Abstract

Evaluation of Efficacy of Locally Delivered 10% Azadirachta indica (Neem) Gel as an Adjunct to Scaling and Root Planing in the Treatment of Chronic Periodontitis Patients with Type II Diabetes Mellitus: Clinico-Microbiological Study

Introduction: Increased prevalence and severity of periodontitis is seen in patients with Diabetes Mellitus (DM). This relationship is evident in patients with chronic periodontitis and poorly controlled diabetes. Lately, A. indica has been sh own to have anti-plaque activity. A. indica has shown remarkable improvements in the blood glucose levels signifying a possible hypoglycemic effect. The present study evaluated the clinical and microbiological effect of locally delivered 10% A. indica gel in the treatment of chronic periodontitis with Type II diabetes mellitus patients.

Materials and methods: A total of 15 chronic periodontitis with Type II Diabetes mellitus patients were included in the study. 30 sites from 15 patients were selected according to split-mouth design. Control group: (n=15) SRP alone. Test group: (n=15) SRP+A. indica gel. At the selected sites, clinical parameters were recorded at day 0, 6 weeks, and 3 months post-therapy. Plaque samples were collected at baseline and 3 months post-therapy for microbiological evaluation of Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, Capnocytophaga, and Aggregatibacter actinomycemetemcomitans by multiplex Polymerase Chain Reaction (PCR). HbA1c levels were noted at baseline and 3 months.

Results: All clinical parameters showed a statistically significant difference in their baseline and 3 months (intragroup) comparison while in the comparison between the groups i.e. control and test group only PPD, RAL showed statistical significance, while PI, GI, RGML did not show a statistically significant difference. The HbA1 levels showed a statistically significant difference at 3 months. In the microbiological evaluation, all bacteria in both control and test groups at baseline and 3 months post-therapy showed statistical significance except Tannerella forsythia did not show a statistically significant difference. Intergroup comparison was statistically not significant.

Conclusion: The present study concluded that 10% A. indica gel can be effectively used as an adjunct to SRP in the treatment of chronic periodontitis with type II DM patients and for the reduction of microbial load in the subgingival environment.

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