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Divya Bharathi S, Aiswarya S, Sankar AR. Comparative evaluation of the efficacy of Triphala mouthwash and Curcumin mouthwash in the treatment of gingivitis - A randomized controlled study. J Oral Biol Craniofac Res 2024; 14:407-414. [PMID: 38832298 PMCID: PMC11144734 DOI: 10.1016/j.jobcr.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 05/02/2024] [Accepted: 05/07/2024] [Indexed: 06/05/2024] Open
Abstract
Background Numerous studies on Triphala and Curcumin mouthwashes were analyzed individually and no study has compared the efficacy of Triphala mouthwash to Curcumin mouthwash in the management of gingivitis. Although various mouthwashes have shown reduction of plaque and gingivitis the search is still on for an ideal mouthwash with minimum side effects and better patient acceptance. Objectives To access the efficacy of all the mouthwashes in the management of gingivitis. Methods By purposive sampling, 81 patients of both sexes with gingivitis were randomized by lottery method into 3 groups - A, B and C. Group A received scaling and Triphala mouthwash, Group B received scaling and Curcumin mouthwash and Group C underwent scaling and received Chlorhexidine mouthwash. Oral hygiene was assessed using Plaque, Gingival and Bleeding indices at baseline,7th day and 14th day. The inter-group comparisons were analysed using One-way analysis of variance (ANOVA) and multiple comparisons using Tukey's Honest significant difference test (α = 0.05) and the intra-group comparisons for the indices across various time periods within each group were analysed using Repeated-measures ANOVA and Bonferroni-adjusted pairwise comparisons post hoc test (α = 0.05). The statistical significance was set at p ≤ 0.05. Results The study has shown that herbal mouthwashes are as effective as chlorhexidine in treating gingivitis although curcumin mouthwash showed a greater potential in reducing gingival inflammation. Conclusion Both Triphala and Curcumin mouthwashes were proven to be equally effective in reducing plaque, gingival and bleeding scores, although curcumin was better in reducing gingival inflammation. Hence herbal mouthwashes such as Triphala and Curcumin with no side effects can be considered as an alternative mouthwash to chlorhexidine.
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Affiliation(s)
- S. Divya Bharathi
- Vinayaka Mission's Sankarachariyar Dental College, Vinayaka Mission's Research Foundation (Deemed to be University), Salem, India
| | - S.P. Aiswarya
- Vinayaka Mission's Sankarachariyar Dental College, Vinayaka Mission's Research Foundation (Deemed to be University), Salem, India
| | - Archana R. Sankar
- Department of Periodontology, Vinayaka Mission's Sankarachariyar Dental college, Vinayaka Mission's Research Foundation (Deemed to be University), Salem, India
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Rajkumar DS, Mariswamy AB. Comparative evaluation of Emblica officinalis as an etchant and an MMP inhibitor with orthophosphoric acid and chlorhexidine on the microshear bond strength of composite resin: an ex vivo study. Restor Dent Endod 2021; 46:e36. [PMID: 34513642 PMCID: PMC8411005 DOI: 10.5395/rde.2021.46.e36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 09/02/2020] [Accepted: 09/14/2020] [Indexed: 11/28/2022] Open
Abstract
Objectives This study aimed to evaluate Emblica officinalis (Indian gooseberry or amla) as an acid etchant and matrix metalloproteinase (MMP) inhibitor, and to compare its effect on the microshear bond strength of composite resin with orthophosphoric acid (OPA) and 2% chlorhexidine (CHX) as an acid etchant and MMP inhibitor, respectively. Materials and Methods The etching effect and MMP-inhibiting action of amla on dentin samples were confirmed by scanning electron microscopy (SEM) and gelatin zymography, respectively. Dentinal slabs (3 mm thick) from 80 extracted human molars were divided into 10 and 20 samples to form 2 control groups and 3 experimental groups. Groups 1, 2, and 4 were etched with OPA and groups 3 and 5 with amla juice. An MMP inhibitor was then applied: CHX for group 2 and amla extract for groups 4 and 5. Groups 1 and 3 received no MMP inhibitor. All specimens received a standardized bonding protocol and composite resin build-up, and were subjected to microshear bond strength testing. The force at which the fracture occurred was recorded and statistically analyzed. Results Amla juice had a similar etching effect as a self-etch adhesive in SEM and 100% amla extract was found to inhibit MMP-9 by gelatin zymography. The microshear bond strength values of amla were lower than those obtained for OPA and CHX, but the difference was not statistically significant. Conclusions Amla has a promising role as an acid etchant and MMP inhibitor, but further studies are necessary to substantiate its efficacy.
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Affiliation(s)
- Divya Sangeetha Rajkumar
- Department of Conservative Dentistry and Endodontics, JSS Dental College and Hospital, JSS Academy of Higher Education & Research, Mysuru, India
| | - Annapoorna Ballagere Mariswamy
- Department of Conservative Dentistry and Endodontics, JSS Dental College and Hospital, JSS Academy of Higher Education & Research, Mysuru, India
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Deshpande MA, Baliga S, Thosar N, Rathi N, Jyothishi S, Deulkar PV, Bane SP. Evaluation of antibacterial efficacy of Triphala toothwipes on oral Streptococcus mutans count in intellectually disabled children. SPECIAL CARE IN DENTISTRY 2021; 41:619-625. [PMID: 33852738 DOI: 10.1111/scd.12597] [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: 01/25/2021] [Revised: 03/23/2021] [Accepted: 03/27/2021] [Indexed: 11/29/2022]
Abstract
AIM To evaluate antibacterial efficacy of Triphala toothwipes on oral Streptococcus mutans counts in intellectually disabled (ID) children. METHODS Twenty-seven children with a mild ID were randomly divided into two groups: A - Triphala and B - placebo group. Toothwipes were given to caregivers of children belonging to the respective groups, and were instructed to use them 1 h after their meals, twice a day for 7 days. Simplified Plaque index was recorded and plaque samples were collected for microbiological examination at baseline, 48 h, and 7 days. The obtained data were tabulated and analyzed. RESULTS Triphala group showed a statistically significant reduction of S. mutans after 48 h and 7 days. Both Triphala and placebo groups showed a statistically significant reduction in dental plaque after 48 h and 7 days. CONCLUSION Triphala toothwipes are effective against the oral S. mutans compared with placebo toothwipes, while both the toothwipes are equally effective in reducing dental plaque. Thus, Triphala toothwipes can be used as an adjunct aid along with routine oral hygiene practices in individuals who lack psychomotor skills or are dependent on others to maintain oral hygiene, including infants, preschoolers, geriatric population, and children with special health care needs.
