Efficacy of Triphala in treating Gingivitis diseases
A systematic review and meta-analysis
Keywords:
Triphala, mouthwash, Chlorhexidine, gingival diseases, plaque indexAbstract
Background and Objective: Triphala facilitates the action of anti-cavities, decreases plaque and has an antibacterial effect. Therefore, the purpose of this study was to perform a systematic review and meta-analysis of randomised controlled trials (RCTs) only to compare the overall effects of Triphala herbal mouthwashes in the treatment of gingivitis as a complement to daily oral hygiene on both plaque and chlorhexidine inflammation regulation. Methods: Electronic searches in MEDLINE/PubMed, EMBASE and CENTRAL were conducted in databases up to April 2020. Original articles, invivo studies and articles on the efficacy of Triphala on gingivitis were included in the study. 9 RCTs were included in the systematic review and 6 articles were included in meta-analysis. Results: Four included studies showed significantly greater reductions in plaque, gingivitis, and bleeding indices after the use of herbal mouthwashes (Triphala) compared with Chlorhexidine, while five studies reported that no difference was observed between herbal Triphala mouthwash and Chlorhexidine. Considering the effects of Triphala mouthwash on clinical gingival inflammatory parameters, significant heterogeneity for both gingival index (Q=102.55; pQ=0.000; I2=95.12%; T2=0.62; T=0.79) and plaque index (Q=43.83; pQ=0.000; I2=88.59%; T2=0.23; T=0.48) was observed between both Triphala mouthwash and Chlorhexidine groups.
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Gowda D, Ganesh M, Rohan D, Rangesh P. Phytochemical and pharmacological actions of Triphala: Ayurvedic formulation-A review. Int J Pharm Sci Rev Res. 2012;15:61–5.
Adhikari PP, Paul SB. History of indian traditional medicine: a medical inheritance. Asian J Pharm Clin Res 2018;11(1): 421-426
Telles S, Naveen KV, Balkrishna A. Use of Ayurveda in promoting dental health and preventing dental caries. Indian J Dent Res 2009;20(2):246
Baiju RM, Peter E, Varghese NO, Sivaram R. Oral Health and Quality of Life: Current Concepts. J Clin Diagn Res. 2017;11(6):ZE21-ZE26.
Gupta R, Ingle NA, Kaur N, Yadav P, Ingle E, Charania Z, et al. Ayurveda in dentistry: A Review. J Int Oral Health 2015;7:141‑3.
Bose S, Sinha S, Mukherjee G. In-vitro study of Triphala on antioxidant activity. Sci Cult 2011;77:511-513.
Abraham S, Kumar MS, Sehgal P, Nitish S, Jayakumar N. Evaluation of the inhibitory effect of Triphala on PMN-type matrix metalloproteinase (MMP-9). Journal of periodontology 2005;76:497-502.
Valkenburg C, Van der Weijden FA, Slot DE. Plaque control and reduction of gingivitis: The evidence for dentifrices. Periodontology 2019;79:221-232.
Padiyar B, Marwah N, Gupta S, Padiyar N. Comparative Evaluation of Effects of Triphala, Garlic Extracts, and Chlorhexidine Mouthwashes on Salivary Streptococcus mutans Counts and Oral Hygiene Status. Int J Clin Pediatr Dent. Jul-Aug 2018, Vol-11(4) 299-306, DOI: 10.5005/jp-journals-10005-1530 [PUB MED]
Penmetsa GS, Vivek B, Bhupathi AP, Sudha Rani P, Subbareddy BV, Ramesh M. Comparative Evaluation of Triphala, Aloe vera, and Chlorhexidine Mouthwash on Gingivitis: A Randomized Controlled Clinical Trial. Contemp Clin Dent. Apr-Jun 2019, Vol-10(2): 333–337, DOI: 10.4103/ccd.ccd_583_18 [PUB MED]
Baratakke SU, Raju R, Kadanakuppe S, Savanur NR, Gubbihal R, Kousalaya PS. Efficacy of Triphala extract and chlorhexidine mouth rinse against plaque accumulation and gingival inflammation among female undergraduates: A randomized controlled trial. Indian J Dent Res. Jan-Feb 2017, Vol- 28(1):49-54, DOI: 10.4103/0970-9290.203622. [PUB MED]
