Current herbal medicine as an alternative treatment in dentistry: In vitro, in vivo and clinical studies

Azadirachta indica (A. Juss), also known as the neem tree, has been used for millennia as a traditional remedy for a multitude of human ailments. Also recognized around the world as a broad-spectrum pesticide and fertilizer, neem has applications in agriculture and beyond. Currently, the extensive antimicrobial activities of A. indica are being explored through research in the fields of dentistry, food safety, bacteriology, mycology, virology, and parasitology. Herein, some of the most recent studies that demonstrate the potential of neem as a previously untapped source of novel therapeutics are summarized as they relate to the aforementioned research topics. Additionally, the capacity of neem extracts and compounds to act against drug-resistant and biofilm-forming organisms, both of which represent large groups of pathogens for which there are limited treatment options, are highlighted. Updated information on the phytochemistry and safety of neem-derived products are discussed as well. Although there is a growing body of exciting evidence that supports the use of A. indica as an antimicrobial, additional studies are clearly needed to determine the specific mechanisms of action, clinical efficacy, and in vivo safety of neem as a treatment for human pathogens of interest. Moreover, the various ongoing studies and the diverse properties of neem discussed herein may serve as a guide for the discovery of new antimicrobials that may exist in other herbal panaceas across the globe.

https://www.frontiersin.org/articles/10.3389/fphar.2022.891535/pdf

The Antimicrobial Potential of the Neem Tree Azadirachta indica

Infectious disease (ID) is one of the top-most serious threats to human health globally, further aggravated by antimicrobial resistance and lack of novel immunization options. Andrographis paniculata (Burm. f.) Wall. ex Nees and its metabolites have been long used to treat IDs. Andrographolide, derived from A. paniculata, can inhibit invasive microbes virulence factors and regulate the host immunity. Controlled clinical trials revealed that A. paniculata treatment is safe and efficacious for acute respiratory tract infections like common cold and sinusitis. Hence, A. paniculata, mainly andrographolide, could be considered as an excellent candidate for antimicrobial drug development. Considering the importance, medicinal values, and significant role as antimicrobial agents, this study critically evaluated the antimicrobial therapeutic potency of A. paniculata and its metabolites, focusing on the mechanism of action in inhibiting invasive microbes and biofilm formation. A critical evaluation of the secondary metabolites with the aim of identifying pure compounds that possess antimicrobial functions has further added significant values to this study. Notwithstanding that A. paniculata is a promising source of antimicrobial agents and safe treatment for IDs, further empirical research is warranted.

https://www.mdpi.com/2075-1729/11/4/348/pdf

Andrographis paniculata (Burm. f.) Wall. ex Nees: An Updated Review of Phytochemistry, Antimicrobial Pharmacology, and Clinical Safety and Efficacy.

Objectives: The aim of this study is to evaluate and compare the antibacterial efficacy of Thymus vulgaris, Salvadora persica, Acacia nilotica, Calendula arvensis, and 5% sodium hypochlorite against Enterococcus faecalis. Methodology: Herbal extracts of T. vulgaris, S. persica, A. nilotica and C. arvensis were prepared. Tryptone soya broth was used to grow E. faecalis and agar plates were prepared. The tested solutions (Group A: 5% NaOCl, Group B: 20% T. vulgaris, Group C: 12.5% S. persica, Group D: 10% A. nilotica, Group E: 10% C. arvensis) were added to the wells made on agar media. Agar diffusion test was performed. Plates were incubated at 37°C for 24 h. Bacterial zones of inhibition were recorded. Results: The data were analyzed statistically by Analysis of Variance (ANOVA) and post hoc comparison by Tukey's t-test. The highest zone of inhibition against E. faecalis was shown by 5% NaOCl, followed by 10% C. arvensis, 20% T. vulgaris and 10% A. nilotica showed similar comparable antibacterial activity. The least zone of inhibition was showed by S. persica. Conclusion: 5% NaOCl showed the maximum antibacterial activity, and herbal products demonstrated significant antibacterial activity against E. faecalis and can be employed as an alternative to NaOCl.

A comparative evaluation of the antibacterial efficacy of Thymus vulgaris, Salvadora persica, Acacia nilotica, Calendula arvensis, and 5% sodium hypochlorite against Enterococcus faecalis: An in-vitro study.

Aim: The present study aimed to individually evaluate and compare the aerobic and anaerob?ic antibacterial activity of Allium sativum extract, aqueous ozone, diode laser, and 3% sodium hypochlorite (NaOCl) as root canal irrigants. Materials and Methods: Forty-eight patients were selected and randomly allocated to one of the four groups (n = 12 each) according to the irrigant to be used in each group. For each included tooth, the preirrigation and postirrigation (after irrigation with the test solution) samples were collected through sterile paper points and microbial culturing was done by swabbing on blood agar plates followed by incubation for aerobic and anaerobic bacteria. Statistical Analysis: Manual colony-forming units counting were done, and statistical analysis was performed. Analysis of variance (one-way) followed by post hoc test was performed as a parametric test to compare the difference between the groups for both aerobic and anaerobic bacteria. Results: All the groups showed a statistically significant reduction in bacteria (P Conclusion: A. sativum extract, aqueous zone, diode laser, and 3% NaOCl showed significant antibacterial activity against aerobic and anaerobic bacteria.

Comparative evaluation of antibacterial efficacy of Allium sativum extract, aqueous ozone, diode laser, and 3% sodium hypochlorite in root canal disinfection: An in vivo study

Aim: The aim is to test the antimicrobial activity of Andrographis Paniculata, Azadirachta indica (neem), and Curcuma Longa (curcumin) as a root canal irrigant, against Staphylococcus aureus and Candida albicans using agar diffusion test. Sodium hypochlorite (NaOCl) served as a standard control for comparisons. Materials and Methods: The bacterial strains of C. albicans and S. aureus culture were grown overnight (18–20 h) in the brain heart infusion broth at 37°C and inoculated in Mueller–Hinton agar plates. Antibacterial inhibition was assessed using agar well-diffusion method using the methanolic extracts of the three plants to be tested and NaOCl. Bacterial inhibition zone around each well was recorded. The results were tabulated and analyzed statistically for significance. Results: The novel A. paniculata showed significantly higher zone of inhibition against C. albicans (P 0.05). Conclusion: Zones of inhibition exhibited by novel herbal agent A. paniculata were higher against C. albicans and similar against S. aureus, when compared to NaOCl.

Efficacy of Andrographis paniculata compared to Azadirachta indica, Curcuma longa, and sodium hypochlorite when used as root canal irrigants against Candida albicans and Staphylococcus aureus: An in vitro antimicrobial study.

Alexandar Maniangat Luke

Papers

Efficacy of Andrographis paniculata compared to Azadirachta indica, Curcuma longa, and sodium hypochlorite when used as root canal irrigants against Candida albicans and Staphylococcus aureus: An in vitro antimicrobial study.