Efficacy of alcohol-free mouthwash containing essential oil from the fruits of Zanthoxylum limonella Alston on dental biofilm, gingivitis, and Streptococcus mutans controls
Article Sidebar
Main Article Content
Abstract
Objective: To evaluate the efficacy of mouthwash containing essential oil from the fruits of Ma-Khwaen (Zanthoxylum limonella Alston) on dental biofilm, gingival inflammation, and Streptococcus mutans controls.
Materials and Methods: The crossover clinical trial was conducted in twenty-four volunteers who were allocated into three groups according to the types of mouthwash including 0.12% chlorhexidine digluconate (CHX), 0.5% Ma-Khwaen mouthwash (Ma-Kh), and distilled water (DW). After receiving professional prophylaxis and 2 -weeks run-in period, the volunteers started to rinse with their allocated mouthwashes, immediately after brushing in the morning and at night for 14 days. Clinical parameters, plaque index (PI), gingival index (GI), as well as S.mutans colony forming unit (CFU) count from collected supragingival plaque of four molars were conducted at baseline, Day 7, and Day 14. At the end of each experimental phase, the volunteers underwent 2-weeks washout period before starting the second and third allocations.
Results: Both CHX and Ma-Kh groups demonstrated the reduction on PI and GI statistically significant difference from baseline to Day 7 and Day 14. DW had no effects on PI and GI reduction. There was statistically significant difference when compared the efficacy in PI and GI reduction between CHX and DW groups as well as Ma-Kh and DW groups, but no significant difference between CHX and Ma-Kh groups. S.mutans CFU count significantly decreased in CHX group from baseline to Day 7 and Day 14, and in Ma-Kh group from baseline to Day 7. DW had no effect on S.mutans CFU reduction.
Conclusion: The alcohol-free mouthwash formulation containing essential oil from Ma-Khwaen fruits demonstrates the clinical efficacy on dental biofilm and gingival inflammation reduction but has little effect on S.mutans control. Ma-Khwaen mouthwash seems to be possible alternative to CHX mouthwash as part of the daily oral hygiene of patients with gingivitis.
Article Details
References
Figuero E, Nobrega DF, Garcıa-Gargallo M, Tenuta Livia MA, Herrera D, Carvalho JC. Mechanical and chemical plaque control in the simultaneous management of gingivitis and caries: a systematic review. J Clin Periodontol 2017; 44: S116-34.
Chapple Iain LC, Van der Weijden FA, Doerfer C, Herrera D, Shapira L, Polak D, et.al. Primary prevention of periodontitis: managing gingivitis. J Clin Periodontol 2015; 42: S71-6.
Van der Weijden FA, Van der Sluijs E, Ciancio SG, Slot DE. Can Chemical Mouthwash Agents Achieve Plaque/ Gingivitis Control? Dent Clin North Am 2015; 59: 799-829.
Cai H, Chen J, Nirmala K, Perera P, Liang X. Effects of Herbal Mouthwashes on Plaque and Inflammation Control for Patients with Gingivitis: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Evi Compl Alt Med 2020, Article ID 2829854.
James P, Worthington HV, Parnell C, Harding M, Lamont T, Cheung A, et al. Chlorhexidine mouthrinse as an adjunctive treatment for gingival health. Cochrane Database of Syst Rev 2017; 3: Art. No.: CD008676.
Chen Y, Wong RW, McGrath C, Hagg U, Seneviratne CJ. Natural compounds containing mouthrinses in the management of dental plaque and gingivitis: a systematic review. Clin Oral Investig 2014; 18: 1-16.
Carson CF, Riley TV. Antimicrobial activity of the major components of the essential oil of Melaleuca alternifolia. J Appl Bacteriol 1995; 78: 264-9.
Pavoni L, Perinelli DR, Bonacucina G, Cespi M, Palmieri GF. An Overview of Micro- and Nano emulsions as Vehicles for Essential Oils: Formulation, Preparation and Stability. Nanomaterials 2020; 10: 135.
