that ensure that the limitations imposed by low stability, toxicity, absorption, and targeted and prolonged release can be overcome. The metabolite profile of Romanian wild-grown Chelidonium majus contains a total of seventy-four phytochemicals belonging to eight secondary metabolite categories, including alkaloids, amino acids, phenolic acids, flavonoids, carotenoids, fatty acids, sterols, and miscellaneous others. In this study, various techniques (XRD, FTIR, SEM, DLS, and TG/DTG) were employed to investigate his new carrier system's morpho-structural and thermal properties. In vitro assays were conducted to evaluate the antioxidant potential and release profile. The results indicate 99.9% and 94.4% dissolution at different pH values for the CG-AuNPs carrier system and 93.5% and 85.26% for greater celandine at pH 4 and pH 7, respectively. Additionally, three in vitro antioxidant assays indicated an increase in antioxidant potential (flavonoid content 3.8%; FRAP assay 24.6%; and DPPH 24.4%) of the CG-AuNPs carrier system compared to the herb sample. The collective results reflect the system's promising perspective as a new efficient antimicrobial and anti-inflammatory candidate with versatile applications, ranging from target delivery systems, oral inflammation (periodontitis), and anti-age cosmetics to extending the shelf lives of products in the food industry.

Antimicrobial and Antiproliferative Effects of Zingiberaceae Oils: A Natural Solution for Oral Health

Essential oils have been recognised for their potential benefits in oral care. The aim of this study was to evaluate the antibacterial and antiproliferative activity of essential oils derived from four Zingiberaceae species. A combination of GC/MS and GC-FID was employed to analyse these essential oils. The results showed that β-myrcene (79.77 %) followed by ethyl-cinnamate (40.14 %), β-curcumene (34.90 %), and alloaromadendrene (25.15 %) as the primary constituents of Curcuma mangga, Curcuma xanthorrhiza, Kaempferia galanga and Curcuma aeruginosa, respectively. The Zingiberaceae oils were tested for their antibacterial activity against oral bacteria using the disc diffusion test. Curcuma xanthorrhiza oil showed the largest inhibition zones against Streptococcus mitis (19.50±2.22 mm) and Streptococcus sanguinis (15.04±3.05 mm). Similarly, Curcuma mangga oil exhibited significant antibacterial activity against Streptococcus mutans (12.55±0.45 mm) and mixed oral bacteria (15.03±3.82 mm). Furthermore, the MTT viability assay revealed moderate inhibitory activity of these essential oils against H103 and ORL-204 oral cancer cells. The study findings demonstrate that Curcuma xanthorrhiza and Curcuma mangga essential oils have potent antibacterial properties, suggesting their potential use as natural alternatives to synthetic antibacterial agents in oral care products. However, further investigations are necessary to fully explore their therapeutic applications.

Comparison of the Clinical Efficacy of Herbal, Chlorhexidine, and Normal Saline Mouthwash in the Management of Chronic Gingivitis

BACKGROUND

The incidence of chronic gingivitis, a widespread inflammatory condition of the gums, is considerable across the demographic spectrum, with potential progression to advanced periodontal pathology in the absence of intervention. The objective of this investigation was to conduct a comparative analysis of the clinical effectiveness of various oral rinses in mitigating the symptoms of chronic gingivitis.

METHODS

This empirical study was conducted within the confines of the Department of Oral Medicine and Radiology. A cohort of 60 individuals diagnosed with chronic gingivitis, ranging from 18 to 45 years of age and inclusive of all sexes, was systematically selected for participation.

RESULTS

Quantitative analysis yielded data indicating that the mean score on the gingival index was minimally recorded for participants utilizing herbal mouthwash (HO), in contrast to those administered with normal saline (NS), which displayed the highest mean score. A corresponding trend was observed with the plaque index, where the HO users exhibited the lowest mean values, as opposed to the NS cohort, which demonstrated the highest.

CONCLUSION

Employing post-hoc statistical evaluations, a pronounced disparity in the mean gingival index was discerned favoring the chlorhexidine (CHX) and HO groups over the NS group. No statistical significance was detected in the comparative mean gingival index between the CHX and HO cohorts. This pattern of findings was paralleled in the plaque index assessments, where the NS group's values were significantly elevated relative to those of both the CHX and HO groups.

Combating Cariogenic Streptococcus mutans Biofilm Formation and Disruption with Coumaric Acid on Dentin Surface

Streptococcus mutans, the primary cause of dental caries, relies on its ability to create and sustain a biofilm (dental plaque) for survival and pathogenicity in the oral cavity. This study was focused on the antimicrobial biofilm formation control and biofilm dispersal potential of Coumaric acid (CA) against Streptococcus mutans on the dentin surface. The biofilm was analyzed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) viability assay, microtiter plate assay, production of extracellular polymeric substances (EPSs), florescence microscopy (surface coverage and biomass μm2) and three-dimensional (3D) surface plots. It was observed that CA at 0.01 mg/mL reduced bacterial growth by 5.51%, whereases at 1 mg/mL, a significant (p < 0.05) reduction (98.37%) was observed. However, at 1 mg/mL of CA, a 95.48% biofilm formation reduction was achieved, while a 73.45% biofilm dispersal (after 24 h. treatment) was achieved against the preformed biofilm. The MTT assay showed that at 1 mg/mL of CA, the viability of bacteria in the biofilm was markedly (p < 0.05) reduced to 73.44%. Moreover, polysaccharide (EPS) was reduced to 24.80 μg/mL and protein (EPS) to 41.47 μg/mL. ImageJ software (version 1.54 g) was used to process florescence images, and it was observed that the biofilm mass was reduced to 213 (μm2); the surface coverage was reduced to 0.079%. Furthermore, the 3D surface plots showed that the untreated biofilm was highly dense, with more fibril-like projections. Additionally, molecular docking predicted a possible interaction pattern of CA (ligand) with the receptor Competence Stimulating Peptide (UA159sp, PDB ID: 2I2J). Our findings suggest that CA has antibacterial and biofilm control efficacy against S. mutans associated with dental plaque under tested conditions.

The In Vitro Assessment of Antibacterial and Antioxidant Efficacy in Rosa damascena and Hypericum perforatum Extracts against Pathogenic Strains in the Interplay of Dental Caries, Oral Health, and Food Microbiota

The rising demand for novel antibiotic agents prompts an investigation into natural resources, notably plant-derived compounds. In this study, various extracts (aqueous, ethanolic, aqueous-ethanolic, and enzymatic) of Rosa damascena and Hypericum perforatum were systematically evaluated against bacterial strains isolated from dental lesions (n = 6) and food sources (raw milk and broiler carcass, n = 2). Minimal inhibitory concentration (MIC), minimal bactericidal concentration (MBC), antibiofilm activity, and time-kill kinetics were assessed across a range of extract concentrations, revealing a dose-responsive effect. Notably, some extracts exhibited superior antibacterial efficacy compared to standard clinical antibiotics, and the time-kill kinetics demonstrated a rapid elimination of bacterial loads within 24 h. The susceptibility pattern proved strain-specific, contingent upon the extract type, yet all tested pathogens exhibited sensitivity. The identified extracts, rich in phenolic and polyphenolic compounds, as well as other antioxidant properties, contributed to their remarkable antibiotic effects. This comprehensive investigation not only highlights the potential of Rosa damascena and Hypericum perforatum extracts as potent antibacterial agents against diverse bacterial strains including caries pathogens, but also underscores their rapid action and dose-dependent efficacy. The findings suggest a promising avenue for harnessing plant-derived compounds in the development of novel antimicrobial strategies against dental caries and other oral inflammations, bridging the gap between natural resources and antibiotic discovery.

Contact sensitisation in oral lichen planus: An Australian perspective

BACKGROUND

The role of contact sensitisation in the pathogenesis of oral lichen planus (OLP) has not been clearly defined.

OBJECTIVE

We aimed to evaluate relevant contact sensitisers in OLP.

METHODS

A retrospective study was conducted on OLP patients who underwent patch testing from 1 January 2006 to 31 December 2020 at an Australian tertiary dermatology institution, compared to cheilitis patients patch tested over the same time period.

