Background: Gingivitis is frequently painless, rarely causes spontaneous bleeding and is manifested by minor clinical changes. Therefore, most patients are unaware of the disease or do not seek treatment, as it is asymptomatic. Several methods for removing microbial plaque have been proposed, including mechanical and chemical ones. Amla or Indian gooseberry is a medicinal herb; its secondary metabolites, such as phenolic acid, flavonoids and terpenoids, can be used to preferentially reduce metal ions and form nanoparticles (NPs). Green synthesis with the use of the amla seed extract is a unique approach for the production of graphene oxide (GO)-silver (Ag) nanocomposite mouthwash.
Objectives: The aim of the present study was to prepare an amla seed-mediated GO-Ag nanocomposite mouthwash, and to assess its antibacterial and anti-inflammatory efficacy in plaque-induced gingivitis.
Material and methods: The present double-blind randomized controlled trial was conducted among 30 gingivitis patients. The patients were randomly allocated into 2 groups based on the intervention: group A (n = 15; nanocomposite mouthwash); and group B - control (n = 15; 0.2% chlorhexidine (CHX) mouthwash). Clinical parameters, including the plaque index (PI), the gingival index (GI), a microbiological parameter - colony forming units (CFUs), and a biochemical parameter - the C-reactive protein (CRP) level in gingival crevicular fluid (GCF), were assessed at baseline and at 15 days.
Results: The study results showed statistically significant differences in the mean PI and GI scores, and the CRP levels in the post-intervention period as compared to baseline in both groups. After the intervention period of 15 days, there were statistically significant differences between the 2 study groups in terms of mean PI and GI scores, and CRP levels.
Conclusions: The amla seed-mediated GO-Ag nanocomposite mouthwash efficiently reduced plaque, gingival inflammation and CFUs among patients with plaque-induced gingivitis, but was not equivalent to the CHX mouthwash.
Keywords: graphene oxide; nanoparticle; silver.