Antibacterial and Cytotoxic Effects of Moringa oleifera (Moringa) and Azadirachta indica (Neem) Methanolic Extracts against Strains of Enterococcus faecalis

Leaf Extracts of Moringa oleifera Cultivated in Baghdad: Characterization and Antimicrobial Potential against Endodontic Pathogens

The use of medicinal plant preparations to clean and disinfect root canal infection is gaining popularity. The aim of this study was to evaluate the bioactive composition of leaf extracts of Moringa oleifera plants cultivated in Iraq (specifically Baghdad) and their antimicrobial activity against selected root canal pathogens for potential application in endodontic treatment. Materials and Methods. Moringa leaf extracts were prepared either through cold maceration or warm digestion techniques to perform an ethanolic or aqueous extraction, respectively. Phytochemical detection was performed before thin layer chromatography (TLC) and high-performance liquid chromatography (HPLC) to measure flavonoids and phenolic compounds within both extracts. Then, their antimicrobial activities were investigated against Streptococcus mutans, Enterococcus faecalis, and Candida albicans through minimal inhibitory concentration (MIC), minimal bactericidal concentration (MBC), and agar well diffusion assay in comparison to NaOCl and Ca(OH)2. Results. Phytochemical screening showed several active ingredients but with higher expression of flavonoids and phenolic compounds. Also, different types of these compounds were detected through TLC and quantified by HPLC. MIC values for ethanolic extract against Streptococcus mutans, Enterococcus faecalis, and Candida albicans were 60, 65, and 55, respectively, while for aqueous extract, MIC values were 70, 80, and 50, respectively. Aqueous extract showed a higher inhibition zone than ethanolic extract for both Streptococcus mutans and Enterococcus faecalis with a statistically significant difference (p ≤ 0.001) for all tested materials except with NaOCl and Ca(OH)2 in Streptococcus mutans and Enterococcus faecalis, respectively. The ethanolic extract showed a higher inhibition zone against Candida albicans, with a statistically significant difference (p ≤ 0.001) for all tested materials. Conclusion. Ethanolic and aqueous extracts of Moringa oleifera leaves cultivated in Baghdad contain considerable quantities of phytochemicals, especially flavonoid and phenolic compounds, and demonstrated antimicrobial activities against selected endodontic pathogens. Therefore, Moringa leaf extracts could be suggested as an alternative antimicrobial material in endodontic treatment.

Antibacterial and smear layer removal efficacy of moringa (Moringa oleifera): An in vitro study

Objective

This study evaluated the effectiveness of moringa (Moringa oleifera) leaves decoction for removing a smear layer compared to sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA), as well as its antimicrobial activities.

Methods

The moringa leaves were extracted using hot water decoction at two different concentrations (2.5% and 5.0% w/v). A total of 30 extracted human single-rooted teeth were prepared to assess the smear layer removal efficacy. The presence of a smear layer in the middle third of the root canal was detected by confocal microscopy. Then the antibacterial effects were assessed against Enterococcus faecalis and Streptococcus mutans bacteria using the agar diffusion method.

Results

The 2.5% and 5.0% decoction were significantly more effective than 0.25% NaOCl in removing the smear layer (p < 0.05); however, no significant difference was observed compared to EDTA (p > 0.05). The in vitro antimicrobial assay showed that 5.0% decoction had higher antimicrobial activity against both of the test pathogens.

Conclusion

The findings of this study suggest that moringa leaves decoction can be considered an effective irrigant in endodontics.

Moringa oleifera Use in Maintaining Oral Health and Its Potential Use in Regenerative Dentistry

Phytomedicine refers to the use of naturally derived products to cure and mitigate human conditions. Natural products have the advantages of causing minimum side effects, being biocompatible, available, and economical, with a wide array of biological activities. Reports have described the use of natural products with antimicrobial and anti-inflammatory properties to treat oral conditions and promote wound healing. Moringa oleifera, known as the "drumstick" or "horseradish" tree, is believed to have medicinal properties regarding a range of medical conditions, though there is limited information on its use in oral medicine. This narrative review focuses on the use of Moringa extracts in the management of oral conditions, including oral infections, inflammatory conditions, the remineralization of hard tissues, oral wound healing, and tissue regeneration, drawing from both in vitro and in vivo studies which indicate that the potential of Moringa extracts in supporting dentin-pulp regeneration after caries or trauma is worthy of more careful consideration.

