Comparative Clinical Evaluation of Two Local Drug Delivery Agents (Neem Chip and Turmeric Chip) in Chronic Periodontitis: An Experimental Study
Komal Saini, Priyanka Chopra, Amit Bhardwaj, Manish Yadav, Sachin Saini
Chronic periodontitis, Curcumin, Local drug delivery, Neem chip, Turmeric chip
Citation Information :
Saini K, Chopra P, Bhardwaj A, Yadav M, Saini S. Comparative Clinical Evaluation of Two Local Drug Delivery Agents (Neem Chip and Turmeric Chip) in Chronic Periodontitis: An Experimental Study. World J Dent 2021; 12 (2):138-143.
Aim and objective: This study aimed to evaluate the efficacy of herbal local drug delivery (LDD) agents as an adjunct to scaling and root planing (SRP) and SRP alone in the treatment of chronic periodontitis.
Material and methods: This split-mouth study was conducted at the Department of Periodontology, SGT Dental College, Haryana, in 30 patients between 30 years and 65 years of age where 90 sites (3 sites in one patient) were selected. Only those teeth with probing pocket depth (PPD) of ≥5 mm were included. Sites were randomized into three treatment groups. Group I with SRP + neem chip, group II with SRP + turmeric chip, and group III received SRP only. Clinical parameters plaque index (PI), gingival index (GI), PPD, and relative attachment level (RAL) were recorded at baseline, 1 month after the intervention, and at 3 months. Intergroup comparisons were done using Kruskal–Wallis test followed by post hoc comparison using Mann–Whitney U test.
Results: Mean PI and GI at 1 month for group I, II, and III were (1.33 ± 0.28, 1.37 ± 0.28, and 1.66 ± 0.27) (1.20 ± 0.31, 1.24 ± 0.26, and 1.31 ± 0.39), respectively. Improvement in mean PI and mean GI of group I and group II at 1 month is significant when compared with group III (p < 0.05). Probing pocket depth at 1 month for group I, II, and III was 4.16 ± 0.88, 4.21 ± 0.61, and 4.63 ± 0.68, respectively (p < 0.05 for all groups). Mean RAL at 1 month for group I, II, and III was 8.41 ± 1.59, 8.43 ± 1.66, and 9.01 ± 1.50, respectively. The mean RAL of group I and group II is significant when compared with group III at 1 month (p < 0.05).
Conclusion: Better immediate results can be achieved in the management of chronic periodontitis by the use of locally delivered neem and turmeric extract in form of chips.
Clinical significance: These herbal chips are natural, cost-effective without any side effects, and can be used in treating chronic periodontitis.
Berglundh T, Donati M. Aspects of adaptive host response in periodontitis. J Clin Periodontol 2005;32(s6):87–107. DOI: 10.1111/j.1600-051X.2005.00820.x.
Baker KA. The role of dental professionals and the patient in plaque control. Periodontol 2000 1995;8(1):108–113. DOI: 10.1111/j.1600-0757.1995.tb00048.x.
Cugini MA, Haffajee AD, Smith C, et al. The effect of scaling and root planing on the clinical and microbiological parameters of periodontal diseases: 12 months results. J Clin Periodontol 2000;27(1):30–36. DOI: 10.1034/j.1600-051x.2000.027001030.x.
Magnusson I, Lindhe J, Yoneyama T, et al. Recolonization of a subgingival microbiota following scaling in deep pockets. J Clin Periodontol 1984;11(3):193–207. DOI: 10.1111/j.1600-051X.1984.tb01323.x.
Goodson JM, Tanner A. Antibiotic resistance of the subgingival microbiota following local tetracycline therapy. Oral Microbiol Immunol 1992;7(2):113–117. DOI: 10.1111/j.1399-302X.1992.tb00520.x.
Puri K, Dodwad V, Bhat K, et al. Effect of controlled release periochip on clinical and microbiological parameters in patients of chronic periodontitis. J Ind Soc Periodontol 2013;17(5):605–611. DOI: 10.4103/0972-124X.119299.
