Assessment of clinical efficacy of locally delivered 0.2% Thymoquinone gel in the treatment of periodontitis

Histological Assessment of the Anti-Inflammatory Effectiveness of Peperomia pellucida Extract Administered to the Gingival Sulcus in Rats Induced with Periodontitis

This study aims to assess the impact of Peperomia pellucida extract on periodontitis in rats, using the Papillary Bleeding Index (PBI), gingival index (GI), and histological evaluation of key inflammatory cells such as osteoclasts, osteoblasts, polymorphonuclear neutrophils (PMNs), macrophages, and fibroblasts to explore its potential in reducing inflammation and preserving periodontal tissue.The extract was prepared using the reflux method with 96% ethanol as a solvent, followed by phytochemical screening and antibacterial testing via the disk diffusion method. This in vivo study utilized a posttest control group experiment with 24 Wistar rats, divided into four groups: nonperiodontitis, no-treatment, chlorhexidine-treated (CHX), and extract-treated groups, with the latter three groups induced with periodontitis. Induction was performed using a 0.3-mm ligature wire and plaque from periodontitis patients, along with nicotine administration (0.001 mg/L) for 7 days. The extract group received a topical application of 2.5 µL of P. pellucida leaf extract, while the CHX group was administered 0.05 mL of CHX daily for 1 week. Observations of GI and PBI were made on days 0, 3, 5, and 7. Histological changes were assessed on day 7 by evaluating the cell counts of osteoclasts, osteoblasts, fibroblasts, macrophages, and PMNs.Data were analyzed using one-way analysis of variance and Kruskal-Wallis with Mann-Whitney post hoc tests for pairwise comparisons.Phytochemical analysis confirmed the presence of alkaloids, polyphenols, tannins, flavonoids, quinones, monoterpenoids, and sesquiterpenoids in P. pellucida extract. The extract demonstrated antibacterial activity against Porphyromonas gingivalis, a key pathogen in periodontitis. Clinical and histological assessments showed significant improvements in the extract-treated group, with outcomes comparable to the CHX-treated group after 7 days.Based on these findings, P. pellucida (L.) Kunth extract contains phytochemicals and exhibits antibacterial and anti-inflammatory properties, as demonstrated by clinical and histological parameters in rats induced with periodontitis.

An Assessment of the Clinical Efficacy of a Topical Application of 5% Thymoquinone Gel for Plaque-Induced Gingivitis Patients: A Randomized Controlled Clinical Trial

BACKGROUND

Gingival diseases, encompassing a spectrum of oral health concerns, represent a prevalent issue within the global population. Despite their widespread occurrence, the research landscape concerning effective interventions, particularly those rooted in herbal products, remains somewhat limited. Addressing this knowledge gap, the current study undertook a comprehensive evaluation aimed at assessing the clinical efficacy of a novel intervention: a 5% thymoquinone (TQ) gel. This investigation specifically focused on the application of TQ gel as an adjunctive measure to the standard protocol of scaling (SC) in individuals afflicted with plaque-induced gingivitis. Through rigorous examination and analysis, this study seeks to provide valuable insights into the potential utility and therapeutic benefits of this herbal-based intervention in managing gingival diseases.

OBJECTIVE

To evaluate the efficacy of 5% TQ gel using a novel liposome drug delivery as a topical application following SC in gingivitis patients.

METHODS

A double-blinded, parallel, randomized controlled clinical trial. The study was performed at the Faculty of Dentistry, King Abdulaziz University, and Qassim University, Saudi Arabia. This trial enrolled 63 participants in an age group between 18 and 40 years attending the outpatient clinics of the Faculty of Dentistry, Qassim University, Saudi Arabia, and a clinical diagnosis of gingivitis was made. The enrolled subjects were categorized into three groups: Group I-TQ gel with SC, Group II-Placebo with SC, and Group III-SC alone, and clinical outcomes were measured at baseline and two-week follow-up visits. Plaque index (PI), papillary bleeding index (PBI), and any adverse events with TQ gel are categorized as mild, moderate, and severe. 63 patients. Group I (n = 21); Group II (n = 21); Group III (n = 21).

RESULTS

The paired t-test compared the mean differences in PI and PBI at two time points and it was observed that there were significant differences in Group I with p-values of 0.04 and 0.05, respectively. A one-way ANOVA test was performed and it showed significant differences in the mean scores between the three groups for PI (p-value-0.01) and PBI (p-value-0.05). The post hoc Tukey's test compared the mean differences in PI and PBI between the groups and the results were in favor of Group I which used TQ gel with SC.

