Clinical Effects of Subgingival Application of Salvadora persica Gel in Generalized Chronic Periodontitis

Abstract

Background: Salvadora persica (SP), or miswak, possess anti-inflammatory, antioxidant, anti-coagulant and anti-bacterial properties that may provide therapeutic benefits in the treatment of chronic periodontitis (CP). In developing countries, prevalence of CP, bacterial resistance and adverse effects of antibacterial agents, has increased over the years. The current study aimed to explore the effectiveness of a locally delivered SP gel as an adjunct to scaling and root planing (SRP) in the treatment of CP.

Methods: Sixty-six subjects with chronic periodontitis were selected and full-mouth periodontal parameters (periodontal pocket depth, recession, clinical attachment loss, plaque score and bleeding) were measured. The subjects were divided into a control group [scaling and root planning (SRP)] and an SP group [subgingival placement of Salvadora persica gel in periodontal pockets]. On 6 weeks’ follow-up, the periodontal parameters were recorded. The distributions of variables were analyzed by the Wilcoxon Signed Rank test and paired t-test. The p-value ≤ 0.05 was considered statistically significant.

Results: A reduction in periodontal pocket depth (PPD), plaque score (PS) and bleeding on probing (BOP) and clinical attachment loss (CAL) was observed within both SP and control group on 6 weeks follow-up. Comparison of changes in periodontal parameters between the groups revealed a statistically significant difference in bleeding on probing score in SP group compared to control group (p = 0.002), while there was no statistically significant difference in changes in periodontal pocket depth, gingival recession, clinical attachment loss and plaque score between both groups.

Conclusion: The SP group demonstrated improved gingival health (p=0.001), reducing bleeding score compared to the control group. However, insignificant results were observed in periodontal pocket depth, recession, clinical attachment loss and plaque score.

Keywords: Miswak; Chronic Periodontitis; Scaling and Root Planing; Periodontal Pocket; Clinical Attachment Level.