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Carvalho-Silva JM, Teixeira ABV, Valente MLDC, Shimano MVW, Dos Reis AC. Antimicrobial activity of essential oils against biofilms formed in dental acrylic resin: a systematic review of in vitro studies. BIOFOULING 2024; 40:114-129. [PMID: 38538551 DOI: 10.1080/08927014.2024.2332709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 03/11/2024] [Indexed: 04/09/2024]
Abstract
This study aimed to answer the question formulated according to the PICO strategy: 'Which essential oils show antimicrobial activity against biofilms formed on dental acrylic resin?' composed by population (dental acrylic resin), intervention (application of essential oils), comparison (denture cleansers, antifungal drugs, chlorhexidine, and oral mouthwashes), and outcome (antibiofilm activity). In vitro experimental studies evaluating the activity of EOs on biofilm formed on acrylic resin were included. PRISMA guidelines were followed, and the search was performed in the PubMed, Science Direct, Embase, and Lilacs databases and in the gray literature using Google Scholar and ProQuest in December 2023. A manual search of the reference lists of the included primary studies was performed. Of the 1467 articles identified, 37 were selected for full-text reading and 12 were included. Twelve EOs were evaluated, of which 11 showed activity against Candida spp., 3 against Staphylococcus aureus, and 1 against Pseudomonas aeruginosa. The EOs of Cymbopogon citratus, Cinnamomum zeylanicum, and Cymbopogon nardus showed higher action than chlorhexidine, C. nardus higher than Listerine, C. citratus higher than nystatin, and Melaleuca alternifolia higher than fluconazole and nystatin. However, chlorhexidine was more effective than Lippia sidoides and Salvia officinalis, sodium hypochlorite was more effective than L. sidoides, nystatin was more effective than Zingiber officinale, Amphotericin B more effective than Eucalyptus globulus and M. alternifolia. In conclusion, the EOs of C. zeylanicum, C. citratus, C. nardus, and M. alternifolia showed antimicrobial activity to reduce biofilm on dental acrylic resin.
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Affiliation(s)
- João Marcos Carvalho-Silva
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Ana Beatriz Vilela Teixeira
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Mariana Lima da Costa Valente
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Marcos Vinicius Wada Shimano
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Andréa Cândido Dos Reis
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo (USP), Ribeirão Preto, Brazil
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Astasov-Frauenhoffer M, Göldi L, Rohr N, Worreth S, Dard E, Hünerfauth S, Töpper T, Zurflüh J, Braissant O. Antimicrobial and mechanical assessment of cellulose-based thermoformable material for invisible dental braces with natural essential oils protecting from biofilm formation. Sci Rep 2023; 13:13428. [PMID: 37596293 PMCID: PMC10439145 DOI: 10.1038/s41598-023-39320-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 07/23/2023] [Indexed: 08/20/2023] Open
Abstract
Controlling biofilm formation in the oral cavity during orthodontic treatments is crucial. Therefore, antimicrobial surfaces for invisible dental appliances are of interest to both therapists and patients. Here we present a cellulose-based thermoformable material used for invisible braces that can be loaded with essential oils (EOs) having antibacterial and antifungal properties. We hypothesize that this material can absorb and release EOs, thus providing an antimicrobial effect without compromising the safety and mechanical properties necessary for dental invisible braces. Conventional microbiology and isothermal microcalorimetry analyses revealed that the thermoformable material loaded with essential oils significantly delayed the biofilm formation of oral streptococci (S. mutans and S. mitis) under static conditions (p < 0.05) and while simulating saliva flow (p < 0.05). In addition, cytotoxicity tests (ISO 10993-5), revealed that the loaded material is well tolerated by human gingival fibroblasts. Finally, the loading with antibacterial agents did not significantly alter the mechanical properties and stability of the material (initial force (p = 0.916); initial stress (p = 0.465)). Compared to gold-standard clear aligner materials, this material offers a reliable transmission of forces for orthodontic treatments. Moreover, this approach exhibits the potential for acting as an oral drug delivery platform for multiple compounds.
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Affiliation(s)
- Monika Astasov-Frauenhoffer
- Department Research, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, Basel, Switzerland
| | - Livia Göldi
- Department Research, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, Basel, Switzerland
| | - Nadja Rohr
- Department Research, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, Basel, Switzerland
| | - Sarah Worreth
- Department of Biomedical Engineering (DBE), Center of Biomechanics and Biocalorimetry, University of Basel, Allschwil, Switzerland
| | - Elise Dard
- Bottmedical AG Technologiepark Basel, Hochbergerstrasse 60C, 4057, Basel, Switzerland
| | - Selina Hünerfauth
- Bottmedical AG Technologiepark Basel, Hochbergerstrasse 60C, 4057, Basel, Switzerland
| | - Tino Töpper
- Bottmedical AG Technologiepark Basel, Hochbergerstrasse 60C, 4057, Basel, Switzerland
| | - Jonas Zurflüh
- Department Chemie, University of Basel, Mattenstrasse 24a, Basel, Switzerland
| | - Olivier Braissant
- Department of Biomedical Engineering (DBE), Center of Biomechanics and Biocalorimetry, University of Basel, Allschwil, Switzerland.
