Effect of Various Mouthwashes on the Levels of Interleukin-2 and Interferon- in Chronic Gingivitis

The aim of this double blind study was to evaluate the effect of various mouthwashes: Chlorhexidine, Essential oil, Azadirachta indica (Neem) extract, and Povidone iodine on gingival tissue interleukin-2 (IL-2) and interferon-γ (IFN-γ) levels in patients with chronic gingivitis. A total of 80 patients (42 boys, 38 girls; mean age 16.0 ± 1.8 years) were included in this study. Patients were randomly assigned into four groups of 20 each: Group I- Azadirachta indica (Neem) extract, Group II - Essential oil, Group III - Povidone iodine, and Group IV - Chlorhexidine. They were instructed to use these mouthwashes for two weeks. Plaque and gingival indices scores, and IL-2 and IFN-γ levels in the gingival tissues were measured at baseline and after two weeks of mouthwash use. Results showed the reduction of plaque and gingival indices, and IL-2 and IFN-γ level with Chlorhexidine, Essential oil, and Povidone iodine, which were found to be statistically significant. Although Neem reduced the level of plaque and gingival indices, and IL-2 and IFN-γ to a certain level, it was not statistically significant. Therefore, Chlorhexidine, Essential oil, and Povidone iodine mouthwashes can be used as an adjunct to oral prophylaxis in reducing pro-inflammatory cytokines, IL-2 and IFN-γ in patients with chronic gingivitis.

Chronic gingivitis, interleukin-2, interferon-, Azadirachta indica, Povidone iodine, Chlorhexidine

1. Berglundh T, Liljenberg B, Lindhe J: Some cytokine profiles of T-helper cells in lesions of advanced periodontitis. J Clin Periodontol, 29: 705–709, 2002.

2. Page RC: The role of inflammatory mediators in the pathogenesis of periodontal disease. J Periodont Res, 26: 230, 1991.

3. Johnson RB and Serio FG: Interleukin – 18 concentrations and the pathogenesis of periodontal disease. J Periodontol, 76 (5): 785–90, 2005.

4. Gorska R, Gregorek H, Kowalski J, Laskus-Perendyk A, Syczewska M, Madalinski K: Relationship between clinical parameters and cytokine profiles in inflamed gingival tissue and serum samples from patients with chronic periodontitis. J Clin Periodontol, 30: 1046–1052, 2003.

5. Bowden DEJ, Davies RM, Holloway PJ, Lennon MA, Rugg-Gunn AJ: A treatment need survey of a 15 year old population. Br Dent J, 134: 375–379, 1973.

6. Wolinsky LE, Mania S, Nachnani S and Ling S: The inhibiting effect of Aqueous Azadirachta indica (Neem) extract upon bacterial properties influencing in vitro plaque formation. J Dent Res, 75(2): 816–822, 1996.

7. Pai MR, Acharya LD, Udupa N: Evaluation of anti-plaque activity of Azadirachta indica leaf extract gel – a 6 weeks clinical study. J Ethnopharmacol, 90(1): 99–103, 2004.

8. Goodson JM: Response In: Loe H and Kleinman DV (Eds.) Dental plaque control measures and oral hygiene practices. pp. 143–146. Oxford IRL Press (1986).

9. Boisnic S, Ben Slama L, Branchet Gumila MC, d’Arros G: Contribu-tion of Parodium gel in an experimental model of human gingival inflammation. Rev Stomatol Chir Maxillofac, 104: 201–5, 2003.

10. Yucel-Lindberg T, Twetman S, Skold Larson K, Modeer T: Effect of an antibacterial dental varnish on the levels of prostanoids, leukotriene B4 and IL-1‚ in GCF. Acta Odontol Scand, 57(1): 23–27, 1999.

11. Loe H: The gingival index, the plaque index, and the retention index systems. J Periodontol, 38: 610(suppl), 1967.

12. Silness P, Loe H: Periodontal disease in pregnancy. Acta Odontol Scand, 22: 121, 1964.

13. Bartova J, Kratka-Opatrna Z, Prochazkova J et al: Th1 and Th2 cytokine profile in patients with early onset periodontitis and their healthy sib-lings. Mediators Inflamm, 9(2): 115–20, 2000.

14. Loe H and Schiott CR: The effect of mouthrinses and topical applica-tion of chlorhexidine on the development of dental plaque and gingivi-tis in man. J Periodontal Res, 5: 79–83, 1970.

15. Jorgensen MG and Slots J: Practical antimicrobial periodontal therapy. Compend Contin Educ Dent, 21: 111, 2002.

16. Vanka A, Tandon S, Rao SR, Udupa N: The effect of indigenious neem mouthwash on S. mutans and Lactobacilli growth. Indian J Dent Res, 12(4): 193, 2001.

17. Mombelli A and Graf H: Depth force patterns in periodontal probing. J Clin Periodontol, 13: 126, 1996.

18. Seymour GJ and Gemmell E: Cytokines in periodontal disease: where to from here? Acta Odontol Scand, 9: 167–173, 2001.

19. Ebersole JL, Suger RE, Steffensen B, Filloon T, Kornman KS: Inflam-matory mediators and Immunoglobulins in GCF from healthy, gingivi-tis and periodontitis sites. J Periodont Res, 28: 543–546, 1993.

20. Prabhu A, Michalowicz B and Mathur A: Detection of local and sys-temic cytokines in adult periodontitis. J Periodontol, 67: 515–522, 1996.