Combined antioxidant effects of Neem extract, bacteria, red blood cells and Lysozyme: possible relation to periodontal disease

Anticoccidial potentials of Azadirachta indica ethosomal nanovesicle in broiler chicks

This study evaluated the efficacy of Azadirachta indica ethosomal nanovesicle against Eimeria tenella infection in broiler chicks. Azadirachta indica ethanolic extract was screened phtochemically and analyzed active components of the extracts using high‑performance liquid chromatography (HPLC). Azadirachta indica ethosomal nanovesicle was synthesized and characterized by zeta potential and scanning electron microscope. Broiler chicks were allocated into seven groups. Control group. The second group administered nanosized ethosomal vesicles (1 mL/kg b.wt.). The third group administered Azadirachta indica nanovesicles (30 mg/kg b.wt.) from 10th day of age. Fourth group was infected with E. tenella at a dose of 1 mL containing 40000 oocyst/ chick at 14th day of age. The fifth group administered Azadirachta indica nanovesicle (30 mg/kg b.wt.) from 10th day of age and infected with E. tenella as fourth group. The sixth group infected with E. tenella as the fourth group and treated with Azadirachta indica nanovesicle (30 mg/kg b.wt. for 4 days after clinical signs appearance. The seventh group infected with E. tenella as the fourth group and treated with diclazuril group (1 mL/4 L of water) for 2 successive days. Coccidiosis significantly decreased body weight, feed intake, reduced glutathione (GSH) level while increased feed conversion ratio, oocyst count, malonaldehyde (MDA) and nitric oxide (NO) serum levels, protein expression of interleukin-1 beta (IL-1β), interleukin 6 (IL-6), BAX and Caspase 3, in cecal tissue and induced cecal tissue injury. However, administration of coccidiosis chicks Azadirachta indica nanovesicle enhanced body weight, and serum GSH. While decreased feed intake, feed conversion ratio, oocyst count, MDA, and NO serum levels, and protein expression of IL-1β, IL-6, BAX, and caspase 3 in cecal tissues and ameliorated cecal tissue damage. This study indicated that, A. indica ethosomal nanovesicle had potent anticoccidial properties.

The therapeutic role of Azadirachta indica leaves ethanolic extract against detrimental effects of Aeromonas veronii infection in Nile tilapia, Oreochromis niloticus

Bacterial pathogens cause high fish mortalities and in turn economic losses in fish farms. Innovative strategies should be applied to control bacterial infections instead of antibiotics to avoid the resistance problem. Consequently, the present investigation studied the curative potential of Azadirachta indica leave ethanolic extract (AILEE) on Aeromonas veronii infection in Oreochromis niloticus. A preliminary trial was assessed to evaluate the curative dose of AILEE which was found to be 2.5 mg/L. One hundred and sixty fish were divided into equal four groups in four replications, where group 1 and group 2 were non-challenged and treated with 0- and 2.5-mg/L AILEE, respectively. Group 3 and group 4 were challenged with A. veronii and treated with 0- and 2.5-mg/L AILEE, respectively for 10 days. A. veronii infection produced severe clinical manifestations and a high mortality rate in the infected fish. Furthermore, the infected fish exhibited a significant rise in the hepatorenal indices (aspartate aminotransferase, alanine aminotransferase, and creatinine), the oxidant biomarker (malondialdehyde), and the stress indicators (glucose and cortisol). A significant reduction in the protein profile and antioxidant/immune parameters (catalase, immunoglobulin M, lysozyme, nitric oxide, and phagocytic activity) was observed in the infected fish. Water application of the infected group to 2.5-mg/L AILEE notably ameliorated the hepatorenal indices, the oxidant biomarker, and the stress indicators. Furthermore, AILEE improved the antioxidant/immune indices. Water application of 2.5-mg/L AILEE could be useful against A. veronii infection in O. niloticus culture.

Phytotherapy in periodontics as an effective and sustainable supplemental treatment: a narrative review

PURPOSE

Periodontal disease is a chronic condition caused by microbial infection and mediated by the host's immune response. Phytotherapy is a therapeutic approach that utilizes a renewable resource capable of supplying less expensive medicines for the world's growing population. This review aimed to present clinical evidence on the use of complementary medicinal herbs in the treatment of periodontal diseases.

METHODS

Different databases were searched using the terms "herbal" and "periodontitis." All included studies were examined with a focus on herbal indications, type, and prescription length. Dentists' therapeutic and prophylactic herbal prescribing habits were also assessed.