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An S, Evans JL, Hamlet S, Love RM. The mechanical properties of 3D printed denture base resin incorporating essential oil microcapsules. J Adv Prosthodont 2023; 15:189-201. [PMID: 37662856 PMCID: PMC10471502 DOI: 10.4047/jap.2023.15.4.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 07/07/2023] [Accepted: 07/19/2023] [Indexed: 09/05/2023] Open
Abstract
Purpose The aim of this study was to investigate the mechanical properties of three-dimensional (3D) printed denture base resin incorporating microcapsules containing plant essential oils. Materials and Methods Denture base specimens containing up to 3% w/v essential oil microcapsule powders (MCPs), i.e., eucalyptus, geranium, lavender, menthol, and tea tree, in two resins (Detax and NextDent 3D+) were 3D printed using two printers (Asiga and NextDent 5100). The dispersion and interaction of the MCPs in the resin were assessed by SEM while the mechanical properties of the incorporated denture base including flexural strength (MPa), flexural modulus (MPa), Vickers hardness (VHN), and surface roughness (Ra) were also subsequently evaluated. Statistical analysis of any differences in mean values was determined using a two-way ANOVA with Tukey's post hoc testing (α = .05). Results The spherical shape of the MCPs was maintained during the mixing and polymerization/printing process. However, the Detax-Asiga group showed significant agglomeration of the MCPs even at the lowest MCP concentration levels (0.5% w/v). Overall, as the microcapsule concentration increased, the mean flexural strength decreased, though the menthol MCP groups remained compliant with the ISO standard. The flexural modulus and harness remained relatively unchanged, and the flexural modulus complied with the ISO standard regardless of the MCP concentration. Surface roughness increased with the addition of the MCPs but also remained below that required for clinical acceptance. Conclusion Incorporation of microencapsulated plant essential oils into 3D printed denture base resin was successfully achieved. While incorporation negatively influenced flexural strength and surface roughness, little effect on flexural modulus and Vickers hardness was demonstrated.
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Affiliation(s)
- Steve An
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Jane Lesleigh Evans
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Stephen Hamlet
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Robert Matthew Love
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
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Di Vito M, Garzoli S, Rosato R, Mariotti M, Gervasoni J, Santucci L, Ovidi E, Cacaci M, Lombarini G, Torelli R, Urbani A, Sanguinetti M, Bugli F. A New Potential Resource in the Fight against Candida auris: the Cinnamomum zeylanicum Essential Oil in Synergy with Antifungal Drug. Microbiol Spectr 2023; 11:e0438522. [PMID: 36975835 PMCID: PMC10101117 DOI: 10.1128/spectrum.04385-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 03/10/2023] [Indexed: 03/29/2023] Open
Abstract
Candida auris is a multidrug-resistant fungus known to be a global public health problem. The skin-based transmission, together with the marked resistance to drugs, resulted in its rapid spread to all continents. The aim of this study was to identify an essential oil (EO) active in the fight against C. auris. A total of 15 EOs were tested against 10 clinical strains of C. auris. Cinnamomum zeylanicum EO (CZ-EO) was the most effective (MIC90 and MFC90 equal to 0.06% vol/vol). Three fractions obtained from CZ-EO, and the cinnamaldehyde (CIN), the major chemical compound, were tested to identify the principal compound effectives against C. auris. All CIN-containing samples showed anti-fungal activity. To study the synergy with fluconazole, CZ-EO, its active fraction (FR2), and CIN were tested in checkerboard tests. Results show that CZ-EO and FR2, but not CIN, synergize with fluconazole. Furthermore, only the copresence of CZ-EO or FR2 synergize with fluconazole at therapeutic concentrations of the drug (0.45 ± 0.32 μg/mL and 0.64 ± 0.67 μg/mL, respectively), while CIN only shows additive activity. In vivo studies conducted on Galleria mellonella larvae show the absence of toxicity of CZ-EO up to concentrations of 16% vol/vol, and the ability of CZ-EO to reactivate the efficacy of fluconazole when formulated at synergic concentrations. Finally, biochemical tests were made to study the mechanism of action of CZ-EO. These studies show that in the presence of both fluconazole and CZ-EO, the activity of fungal ATPases decreases and, at the same time, the amount of intracellular drug increases. IMPORTANCE This study highlights how small doses of CZ-EO are able to inhibit the secretion of fluconazole and promote its accumulation in the fungal cell. In this manner, the drug is able to exert its pharmacological effects bypassing the resistance of the yeast. If further studies will confirm this synergy, it will be possible to develop new therapeutic formulations active in the fight against C. auris resistances.