CONCLUSIONS

The clinical trial concluded that the plaque and gingival bleeding scores were significantly reduced in the group of patients who intervened with TQ gel following SC when compared to SC-alone and placebo groups. Also, there were significant reductions in the scores from the baseline to the two-week follow-up visit in patients treated with TQ gel and SC.

Insights into the antioxidant, anti-inflammatory and anti-microbial potential of Nigella sativa essential oil against oral pathogens

Oral disorders can exert systemic ramifications beyond their localized effects on dental tissues, implicating a wide array of physiological conditions. The utilization of essential oils (EOs) for protection of oral health represents a longstanding practice. Consequently, in this investigation, essential oil derived from Nigella sativa seeds (NSEO) underwent isolation via the hydro-distillation process, followed by a comprehensive evaluation of its antioxidant, anti-inflammatory, anti-fungal, antibacterial activities, and cytocompatibility. The isolated NSEO manifested as a pale-yellow substance and was found to harbor a diverse spectrum of bioactive constituents, including steroids, triterpenoids, flavonoids, phenols, proteins, alkaloids, tannin, sesquiterpenoid hydrocarbons, monoterpenoid alcohol, and monoterpenoid ketone (thymoquinone). Notably, the total phenolic content (TPC) and total flavonoid content (TFC) of NSEO were quantified at 641.23 μg GAE/gm and 442.25 μg QE/g, respectively. Furthermore, NSEO exhibited concentration-dependent inhibition of protein denaturation, HRBC membrane stabilization, and hemolysis inhibition. Comparative analysis revealed that NSEO and chlorhexidine (CHX) 0.2% displayed substantial inhibition of hemolysis compared to aspirin. While NSEO and CHX 0.2% demonstrated analogous antibacterial activity against Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa, NSEO showcased heightened efficacy against Lactobacillus acidophilus and Candida albicans. Additionally, NSEO exhibited pronounced effects against periodontal pathogens such as Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, and Prevotella intermedia. Importantly, no cytotoxicity was observed on human gingival fibroblast cell lines. These findings underscore the potential of NSEO as a potent antibacterial and antifungal agent in the management of oral microbial pathogens, thereby offering avenues for the development of innovative therapies targeting diverse oral inflammatory conditions. Nevertheless, further investigations are imperative to unlock its full therapeutic repertoire.

Syringeable atorvastatin loaded eugenol enriched PEGylated cubosomes in-situ gel for the intra-pocket treatment of periodontitis: statistical optimization and clinical assessment

Atorvastatin calcium (ATV) is a well-known anti-hyperlipidemic drug currently being recognized for possessing an anti-inflammatory effect. Introducing it as a novel remedy for periodontitis treatment necessitates developing a syringeable modified delivery system capable of targeting inflammation within the periodontal pockets. Thus, a 33 Box-Behnken design was used to generate eugenol enriched PEGylated cubosomes. Based on the desirability function, the optimized formulation (OEEPC) was selected exhibiting a solubilization efficiency (SE%) of 97.71 ± 0.49%, particle size (PS) of 135.20 ± 1.11 nm, polydispersity index (PDI) of 0.09 ± 0.006, zeta potential (ZP) of -28.30 ± 1.84 mV and showing a sustained drug release over 12 h. It displayed a cubic structure under the transmission electron microscope, furthermore, it was stable upon storage for up to 30 days. Hence, it was loaded into an optimum syringeable in-situ gel (ISG) which displayed the desired periodontal gelation temperature (34 ± 0.70 °C) and an adequate gelation time (46 ± 2.82 sec), it also released approximately 75% of the drug within 72 h. Clinical evaluation of the ISG showed a promising percentage reduction of about 58.33% in probing depth, 90% in the bleeding index, 81.81% in the plaque index, and 70.21% in gingival levels of transforming growth factor-β1. This proved that the formulated syringeable intra-pocket delivery system of ATV is an efficient candidate for diminishing inflammation in periodontitis.

Clinical Efficacy of a Novel Lipid-based Thymoquinone Gel: A Two-arm, Single-blinded, and Randomized Study

Objective:

To evaluate the clinical efficacy of topical 0.1% lipid-based Thymoquinone (TQ) gel, as an antiplaque and antigingivitis agent.

Materials and Methods:

A randomized clinical trial was carried out in the Outpatient Department of Pediatric and Preventive Dentistry, Dr. Z.A. Dental College, India with a purposive sample of 60 healthy children of 12–18 years of age, having a gingival and plaque index ≥1; the children were divided into two groups by simple randomization. Group A (30 subjects) was advised to apply peanut amount of Chlorhexidine (CHX) gel, twice a day for 2min. Group B (30 subjects) was advised the same but with a peanut amount of 0.1% lipid-based TQ gel. The clinical parameters were the recording of plaque and gingival indices, prior to the treatment (baseline) and at the 14th and 28th day, respectively (post-treatment). The total duration of the study was 28 days with follow-up.

