Aloe vera and Probiotics in Treatment of Chronic Periodontitis Patients: A Clinicoradiographic Study

Periodontitis describes a chronic inflammatory disease resulting in destruction of the tissues that support the teeth. In recent years, various host response modulation therapies and local drug therapies have been developed to block the pathways responsible for periodontal tissue breakdown. The objective of this study was to compare and evaluate the efficacy of aloe vera gel as local drug delivery and probiotic as lozenges in treatment of chronic periodontitis using clinical and radiographic parameters. Methodology: The study involved 32 chronic periodontitis patients visiting the Department of Periodontics in a dental college of Karnataka. The patients were randomly allotted into two groups; A and B and were irrespectively subjected to routine Scaling and Root Planing. As an adjunct, aloe vera gel in group A and probiotic lozenges in group B were adopted as schemes for treatment. The clinical parameters and radiographic assessments were performed using appropriate techniques. The values in clinical parameters were recorded at baseline, one month and two months. Radiographic assessment was done using Prolmage digital radiography software appreciating difference in terms of bone density and noting the gain, loss or similar levels post treatment at two months in both groups. The collected data for clinical and radiographic parameters was assessed by statistical analysis using independent t test for intergroup comparison and paired t test for intragroup comparison and Chi square test using a statistical package SP S S version 20.0. Results: The intergroup results did not show any statistical significance but results indicated aloe vera apparently better over probiotics in the present study. The radiographic assessment revealed 57.1% gain in bone density in both the groups though statistically non significant. Conclusion: Both aloe vera and probiotic in the light of present observation have unfolded as novel and effective treatment modalities in controlling the extent of damaged periodontium. However, prospective studies with larger sample size comparing both modalities are encouraged in future. INTRODUCTION Periodontitis describes a chronic inflammatory disease resulting in destruction of the tissues that support the teeth. It results from extension of the inflammatory process initiated in the gingiva to the supporting periodontal tissues. In the era of widespread antibiotic resistance where treatment to chronic inflammatory conditions have become a challenging task, shifting the paradigm to natures healing ability is emerging as an alternative field. In recent years, various host -response modulation therapies and local drug therapies have been developed to block the pathways responsible for periodontal tissue breakdown.' Aloe vera has an unlimited future in dentistry for its antiinflammatory and antiviral properties alongwith immunological benefits for the patients.2 The antimicrobial properties are attributed to its diverse phytochemical constitution and biochemical nature. The lignins have the properties to penetrate the tissues while saponins are responsible for the antibacterial properties. Varied vitamins Vitamin A , C and E are necessary for maintaining the integrity of epithelial cells along with antioxidant properties and periodontal tissue regeneration.3,4 Also, the application of health promoting bacteria for therapeutic purpose is one of the strongest emerging fields. Shift in the paradigm of the treatment from specific bacteria elimination to alteration of the bacterial ecology by using probiotics has been made.'