RESULTS

Various herbs such as turmeric, neem, aloe-vera, pomegranate, catechu, tulsi, cloves, lemon grass, green tea, tea tree oil, peppermint, garlic, pineapple, oak bark, babul, bakul, sage, coriander, moringa, amla, guava, and grape seed extract have been used in the treatment of periodontitis. These herbs have been reported to exhibit a range of therapeutic effects, including anti-inflammatory, antiplaque, antihalitosis, antiresorptive, antioxidant, antibacterial, antifungal, antiviral, and antimicrobial properties. These components can be utilized in various forms such as mouth rinse, gel, oil, toothpaste, aqueous extract, mouthwash, or tooth powder.

CONCLUSIONS

Several readily available herbal formulations are now available on the market and have been shown to be effective as supplemental periodontal phytotherapy. However, these should be used under the supervision of a dental professional to ensure optimal benefits and effectiveness. Therefore, it is necessary to improve the understanding of suggested herbal prescription practices among dental professionals.

The Role of Natural Compounds in Optimizing Contemporary Dental Treatment-Current Status and Future Trends

For a long period of time, natural remedies were the only ailment available for a multitude of diseases, and they have proven effective even after the emergence of modern medicine. Due to their extremely high prevalence, oral and dental disorders and anomalies are recognized as major public health concerns. Herbal medicine is the practice of using plants with therapeutic characteristics for the purpose of disease prevention and treatment. Herbal agents have made a significant entry into oral care products in recent years, complementing traditional treatment procedures due to their intriguing physicochemical and therapeutic properties. There has been a resurgence of interest in natural products because of recent updates, technological advancements, and unmet expectations from current strategies. Approximately eighty percent of the world's population uses natural remedies, especially in poorer nations. When conventional treatments have failed, it may make sense to use natural drugs for the treatment of pathologic oral dental disorders, as they are readily available, inexpensive, and have few negative effects. The purpose of this article is to provide a comprehensive analysis of the benefits and applications of natural biomaterials in dentistry, to gather relevant information from the medical literature with an eye toward its practical applicability, and make suggestions for the directions for future study.

Biosynthesized selenium nanoparticles to rescue coccidiosis-mediated oxidative stress, apoptosis and inflammation in the jejunum of mice

One of the most crucial approaches for treating human diseases, particularly parasite infections, is nanomedicine. One of the most significant protozoan diseases that impact farm and domestic animals is coccidiosis. While, amprolium is one of the traditional anticoccidial medication, the advent of drug-resistant strains of Eimeria necessitates the development of novel treatments. The goal of the current investigation was to determine whether biosynthesized selenium nanoparticles (Bio-SeNPs) using Azadirachta indica leaves extract might treat mice with Eimeria papillata infection in the jejunal tissue. Five groups of seven mice each were used, as follows: Group 1: Non-infected-non-treated (negative control). Group 2: Non-infected treated group with Bio-SeNPs (0.5 mg/kg of body weight). Groups 3-5 were orally inoculated with 1×10³ sporulated oocysts of E. papillata. Group 3: Infected-non-treated (positive control). Group 4: Infected and treated group with Bio-SeNPs (0.5 mg/kg). Group 5: Infected and treated group with the Amprolium. Groups 4 and 5 daily received oral administration (for 5 days) of Bio-SeNPs and anticoccidial medication, respectively, after infection. Bio-SeNPs caused a considerable reduction in oocyst output in mice feces (97.21%). This was also accompanied by a significant reduction in the number of developmental parasitic stages in the jejunal tissues. Glutathione reduced (GSH), glutathione peroxidase (GPx), and superoxide dismutase (SOD) levels were dramatically reduced by the Eimeria parasite, whereas, nitric oxide (NO) and malonaldehyde (MDA) levels were markedly elevated. The amount of goblet cells and MUC2 gene expression were used as apoptotic indicators, and both were considerably downregulated by infection. However, infection markedly increased the expression of inflammatory cytokines (IL-6 and TNF-α) and the apoptotic genes (Caspase-3 and BCL2). Bio-SeNPs were administrated to mice to drastically lower body weight, oxidative stress, and inflammatory and apoptotic indicators in the jejunal tissue. Our research thus showed the involvement of Bio-SeNPs in protecting mice with E. papillata infections against jejunal damage.

