Analgesic Efficacy of Aloe Vera and Green Tea Mouthwash After Periodontal Pocket Reduction Surgery: A Randomized Split-Mouth Clinical Trial
Journal of Dental School,
Vol. 34 No. 3 (2016),
30 September 2016
,
Page 176-185
https://doi.org/10.22037/jds.v34i3.24642
Abstract
Objectives: The aim of this study was to assess the efficacy of aloe vera and green tea mouthwash for reducing pain after periodontal pocket reduction surgery.
Methods: This randomized, split-mouth, double-blind, cross-over clinical trial was carried out on 45 patients between 25 and 50 years of age requiring pocket reduction surgery. Patients underwent bilateral surgeries in two sessions. After the first surgery, the patients were randomized to receive either mouthwash or placebo for 10 days; then, each group used the other product for the same time period. The parameters assessed following each procedure were the numeric pain rating scale (NPRS) and number of painkillers taken by patients to alleviate postoperative pain. Also, patients were requested to report side effects, if any, after using the mouthwash.
Results: The reported postoperative pain score was significantly lower after using the aloe vera and green tea mouthwash compared to the placebo only in the first postoperative day (P=0.002). Furthermore, number of analgesic tablets used in the first postoperative day was significantly lower than that in the control group (P=0.007).
Conclusion: Our results indicated that patients experienced significantly less early postoperative pain when they used aloe vera and green tea mouthwash. Thus, its application can be recommended to decrease pain after periodontal pocket reduction surgery.
- Aloe vera gel
- Green tea extract polyphenone E
- Mouthwashes
- Pain
- Periodontal Pocket
- Surgery
How to Cite
References
Rajeswari SR, Gowda TM, Kumar TA, Thimmasetty J, Mehta DS. An appraisal of innovative meloxicam mucoadhesive films for periodontal postsurgical pain control: A double-blinded, randomized clinical trial of effectiveness. Contemp Clin Dent. 2015 Jul-Sep;6(3):299-304.
Durand R, Tran SD, Mui B, Voyer R. Managing postoperative pain following periodontal surgery. J Can Dent Assoc. 2013;79:d66.
Canakci CF, Canakci V. Pain experienced by patients undergoing different periodontal therapies. Journal of the American Dental Association (1939). 2007 December;138(12):1563-73.
Chaparro-Avendano AV, Perez-Garcia S, Valmaseda-Castellon E, Berini-Aytes L, Gay-Escoda C. Morbidity of third molar extraction in patients between 12 and 18 years of age. Med Oral Patol Oral Cir Bucal. 2005 Nov-Dec;10(5):422-31.
Holt VP, McHugh K. Factors influencing patient loyalty to dentist and dental practice. British dental journal. Br Dent J. 1997 Nov;183(10):365-70.
Ong CK, Seymour RA. An evidence-based update of the use of analgesics in dentistry. Periodontol 2000. 2008;46:143-64.
Pozzi A, Gallelli L. Pain management for dentists: the role of ibuprofen. Ann Stomatol (Roma). 2011 Jul;2(3-4 Suppl):3-24.
Becker DE. Pain Management: Part 1: Managing Acute and Postoperative Dental Pain. Anesthesia Progress. Summer 2010;57(2):67-79.
Bushra R, Aslam N. An Overview of Clinical Pharmacology of Ibuprofen. Oman Med J. 2010 Jul;25(3):155-1661.
Cashman JN. The mechanisms of action of NSAIDs in analgesia. Drugs. 1996;52 Suppl 5:13-23.
Coxib, traditional NTC. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet. 2013 Aug; 382(9894): 769–779.
Whittle BJ. Gastrointestinal effects of nonsteroidal anti-inflammatory drugs. Fundam Clin Pharmacol. 2003 Jun;17(3):301-13.
Sostres C, Gargallo CJ, Arroyo MT, Lanas A. Adverse effects of non-steroidal anti-inflammatory drugs (NSAIDs, aspirin and coxibs) on upper gastrointestinal tract. Best Pract Res Clin Gastroenterol. 2010 Apr;24(2):121-32.
Schafer AI. Effects of nonsteroidal antiinflammatory drugs on platelet function and systemic hemostasis. J Clin Pharmacol. 1995 Mar;35(3):209-19.