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Affiliation(s)
- Meghana Ajay Deshpande
- Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Sudhindra Baliga
- Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Nilima Thosar
- Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Nilesh Rathi
- Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Shriramji Jyothishi
- Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Pranjali Vilas Deulkar
- Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Sphurti Pramod Bane
- Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India
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Chaweewannakorn C, Harada T, Nyasha MR, Koide M, Shikama Y, Hagiwara Y, Sasaki K, Kanzaki M, Tsuchiya M. Imaging of muscle activity-induced morphometric changes in fibril network of myofascia by two-photon microscopy. J Anat 2021; 238:515-526. [PMID: 33078407 PMCID: PMC7855069 DOI: 10.1111/joa.13339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 08/10/2020] [Accepted: 09/28/2020] [Indexed: 01/15/2023] Open
Abstract
Myofascia, deep fascia enveloping skeletal muscles, consists of abundant collagen and elastin fibres that play a key role in the transmission of muscular forces. However, understanding of biomechanical dynamics in myofascia remains very limited due to less quantitative and relevant approaches for in vivo examination. The purpose of this study was to evaluate the myofascial fibril structure by means of a quantitative approach using two-photon microscopy (TPM) imaging in combination with intravital staining of Evans blue dye (EBD), a far-red fluorescence dye, which potentially labels elastin. With focus on myofascia of the tibial anterior (TA) muscle, the fibril structure intravitally stained with EBD was observed at the depth level of collagen fibrous membrane above the muscle belly. The EBD-labelled fibril structure and orientation in myofascia indicated biomechanical responses to muscle activity and ageing. The orientation histograms of EBD-labelled fibrils were significantly modified depending upon the intensity of muscle activity and ageing. Moreover, the density of EBD-labelled fibrils in myofascia decreased with habitual exercise but increased with muscle immobilization or ageing. In particular, the diameter of EBD-labelled fibrils in aged mice was significantly higher. The orientation histograms of EBD-labelled fibrils after habitual exercise, muscle immobilization and ageing showed significant differences compared to control. Indeed, the histograms in bilateral TA myofascia of exercise mice made simple waveforms without multiple sharp peaks, whilst muscular immobilization or ageing significantly shifted a histogram with sustaining multiple sharp peaks. Therefore, the dynamics of fibre network with EBD fluorescence in response to the biomechanical environment possibly indicate functional tissue adaptation in myofascia. Furthermore, on the basis of the knowledge that neutrophil recruitment occurs locally in working muscles, we suggested the unique reconstruction mechanism involving neutrophilic elastase in the myofascial fibril structure. In addition to the elastolytic susceptibility of EBD-labelled fibrils, distinct immunoreactivities and activities of neutrophil elastase in the myofascia were observed after electric pulse stimulation-induced muscle contraction for 15 min. Our findings of EBD-labelled fibril dynamics in myofascia through quantitative approach using TPM imaging and intravital fluorescence labelling potentially brings new insights to examine muscle physiology and pathology.
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Affiliation(s)
- Chayanit Chaweewannakorn
- Division of Advanced Prosthetic DentistryGraduate School of DentistryTohoku UniversitySendaiJapan
- Graduate School of Biomedical EngineeringTohoku UniversitySendaiJapan
| | - Takashi Harada
- Department of Orthopaedic SurgeryGraduate School of MedicineTohoku UniversitySendaiJapan
| | - Mazvita R. Nyasha
- Graduate School of Biomedical EngineeringTohoku UniversitySendaiJapan
| | - Masashi Koide
- Department of Orthopaedic SurgeryGraduate School of MedicineTohoku UniversitySendaiJapan
| | - Yosuke Shikama
- Department of Oral Disease ResearchNational Center for Geriatrics and GerontologyObuJapan
| | - Yoshihiro Hagiwara
- Department of Orthopaedic SurgeryGraduate School of MedicineTohoku UniversitySendaiJapan
| | - Keiichi Sasaki
- Division of Advanced Prosthetic DentistryGraduate School of DentistryTohoku UniversitySendaiJapan
| | - Makoto Kanzaki
- Graduate School of Biomedical EngineeringTohoku UniversitySendaiJapan
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Eskandarinezhad M, Hooman Sadr Haghighi A, Khademnezhad S, Aghazadeh Z, Noruzani F. Effect of incorporation of triphala into AH26 sealer on its cytotoxicity at different intervals. J Dent Res Dent Clin Dent Prospects 2021; 14:181-185. [PMID: 33408824 PMCID: PMC7770399 DOI: 10.34172/joddd.2020.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 07/31/2020] [Indexed: 12/01/2022] Open
Abstract
Background. One of the essential properties of sealers used during endodontic treatment is their biocompatibility. Different materials are added to these sealers to improve their properties, including antibacterial activity. In recent years, there has been an increase in interest in the use of herbal medicines. This study aimed to evaluate the effect of incorporating triphala into AH26 sealer on its cytotoxicity on gingival fibroblasts at different intervals after mixing.
Methods. In the present in vitro study, the cytotoxicity of AH26 sealer was evaluated once in its pure form and once after mixing it with triphala at 24-, 48-, and 72-hour, and 7-day intervals after mixing using the standard MTT assay protocol on gingival fibroblasts.
Results. Two-way ANOVA was used to evaluate the effect of groups on the mean changes in cytotoxicity at different time intervals at a significance level of P<0.05. The results showed that the incorporation of triphala into the AH26 sealer did not increase or decrease its cytotoxicity (P=0.909). Besides, there was a decrease in cytotoxicity in both study groups. However, there was a relative increase in the sealers’ cytotoxicity in both groups in the first 72 hours (P<0.0001).
Conclusion. Considering the well-established antibacterial properties of triphala in our previous study, the present study’s results showed that the incorporation of triphala into the AH26 sealer did not increase the cytotoxicity of the sealer. Therefore, it can be incorporated into the AH26 sealer to improve the other properties of the sealer, including its antibacterial activity.