RESULTS

Ninety-six OLP patients and 152 cheilitis patients were patch tested during the 15-year period. Seventy-one (73.9%) OLP patients and 100 (65.8%) cheilitis patients recorded one or more relevant reactions. Forty-three (44.8%), 22 (22.9%), 21 (21.9%) and 17 (17.7%) OLP patients had relevant reactions to mercury-related chemicals, amalgam, spearmint and carvone, respectively, compared to 6 (3.9%), 3 (2.0%), 4 (2.6%) and 0 (0%) cheilitis patients, respectively (p-value <0.001 each). Four (4.2%) OLP patients had relevant positive reactions to sodium metabisulfite, compared to none in the cheilitis group (p-value 0.021).

CONCLUSION

While dental amalgam is used less frequently these days, we report that mercury (found in amalgam) and additionally spearmint and carvone are relevant sensitisers in OLP in Australia. Sodium metabisulfite may also be a relevant sensitiser in OLP, which has not previously been reported.

Efficacy of a herbal mouthwash for management of periodontitis and radiation-induced mucositis - A consolidated report of two randomized controlled clinical trials

BACKGROUND

Oral diseases like periodontitis and mucositis often require home care using topical agents in the form of mouthwashes. Many herbal mouthwashes are found to be beneficial; however lack proper scientific evidence to support their use.

OBJECTIVES

Study 1 evaluated clinical efficacy of herbal mouthwash in the management of chronic periodontitis in comparison with chlorhexidine mouthwash. Study 2 aimed at assessment of herbal mouthwash in patients of radiation-induced mucosititis.

METHODS

The novel herbal mouthwash used in the present study wa prepared from extracts of five plants namely Emblica Officinalis, Terminalia chebula, Terminalia bellerica, Glycyrrhiza glabra, and Azadirachta indica. 50 periodontitis patients were randomly allocated to two groups. As per allocation, they were instructed to use either herbal mouthwash or chlorhexidine mouthwash twice daily for two weeks after nonsurgical periodontal therapy. Similarly, patients with radiation-induced mucositis were randomly given herbal mouthwash and soda saline mouthwash. Intergroup and intragroup comparisons of continuous variables were conducted using paired and unpaired t-tests. Categorical variables were compared using the chi-square test.

RESULTS

Significant reductions in gingival bleeding, plaque accumulation, and pocket depth were noticed in periodontitis patients in both groups. Patients reported acceptable taste, freshness, and satisfaction after the use of herbal mouthwash. The herbal mouthwash group noticed a significant reduction in the severity of radiation-induced mucositis and analgesic requirements. The intensity of pain, dryness of mouth, oral hygiene, and need for the use of antibiotic and antifungal during radiotherapy was not significant among the groups.

CONCLUSION

The results of this preliminary clinical trial support the use of the tested herbal formulation mouthwash as an adjunct in the treatment of periodontitis as well as radiation-induced mucositis.

CLINICAL TRIAL REGISTRATION NUMBER

For Study 1: CTRI/2019/10/021574, Study 2: CTRI/2020/04/024851.

Antimicrobial Effects of Edible Mixed Herbal Extracts on Oral Microorganisms: An In Vitro Study

Background and Objectives: The oral cavity is inhabited by pathogenic bacteria, whose growth can be inhibited by synthetic oral drugs, including antibiotics and other chemical compounds. Natural antimicrobial substances that elicit fewer negative side effects may serve as alternatives to synthetic agents for long-term use. Thus, the aim of this study was to evaluate the effects of edible mixed herbal extracts on the growth of oral pathogenic bacteria. Materials and Methods: The yield of each herbal extract was as follows: 5% Schizonepeta tenuifolia Briq (STB), 10.94% Mentha piperascens (MP), 5.47% Acanthopanax sessiliflorus Seem (AS), and 10.66% Glycyrrhiza uralensis (GU). The herbal extracts used included 0.5 mg/mL STB, 1.5 mg/mL MP, 1.5 mg/mL AS, and 2.0 mg/mL GU. Antimicrobial tests, morphological analyses (using scanning electron microscopy), microbial surface hydrophobicity measurements, and oral malodor reduction tests were performed using each extract. Statistical analyses were performed with IBM® SPSS® (version 24), using paired t-tests. Results: The mixed herbal extracts significantly inhibited the growth of Streptococcus mutans, Enterococcus faecalis, Candida albicans, and Porphyromonas gingivalis compared to the control (p < 0.001). Scanning electron microscopy results further revealed altered cellular morphology in the groups treated with the mixed herbal extracts. Additionally, the hydrophobicity assay results showed that the mixed herbal extracts reduced the oral adhesion capacities of bacteria (p < 0.001). Administration of the mixed herbal extracts also reduced the levels of volatile sulfur compounds, the main contributors to oral malodor (p < 0.001). Conclusions: Edible mixed herbal extracts can effectively eliminate oral pathogens and may be useful for improving oral health. The herbal extracts used were effective against all species of oral pathogens studied in this report.

Evaluation of the biological activities of Copaiba (Copaifera spp): a comprehensive review based on scientometric analysis

Copaíba oil-resin is extracted from the trunk of the Copaíba tree and has medicinal, cosmetic, and industrial properties. As a result, widespread knowledge about the use of Copaíba oil-resin has evolved, attracting the scientific community's attention. This paper aims to map the global knowledge production regarding the biological activities of Copaíba (Copaifera spp.). Bibliometric methodological instruments were used to conduct a search of the Web of Science-Core Collection database. The search resulted in 822 references. After screening titles and abstracts, 581 references did not meet the eligibility criteria, leaving 246 references for full-text examination. Subsequently, 15 studies were excluded, resulting in a final set of 232 records for the bibliometric analysis. In vitro was the most published study type, mainly from Brazil, from 2010 to 2020. Regarding the authors, Bastos, JK, and Ambrosio, SR were the ones with the most significant number of papers included. The most frequent keywords were Copaíba oil, Copaíba, and Copaifera. Our findings revealed global study trends about Copaíba, mainly related to its various effects and use over time. In general, all countries have conducted more research on antimicrobial and anti-inflammatory activities, also exposing its antioxidant and healing properties. Copaifera reticulata was the most investigated, followed by Copaifera langsdorffi and Copaifera multijuga in both in vitro and in vivo studies. Therefore, there is a need for human reports, given the promising results that Copaíba oils have been demonstrating.

The Effect of Rosmarinus Officinalis as a Potential Root Canal Medication on the Viability of Dental Pulp Stem Cells

AIM

The objective of the current study was to assess and compare the impact of triple antibiotic paste (TAP) and calcium hydroxide (Ca(OH)2) with rosmarinic acid (RA) on the viability of dental pulp stem cells (DPSCs).

MATERIALS AND METHODS

Dental pulp stem cells were isolated and characterized using flow cytometry. The cells were treated with (0.25, 0.5, 1, 2.5, and 5 mg/mL) concentrations for TAP and Ca(OH)2 and (6.25, 12.5, 25, 50, and 100 µM) concentrations for RA. Cell viability was evaluated after 3 days, with cell proliferation further analyzed over 3, 5, and 7 days utilizing the MTT assay. The optical density (OD) was quantified at 570 nm, subsequently enabling the determination of corrected OD and cell viability. ANOVA followed by the post hoc Tuckey test evaluated the statistical significance at p < 0.05.

RESULTS

Following the cell viability test, 0.25 and 0.5 mg/mL of TAP and Ca(OH)2 showed no significant difference for DPSCs compared to the control group. While dosages of 1 mg/mL, 2.5 mg/mL, and 5 mg/mL significantly reduced cell viability (p < 0.05). However, 6.25 µM and 12.5 µM concentrations of RA showed a significant increase in cell viability compared to untreated cells, 25 µM and 50 µM concentrations showed no significant difference compared to untreated cells while 100 µM concentration showed a decrease in cell viability (p < 0.05). Moreover, RA at a concentration of 12.5 µM exhibited a significant enhancement in cell proliferation rates after 5 and 7 days.

CONCLUSION

Rosmarinic acid showed a significant increase in cell viability when used at 6.25 and 12.5 µM concentrations compared to TAP and CA(OH)2.

CLINICAL SIGNIFICANCE

The assessment of cytotoxicity associated with bioactive compounds like RA, which processes antimicrobial and anti-inflammatory properties, holds importance. This evaluation could pave the way for novel intracanal medicaments that enhance the regenerative potential of DPSCs.

