Comparative evaluation of clinical efficacy of clove oil,lemongrass, ginger oil and hyaluronic acid gel as local drug delivery in the treatment of stage-I and stage II Periodontitis

The primary goal of periodontal therapy is removal of the biofilm deposits and create an environment conducive for the shift of microbiome from pathobionts to symbionts. This is often achieved by the gold standard- scaling and root planning (SRP) procedure, alone or with adjunctive administration of systemic or local antimicrobial agents, and surgical periodontal therapy, if required. However, use of systemic antimicrobials were shown to have adverse effects such as drug toxicity, acquired bacterial resistance, poor patient compliance and unwanted drug interactions. To tackle these limitations, local delivery of antibacterial agents into periodontal pocket is being extensively used. 

The benefits of using local drug delivery include better patient compliance, enhanced pharmacokinetic response, greater access and ability to position the drug adjacent to the disease and ability to lower total dosage of the drug at a more controlled concentration. Similarly, phytotherapy has long been a source of medicinal products and over the years there have been many attempts to use herbal medicines for the treatment of chronic periodontitis, with the advantage of few side effects and cost-effectiveness.Natural products are the drugs of choice due to novelty in their chemical structure and mechanism of action.

Clove oil, rich in eugenol, has antibacterial, antifungal, and anti-inflammatory properties, benefiting dental care, wound healing, and overall health.Ginger, containing beta-bisabolol, gingerol, and paradol, offers anti-inflammatory, antioxidant, and anti-cancer benefits, aiding in glycemic control and periodontal health.Lemongrass oil, rich in phenols and flavonoids, exhibits antioxidant, anti-inflammatory, and antimicrobial effects, inhibiting various microorganisms at under 2% concentration.Hyaluronic acid, a glycosaminoglycan, aids healing and tissue regeneration, reducing inflammation and matrix metalloproteinases, enhancing chemotherapeutic and periodontal treatments.Taking the above facts into account, the present study is planned to compare the clinical efficacy of clove oil, ginger oil, lemongrass, and hyaluronic acid gel as an adjunct to scaling and root planning in the management of stage-1 and stage-2 periodontitis.