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Affiliation(s)
- Mahsa Eskandarinezhad
- Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Hooman Sadr Haghighi
- Department of Orthodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sahar Khademnezhad
- Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Aghazadeh
- Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz,Iran
| | - Fateme Noruzani
- Undergraduate Student, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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AlJameel AH, Almalki SA. Effect of triphala mouthrinse on plaque and gingival inflammation: A systematic review and meta‐analysis of randomized controlled trials. Int J Dent Hyg 2020; 18:344-351. [DOI: 10.1111/idh.12444] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 04/17/2020] [Accepted: 05/03/2020] [Indexed: 11/27/2022]
Affiliation(s)
- AlBandary Hassan AlJameel
- Department of Periodontics and Community Dentistry College of Dentistry King Saud University Riyadh Saudi Arabia
| | - Sultan A. Almalki
- Department of Preventive Dental Sciences College of Dentistry Prince Sattam Bin Abdulaziz University Alkharj Saudi Arabia
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Shivaprasad BM, Patil P, Nair SK, Singh N, Shivanand S, Sameera U. Triphala: A phytomedicine for local drug delivery - A strategic intervention. Ayu 2019; 40:53-57. [PMID: 31831970 PMCID: PMC6891999 DOI: 10.4103/ayu.ayu_40_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background In the Indian system of medicine (ISM) Triphala is one of the oldest and longest used natural herbal remedy which consist of mixture of equal parts of the Embilica officinalis Gaertn. (Family- Euphorbiaceae), Terminalia Chebula Retz. (Family- Combretaceae) and Terminalia beleria [Gaertn.] Roxb. (Family- Combretaceae). Currently, Triphala is being extensively researched for its various therapeutic effects including its anti-caries, antioxidant, anti-collagenase and anti-microbial activities. This fruit extract is used in various forms in the treatment of periodontitis. Aim The aim of the present study was to compare the clinical and microbiological benefits of routine scaling and root planing (SRP) with adjunctive use of Triphala (Hiora GA) as local drug delivery agent in the management of periodontitis. Materials and Methods Thirteen patients diagnosed with chronic periodontitis were included in the present study. The control sites received SRP alone and the test sites received SRP with locally delivered Triphala (Hiora GA). The clinical parameters were evaluated at baseline, 15 days and 1 month. The plaque samples were cultured anaerobically for the keystone-periodontal pathogen Porphyromonas gingivalis, Fusobacterium nucleatum and Prevotella intermedia. The Mann-Whitney U-test and Wilcoxon signed-rank tests were performed to compare the results between the test and control groups. Results Statistically significant improvement was observed in both groups. Intergroup comparison of prevalence of microorganisms also revealed a statistically significant difference (P = 0.0007) at 15 days and 1 month. Conclusion Subgingivally delivered Triphala (Hiora GA) as an adjunct to SRP in the treatment of chronic periodontitis has shown anticipative results revealing slow and constant releasing property of Triphala.
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Affiliation(s)
- B M Shivaprasad
- Department of Periodontology, Raja Rajeswari Dental College and Hospital, Bengaluru, Karnataka, India
| | - Padmavati Patil
- Department of Periodontology, Raja Rajeswari Dental College and Hospital, Bengaluru, Karnataka, India
| | - Sruthi K Nair
- Department of Periodontology, Raja Rajeswari Dental College and Hospital, Bengaluru, Karnataka, India
| | - Navnita Singh
- Department of Periodontology, Raja Rajeswari Dental College and Hospital, Bengaluru, Karnataka, India
| | - Shilpa Shivanand
- Department of Periodontology, Raja Rajeswari Dental College and Hospital, Bengaluru, Karnataka, India
| | - Ume Sameera
- Department of Periodontology, Raja Rajeswari Dental College and Hospital, Bengaluru, Karnataka, India
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Sezgin Y, Memis Ozgul B, Alptekin NO. Efficacy of oil pulling therapy with coconut oil on four-day supragingival plaque growth: A randomized crossover clinical trial. Complement Ther Med 2019; 47:102193. [DOI: 10.1016/j.ctim.2019.102193] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 07/22/2019] [Accepted: 09/03/2019] [Indexed: 11/17/2022] Open
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Shanmuganathan S, Angayarkanni N. Chebulagic acid Chebulinic acid and Gallic acid, the active principles of Triphala, inhibit TNFα induced pro-angiogenic and pro-inflammatory activities in retinal capillary endothelial cells by inhibiting p38, ERK and NFkB phosphorylation. Vascul Pharmacol 2018; 108:23-35. [DOI: 10.1016/j.vph.2018.04.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 04/05/2018] [Accepted: 04/15/2018] [Indexed: 12/15/2022]
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Seto SW, Chang D, Kiat H, Wang N, Bensoussan A. Chinese Herbal Medicine as a Potential Treatment of Abdominal Aortic Aneurysm. Front Cardiovasc Med 2018; 5:33. [PMID: 29732374 PMCID: PMC5919947 DOI: 10.3389/fcvm.2018.00033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 03/20/2018] [Indexed: 12/19/2022] Open
Abstract
Abdominal aortic aneurysm (AAA) is an irreversible condition where the abdominal aorta is dilated leading to potentially fatal consequence of aortic rupture. Multiple mechanisms are involved in the development and progression of AAA, including chronic inflammation, oxidative stress, vascular smooth muscle (VSMC) apoptosis, immune cell infiltration and extracellular matrix (ECM) degradation. Currently surgical therapies, including minimally invasive endovascular aneurysm repair (EVAR), are the only viable interventions for AAAs. However, these treatments are not appropriate for the majority of AAAs, which measure <50 mm. Substantial effort has been invested to identify and develop pharmaceutical treatments such as statins and doxycycline for this potentially lethal condition but these interventions failed to offer a cure or to retard the progression of AAA. Chinese herbal medicine (CHM) has been used for the management of cardiovascular diseases for thousands of years in China and other Asian countries. The unique multi-component and multi-target property of CHMs makes it a potentially ideal therapy for multifactorial diseases such as AAA. In this review, we review the current scientific evidence to support the use of CHMs for the treatment of AAA. Mechanisms of action underlying the effects of CHMs on AAA are also discussed.
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Affiliation(s)
- Sai Wang Seto
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
| | - Dennis Chang
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
| | - Hosen Kiat
- Faculty of Medicine, University of New South Wales, Sydney, Australia.,School of Medicine, Western Sydney University, Penrith, Australia.,Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Ning Wang
- NICM Health Research Institute, Western Sydney University, Penrith, Australia.,Key Laboratory of Xin'an Medicine, Ministry of Education, Hefei, China.,College of Pharmacy, Anhui University of Chinese Medicine, Hefei, China.,Institute for Pharmacodynamics and Safety Evaluation of Chinese Medicine, Anhui University of Chinese Medicine, Hefei, China
| | - Alan Bensoussan
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
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Naiktari RS, Dharmadhikari C, Gurav AN, Kakade S. Determining the antibacterial substantivity of Triphala mouthwash and comparing it with 0.2% chlorhexidine gluconate after a single oral rinse: A crossover clinical trial. J Indian Soc Periodontol 2018; 22:498-502. [PMID: 30631228 PMCID: PMC6305101 DOI: 10.4103/jisp.jisp_265_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Context: Triphala has been extensively used in dentistry as a mouthwash because of its antiplaque and antigingivitis properties. Aim: The present study is designed to determine the duration of its antibacterial substantivity after a single oral rinse and to compare it with the substantivity of 0.2% chlorhexidine gluconate (CHX). Materials and Methods: In this clinical crossover trial, unstimulated saliva from 30 individuals was collected 2 h after routine oral hygiene procedures but not rinsing (pre-sample) with randomly selected mouthwash, (10% Triphala mouthwash, 0.2% CHX, and normal saline) and 5 min after rinsing (postsample). A washout period of 1 week was kept between two rinses. The sampling was repeated after every 2 h for 12 h (post 1, post 2, post 3, post 4, post 5, and post 6) and was checked for microbial count. Statistical Analysis Used: Friedman test, Kruskal–Wallis test, and post hoc analysis were used to assess the effect of different mouthrinses on colony forming units at different times. Results: Ten percent Triphala showed statistically significant results when the antibacterial effect at post, post 1 and post 2 were compared to pre-assessment count (P < 0.05). After which the effect was at par with normal saline (P > 0.05). The results for CHX were statistically significant at all times when compared to pre-assessment count (P < 0.05) and it showed the maximum substantivity of 7 h. Conclusion: After a single rinse with no eating and drinking restrictions over the day, 10% Triphala mouthwash had an antibacterial effect for 3–4 h. It can be used three times daily for its maximum antibacterial effect.
