Anti-biofilm and anti-inflammatory effect of a herbal nanoparticle mouthwash: a randomized crossover trial

Abstract Laboratory evidence has demonstrated the antimicrobial effect of Melaleuca alternifolia (MEL) against oral microorganisms. This randomized, double-blind, crossover clinical trial, compared the anti-biofilm and anti-inflammatory effects of MEL nanoparticles with 0.12% chlorhexidine gluconate (CHX) on biofilm-free (BF) and biofilm-covered (BC) surfaces. Before each experimental period, the participants refrained from all oral hygiene practices for 72 hours. The 60 participants were randomly assigned to professional prophylaxis in two quadrants (Q1–Q3 or Q2–Q4), and rinsed with MEL or CHX for four days. The Quigley & Hein plaque index (QHPI), gingival crevicular fluid (GCF) volume, and participants’ perceptions were assessed. CHX showed significantly lower mean QHPI on BF (2.65 ± 0.34 vs. 3.34 ± 0.33, p < 0.05) and BC surfaces (2.84 ± 0.37 vs. 3.37 ± 0.33, p < 0.05). Intragroup comparisons indicated reductions in GCF in all the groups, with significant differences only for CHX on BF surfaces (p < 0.05). Intergroup comparisons revealed no significant differences (p > 0.05). Based on individual perceptions, CHX had better taste and biofilm control, but resulted in a greater change in taste. Nevertheless, MEL demonstrated anti-inflammatory effects similar to those of CHX. Further clinical trials testing different protocols, concentrations and follow-up periods are required to establish its clinical application.

摘要：实验室研究已证实互叶白千层（Melaleuca alternifolia，简称MEL）对口腔微生物具有抗菌活性。本项随机双盲交叉临床试验对比了MEL纳米颗粒与0.12%葡萄糖酸氯己定（CHX）在无生物膜（BF）及有生物膜（BC）表面的抗生物膜与抗炎效果。每轮试验周期开始前，受试者需暂停所有口腔卫生操作72小时。60名受试者被随机分配至两个象限（Q1-Q3或Q2-Q4）接受专业洁治，随后分别使用MEL或CHX含漱4天。本研究评估了Quigley-Hein菌斑指数（Quigley & Hein Plaque Index，QHPI）、龈沟液（gingival crevicular fluid，GCF）体积及受试者的主观反馈。结果显示，CHX在BF表面的平均QHPI得分显著更低（2.65±0.34 vs 3.34±0.33，p<0.05），在BC表面亦呈现相同趋势（2.84±0.37 vs 3.37±0.33，p<0.05）。组内比较表明，所有组别龈沟液量均有所下降，仅CHX在BF表面的差异具有统计学意义（p<0.05）；组间比较则未发现显著差异（p>0.05）。基于受试者主观反馈，CHX在口感与菌斑控制方面表现更优，但会引发更明显的味觉改变。不过，MEL展现出与CHX相近的抗炎效果。未来仍需开展不同给药方案、浓度及随访周期的临床试验，以明确其临床应用价值。