A Comparative Evaluation of Antibacterial Efficacy of Moringa oleifera Leaf Extract, Octenidine Dihydrochloride, and Sodium Hypochlorite as Intracanal Irrigants against Enterococcus faecalis: An In Vitro Study

Objectives

The aim of this study is to investigate and compare the microbial efficacy of Moringa oleifera leaf extract, octenidine dihydrochloride (OCT), NaOCl, and their combinations as intracanal irrigants against Enterococcus faecalis.

Materials and Methods

Sixty single-rooted mandibular premolars were decoronated followed by root canal preparation. Each root specimen was autoclaved, inoculated with E. faecalis, and incubated at 37°C for 48 hr. Then, the specimens were divided into six groups based on the irrigation solution used: 2.5% NaOCl (Group 1), 0.1% OCT (Group 2), M. oleifera leaves extract (Group 3), a combination of M. oleifera extract and 1.25% NaOCl (Group 4), a combination of M. oleifera extract and OCT (Group 5) and normal saline (Group 6). Microbial samples were taken from each root canal before (S1) and after (S2) irrigation and the bacterial viability was assessed using colony-forming units (CFU) on bile esculin agar plates.

Results

Comparing the number of CFU/ml before and after irrigation showed a significant reduction (P < 0.001) in all studied groups. Comparison between the CFU/ml after irrigation by NaOCl and each of the combination groups showed a significant difference.

Conclusion

M. oleifera leaves extract and 0.1% OCT solutions have antibacterial effect against E. faecalis comparable to 2.5% NaOCl and might be used as root canal irrigants. The combination groups showed better antimicrobial activities than individual irrigants. However, further studies are required to investigate the biocompatibility and possible toxic effects of the tested irrigants.

Assessing the cytotoxic effect and antimicrobial activity of Moringa oleifera aqueous and ethanolic extract against oral pathogens extracted from periodontal and orthodontic patients

Background: Periodontitis is the result of inflammation caused due to the activity of microorganisms. The prevalence of anaerobic organisms is more when it comes to periodontal pockets and orthodontic patients. Plants with phytochemicals that could exert antimicrobial effects could aid in host modulation for management of periodontitis caused by these bacteria in periodontal and orthodontic patients Aim: To assess the antimicrobial effect of aqueous extract of Moringa oleifera Lam (MOL) and cytotoxic effect of aqueous and ethanol extracts of MOL. Materials and methods: Moringa oleifera Lam. extracts were prepared by maceration. Subgingival plaque samples were collected and microorganisms were cultured in anaerobic environment. The microorganisms were treated with the extracts and minimum inhibitory concentration and minimum bactericidal concentration was assessed. The cytotoxic effects were assessed by brine shrimp assay. Results: Aqueous extract showed antimicrobial effect in dose and time dependent manner and both extracts exhibited cytotoxic effects in a dose and time dependent manner Summary and Conclusion: The antimicrobial effect of MOL could be utilized to develop a nature derived local drug delivery system for treating plaque induced periodontitis in different clinical situations.

Galleria mellonella (greater wax moth) as an eco-friendly in vivo approach for the assessment of the acute toxicity of medicinal plants: Application to some plants from Cameroon

Background:

The evaluation of medicinal plants’ toxicity is a prerequisite prior to their usage. The vertebrate models used for this purpose are often the object of ethical consideration. Though invertebrate models including Galleria mellonella (GM) have demonstrated the ability to be used to assess the toxicity of various products. To the authors’ knowledge, GM has never been exploited to determine the toxicity of medicinal plants.

Aim:

The aim of this study was to demonstrate the potential of GM larvae as a simple, inexpensive, and rapid model for the evaluation of the toxicity of herbal medicines.

Method:

In this study, the toxicity of aqueous and ethanolic (80%, v/v) extracts of seven well known plants from Cameroon namely leaves of Cymbopogon citratus (DC.) Stapf, Moringa oleifera Lam and Vernonia amygdalina Delile; barks of Cinchona officinalis and Enantia chlorantha Oliv; barks and seeds of Garcinia lucida Vesque and leaves and seeds of Azadirachta indica (Neem) was evaluated using the larval form of GM. The median lethal doses (LD₅₀), 90% (LD₉₀), and 100% (LD₁₀₀) were determined using the spline cubic survival curves and equations from the data obtained on the survival rate of GM 24 hours after the injection with the extracts.

Results:

We found that distilled water extracted a more important mass of phytochemical compounds (7.4%–21.2%) compared to ethanolic solution (5.8%–12.4%). LD varied depending on the plant materials and ethanolic extracts (hydroalcoholic extract, (HAE)) were more toxic to GM than aqueous ones. The LD₅₀ (mg/ml) of the tested extracts varied from 4.87 [3.90 g/kg body weight (bw)] to >200 (> 166.67 g/kg bw), the LD₉₀ (mg/ml) from 25.00 (18.52 g/kg bw) to >200 (> 181.82 g/kg bw) and LD₁₀₀ (mg/ml) from 45.00 (40.91 g/kg bw) to > 200 (>181.82 g/kg bw). The HAE of A. indica seed and C. officinalis bark exhibited the highest toxicity with LD₅₀ (g/kg bw) of 3.90 and 4.81, respectively.

