CClinicalTrials.gg
CompletedNCT02624336ESAAUpdated Dec 8, 2015

Evaluation of Synergistic Anti-plaque Activity of Salvadora Persica L. and Green Tea: A Clinical Comparative Study

A Phase 2 interventional study of DTC1 and Oradex in Healthy Volunteers, sponsored by University of Malaya. Completed. Open to male participants aged 25 Years to 40 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2015-12-08.

Sponsored by University of Malaya · Phase 2, Interventional, and Prevention

Phase
Phase 2
Study type
Interventional
Enrollment
14
Allocation
Randomized
Ages
25 Years to 40 Years
Sex
Male
01

Study summary

Accumulation of dental plaque may result in negative effects on the tooth and tooth supporting periodontal tissue. In addition, it contributes to the development of caries and periodontal diseases. Therefore, an effective dental plaque control is essential for maintaining good oral hygiene. Mechanical plaque control has its limitation thus chemical plaque control may be used as an adjunct in dental plaque control. Various types of medicinal plants can be utilized as stable, safe and biologically active plant-derived galenicals as alternative to synthetic mouth wash. Among these plants, Salvadora persica L. (Sp) root sticks and green tea (Gt) aqueous extracts were reported to have anti-microbial activity against many oral bacteria. The objective of this study was to investigate the efficacy of the combination of Gt aqueous extract and Sp aqueous extract as a synergistic anti-bacterial and anti-adherence efficacy against primary plaque colonizers.

Read the detailed description

Dental plaque is the soft deposits that form the biofilm adhering to the tooth surface or other hard surfaces inside oral cavity, including removable and fixed restoration. The dental plaque is composed of over 500 bacterial species. The colonization of these bacteria follows a special pattern starting by adhesion of initial bacterial colonizers to the salivary pellicles covering tooth enamel and other hard surfaces in the oral cavity followed by secondary colonization of follower bacteria through inter-bacterial adhesion leading to dental plaque maturation.

Periodontal health can be considered to be in a state of balance when the bacterial mass presents in the host oral cavity and causes no damage to either the bacteria or the host periodontal tissues. Any disruption of this balance results in alterations in both the host periodontal and biofilm bacteria and leads ultimately to destruction of the periodontium. Accumulation of dental plaque may lead to several harmful effects on the tooth and tooth supporting periodontal tissue that contributes to the development of caries and periodontal diseases. Therefore, an effective dental plaque control is essential for maintaining good oral hygiene.

Mechanical plaque control, by using toothbrushes and interdental aids, is the mostly adopted method. Unfortunately, it is a time consuming process and needs high manual dexterity. Moreover, epidemiological studies revealed high prevalence of gingivitis among toothbrush users. Hence, chemical plaque control may be used to assist in dental plaque control.

The anti-plaque agent is that agent that interferes with one of the different phases of dental plaque development: interferes with the adhesion of oral bacteria to oral surfaces and prevent biofilm formation; interferes with co-aggregation mechanism which thereby prevents future growth of micro-colonies; or removes or disrupts existing dental plaque. To date, chlorhexidine (CHX) mouthwash is the standard solution used in chemical plaque control, but it was found to have several side effects including tooth and some restorations staining, unpleasant test, sloughing of oral mucosa and enhancement of supra-gingival calculus formation.

The widely available traditional natural medicinal plants can be utilized as stable, safe and biologically active plant-derived galenicals as alternative to synthetic drugs. Among these plants, Salvadora persica L. (Sp) root sticks and green tea (Gt), leafs of Camellia sinensis. Kuntze, aqueous extracts were reported to have anti-microbial activity against many oral bacteria. In our in vitro study, we found that the combination (Co.) of 0.25mg Gt aqueous extract and 7.82mg Sp aqueous extract in 1ml exhibited significant synergistic anti-bacterial and anti-adherence efficacy against primary plaque colonizers.

The dental plaque is classified into two categories, supra-gingival plaque and sub-gingival plaque, in relation to gingival margin. The supra-gingival dental plaque may be readily visualized on teeth after 24 to 48 hours with no oral hygiene measures and it appears white, grayish, or yellow in color and has a globular appearance.