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Affiliation(s)
- M. Di Vito
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - S. Garzoli
- Dipartimento di Chimica e Tecnologie del Farmaco, Università di Roma Sapienza, Rome, Italy
| | - R. Rosato
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - M. Mariotti
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - J. Gervasoni
- UOC Chimica, Biochimica e Biologia Molecolare Clinica, Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - L. Santucci
- UOC Chimica, Biochimica e Biologia Molecolare Clinica, Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - E. Ovidi
- Department for Innovation in Biological, Agro-Food and Forest Systems DIBAF—University of Tuscia, Viterbo, Italy
| | - M. Cacaci
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - G. Lombarini
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - R. Torelli
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - A. Urbani
- UOC Chimica, Biochimica e Biologia Molecolare Clinica, Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - M. Sanguinetti
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - F. Bugli
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Effects of long-term cinnamaldehyde immersion on the surface roughness and color of heat-polymerized denture base resin. J Prosthet Dent 2022; 128:521.e1-521.e8. [PMID: 35970612 DOI: 10.1016/j.prosdent.2022.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 11/21/2022]
Abstract
STATEMENT OF PROBLEM Cinnamaldehyde has been successfully used for the short-term disinfection of dentures; however, its long-term effects on the surface and color properties of denture base materials remain unknown. PURPOSE The purpose of this in vitro study was to evaluate the effects of simulated immersion in cinnamaldehyde for up to 5 years on the surface roughness and color parameters of a heat-polymerized denture resin. MATERIAL AND METHODS Eighty Ø10×5-mm disk-shaped specimens were prepared from microwave heat-polymerized polymethylmethacrylate (PMMA) and immersed in 4 solutions (n=20): TW-tap water (control), SH - 0.5% sodium hypochlorite, PX-alkaline peroxide, and CA-cinnamaldehyde (27 μg/mL). The immersion protocol simulated 104 cycles (3.5 months), 913 cycles (2.5 years), and 1825 immersion cycles (5 years) of a daily immersion cleaning protocol, with immersion times ranging from 10 to 20-minutes. Surface roughness (Sa) and the color parameters of CIELab (L∗ a∗ b∗, ΔEab), CIEDE2000 (ΔE00), and the National Bureau of Standards (NBS) were analyzed at baseline (t=0) and after the immersion cycles. The data were analyzed by 2-way analysis of variance (ANOVA) for repeated measures and the Tukey post hoc test (α=.01). RESULTS Sa was significantly increased in all groups after 1825 cycles compared with baseline (P<.01), regardless of the solution. Only the time factor significantly affected ΔEab, ΔE00, and NBS parameters, which were below the perceptibility and acceptability thresholds. After a simulated 5-year immersion, the surface roughness and color values of CA-treated specimens were not statistically different from those of the other groups (P>.01). CONCLUSIONS Cinnamaldehyde solution (27 μg/mL) produced minor effects on the surface roughness and color parameters of a heat-polymerized denture base resin similar to those of 0.5% sodium hypochlorite and alkaline peroxide after a 5-year simulated immersion.
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Development and Evaluation of Clove and Cinnamon Supercritical Fluid Extracts-Loaded Emulgel for Antifungal Activity in Denture Stomatitis. Gels 2022; 8:gels8010033. [PMID: 35049568 PMCID: PMC8774589 DOI: 10.3390/gels8010033] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 12/30/2021] [Accepted: 01/01/2022] [Indexed: 12/15/2022] Open
Abstract
Denture stomatitis (DS), usually caused by Candida infection, is one of the common denture-related complications in patients wearing dentures. Clove and cinnamon oils have been acknowledged for their anti-inflammatory, antimicrobial activity, and antifungal effects in the oral cavity. The aim of this study, therefore, was to prepare clove/cinnamon oils-loaded emulgel and to assess its efficacy in treating Candida albicans-associated denture stomatitis. Central composite design was adopted to formulate and optimize clove/cinnamon extracts-loaded emulgel. The formulated preparations were assessed for their physical appearance, particle size, viscosity, spreadability, and in-vitro drug release. In addition, in-vivo therapeutic experiments were conducted on 42 patients with denture stomatitis. The prepared emulgel formulations showed good physical characteristics with efficient drug release within 3 h. In addition, in-vivo antifungal studies revealed that the optimized formula significantly (p < 0.001) reduced Candida colony counts from the denture surface, compared to commercially available gel (240.38 ± 27.20 vs. 398.19 ± 66.73 CFU/mL, respectively). Furthermore, the optimized formula and succeeded in alleviating denture stomatitis-related inflammation with a better clinical cure rate compared to commercially available gel Collectively, herbal extracts-loaded emulgel might be considered an evolution of polyherbal formulations and might represent a promising alternative to the existing allopathic drugs for the treatment of denture stomatitis, with better taste acceptability and no side effects.
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Evaluation of Effectiveness of a Toothpaste Containing Tea Tree Oil and Ethanolic Extract of Propolis on the Improvement of Oral Health in Patients Using Removable Partial Dentures. Molecules 2021; 26:molecules26134071. [PMID: 34279411 PMCID: PMC8271704 DOI: 10.3390/molecules26134071] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 06/30/2021] [Accepted: 06/30/2021] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to evaluate the effect of toothpaste containing natural tea tree essential oil (TTO) and ethanolic extract of propolis (EEP), on microflora and selected indicators of oral health in patients using removable acrylic partial dentures. Fifty patients with varying conditions of hygiene were divided into two groups. The study group received the toothpaste with TTO and EEP, while the control group received the same toothpaste but without TTO and EEP. At the first visit, oral hygiene and hygiene of the prostheses were carried out. Control visits took place 7 and 28 days later and compared to baseline. Indexes like API (Approximal Plaque Index), mSBI (modified Sulcus Bleeding Index), OHI-s (simplified Oral Hygiene Index), and DPI (Denture Plaque Index) were assessed in three subsequent stages, and swabs were collected from floor of the mouth area to assess the microbiota. After 7 and 28 days of using the toothpaste with TTO and EEP, a statistically significant decrease of the examined indicator values were observed in the study group as compared to the values upon the initial visit. The number of isolated strains of microorganisms in the study group was decreased or maintained at the same level, whereas in the control group an increase in the number of isolated strains was observed. The observed stabilization of oral microbiota in patients from the study group confirms the beneficial activity of toothpaste containing EEP and TTO compared to the control group.
