These results were already expected, as the biocompatibility of L. sidoides essential oil has been reported previously,26 although mild, transient burning had been noted after use of a mouth rinse containing this natural agent.10 Unfortunately, chlorhexidine sellckchem has some disadvantages, such as discoloration in proximal areas and the tongue and a reversible effect on taste.4,8,9 In the present study, these aspects were indeed observed in some participants, in accordance with the findings of Botelho et al.10 In this study, the Turesky index24 was used due its sensitivity for detection of small plaque deposits.2,22 However, as the cutoff between scores can be difficult to assess and could interfere with results, calibration of examiners was performed to address this issue and ensure the reliability of results.
2 Other studies have recorded plaque accumulation using a similar plaque index.2,14,25 In the control group, PI and BI remained at baseline levels at the end of the experiment, indicating the inability of this adult population to perform adequate tooth cleaning. In contrast with other studies, in which patients were instructed to use the Bass technique,14,25 habitual tooth brushing was not modified to avoid concealment of the actual effect of the test agents. Recently, reports of a number of medicinal herbs used in the treatment and prevention of gingivitis have been published worldwide, with limited13,14,15,25 and encouraging results.10,11,12,22,27,28. Despite its commercial use for pharmaceutical purposes, there is a lack of data to support claims of an antigingivitis and antiplaque effect of L.
sidoides. To the best of our knowledge, the present work is the first to evaluate the effect of a gel containing L. sidoides essential oil in the treatment of gingivitis. The results showed that both test formulations were efficient for plaque reduction (52% in the CLX group and 50% in the LS group). This percent difference was not significant at the end of the trial. Conversely, the control group presented a higher, but not significant, percent increase in plaque buildup (12%). In vitro studies have shown that L. sidoides extract was effective in inhibiting the growth of oral pathogens,18,20 which led us to deduce that this phytopharmaceutical could be used as an antiplaque agent. This hypothesis was confirmed in this study and is in agreement with the previous findings of Botelho et al.
10 The concentration of L. sidoides essential oil used in this trial was based in a previous in vitro study, in which 2%, 5% or 10% L. sidoides preparations showed inhibition rates similar to those of chlorhexidine.20 Because in vitro conditions do not fully reproduce the oral environment and part of Batimastat the gel could be lost by expectoration or other factors,22,29 the highest concentration was used. Nevertheless, another clinical study showed an antiplaque effect of 1% L. sidoides-based mouth rinse using a 7-day treatment regimen.