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Comparative evaluation of the antibacterial efficacy of P. juliflora and three commercially available mouthrinses: an in vitro study
Hari Prasad O *1, Sudheer Aluru 1, Kishore Kumar A 2, Navya A 3, Hari Krishna O 2, Bhaskar M 1, Papa Rao A 4, Ravindra Reddy N 2 1 Division of Animal Biotechnology, Department of Zoology, S.V University, Tirupati, Andhra Pradesh, India 2. Department of Periodontology, CKS Teja Dental College,Tirupati, Andhra Pradesh, India 3. Department of Applied Microbiology, SPMVV, Tirupati, Andhra Pradesh, India 4. Department of Anthropology, S.V University, Tirupati, Andhra Pradesh, India
INTRODUCTION
Periodontal diseases represent possible reservoirs of opportunistic bacteria in the oral cavity, which display important virulence properties and cause a wide range of human systemic diseases including pneumonia, septicemia, and endocarditis [1,2,3,4]. The microbiota associated with localized aggressive periodontitis is composed of gram negative, capnophilic and anaerobic bacteria [5,6,7]. Enterococcus faecalis is the most frequently isolated species from endodontic infections and associated with re-infection leads to subsequent failure of endodontically treated teeth [8,9,10]. Anaerobes too play a predominant role in most periodontal infections. Prevotella intermedia, Porphyromonas gingivalis, Fusobacterium nucleatum, Treponema denticola and Aggregatibacter actinomycetemcomitans are some of the organisms which are found in periodontal infections [5]. A modest association was also observed between periodontitis and cardiovascular disease, stroke and atherosclerosis [11]. Mouthrinses are most frequently recommended to patients whose mechanical oral hygiene procedures are inadequate for the plaque control. This study provides an additional rationale of mouthrinses in effective control of oral bacteria. The success of any mouthrinse depends on its ability in inhibiting or killing a varied number of pathogenic oral and periodontal microflora. Chlorhexidine, the most commonly used compound in various mouthrinses is a proved antimicrobial agent. This is used in combination with a variety of compounds under different brand names. But prolonged use of Chlorhexidine can cause several side effects including staining of teeth, gastro-intestinal problems, gingivitis, dry mouth and many more [12]. There are many natural ways to treat periodontal diseases. Herbal remedies like Aloe vera, Clove oil have been reported to relieve pain and discomfort when applied on gums [13]. Herbal remedies have an edge over conventional antibiotics which suffer the limitation of low benefit to high risk as compared to herbal treatment which possess high benefit to low risk ratio [14]. Prosopis juliflora , a convenient neighborhood plant has a wide range of applicability since ages as a folk medicine. Pharmacological properties under in vitro conditions shows that it has antibacterial [15,16,17,18], antifungal [19,20], hemolytic [21] anti-inflammatory [20] and wound healing activities. Antitumor activity against several human epithelial and hepatic tumor cells [20] and MDA-MB-231 breast adenocarcinoma cells [22] was also recorded. It is known from earlier literature that P.juliflora leaf extract contains flavonoids Apigenin and Quercetin which shows antibacterial activity [23]. It also used in healing bladder infections, painful gums and headaches [24,25]. The present study evaluated the in vitro antibacterial efficacy of P. juliflora leaf crude extract against three commercially available and popular mouthrinses. The selected microbes S. aureus, E. faecalis, A. actinomycetemcomitans, P. intermedia and P. gingivalis were pathogenic that predominantly involve in oral and periodontal infections causing bleeding on probing and increased pocket depth [25]. They have significant relation in Cardio Vascular Diseases (CVDs), endothelial damage and cholesterol plaque formation [26]. MATERIALS AND METHODS Preparation of Plant extract: P. juliflora leaves were selected from in and around Tirupati and Taxonomical identification of the plant was done by department of Botany, Sri Venkateswara University, Andhra Pradesh, India. Care was taken while selecting the leaves to be free from any disease. Leaf samples of 100g were surface sterilized with autoclaved distilled water, twice. These were allowed to air dry and blotted for any excess water. This was now macerated with 100ml sterile distilled water and blended for 10 minutes to obtain a homogenous mixture. Filtration of this mixture with double layered muslin cloth and subjecting it to 4000g centrifugation for 30 minutes gave a supernatant which on filtration with Whatmann No.1 filter paper gave a pure solution [27]. This served as aqueous extract of the plant and 1g/ml of the obtained extract was used as stock solution labeled D. Collection of Mouthrinses: Three commercially available mouthrinses with different chemical combinations were taken as A, B and C. Mouthrinse A was chemically composed of Chlorhexidine Gluconate (0.2% w/v), Sodium Flouride IP (0.05% w/v) and Zinc Chloride IP (0.09% w/v). Mouthrinse B had Chlorhexidine Gluconate solution IP diluted to Chlorhexidine Gluconate (0.2% w/v). Mouthrinse C contained purified water, Sorbitol, Alcohol, n-Propanol, Poloxamer 407, Benzoic Acid, Sodium Saccharin, mouthwash Flavour, Eucalyptol, Methylsalicylate, Thymol, Sodium Banzoate and Menthol. Ciprofloxacin (CF) - 5g Disc (Hi-Media laboratories, India) was used as control.