Antibacterial mechanism of areca nut essential oils against Streptococcus mutans by targeting the biofilm and the cell membrane

Introduction

Dental caries is one of the most common and costly biofilm-dependent oral diseases in the world. Streptococcus mutans is the major cariogenic pathogen of dental caries. S. mutans synthesizes extracellular polysaccharides by autologous glucosyltransferases, which then promotes bacterial adhesion and cariogenic biofilm formation. The S. mutans biofilm is the principal target for caries treatment. This study was designed to explore the antibacterial activity and mechanisms of areca nut essential oil (ANEO) against S. mutans.

Methods

The ANEOs were separated by negative pressure hydro-distillation. The Kirby-Bauer method and broth microdilution method were carried out to evaluate the antibacterial activity of different ANEOs. The antibacterial mechanism was revealed by crystal violet staining, XTT reduction, microbial adhesion to hydrocarbon test, extracellular polysaccharide production assay, glucosyltransferase activity assay, lactate dehydrogenase leaking, propidium iodide staining and scanning electron microscopy (SEM). The cytotoxicity of ANEOs was determine by MTT assay.

Results

The ANEOs separated at different temperatures exhibited different levels of antibacterial activity against S. mutans, and the ANEO separated at 70°C showed the most prominent bacteriostatic activity. Anti-biofilm experiments showed that the ANEOs attenuated the adhesion ability of S. mutans by decreasing the surface hydrophobicity of the bacteria, prevented S. mutans biofilm formation by inhibiting glucosyltransferase activity, reducing extracellular polysaccharide synthesis, and reducing the total biofilm biomass and activity. SEM further demonstrated the destructive effects of the ANEOs on the S. mutans biofilm. Cell membrane-related experiments indicated that the ANEOs destroyed the integrity of the cell membrane, resulting in the leakage of lactic dehydrogenase and nucleic acids. SEM imaging of S. mutans cell showed the disruption of the cellular morphology by the ANEOs. The cytotoxicity assay suggested that ANEO was non-toxic towards normal oral epithelial cells.

Discussion

This study displayed that ANEOs exerted antibacterial activity against S. mutans primarily by affecting the biofilm and disrupting the integrity of the cell membrane. ANEOs has the potential to be developed as an antibacterial agent for preventing dental caries. Additionally, a new method for the separation of essential oil components is presented.

Green Alternatives as Antimicrobial Agents in Mitigating Periodontal Diseases: A Narrative Review

Periodontal diseases and dental caries are the most common infectious oral diseases impacting oral health globally. Oral cavity health is crucial for enhancing life quality since it serves as the entranceway to general health. The oral microbiome and oral infectious diseases are strongly correlated. Gram-negative anaerobic bacteria have been associated with periodontal diseases. Due to the shortcomings of several antimicrobial medications frequently applied in dentistry, the lack of resources in developing countries, the prevalence of oral inflammatory conditions, and the rise in bacterial antibiotic resistance, there is a need for reliable, efficient, and affordable alternative solutions for the prevention and treatment of periodontal diseases. Several accessible chemical agents can alter the oral microbiota, although these substances also have unfavorable symptoms such as vomiting, diarrhea, and tooth discoloration. Natural phytochemicals generated from plants that have historically been used as medicines are categorized as prospective alternatives due to the ongoing quest for substitute products. This review concentrated on phytochemicals or herbal extracts that impact periodontal diseases by decreasing the formation of dental biofilms and plaques, preventing the proliferation of oral pathogens, and inhibiting bacterial adhesion to surfaces. Investigations examining the effectiveness and safety of plant-based medicines have also been presented, including those conducted over the past decade.

Thevetia peruviana leaves, HPLC profile, isolation, and in vitro cytotoxicity

Phytochemicals have played a significant role in the discovery of many clinically anticancer medicines. Thevetia peruviana being famous as an ornamental plant, widely cultivated, and including a wide variety of secondary metabolites this motivated us to explore more about its potential medical applications. In this study, the total methanol extract of T. peruviana leaves (family Apocyanaceae) was sequentially fractionated into hexane, methylene chloride, ethyl acetate, and butanol fractions. The total phenolic content of the methanol extract of T. peruviana was determined spectrophotometrically and found to be 72.37 mg g^-1, while the total flavonoid content was found to be 12.47 mg g^-1. Fourteen polyphenolic compounds were detected by the HPLC analysis of the methanol extract, in addition to five phenolic compounds, which were isolated and identified for the first time from the EtOAc extract. They were identified as gallic acid (C1), chlorogenic acid (C2), p-coumaric acid (C3), quercetin (C4), and rutin (C5). The structures were elucidated by NMR and EI/MS spectroscopic techniques. The cytotoxic activity of the methanol extract was evaluated in vitro by cell viability assay. The cytotoxicity results showed significant anticancer activity against human colon carcinoma HCT-116 with IC₅₀ 39.3 μg mL^-1 and lesser activity against human lung carcinoma A-549 and human breast carcinoma MCF-7 cell lines with IC₅₀ 93.4 and 110.3 μg mL^-1, respectively.

Evaluation of the antibacterial effect of hydroalcoholic extract of the galls of Quercus infectoria on Aggregatibacter actinomycetemcomitans

Background

Aggregatibacter actinomycetemcomitans (Aa) plays a vital role in some destructive forms of periodontitis. While mechanical and chemical plaque control is the first step in periodontitis treatment, side effects of adjunctive chemical agents such as chlorhexidine (CHX) mouthwash have led to the application of natural alternatives with minimal side effects. Therefore, this study evaluated the antibacterial effect of the hydroalcoholic extract of Quercus infectoria (Qi) galls on Aa in vitro.

Methods

The hydroalcoholic extract of Qi was obtained by the maceration method, and Aa bacterial strain was cultured. The inhibition zone diameter was measured through the agar well diffusion method. Also, the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values were determined by the broth microdilution method. All the experiments were repeated three times. 0.2% CHX was used as a control.

Results

The inhibition zone diameter of Aa increased with increasing concentration of Qi extract. While MIC and MBC values for CHX were 0.0039 and 0.0078 mg/mL, respectively, both MIC and MBC values of the Qi extract for this bacterium were similar, i.e., 2.5 mg/mL, which was significantly higherd.

Conclusion

Since other in vivo studies have confirmed the other properties of this extract and its safety in terms of cytotoxicity and mutagenicity, hydroalcoholic extract of Qi may be used in mouthwashes or local delivery systems to affect periodontal biofilm.

Hepatoprotective Effect of Ethanolic Extract of Garlic Against Reserpine Induced Toxicity in Wistar Rats

Reserpine, a bioactive compound isolated from the roots of Rauwolfia serpentine, is known to deplete dopamine, a neurotransmitter. The clinical application of reserpine has been associated to manage hypertension, insanity, insomnia and schizophrenia. However, the usage of reserpine as a drug is restricted because of its ability of inducing excess free radicals production and oxidative stress resulting into damage to liver and other organs. Here, we have explored the antioxidative potential of extract of garlic prepared using ethanol (EEG) against reserpine-induced hepatic damage in the albino Wister rats.The animals were divided into four different groups containing 6 animals in each: (1) control + placebo, (2) control + EEG, (3) reserpine and (4) reserpine with EEG. The reserpine treatment resulted into sharp increase in the level of MDA and significant reduction in the activitiesof key antioxidative enzymes (SOD, GST, and CAT) in the rat liver. It also caused sharp perturbations in the levels of certain hepatic transaminases (ALT, AST) and glycolytic LDH. The histopathological results revealed hepatic necrosis, which could have occurred due to reserpine induced lipid peroxidation as well as reduction in the levels of antioxidant species.The administration of EEG, however, significantly ameliorated reserpine induced hepatotoxicity. These results reflected the ameliorative property of EEG, which was probably mediated via its antioxidant function as it contains several bioactive molecules with free radical quenching potential.This study suggestedthe prospective application of EEG as a supplement to combat the side effects of reserpine.

