A Randomized, Controlled Clinical Trial on the Clinical and Microbiological Efficacy of Punica granatum Linn Mouthwash

Objective: To evaluate the clinical efficacy of a mouthwash containing Punica granatum L as compared to 0.12% chlorhexidine digluconate on the control of dental biofilm and gingival inflammation. Material and Methods: A randomized, controlled, double-blind clinical trial was carried out comprising a sample of 35 students aged nine to twelve years having Simplified Oral Hygiene Index value equal to or higher than 1.6, with at least 20 teeth. The sample was divided into two groups: group A, administration of 0.12% chlorhexidine mouthwash twice a day for 14 days; and group B, administration of Punica granatum mouthwash (6.25%) following the same protocol described above. The Plaque Index (PI) and Bleeding on Probing Index (BPI) were used to evaluate biofilm control and gingival inflammation on days 0, 7 and 14. Counting of oral streptococci from saliva samples was also performed on days 0 and 14. The data were analyzed using Student’s t test and Analysis of Variance (ANOVA). Results: The findings showed that P. granatum mouthwash reduced the mean values of PI and BPI, but with no significant difference. However, there was a significant reduction in the counting of oral streptococci. In the control group, all variables were found to be significantly reduced. Conclusion: Punica granatum mouthwash was not effective for the control of dental biofilm and gingival inflammation, but it was effective in reducing the counting of oral streptococci.

[1]  R. A. Lins,et al.  Clinical efficacy analysis of the mouth rinsing with pomegranate and chamomile plant extracts in the gingival bleeding reduction. , 2014, Complementary therapies in clinical practice.

[2]  S. Ravindra,et al.  Efficacy of a herbal extract gel in the treatment of gingivitis: A clinical study , 2012, Journal of Ayurveda and integrative medicine.

[3]  B. Ncube,et al.  In vitro antimicrobial synergism within plant extract combinations from three South African medicinal bulbs. , 2012, Journal of ethnopharmacology.

[4]  Anirudh B Acharya,et al.  The antiplaque efficacy of pomegranate mouthrinse. , 2011, Quintessence international.

[5]  C. Rösing,et al.  Staining and calculus formation after 0.12% chlorhexidine rinses in plaque-free and plaque covered surfaces: a randomized trial , 2010, Journal of applied oral science : revista FOB.

[6]  V. Lara,et al.  Phytomedicines for Candida-associated denture stomatitis. , 2010, Fitoterapia.

[7]  P. Marsh Controlling the oral biofilm with antimicrobials. , 2010, Journal of dentistry.

[8]  N. Al-zoreky,et al.  Antimicrobial activity of pomegranate (Punica granatum L.) fruit peels. , 2009, International journal of food microbiology.

[9]  R. DiSilvestro,et al.  Pomegranate extract mouth rinsing effects on saliva measures relevant to gingivitis risk , 2009, Phytotherapy research : PTR.

[10]  G. Chambat,et al.  Effect of antiplaque compounds and mouthrinses on the activity of glucosyltransferases from Streptococcus sobrinus and insoluble glucan production. , 2008, Oral microbiology and immunology.

[11]  F. Groppo,et al.  Use of phytotherapy in dentistry , 2008, Phytotherapy research : PTR.

[12]  M. Timmerman,et al.  Inhibition of "de novo" plaque formation with 0.12% chlorhexidine spray compared to 0.2% spray and 0.2% chlorhexidine mouthwash. , 2007, Journal of periodontology.

[13]  J. Cortelli,et al.  The effect of mouthrinses against oral microorganisms , 2007 .

[14]  S. L. Pereira,et al.  ANTIPLAQUE AND ANTIGINGIVITIS EFFECTS OF A GEL CONTAINING PUNICA GRANATUM LINN EXTRACT. A DOUBLE-BLIND CLINICAL STUDY IN HUMANS , 2006, Journal of applied oral science : revista FOB.

[15]  G. Viana,et al.  Punica granatum (Pomegranate) Extract Is Active Against Dental Plaque , 2006, Journal of herbal pharmacotherapy.

[16]  F. Sampaio,et al.  Minimum inhibitory concentration of adherence of Punica granatum Linn (pomegranate) gel against S. mutans, S. mitis and C. albicans. , 2006, Brazilian dental journal.

[17]  B. Willershausen,et al.  Clinical study on the effectiveness and side effects of hexetidine and chlorhexidine mouthrinses versus a negative control. , 2005, Quintessence international.

[18]  David Heber,et al.  In vitro antiproliferative, apoptotic and antioxidant activities of punicalagin, ellagic acid and a total pomegranate tannin extract are enhanced in combination with other polyphenols as found in pomegranate juice. , 2005, The Journal of nutritional biochemistry.

[19]  M. Barnett,et al.  Determination of the in situ bactericidal activity of an essential oil mouthrinse using a vital stain method. , 2000, Journal of clinical periodontology.

[20]  P. Huovinen,et al.  In vitro susceptibility of Streptococcus mutans to chlorhexidine and six other antimicrobial agents , 1993, Antimicrobial Agents and Chemotherapy.

[21]  A. Scalbert Antimicrobial properties of tannins , 1991 .

[22]  J. Ainamo,et al.  Problems and proposals for recording gingivitis and plaque. , 1975, International dental journal.

[23]  J. van Houte,et al.  A selective medium for Streptococcus mutans. , 1973, Archives of oral biology.

[24]  H. Löe,et al.  PERIODONTAL DISEASE IN PREGNANCY. II. CORRELATION BETWEEN ORAL HYGIENE AND PERIODONTAL CONDTION. , 1964, Acta odontologica Scandinavica.

[25]  J C GREENE,et al.  THE SIMPLIFIED ORAL HYGIENE INDEX. , 1964, Journal of the American Dental Association.