Triphala: A phytomedicine for local drug delivery - A strategic intervention.

In the Indian system of medicine (ISM) Triphala is one of the oldest and longest used natural herbal remedy which consist of mixture of equal parts of the Embilica officinalis Gaertn. (Family- Euphorbiaceae), Terminalia Chebula Retz. (Family- Combretaceae) and Terminalia beleria [Gaertn.] Roxb. (Family- Combretaceae). Currently, Triphala is being extensively researched for its various therapeutic effects including its anti-caries, antioxidant, anti-collagenase and anti-microbial activities. This fruit extract is used in various forms in the treatment of periodontitis.

The aim of the present study was to compare the clinical and microbiological benefits of routine scaling and root planing (SRP) with adjunctive use of Triphala (Hiora GA) as local drug delivery agent in the management of periodontitis.

Thirteen patients diagnosed with chronic periodontitis were included in the present study. The control sites received SRP alone and the test sites received SRP with locally delivered Triphala (Hiora GA). The clinical parameters were evaluated at baseline, 15 days and 1 month. The plaque samples were cultured anaerobically for the keystone-periodontal pathogen Porphyromonasgingivalis, Fusobacteriumnucleatum and Prevotellaintermedia. The Mann-Whitney U-test and Wilcoxon signed-rank tests were performed to compare the results between the test and control groups.

Statistically significant improvement was observed in both groups. Intergroup comparison of prevalence of microorganisms also revealed a statistically significant difference (P = 0.0007) at 15 days and 1 month.

Subgingivally delivered Triphala (Hiora GA) as an adjunct to SRP in the treatment of chronic periodontitis has shown anticipative results revealing slow and constant releasing property of Triphala.