Supra-gingival plaque accumulation on tooth surfaces can be quantified through different plaque index systems. In this study, the clinical parameter to record plaque quantity was modified Quigely Hein Plaque Index. In this index, a score of 0 to 5 was assigned for each facial and lingual (palatal) surface of all teeth except the third molars.

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Conditions studied

  • Healthy Volunteers

Keywords

  • periodontal disease
  • caries
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In context

Lead sponsor

University of Malaya is the lead sponsor of 280 studies on the registry; 55 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
25 Years to 40 Years
Sexes eligible
Male
Accepts healthy volunteers
Yes

Inclusion criteria

  • Participants should be medically healthy.
  • Participants should have more than 20 teeth.

Exclusion criteria

Exclusion Criteria:

  • Participants who have active cavity caries and/or periodontal disease.
  • Participants who have ongoing orthodontic treatment.
  • Participants who have been on antibiotics within the past 4 months.
  • Participants who require prophylactic antibiotic coverage.
  • Participants who have been on systemic or topical non-steroidal anti-inflammatory drugs for the past 4 months.
  • Participants who are pregnant or intended to and lactating mother.
  • Participants who have heart valve replacement and have known intolerance or allergy to mouth rinses.
  • Participants who have any systemic disease.
05

Study design

Phase
Phase 2
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
14 participants (actual)

Study arms

  • Active comparator
    DTC1 mouth wash

    15ml twice a day, rinse for 30sec refrain from eating or drinking for 30min

    Other: DTC1

  • Placebo comparator
    Oradex mouth wash

    15ml twice a day, rinse for 30sec refrain from eating or drinking for 30min

    Other: Oradex

  • Placebo comparator
    Distilled water

    15ml twice a day, rinse for 30sec refrain from eating or drinking for 30min

    Other: Distilled water

Interventions

  • OtherDTC1

    15ml DTC1 twice a day, rinse for 30sec refrain from eating or drinking for 30min

  • OtherOradex

    15ml Chlorhexidine gluconate 0.12% (w/v) twice a day, rinse for 30sec refrain from eating or drinking for 30min

    Also known as: CHX

  • OtherDistilled water

    15ml distilled water twice a day, rinse for 30sec refrain from eating or drinking for 30min

06

What researchers measure

Primary outcomes

  1. Mean amount plaque between different DTC1 and placebo comparators i.e. Oradex and distilled water, as anti-plaque agent following 24 hrs plaque regrowth clinical trial by means of modified Quigely Hein Plaque Index [Turesky, 1970].

    Time frame: 24 hours

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Study locations

No study locations are listed for this record.