Comparison of the Anti-bacterial Efficacy of Saussurea costus and Melaleuca alternifolia Against Porphyromonas gingivalis, Streptococcus mutans, and Enterococcus faecalis: An in-vitro Study

The aim was to compare the in-vitro antibacterial effectiveness of two herbal extracts (a) Saussurea-costus (S. costus) and (b) Melaleuca-alternifolia (M. alternifolia) against Porphyromonas gingivalis (P. gingivalis), Streptococcus mutans (S. mutans) and Enterococcus faecalis (E. faecalis). Aqueous extracts from M. alternifolia were prepared by adding 2 grams of S. costus and M. alternifolia, respectively to 100 ml distilled water. Bacterial strains of P. gingivalis, E. faecalis and S. mutans were treated into 3 groups. In groups 1 and 2, bacterial strains were treated with aqueous extracts of S. costus and M. alternifolia, respectively. In the control-group, bacterial strains were exposed to distilled water. Antibacterial activity of the samples and nanoparticles was determined. The minimum-inhibitory-concentration (MIC) values were determined using the microdilution method. P < 0.01 was considered statistically significant. The MIC for all bacterial strains treated with S. costus was significantly higher than that of M. alternifolia (P < 0.001). There was no significant difference in MIC for strains of P. gingivalis, E. faecalis and S. mutans treated with S. costus. For bacterial strains treated with M. alternifolia, the MIC was significantly higher for P. gingivalis compared with E. faecalis and S. mutans strains (P < 0.01). There was no difference in MIC for E. faecalis and S. mutans strains treated with M. alternifolia. The in-vitro antibacterial efficacy of M. alternifolia is higher than S. costus against P. gingivalis, E. faecalis and S. mutans.

Effects of a Dried Neem Leaf Extract on the Growth Performance, Meat Yield and Meat Quality in Skeletal Muscle of Broiler Chickens Under High-Temperature Conditions

We aimed to examine the effects of cyclical high ambient temperature (HT) and dried Neem (Azadirachta indica) leaf extract (DNE) supplementation on the growth performance, muscle lipid peroxidation level, and muscle drip loss of broiler chickens. Twenty-four 15-day old broiler chickens (Chunky strain ROSS 308) were divided into four treatment groups that were fed diets with or without 2.0% DNE under thermoneutral (25 ± 1°C) or cyclical HT (35 ± 1°C for 8 h/day) conditions. Supplementation of DNE did not affect the growth performance of the chicks, but HT reduced their feed intake, the weights of breast muscle and heart. In addition, supplementation with DNE ameliorated the negative effects of cyclical HT on feed intake and breast muscle mass. Furthermore, cyclical HT increased the malondialdehyde (MDA) concentration and drip loss over 48 h of storage of the breast muscle, and these effects were ameliorated by DNE. Collectively, we conclude that dietary supplementation with DNE reduces the muscle MDA concentration and drip loss of broiler chickens kept under HT conditions.

The Antimicrobial Potential of the Neem Tree Azadirachta indica

Azadirachta indica (A. Juss), also known as the neem tree, has been used for millennia as a traditional remedy for a multitude of human ailments. Also recognized around the world as a broad-spectrum pesticide and fertilizer, neem has applications in agriculture and beyond. Currently, the extensive antimicrobial activities of A. indica are being explored through research in the fields of dentistry, food safety, bacteriology, mycology, virology, and parasitology. Herein, some of the most recent studies that demonstrate the potential of neem as a previously untapped source of novel therapeutics are summarized as they relate to the aforementioned research topics. Additionally, the capacity of neem extracts and compounds to act against drug-resistant and biofilm-forming organisms, both of which represent large groups of pathogens for which there are limited treatment options, are highlighted. Updated information on the phytochemistry and safety of neem-derived products are discussed as well. Although there is a growing body of exciting evidence that supports the use of A. indica as an antimicrobial, additional studies are clearly needed to determine the specific mechanisms of action, clinical efficacy, and in vivo safety of neem as a treatment for human pathogens of interest. Moreover, the various ongoing studies and the diverse properties of neem discussed herein may serve as a guide for the discovery of new antimicrobials that may exist in other herbal panaceas across the globe.