Kukreja BJ, Dodwad V. Herbal mouthwashes: a gift of nature. Int J Pharm Biol Sci 2012;3:46–52.
Silness P, Loe H. Periodontal disease in pregnancy. Acta Odontol Scand 1964;22(1):121–135. DOI: 10.3109/00016356408993968.
Loe H. The gingival index, the plaque index and the retention index systems. J Periodontol 1967;38(6 Part II):610–616. DOI: 10.1902/jop.1967.38.6_part2.610.
Pragati S, Ashok S, Kuldeep S. Recent advances in periodontal drug delivery systems. Int J Drug Delivery 2009;1:19–23.
Vennila K, Elanchezhiyan S, Ilavarasu S. Efficacy of 10% whole Azadirachta indica (neem) chip as an adjunct to scaling and root planing in chronic periodontitis: a clinical and microbiological study. Ind J Dent Res 2016;27(1):15–21. DOI: 10.4103/0970-9290.179808.
Kaner D, Bernimoulin JP, Hopfenmuller W. Controlled delivery chlorhexidine chip versus amoxicillin/metronidazole as adjunctive antimicrobial therapy for generalized aggressive periodontitis: a randomized controlled clinical trial. J Clin Periodontol 2007;34(10):880–891. DOI: 10.1111/j.1600-051X.2007.01122.x.
Jurenka JS. Anti-inflammatory properties of curcumin, a major constituent of Curcuma longa: a review of preclinical and clinical research. Alt Med Review 2009;14:141–153.
Sharma OP. Antioxidant activity of curcumin and related compounds. Biochem Pharmacol 1976;25(15):1811–1812. DOI: 10.1016/0006-2952(76)90421-4.
Basnet P, Basnet NS. Curcumin: an anti-inflammatory molecule from a curry spice on the path to cancer treatment. Molecules 2011;16(6):4567–4598. DOI: 10.3390/molecules16064567.
Rao DVK, Singh I, Chopra PC, et al. In vitro antibacterial activity of neem oil. Ind J Med Res 1986;84:314–316.
Chatterjee A, Saluja M, Singh N, et al. To evaluate the antigingivitis and antipalque effect of an Azadirachta indica (neem) mouthrinse on plaque induced gingivitis: A double-blind, randomized, controlled trial. J Indian Soc Periodontol 2011;15:398–401. DOI: 10.4103/0972-124X.92578
Chaudhary S, Kanwar RK, Sehgal A, et al. Progress on Azadirachta indica based biopesticides in replacing synthetic toxic pesticides. Front Plant Sci 2017;8:610–617. DOI: 10.3389/fpls.2017.00610.
Jeffcoat MK, Bray KS, Ciancio SG, et al. Adjunctive use of a subgingival controlled-release chlorhexidine chip reduces probing depth and improves attachment level compared with scaling and root planing alone. J Periodontol 1998;69(9):989–997. DOI: 10.1902/jop.1918.104.22.1689.
Singh A, Sridhar R, Shrihatti R, et al. Evaluation of turmeric chip compared with chlorhexidine chip as a local drug delivery agent in the treatment of chronic periodontitis: a split mouth randomized controlled clinical trial. J Alternat Complement Med 2017;14(1):1–9. DOI: 10.1625/jcam.14.1.
Gottumukkala S, Sudarshan S, Satyanarayana RM. Comparative clinical evaluation of the efficacy of two controlled release devices: chlorhexidine chips and indigenous curcumin-based collagen as local drug delivery systems. Contemp Clin Dent 2014;5(2):175–181. DOI: 10.4103/0976-237X.132310.
Jain S, Kaur H, Brar S. To evaluate the efficacy of neem chip as an adjunct to scaling and root planing (SRP) in patients with periodontitis. Ind J Dent Sci 2012;4:42–45.
Mehta WP, Kudva P, Kudva PH. Comparative evaluation of the efficacy of neem and tetracycline when incorporated in a local drug delivery system when used as an adjunct to scaling and root planing a clinico-microbiological study. IOSR J Dent Med Sci 2015;14:47–50.