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de Araújo MRC, Maciel PP, Castellano LRC, Bonan PRF, Alves DDN, de Medeiros ACD, de Castro RD. Efficacy of essential oil of cinnamon for the treatment of oral candidiasis: A randomized trial. SPECIAL CARE IN DENTISTRY 2021; 41:349-357. [PMID: 33475184 DOI: 10.1111/scd.12570] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/10/2020] [Accepted: 01/05/2021] [Indexed: 02/06/2023]
Abstract
AIM It was analyzed the efficacy of mouthwash and spray containing essential oil (EO) of Cinnamomum zeylanicum Blume for the treatment of oral candidiasis. METHODS AND RESULTS A randomized, controlled, and blinded clinical trial was conducted with 36 individuals (probabilistic sample) with oral candidiasis who were divided into two treatment groups: C. zeylanicum (0.5 mg/mL), n = 18; nystatin (100,000IU/mL), n = 18. The efficacy of the products was evaluated by two parameters: (a) clinical evolution recorded by calibrated examiners (Kappa = 0.822) according to Newton's classification and (b) reduction of colony-forming units/mL. Mycological and clinical parameters were analyzed before and at 15 days after treatment. Clinical examination of the mucosa showed that C. zeylanicum (p < 0.0339) and nystatin (p < .0139) had efficacy, resulting in a reduction of signs and symptoms (Mann-Whitney test). Mycological analysis showed that C. zeylanicum caused a reduction of 61% and 33% of Candida spp., isolates oral mucosa and dentures, respectively. Candida tropicalis strains were eliminated after C. zeylanicum, in both sites. The participants reported a pleasant taste and few product-related complaints. CONCLUSION C. zeylanicum EO and nystatin exhibited clinical efficacy, according to the Newton classification, and reducing in Candida spp. The clinical trial has been registered (Registration number: NBR-33s6 × 5, ensaiosclinicos.gov.br).
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Affiliation(s)
| | - Panmella Pereira Maciel
- Departament of Clinical and Social Dentistry, Federal University of Paraíba, João Pessoa, Brazil
| | | | | | | | | | - Ricardo Dias de Castro
- Departament of Clinical and Social Dentistry, Federal University of Paraíba, João Pessoa, Brazil
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Gharibpour F, Shirban F, Bagherniya M, Nosouhian M, Sathyapalan T, Sahebkar A. The Effects of Nutraceuticals and Herbal Medicine on Candida albicans in Oral Candidiasis: A Comprehensive Review. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1308:225-248. [PMID: 33861447 DOI: 10.1007/978-3-030-64872-5_16] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Candida albicans is part of the healthy flora in the oral cavity. It can also cause opportunistic infection, which can be deleterious. The most typical type of chronic oral candidiasis is denture stomatitis, and C. albicans is identified as the most crucial organism in this situation. Due to the development of the resistant form of candida, using conventional drugs can sometimes be ineffective. Herbs and naturally imitative bioactive compounds could become a new source for antimycotic therapy. Several review studies suggest that herbal medicine and natural bioactive compounds have antibacterial, antiviral and antifungal effects. Thus, it is hypothesized that these natural products might have beneficial effects on pathogenic oral fungal flora such as C. albicans. Although the effects of herbs have been investigated as antifungal agents in several studies, to the best of our knowledge, the effects of these natural products on C. albicans have not yet been reviewed. Thus, the aim of this study was to review the anti-candida activity (especially C. albicans in oral candidiasis) of herbal medicines and natural bioactive compounds. It is concluded that, in general, medicinal plants and nutraceuticals such as garlic, green tea, propolis, curcumin, licorice root, cinnamon, resveratrol, ginger, and berberine are useful in the treatment of C. albicans in oral candidiasis and could be considered as a safe, accessible, and inexpensive management option in an attempt to prevent and treat oral diseases. However, most of the evidence is based on the in vitro and animal studies, so more clinical trials are needed.
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Affiliation(s)
- Fateme Gharibpour
- Post graduate, Dental students, Research Committee, Department of Orthodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farinaz Shirban
- Dental Research Center, Department of Orthodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Bagherniya
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohsen Nosouhian
- Post graduate, Dental students, Research Committee, Department of Orthodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Thozhukat Sathyapalan
- Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Hull, UK
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
- Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland.
