A clinical and microbiological study to assess the efficacy of Acmella oleracea and Acacia catechu herbs as local drug delivery in treatment of chronic generalized periodontitis patients

AIM: A randomized controlled clinical trial was conducted to evaluate the effect of local drug delivery (LDD) of Acmella oleracea (Akarkara) and Acacia catechu (kattha) gels as an adjunct to scaling and root planing (SRP) in generalized chronic periodontitis patients. MATERIALS AND METHODS: Thirty patients with ninety sites aged 25–65 years with generalized chronic periodontitis having pocket probing depth (PPD) of more than or equal to 5 mm on the basis of inclusion and exclusion criteria were selected. They were treated according to split-mouth design protocol. The placement of gel containing A. oleracea (1%) (Group 1) and A. catechu (1%) (Group 2) as LDD was placed at the two test sites, respectively, and only SRP was done in the control group (Group 3). Periodontal dressing was applied to all the three sites after procedure, and patients were given oral care guidelines. Evaluation of clinical parameters gingival index (GI), plaque index (PI), gingival bleeding index (GBI), PPD, clinical attachment level (CAL), and relative attachment level (RAL) was done at baseline, 1, 3, and 6 months, and microbiological parameter was assessed at baseline and 6 months. N-benzoyl-DL-arginine-2-napthylamide (BANA) test was used for the microbiological analysis. RESULTS: Clinical parameters from baseline to 6 months at different time intervals demonstrated a significant reduction in mean GI, PI, GBI, and PPD and gain in CAL and RAL over a period of 6 months, and results were statistically significant in all the three treatment groups. However, on intergroup comparison, clinically significant difference was observed, but statistically, results were significant at few intervals. The microbiological analysis revealed a statistically nonsignificant reduction at the end of 6 months on intra- and intergroup comparison. CONCLUSION: The study concluded that the use of A. catechu gel and A. oleracea gel clinically showed improvement in clinical parameters when combined with SRP, attributing to better anti-inflammatory and healing properties.