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Affiliation(s)
| | - Chandrakant Dharmadhikari
- Department of Microbiology, Tatyasaheb Kore Dental College and Research Centre, Kolhapur, Maharashtra, India
| | - Abhijit Ningappa Gurav
- Department of Periodontics, Tatyasaheb Kore Dental College and Research Centre, Kolhapur, Maharashtra, India
| | - Satish Kakade
- Department of Preventive and Social Medicine, Krishna Institute of Dental Sciences, Karad, Maharashtra, India
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Abstract
Aim: The aim of this article is to review the current literature on the therapeutic uses and efficacy of Triphala. Herbal remedies are among the most ancient medicines used in traditional systems of healthcare such as Ayurveda. Triphala, a well-recognized and highly efficacious polyherbal Ayurvedic medicine consisting of fruits of the plant species Emblica officinalis (Amalaki), Terminalia bellerica (Bibhitaki), and Terminalia chebula (Haritaki), is a cornerstone of gastrointestinal and rejuvenative treatment. Methods: A search of the PubMed database was conducted. Results: In addition, numerous additional therapeutic uses described both in the Ayurvedic medical literature and anecdotally are being validated scientifically. In addition to laxative action, Triphala research has found the formula to be potentially effective for several clinical uses such as appetite stimulation, reduction of hyperacidity, antioxidant, anti-inflammatory, immunomodulating, antibacterial, antimutagenic, adaptogenic, hypoglycemic, antineoplastic, chemoprotective, and radioprotective effects, and prevention of dental caries. Polyphenols in Triphala modulate the human gut microbiome and thereby promote the growth of beneficial Bifidobacteria and Lactobacillus while inhibiting the growth of undesirable gut microbes. The bioactivity of Triphala is elicited by gut microbiota to generate a variety of anti-inflammatory compounds. Conclusions: This review summarizes recent data on pharmacological properties and clinical effects of Triphala while highlighting areas in need of additional investigation and clinical development.
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Affiliation(s)
- Christine Tara Peterson
- 1 Department of Family Medicine and Public Health, UC San Diego School of Medicine, Center of Excellence for Research and Training in Integrative Health , La Jolla, CA.,2 Chopra Foundation , Department of Ayurveda and Yoga Research, Carlsbad, CA
| | - Kate Denniston
- 3 Department of Naturopathic Medicine, Bastyr University , San Diego, CA
| | - Deepak Chopra
- 1 Department of Family Medicine and Public Health, UC San Diego School of Medicine, Center of Excellence for Research and Training in Integrative Health , La Jolla, CA.,2 Chopra Foundation , Department of Ayurveda and Yoga Research, Carlsbad, CA
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Terminalia arjuna prevents Interleukin-18-induced atherosclerosis via modulation of NF-κB/PPAR-γ-mediated pathway in Apo E-/- mice. Inflammopharmacology 2017; 26:583-598. [PMID: 28547701 DOI: 10.1007/s10787-017-0357-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Accepted: 04/29/2017] [Indexed: 12/23/2022]
Abstract
AIM OF THE STUDY Terminalia arjuna is a medicinal plant well known as a cardiotonic in Ayurvedic system of medicine. We hypothesized that aqueous stem bark extract of T. arjuna (TAE) may inhibit IL-18-induced atherosclerosis via NF-κB/PPAR-γ-mediated pathway in Apo E-/- mice. MATERIALS AND METHODS 12-week-old, male Apo E-/- mice divided into four groups (n = 6/group) fed with normal chow-diet were employed: GP I: phosphate buffer saline (PBS) (2 month); GP II: rIL-18 (1 month) followed by PBS (1 month); GP III: rIL-18 (1 month) followed by TAE (1 month); GP IV: rIL-18 (1 month) followed by atorvastatin (1 month). RESULTS IL-18 treatment induced a significant increase (p < 0.001) in pro-inflammatory marker (IL-18) (170 ± 9.16 vs. 1178.66 ± 8.08, pg/ml), and downregulated cholesterol efflux gene (PPAR-γ) by ~0.6-fold vs. 1.00 in IL-18-treated mice as compared to the control animals, respectively. TAE treatment to both groups caused a significant reduction in IL-18 to 281.66 ± 9.60 vs. 1178.66 ± 8.08 (pg/ml), upregulated cholesterol efflux gene by ~1.5- vs. 0.6-fold in TAE-treated group, decreased atherogenic lipids, and percentage atherosclerotic lesion area, demonstrating comparable effects with atorvastatin. CONCLUSION Our data demonstrate that TAE protects against IL-18-induced atherosclerosis via NF-κB/PPAR-γ-mediated pathway.
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Pradeep AR, Suke DK, Martande SS, Singh SP, Nagpal K, Naik SB. Triphala, a New Herbal Mouthwash for the Treatment of Gingivitis: A Randomized Controlled Clinical Trial. J Periodontol 2016; 87:1352-1359. [PMID: 27442086 DOI: 10.1902/jop.2016.130406] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND An antiplaque agent with minimal side effects that can be used as an effective adjunct to mechanical plaque control is needed. The current study is designed to evaluate efficacy of triphala (TRP) mouthwash in reduction of plaque and gingivitis. METHODS Ninety individuals with chronic generalized gingivitis were randomly assigned to three groups: 1) group I, placebo mouthwash; 2) group II, TRP mouthwash; and 3) group III, chlorhexidine (CHX) mouthwash. All individuals were instructed to rinse with their respective mouthwash twice daily. 1) Plaque index (PI); 2) gingival index (GI); 3) oral hygiene index-simplified (OHI-S); and 4) microbiologic colony counts were recorded at baseline and at 7, 30, and 60 days. RESULTS All three groups showed gradual reduction in PI, GI, and OHI-S levels from baseline to 7, 30, and 60 days. There was also significant reduction in microbial counts in all groups at all time intervals except in group I. A significant difference was noticed with respect to reduction in PI, GI, OHI-S, and microbiologic counts in group I compared with groups II and III. However, no significant differences were found between groups II and III for any parameters at any time intervals. CONCLUSIONS TRP mouthwash was found to decrease inflammatory parameters from baseline to follow-up intervals. Because improvement in gingivitis was comparable with that of CHX mouthwash, TRP mouthwash can be considered a potential therapeutic agent in the treatment of gingivitis.
