Clinical, in vitro and phytochemical, studies of Scrophularia striata mouthwash on chronic periodontitis disease

Ethnopharmacological relevance: Chronic periodontitis is an inflammatory process of the oral cavity that is caused by different reasons. Streptococcus mutans bacteria is the main cause of the disease. Scrophularia striata in Iranian traditional medicine is used to heal inflammation of gum and mouth. Also, In vitro anti-bacterial effect of S. striata in S. mutans have been demonstrated. Aim of the study: Clinical, in vitro and chemical constituent studies of S. striate on chronic periodontitis disease. Materials and methods: This study is a randomized clinical trial that was performed in Dental College, Hamadan University of Medical Sciences. Fifty patients with chronic periodontitis (20-50 years old) were selected and the study was approved and registered in Iranian Registry of Clinical Trials as number IRCT2015081323468N1 prior to the experiment. The 50 patients were divided into two groups. One group used herbal mouthwash that was made from hydro alcoholic extract of S. striata and another group used Irsha mouthwash (Iranian form of Listerine mouthwash). Patients were followed up after two weeks and four weeks of using mouthwash for assessment of plaque index (PI), pocket depth (PD), bleeding on probing (BOP) and counting Streptococcus mutans. The mouthwash was standardized according to gallic acid, quercetin and apigenin reference using the RP-HPLC method. The total phenolic and flavonoids contents were also determined spectrophotometerically. Results: S. striate in the short term, improve plaque index, pocket depth and bleeding on probing but the number of Streptococcus mutans changed significantly in the long term and is more potent in comparison to Irsha mouthwash. The mouthwash was standardized according to gallic acid, quercetin and apigenin standard (3, 24, 11 mu g, respectively). The total phenolic and flavonoid content of mouthwash were 120.7 mu g GAE/100 cc and 78.6 mu g QE/100 cc respectively. Conclusions: S. striate mouthwash is effective in the treatment of chronic periodontitis disease and is more potent comparing the Iranian Irsha mouthwash.