Development and in vitro characterization of a mucoadhesive gel with Moringa oleifera extract for periodontal drug delivery

Background

Extensive in vitro and in vivo research has been conducted in the previous decades to analyze the effectiveness of medicinal plants in the treatment of periodontal diseases. Moringa oleifera is a highly potent medicinal plant that has anti-inflammatory and immuno-modulatory properties. In our study, we aim to design, formulate, and evaluate the antibacterial efficacy of M. oleifera extract for local drug delivery (LDD) as periodontal treatment.

Materials and Methods

This study was an in vitro experimental model. M. oleifera extract was prepared using a maceration process with powdered dried leaves of M. oleifera and 70% ethanol. The minimum inhibitory concentration (MIC) of Moringa extract against Porphyromonas gingivalis was assessed using the broth dilution method. The gel was prepared with the obtained MIC of Moringa extract and a combination of polymers- Polyethylene glycol 6000, Carbopol 940, and Chitosan. Further, the formulated gel was subjected to in vitro characterization by thermodynamic stability tests, pH determination, and syringeability test. Viscosity was determined using Brookfield DV-II + Viscometer. Mucoadhesive strength was determined using a fabricated mucoadhesive strength test apparatus.

Results

M. oleifera leaves extract possesses a bactericidal effect against P. gingivalis even at a low amounts of 25 μg/ml and so is a potent botanical extract for the formulation of LDD agents for periodontal diseases. The formulation shows adequate stability, good mucoadhesiveness, and controlled drug release, on incorporating the herbal extract into the blank gel.

Conclusion

The M. oleifera leaves extract possesses a bactericidal effect against P. gingivalis which has been suggested to be the keystone pathogen in the etiopathogenesis of periodontitis. Hence, M. oleifera leaves extract can be used to treat periodontal diseases as a LDD agent.

Analgesic and Anti-Inflammatory Activities of 80% Methanol Extract and Solvent Fractions of Ehretia cymosa Thonn (Boraginaceae) Leaves in Rodents

Background

Ethnobotanical studies in various districts of Ethiopia reported that Ehretia cymosa (E. cymosa) is used for the management of headache, abdominal pain, arthritis and rheumatism. However, there is no scientific investigation done so far to confirm these traditional claims. Thus, the aim of this study was to assess the analgesic and anti-inflammatory effects of the 80% methanol extract and fractions of E. cymosa leaves.

Methods

The dried and pulverized leaves of E. cymosa were soaked with 80% methanol to obtain a crude extract. Fractionation was done using chloroform, ethyl acetate and water by a soxhlet apparatus. The analgesic effects of the crude extract and solvent fractions were assessed using acetic acid-induced writhing and hot plate tests whereas anti-inflammatory activities were investigated using carrageenan-induced paw edema and cotton-pellet-induced granuloma models.

Results

In all the tested doses, the 80% methanol extract and solvent fractions revealed substantial (p < 0.001) analgesic activities in acetic acid induced writhing test. In the hot plate method, all the tested doses of E. cymosa crude extract and the solvent fractions produced significant analgesic activities (p < 0.05). In the carrageenan-induced acute inflammation model, all tested doses of the crude extract and solvent fractions resulted in a significant decline in paw edema. The 80% methanol extract and solvent fractions of E. cymosa at all the tested doses significantly reduced inflammatory exudates and granuloma mass formations (p < 0.001).

Conclusion

From the results of this investigation, it can be stated that 80% methanol extract, aqueous, ethyl acetate and chloroform fractions of E. cymosa exhibited considerable analgesic and anti-inflammatory activities, supporting the plant's traditional use as a remedy for a variety of painful and inflammatory conditions.

Revisiting the Therapeutic Effects of Essential Oils on the Oral Microbiome

The extensive use of antibiotics has resulted in the development of drug-resistant bacteria, leading to a decline in the efficacy of traditional antibiotic treatments. Essential oils (EOs) are phytopharmaceuticals, or plant-derived compounds, that possess beneficial properties such as anti-inflammatory, antibacterial, antimicrobial, antiviral, bacteriostatic, and bactericidal effects. In this review, we present scientific findings on the activity of EOs as an alternative therapy for common oral diseases. This narrative review provides a deeper understanding of the medicinal properties of EOs and their application in dentistry. It not only evaluates the effectiveness of these oils as antibacterial agents against common oral bacteria but also covers general information such as composition, methods of extraction, and potential toxicity. Further nonclinical and clinical studies must be conducted to determine their potential use and safety for treating oral diseases.

Synergistic inhibitory activity of Glycyrrhizae Radix and Rubi Fructus extracts on biofilm formation of Streptococcus mutans

BACKGROUND

Streptococcus mutans is a bacterium that causes oral diseases. Plaque, a biofilm produced by S. mutans and other bacteria, makes it difficult to remove cariogenic oral microorganisms, including biofilm producers. Glucan synthesis by glucosyltransferase is one of the mechanisms underlying plaque formation. This study demonstrates the effectiveness of inhibiting biofilm formation by interfering with the glucosyltransferase activity of S. mutans using edible herbal medicines.

METHODS

This study investigated the inhibitory activity of Glycyrrhizae Radix extract, Rubi Fructus extract, glycyrrhizin from Glycyrrhizae Radix, and ellagic acid from Rubi Fructus against glucosyltransferase activity of S. mutans. Enzyme kinetic analysis identified the mechanism by which glycyrrhizin and ellagic acid inhibit enzyme activity.

RESULTS

The conditions for synergistically inhibiting biofilm formation by combining Glycyrrhizae Radix and Rubi Fructus extracts were identified. Biofilm formation was also synergistically inhibited by mixing their respective active constituents, glycyrrhizin and ellagic acid. Glycyrrhizin and ellagic acid inhibited glucosyltransferase via noncompetitive and uncompetitive mechanisms, respectively, indicating that they inhibit it via distinct mechanisms.

CONCLUSIONS

This study presents an effective oral hygiene method using the synergistic activity of two natural plant extracts to inhibit biofilm formation through different inhibitory mechanisms against glucosyltransferase of S. mutans.

Isolation of high-purity and high-stability exosomes from ginseng

Exosomes are nano-sized extracellular vesicles that regulate cell growth and defense by delivering bioactive cellular constituents. They are a promising material for biomedical and cosmetic utilization, especially in medicinal crops such as ginseng. One main hurdle to their usage is the need for a method to isolate stable exosomes with high purity. In this study, we first tested two methods to isolate exosomes from ginseng: ultracentrifugation, the most widely used method; and the ExoQuick system, a polymer-based exosome precipitation approach. We also designed and tested a third method in which we combined ultracentrifugation and ExoQuick methods. Size distribution analysis revealed that the exosome isolation purity by the ultracentrifugation and ExoQuick methods alone were 34.1% and 59.7%, respectively, while the combination method greatly improved exosome isolation purity (83.3%). Furthermore, we found that the combination method also increases the colloidal stability of isolated ginseng exosomes, and the increase was almost double that of the ultracentrifugation method. Lastly, we showed that the combination method can also be used to isolate high-purity and high-stability exosomes from the model plant Arabidopsis. Overall, our findings indicate that the combination method is suitable to isolate high-purity and high-stability exosomes from plants including ginseng.

Euphorbia neriifolia (Indian Spurge Tree): A Plant of Multiple Biological and Pharmacological Activities

Although India has a well-established and growing economy surrounding synthetic drug chemistry with an antibiotic base, a large part of the population, especially in forested villages and tribal belts, is relying solely on plant-derived drugs. This is due to a lower number of side effects, low chances of resistance development against pathogenic microorganisms, as well as the diversity and affordability of such drugs. In the Indian subcontinents, Euphorbia neriifolia Linn. (EN) is one of the valuable plants from the big family of Euphorbiaceae, which is usually found in rocky and hilly areas. E. neriifolia was found to be useful in curing tumors, abdominal swelling, bronchial infection, hydrophobia, earache, cough and cold, asthma, leprosy, gonorrhea, spleen enlargement, leucoderma, snake bites, scorpion stings, and causing appetite improvement, etc. Different in vitro and in vivo experimental studies were performed to determine the antioxidant, anti-diabetic, immunomodulatory, anti-inflammatory, anti-arthritic, wound healing, anti-atherosclerosis, radioprotective, anti-anxiety, anti-convulsant, anti-psychotic, anti-thrombotic, dermal irritation, hemolytic, analgesic, anti-fertility, diuretic, anti-microbial, anti-diarrheal, and anti-carcinogenic activities of the various parts of EN. Several bioactive compounds, such as euphol, nerifoliol, taraxerol, euphonerins A–G, lectin, etc., were isolated from E. neriifolia and need to be investigated further for various biological activities (cardiovascular and neuronal diseases). In the pharmaceutical sector, E. neriifolia was selected for the development of new drugs due to its broad pharmacological activities. Therefore, in the present review, distribution, classification, morphological and microscopical description, phytochemical investigation, pharmacological activities, medicinal uses, harmful effects, and their treatment were evaluated, especially against different lifestyle-related diseases.

