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Background  The common usage of chewing sticks prepared from Neem tree ( Azadirachta indica ) in India suggests its potential efficacy in periodontal diseases. The objective of this study is to explore the antibacterial effects of Neem leaf extract on the periodontophatic bacteria  Porphyromonas gingivalis  and  Fusobacterium nucleatum , and its antioxidant capacities alone and in combination with bacteria and polycationic peptides that may be at the site of inflammation.    Methods  Neem leaf extract was prepared by ethanol extraction. The growth kinetics of  P. gingivalis  and  F. nucleatum  under anaerobic conditions in the presence of Neem leaf extract were measured. Broth microdilution test was used to determine the Minimal Inhibitory Concentration (MIC) of Neem leaf extract against each bacterial strain. The effect of Neem leaf extract on the coaggregation of the bacteria was assessed by a visual semi-quantitative assay. The antioxidant capacities of Neem leaf extract alone and in combination with bacteria, with the addition of red blood cells or the polycationic peptides chlorhexidine and lisozyme, were determined using a chemiluminescence assay.    Results  Neem leaf extract showed prominent dose-dependent antibacterial activity against  P. gingivalis , however, had no effect on the growth of  F. nucleatum  nor on the coaggregation of the two bacteria. Yet, it showed intense antioxidant activity, which was amplified following adherence to bacteria and with the addition of red blood cells or the polycationic peptides.    Conclusions  Neem leaf extract, containing polyphenols that adhere to oral surfaces, have the potential to provide long-lasting antibacterial as well as synergic antioxidant activities when in complex with bacteria, red blood cells and lisozyme. Thus, it might be especially effective in periodontal diseases.

Combined antioxidant effects of Neem extract, bacteria, red blood cells and Lysozyme: possible relation to periodontal disease