*Corresponding author.
*Dr.Hari Prasad Osuru, Department of Pathology, University of Virginia School of Medicine, MR5 Building,415 Lane Road, Charlottesville, Virginia-220908-0904, USA. Tel : +14342422024, +14342708763. E-mail:hari.osuru@gmail.com
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A B C D CF
As periodontal diseases are bacterial infections, an antibacterial treatment seems to be an apt solution in controlling the disease progression; but the most common problem with conventional treatment is systemic drug administration, which give rise to toxicity issues. So as an alternative local drug administration proves to be more beneficial. Mouthrinses, irrigating solutions, dentogels and sustained release devices are some of the local delivery systems [30]. Several studies indicated the importance of mouthrinses in keeping up the oral hygiene. Hence the importance for them has been shooting up in the modern world. The active ingredient Chlorhexidine, found in most mouthrinses effectively acts against a variety of pathogens, preventing and controlling supragingival plaque and several other complications if used as per oral hygiene regimens [31,32,33,34,35,36]. Antibiotics play a vital role in control and treatment of bacterial infections. There have been several drugs formulated and practiced till date but it is known that they produce several side effects and develop resistance towards causative organisms on prolonged use. So as an alternative natural compounds such as plant extracts are used. In the present study the leaf extract of P. juliflora was tested for its antibacterial activity and minimal quantity of 100g/ 10l leaf extract was effective enough for a wide spectrum of microbes. The microbes utilized in the study were characterized clinical isolates of most potent and commonest pathogens involved with oral and periodontal infections [37]. Staphylococcus species are not usually isolated from the oral cavity and considered transitory microbiota. P. intermedia, P. gingivalis and A. actinomycetemcomitans were considered for the study as they are common pathogens of oral and periodontal infections [38]. It is known from earlier literature that the compounds like Quercetin and Apigenin have the antibacterial activity [22,23] but no work has been conducted so far against oral and periodontal organisms. This bactericidal activity of P. juliflora may be due to the presence of Quercetin having analgesic, antiallergenic, antibacterial, antidiabetic and anti-inflammatory activity and Apigenin with antiallergenic, antibacterial, antidermatitic, anti-inflammatory and antiviral activity [23]. Majority of the commercially available mouthrinses had Chlorhexidine as an active compound in form of Chlorhexidine Gluconate 0.2% w/v but the P. juliflora crude extract had no additionally added compounds still proved its antibacterial efficacy against tested organisms. Compared to mouthrinses, it had a better effect and zone of inhibition was higher than commercial mouthrinse B containing Chlorhexidine. The compounds such as Quercetin and Apigenin with well-known antibacterial activity may consider to have played a vital role in the inhibition of these pathogens too. CONCLUSION This in vitro study states the antibacterial activity of P. juliflora against oral and periodontal pathogens tested, at the outset. It was effective than the commercially available mouthrinses without any additional compounds added to it. This gives a better opportunity for further research in the concerned subject. Further purification of the extract may increase its activity proving to be more effective. However, several clinical and pharmacological trails have to be carried out for complete analysis of the active compounds in the P. juliflora leaf aqueous extract. REFERENCES
1. 2. 3. 4. Ohman SC, Osteberg Y, Dahlen G, Landahl S. The prevalence of Staphylococcus aureus, Enterobacteriaceae species, and Candida species and their relation to oral mucosal lesions in a group of 79-year-olds in Gteborg. Acta Odontol. Scand, 1995; 53: 49-54. Younessi OJ, Walker DM, Ellis P and Dwyer DE. Fatal Staphylococcus aureus infective endocarditis. Oral. Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 1998; 85: 168-72. Dahln G and Wikstrom M. Occurrence of enteric rods, staphylococci and Candida in subgingival samples. Oral Microbiol. Immunol, 1995; 10: 42-46. Van Winkelhoff AJ, Rams TR, Slots J. Systemic antibiotic therapy in periodontics. Periodontology 2000, 1996; 10: 45-78. Newman MG and Socransky SS. Predominant cultivable microbiota in periodontosis. J Periodontal Res, 1977; 12:120. Newman MG, Socransky SS and Savitt ED. Studies of the microbiology of periodontosis. J
Figure 1 - Zones of inhibition observed for Enterococcus faecalis on Muller Hinton media for Mouthrinse A, B, C, Ciprofloxacin CF and P. juliflora extract D.
Figure 2 - Zones of inhibition observed for Aggregatibacter actinomycetemcomitanson Wilkins Chalgren Blood Agar media for Mouthrinse A, B, C, Ciprofloxacin CF and P. juliflora extract D.
Figure 3 - Zones of inhibition observed for Staphylococcus aureus grown on MullerHinton media with Coomassie Brilliant Blue for Mouthrinse A, B, C, Ciprofloxacin CF and P. juliflora extract D.
Figure 4 - Zone of inhibition observed for Prevotella intermedia grownon WilkinsChalgren Blood Agar for Mouthrinse A, B, C, Ciprofloxacin CF and P.juliflora extract D.
5. 6.
DISCUSSION
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