Synergic Effect of Honey with Other Natural Agents in Developing Efficient Wound Dressings

Honey has been used for therapeutic and nutritional purposes since ancient times. It was considered one of the essential medical assets in wound healing. According to research, honeybees have significant antibacterial, antioxidant, anti-inflammatory, antitumor, and wound-healing properties. Lately, scientific researchers have focused on apitherapy, using bee products to protect and strengthen the immune system. Since honey is the most important natural product rich in minerals, proteins, and vitamins, it has been intensively used in such therapies. Honey has gained significant consideration because of the beneficial role of its antioxidant compounds, such as enzymes, proteins, amino and organic acids, polyphenols, and carotenoids, but mainly due to flavonoids and phenolic acids. It has been proven that phenolic compounds are responsible for honey's biological activity and that its physicochemical properties, antioxidants, and antimicrobial potential are significant for human health. The review also presents some mechanisms of action and the medical applications of honey, such as wound healing dressings, skin grafts, honey-based nanofibers, and cochlear implants, as the most promising wound healing tools. This extensive review has been written to highlight honey's applications in medicine; its composition with the most important bioactive compounds also illustrates its synergistic effect with other natural products having remarkable therapeutic properties in wound healing.

Therapeutic Potential of Flavonoids and Tannins in Management of Oral Infectious Diseases-A Review

Medicinal plants are rich sources of valuable molecules with various profitable biological effects, including antimicrobial activity. The advantages of herbal products are their effectiveness, relative safety based on research or extended traditional use, and accessibility without prescription. Extensive and irrational usage of antibiotics since their discovery in 1928 has led to the increasing expiration of their effectiveness due to antibacterial resistance. Now, medical research is facing a big and challenging mission to find effective and safe antimicrobial therapies to replace inactive drugs. Over the years, one of the research fields that remained the most available is the area of natural products: medicinal plants and their metabolites, which could serve as active substances to fight against microbes or be considered as models in drug design. This review presents selected flavonoids (such as apigenin, quercetin, kaempferol, kurarinone, and morin) and tannins (including oligomeric proanthocyanidins, gallotannins, ellagitannins, catechins, and epigallocatechin gallate), but also medicinal plants rich in these compounds as potential therapeutic agents in oral infectious diseases based on traditional usages such as Agrimonia eupatoria L., Hamamelis virginiana L., Matricaria chamomilla L., Vaccinium myrtillus L., Quercus robur L., Rosa gallica L., Rubus idaeus L., or Potentilla erecta (L.). Some of the presented compounds and extracts are already successfully used to maintain oral health, as the main or additive ingredient of toothpastes or mouthwashes. Others are promising for further research or future applications.

Enzyme Inhibitory Activities of Extracts and Carpachromene from the Stem of Ficus benghalensis

Ficus benghalensis is one of the potential medicinal plants which is used locally for the treatment of various ailments such as diabetes, antiasthmatic, and wound healing. To provide a scientific background to these folklores, the current study was designed to evaluate the extract and isolated compound against various enzymes such as ureases, tyrosinase, and phosphodiesterase. The methanolic extract and carpachromene demonstrated a significant urease inhibition effect with maximum percent inhibition of 72.09 and 92.87%, respectively. Regarding the tyrosinase inhibition, the percent antagonist effect of carpachromene and the methanolic extract was 84.80 and 70.98%, respectively. The phosphodiesterase was also significantly antagonized by crude extract and carpachromene with a maximum percent inhibition of 82.98% and 89.54%, respectively. The docking study demonstrated that the carpachromene fits well into the active site of all three enzymes with significant interactions. Carpachromene might possess the potential to inhibit all three enzymes and can effectively treat different diseases associated with the hyperactivity of these enzymes. In conclusion, the crude extract and carpachromene exhibit significant urease, tyrosinase, and phosphodiesterase inhibitory activity which might be used against various diseases. In conclusion, the crude extract and carpachromene exhibit significant urease, tyrosinase, and phosphodiesterase inhibitory activity which might be used against diabetes and bronchoconstriction. Further, the current study provides scientific backup to the folklore (antidiabetic and antiasthmatic) of Ficus benghalensis.

An Assessment of the In Vitro Models and Clinical Trials Related to the Antimicrobial Activities of Phytochemicals

An increased number antibiotic-resistant bacteria have emerged with the rise in antibiotic use worldwide. As such, there has been a growing interest in investigating novel antibiotics against antibiotic-resistant bacteria. Due to the extensive history of using plants for medicinal purposes, scientists and medical professionals have turned to plants as potential alternatives to common antibiotic treatments. Unlike other antibiotics in use, plant-based antibiotics have the innate ability to eliminate a broad spectrum of microorganisms through phytochemical defenses, including compounds such as alkaloids, organosulfur compounds, phenols, coumarins, and terpenes. In recent years, these antimicrobial compounds have been refined through extraction methods and tested against antibiotic-resistant strains of Gram-negative and Gram-positive bacteria. The results of the experiments demonstrated that plant extracts successfully inhibited bacteria independently or in combination with other antimicrobial products. In this review, we examine the use of plant-based antibiotics for their utilization against antibiotic-resistant bacterial infections. In addition, we examine recent clinical trials utilizing phytochemicals for the treatment of several microbial infections.

Experimental and clinical trial investigations of phyto-extracts, phyto-chemicals and phyto-formulations against oral lichen planus: A systematic review

ETHNOPHARMACOLOGICAL RELEVANCE

Bio-assay guided phytoextracts and derived phytoconstituents reported having multipotent biological activities and nearly 60-80% of the global population still using natural regimens as an alternative therapeutic source. This study focused on the ethnopharmacological and experimental evidence of natural remedies that are effective in treating oral lichen planus (OLP), a chronic T-cell mediated autoimmune disease that is associated with oral cancer transmission.

AIM OF THE REVIEW

A number of studies have shown that antioxidants and antiinflammatory phytoextracts and phyto-constituents are effective against OLP. In this systematic review, we summarize the details of experimentally assessed ancient Traditional Chinese Medicine (TCM), Indian Ayurveda or Ayurvedic Medicine, and Japanese Kampo Medicine (JKM) regimens (crude extracts, individual phytochemicals, and phyto-formulations) that reduce oral lesion, severity index and pain associated with OLP based on studies conducted in vivo, in vitro, and in randomized controlled trials (RCTs).

MATERIALS AND METHODS

Experimental, clinical and RCT investigation reports were gathered and presented according to PRISMA-2020 format. Briefly, the information was obtained from PubMed, ScienceDirect, Wiley journal library, Scopus, Google Scholar with ClinicalTrials.gov (a clinical trial registry database operated by the National Library of Medicine in the United States). Further, individual phytochemical structures were verified from PubChem and ChemSpider databases and visualized by ChemDraw 18.0 software.

RESULTS

We summarized 11 crude phytoextracts, 7 individual phytochemicals, 9 crude formulations, 8 specific TCM and JKM herbal cocktails, and 6 RCTs/patents corroborated by multiple in vitro, in vivo and enzyme assay methods. Briefly, plants and their family name, used plant parts, reported phytochemicals and their chemical structure, treatment doses, and duration of each experiment were presented more concisely and scientifically.

CONCLUSION

Documentation of evidence-based natural ethnomedicines or remedies could be useful for promoting them as potential, cost-effective and less toxic alternatives or as complementary to commonly prescribed steroids towards the control of OLP.

