The effect of pomegranate mouthrinse on Streptococcus mutans count and salivary pH: An in vivo study

Characterization, Antimicrobial Activity, and Antioxidant Efficacy of a Pomegranate Peel Solution Against Persistent Root Canal Pathogens

BACKGROUND

The limitations of dental irrigation solutions reinforce the need to explore novel bioactive compounds that are safer and biodegradable. This study aimed to prepare a 10% pomegranate peel solution (Punica granatum extract - PGE) and evaluate its antimicrobial and antioxidant effects for root canal treatment.

METHODS

Lyophilized extracts (1g/10 mL) from pomegranate peels were prepared, and the punicalagin content was assessed by ultra-performance liquid chromatography using pure punicalagin (standard). The antimicrobial activity was tested against common persistent root canal pathogens by the agar diffusion method, minimum inhibitory concentration (MIC), and minimum bactericidal/fungicide concentration (MCB/MFC). The antioxidant activity (%AA) was assessed by the DPPH radical scavenging method. Data were analyzed by ANOVA and Tukey's test (α = 0.05).

RESULTS

The total phenolic content of the PGEextract was 6.55 µg/mL. Differences were found among the inhibition zone of PGE (23.32 ± 3.65), 1% NaOCl (30.76 ± 4.73), and 50% ethanol (without inhibition) (p < 0.05). The MIC values of PGE ranged between 6.25 and 75 mg/ml, and PGE was effective against the tested pathogens. PGE had antioxidant potential (IC50 = 3.52 µg/mL); however, the mean values were inferior to that of the quercetin (positive control) (IC50 = 0.95 µg/mL). The DPPH scavenging effect (%AA) of PGE (70.98 ± 2.3) had no difference from the positive control (72.94 ± 2.1) (p = 0.253).

CONCLUSION

The PGE extract was successfully biosynthesized and exhibited antimicrobial and antioxidant activity, suggesting its potential use as an adjuvant therapy during root canal treatment.

Nutritional importance and industrial uses of pomegranate peel: A critical review

Pomegranate (Punica granatum L.), commonly known as a seeded or granular apple, is a delectable fruit eaten worldwide. Pomegranate is one of the healthiest fruits, with a high concentration of phenolic compounds. Large quantities of byproducts, such as seeds and peels, are produced during the pomegranate juice extraction process, which causes disposal problems and environmental contamination. Pomegranate peel (PoP), which accounts for around 30%-40% of the fruit component, is a byproduct of the fruit juice manufacturing industry. PoP is a rich source of polyphenols including phenolic acids, tannins, and flavonoids, especially anthocyanin. These peels offer several functional and nutraceutical qualities owing to their bioactive ingredients, including lowering blood pressure, reducing oxidative stress, lowering cholesterol levels, and restoring heart health. PoPs have a variety of biological effects, including the ability to resist pathogenic microbes effectively, and used as an additive in various food applications. The current review focuses on the PoP's nutritional and practical attributes, as well as their functions as food additives and functional food preparations.

The Antimicrobial Effect of Pomegranate Peel Extract versus Chlorhexidine in High Caries Risk Individuals Using Quantitative Real-Time Polymerase Chain Reaction: A Randomized Triple-Blind Controlled Clinical Trial

The aim of the present study was to compare the antibacterial effectiveness of chlorhexidine and PPE oral rinse on S. mutans, Lactobacilli, and Veillonella, in clinical salivary samples of patients with advanced stages of dental caries at baseline and two and four weeks with PCR technique. This triple-blind randomized clinical trial involved 60 high caries risk adult patients, 19–59 years of age, randomly allocated into two groups of 30 subjects each. The intervention group received pomegranate peel extract mouthwash, whereas the control group received chlorhexidine mouthwash. Unstimulated pooled saliva was collected from the floor of the mouth before and after the intervention. The quantitative real-time polymerase chain reaction was employed to analyze the bacterial copies of each salivary sample at baseline and two and four weeks. The significance level was fixed at 5% (α = 0.05). Overall comparison of antimicrobial effectiveness across both groups revealed insignificant outcomes. The control group evinced a significant reduction in S. mutans between a specific time, i.e., baseline and 4 weeks (p=0.043). PPE oral rinse as a natural product or ecological alternative was effective in disrupting activity across all microorganisms tested in this triple-blind RCT; however, the nutraceutical, when compared to chlorhexidine, was not as effective against S. mutans.

Effect of Punica granatum on the virulence factors of cariogenic bacteria Streptococcus mutans

Dental caries is caused by acids produced by biofilm-forming Streptococcus mutans from fermentable carbohydrates and bacterial byproducts. Control of these bacteria is important in the prevention of dental caries. This study investigated the effect of the fruit peel of Punica granatum on biofilm formation, acid and extracellular polysaccharides production (EPS) by S. mutans. Pomegranate fruit peels crude extracts were prepared. The Minimum bactericidal concentrations (MBC) were determined against S. mutans. At 3 sub-bactericidal concentrations, the effect on the acid production, biofilm formation and EPS production was determined. The results were analysed using Kruskal-Wallis and Wilcoxon Rank Sum Tests. The lowest MBC was 6.25 mg/mL. Punica granatum significantly inhibited acid production (p < 0.01). After 6 and 24 h, it significantly reduced biofilm-formation by 91% and 65% respectively (p < 0.01). The plant extract did not inhibit the production of soluble EPS in either the biofilm or the planktonic growth. However, it significantly reduced the insoluble EPS in the biofilm and the plantktonic (p = < 0.01) form of S. mutans. The crude extract of P. granatum killed cariogenic S. mutans at high concentrations. At sub-bactericidal concentrations, it reduced biofilm formation, acid and EPS production. This suggests that P. granatum extract has the potential to prevent dental caries.