Ramsay MAE. Acute postoperative pain management. Proc (Bayl Univ Med Cent). 2000 Jul;13(3):244-7.
Antonucci R, Zaffanello M, Puxeddu E, Porcella A, Cuzzolin L, Pilloni MD, et al. Use of non-steroidal anti-inflammatory drugs in pregnancy: impact on the fetus and newborn. Curr Drug Metab. 2012 May 1;13(4):474-90.
Sujatha G, Kumar GS, Muruganandan J, Prasad TS. Aloe vera in dentistry. Journal of clinical and diagnostic research : J Clin Diagn Res. 2014 Oct;8(10):ZI01-2.
Dat AD, Poon F, Pham KB, Doust J. Aloe vera for treating acute and chronic wounds. Cochrane Database Syst Rev. 2012 Feb;(2):CD008762.
Davis RH, Donato JJ, Hartman GM, Haas RC. Anti-inflammatory and wound healing activity of a growth substance in Aloe vera. J Am Podiatr Med Assoc. 1994 Feb;84(2):77-81.
t'Hart LA, van den Berg AJ, Kuis L, van Dijk H, Labadie RP. An anti-complementary polysaccharide with immunological adjuvant activity from the leaf parenchyma gel of Aloe vera. Planta Med. 1989 Dec;55(6):509-12
Wang HH, Chung JG, Ho CC, Wu LT, Chang SH. Aloe-emodin effects on arylamine N-acetyltransferase activity in the bacterium Helicobacter pylori. Planta Med. 1998 Mar;64(2):176-8.
Vazquez B, Avila G, Segura D, Escalante B. Antiinflammatory activity of extracts from Aloe vera gel. J Ethnopharmacol. 1996 Dec;55(1):69-75.
Ahmadi A. Potential prevention: Aloe vera mouthwash may reduce radiation-induced oral mucositis in head and neck cancer patients. Chin J Integr Med. 2012 August ;18(8):635-40.
Oryan A, Mohammadalipour A, Moshiri A, Tabandeh MR. Topical Application of Aloe vera Accelerated Wound Healing, Modeling, and Remodeling: An Experimental Study. Annals of Plastic Surgery. 2016;77(1):37-46.
Su CK, Mehta V, Ravikumar L, Shah R, Pinto H, Halpern J, et al. Phase II double-blind randomized study comparing oral aloe vera versus placebo to prevent radiation-related mucositis in patients with head-and-neck neoplasms. Int J Radiat Oncol Biol Phys. 2004 Sep;60(1):171-7.
Ajmera N, Chatterjee A, Goyal V. Aloe vera: It's effect on gingivitis. J Indian Soc Periodontol. 2013 Jul;17(4):435-8.
Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea--a review. J Am Coll Nutr. 2006 Apr;25(2):79-99.
Sur P, Chaudhuri T, Vedasiromoni JR, Gomes A, Ganguly DK. Antiinflammatory and antioxidant property of saponins of tea [Camellia sinensis (L) O. Kuntze] root extract. Phytother Res. 2001 Mar;15(2):174-6.
Shahakbari R, Eshghpour M, Rajaei A, Rezaei N, Golfakhrabadi P, Nejat A. Effectiveness of green tea mouthwash in comparison to chlorhexidine mouthwash in patients with acute pericoronitis: a randomized clinical trial. Int J Oral Maxillofac Surg. 2014 Nov;43(11):1394-8.
Priya BM, Anitha V, Shanmugam M, Ashwath B, Sylva SD, Vigneshwari SK. Efficacy of chlorhexidine and green tea mouthwashes in the management of dental plaque-induced gingivitis: A comparative clinical study. Contemporary clinical dentistry. 2015 Nov;6(4):505-9.
Hirasawa M, Takada K, Otake S. Inhibition of acid production in dental plaque bacteria by green tea catechins. Caries research. 2006;40(3):265-70. Caries Res. 2006;40(3):265-70.
Chatterjee A, Saluja M, Agarwal G, Alam M. Green tea: A boon for periodontal and general health. J Indian Soc Periodontol. 2012 Apr;16(2):161-7.
Sehgal I, Winters WD, Scott M, David A, Gillis G, Stoufflet T, et al. Toxicologic assessment of a commercial decolorized whole leaf aloe vera juice, lily of the desert filtered whole leaf juice with aloesorb. Journal of Toxicology. 2013;2013:802453.