Origanum vulgare ethanolic extracts as a promising source of compounds with antimicrobial, anti-biofilm, and anti-virulence activity against dental plaque bacteria

Dental caries and periodontal diseases remain a challenge for oral health, especially given the lack of effective and safe treatment options that are currently available. Against the backdrop of an ongoing antimicrobial resistance crisis, a renewed interest in traditional medicinal plants as a potential source of new bioactive compounds has surfaced. In this context, we systematically screened the antimicrobial and anti-biofilm activities of both ethanolic and aqueous extracts of nine Algerian medicinal plants (Artemisia herba alba, Centaurium erythraea, Juglans regia, Laurus nobilis, Matricaria recutita, Mentha pulegium, Mentha piperita, Origanum vulgare and Taraxacum officinale). To evaluate the activity spectrum of the extracts, the screening was carried out against an extensive collection of Streptococcus, Enterococcus and Lacticaseibacillus isolates recovered from dental plaques of Algerian patients. Broad-spectrum antimicrobial and anti-biofilm properties were observed, especially among ethanolic extracts, which marks them as a promising source for bioactive compounds to control oral biofilms. The ethanolic extract of O. vulgare, which showed the most promising effects in the initial screening, was further characterized. We first verified the biocompatibility of this extract using human oral keratinocytes and selected a range of non-cytotoxic concentrations (0.195-0.781 mg/ml) to further validate its anti-biofilm and anti-virulence potential. At these concentrations, the extract not only prevented biofilm formation (10.04 ± 0.75-87.91 ± 9.08% of reduction) of most dental plaque isolates on a polystyrene surface, but also significantly reduced their adherence to hydroxyapatite (34.58 ± 9.09-62.77 ± 0.95%). Moreover, the extract showed curative potential against mature biofilms grown under conditions mimicking the oral niche. In addition to its anti-biofilm properties, we observed an inhibition of glucosyltransferase activity, a reduction in acidogenesis and a downregulation in the expression of multiple virulence-associated genes for extract-treated samples. Since anti-virulence properties are more robust to the development of resistance, they provide an attractive complementation to the antimicrobial activities of the extract. Thymol was identified as an important active compound of the extract using GC-MS analysis, but synergy with other compounds was also detected, suggesting a potential advantage of using the whole extract over purified thymol. Further research into the bioactive compounds of the O. vulgare ethanolic extract could yield novel products to fight dental caries.

Chitosan as a Functional Carrier for the Local Delivery Anti-Inflammatory Systems Containing Scutellariae baicalensis radix Extract

The aim of the study was to establish the influence of chitosan on the preparation of systems containing Scutellariae baicalensis radix extract and to demonstrate the potential of anti-inflammatory action for the treatment of periodontitis. In the first stage, the impact of the variables (extraction mixture composition, temperature, and the number of extraction cycles) on the extracted samples' biological characteristics was analyzed using the Design of Experiments (DoE) approach. The best conditions for baicalin, baicalein, and wogonin extraction from Scutellariae baicalensis radix were 80% methanol in the extraction mixture, 70 °C, and 4 cycles per 60 min. The DoE approach can be used to choose the best chitosan system parameters with equal success. An increase in the deacetylation degree of chitosan used in the system improved the potential for reducing free radicals and inhibiting the hyaluronidase enzyme. Also, increasing the degree of chitosan deacetylation results in increased resistance of the carrier to biodegradation and an extended baicalin release profile, which is also associated with an increase in the viscosity of the chitosan-based system. In total, the system of a freeze-dried extract with chitosan 90/500 in the ratio of 2:1 (system S9) turns out to be the one with the best physicochemical (high percentage of baicalin release and the highest viscosity conditioning the prolonged stay at the site of administration) and biological properties (the highest antioxidant and anti-inflammatory activities), resulting in the highest potential for use in the treatment of oral inflammatory diseases.

Medicinal Plants Used as an Alternative to Treat Gingivitis and Periodontitis

For various ailments, natural remedies have been traditionally used. To defend against common disorders, medicinal plants are progressively used as nutritional supplements. Gingivitis and periodontitis are widespread and can affect most of the world's population. Gingivitis is a very common, nondestructive inflammatory disease of gums that causes redness and irritation of the gingiva (gums), but periodontitis causes permanent damage to teeth' subsidiary structures. Herbal medicines are getting popular for the treatment of such types of disorders due to being economical with their medicinal effectiveness, compatibility, and nontoxicity. Traditional chemical therapies can cause cell toxicity along with their disease-curing effects. In this article, we discussed the medicinal plants that can be used as an alternative for the treatment of gingivitis (early-stage gum disease) and periodontitis (chronic-stage gum disease).

Comparative Evaluation of the Remineralization Potential of Fluoride-containing Toothpaste, Honey Ginger Paste and Ozone. An In Vitro Study

Introduction

A drop in pH of the oral cavity results in demineralization, which, if continued, leads to loss of minerals from tooth structure, resulting in dental caries. A goal of modern dentistry is to manage noncavitated caries lesions noninvasively through remineralization in an attempt to prevent disease progression.

Materials and methods

A total of 40 extracted premolar teeth were selected for the study. The specimens were divided into four groups, group I, the control group; group II, remineralizing agent as fluoride toothpaste; group III, the treatment material as ginger and honey paste; and group IV, the treatment material as ozone oil. An initial reading of surface roughness and hardness was recorded for the group (control group). Repeated treatment has continued lasting 21 days. This saliva was changed each day. Following the lesion formation procedure, the surface microhardness was measured for all specimens. The parameters were 200 gm force for 15 seconds with a Vickers indenter and the roughness of the demineralized area of each specimen was obtained by using the surface roughness tester.

Results

Surface roughness was checked by using a surface roughness tester. Before starting the pH cycle, the baseline value for the control group was calculated. The baseline value for the control group was calculated. The surface roughness average value for 10 samples is 0.555 µm and the average surface microhardness is 304 HV; the average surface roughness value for fluoride is 0.244 µm and the microhardness is 256 HV, 0.241 µm, and 271 HV value for honey-ginger paste. For ozone surface roughness average value is 0.238 µm and the surface microhardness average mean value is 253 HV.

Conclusion

The future of dentistry will rely on the regeneration of tooth structure. There is no significant difference seen between each treatment group. Considering the adverse effect of fluoride, we can consider honey-ginger and ozone as good remineralizing agents for fluoride.

How to cite this article

Kade KK, Chaudhary S, Shah R, et al. Comparative Evaluation of the Remineralization Potential of Fluoride-containing Toothpaste, Honey Ginger Paste and Ozone. An In Vitro Study. Int J Clin Pediatr Dent 2022;15(5):541-548.

The Treatment Efficiency and Microbiota Analysis of Sapindus mukorossi Seed Oil on the Ligature-Induced Periodontitis Rat Model

Periodontitis is a common oral disease mainly caused by bacterial infection and inflammation of the gingiva. In the prevention or treatment of periodontitis, anti-bacterial agents are used to inhibit pathogen growth, despite increasing levels of bacterial resistance. Sapindus mukorossi Gaertn (SM) seed oil has proven anti-bacterial and anti-inflammation properties. However, the possibility of using this plant to prevent or treat periodontitis has not been reported previously. The aim of this study was to evaluate the effects of SM oil on experimental periodontitis in rats by using micro-CT and microbiota analysis. The distance between cementoenamel junction (CEJ) and alveolar bone crest (ABC) on the sagittal micro-CT slide showed that total bone loss (TBL) was significantly lower in CEJ-ABC distances between SM oil and SM oil-free groups on Day 14. Histology data also showed less alveolar bone resorption, a result consistent result with micro-CT imaging. The microbiota analyzed at phylum and class levels were compared between the SM oil and SM oil-free groups on Day 7 and Day 14. At the phylum level, Proteobacteria, Firmicutes, Bacteroidetes, and Actinobacteria were the dominant bacterium. Firmicutes in box plot analysis was significantly less in the SM oil group than in the SM oil-free group on Day 7. At the class level, Bacteroidia, Gammaproteobacteria, Bacilli, Clostridia, and Erysipelotrichia were the dominant bacteria. The bacteria composition proportion of Bacilli, Clostridiay, and Erysipelotrichia could be seen in the SM oil group significantly less than in t SM oil-free group on Day 7. Overall, the present results show that topical application of SM oil can reduce bone resorption and change bacteria composition in the ligature-induced periodontitis model. According to these results, it is reasonable to suggest SM oil as a potential material for preventing oral disease.

