Proanthocyanidin-enriched extract from Rumex acetosa L. as a prophylactic agent against Porphyromonas gingivalis: a clinical pilot trial

Aims: Periodontitis is a biofilm depended oral infection. It leads to inflammatory destruction of periodontal tissue and can also affect systemically the host's immune response. Porphyromonas gingivalis (P.g.) is one of the major pathogens associated with the onset and progression of periodontitis. The bacterial adhesion to oral mucosa cells is primarily essential for the tissue invasion and following breakdown. Previous in vitro studies have shown that a proanthocyanidin-enriched extract from Rumex acetosa L. inhibits the adhaesion of P.g. and acts in a cytoprotective manner. Therefore the aim of this controlled, randomized and double blinded study was to evaluate these effects in humans.

Material and Methods: 35 P.g. positive, but periodontally and generally healthy patients received a supragingival debridement. Afterwards they were randomly assigned to the test or control group and were instructed to rinse 3 times per day with either a Rumex acetosa extract (0.8% w/w) containing mouth wash or placebo for 7 days. Plaque samples were taken at different visits (screening, baseline, 2, 4, 7 and 14 days after baseline) and P.g. was identified and quantified by real-time polymerase chain reaction. Additionally clinical parameters as plaque- and bleeding index were recorded.

Results: Preliminary microbiological results did not show any significant differences, but the median of the P.g. prevalence showed a tendential greater increase in the test group. A significant reduction of the gingival bleeding index was monitored in the test group at day 14 (p = 0.003) compared to the baseline values, this was not detected in the control group (p = 0.074).

Conclusion: This study indicates that the usage of a Rumex acetosa extract in combination with professional tooth cleaning results in a favorable anti-inflammatory outcome in P.g. positive patients. Further investigations have to be made regarding this cytoprotective effect and the heterogenic outcome of the P.g. prevalence.