Effects of Supplementation with Dried Neem Leaf Extract on Lipid Peroxidation and Antioxidant Enzyme mRNA Expression in the Pectoralis Major Muscle of Broiler Chickens

This study was conducted to evaluate the effects of dietary supplementation of dried neem (Azadirachta indica) leaf extract (DNE) on lipid peroxidation and the expression of genes encoding mRNAs in antioxidant enzymes in the pectoralis major muscle of chickens. A total of 24 male broiler chickens (ROSS308) were divided into three groups (n=8) at 21 days of age. The control group of chickens was fed a basal diet, and the remaining two groups of chickens were fed a basal diet supplemented with DNE at a concentration of 0.5% or 2.0% until 35 days of age. Growth performance (body weight, weight gain, feed intake, and feed conversion ratio) and tissue weights did not differ among the three groups. The 2.0% DNE-supplemented diet decreased the muscle malondialdehyde content, a marker of lipid peroxidation, and drip loss compared to the control chickens. In addition, the expression of genes encoding mRNAs of antioxidant enzymes (i.e., Cu/Zn-superoxide dismutase, Mn-superoxide dismutase, glutathione peroxidase 7, and catalase) were higher in the pectoralis major muscle of chickens fed the 2.0% DNE-supplemented diet than in the control chickens. Therefore, DNE supplementation increased the expression of genes encoding mRNAs in antioxidant enzymes and reduced lipid peroxidation and drip loss in the pectoralis major muscle of broiler chickens.

Detoxification of Aflatoxin B1 and Ochratoxin A Using Salvia farinacea and Azadirachta indica Water Extract and Application in Meat Products

Seventy-five samples of selected meat products, including luncheon, beef burger, sausage, basterma, and kofta, were collected from Alexandria and New Borg El-Arab cities (Egypt). The samples were subjected to mycological examination as well as for detection of aflatoxin B1 (AFB1) and ochratoxin A (OTA) residues. Besides, the study evaluated the effect of aqueous leaf extracts from mealycup sage (Salvia farinacea) and neem (Azadirachta indica), individually and in combination, on the growth of human pathogens Aspergillus parasiticus and Aspergillus flavus producing AFB1, as well as Aspergillus ochraceus and Aspergillus niger which produce OTA. The obtained results revealed that sausage samples had the highest mould count with a mean value of 13.20×102/g, followed by basterma samples 12.05×102/g, then beef burger 7.39×102/g. In contrast, luncheon and kofta samples had the lowest count with a mean value of 5.51×102/g and 2.82×102/g. The findings revealed the antifungal potential of tested extracts. The total inhibition of A. parasitcus and A. niger growth was observed at 2 mg/mL of the combined extract. Salvia farinacea extract had the highest total phenolic content and total flavonoid content with a value of 174.1 and 52.6 mg g-1, respectively. Rutin was the major phenolic component in neem and combined extracts, accounting for 19123 and 8882 μg/g, respectively. Besides, the study investigated detoxification of AFB1 and OTA using combined extract in albino rats. The results confirmed the convenient and safe use of Salvia farinacea and Azadirachta indica extract and their combination as natural antifungal and antioxidant agents. The combined extract could be used as a natural preservative in food processing to control or prevent contamination.

Ameliorative Effect of Neem Leaf and Pomegranate Peel Extracts in Coccidial Infections in New Zealand and V-Line Rabbits: Performance, Intestinal Health, Oocyst Shedding, Carcass Traits, and Effect on Economic Measures

Healthy, weaned, coccidial-free male rabbits from two breeds (New Zealand white (NZ) and V-line (VL)) were divided into 10 equal groups (5 groups each for NZ and VL) (3 replicates/group, 6 rabbits/replicate, 18 rabbits/group). All rabbits were inoculated with 5 × 10⁴&nbsp;Eimeria spp. oocysts (E. intestinalis (67%), E. magna (22%), and E. media (11%)) except for the rabbits in the first group (G1), which were inoculated with a sterile solution and served as a negative control. The remaining four groups were treated as follows: G2, no treatment/positive control, G3, treated with neem leaf extract, G4, treated with pomegranate peel extract (PPE), and G5, treated with a combination of neem leaf extract and PPE. For both breeds, our results showed that the use of neem leaf and/or pomegranate peel extract resulted in improved growth performance, with a significant improvement in relative feed conversion ratio (FCR) compared to the positive control groups, which recorded the worst values, as well as a significant (p ≤ 0.05) reduction in mean oocyst count compared to the positive control groups. We also observed downregulation of mRNA levels of IL-1βα, IL6, and TNF-α in the herbal treatment groups compared with the mRNA levels of these genes in the positive control groups. Herbal treatment with neem leaf and/or pomegranate peel extracts had positive effects on the NZ and VL rabbits experimentally infected with mixed Eimeria species, as evidenced by their healthy appearance, good appetite, no mortalities, an anticoccidial index > 120, and a significantly higher total return and net profit when compared to the positive control groups of both breeds. In NZ rabbits, the treatment with neem leaf extract alone (G3) or in combination with PPE (G5) recorded the most efficient economic anticoccidial activity.