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Affiliation(s)
- A R Pradeep
- Department of Periodontics, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - Deepak Kumar Suke
- Department of Periodontics, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - Santosh S Martande
- Department of Periodontology and Oral Implantology, Dr. D.Y. Patil Dental College and Hospital, Pimpri, Pune, Mahrashtra, India
| | - Sonender Pal Singh
- Department of Periodontics, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - Kanika Nagpal
- Department of Periodontics, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - Savitha B Naik
- Department of Conservative Dentistry and Endodontics, Government Dental College and Research Institute
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15
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Venkateshbabu N, Anand S, Abarajithan M, Sheriff SO, Jacob PS, Sonia N. Natural Therapeutic Options in Endodontics - A Review. Open Dent J 2016; 10:214-26. [PMID: 27386007 PMCID: PMC4911752 DOI: 10.2174/1874210601610010214] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 01/10/2016] [Accepted: 01/28/2016] [Indexed: 11/22/2022] Open
Abstract
Complete eradication of microbial biofilms and elimination of the smear layer are the key factors during endodontic treatment. Various chemical irrigants have been proposed in the literature for the same. The major setback with these chemical irrigants is that they are not bio-friendly to the dental and peri-radicular tissues. In the recent years, research to use natural products for root canal disinfection has gained importance. The aim of this article is to compile various herbal products that have been used as an irrigants and intracanal medicaments in the field of Endodontics to eradicate the biofilm and remove smear layer.
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Affiliation(s)
| | - Suresh Anand
- Department of Conservative Dentistry and Endodontics, Penang International Dental College, Penang, Malaysia
| | | | - Sultan O Sheriff
- Department of Restorative Dentistry, International Medical University, Kuala lumpur, Malaysia
| | - Pulikkotil S Jacob
- Department of Restorative Dentistry, International Medical University, Kuala lumpur, Malaysia
| | - Nath Sonia
- Department of Periodontology, Vananchal Dental College, Garhwa, India
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16
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Zaid AN, Abualhasan MN, Jaradat N, Marar M, Mansoor K, Qa’dan F. Development and validation of a new analytical HPLC method for the estimation of carvone in suppositories. JOURNAL OF PHARMACEUTICAL INVESTIGATION 2016. [DOI: 10.1007/s40005-016-0264-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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17
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Ramesh A, Varghese SS, Doraiswamy JN, Malaiappan S. Herbs as an antioxidant arsenal for periodontal diseases. JOURNAL OF COMPLEMENTARY MEDICINE RESEARCH 2016; 5:92-6. [PMID: 27069730 PMCID: PMC4805154 DOI: 10.5455/jice.20160122065556] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 01/05/2016] [Indexed: 01/01/2023]
Abstract
Herbal medicines have long been used as a traditional mode of therapy for various ailments in India. They are being used increasingly as dietary supplements to ward off common diseases. Periodontal diseases are highly prevalent and can affect up to 90% of the world population. Gingivitis is the mild form whereas periodontitis results in an irreversible loss of supporting structures of the teeth. Even though periodontal pathogens form a crucial component in the etiopathogenesis of periodontitis, there is a growing body of evidence suggesting oxidative stress playing a pivotal role in the disease initiation and progression. Studies have shown a direct correlation between increased levels of biomarkers for tissue damage induced by reactive oxygen species (ROS) to the severity of periodontal disease. Thus, the focus of attention has revolved back to herbal medicines due to their wide spectrum of biological and medicinal activities, lower costs, and higher safety margin. Internet databases Pubmed and Google Scholar were searched, and the most relevant articles were considered for review. This review briefly describes the various herbs with antioxidant capacity and their potency in the treating periodontal disease.
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Affiliation(s)
- Asha Ramesh
- Department of Periodontics, Saveetha Dental College and Hospital, Chennai, India
| | - Sheeja Saji Varghese
- Department of Periodontics, Saveetha Dental College and Hospital, Chennai, India
| | | | - Sankari Malaiappan
- Department of Periodontics, Saveetha Dental College and Hospital, Chennai, India
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18
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Aqueous and alcoholic extracts of Triphala and their active compounds chebulagic acid and chebulinic acid prevented epithelial to mesenchymal transition in retinal pigment epithelial cells, by inhibiting SMAD-3 phosphorylation. PLoS One 2015; 10:e0120512. [PMID: 25793924 PMCID: PMC4368423 DOI: 10.1371/journal.pone.0120512] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 02/06/2015] [Indexed: 11/24/2022] Open
Abstract
Epithelial to Mesenchymal Transition (EMT) of the retinal pigment epithelium is involved in the pathogenesis of proliferative vitreoretinopathy (PVR) that often leads to retinal detachment. In this study, Triphala, an ayurvedic formulation and two of its active ingredients, namely chebulagic acid and chebulinic acid were evaluated for anti-EMT properties based on in vitro experiments in human retinal pigment epithelial cell line (ARPE-19) under TGFβ1 induced conditions. ARPE-19 cells were treated with TGFβ1 alone or co-treated with various concentrations of aqueous extract (AqE) (30 - 300 μg/ml); alcoholic extract (AlE) (50 - 500 μg/ml) of triphala and the active principles chebulagic acid (CA) and chebulinic acid (CI) (CA,CI: 50 - 200 μM). The expression of EMT markers namely MMP-2, αSMA, vimentin and the tight junction protein ZO-1 were evaluated by qPCR, western blot and immunofluorescence. The functional implications of EMT, namely migration and proliferation of cells were assessed by proliferation assay, scratch assay and transwell migration assay. AqE, AlE, CA and CI reduced the expression and activity of MMP-2 at an ED50 value of 100 μg/ml, 50 μg/ml, 100 μM and 100 μM, respectively. At these concentrations, a significant down-regulation of the expression of αSMA, vimentin and up-regulation of the expression of ZO-1 altered by TGFβ1 were observed. These concentrations also inhibited proliferation and migration of ARPE-19 cells induced by TGFβ1. EMT was found to be induced in ARPE-19 cells, through SMAD-3 phosphorylation and it was inhibited by AqE, AlE, CA and CI. Further studies in experimental animals are required to attribute therapeutic potential of these extracts and their active compounds, as an adjuvant therapy in the disease management of PVR.