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References and documents

Publications

  • Addy M, Moran J, Newcombe R, Warren P. The comparative tea staining potential of phenolic, chlorhexidine and anti-adhesive mouthrinses. J Clin Periodontol. 1995 Dec;22(12):923-8. doi: 10.1111/j.1600-051x.1995.tb01796.x. PubMed 8613560 ↗
  • Allison DG, Gilbert P. Modification by surface association of antimicrobial susceptibility of bacterial populations. J Ind Microbiol. 1995 Oct;15(4):311-7. doi: 10.1007/BF01569985. PubMed 8605070 ↗
  • Baehni PC, Takeuchi Y. Anti-plaque agents in the prevention of biofilm-associated oral diseases. Oral Dis. 2003;9 Suppl 1:23-9. doi: 10.1034/j.1601-0825.9.s1.5.x. PubMed 12974527 ↗
  • Chelli-Chentouf N, Tir Touil Meddah A, Mullie C, Aoues A, Meddah B. In vitro and in vivo antimicrobial activity of Algerian Hoggar Salvadora persica L. extracts against microbial strains from children's oral cavity. J Ethnopharmacol. 2012 Oct 31;144(1):57-66. doi: 10.1016/j.jep.2012.08.025. Epub 2012 Aug 29. PubMed 22963838 ↗
  • Dhar V, Jain A, Van Dyke TE, Kohli A. Prevalence of gingival diseases, malocclusion and fluorosis in school-going children of rural areas in Udaipur district. J Indian Soc Pedod Prev Dent. 2007 Apr-Jun;25(2):103-5. doi: 10.4103/0970-4388.33458. PubMed 17660647 ↗
  • Farnsworth NR, Akerele O, Bingel AS, Soejarto DD, Guo Z. Medicinal plants in therapy. Bull World Health Organ. 1985;63(6):965-81. PubMed 3879679 ↗
  • Hellden L, Camosci D, Hock J, Tinanoff N. Clinical study to compare the effect of stannous fluoride and chlorhexidine mouthrinses on plaque formation. J Clin Periodontol. 1981 Feb;8(1):12-6. doi: 10.1111/j.1600-051x.1981.tb02019.x. PubMed 7019266 ↗
  • Ismail AI, Szpunar SM. The prevalence of total tooth loss, dental caries, and periodontal disease among Mexican Americans, Cuban Americans, and Puerto Ricans: findings from HHANES 1982-1984. Am J Public Health. 1990 Dec;80 Suppl(Suppl):66-70. doi: 10.2105/ajph.80.suppl.66. PubMed 9187585 ↗
  • Manganiello AD, Socransky SS, Smith C, Propas D, Oram V, Dogon IL. Attempts to increase viable count recovery of human supragingival dental plaque. J Periodontal Res. 1977 Mar;12(2):107-19. doi: 10.1111/j.1600-0765.1977.tb00113.x. No abstract available. PubMed 138728 ↗
  • Rosan B, Lamont RJ. Dental plaque formation. Microbes Infect. 2000 Nov;2(13):1599-607. doi: 10.1016/s1286-4579(00)01316-2. PubMed 11113379 ↗
  • Sofrata A, Brito F, Al-Otaibi M, Gustafsson A. Short term clinical effect of active and inactive Salvadora persica miswak on dental plaque and gingivitis. J Ethnopharmacol. 2011 Oct 11;137(3):1130-4. doi: 10.1016/j.jep.2011.07.034. Epub 2011 Jul 20. PubMed 21798329 ↗
  • Sofrata A, Santangelo EM, Azeem M, Borg-Karlson AK, Gustafsson A, Putsep K. Benzyl isothiocyanate, a major component from the roots of Salvadora persica is highly active against Gram-negative bacteria. PLoS One. 2011;6(8):e23045. doi: 10.1371/journal.pone.0023045. Epub 2011 Aug 1. PubMed 21829688 ↗
  • Teles RP, Teles FR. Antimicrobial agents used in the control of periodontal biofilms: effective adjuncts to mechanical plaque control? Braz Oral Res. 2009;23 Suppl 1:39-48. doi: 10.1590/s1806-83242009000500007. PubMed 19838557 ↗
  • Tsai TH, Tsai TH, Chien YC, Lee CW, Tsai PJ. In vitro antimicrobial activities against cariogenic streptococci and their antioxidant capacities: A comparative study of green tea versus different herbs. Food Chem. 2008 Oct 15;110(4):859-64. doi: 10.1016/j.foodchem.2008.02.085. Epub 2008 Mar 4. PubMed 26047271 ↗
  • Turesky S, Gilmore ND, Glickman I. Reduced plaque formation by the chloromethyl analogue of victamine C. J Periodontol. 1970 Jan;41(1):41-3. doi: 10.1902/jop.1970.41.41.41. No abstract available. PubMed 5264376 ↗
  • Abdulbaqi HR, Himratul-Aznita WH, Baharuddin NA. Evaluation of Salvadora persica L. and green tea anti-plaque effect: a randomized controlled crossover clinical trial. BMC Complement Altern Med. 2016 Dec 1;16(1):493. doi: 10.1186/s12906-016-1487-0. PubMed 27903262 ↗

Individual participant data

Plan to share: No

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 8, 2015, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT02624336
Lead sponsor
University of Malaya
Responsible party
Sponsor
First posted
Dec 8, 2015
Start date
Feb 2015
Primary completion
Jun 2015
Completion
Jun 2015
Last update
Dec 8, 2015

Study contacts

Nor_Adinar Baharuddin, DClinDent
principal investigator · University of Malaya

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Dec 2015. You cannot join it, but the record below documents what was studied.

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