Conclusion:

The results obtained in this study suggest that GM can be used as a sensitive, reliable, and robust eco-friendly model to gauge the toxicity of medicinal plants. Thus, avoid the sacrifice of vertebrate models often used for this purpose to limit ethical concerns.

Leaf and Fruit Methanolic Extracts of Azadirachta indica Exhibit Antifertility Activity on Rats' Sperm Quality and Testicular Histology

BACKGROUND

The world's population is still growing, having an impact on the environment and the economic growth of developing countries; so that, there is a particular interest in the development of new fertility control methods, focused on male contraception.

OBJECTIVE

The objective of this study was to evaluate the effect of methanolic extracts of leaf and fruit of Azadirachta indica on sperm quality and testicular histology of Long Evans rats.

METHODS

Antifertility effects of a methanolic leaf and fruit extracts of A. indica on 24 male rats were investigated. The animals were randomly divided into two control groups and four treatment groups (n=4). Doses of the leaf and fruit extract were given at concentrations of 100 and 200 μg mL-1.

RESULTS

A significant decrease in the viability of sperm cells was observed. The leaf extract at a concentration of 200 μg mL-1 inhibited cell viability compared to the negative control (p< 0.001). The percentage of abnormal cells in leaf extract was shown in 100 and 200 μg mL-1, the conditions at which a higher percentage of morphological irregularities of observed (15% and 16% respectively). The results show that there was cellular detachment in the seminiferous epithelium in the experimental groups treated with methanolic extracts. Sperm death was observed without decreasing the number of sperm.

CONCLUSION

The methanolic extracts of Azadirachta indica have a modulating effect on the spermatogenesis of experimental rats through sperm morphological alterations.

Synergistic Effect of Plant Extracts on Endodontic Pathogens Isolated from Teeth with Root Canal Treatment Failure: An In Vitro Study

BACKGROUND AND OBJECTIVES

This study aimed to evaluate the synergistic antimicrobial activity of extracts obtained from Salvadora persica (Miswak), Commiphora molmol (myrrh) and Azadirachta indica (neem) in combination with commercially available antimicrobial agents: penicillin, tetracycline, ofloxacin and fluconazole on endodontic pathogens such as Enterococcus faecalis, Streptococcus mitis,Actinomyces naeslundii and Candida albicans.

MATERIALS AND METHODS

Microbiological samples from the root canals of the teeth undergoing retreatment were taken using sterile paper points kept at full length in the canal for 30 s. The disc diffusion method was used to check the susceptibility of microbes to the plant extracts and antimicrobials by measuring the diameter of the inhibition zones. Against the microbes, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC)/minimum fungicidal concentration (MFC) of the plant extracts were assessed. The fractional inhibitory concentration index (FICI) was used to estimate the synergistic effect of plant extracts combined with antimicrobials against the resistant endodontic microbes.

RESULTS

The findings clearly indicate the effectiveness of all the three plant extracts, Commiphora molmol, Azadirachta indica, Salvadora persica, against all the experimental pathogenic microorganisms except for the ineffectiveness of Azadirachta indica, Salvadora persica against Candidaalbicans. Maximum antimicrobial activity was displayed by Azadirachta indica against Enterococcusfaecalis (MIC = 0.09 ± 1.2 mg/mL, MBC = 0.78 ± 1.25 mg/mL) and the minimum antimicrobial activity was displayed by Commiphora molmol against Actinomyces naeslundii (MIC = 12.5 ± 3.25 mg/mL, MBC = 100 ± 3.75 mg/mL). The best synergy was displayed by Commiphora molmol with fluconazole against Candidaalbicans (FICI = 0.45).

CONCLUSIONS

The current study delineates the variable antimicrobial activity of plant extracts against the experimental endodontic pathogenic microorganisms. Plant extracts in conjunction with various antimicrobials can be valuable aids in combating relatively resistant endodontic microorganisms that have been the cause of worry in recent years, leading to failure even in treatment procedures following all required protocols.