Saxena S, Lakshminarayan N, Gudli S, Kumar M. Anti-Bacterial Efficacy of Terminalia Chebula, Terminalia Bellirica, Embilica Officinalis and Triphala on Salivary Streptococcus Mutans Count - A Linear Randomized Cross Over Trial. J Clin Diagn Res. Feb 2017, Vol- 11(2):ZC47-ZC51, DOI: 10.7860/JCDR/2017/23558.9355. [PUB MED]
Chainani SH, Siddana S, Reddy CVK, Manjunathappa TH, Manjunath M, Rudraswamy S. Antiplaque and antigingivitis efficacy of Triphala and chlorhexidine mouthrinse among schoolchildren - a cross-over, double-blind, randomised controlled trial. Oral Health Prev Dent. 2014, Vol- 12(3):209-17, DOI: 10.3290/j.ohpd.a32674. [PUB MED]
Srinagesh J, Pushpanjali K. Assessment of antibacterial efficacy of Triphala against mutans streptococci: a randomised control trial. Oral Health Prev Dent. 2011, Vol- 9(4):387-93, DOI: 10.3290/j.ohpd.a22663 [PUB MED]
Naiktari RS, Gaonkar P, Gurav AN, Khiste SV. A randomized clinical trial to evaluate and compare the efficacy of Triphala mouthwash with 0.2% chlorhexidine in hospitalized patients with periodontal diseases. J Periodontal Implant Sci. June 2014, Vol- 44(3):134-40, DOI: 10.5051/jpis.2014.44.3.134. [PUB MED]
Bajaj N, Tandon S. The effect of Triphala and Chlorhexidine mouthwash on dental plaque, gingival inflammation, and microbial growth. Int J Ayurveda Res. Jan 2011, Vol-2(1):29-36, DOI: 10.4103/0974-7788.83188. [PUB MED]
Mamgain P, Kandwal A, Mamgain RK. Comparative Evaluation of Triphala and Ela Decoction With 0.2% Chlorhexidine as Mouthwash in the Treatment of Plaque-Induced Gingivitis and Halitosis: A Randomized Controlled Clinical Trial. J Evid Based Complementary Altern Med. July 2017, Vol- 22(3):468-472, DOI: 10.1177/2156587216679532. [PUB MED]
ChampaklalPranlalBoghani. Progress of periodontal research and practice in India. In: Bartold PM, Ishikawa I, Sirirat M, eds. Progress of Periodontal Research and Practice in Asian Pacific Countries. Bangkok: Asian Pacific Society of Periodontology; 2000:75-96.
Beiswanger BB, Mallat ME, Jackson RD, et al. Clinical effects of a 0.12% chlorhexidine rinse as an adjunct to scaling and root planing. J Clin Dent 1992;3:33-38.
Gru¨ndemann LJ, Timmerman MF, Ijzerman Y, van der Weijden GA, van der Weijden GA. Stain, plaque and gingivitis reduction by combining chlorhexidine and peroxyborate. J Clin Periodontol2000;27:9-15.
ErnstCP, Prockl K, WillershausenB. The effectiveness and side effects of 0.1% and 0.2% chlorhexidine mouthrinses: A clinical study. Quintessence Int 1998;29:443-448.
Jones CG. Chlorhexidine: Is it still the gold standard? Periodontol 2000 1997;15:55-62.
Brecx M, Macdonald LL, Legary K, Cheang M, Forgay MG. Long-term effects of Meridol and chlorhexidine mouthrinses on plaque, gingivitis, staining, and bacterial vitality. J Dent Res 1993;72:1194-1197.
Addy M, Moran J, Griffiths AA, Wills-Wood NJ. Extrinsic tooth discoloration by metals and chlorhexidine. I. Surface protein denaturation or dietary precipitation? Br Dent J 1985;159:281-285.
Sabina EP, Rasool M. An in vivo and in vitro potential of Indian ayurvedic herbal formulation Triphala on experimental gouty arthritis in mice. VasculPharmacol2008;48:14-20.
Chatterjee A, Saluja M, Singh N, Kandwal A. To evaluate the antigingivitis and antipalque effect of an Azadirachta indica (neem) mouthrinse on plaque induced gingivitis: A double-blind, randomized, controlled trial. J Indian Soc Periodontol2011;15:398-401.
WichtlM. Herbal Drugs and Phytopharmaceuticals. Boca Raton, FL: CRC Press; 1994:322-325.
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