Ahlawat KS, Khatkar BS. Processing, food applications and safety of aloe vera products: a review. J Food Sci Technol. 2011 Oct;48(5):525-33.
Chow H-HS, Cai Y, Hakim IA, Crowell JA, Shahi F, Brooks CA, et al. Pharmacokinetics and Safety of Green Tea Polyphenols after Multiple-Dose Administration of Epigallocatechin Gallate and Polyphenon E in Healthy Individuals. Clin Cancer Res. 2003 Aug;9(9):3312-9.
Chacko SM, Thambi PT, Kuttan R, Nishigaki I. Beneficial effects of green tea: a literature review. Chin Med. 2010 Apr;5:13.
Gupta RK, Gupta D, Bhaskar DJ, Yadav A, Obaid K, Mishra S. Preliminary Antiplaque Efficacy of Aloe Vera Mouthwash on 4 Day Plaque Re-Growth Model: Randomized Control Trial. Ethiop J Health Sci. 2014 Apr; 24(2): 139–144
Betancourt JW, Kupp LI, Jasper SJ, Farooqi OA. Efficacy of ibuprofen-hydrocodone for the treatment of postoperative pain after periodontal surgery. J Periodontol. 2004 Jun;75(6):872-6.
Doshi S, Jain S, Hegde R. Effect of low-level laser therapy in reducing dentinal hypersensitivity and pain following periodontal flap surgery. Photomed Laser Surg. 2014 Dec;32(12):700-6.
Golpayegani MV, Ansari G, Tadayon N, Shams S, Mir M. Low-level laser therapy for pulpotomy treatment of primary molars. Journal of Dentistry of Tehran University of Medical Sciences. 2009;6(4):168-74.
Golpayegani MV, Ansari G, Tadayon N. Clinical and radiographic success of low level laser therapy (LLLT) on primary molars pulpotomy. Res J Biol Sci. 2010;5(1):51-5.
Eshghpour M, Mortazavi H, Mohammadzadeh Rezaei N, Nejat A. Effectiveness of green tea mouthwash in postoperative pain control following surgical removal of impacted third molars: double blind randomized clinical trial. DARU Journal of Pharmaceutical Sciences. 2013 July;21(1):59.
Arzi A, Ghorbanzadeh B, Nazari Khorasgani Z. Antinociceptive Effect of Hydroalcoholic Extract of Iranian Green tea in the Formalin Test in Rats. Jundishapur Journal of Natural Pharmaceutical Products. Feb 2013;8(1):10-4.
Meechan JG, Seymour RA. The use of third molar surgery in clinical pharmacology. Br J Oral Maxillofac Surg. 1993 Dec;31(6):360-5.
Robinson ME, Myers CD, Sadler IJ, Riley JL, 3rd, Kvaal SA, Geisser ME. Bias effects in three common self-report pain assessment measures. Clin J Pain. 1997 Mar;13(1):74-81
Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain. 2011 Oct;152(10):2399-404.
Penarrocha M, Sanchis JM, Saez U, Gay C, Bagan JV. Oral hygiene and postoperative pain after mandibular third molar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001 Sep;92(3):260-4.
Haraji A, Rakhshan V. Chlorhexidine gel and less difficult surgeries might reduce post-operative pain, controlling for dry socket, infection and analgesic consumption: a split-mouth controlled randomised clinical trial. J Oral Rehabil. 2015 Mar;42(3):209-19.
Taylor PW, Hamilton-Miller JMT, Stapleton PD. Antimicrobial properties of green tea catechins. Food Sci Technol Bull. 2005;2:71-81.
Babaee N, Zabihi E, Mohseni S, Moghadamnia AA. Evaluation of the therapeutic effects of Aloe vera gel on minor recurrent aphthous stomatitis. Dental research journal. 2012 July;9(4):381-5.
de Oliveira A, Adams SD, Lee LH, Murray SR, Hsu SD, Hammond JR, et al. Inhibition of herpes simplex virus type 1 with the modified green tea polyphenol palmitoyl-epigallocatechin gallate. Food Chem Toxicol. 2013 Feb;52:207-15
Krekmanov L, Nordenram A. Postoperative complications after surgical removal of mandibular third molars. Effects of penicillin V and chlorhexidine. Int J Oral Maxillofac Surg. 1986 Feb;15(1):25-9.
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