The Application of Andrographis Paniculata Gel as an Adjunct in The Treatment of Chronic Periodontitis : Clinical and Microbiological Effects

Abstract

The purpose of this study was to evaluate the clinical and microbiological effects of locally delivered Andrographis paniculata
(AP) gel as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis. Thirty- two systemically healthy
and non-smoking subjects with chronic periodontitis were recruited in this study. The subjects had to comply with the following
criteria; having three single-rooted teeth located in different quadrants with probing pocket depth 5 mm and bleeding on probing,
no history of receiving periodontal therapy or antibiotics within 6 months. The experimental sites of three teeth of each subject were
randomly assigned to receive either of the three treatments; SRP plus AP gel, SRP plus gel base, or SRP only. The gels were applied
at day 0, 1, 2, 3 weeks. Four clinical parameters, i.e., probing pocket depth, clinical attachment level, gingival index, and bleeding
on probing were recored at day 0 (baseline), 1 and 3 months after treatments. Subgingival plaque was also taken using paper points
at the same time points and subjected to the real-time PCR method (EvaGreen) for quantification of Porphyromonas gingivalis.
Results showed that clinical changes at the disease sites were significantly improved after received all three treatments (p<0.05).
When compared the clinical outcomes among the treatments. The clinical outcomes of the SRP plus AP gel-treated sites significantly
showed a better improvement (p<0.05). For microbiological study, P. gingivalis was detected only in eight subjects at baseline. After
treatment for 3 months, the bacteria could not be detected in five subjects. In conclusion, the local application of AP gel as an adjunct
to SRP showed a better improvement of clinical parameters. These results indicated the benefit of AP gel as an adjunct in the
treatment of chronic periodontitis.