Complex Phytoadaptogen Application Aids in Prevention of Chronic Periodontitis

by | Jun 22, 2022 | 2021, Botanicals, Oral Health

Written by Taylor Woosley, Staff Writer. Findings of the 28-day study show that treatment consisting of non-surgical periodontal treatment with the use of complex phytoadaptogens (70% alcoholic extract of G. glabra and 40% alcoholic extracts of R. rosea and A. senticosus in a 2:1:1 ratio) effectively relieves inflammation related to chronic periodontitis.

dentist - oral healthPeriodontal disease (PD) is characterized by inflammation of tissues surrounding and supporting the teeth and is currently considered the sixth most prevalent disease in humans 1. Patients with periodontitis show gingival inflammation and worsening clinical parameters such as bleeding on probing, gingival recession with root exposure, or even tooth loss 2. Development of this disease has many different contributing factors such as poor oral hygiene, smoking, gene susceptibility, anemia, and bacterial plaque 3. Recent evidence has indicated that periodontitis is epidemiologically associated with systemic disorders such as atherosclerosis, rheumatoid arthritis, and diabetes mellitus 4.

Herbal formulations are one method of treatment for periodontitis. Complex phytoadaptogens are a class of herbal medicine used to reduce the negative impact of chronic stress on the body 5. One herb which is commonly used for periodontitis is glycyrrhizin glabra, also known as licorice, which has been proven to prevent ROS production in neutrophils, reducing the inflammatory response experienced with PD 6. Rhodiola rosea is another herb which has gained attention due to salidroside, an extracted compound found in R. rosea studied for its ability to inhibit biofilm production 7. In addition, acanthopanax senticosus is a medicinal plant studied for its role as an immunomodulator with potent anti-inflammatory properties 8.

Dzampaeva et al. conducted a randomized controlled clinical trial to examine the use of complex phytoadaptogens (CFA) as an adjunct to non-surgical periodontal treatment (NSPT) and its potential ability to effectively treat chronic periodontitis (CP) with long-term remission. Systemically healthy subjects (n=40) with chronic generalized periodontitis were assigned to two groups with an additional control group:

Group 1Control – 20 patients with healthy periodontium (21.8 ± 1.6 years)
Group 2NSPT treatment – 20 patients who received NSPT (38.6 ± 2.5 years)
Group 3CFA + NSPT treatment – 20 patients who received NSPT + 28-day treatment with CFA) (39.6 ± 3.4 years)

The complex phytoadaptogen blend used consisted of 70% alcoholic extract of G. glabra and 40% alcoholic extracts of R. rosea and A. senticosus in a 2:1:1 ratio. Control examinations were performed at baseline, after treatment, and 6 months after treatment. After NSPT, subjects completed a Östberg’s questionnaire to determine the chronotype for the selection of CFA treatment. CFA treatment was conducted during periods of exacerbation of CP over the course of 28 days, with CFA dosages consisting of 45 drops in the morning before 10:00 o’clock for morning chronotype; 20 drops three times a day for mixed chronotype; 30 drops at 14:00 o’clock and 20 drops at 19:00 o’clock for evening chronotype. Primary outcome measures included the Simplified Oral Hygiene Index (OHI-S); Sulcus Bleeding Index (SBI); Periodontal Index (PI). Secondary outcome measures were systolic (S), diastolic (D), mean (M) blood flow velocity, pulsatility index (Gosling index), RI-resistivity index (Pourcelot index), SD-Stewart index. Statistical analysis was conducted using the Statistica 10.0 software and comparison between group was performed using the Kruskal-Wallis test.

After completion of the study and data processing of the Östberg’s questionnaires and mode of CFA application, the significant findings are as follows:

  • For group 3, significant changes were noted in the Simplified Oral Hygiene Index (OHI-S); Sulcus Bleeding Index (SBI); and Periodontal Index (PI), clinically proving the preventative effect of CFA during follow-up for 6 months.
  • For group 3, after 28-day CFA treatment, systolic (S) (P = 0.005), diastolic (D) (P = 0.01), and mean (M) (P = 0.009) blood flow velocities increased relative to baseline.
  • For group 2, a reduction in systolic, diastolic, and mean blood flow velocities in comparison with the control group was noted.

Results of the study confirm the use of non-surgical periodontal treatment with CFA as an effective way to manage inflammation related to chronic periodontitis. Comparison of results from group 2 and group 3 further confirm the efficacy of NSPT with CFA, with group 3 results showing to be significantly closer to the control values compared to group 2. Study limitations include the small sample size and the inability to confirm complete adherence to the treatment. Future research should continue to examine the therapeutic use of herbal remedies to combat inflammation and tooth degradation experienced with chronic periodontitis.

Source: Dzampaeva, Zhanna Valerevna, Fatima Sergeevna Datieva, Zaira Savelevna Esenova, and Elena Astanovna Takoeva. “Efficacy of complex phytoadaptogens as an adjunct to non-surgical treatment of chronic periodontitis: A randomized clinical trial.” Journal of International Society of Preventive & Community Dentistry 11, no. 3 (2021): 348.

© 2021 Journal of International Society of Preventive and Community Dentistry | Published by Wolters Kluwer ‑ Medknow

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Posted June 22, 2022.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

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