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Kudalkar MD, Nayak A, Bhat KS, Nayak RN. Effect of Azadirachta indica (Neem) and Aloe vera as compared to subantimicrobial dose doxycycline on matrix metalloproteinases (MMP)-2 and MMP-9: An in-vitro study. Ayu 2014; 35:85-9. [PMID: 25364206 PMCID: PMC4213975 DOI: 10.4103/0974-8520.141947] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: A critical outcome of periodontal diseases is degradation of collagen in the periodontal tissues, by enzymes such as Matrix Metallo-Proteinases (MMPs). Doxycycline is known to down-regulate the activity of MMPs. Azadirachta indica (Neem) and Aloe vera are herbs known to have an anti-inflammatory effect. The present study was designed to evaluate the anti-inflammatory effect of Neem and Aloe vera by way of its inhibitory effect on MMP-2 and MMP-9 activity in cases of chronic periodontitis and compare it with doxcycline. Materials and Methods: A total of 30 subjects were enrolled in this study. Gingival tissue samples were obtained from patients diagnosed with the chronic periodontitis. The tissue extracts were treated with the said drug solutions and inhibition of MMP-2 and MMP-9 was analyzed. Enzymatic activity was detected by electrophoresis. The data was subjected to Student's paired t-test. Results: The results showed that the activity of MMP-2 and MMP-9 was significantly decreased by the use of doxycycline, Neem and Aloe vera. A 53.5% reduction in the MMP-2 and 52.5% reduction in the MMP-9 activity was seen when samples were subjected to Neem treatment at the concentration of 1500 μg/ml. Tissues treated with Aloe vera in the concentration of 2000 μg/ml showed a 20.09% reduction in the MMP-2 and 20.4% reduction in the MMP-9 activity. Doxycycline in the concentration of 300 μg/ml, showed an 82.1% reduction in the MMP-2 and 82.6% reduction in the MMP-9 activity. Conclusion: The present study demonstrated an inhibitory effect of Neem and Aloe vera on MMP-2 and MMP-9, which are involved in the extracellular matrix degradation during periodontitis.
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Affiliation(s)
- Mithun D Kudalkar
- Department of Periodontology, Maratha Mandal's Nathajirao G Halgekar Institute of Dental Sciences and Research Centre, Belgaum, Karnataka, India
| | - Aarati Nayak
- Department of Periodontology, Maratha Mandal's Nathajirao G Halgekar Institute of Dental Sciences and Research Centre, Belgaum, Karnataka, India
| | - Kishore S Bhat
- Department of Molecular Biology and Immunology, Maratha Mandal's Nathajirao G Halgekar Institute of Dental Sciences and Research Centre, Belgaum, Karnataka, India
| | - Ranganath N Nayak
- Department of Oral and Maxillofacial Surgery, Maratha Mandal's Nathajirao G Halgekar Institute of Dental Sciences and Research Centre, Belgaum, Karnataka, India
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20
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Boloor VA, Hosadurga R, Rao A, Jenifer H, Pratap S. Unconventional dentistry in India - an insight into the traditional methods. J Tradit Complement Med 2014; 4:153-8. [PMID: 25161919 PMCID: PMC4142452 DOI: 10.4103/2225-4110.130951] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Unconventional medicine (UM) has been known and practised since the recorded history of civilization. Some unconventional practices may be viewed as “the continuity of traditions, religious beliefs, and even quackery that non-specialists practice.” These practices have been associated with religious beliefs and the spiritual domain as well as with the physical domain. In ancient Old World civilizations, UM was performed by skilled experts or wise men; in today's Western civilization, practitioners may or may not be licensed, and some are charlatans. Dentistry, like medicine, is a traditional, science-based, highly regulated healthcare profession that serves increasingly sophisticated and demanding clients. Today, traditional dental practice is dealing with an array of challenges to the established professional system; these challenges are generally termed “alternative” (or complementary, unconventional, or integrative). Genuine alternatives are comparable methods of equal value that have met scientific and regulatory criteria for safety and effectiveness. Because “alternative care” has become politicized and is often a misnomer – referring to practices that are not alternative to, complementary to, or integrating with conventional health care – the more accurate term “unconventional” is used.
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Affiliation(s)
- Vinita Ashutosh Boloor
- Department of Periodontics, Yenepoya Dental College, Deralakatte, Mangalore, Karnataka, India
| | - Rajesh Hosadurga
- Department of Periodontics, Yenepoya Dental College, Deralakatte, Mangalore, Karnataka, India
| | - Anupama Rao
- Department of Periodontics, Yenepoya Dental College, Deralakatte, Mangalore, Karnataka, India
| | - Haziel Jenifer
- Department of Periodontics, Yenepoya Dental College, Deralakatte, Mangalore, Karnataka, India
| | - Sruthy Pratap
- Department of Periodontics, Yenepoya Dental College, Deralakatte, Mangalore, Karnataka, India
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21
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Prakash S, Shelke AU. Role of Triphala in dentistry. J Indian Soc Periodontol 2014; 18:132-5. [PMID: 24872616 PMCID: PMC4033874 DOI: 10.4103/0972-124x.131299] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Accepted: 09/21/2013] [Indexed: 11/05/2022] Open
Abstract
Ayurveda is considered as the “science of life,” because the ancient Indian system of health care focused views of man and his illness. India has an age-old heritage of traditional herbal medicine. Conventional drugs usually provide effective antibiotic therapy for bacterial infections, but there is an increasing problem of antibiotic resistance and a continuing need for new solutions. Hence, now herbal drugs are being preferred to synthetic antibiotics. ‘Triphala’ is a well-known powdered preparation in the Indian system of medicine (ISM). It consists of equal parts of the Emblica officinalis, Terminalia chebula, and Terminalia belerica. Currently, Triphala is being extensively researched for its various therapeutic effects including its anti-caries, antioxidant, anti-collagenase, and anti-microbial activities. The present review will focus on the comprehensive appraisal of Triphala and its several applications in dentistry.