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Yanakiev S. Effects of Cinnamon ( Cinnamomum spp.) in Dentistry: A Review. Molecules 2020; 25:E4184. [PMID: 32932678 PMCID: PMC7571082 DOI: 10.3390/molecules25184184] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/09/2020] [Accepted: 09/11/2020] [Indexed: 02/07/2023] Open
Abstract
Dental medicine is one of the fields of medicine where the most common pathologies are of bacterial and fungal origins. This review is mainly focused on the antimicrobial effects of cinnamon essential oil (EO), cinnamon extracts, and pure compounds against different oral pathogens and the oral biofilm and the possible effects on soft mouth tissue. Basic information is provided about cinnamon, as is a review of its antimicrobial properties against the most common microorganisms causing dental caries, endodontic and periodontal lesions, and candidiasis. Cinnamon EO, cinnamon extracts, and pure compounds show significant antimicrobial activities against oral pathogens and could be beneficial in caries and periodontal disease prevention, endodontics, and candidiasis treatment.
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Affiliation(s)
- Spartak Yanakiev
- Medical College Y. Filaretova, Medical University-Sofia, Yordanka Filaretova Street 3, 1000 Sofia, Bulgaria
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de Almeida MAL, Batista AUD, de Araújo MRC, de Almeida VFDS, Bonan PRF, Nóbrega Alves D, da Costa TKVL, Nóbrega DF, de Castro RD. Cinnamaldehyde is a biologically active compound for the disinfection of removable denture: blinded randomized crossover clinical study. BMC Oral Health 2020; 20:223. [PMID: 32807162 PMCID: PMC7433048 DOI: 10.1186/s12903-020-01212-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 08/09/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Fungal infections associated with the use of dentures, like denture stomatitis, are difficult to prevent and treat. This in situ study aimed to investigate the efficacy of cinnamaldehyde for the disinfection of complete removable dentures, and the effect on the physical and mechanical properties (Vickers microhardness, color, and surface roughness) of the acrylic resin. METHODS Acrylic resin disks were inserted into the dentures of a probabilistic sample of 33 complete denture users, that used cinnamaldehyde (27 μg/mL) and 0.5% sodium hypochlorite solutions in a 20 min/7-days protocol of dentures immersion in each solution, with a wash-out period of 7 days, to constitute a crossover-study. The disks were analyzed before and after the immersion, for the presence of microorganisms (CFU/mL) and by scanning electron microscope (SEM). Also, the surface roughness (Ra) and Vickers microhardness were measured, and color parameters were analyzed using the National Bureau of Standards (NBS) method. Data was analyzed by Wilcoxon and Friedman (microbiological evaluation), paired t-test (color and roughness) and independent t-test (Vickers hardness) (α = 0.05). RESULTS A significant reduction (P < 0.05) in the number of microorganisms was observed for each species (total microorganisms, Streptococcus mutans, and Candida spp.), with no significant differences (P > 0.05) between hypochlorite and cinnamaldehyde. There was an increase in the roughness and a decrease in the hardness of the test specimens, with no difference between the two disinfectant substances (P > 0.05). Both hypochlorite and cinnamaldehyde also caused changes in color, considered as "perceptible" by the NBS classification, but with no significant difference between disinfectant substances (P < 0.05), and under the clinically acceptable limit (ΔE ≤ 3.7). CONCLUSION The 27 μg/mL cinnamaldehyde solution was effective against all evaluated microorganisms and caused minor alterations in hardness, surface roughness, and color parameters, with no clinical relevance.
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Affiliation(s)
- Marco Antônio Lavorato de Almeida
- Faculty of Dentistry, Department of Clinical and Social Dentistry, Federal University of Paraíba, Campus I, João Pessoa, PB 58051-970 Brazil
| | - André Ulisses Dantas Batista
- Faculty of Dentistry, Department of Clinical and Social Dentistry, Federal University of Paraíba, Campus I, João Pessoa, PB 58051-970 Brazil
| | - Maria Rejane Cruz de Araújo
- Faculty of Dentistry, Department of Clinical and Social Dentistry, Federal University of Paraíba, Campus I, João Pessoa, PB 58051-970 Brazil
| | | | - Paulo Rogério Ferreti Bonan
- Faculty of Dentistry, Department of Clinical and Social Dentistry, Federal University of Paraíba, Campus I, João Pessoa, PB 58051-970 Brazil
| | - Danielle Nóbrega Alves
- Faculty of Dentistry, Department of Clinical and Social Dentistry, Federal University of Paraíba, Campus I, João Pessoa, PB 58051-970 Brazil
| | - Tereza Karla Vieira Lopes da Costa
- Faculty of Dentistry, Department of Clinical and Social Dentistry, Federal University of Paraíba, Campus I, João Pessoa, PB 58051-970 Brazil
| | - Diego Figueiredo Nóbrega
