The effect of Garlie Extract in Suppression of periodontal pathogens Among Patients with Aggressive Periodontitis

Abstract

Introduction: Aggressive periodonntitis is a destructive priodontal disease which may lead to early loss of teeth. The etiology of the disease is unknown but there are many studies about the implication of gram-negative bacteria A:-Iinobucillns uctinoniycetunicomitans, Prophrononioirzs gingitw/is, Rinrermerlia and 71/70/‘llwnsis in the disease progression, also there is a genetic factor ,(defect in polymorph nuclear leucocytes) that may be involved .The disease is treated with antibiotics to reduce the amount of micro-organisms in the treated sites, bu“ the long use of antibiotics have many side effects. This study is done to iduitily the major causative micro-organism Actinohuci/[us (ll‘HMOHll/('01!II1!C‘()IH[f(1!1S, and Pruphronumanus gingivulis and use of garlic extract as newer, safer and more potent antimicrobial agent . Material and Method: Thirty aggressive periodontitis patients were recruited from patients attending Khartoum Teaching Dental Hospital after written approval. Patients gave verbal consent for clinical examination ,age range 18-35 years.Patients examined for plaque index (PLl), Gingival Index (Gl), Probable pocket depth and attachment loss in mm . Microbiologically: Sub-gingival plaque samples were obtained from two deepest site per quadrant for each patient for identification of the major causative micro-organisms /tc/inobncil/us u<‘rin0n1_iit-0/urncomilans. and Proplironomonas girigiralis. ldentilieatiun was done by culture and PCR techniques after DNA extraction. Atter the extraction 0t' garlic, the extract was subjected to preliminary antimicrobial screening using the cup-plate tliftiusion method against the detected bacteria. Results: There was an increase in plaque index, gingival index, pocket depth and loss of attachment among aggressive periodontitis patientsfigingivalis was present in 20 pooled samples out of thirty but Actino/mcillus actinom_vc~emn1cQn1i!ans was not present in all examined pooled samples by both culture and PCR techniques. Garlic extract showed an inhibitory effect against P.gingii-alis. The Minimum inhibitory concentration (MIC) of the garlic extract was detennined and it was comparable to Chlorhexidine 0.2% mouth wash. V Discussion: The result is in agreement with previous reports which ditl not support the association ot‘ ucllnobuci/lu.\' acrilzolriyr-4'/uni conzirarzs with aggressive periodontitis; Mohammad Hossein et al (Z004), M. Faveri r ‘1 al (2007) ,.J0sé Roberto Coitelli ta) 2010 and to lau.l (2004) Elamin A ct al (201 l) in which the presence of the A. acIin0n|yc'4'renzmmiluns JP] clone zmzl n0n~JI’3 genotypes of A. ucri/1onrvcciemcomituns was not detected in the sub gingival plaque ofeither the cases or the controls. The result is not in agreement with the studies of ; Christen LA(l9‘)3 ) Tonetti et al .YaMmoto (1999 )Jose Rcoitelli (2005), Wilson Rosalen (2006) Meng S,et al (20()9),J0se Roberto (2010), Farshidk Kafilzideh (2010). ln present study pgirzgivalis was detected in 70% ct‘ aggressive periodontitis patients by using culture method (gold standard) and Real time PCR for pooled samples. This result is nearly in agreement with the previous studies of; savit ED et al( I 988) Ann L _et al (1998) Lag, ct ill (2004) Conclusion: The result of this study indicated that aggressive periodontitis disease is prevalent among Sudanese population Patients have deep pockets and severe gingival recession which lead to teeth mobility. P.gingiw1/is was present in periodontal pockets and considered as the major causative mic1'o- organisms. So we need more studies on the other causative micro-organisms and more studies about role of genetic factors in the etiology ofthe disease. Since the result of this study showed inhibitory effect of garlic extract, we recommend its use as mouth wash or ointment for prevention.