DOI QR코드

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A randomized clinical trial to evaluate and compare the efficacy of triphala mouthwash with 0.2% chlorhexidine in hospitalized patients with periodontal diseases

  • Naiktari, Ritam S. (Department of Periodontology, Tatyasaheb Kore Dental College & Research Centre) ;
  • Gaonkar, Pratima (Department of Periodontology, Tatyasaheb Kore Dental College & Research Centre) ;
  • Gurav, Abhijit N. (Department of Periodontology, Tatyasaheb Kore Dental College & Research Centre) ;
  • Khiste, Sujeet V. (Department of Periodontology, Tatyasaheb Kore Dental College & Research Centre)
  • 투고 : 2014.03.24
  • 심사 : 2014.05.01
  • 발행 : 2014.06.30

초록

Purpose: Triphala is a combination of three medicinal plants, extensively used in Ayurveda since ancient times. Triphala mouthwash is used in the treatment of periodontal diseases because of its antimicrobial and antioxidant properties. The aim of this study is to compare the efficacy of triphala mouthwash with 0.2% chlorhexidine in hospitalized periodontal disease patients. Methods: In this double-blind, randomized, multicenter clinical trial, 120 patients were equally divided into three groups. Patients in group A were advised to rinse their mouths with 10 mL of distilled water, group B with 0.2% chlorhexidine, and group C with triphala mouthwash for 1 minute twice daily for two weeks. The plaque index (PI) and the gingival index (GI) were recorded on the first and the fifteenth day. Results: There was no significant difference when the efficacy of triphala was compared with 0.2% chlorhexidine in hospitalized patients with periodontal disease. However, a statistically significant difference was observed in PI and GI when both group B and group C were compared with group A and also within groups B and C, after 15 days (P<0.05). Conclusions: The triphala mouthwash (herbal) is an effective antiplaque agent like 0.2% chlorhexidine. It is significantly useful in reducing plaque accumulation and gingival inflammation, thereby controlling periodontal diseases in every patient. It is also cost effective, easily available, and well tolerable with no reported side effects.