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Affiliation(s)
- Shobha Prakash
- Department of Periodontics, College of Dental Sciences, Davangere, Karnataka, India
| | - Anup U Shelke
- Department of Periodontics, College of Dental Sciences, Davangere, Karnataka, India
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22
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Naiktari RS, Gaonkar P, Gurav AN, Khiste SV. A randomized clinical trial to evaluate and compare the efficacy of triphala mouthwash with 0.2% chlorhexidine in hospitalized patients with periodontal diseases. J Periodontal Implant Sci 2014; 44:134-40. [PMID: 24921057 PMCID: PMC4050230 DOI: 10.5051/jpis.2014.44.3.134] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 05/01/2014] [Indexed: 11/08/2022] Open
Affiliation(s)
- Ritam S Naiktari
- Department of Periodontology, Tatyasaheb Kore Dental College & Research Centre, Kolhapur, India
| | - Pratima Gaonkar
- Department of Periodontology, Tatyasaheb Kore Dental College & Research Centre, Kolhapur, India
| | - Abhijit N Gurav
- Department of Periodontology, Tatyasaheb Kore Dental College & Research Centre, Kolhapur, India
| | - Sujeet V Khiste
- Department of Periodontology, Tatyasaheb Kore Dental College & Research Centre, Kolhapur, India
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23
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Napoleon AA, Nawaz Khan FR. Potential anti-tubercular and in vitro anti-inflammatory agents: 9-substituted 1,8-dioxo-octahydroxanthenes through cascade/domino reaction by citric fruit juices. Med Chem Res 2014. [DOI: 10.1007/s00044-014-1033-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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24
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Bhattacharjee R, Nekkanti S, Kumar NG, Kapuria K, Acharya S, Pentapati KC. Efficacy of triphala mouth rinse (aqueous extracts) on dental plaque and gingivitis in children. ACTA ACUST UNITED AC 2014; 6:206-10. [PMID: 24850703 DOI: 10.1111/jicd.12094] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 01/14/2014] [Indexed: 11/27/2022]
Abstract
AIM The aim of the present study was to evaluate the efficacy of triphala mouth rinse (aqueous) in the reduction of plaque and gingivitis among children. METHODS The study was a randomized, double-blinded, controlled trial, with a total of 60 school children (n = 30 in each group; triphala and chlorhexidine groups). Plaque and gingival indices were used to evaluate baseline and follow-up plaque and gingivitis. RESULTS A total of 57 children completed the study. Both chlorhexidine and triphala groups showed significantly lower mean gingival and plaque index scores at follow up than baseline (P < 0.001). There was no significant difference in the percentage change in the mean gingival index between the two groups (P = 0.826). The percentage change in the mean plaque index was significantly higher in the chlorhexidine group compared to the triphala group (P = 0.048). CONCLUSION The effectiveness of triphala in the reduction of plaque and gingivitis was comparable to chlorhexidine, and can be used for short-term purposes without potential side-effects. It is a cost-effective alternative in reducing plaque and gingivitis.
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Affiliation(s)
- Ritesh Bhattacharjee
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India
| | - Sridhar Nekkanti
- Department of Pedodontics and Preventive Dentistry, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India
| | - Nikesh G Kumar
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India
| | - Ketan Kapuria
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India
| | - Shashidhar Acharya
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India
| | - Kalyana C Pentapati
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India
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25
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Baliga MS, Meera S, Mathai B, Rai MP, Pawar V, Palatty PL. Scientific validation of the ethnomedicinal properties of the Ayurvedic drug Triphala: A review. Chin J Integr Med 2012; 18:946-54. [DOI: 10.1007/s11655-012-1299-x] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2011] [Indexed: 11/30/2022]
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26
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Kumar AJ, Anumala N, Avula H. Novel and often bizarre strategies in the treatment of periodontal disease. J Indian Soc Periodontol 2012; 16:4-10. [PMID: 22628955 PMCID: PMC3357033 DOI: 10.4103/0972-124x.94595] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Accepted: 01/09/2012] [Indexed: 01/09/2023] Open
Abstract
Treatment of periodontal disease involves complex mechanical, surgical, and medical modalities. Some of the treatment regimens are patient centered, some involve a great amount of technical expertise and competence from a practitioner, and often involve complex procedures like use of tissue-engineered products. In spite of several advances, treatment of periodontal disease depends on scaling and root planing and various surgical procedures as the mainstay, but results of treatment are not always predictable and are often frustrating. The ultimate aim of periodontal treatment is regeneration of periodontal tissues and more particularly lost alveolar bone support. The treatment options include a myriad of approaches and scientists and researchers have tried various tools and agents to improve alveolar bone status and improve periodontal health. These approaches vary from simple monotherapy with systemic antibiotic usage to exotic and novel procedures like shock wave therapy, photodynamic therapy and application.
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Affiliation(s)
- A Jaya Kumar
- Department of Periodontics, Sri Sai College of Dental Surgery, Vikarabad, Andhra Pradesh, India
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27
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Zeidán-Chuliá F, Rybarczyk-Filho JL, Gursoy M, Könönen E, Uitto VJ, Gursoy OV, Cakmakci L, Moreira JCF, Gursoy UK. Bioinformatical and in vitro approaches to essential oil-induced matrix metalloproteinase inhibition. PHARMACEUTICAL BIOLOGY 2012; 50:675-686. [PMID: 22571397 DOI: 10.3109/13880209.2012.677847] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
CONTEXT Essential oils carry diverse antimicrobial and anti-enzymatic properties. OBJECTIVE Matrix metalloproteinase (MMP) inhibition characteristics of Salvia fruticosa Miller (Labiatae), Myrtus communis Linnaeus (Myrtaceae), Juniperus communis Linnaeus (Cupressaceae), and Lavandula stoechas Linnaeus (Labiatae) essential oils were evaluated. MATERIALS AND METHODS Chemical compositions of the essential oils were analyzed by gas chromatography-mass spectrometry (GC-MS). Bioinformatical database analysis was performed by STRING 9.0 and STITCH 2.0 databases, and ViaComplex software. Antibacterial activity of essential oils against periodontopathogens was tested by the disc diffusion assay and the agar dilution method. Cellular proliferation and cytotoxicity were determined by commercial kits. MMP-2 and MMP-9 activities were measured by zymography. RESULTS Bioinformatical database analyses, under a score of 0.4 (medium) and a prior correction of 0.0, gave rise to a model of protein (MMPs and tissue inhibitors of metalloproteinases) vs. chemical (essential oil components) interaction network; where MMPs and essential oil components interconnected through interaction with hydroxyl radicals, molecular oxygen, and hydrogen peroxide. Components from L. stoechas potentially displayed a higher grade of interaction with MMP-2 and -9. Although antibacterial and growth inhibitory effects of essential oils on the tested periodontopathogens were limited, all of them inhibited MMP-2 in vitro at concentrations of 1 and 5 µL/mL. Moreover, same concentrations of M. communis and L. stoechas also inhibited MMP-9. MMP-inhibiting concentrations of essential oils were not cytotoxic against keratinocytes. DISCUSSION AND CONCLUSION We propose essential oils of being useful therapeutic agents as MMP inhibitors through a mechanism possibly based on their antioxidant potential.
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Affiliation(s)
- Fares Zeidán-Chuliá
- Department of Biochemistry, Center of Oxidative Stress Research, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.
