Comparison of Antimicrobial Efficacy of Natural Extracts as a Disinfectant for Removable Orthodontic Appliances: An Ex Vivo Study

Abstract

Aim The purpose of the study is to formulate a standard protocol for cleaning and disinfecting removable appliances by evaluating the antimicrobial efficacy of three natural extracts. Materials and methods Fifty patients with removable orthodontic appliances were selected and divided into five groups [chlorhexidine 0.2% (positive control), extracts of neem , katha , cinnamon, and normal saline (negative control)] with 10 samples each. Saliva sample from the appliance was collected using a sterile cotton swab and cultured. Agar diffusion method was used and zones of inhibition were measured. Statistical analysis The obtained data were subjected to statistical analysis by the Kruskal–Wallis ANOVA test and the Mann–Whitney U test. Results The neem extract had the highest zone of inhibition measuring 14.95 mm (mean) followed by katha extract with the value of 13.85 mm which was found to be comparable to chlorhexidine with 15.85 mm. Conclusion Thus, neem and katha extracts can be used to disinfect removable appliances because of their good antimicrobial activity. Clinical significance By following these simple cleaning protocols, it is possible to avoid numerous health hazards caused by unclean removable appliances in children. How to cite this article Janani J, Nagar P, Kaniappan AS, et al. Comparison of Antimicrobial Efficacy of Natural Extracts as a Disinfectant for Removable Orthodontic Appliances: An Ex Vivo Study. Int J Clin Pediatr Dent 2020;13(6):640–643.

What Are the Cleaning and Disinfection Methods for Acrylic Orthodontic Removable Appliance? A Systematic Review

“…Characteristics for each individual study are described in Tables 2 and 3. Out of the eight studies reviewed, six of them were randomized controlled trials [25][26][27][28][29][30] and two were non-randomized controlled studies [31,32], published from 2006 to 2020. In terms of geographic localization, three studies were conducted in Brazil [27,29,30], two in Malta [25,26], one in Germany [31], one in China and USA [28], and one in India [32].…”

“…Out of the eight studies reviewed, six of them were randomized controlled trials [25][26][27][28][29][30] and two were non-randomized controlled studies [31,32], published from 2006 to 2020. In terms of geographic localization, three studies were conducted in Brazil [27,29,30], two in Malta [25,26], one in Germany [31], one in China and USA [28], and one in India [32]. All studies considered, a total of 318 subjects were enrolled in the studies, and also 318 acrylic removable orthodontic appliances were studied.…”

“…Three studies assessed the efficiency of liquid solution (enzymatic commercial solution (Ortoform ® ), 0.5% sodium hypochlorite, 0.05% cetylpyridinium chloride (Cepacol ® ) or 0.12% chlorhexidine gluconate (Periogard ® )) [27,29,30], three used commercial cleaning tablets [25,26,31], one investigated the effects of natural plant extracts [32] and the remaining one [28] evaluated incorporating an antimicrobial agent in the resin. Immersion eight times a day (5 min) in 20% sucrose solution to enhance biofilm formation.…”

“…Jagganathan et al [32] Salivary swabs were collected from palatal side of the appliance. Neem, katha, and cinnamon extracts were prepared.…”

“…Global biofilm amount, with no distinction between microbial species, was evaluated by four [28,29,31,32] of the studies. Two studies specifically counted Mutans streptococci (MS) colonies [27,30], while the remaining two focused on Candida amount (all subspecies included) [25,26].…”