Exploring the role of Azadirachta indica (neem) and its active compounds in the regulation of biological pathways: an update on molecular approach

In ethnomedicine, plant parts and compounds are used traditionally to treat different diseases. Neem (Azadirachta indica A. Juss) is the most versatile and useful medicinal plant ever found. Its every part is rich in bioactive compounds, which have traditionally been used to treat different ailments including infectious diseases. Bioactive compounds such as nimbolide, azarirachtin, and gedunin of neem are reported to have a tremendous ability to regulate numerous biological processes in vitro and in vivo. The present review article aims to explore the importance of neem extracts and bioactive compounds in the regulation of different biological pathways. We have reviewed research articles up to March 2020 on the role of neem in antioxidant, anti-inflammatory, antiangiogenic, immunomodulatory, and apoptotic activities. Studies on the concerned fields demonstrate that the bioactive compounds and extracts of neem have a regulatory effect on several biological mechanisms. It has been unveiled that extensive research is carried out on limonoids such as nimbolide and azarirachtin. It is evidenced by different studies that neem extracts are the potential to scavenge free radicals and reduce ROS-mediated damage to cells. Neem can be used to normalize lipid peroxidation and minimize ROS-mediated cell death. Besides, neem extracts can significantly reduce the release of proinflammatory cytokines and elevate the count of CD4 + and CD8 + T-cells. This review indicates the pivotal roles of A. indica in the regulation of different biological pathways. However, future investigations on other bioactive compounds of neem may reveal different therapeutic potentials.

Potential benefits of phytochemicals from Azadirachta indica against neurological disorders

Azadirachta indica or Neem has been extensively used in the Indian traditional medical system because of its broad range of medicinal properties. Neem contains many chemically diverse and structurally complex phytochemicals such as limonoids, flavonoids, phenols, catechins, gallic acid, polyphenols, nimbins. These phytochemicals possess vast array of therapeutic activities that include anti-feedant, anti-viral, anti-malarial, anti-bacterial, anti-cancer properties. In recent years, many phytochemicals from Neem have been shown to be beneficial against various neurological disorders like Alzheimer's and Parkinson's disease, mood disorders, ischemic-reperfusion injury. The neuroprotective effects of the phytochemicals from Neem are primarily mediated by their anti-oxidant, anti-inflammatory and anti-apoptotic activities along with their ability to modulate signaling pathways. However, extensive studies are still required to fully understand the molecular mechanisms involved in neuropotective effects of phytochemicals from Neem. This review is an attempt to cover the neuroprotective properties of various phytochemicals from Neem along with their mechanism of action so that the potential of the compounds could be realized to reduce the burden of neurodegenerative diseases.

Views on antioxidant mouthwashes as adjunct in periodontal therapy

Clinical decision is often difficult with chlorhexidine mouthwash. The use of antioxidant mouthwashes for the treatment of periodontal disease is in practise. Therefore, it is of interest to collect gleaned information on Antioxidant mouthwashes as periodontal therapy from known literature. Improvement in treatment using antioxidant mouthwashes is reported in several studies. The mouthwash with antioxidants has similar anti-gingivitis, antiplaque and antimicrobial effects as that of chlorhexidine mouthwash.

In vitro activity of neem (Azadirachta indica) oil extract against Helicobacter pylori

ETHNOPHARMACOLOGICAL RELEVANCE

The neem tree (Azadirachta indica A.Juss), of the Meliaceae family, has been used in India for millennia in traditional medicine. Parts of the tree are used to treat problems with the gastrointestinal tract, urinary tract, and hair; to combat infections of smallpox and plasmodium; and to treat ulcers, diabetes, blood pressure, headache, and heartburn. Natural products and extracts from the tree have been reported to have antimicrobial, antifungal, and antiparasitic activities.

