Comparative Evaluation of Efficacy of Chlorhexidine with Centella asiatica in the Management of Stage 2 Grade B Periodontitis in Type 2 Diabetes Mellitus Patients - A Randomised Controlled Clinical Trial

Introduction: Chemical plaque control agents are used as an adjunct to non-surgical periodontal therapy. Adjunctives can assist in proper oral hygiene maintenance. Type 2 diabetes mellitus is a metabolic disease that can reflect in the periodontium. Periodontal disease prevention and management in Type 2 diabetes patients need routine dental care. Over counter mouthwashes used by patients can result in side effects; this has popularised the use of herbal mouthrinses that have minimal side effects. Aim: The present study aimed at evaluating the efficacy of chlorhexidine (CHX) with Centella asiatica in the management of Stage 2 Grade B periodontitis in type 2 diabetes mellitus patients. Materials and method: Seventy Type 2 diabetes mellitus patients with periodontitis were recruited for this study. In Group A, 35 subjects received scaling and root planing (SRP) and 10% C. asiatica mouthwash. In Group B, 35 subjects received SRP and 0.2% CHX mouthwash (Colgate-plax, Colgate-Palmolive). Clinical periodontal outcomes measured were plaque index (PI), gingival index (GI), bleeding on probing (BOP) and probing depth (PD) at baseline, 1 month and 3 months post therapy. Salivary total antioxidant capacity (TAOC) and Interleukin 1b levels were also measured at baseline and 3 months. Results: Clinical parameters PI, GI, BOP and PD were reduced significantly in groups A and B, post-treatment, 3-month follow-up. However, the intergroup comparison didnot show any significant difference. Salivary TAOC levels were significantly increased in both groups after 3 months therapy. The intergroup comparison of salivary TAOC levels between groups didnot show any significant difference. Salivary interleukin 1β levels were significantly reduced in both groups post-treatment. Conclusion: This study suggests the anti-inflammatory and antioxidant potential of C. asiatica mouthwash and a safe alternative to CHX mouthwash as an adjunct in the management of Stage 2 Grade B periodontitis in type 2 diabetes mellitus patients.