Effect of Plant-Based Mouthwash (Morinda citrifolia and Ocimum sanctum) on TNF-α, IL-α, IL-β, IL-2, and IL-6 in Gingival Crevicular Fluid and Plaque Scores of Patients Undergoing Fixed Orthodontic Treatment

Medicina (Kaunas). 2023 Nov 8;59(11):1968. doi: 10.3390/medicina59111968.

Abstract

Background and Objectives: To investigate the antiplaque properties of two plant-based mouthwashes, Morinda citrifolia (MC) and Ocimum sanctum (OS), and their effect on TNF-α, IL-α, IL-β, IL-2, and IL-6 in gingival crevicular fluid (GCF) of patients undergoing fixed orthodontic treatment. Materials and Methods: Seventy-five individuals were recruited according to defined inclusion and exclusion criteria. This study was structured into two distinct phases. Phase I was a combination of toothbrushing using toothpaste containing fluoride (Protocol A), while Phase II toothbrushing included fluoride toothpaste and use of a mouthwash (Protocol B). For Phase II, individuals participating in this study were allocated into different groups through a randomization process: Group 1-0.12% CHX, Group 2-5% MC, and Group 3-4% OS. Each individual's Phase I and Phase II scores were assessed. GCF was measured in three phases to determine the level of inflammatory biomarkers. The paired t-test evaluated the disparities between the pre- and post-plaque index. Categorical data were subjected to crosstab analysis to assess qualitative variables. The mean values of cytokine levels were presented. An unpaired t-test was employed to assess the levels of cytokines between individuals in Phase I and Phase II. Results: Toothbrushing, fluoride toothpaste, and the supplementary use of mouthwash (Phase II) resulted in mean plaque scores significantly lower than group A (p < 0.001). Cytokines TNF-α, IL-α, and IL-β demonstrated a significant downward trend in herbal mouthwash users. Conclusions: In conjunction with fluoridated toothpaste and brushing, OS and MC can serve as a viable alternative to conventional synthetic mouthwash CHX. This combination demonstrates reducing mean plaque scores and diminishing the levels of cytokines TNF-α, IL-α, and IL-β.

Keywords: inflammatory cytokines; orthodontics; plant-based mouthwash; plaque scores.

MeSH terms

  • Cytokines
  • Fluorides / therapeutic use
  • Gingival Crevicular Fluid
  • Humans
  • Interleukin-2
  • Interleukin-6
  • Morinda*
  • Mouthwashes* / therapeutic use
  • Ocimum sanctum
  • Toothpastes
  • Tumor Necrosis Factor-alpha

Substances

  • Mouthwashes
  • Tumor Necrosis Factor-alpha
  • Interleukin-2
  • Interleukin-6
  • Toothpastes
  • Fluorides
  • Cytokines