- Faculty of Dentistry, Department of Clinical and Social Dentistry, Federal University of Paraíba, Campus I, João Pessoa, PB 58051-970 Brazil
| | - Ricardo Dias de Castro
- Faculty of Dentistry, Department of Clinical and Social Dentistry, Federal University of Paraíba, Campus I, João Pessoa, PB 58051-970 Brazil
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12
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An S, Evans JL, Hamlet S, Love RM. Incorporation of antimicrobial agents in denture base resin: A systematic review. J Prosthet Dent 2020; 126:188-195. [PMID: 32800329 DOI: 10.1016/j.prosdent.2020.03.033] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 03/26/2020] [Accepted: 03/27/2020] [Indexed: 12/12/2022]
Abstract
STATEMENT OF PROBLEM Denture base resins (DBRs), such as polymethyl methacrylate, are commonly used in the fabrication of removable dentures because of their physical, mechanical, and esthetic properties. However, the denture base acts as a substrate for microorganism adherence and biofilm formation, which may lead to denture stomatitis and be further complicated by fungal infections, of especial importance with geriatric and immunosuppressed patients. Therefore, methods to enhance the antimicrobial property of DBRs will be beneficial. PURPOSE The purpose of this systematic review was to evaluate the literature on the antimicrobial activity of DBRs incorporating antimicrobial agents or materials. MATERIAL AND METHODS A search of English peer-reviewed literature up to February 2019 reporting on antimicrobial activity of DBRs with respect to antimicrobial agents or materials, antimicrobial test effects and methods, and conclusion or knowledge gaps was conducted by using Embase, Google Scholar, PubMed, and Web of Science databases. Search terms included denture base resin and antibacterial, denture base resin and antifungal, and denture base resin and antimicrobial. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were applied for subsequent data analysis. RESULTS Of 2536 identified articles, 28 met the inclusion criteria for the systematic review. Antimicrobial materials were divided into 3 groups: antimicrobial monomer or copolymer, phytochemical or phytomedical components, and other compounds. Strategies on how to incorporate these substances into DBRs and their impact on the reduction and prevention of the growth of microorganisms were identified. CONCLUSIONS Although many efforts have been made to improve the antimicrobial ability of DBRs, this systematic review found that the effectiveness of incorporating of antimicrobial agents into DBRs has not been demonstrated conclusively.
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Affiliation(s)
- Steve An
- Lecturer, School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia.
| | - Jane L Evans
- Associate Professor, School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia
| | - Stephen Hamlet
- Senior Research Fellow, School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia
| | - Robert M Love
- Professor, School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia
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13
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Leite KLDF, Martins ML, de Medeiros MMD, Bezerra NVF, Brito CSDM, de Almeida LDFD, Cavalcanti YW. Red propolis hydroalcoholic extract inhibits the formation of Candida albicans biofilms on denture surface. J Clin Exp Dent 2020; 12:e626-e631. [PMID: 32904863 PMCID: PMC7462375 DOI: 10.4317/jced.56843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 04/26/2020] [Indexed: 11/07/2022] Open
Abstract
Background To evaluate the antifungal activity of the red propolis hydroalcoholic extract (RPHE) against Candida albicans biofilms.
Material and Methods The minimum inhibitory and fungicidal concentrations (MIC and MFC) of the RPHE were determined by the microdilution technique. C. albicans biofilms were formed on the surface of resin specimens preconditioned with artificial saliva (1h). The specimens (N=48) were equally divided according to the four solutions used for anti-biofilm evaluation (n=12 per group). After overnight incubation, biofilms were daily exposed (2x/day for 15 min) along 3 days with 3% RPHE, 0.12% chlorhexidine (CHX), 50,000 IU/mL nystatin (NYS) or saline (0.9% NaCl). Biofilms were analyzed regarding the number of viable microorganisms (CFU/mL), the metabolic activity (MTT assay) and the proportion of hyphae (optical microscopy).
Results The MIC and MFC of RPHE were respectively 0.29 mg/mL (0.03%) and 1.17 mg/mL (0.12%). There was no difference in the microorganisms’ viability (CFU/mL) among groups treated with RPHE (4.92×103), CHX (3.33×102) or NYS (6.8×104), being all of them different from NaCl (3.93×107) (p<0.05). The CHX (0.133) had the lowest metabolic activity (p<0.05), followed by RPHE (0.292) and NYS (0.302) (p>0.05). All experimental groups had a mean proportion of hyphae <10%, lower than NaCl (70%).
Conclusions RPHE has antifungal activity against C. albicans biofilms, suggesting its use for the biofilm control on denture surfaces. Key words:Propolis, Candida albicans, biofilm, dentures, antifungal agents.