Alleviation of lead acetate-induced nephrotoxicity by Moringa oleifera extract in rats: highlighting the antioxidant, anti-inflammatory, and anti-apoptotic activities

Lead (Pb) is an environmental toxicant; its consumption can induce renal deficits. In this study, we explored the possible protective efficiency of Moringa oleifera extract (MOE) against lead acetate (PbAc)-mediated reprotoxicity. Four experimental groups of seven rats each were used: control, PbAc, MOE, and MOE+PbAc groups. All groups were given their respective treatment for 4 weeks. PbAc impaired the oxidative/antioxidative balance in the renal tissue, as shown by the decreased antioxidant proteins (glutathione, glutathione reductase, glutathione peroxidase, catalase, and superoxide dismutase) and increased oxidants (lipid peroxidation and nitric oxide). Additionally, PbAc enhanced the progression of kidney inflammation by increasing tumor necrosis factor-alpha, interleukin-1 beta, and nuclear factor kappa B associated with upregulation of inducible nitric oxide synthase. Moreover, a dysregulation in the apoptotic-regulating proteins (Bax, caspase-3, and Bcl2) were recorded upon PbAc exposure. Remarkably, MOE oral administration restored redox homeostasis, suppressed the inflammatory and apoptotic responses in the kidney tissue. Our findings point out that MOE could be used as an alternative remedy to overcome the adverse effects of Pb exposure, which may be due to its potent antioxidant, anti-inflammatory, and anti-apoptotic effects.

Azadirachta indica A. juss, Morinda citrifolia L. and Triphala as herbal endodontic irrigants: A scoping review

Background:

The success of the root canal treatment depends on the complete elimination of the microflora, biofilms and smear layer from the pulp space. A wide variety of chemical endodontic irrigants are available to achieve disinfection and thorough debridement besides mechanical means. However, detrimental properties such as allergic potential, cytotoxicity, antimicrobial resistance and safety concerns have intrigued researchers over the years to look for safer options.

Aim:

The review is aimed at providing comprehensive information of the studies evaluating the efficacy of Azadirachta indica A. juss (A. indica), Morinda citrifolia L. (M. citrifolia) and Triphala (fruits of Emblica officinalis Gaertn., Terminalia chebula (Gaertn.) Roxb. and Terminalia belerica Retz.) as herbal endodontic irrigants.

Materials and methods:

The literature review was conducted using indexed databases (PubMed, Google Scholar, Cochrane) electronically for publications in peer-reviewed journals for relevant articles evaluating the efficacy of A. indica, Triphala, M. citrifolia as endodontic irrigant from the year 1985-March 2020.

Results:

A total of 58 studies were identified for full text reviewing after duplicate removal and screening title and abstracts. A total of 32 studies were included and processed for data extractions.

Conclusion:

Various in-vitro/in-vivo studies utilizing these herbal irrigants have documented promising results and hold the potential to replace chemical endodontic irrigants in routine practice but more preclinical and clinical trials are needed to substantiate these results before they can conclusively be recommended as intracanal irrigating solutions.

First Report on Evaluation of Basic Nutritional and Antioxidant Properties of Moringa Oleifera Lam. from Caribbean Island of Saint Lucia

Moringa oleifera Lam. has been considered as a multipurpose tree. The studies on it focus on its variable nutritional benefits. It is growing in many regions, but information about nutritional properties of those growing in the Caribbean is missing. The present study focused on biochemical analysis of main nutritional and antioxidant properties in plant material-dried leaves and seeds-of Moringa oleifera. The composition of lipids, proteins, and vitamin E was evaluated in powdered dried leaves and seeds. Fatty acids were evaluated in oil extracted from the moringa seeds. Potential antioxidant properties of the moringa were evaluated in extract from crushed and powdered leaves, as well as from the powdered seeds. The total amounts of lipids, proteins, and vitamin E were higher in powdered seeds (31.85%, 35.13%, and 220.61 mg/kg) than in powdered leaves (12.48%, 20.54%, and 178.10 mg/kg). The main compound of fatty acids presented oleic acid (76.78%) in seeds' oil and oleic (25.01%), palmitic (24.84%), and linolenic (24.71%) acids in leaves. Neohesperidin (126.8 mg/kg), followed by chlorogenic acid (99.96 mg/kg) and quercetin (43.44 and 21.44 mg/kg) were main phenolic compounds identified. Total phenols in powdered leaves' extract (635.6 mg GAE/L) was higher than in powdered seeds' extract (229.5 mg GAE/L). The activity against superoxide radical and hydroxyl radical was 92.4% and 73.1% by leaves' powder extract and 83.6% and 60.7% by crushed-leaf extract; seed-powder extract exhibited a pro-oxidation activity (-68.4%) against superoxide radical and the lowest antioxidant effect against the hydroxyl radical (55.0%).