AIM OF THE STUDY

Antibiotic resistance in the gastric pathogen Helicobacter pylori is increasing, and novel therapeutics to eradicate this bacterium are needed. Given the growing interest in the use of natural products as antimicrobials, this study was designed to examine the bactericidal effects of an extract of neem oil against H. pylori.

MATERIALS AND METHODS

Neem oil was obtained from a commercial source and subjected to liquid-liquid extraction with diethyl ether and aqueous methanol; the methanol-soluble fraction was retained. The minimum inhibitory (MIC) and bactericidal (MBC) concentrations were determined against nine strains of H. pylori. Additionally, specific properties of the extract were characterized using H. pylori strain G27: bactericidal kinetics, reversibility, and effectiveness under growth arrest conditions and at low pH. The hemolytic activity of the extract was measured in vitro.

RESULTS

The MIC and MBC of the extract against the H. pylori strains were between 25 and 51 µg/mL and 43-68 µg/mL, respectively. The bactericidal activity was time- and concentration-dependent, and at the highest concentrations (75-105 µg/mL), no detectable bacteria were present by 6 h. The activity of the extract was reversible, independent of H. pylori growth, and increased at low pH. The extract exhibited no appreciable hemolytic activity.

CONCLUSIONS

Neem oil extract has significant bactericidal activity against H. pylori. The extract has several favorable pharmacological properties, including ability to kill non-growing bacteria, increased activity at low pH, and no hemolytic activity. The compound(s) present in the extract could potentially be used as a future treatment for H. pylori infection.

Polyphenols in the prevention and treatment of periodontal disease: A systematic review of in vivo, ex vivo and in vitro studies

Plant-derived polyphenols with antimicrobial and immunomodulatory characteristics appear to provide a variety of oral health benefits. Thus, the aim of the present study was to review the scientific literature to identify these effects of polyphenols on periodontal pathogens and inflammation. A MEDLINE search from 1st January 2013 to 18th January 2018 was performed to identify studies reporting polyphenol-containing plant extracts. Reports regarding pure compounds and essential oils, as well as effects on bacteria that are not defined as periodontal pathogens, were excluded. Thirty-eight studies matched the selection criteria. Studies on immunomodulatory effects included in vitro, ex vivo, and in vivo studies (n = 23), whereas studies reporting antibacterial effects against periodontal pathogens included only in vitro studies (n = 18). Three studies were included in both groups. The antibacterial effects were characterised by inhibition of bacterial growth, adhesion to oral cells, and enzymatic activity. Decreased secretion of pro-inflammatory and increased secretion of anti-inflammatory cytokines were demonstrated. Higher attachment levels, lower inflammation, and bone loss were reported by in vivo studies. Due to the high heterogeneity, it is difficult to draw clear conclusions for applicability; nevertheless, polyphenols have great potential as antimicrobial and immunomodulatory substances in the treatment and prevention of periodontal disease.

A Novel Herbal Formulation versus Chlorhexidine Mouthwash in Efficacy against Oral Microflora

Aims and Objectives:

The aim of the study was to compare and to analyze the antimicrobial efficacy of 0.12% chlorhexidine and new formulated herbal mouthwash after using for 14 days. The objective was to signify whether the noval herbal combination could be a better alternative mouthwash to Chlorhexidine (CHX).

Materials and Methods:

This is a double-blinded, random controlled research study conducted in the Department of Oral Pathology and Microbiology. A total of 200 dental students were selected randomly, comprising of two groups, 100 in each, aged between 18 and 22 years with gingival index of score II. The first group was advised to oral rinse with 0.12% chlorhexidine mouthwash and the second group with new formulated herbal mouthwash for 14 days. Saliva samples were collected on the day 0 (baseline), followed by day 7 and 14 and microbial colony count was performed. The data obtained was statistically analyzed using SPSS version 16. Student's t-test was applied for comparison of the mean microbial count between the two groups. Repeated measures analysis of variance followed by Tukey's post hoc test was applied to assess the changes from day 0 to day 7 to day 14. The statistical significance level was set at P < 0.05.

Results:

Microbial colonies were reduced better in chlorhexidine group on the day 7 whereas, on day 14, greater reduction was observed in the herbal group in both gender groups with high statistical significance (P < 0.001).

Conclusions:

Herbal mouthwash formulation performed effectively well on long-term usage, could be used as an alternative mouthwash to overcome the disadvantages of chlorhexidine.