Comparative evaluation of 0.5% Attukal Kizhangu (Drynaria fortunei) herbal mouthwash and 0.2% chlorhexidine in the management of periodontal diseases: A randomized controlled clinical trial
Sakshi Gupta, Neelam Mittal, Harakh Chand Baranwal, Pragati DubeyAbstract:
Background:
Periodontal diseases are chronic inflammatory conditions caused by microbial dental plaque. Although 0.2% chlorhexidine (CHX) is the gold standard adjunctive mouthwash for plaque control, its long-term use is associated with adverse effects, including tooth staining, altered taste sensation, and mucosal irritation. Attukal Kizhangu (Drynaria fortunei), a medicinal fern with antimicrobial, anti-inflammatory, antioxidant, and regenerative properties, has emerged as a potential herbal alternative.
Aim:
To formulate and characterize a 0.5% Attukal Kizhangu herbal mouthwash and evaluate its antimicrobial efficacy and clinical effectiveness compared with 0.2% CHX and normal saline.
Materials and Methods:
A randomized, parallel-arm, examiner-blinded clinical trial was conducted among 72 participants with gingivitis or periodontitis. Participants received normal saline, 0.2% CHX, or 0.5% Attukal Kizhangu mouthwash. The formulation was characterized by high-resolution mass spectrometry, pH, surface tension, stability, and antimicrobial susceptibility testing. Following scaling and root planing, participants used the assigned mouthwash twice daily for 90 days. Clinical outcomes were assessed using the oral hygiene index-simplified (OHI-S), plaque index (PI), gingival index (GI), and gingival bleeding score (GBS).
Results:
Both the Attukal Kizhangu and CHX groups showed significant reductions in OHI-S, PI, GI, and GBS scores after 3 months (
Conclusion:
The 0.5% Attukal Kizhangu herbal mouthwash demonstrated efficacy comparable to 0.2% CHX and may serve as a promising herbal adjunct in periodontal therapy. Larger multicenter trials with longer follow-up are required to confirm its long-term safety and effectiveness.