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Affiliation(s)
- Karla-Lorene-de França Leite
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Mariana-Leonel Martins
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | | | | | | | - Yuri-Wanderley Cavalcanti
- Department of Clinical and Social Odontology, Federal University of Paraíba, João Pessoa, PB, Brazil
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14
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Nasreen S, Awan MA, ul-Husna A, Rakha BA, Ansari MS, Holt W, Akhter S. Honey as an Alternative to Antibiotics for Cryopreservation of Nili-Ravi Buffalo Bull Spermatozoa. Biopreserv Biobank 2020; 18:25-32. [DOI: 10.1089/bio.2019.0054] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Affiliation(s)
- Shiza Nasreen
- Department of Zoology, Pir Mehr Ali Shah Arid Agriculture University, Rawalpindi, Pakistan
| | - Muhammad Amjad Awan
- Department of Zoology, Pir Mehr Ali Shah Arid Agriculture University, Rawalpindi, Pakistan
| | - Asma- ul-Husna
- Department of Zoology, Pir Mehr Ali Shah Arid Agriculture University, Rawalpindi, Pakistan
| | - Bushra Allah Rakha
- Department of Wildlife Management, Pir Mehr Ali Shah Arid Agriculture University, Rawalpindi, Pakistan
| | - Muhammad Sajjad Ansari
- Division of Science and Technology, Township, Department of Zoology, University of Education, Lahore, Pakistan
| | - William Holt
- Academic Unit of Reproductive and Developmental Medicine, University of Sheffield, Sheffield, United Kingdom
| | - Shamim Akhter
- Department of Zoology, Pir Mehr Ali Shah Arid Agriculture University, Rawalpindi, Pakistan
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15
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Wińska K, Mączka W, Łyczko J, Grabarczyk M, Czubaszek A, Szumny A. Essential Oils as Antimicrobial Agents-Myth or Real Alternative? Molecules 2019; 24:molecules24112130. [PMID: 31195752 PMCID: PMC6612361 DOI: 10.3390/molecules24112130] [Citation(s) in RCA: 236] [Impact Index Per Article: 47.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/03/2019] [Accepted: 06/04/2019] [Indexed: 02/07/2023] Open
Abstract
Herbs and the essential oils derived from them have been used from the beginning of human history for different purposes. Their beneficial properties have been applied to mask unpleasant odors, attract the attention of other people, add flavor and aroma properties to prepared dishes, perfumes, and cosmetics, etc. Herbs and essential oils (EOs) have also been used in medicine because of their biological properties, such as larvicidal action, analgesic and anti-inflammatory properties, antioxidant, fungicide, and antitumor activities, and many more. Many EOs exhibit antimicrobial properties, which is extremely important in fields of science and industry, such as medicine, agriculture, or cosmetology. Among the 250 EOs which are commercially available, about a dozen possess high antimicrobial potential. According to available papers and patents, EOs seem to be a potential alternative to synthetic compounds, especially because of the resistance that has been increasingly developed by pathogenic microorganisms. In this review we summarize the latest research studies about the most-active EOs that are known and used because of their antimicrobial properties. Finally, it is noteworthy that the antimicrobial activities of EOs are not preeminent for all strains. Further investigations should, thus, focus on targeting EOs and microorganisms.
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Affiliation(s)
- Katarzyna Wińska
- Department of Chemistry, Wrocław University of Environmental and Life Sciences, Norwida 25, 50-375 Wrocław, Poland.
| | - Wanda Mączka
- Department of Chemistry, Wrocław University of Environmental and Life Sciences, Norwida 25, 50-375 Wrocław, Poland.
| | - Jacek Łyczko
- Department of Chemistry, Wrocław University of Environmental and Life Sciences, Norwida 25, 50-375 Wrocław, Poland.
| | - Małgorzata Grabarczyk
- Department of Chemistry, Wrocław University of Environmental and Life Sciences, Norwida 25, 50-375 Wrocław, Poland.
| | - Anna Czubaszek
- Department of Fermentation and Cereals Technology, Wrocław University of Environmental and Life Sciences, Chełmońskiego 37/41, 51-630 Wrocław, Poland.
| | - Antoni Szumny
- Department of Chemistry, Wrocław University of Environmental and Life Sciences, Norwida 25, 50-375 Wrocław, Poland.
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16
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Sim JXF, Khazandi M, Pi H, Venter H, Trott DJ, Deo P. Antimicrobial effects of cinnamon essential oil and cinnamaldehyde combined with EDTA against canine otitis externa pathogens. J Appl Microbiol 2019; 127:99-108. [PMID: 31050849 DOI: 10.1111/jam.14298] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/25/2019] [Accepted: 04/28/2019] [Indexed: 12/27/2022]
Abstract
AIMS The antimicrobial activity of cinnamon essential oil and cinnamaldehyde against bacterial and fungal pathogens associated with canine otitis externa, as well as the effect of their combination with EDTA were investigated. METHODS AND RESULTS Antimicrobial susceptibility testing was performed using the broth microdilution method while spot-plating technique was used to determine their bactericidal activity. Time-kill kinetics and checkerboard assays were performed to confirm the bactericidal activity and combination effects of the compounds. Cinnamon oil and cinnamaldehyde exhibited antimicrobial activity against Gram-positive and Gram-negative pathogens, as well as Malassezia pachydermatis. Synergistic interaction was shown when EDTA (672 μg ml-1 ) was combined with cinnamon oil (41 μg ml-1 ) and cinnamaldehyde (22 μg ml-1 ) against Pseudomonas aeruginosa. Cinnamaldehyde exhibited significantly stronger antimicrobial activity than cinnamon bark oil. CONCLUSIONS Cinnamon essential oil and cinnamaldehyde, either used alone or in combination with EDTA, were effective against the causative micro-organisms of canine otitis externa. The data suggest that cinnamaldehyde could be a promising antimicrobial agent against canine otitis externa. SIGNIFICANCE AND IMPACT OF THE STUDY This study shows that cinnamon essential oil and cinnamaldehyde, especially the latter, could be used in combination with EDTA as novel treatment for sensitive and resistant bacterial and fungal pathogens involved in canine otitis externa.