Results:

Data analysis was done by employing IBM Statistical Package for Social Sciences Windows software, version 20 (IBM Corp, Armonk, NY, USA). The 0.1% lipid-based TQ gel had a statistically significant reduction (P < 0.001) in plaque index as compared with CHX gel during the 0–14th day and 0–28th day, respectively. Similarly, 0.1% lipid-based TQ gel showed a statistically significant reduction in gingival index (P = 0.005) during the 0–14th day and a statistically significant reduction during the 0–28th day (P < 0.001), as compared with CHX gel.

Conclusions:

Statistically significant reduction in plaque (P < 0.001) and gingival index (P < 0.001) with the usage of 0.1% lipid-based TQ gel.

Nigella sativa and Thymoquinone: A Natural Blessing for Periodontal Therapy

Thymoquinone (TQ), the chief active constituent of Nigella sativa (NS), shows very valuable biomedical properties such as antioxidant, antimicrobial, anticancer, anti-inflammatory, antihypertensive, hypoglycemic, antiparasitic and anti-asthmatic effects. Several studies have examined the pharmacological actions of TQ in the treatment of oral diseases but its potential role in periodontal therapy and regeneration is not yet fully defined. The present investigation has been designed to review the scientific studies about the effects of TQ as an adjunct to periodontal treatment to promote healing and periodontal regeneration. Along with clinical experiments, in vitro studies exhibit the beneficial effects of TQ during periodontal therapy. Nevertheless, additional comprehensive clinical and preclinical studies at cellular and molecular levels are essential to examine the particular action mechanisms of Nigella sativa and its elements, particularly TQ, during periodontal treatment or regeneration.

An examination of carbopol hydrogel/organogel bigels of thymoquinone prepared by microwave irradiation method

Nigella sativa L. is shown wide spread over the world and contains many useful phytochemicals. Much of the biological activity of the seeds has been shown due to the presence of thymoquinone (TQ). Its poor aqueous solubility of TQ hinders its delivery to target site. The aim of this work was to prepare TQ bigels composed of Carbopol 974 P NF (C974) in PEG 400 (organogel) or C974 in water (hydrogel) with microwave heating method. A novel technique, high speed homogenization followed by microwave heating, was used to prepare organogels. The pH, electrical conductivity, differential scanning calorimetry, rheological properties, and morphological structure of the formulations have been evaluated, and the effect of microwave on drug content and TQ antioxidant activity has been investigated. The bigels of TQ were successfully produced via high-speed homogenization followed by microwave-assisted heating for the first time in this study. Highly lipophilic TQ was successfully dissolved in organogel, and it was not affected from the microwaves. It can be stated that microwave heating is a promising method to obtain C974 organogels and thus bigels with appropriate above indicated investigated physicochemical characteristics. The time and energy consumption could be decreased with microwave-assisted heating, especially for gel preparation in the field of pharmaceuticals.

Effect of thymoquinone on Fusobacterium nucleatum‑associated biofilm and inflammation

Periodontitis affects oral tissues and induces systemic inflammation, which increases the risk of cardiovascular disease and metabolic syndrome. Subgingival plaque accumulation is a trigger of periodontitis. Fusobacterium nucleatum (FN) contributes to subgingival biofilm complexity by intercalating with early and late bacterial colonizers on tooth surfaces. In addition, inflammatory responses to FN are associated with the progression of periodontitis. Nigella sativa Lin. seed, which is known as black cumin (BC), has been used as a herbal medicine to treat ailments such as asthma and infectious diseases. The current study examined the inhibitory effect of BC oil and its active constituents, thymol (TM) and thymoquinone (TQ), on FN-associated biofilm and inflammation. FN-containing biofilms were prepared by co-cultivation with an early dental colonizer, Actinomyces naeslundii (AN). The stability and biomass of FN/AN dual species biofilms were significantly higher compared with FN alone. This effect was retained even with prefixed cells, indicating that FN/AN co-aggregation is mediated by physicochemical interactions with cell surface molecules. FN/AN biofilm formation was significantly inhibited by 0.1% TM or TQ. Confocal laser scanning microscopy indicated that treatment of preformed FN/AN biofilm with 0.01% of BC, TM or TQ significantly reduced biofilm thickness, and TQ demonstrated a cleansing effect equivalent to that of isopropyl methylphenol. TQ dose-dependently suppressed TNF-α production from a human monocytic cell line, THP-1 exposed to FN, yet showed no toxicity to THP-1 cells. These results indicated that oral hygiene care using TQ could reduce FN-associated biofilm and inflammation in gingival tissue.