|DENTAL SCIENCE - ORIGINAL ARTICLE
|Year : 2015 | Volume
| Issue : 6 | Page : 597-599
Antibacterial efficacy and effect of Morinda citrifolia L. mixed with irreversible hydrocolloid for dental impressions: A randomized controlled trial
A Shafath Ahmed, P David Charles, R Cholan, M Russia, R Surya, L Jailance
Department of Maxillofacial Prosthodontics and Oral Implantology, SRM Dental College and Hospital, Chennai, Tamil Nadu, India
|Date of Submission||28-Apr-2015|
|Date of Decision||28-Apr-2015|
|Date of Acceptance||22-May-2015|
|Date of Web Publication||1-Sep-2015|
Dr. A Shafath Ahmed
Department of Maxillofacial Prosthodontics and Oral Implantology, SRM Dental College and Hospital, Chennai, Tamil Nadu
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Aim: This study aimed to evaluate whether the extract of Morinda citrifolia L. mixed with irreversible hydrocolloid powder decreases microbial contamination during impression making without affecting the resulting casts. Materials and Methods: Twenty volunteers were randomly divided into two groups (n = 10). Group A 30 ml extract of M. citrifolia L diluted in 30 ml of water was mixed to make the impression with irreversible hydrocolloid material. Group B 30 ml deionized water was mixed with irreversible hydrocolloid material to make the impressions following which the surface roughness and dimensional stability of casts were evaluated. Results: Extract of M. citrifolia L. mixed with irreversible hydrocolloid decreased the percentage of microorganisms when compared with water (P < 0.001) but did not affect the surface quality or dimensional stability of the casts. Conclusion: Mixing the extract of M. citrifolia L. with irreversible hydrocolloid powder is an alternative method to prevent contamination without sacrificing impression quality.
Keywords: Antibacterial efficacy, irreversible hydrocolloid, Morinda citrifolia L
|How to cite this article:|
Ahmed A S, Charles P D, Cholan R, Russia M, Surya R, Jailance L. Antibacterial efficacy and effect of Morinda citrifolia L. mixed with irreversible hydrocolloid for dental impressions: A randomized controlled trial. J Pharm Bioall Sci 2015;7, Suppl S2:597-9
|How to cite this URL:|
Ahmed A S, Charles P D, Cholan R, Russia M, Surya R, Jailance L. Antibacterial efficacy and effect of Morinda citrifolia L. mixed with irreversible hydrocolloid for dental impressions: A randomized controlled trial. J Pharm Bioall Sci [serial online] 2015 [cited 2022 Aug 19];7, Suppl S2:597-9. Available from: https://www.jpbsonline.org/text.asp?2015/7/6/597/163562
The use of irreversible hydrocolloid has been the material of choice for making dental impressions. These impressions are disinfected either by spraying the disinfectant or by immersing the impression into the disinfectants.  Although these techniques have appreciable results on the impression surface; however there is an uncertainty regarding the presence of the microorganisms inside the body of the impressions.  Plants have always been among the common sources of medicines, either processed as traditional preparations or used to extract active principles. The large chemical diversity of secondary plant metabolites, which are mostly targeted to animal physiology, makes it a promising source for new therapeutic candidates for a great variety of diseases.
Morinda citrifolia L. (noni) is a common traditional medicinal plant of the native people of the South Pacific, who used all parts of the plant for the treatment of a broad variety of diseases, including gingivitis. ,,, In the last 15 years, various in vitro and in vivo investigations have been done about the biological activity of noni. In many situations, a juice prepared from ripe noni fruits was used for these investigations. Surrounded by various positive effects on health, current research results declare that noni juice has, antifungal effects,  antibacterial effects, , anti-inflammatory effects, , immune enhancements, , and analgesic effects.  The incorporation of this M. citrifolia L. extract into dental impressions may provide an alternative method for preventing contamination of impressions. Therefore, the aim of the study was to evaluate whether the extract of M. citrifolia L. mixed with irreversible hydrocolloid decreased the percentage of microorganisms when compared with water without affecting the accuracy of the resulting cast. The null hypothesis was that the addition of M. citrifolia L. would produce no significant differences regarding microbial contamination or dimensional accuracy of the resulting cast.
| Materials and Methods|| |
The following clinical study was performed as a triple-blinded inclusive of the patient, the operator and the microbiologist and a completely randomized design. The study was performed according to the CONSORT statement. The volunteers were assessed for oral health. Sample size calculation (n = 8) was performed using Mann-Whitney test with the study power of 80% (α =5%).  Twenty volunteers were selected for the study.
The patients were divided randomly into two different groups (n-10) based on the type of liquid used with the irreversible hydrocolloid, using a computer-generated random number table. Standard proportion based on the manufacturer instructions irreversible hydrocolloid was mixed either with deionized distilled water or 30 ml extract of M. citrifolia L diluted with 30 ml of water. The sequence of the treatment was concealed in sealed envelopes.
Samples of saliva were collected before and after impression making. Preferably maxillary impressions were made, and a piece was cut from the palatal area with 10 mm diameter and 2 mm thickness. Each sample was inoculated on specific media and was incubated at 37°C for 24-96 h. The colony forming units were counted and assessed as the percentage reduction of microorganisms following which the measurements were done by a blind examiner under the same condition.
