COMPARATIVE EVALUATION OF TWO HERBAL MOUTHWASHES AND CHLORHEXIDINE ON CALPROTECTIN IN GINGIVITIS PATIENTS: A DOUBLE-BLIND RANDOMIZED CONTROLLED TRIAL.

Abstract

Background: Gingivitis is a reversible inflammatory condition primarily caused by dental biofilm accumulation. Gingival crevicular fluid (GCF) serves as a non-invasive diagnostic medium reflecting periodontal status. Biomarkers such as Calprotectin (biomarker of neutrophil-mediated inflammatory activity) are associated with immune activation and periodontal inflammation and have also been associated with systemic conditions.

Objective: To evaluate the efficacy of two herbal mouthwashes-GEM (propolis, neem, and chlorophyll) and Propolinse (propolis and green tea)-compared with chlorhexidine on Calprotectin in gingivitis patients.

Material and methods: Forty-four male patients with generalized gingivitis were randomly assigned into four groups (n=11). Participants used GEM, Propolinse, 0.12% alcohol-free CHX, or distilled water (control) twice daily for 7 days alongside mechanical oral hygiene. Clinical parameters (Plaque Index (PI), Gingival Index (GI), Bleeding on Probing (BOP)) and GCF biomarkers were assessed at baseline and after 7 days. GCF samples were collected from maxillary anterior teeth by periopaper strips. Calprotectin concentrations were measured via ELISA. SPSS was used for statistical analysis, with a significance threshold of p<0.05.

Results: All groups showed significant improvements in PLI, GI, and BOP (p≤0.001). And all groups showed significant decreases in calprotectin levels, with no statistically significant intergroup differences observed in mean change values (p=0.760). Notably, herbal formulations demonstrated greater reduction in calprotectin (a neutrophil-derived biomarker), suggesting differential modulation of immune pathways.

Conclusion: Both herbal mouthwashes and 0.12% chlorhexidine demonstrated comparable anti-inflammatory effects. Propolis-based formulations may represent effective adjunctive alternatives in the short-term management of gingivitis, potentially exerting differential effects on neutrophil-mediated inflammatory responses, with possible implications for systemic inflammatory conditions.