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28
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Surathu N, Kurumathur AV. Traditional therapies in the management of periodontal disease in India and China. Periodontol 2000 2011; 56:14-24. [DOI: 10.1111/j.1600-0757.2010.00369.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kumar MS, Kirubanandan S, Sripriya R, Sehgal PK. Triphala promotes healing of infected full-thickness dermal wound. J Surg Res 2007; 144:94-101. [PMID: 17662304 DOI: 10.1016/j.jss.2007.02.049] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2006] [Revised: 02/20/2007] [Accepted: 02/27/2007] [Indexed: 11/18/2022]
Abstract
BACKGROUND Infection is a major problem in the management of wounds. Even though the development of synthetic antimicrobial agents persists, drug resistance and toxicity hinder their way. Many plants with multi-potent pharmaceutical activities may offer better treatment options, and Triphala (dried fruits of Terminalia chebula, Terminalia bellirica, and Phyllanthus emblica) are potential formulations evaluated for healing activity on infected wound as it possesses numerous activities. MATERIALS AND METHODS Alcoholic extract of Triphala has shown in vitro antimicrobial activity against wound pathogens such as Staphylococcus aureus, Pseudomonas aeruginosa, and Streptococcus pyogenes. An ointment was prepared from the Triphala extract (10% w/w) and assessed for in vivo wound healing on infected rat model by rate of healing, bacterial count, biochemical analysis, and expression of matrix metalloproteinases. RESULTS The treated group has shown significantly improved wound closure. Assessment of granulation tissue on every fourth day showed significant reduction in bacterial count with significant level of collagen, hexosamine, uronic acid, and superoxide dismutase in the treated group (P < 0.01). Reduction of matrix metalloproteinase expression observed in the treated group by gelatin zymography and immunoblotting confirms our in vivo assessment. CONCLUSIONS The above results showed the antibacterial, wound healing, and antioxidant activities of Triphala ointment, necessary for the management of infected wounds. Active principles of the Triphala may be further evaluated and used as an excellent therapeutic formulation for infected wounds.
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Srikumar R, Parthasarathy NJ, Shankar EM, Manikandan S, Vijayakumar R, Thangaraj R, Vijayananth K, Sheeladevi R, Rao UA. Evaluation of the growth inhibitory activities of Triphala against common bacterial isolates from HIV infected patients. Phytother Res 2007; 21:476-80. [PMID: 17273983 DOI: 10.1002/ptr.2105] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The isolation of microbial agents less susceptible to regular antibiotics and the rising trend in the recovery rates of resistant bacteria highlights the need for newer alternative principles. Triphala has been used in traditional medicine practice against certain diseases such as jaundice, fever, cough, eye diseases etc. In the present study phytochemical (phenolic, flavonoid and carotenoid) and antibacterial activities of aqueous and ethanol extracts of Triphala and its individual components (Terminalia chebula, Terminalia belerica and Emblica officinalis) were tested against certain bacterial isolates (Pseudomonas aeruginosa, Klebsiella pneumoniae, Shigella sonnei, S. flexneri, Staphylococcus aureus, Vibrio cholerae, Salmonella paratyphi-B, Escherichia coli, Enterococcus faecalis, Salmonella typhi) obtained from HIV infected patients using Kirby-Bauer's disk diffusion and minimum inhibitory concentration (MIC) methods. T. chebula was found to possess high phytochemical content followed by T. belerica and E. officinalis in both aqueous and ethanol extracts. Further, most of the bacterial isolates were inhibited by the ethanol and aqueous extracts of T. chebula followed by T. belerica and E. officinalis by both disk diffusion and MIC methods. The present study revealed that both individual and combined aqueous and ethanol extracts of Triphala have antibacterial activity against the bacterial isolates tested.
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Affiliation(s)
- R Srikumar
- Department of Physiology, Faculty of Medicine, Dr. ALM PG Institute of Basic Medical Sciences, University of Madras, Taramani Campus, Chennai, Tamilnadu, India 600 113
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Sumantran VN, Kulkarni AA, Harsulkar A, Wele A, Koppikar SJ, Chandwaskar R, Gaire V, Dalvi M, Wagh UV. Hyaluronidase and collagenase inhibitory activities of the herbal formulation Triphala guggulu. J Biosci 2007; 32:755-61. [PMID: 17762148 DOI: 10.1007/s12038-007-0075-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Myrrh (guggulu) oleoresin from the Commiphora mukul tree is an important component of antiarthritic drugs in Ayurvedic medicine. Clinical data suggest that elevated levels of hyaluronidase and collagenase type 2 enzymes contribute significantly to cartilage degradation. Triphala guggulu (TG) is a guggulu-based formulation used for the treatment of arthritis. We assessed the chondroprotective potential of TG by examining its effects on the activities of pure hyaluronidase and collagenase type 2 enzymes. Triphala shodith guggulu (TSG), an intermediate in the production of TG, was also examined. A spectrophotometric method was used to assay Hyaluronidase activity, and to detect potential Hyaluronidase inhibitors. Aqueous and hydro-alcoholic extracts of TSG showed weak but dose-dependent inhibition of hyaluronidase activity. In contrast, the TG formulation was 50 times more potent than the TSG extract with respect to hyaluronidase inhibitory activity. A validated X-ray film-based assay was used to measure the gelatinase activity of pure collagenase type 2. Hydro-alcoholic extracts of the TG formulation were 4 times more potent than TSG with respect to collagenase inhibitory activity. Components of Triphala were also evaluated for their inhibitory activities on hyaluronidase and collagenase. This is the first report to show that the T2 component of Triphala (T.chebula) is a highly potent hyaluronidase and collagenase inhibitor. Thus, the TG formulation inhibits two major enzymes that can degrade cartilage matrix. Our study provides the first in vitro preclinical evidence of the chondroprotective properties of TG.
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Affiliation(s)
- Venil N Sumantran
- Interactive Research School for Health Affairs (IRSHA), Bhartiya Vidyapeeth Deemed University Medical College Campus, Dhankawadi, Pune 411 043, India.
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Kumar MS, Vamsi G, Sripriya R, Sehgal PK. Expression of matrix metalloproteinases (MMP-8 and -9) in chronic periodontitis patients with and without diabetes mellitus. J Periodontol 2007; 77:1803-8. [PMID: 17076603 DOI: 10.1902/jop.2006.050293] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Matrix metalloproteinases (MMPs) are involved in a number of physiological events, and they are the major players in collagen breakdown during periodontal tissue destruction. Diabetes mellitus (DM) has been associated with altered collagen metabolism and increases the response of the periodontal tissue to pathogenic microorganisms, thereby increasing the severity of periodontal disease. The aim of this study was to assess the expression of MMP-8 and -9 in gingival tissues of diabetic chronic periodontitis (CP), non-diabetic CP, and healthy patients. METHODS The plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) were assessed. The levels of MMP expression in gingival tissue extracts were measured by gelatin zymography and Western blotting. The structural changes in tissues were analyzed by histological examination and collagen estimation. RESULTS Higher levels of PI, GI, CAL, and deeper PD were observed in CP patients with DM than CP patients without DM. The average concentration of MMP-9 was increased three-fold, and the MMP-8 was increased two-fold in CP patients with DM compared to CP patients without DM. A high infiltration of inflammatory cells and less collagen were observed in the histologic analysis of gingival biopsies from diabetic patients. CONCLUSIONS An increased concentration of MMP-8 and -9 in the gingival tissue of diabetic CP patients suggests that the expression of these MMPs contributes to the failure of the healing process in the diabetic condition. Treatment strategies directed toward the inhibition of these MMPs could lead to an improved healing rate in CP patients.
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Affiliation(s)
- Muthusamy Senthil Kumar
- Bio-Products Laboratory, Central Leather Research Institute, Adyar, Chennai, Tamil Nadu, India
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