The dimensional stability of the resultant cast was assessed using a metal master template containing two circular columns on a platform, which was used as control. Impressions were poured using type-4 gypsum products. The distance between the inner and the outer pillars of the casts were compared to the control using a digital caliper. The change in the surface roughness was evaluated using a profilometer (Surfcorder SE 1700 Kozaka industry, Kozaka, Tokyo, Japan) mean value of five readings was made, and the differences were evaluated.
The various microorganism counts, dimensional stability and the surface roughness (P < 0.05) was analyzed using Mann-Whitney U-test, two-way analysis of variance and Student-Newman-Keuls test.
| Results|| |
The impressions of irreversible hydrocolloid mixed with the extract of M. citrifolia L. [Table 1] showed less microorganisms in total (P < 0.001), Candida species (P = 0.10), and streptococcoi counts (P = 0.001). The samples of saliva which were taken after impression making with extract of M. citrifolia L in comparison with deionized distilled water were considerably less contaminated (P = 0.001). The surface characteristics and the dimensional stability of the resultant cast showed no statistically significant differences [Table 2].
|Table 1: Mean (SD) counts of total microorganisms (total Streptococci and Candida colony forming units)|
Click here to view
|Table 2: Mean (SD), surface roughness (Ra,µ m), and dimensional stability (mm)|
Click here to view
| Discussion|| |
The study showed that there was a decrease in the total percentage of microorganisms in the irreversible hydrocolloid impressions made using the extract of M. citrifolia L in comparison with the impressions made using deionized distilled water. There was no change in the dimensional accuracy and the surface characteristics of the resultant cast, which were made following the impression with the extract of M. citrifolia L. Therefore, the null hypothesis was rejected. It should be noted that M. citrifolia L have already been proven to have antifungal  and antibacterial effects; , hence, when this was used with the impression material it showed to prove its ability to act on the microorganisms, which could cause contamination with no differences in dimensions and surface characteristics of the resultant casts. However, the cost of the extract of M. citrifolia L is expensive in comparison with deionized distilled water but the disinfection benefits of the extract, which was observed is worth the increased cost.
The concentration of the extract of M. citrifolia L used in the present study is equal to the concentration which is used to treat gingivitis/periodontitis  and adding on to the additional benefits of using this extract allows internal disinfection of the impression as well.
| Conclusion|| |
The use of the extract of M. citrifolia L with the irreversible hydrocolloid to make dental impressions proved to decrease the contamination of microorganisms with no negative changes on the resultant cast their by preventing any cross-contamination.
| References|| |
Donovan TE, Chee WW. A review of contemporary impression materials and techniques. Dent Clin North Am 2004;48:vi-vii, 445-70.
Rosen M, Touyz LZ. Influence of mixing disinfectant solutions into alginate on working time and accuracy. J Dent 1991;19:186-8.
Stewart M. Noni: The lore of the Hawaiian medicinal plants. Bull Pac Trop Gard 1972;2:37-9.
Parsons C. Sickness Experience and Language: Aspects of Tongan and Western Accounting. Ph.D. Thesis, University of Waikato, Hamilton; 1981.
Dittmar A. Morinda citrifolia
L. Use in indigenous Samoan medicine. J Herbs Spices Med Plants 1993;1:77-92.
Singh YN, Ikahihifo T, Panuve M, Slatter C. Folk medicine in Tonga. A study of the use of herbal medicines for obstetric and gynaecological conditions and disorders. J Ethnopharmacol 1984;12:305-29.
Banerjee S, Johnson AD, Csiszar K, Wansley DL, McGeady P. An extract of Morinda citrifolia
interferes with the serum-induced formation of filamentous structures in Candida albicans
and inhibits germination of Aspergillus nidulans
. Am J Chin Med 2006;34:503-9.
Locher CP, Burch MT, Mower HF, Berestecky J, Davis H, Van Poel B, et al.
Anti-microbial activity and anti-complement activity of extracts obtained from selected Hawaiian medicinal plants. J Ethnopharmacol 1995;49:23-32.
Leach AJ, Leach DN, Leach GJ. Antibacterial activity of some medicinal plants of Papua New Guinea. Sci N G 1988;14:1-7.
McKoy ML, Thomas EA, Simon OR. Preliminary investigation of the anti-inflammatory properties of an aqueous extract from Morinda citrifolia
(noni). Proc West Pharmacol Soc 2002;45:76-8.
Kim HJ, Jang SI, Kim YJ, Chung HT, Yun YG, Kang TH, et al.
Scopoletin suppresses pro-inflammatory cytokines and PGE2 from LPS-stimulated cell line, RAW 264.7 cells. Fitoterapia 2004;75:261-6.
Hirazumi A, Furusawa E, Chou SC, Hokama Y. Immuno-modulation contributes to the anticancer activity of Morinda citrifolia
L.(noni) fruit juice. Proc West Pharmacol Soc 1996;39:7-9.
Hokama Y. The effect of noni fruit extract (Morinda citrifolia
L., Indian mulberry) on thymocytes of BALB/c mouse. FASEB J 1993;7:A866.
Basar S, Uhlenhut K, Högger P, Schöne F, Westendorf J. Analgesic and antiinflammatory activity of Morinda citrifolia
L.(Noni) fruit. Phytother Res 2010;24:38-42.
Glang J, Falk W, Westendorf J. Effect of Morinda citrifolia
L. fruit juice on gingivitis/periodontitis. Mod Res Inflamm 2013;2:21-7.
[Table 1], [Table 2]