키워드

참고문헌

  1. Haffajee AD, Socransky SS. Microbial etiological agents of destructive periodontal diseases. Periodontol 2000 1994;5:78-111. https://doi.org/10.1111/j.1600-0757.1994.tb00020.x
  2. Axelsson P. Mechanical plaque control. In: Lang N, Karring T, editors. Proceedings of the 1st European workshop on periodontics, 1993. London: Quitessence; 1994. p.219-43.
  3. Eley BM. Antibacterial agents in the control of supragingival plaque: a review. Br Dent J 1999;186:286-96.
  4. Nagappan N, John J. Antimicrobial efficacy of herbal and chlorhexidine mouth rinse: a systematic review. J Dent Med Sci 2012;2:5-10.
  5. Addy M, Moran JM. Evaluation of oral hygiene products: science is true; don't be misled by the facts. Periodontol 2000 1997;15: 40-51. https://doi.org/10.1111/j.1600-0757.1997.tb00103.x
  6. Asadoorian J. Oral rinsing. Can J Dent Hyg 2006;40:1-13.
  7. Loe H, Schiott CR. The effect of mouthrinses and topical application of chlorhexidine on the development of dental plaque and gingivitis in man. J Periodontal Res 1970;5:79-83. https://doi.org/10.1111/j.1600-0765.1970.tb00696.x
  8. Imfeld T. Chlorhexidine-containing chewing gum. Clinical documentation. Schweiz Monatsschr Zahnmed 2006;116:476-83.
  9. Van Leeuwen MP, Slot DE, Van der Weijden GA. Essential oils compared to chlorhexidine with respect to plaque and parameters of gingival inflammation: a systematic review. J Periodontol 2011;82:174-94. https://doi.org/10.1902/jop.2010.100266
  10. Rolla G, Loe H, Schiott CR. Retention of chlorhexidine in the human oral cavity. Arch Oral Biol 1971;16:1109-16. https://doi.org/10.1016/0003-9969(71)90215-9
  11. Adams D, Addy M. Mouthrinses. Adv Dent Res 1994;8:291-301. https://doi.org/10.1177/08959374940080022401
  12. Flotra L, Gjermo P, Rolla G, Waerhaug J. Side effects of chlorhexidine mouth washes. Scand J Dent Res 1971;79:119-25.
  13. Overholser CD Jr. Longitudinal clinical studies with antimicrobial mouthrinses. J Clin Periodontol 1988;15:517-9. https://doi.org/10.1111/j.1600-051X.1988.tb01024.x
  14. Addy M. Chlorhexidine compared with other locally delivered antimicrobials: a short review. J Clin Periodontol 1986;13:957-64. https://doi.org/10.1111/j.1600-051X.1986.tb01434.x
  15. Bose S, Sinha SK, Mukherjee G. In-vitro study of triphala on antioxidant activity. Sci Cult 2011;77:511-3.
  16. Surya Prakash DV, Sree Satya N, Avanigadda S, Vangalapati M. Pharmacological review on Terminalia chebula. Int J Res Pharm Biomed Sci 2012;3:679-83.
  17. Dar PA, Sofi G, Parray SA, Jafri MA. Halelah siyah (Terminalia chebula retz): in unani system of medicine and modern pharmacology: a review. Int J Inst Pharm Life Sci 2012;2:138-49.
  18. Vani T, Rajani M, Sarkar S, Shishoo CJ. Antioxidant properties of the Ayurvedic formulation Triphala and its constituents. Pharm Biol 1997;35:313-7. https://doi.org/10.1080/09251619708951274
  19. Padmawar A, Bhadoriya U. Phytochemical investigation and comparative evaluation of in vitro free radical scavenging activity of Triphala & Curcumin. Asian J Pharm Med Sci 2011;1:9-12.
  20. Ariyaphong W, Kanjana J, Seewaboon S. Triphala: The Thai traditional herbal formulation for cancer treatment. Songklanakarin J Sci Technol 2009;31:139-49.
  21. Malhotra R, Grover V, Kapoor A, Saxena D. Comparison of the effectiveness of a commercially available herbal mouthrinse with chlorhexidine gluconate at the clinical and patient level. J Indian Soc Periodontol 2011;15:349-52. https://doi.org/10.4103/0972-124X.92567
  22. Abraham S, Kumar MS, Sehgal PK, Nitish S, Jayakumar ND. Evaluation of the inhibitory effect of triphala on PMN-type matrix metalloproteinase (MMP-9). J Periodontol 2005;76:497-502. https://doi.org/10.1902/jop.2005.76.4.497
  23. Desai A, Anil M, Debnath S. A clinical trial to evaluate the effects of triphala as a mouthwash in comparison with chlorhexidine in chronic generalized periodontitis patient. Indian J Dent Adv 2010; 2:243-7.
  24. Thomas B, Shetty SY, Vasudeva A, Shetty V. Comparative evaluation of antimicrobial activity of triphala and commercially available toothpastes: an in-vitro study. Int J Public Health Dent 2011; 2:8-12.
  25. Biradar YS, Jagatap S, Khandelwal KR, Singhania SS. Exploring of antimicrobial activity of triphala Mashi-an Ayurvedic formulation. Evid Based Complement Alternat Med 2008;5:107-13. https://doi.org/10.1093/ecam/nem002
  26. Griffiths J, Jones V, Leeman I, Lewis D, Patel K, Wilson K. Guidelines for the development of local standards of oral health care for dependent, dysphagic, critically and terminally ill patients. Revised. [London]: British Society for Disability and Oral Health, 2000.
  27. Sumi Y, Nakamura Y, Nagaosa S, Michiwaki Y, Nagaya M. Attitudes to oral care among caregivers in Japanese nursing homes. Gerodontology 2001;18:2-6. https://doi.org/10.1111/j.1741-2358.2001.00002.x
  28. Leyes Borrajo JL, Garcia VL, Lopez CG, Rodriguez-Nunez I, Garcia FM, Gallas TM. Efficacy of chlorhexidine mouthrinses with and without alcohol: a clinical study. J Periodontol 2002;73:317-21. https://doi.org/10.1902/jop.2002.73.3.317
  29. Santos A. Evidence-based control of plaque and gingivitis. J Clin Periodontol 2003;30 Suppl 5:13-6. https://doi.org/10.1034/j.1600-051X.30.s5.5.x
  30. Gupta M. Therapeutic uses of the polyherbal drug triphala in geriatric diseases. Int J Pharm Bio Sci 2010;1:1-13.
  31. Maurya DK, Mittal N, Sharma KR, Nath G. Role of triphala in the management of peridontal disease. Anc Sci Life 1997;17:120-7.
  32. Bajaj N, Tandon S. The effect of triphala and chlorhexidine mouthwash on dental plaque, gingival inflammation, and microbial growth. Int J Ayurveda Res 2011;2:29-36. https://doi.org/10.4103/0974-7788.83188
  33. Narayan A, Mendon C. Comparing the effect of different mouthrinses on de novo plaque formation. J Contemp Dent Pract 2012; 13:460-3.
  34. Jagadish L, Anand Kumar VK, Kaviyarasan V. Effect of triphala on dental bio-film. Indian J Sci Technol 2009;2:30-3.
  35. Tandon S, Gupta K, Rao S, Malagi KJ. Effect of triphala mouthwash on the caries status. Int J Ayurveda Res 2010;1:93-9. https://doi.org/10.4103/0974-7788.64413
  36. Axelsson P, Lindhe J. Efficacy of mouthrinses in inhibiting dental plaque and gingivitis in man. J Clin Periodontol 1987;14:205-12. https://doi.org/10.1111/j.1600-051X.1987.tb00968.x

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