Aims: To compare the anti-plaque and anti-inflammatory effects of new mouth rinse (nut meg) to the conventional chlorhexidine anti-inflammatory and anti-plaque effects (in vivo study). Materials and Methods: Sixteen dental students in the final year participated in this study (2 females and 14 males) aged 22-23 years (mean 22.5 years). A double blind study was carried out by measuring plaque index, modified gingival index and bleeding index pre-treatment and post-treatment with the two mouth rinses (nut meg and chlorhexidine). The same volunteers were participated in the two test periods and each period lasted 5 days with a wash out twice daily. Deterioration rate for each parameter was de- rived and used ass a unit of analysis. Results: The new mouth rinse (nut meg extract) had a significant anti-plaque and anti-inflammatory effects (measured by reduction in bleeding index), which was near- ly equivalent to the anti-plaque and anti-inflammatory effects of chlorhexidine. No significant differ- ence was noticed between post-treatment group (p > 0.05) of the two mouth rinses regarding plaque and bleeding indices. Conclusion: The nut meg extract mouth rinse had anti-inflammatory effect which encourage its use in dentistry as a new mouth rinse for the treatment of gingivitis.
Key Words: Nut meg, herbal extract, anti-inflammatory effect.
Al-Saffar MT, Al-Talib RA, Taqa GA, Taqa AA. The Effect of New Formula (Nut Meg Extract) As A Mouth Wash Compared With Chlorhexidine Mouth Wash. Al-Rafidain Dent J. 2008; 8(2):189-196
Received: 15/8 /2007 Sent to Referees: 15/8 /2007 Accepted for Publication: 20/10 /2007
Dental plaque, which is the soft de- posits that forms as a biofilm adhering to the tooth surface or other hard surfaces,(1 ) induces an inflammatory response in asso- ciated gingival tissues.(2 ) Therefore, if den- tal plaque formation can be minimized, gingivitis could be controlled and possibly eliminated.(3 )
The maintenance of proper standards of plaque control over time by mechanical means (tooth brushing and flossing) is ex- tremely difficult and time-consuming.(4 ) Therefore, anti-microbial agents have been incorporated into mouth rinses for use as adjunct to traditional cleaning pro- cedure.(5 )
The plaque inhibiting effect of chlor- hexidine is well documented since its in- troduction as a chemical anti-plaque agent in 1970. When used twice daily as a mouth rinse, it almost inhibits plaque growth.(6 ) But chlorhexidine has some unpleasant side effects restricting its general use such as its bitter taste, staining of teeth and sometimes sloughing of the oral mucosa.(7 )
In order to overcome such side ef- fects, the World Health Organization (WHO) started to advise researches to in- vestigate the possible use of natural sources such as herbal extract.(3 )
Nut meg (Myristica fragrans), whose seed is widely used as a spice to flavour many kinds of food,(8 ) in alternative medi- cine has reported to have anti-fungal and anti-inflammatory properties mainly due Al-Rafidain Dent J Vol. 8,No.2, 2008
Al-Saffar MT, Al-Talib RA, Taqa GA, Taqa AA.
to inhibition of prostaglandin synthesis.(9 ) It has also been reported to have anti- oxidant activities due to the presence of flavonoid which is a potent anti-oxidant against superoxide radicals.(10,11 )
Nut meg yields 5-15% of volatile oils which contain among their constituent eu- genol that inhibits lipid peroxidation and maintains activities of enzymes like super- oxide dismutase.(12 )
Myristica fragrans has anti-microbial activity by inhibiting the thromboxane synthesis.(13 ) The analgesic property of nut meg has also been reported mainly due to the active components, eugenol and iso- eugenol.(14 )
The present study aimed to compare the anti-plaque and anti-inflammatory effects of nut meg mouth rinse to a con- ventional chlorhexidine mouth rinse (in vivo study).
MATERIALS AND METHODS
1) Volunteer Selection
A total of 16 dental students (in the final year) were from College of Dentistry, University of Mosul volunteered to par- ticipate in this study (2 females and 14 males) with age ranged between 22-23 years.
The selected volunteers have at least
20 scorable teeth with good alignment and good gingival condition (no gingival en- largement or probing depths > 4 mm af- fecting more than two teeth or overt car- ies). No volunteer wore orthodontic appli- ances or removable dentures.