A randomized, placebo-controlled clinical trial evaluating of a mouthwash containing Sambucus williamsii var. coreana extract for prevention of gingivitits

The purpose of this study is to verify the clinical applicability by applying a mouthwash containing Sambucus williamsii var. coreana extract for preventing periodontal disease. A randomized, double-blind, placebo-controlled study was conducted on 64 patients, excluding those with insufficient data, who visited M dental clinic located in Busan, Korea. Thirty-two people were assigned respectively to the saline solution gargle group and the Sambucus williamsii var. coreana extract gargle group to conduct the O'Leary index, plaque index (PI), gingival index (GI), and subgingival plaques. For the homogeneity of the two groups, scaling was carried out one week before the experiment, and the participants were taught for oral care to conduct during the study period. SPSS 24.0 for Windows (IBM Corp., Armonk, NY, USA) was used to compare the saline solution gargle group and the Sambucus williamsii var. coreana extract gargle group as well as to analyze Baseline (before gargle application), Treatment (immediately after gargle application), and After 5 Days (5 days after gargle application). There was a significant difference in the O'Leary index, PI, GI and subgingival plaques after Treatment and After 5 days (p < 0.05). Also, the periodontal-related indexes improved as the application time increased in the Sambucus williamsii var. coreana extract gargle group. The antibacterial effect was also shown for gram-positive bacteria and gram-negative bacteria in subgingival plaques as the application time increased. The use of the mouthwash containing Sambucus williamsii var. coreana extract was found to be effective for oral periodontal-related indicators and bacteria causing periodontal disease. Therefore, using a mouthwash containing Sambucus williamsii var. coreana extract, a natural drug, will possibly maintain healthy periodontal health by inhibiting and preventing the progression of periodontal disease.

In Vitro Activity of Water Extracts of Olive Oil against Planktonic Cells and Biofilm Formation of Arcobacter-like Species

Extra-virgin olive oils contain many bioactive substances that are phenolic compounds. The survival of Arcobacter-like strains in non-buffered (WEOO) and buffered (BEOO) extracts of olive oils were studied. Time kill curves of different strains were measured in the environment of olive oil extracts of different grades. The activity of the extracts was also monitored for biofilm formation using the Christensen method. In vitro results revealed that extra-virgin olive oil extracts exhibited the strongest antimicrobial effects, especially non-buffered extracts, which exhibited strain inhibition after only 5 min of exposure. The weakest inhibitory effects were observed for olive oil extracts. A decrease in biofilm formation was observed in the environment of higher WEOO concentrations, although at lower concentrations of extracts, increased biofilm formation occurred due to stress conditions. The dialdehydic forms of oleuropein derivatives, hydroxytyrosol, and tyrosol were the main compounds detected by HPLC-CoulArray. The results indicate that not all olive oils had a similar bactericidal effect, and that bioactivity primarily depended on the content of certain phenolic compounds.

Effectiveness of tea tree oil versus chlorhexidine in the treatment of periodontal diseases: a systematic review

Background Plaque biofilm that adheres to tooth surfaces and gingiva is the main aetiology of periodontitis. Chlorhexidine (CHX) is considered as a gold standard anti-plaque and anti-gingivitis agent but it has side effects such as permanent staining of teeth and dysgeusia. Tea tree oil (TTO) is an essential oil extracted from the leaves of Melaleuca alternifolia. Many studies have reported that TTO exerts strong antibacterial, antifungal, antiviral and anti-inflammatory activities.Primary study objective The review aims to answer the question of whether TTO (intervention) is a viable alternative to CHX (comparator) for the management of gingival and periodontal disease (outcomes) in adolescents and adults (population).Methods/design The following search terms were used in PubMed, Scopus, Proquest, Web of Science, EBSCO (dentistry and open access), Cochrane database, Clinical.gov.org and ctri.nic.in to search for relevant articles: patients with periodontal disease; OR periodontitis; OR gingivitis; OR gingival inflammation; AND essential oil; OR tea tree oil; OR Melaleuca alternifolia; AND chlorhexidine; AND reduction in gingival index; OR reduction in plaque index; OR reduction in bleeding from gums. The initial check for the title and abstract screening followed by removal of duplicates in Mendeley Reference Manager (version 1.19.4) based on the inclusion and exclusion criteria were performed.Primary outcome measures Parameters such as plaque index (PI), plaque surface score, gingival index (GI), bleeding index or bleeding as measured by % of sites with bleeding on probing (BOP) or bleeding scores, papillary bleeding index (PBI), were the primary outcomes considered.Results TTO is found to be superior to CHX in reducing signs of gingival inflammation; however, CHX is superior to TTO in inhibiting plaque formation, probably due to its increased substantivity.Conclusion TTO may be used as an alternative to CHX for reduction of gingival inflammation in conjunction with efficient plaque control measures.

Comparative Evaluation of Locally Administered 2% Gel Fabricated from Lemongrass Polymer and 10% Doxycycline Hyclate Gel as an Adjunct to Scaling and Root Planing in the Treatment of Chronic Periodontitis-A Randomized Controlled Trial

Background: Extracts of medicinal plant like lemongrass offer a new choice for optional antimicrobial therapy against various oral microorganisms. The objective of this study was to assess, verify, and compare the antimicrobial effectiveness of locally administered 2% lemongrass gel and 10% doxycycline hyclate gel as an adjunct to scaling and root planing (SRP) in treating chronic periodontitis. Method: This is a double-blind parallel arm randomized controlled study. Forty subjects were randomly divided into Group A and B for 2% lemongrass gel and 10% doxycycline hyclate gel, respectively. The clinical assessments of Gingival Index (GI), Plaque Index (PI), Probing Pocket Depth (PPD), and Clinical Attachment Level (CAL) together with microbial colony counts for Porphyromonas gingivalis, Actinomyces naeslundii, and Prevotella intermedia were done at baseline, 1st month, and 3rd month follow-ups. Results: The results showed there was a significant reduction in the mean scores of GI, PPD, and CAL clinical indices from baseline to the 1st and 3rd month follow-ups in both the 2% lemongrass gel and 10% doxycycline gel groups (p < 0.05). Similarly, there was significant reduction in mean CFU scores for all periodontal pathogens from baseline to 1st and 3rd month follow-ups in both the 2% lemongrass gel and 10% doxycycline gel groups (p < 0.05). Conclusions: It could be concluded that the local delivery of 2% lemongrass gel as an adjunct to scaling and root planing is effective and comparable to 10% doxycycline gel in the treatment of chronic periodontitis.

Strategies to Combat Caries by Maintaining the Integrity of Biofilm and Homeostasis during the Rapid Phase of Supragingival Plaque Formation

Bacteria in the oral cavity, including commensals and opportunistic pathogens, are organized into highly specialized sessile communities, coexisting in homeostasis with the host under healthy conditions. A dysbiotic environment during biofilm evolution, however, allows opportunistic pathogens to become the dominant species at caries-affected sites at the expense of health-associated taxa. Combining tooth brushing with dentifrices or rinses combat the onset of caries by partially removes plaque, but resulting in the biofilm remaining in an immature state with undesirables’ consequences on homeostasis and oral ecosystem. This leads to the need for therapeutic pathways that focus on preserving balance in the oral microbiota and applying strategies to combat caries by maintaining biofilm integrity and homeostasis during the rapid phase of supragingival plaque formation. Adhesion, nutrition, and communication are fundamental in this phase in which the bacteria that have survived these adverse conditions rebuild and reorganize the biofilm, and are considered targets for designing preventive strategies to guide the biofilm towards a composition compatible with health. The present review summarizes the most important advances and future prospects for therapies based on the maintenance of biofilm integrity and homeostasis as a preventive measure of dysbiosis focused on these three key factors during the rapid phase of plaque formation.

Remineralizing Potential of Low-fluoridated, Nonfluoridated and Herbal Nonfluoridated Dentifrices on Demineralized Surface of Primary Teeth: An In Vitro Study

Aim

The aim of this in vitro study is to evaluate the remineralizing potential of commercially available low-fluoridated, nonfluoridated, and herbal nonfluoridated child formula dentifrices on primary teeth.