Charles CH, Mostler KM, Bartels LL, Mankodi SM. Comparative antiplaque and antigingivitis effectiveness of a chlorhexidine and an essential oil mouthrinse: 6-month clinical trial. J Clin Periodontol 2004; 31: 878-84.
Charoenying P, Teerarak M, Lao Sinwattana C. An Allelopathic substance isolated from Zanthoxylum limonella Alston fruit. Sci Hortic 2010; 125: 411-6.
Tangjitjaroenkun J, Chavasiri W, Thunyaharn S, Yompakdee C. Bactericidal effects and time–kill studies of the essential oil from the fruits of Zanthoxylum limonella on multi-drug resistant bacteria. J Essent Oil Res 2012; 24: 363-70.
Supabphol R, Tangjitjareonkun J. Chemical Constituents and Biological Activities of Zanthoxylum limonella (Rutaceae). Trop J Pharm Res 2014; 13: 2119-30.
Charoensup R, Duangyod T, Phuneerub P, Singharachai C. Pharmacognostic specification of Zanthoxylum limonella (Dennst.) Alston: Fruits and seeds in Thailand. J Adv Pharm Technol Res 2016; 7: 134–8.
Valente J, Zuzarte M, Gonçalves MJ, Lopes MC, Cavaleiro C, Salgueiro L, et al. Antifungal, antioxidant and anti-inflammatory activities of Oenanthe crocata L.essential oil. Food Chem Toxicol 2013; 62: 349-54.
Arunkumar R, Nair SA, KB and Subramoniam A. The Essential oil constituents of Zornia diphylla (L.) Pers, and anti-inflammatory and antimicrobial activities of the oil. Rec Nat Prod 2014; 8: 385-93.
Quintas V, Prada-Lopez I, Carreira MJ, Suarez-Quintanilla D, Balsa-Castro C, Tomas I. In Situ Antibacterial Activity of Essential Oils with and without Alcohol on Oral Biofilm: A Randomized Clinical Trial. Front Microbiol 2017; 8: 2162:1-16.
Penugonda B, Settembrini L, Scherer W, Hittelman E, Strassler H. Alcohol-containing mouthwashes: effect on composite hardness. J Clin Dent 1994; 5: 60-2.
Yapong B, Tunnukit S, Jitpukdeebodintra S. Efficiency of Mitis salivarius bacitracin agar stored for 4 weeks for isolation of mutans streptococci from human saliva. CU Dent J 2015; 38: 177- 84.
Loe H, Silness J. Periodontal disease in pregnancy I. Prevalence and severity. Acta Odontol Scand 1963; 21: 533-51.
O’Leary TJ, Drake RB, Naylor JE. The plaque control record. J Periodontol 1972; 43: 38.
Glisic SB, Milojevic S, Dimitrijevic SI, Orlovic AM, Skala DU. Antimicrobial activity of the essential oil and different fractions of Juniperus communis L. and a comparison with some commercial antibiotics. J Serbian Chem Soc 2007; 72: 311-20.
Hart PH, Brand C, Carson CF, Riley TV, Prager RH, Finlay-Jones JJ. Terpinen-4-ol, the main component of the essential oil of Melaleuca alternifolia (tea tree oil), suppresses inflammatory mediator production by activated human monocytes. Inflamm Res 2000; 49: 619-26.
Brand C, Ferrante A, Prager RH, Riley TV, Carson CF, Finlay-Jones JJ, et al. The water-soluble components of the essential oil of Melaleuca alternifolia (tea tree oil) suppress the production of superoxide by human monocytes, but not neutrophils, activated in vitro. Inflamm Res 2001; 50: 213-19.
Park BI, Kim BS, Kim KJ, You YO. Sabinene suppresses growth, biofilm formation, and adhesion of Streptococcus mutans by inhibiting cariogenic virulence factors. J Oral Microbiol 2019; 11: 1632101
Ustrell-Borràs M, Traboulsi-Garet B, Gay-Escoda C. Alcohol-based mouthwash as a risk factor of oral cancer: A systematic review. Med Oral Patol Oral Cir Bucal 2020; 25: e1-12.