Volunteers with long term medica- tion, recent intake of systemic antibiotics and systemic diseases were excluded from this study. Non of the volunteers showed pathological changes of the oral mu- cosa.(15 )
The nature of the trial was explained to each volunteer verbally by the examin- ing clinician during a preparation period of
2 weeks (the pre-experimental hygiene phase of the study). The volunteers were received repeated detailed instructions in self performed plaque control to ensure optimal plaque control during this period. They were also given dental floss and in- structions on proper use of it. Oral prophy- laxis to remove all plaque, calculus and extrinsic tooth stain were done for indi-
Al-Rafidain Dent J Vol. 8,No.2, 2008
At the beginning of the experimental period, the individuals had to attain a base- line gingivitis of < 25% sites bleeding on probing. The same volunteers participated in the two test periods and each period lasted 5 days from Sunday to Thursday. Wash out period of two days was allowed between the two different experimental mouth wash periods; during it, the volun- teers were instructed to resume the previ- ous mechanical plaque control.
The volunteers were suspended all oral hygiene practices during the test peri- ods. Instead, they were asked to rinse in a randomly crossed over double blind se- quence with the following mouth washes:
The chlorhexidine digluconate 0.12% aqueous solution (positive control) with the instruction of rinsing twice daily with
10 ml volume used for one minute.
2) Preparation of Nut Meg Extract
The test solution of nut meg was pre- pared by mixing 20 gm of nut meg oil with one liter of 70% ethyl alcohol. The solu- tion was mixed until completely became soluble. The oil of nut meg material pre- pared in this study by pressing 5 KN of 100 gm of dry nut meg plant to obtain 6.2 gm of oil plant.(16 )
The duration of each rinse being one minute. At the beginning and at the end of each test period the volunteers were ex- posed to a new clinical examination in which the presence and amount of plaque was examined and scored by the use of plaque index system.(17 )
The inclusion criteria also involved gingival condition that assessed visually using modified gingival index,(18 ) record from gingiva of each tooth except the wis- dom teeth. In addition to that, gingival bleeding was assessed using National In- stitute of Dental and Craniofacial Research (NIDCR) protocol for the assessment of gingival bleeding as the facial and mesofa- cial sites of teeth in two randomly selected quadrants: One maxillary and one man- dibular were evaluated for bleeding by using periodontal probe after drying the quadrant of teeth with air. Then, started with the most posterior teeth in the quad-
Effect of nut meg mouth rinse in gingival inflammation.
rant (excluding the third molar), the probe placed into the sulcus at the facial site and carefully sweeps the probe into the mesial interproximal area.(19 )
The same dentist performed all of the examination. The chlorhexidine mouth rinses were supplied from Maleh Chemical Product (MKP) and both rinses were sup- plied in the manufacturer's bottles but the product labeling was masked with study labels.
After the test period, the volunteers were asked about their feeling of taste and other side effects of rinsing solution.
The data obtained from this study were subjected to statistical analysis in- cluding descriptive and analytical meth- ods.
For descriptive way, percentage and frequency were used, while Student's t- test was used for paired samples (intra-
group comparison) and for (inter-group) matching of the group with a 5% level of significance.
A total of 16 dental students, 2 fe- males and 14 males, aged between 22-23 years (mean 22.5 years) satisfactorily completed the study. There were no miss- ing data points (the number of teeth sur- faces included were 112 surfaces).
The average total mouth, upper and lower arches and buccal and lingual plaque indices had been recorded for both mouth rinses with average mean from 0.806-
1.132 for chlorhexidine mouth rinse group, and from 0.751-1.161 for nut meg mouth rinse group. There was no significant dif- ference between pre-treatment groups of two mouth rinses (p > 0.05) (Table 1 and Figure 1).
Table (1): Mean and standard deviation of plaque index for the whole mouth for the two mouth rinse treatment groups
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- Quote paper
- Amer Taqa (Author)Maha T. Al-Saffar (Author)Rafi' A. Al-Talib (Author)Ghada A. Taqa (Author), 2007, The Effect of New Formula (Nut Meg Extract) As A Mouth Wash Compared With Chlorhexidine Mouth Wash, Munich, GRIN Verlag, https://www.grin.com/document/208998