Materials and methods

Total of 36 primary teeth were placed in the demineralizing solution for 96 hours to produce artificial carious lesions of approximately 100 μm depth, and then cut longitudinally into 30 sections of 100–150 μm thickness and randomly assigned to three groups. Sections were treated with low-fluoridated, nonfluoridated, and herbal nonfluoridated dentifrice. Lesions were evaluated using polarized light microscopy.

Results

Intragroup comparison of mean lesion depth from pretreatment to posttreatment among the three study groups revealed that maximum reduction in lesion depth was found to be in group I (low-fluoridated) followed in descending order by group III (herbal nonfluoridated) and group II (nonfluoridated), respectively.

Conclusion

Group I (low-fluoridated) and group III (herbal nonfluoridated) demonstrated remineralization of carious lesions by virtue of a decrease in lesion depth, whereas group II (nonfluoridated) showed an increase in lesion depth.

Clinical significance

Fluoride dentifrices are the most widely used products that deliver topical fluoride to the oral environment. The major drawback is the risk of dental fluorosis, which occurs because of ingestion of dentifrices, in preschool children. This necessitates use of preventive measures which include (1) reducing the amount of toothpaste used, (2) supervised brushing in preschool children and (3) developing low-fluoride toothpastes for minimizing risk of dental fluorosis. Further dental professionals must investigate effectiveness of increasingly popular “Herbal” products.

How to cite this article

Tiwari S, Saha S, Dhinsa K, et al. Remineralizing Potential of Low-fluoridated, Nonfluoridated and Herbal Nonfluoridated Dentifrices on Demineralized Surface of Primary Teeth: An In Vitro Study. Int J Clin Pediatr Dent 2022;15(3):251-257.

Inhibitory effects of a water-soluble jujube polysaccharide against biofilm-forming oral pathogenic bacteria

Oral diseases caused by infectious pathogens raises significant concerns in public health. In the light of side effects of current antibiotics therapy and growing drug resistance of pathogenic bacteria, natural products have become attractive alternatives for antibiotics agents in dental practice. This current study investigated the effects of polysaccharides extracted from Zizyphus jujuba Mill. on three major oral biofilm-forming pathogenic bacteria including caries-inducing Streptococcus mutans, lesions-causing MRSA, and periodontitis-related Porphyromonas gingivalis, as well as general oral microbiota. Our results demonstrated that jujube polysaccharide prepared in this study was mainly composed by galacturonic acid with an average molecular weight 242 kDa, which were further characterized for structural features by FT-IR spectra and NMR spectroscopy analysis. This jujube polysaccharide was shown to exhibit remarkable inhibitory effects against all the tested oral bacterial pathogens through various mechanisms including growth inhibition, biofilm prevention and disruption, intervention of bacterial infection (adhesion and invasion), attenuation of cytotoxicity, modulation of excessive inflammatory response of LPS-stimulated and MRSA-infected macrophages as well as positive regulation of oral microbiota. The present study paves the way to explore jujube polysaccharides for the prevention and treatment of oral infectious diseases. Graphic Abstract.

Caralluma edulis (Apocynaceae): A comprehensive review on its Traditional uses, Phytochemical profile and pharmacological effects

Caralluma edulis is a well-known species of the genus Caralluma from Apocynaceae, commonly known as chunga. Caralluma species are mostly succulent perennial herbs, several of which are edible species. The plant has an outstanding therapeutic background in the traditional system of treatment. It has been recommended for the treatment of a number medical disorder such as hypertension, Alzheimer disease, rheumatism, gastric problems and leprosy. Traditionally the stem was boiled in water and this extract was then used to cure diabetes. The pharmacological effects of C.edulis have also been explored in various in vitro and in vivo experiments. In this regard, the extract of the plant exhibited strong antioxidant activity, analgesic, against inflammation as well as xylene mediated ear edema for topical effects. The significant anti-hyperlipidemic effect of the plant extract is also reported. However, the extract was found insignificant in the reversal of alloxan-induced diabetes in rabbit model at test doses. These pharmacological effects are strongly supported by the presence of different bioactive phytochemicals in the plant. These groups of compounds include sterols, terpenoids, flavonoids, and pregnane glycosides. C.edulis is a very potential member of the genus Caralluma with strong traditional history, phytochemistry and phytopharmacology, needed further exploration for clinically used lead compounds. In this review, we have focused to combined different reported data on the traditional uses of the plant, phytochemical profile and pharmacological effects in different experimental assay and subsequent future prospects.

Evaluating hop extract concentrations found in commercial beer to inhibit Streptococcus mutans biofilm formation

AIMS

The purpose of this study was to compare the effect of hop extracts with diverse β-acid concentrations on Streptococcus mutans biofilm formation.

METHODS AND RESULTS

Ten different hop extracts, with α-acid concentrations similar to those found in commercial beer products and β-acid concentrations ranging from 2.6 to 8.1%, were added to distilled water to make standardized concentrations. S. mutans isolates were treated with hop extract dilutions varying from 1:2 to 1:256. The minimum inhibitory, minimum bactericidal, and minimum biofilm inhibitory concentrations were determined and the optical density was evaluated. Live/dead staining confirmed the bactericidal effects. Biofilm formation of several strains of S. mutans was significantly inhibited by hop extract dilutions of 1:2, 1:4, 1:8, 1:16, and 1:32. Strong negative correlations were observed between α- and β-acid concentrations of the hop extracts and S. mutans total growth and biofilm formation.

CONCLUSIONS

The use of hop extracts prepared similarly to commercial beer decreased S. mutans biofilm formation.

SIGNIFICANCE AND IMPACT OF THE STUDY

The inclusion of hops in the commercial beer products may provide beneficial health effects. Further studies are warranted to determine an effect in vivo on the development of dental caries.

Herbal Medications in Endodontics and Its Application-A Review of Literature

Herbal products are gaining popularity in dental and medical practice nowadays due to their biocompatibility, higher antimicrobial activity, antioxidant and anti-inflammatory properties. Herbal medicine has experienced rapid growth in recent years due to its beneficial properties, ease of availability, and lack of side effects. As pathogenic bacteria become more resistant to antibiotics and chemotherapeutic agents, researchers are becoming more interested in alternative products and treatment choices for oral diseases. As a result, natural phytochemicals separated from plants and utilized in traditional medicine are suitable substitutes for synthetic chemicals. The aim of this review article is to list and understand several herbal alternatives that are currently accessible for use as efficient endodontic medicaments. The herbal products used in endodontics have several advantages, including safety, ease of use, increased storability, low cost, and a lack of microbial tolerance. However, preclinical and clinical testing and interactions with other materials and adverse effects are required for these herbal products.

Antimicrobial and Antibiofilm Activity of Cinnamon (Cinnamomum burmanii) Extract on Periodontal Pathogens—An in vitro study

Objective  The aim of this study was to analyze the antibiofilm effectiveness of cinnamon ( Cinnamomum burmanii ) ethanol extract against Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans in vitro .

Material and   Methods Phytochemical tests were done to identify the cinnamon extract active substances. Furthermore, a crystal violet biofilm assay was used to analyze biofilm detachment after treatment with different concentrations (15, 10, 7.5, 5, and 2.5%) of cinnamon. Biofilm turbidity was measured at 595-nm wavelength using a microplate reader. Additionally, MTT assay was done to analyze the toxicity level of cinnamon extract on fibroblast cells.

Statistical Analysis  The obtained data were analyzed for normality using the Kolmogorov–Smirnov test. The differences between each group were analyzed using a one-way analysis of variance statistical test, with a significance level of p <0.05.

Results  The results showed that the ethanol extract of cinnamon contains active compounds of flavonoids, alkaloids, saponins, tannins, quinones, and terpenoids. MTT result showed the cinnamon extract to be nontoxic. The biofilm assay results showed that all cinnamon concentrations exhibited an antibiofilm effect against P. gingivalis and A. actinomycetemcomitans in all incubation time compared with a negative control ( p <0.05).

Conclusions  Cinnamon extracts were effective in inhibiting biofilm of periodontal pathogens. Cinnamon extract might be useful as an alternative therapy for periodontal diseases. Future studies are still needed to confirm this result in vivo to analyze the efficacy of this extract as mouthwash.