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Affiliation(s)
- J X F Sim
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia
| | - M Khazandi
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia.,Australian Centre for Antimicrobial Resistance Ecology, School of Animal and Veterinary Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - H Pi
- Australian Centre for Antimicrobial Resistance Ecology, School of Animal and Veterinary Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - H Venter
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia
| | - D J Trott
- Australian Centre for Antimicrobial Resistance Ecology, School of Animal and Veterinary Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - P Deo
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia
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17
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Dagli N, Dagli R, Mahmoud RS, Baroudi K. Essential oils, their therapeutic properties, and implication in dentistry: A review. J Int Soc Prev Community Dent 2015; 5:335-40. [PMID: 26539382 PMCID: PMC4606594 DOI: 10.4103/2231-0762.165933] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: Antibacterial treatments currently used for treatment cause several side effects, and bacterial resistance to the antibiotics is also increasing. Therefore, there is need to find better alternatives. Essential oils (EOs) have been used for treatment of various ailments since ancient times and have gained popularity over the years. Safety and efficacy of EOs have been proved by several clinical trials. This review gives an overview on the EOs, their uses, and adverse effects. Materials and Methods: A literature search was performed in the PubMed for clinical trial studies and review articles on EOs published up to February 2015. The search was performed during March 2015. The following keywords were used: “Lavender essential oil,” “cinnamon oil,” “clove oil,” “eucalyptus oil,” “peppermint oil,” “lemon EOs,” and “tea tree oil.” Results: Total 70 relevant articles were found in PubMed database. After screening of abstracts, 52 articles were selected to be included in the present review. Conclusion: On the basis of the available information, it can be concluded that EOs have the potential to be developed as preventive or therapeutic agents for various oral diseases, but further clinical trials are required to establish their safety and efficacy.
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Affiliation(s)
- Namrata Dagli
- Ethics Committee, Care Institute of Medical Sciences, Ahmedabad, Gujarat, India
| | - Rushabh Dagli
- Department of Public Health Dentistry, Vyas Dental College and Hospital, Jodhpur, Rajasthan, India
| | - Rasha Said Mahmoud
- Department of Preventive Dental Science, Alfarabi Colleges, Riyadh, Saudi Arabia
| | - Kusai Baroudi
- Department of Preventive Dental Science, Alfarabi Colleges, Riyadh, Saudi Arabia
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18
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Jaafarpour M, Hatefi M, Khani A, Khajavikhan J. Comparative effect of cinnamon and Ibuprofen for treatment of primary dysmenorrhea: a randomized double-blind clinical trial. J Clin Diagn Res 2015; 9:QC04-7. [PMID: 26023601 PMCID: PMC4437117 DOI: 10.7860/jcdr/2015/12084.5783] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 03/02/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS Primary dysmenorrheal has a negative impact on women's quality of life. The purpose of this study was to compare the effect of Cinnamon and Ibuprofen for treatment of primary dysmenorrheal in a sample of Iranian female college students from Ilam University of Medical Sciences (western Iran). MATERIALS AND METHODS In a randomized, double-blind trial, out of 114, control group received placebo (empty capsules contain starch, TDS, n= 38) a test group received Ibuprofen (capsule containing 400mg Ibuprofen, TDS, n=38), or another test group received Cinnamon (capsule containing 420 mg Cinnamon, TDS, n= 38) in 24 h. To determine severity of pain, we used the VAS scale. Pain intensity and duration of pain were monitored in the group during first 72 h of cycle. RESULTS The mean pain severity score and mean duration of pain in Ibuprofen and Cinnamon were less than placebo group respectively (p< 0.001). Of 4 hours after the intervention there were no statistically significant differences between the Cinnamon and placebo group (p> 0.05). Of eight hours after the intervention, the mean pain severity in the cinnamon group was significantly lower than placebo group (p< 0.001). At various time intervals the mean pain severity in the Ibuprofen group were significantly less than Cinnamon and placebo groups (p< 0.001). CONCLUSION Cinnamon compared with placebo significantly reduced the severity and duration of pain during menstruation, but this effect was lower compared with Ibuprofen. Cinnamon can be regarded as a safe and effective treatment for primary dysmenorrhea. More researches are recommended to study the efficacy of Cinnamon on reducing menstrual bleeding.
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Affiliation(s)
- Molouk Jaafarpour
- Faculty, Department of Midwifery, Nursing & Midwifery Faculty, Ilam University of Medical Science, Ilam, IR-Iran
| | - Masoud Hatefi
- Faculty, Department of Neurosurgery, Medicine Faculty, Ilam University of Medical Science, Ilam, IR-Iran
| | - Ali Khani
- Faculty, Department of Nursing, Nursing & Midwifery Faculty, Ilam University of Medical Science, Ilam, IR-Iran
| | - Javaher Khajavikhan
- Faculty, Department of Anesthesiology, Imam Khomeini Hospital, Ilam University of Medical Science, Ilam, IR-Iran
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