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Table 4 Natural anti-biofilm agents under clinical evaluation with outcomes

From: Developing natural products as potential anti-biofilm agents

Studies

Condition

Intervention

Outcome

References

Randomized controlled clinical trials

Denture wearers with denture stomatitis (n = 64)

Control, 0.85% saline

SH1, 0.25% sodium hypochlorite

SH2, 0.5% sodium hypochlorite

RC, 10% Ricinus communis

Ricinus communis showed antimicrobial activity against S. mutans and Candida spp.

[90]

A randomized crossover clinical trial

Denture wearers with denture stomatitis (n = 50)

Control, 0.85% saline

SH1, 0.1% sodium hypochlorite

SH2, 0.2% sodium hypochlorite

RC, 8% Ricinus communis

Ricinus communis alleviated the symptom of denture stomatitis, however anti-biofilm effect was not evident

[91]

Randomized controlled trials

Dental plaque (n = 14)

Control, 0.12% chlorhexidine

Test formulation containing 0.25 g/ml green tea and 7.82 g/ml Salvadora persica L. aqueous extracts

Placebo mouthwashes

The test mouthwash significantly has positive effect on disrupting plaque colonization when compared with placebo and control group for short time treatment (24 h)

[92]

Randomized, double-blind controlled study

Patients undergoing orthodontic treatment with fixed appliances (n = 30)

C: Placebo

T1: mouthwash containing 1% Matricaria chamomilla L. (MTC) extract

T2: 0.12% chlorhexidine (CHX)

MIC could suppress biofilm development and gingival bleeding

[93]

Randomized controlled clinical trials

Patients with moderate chronic periodontitis after scaling and root planing (SRP) (n = 46)

Placebo mouthwashes (n = 23)

Essential oil mouthwash consisting of essential oils (Cymbopogon flexuosus, Thymus zygis and Rosmarinus officinalis) (n = 23)

The combined use of a mouthwash containing essential oils following SRP was well tolerated and had anti-biofilm effect in the subgingival for 14-day treatment

[94]

Randomized double-blind clinical study

Oral malodour (n = 20)

Lemongrass oil (LG) mouthrinse

LG mouthwash showed selective anti-bacteria effect against Aggregatibacter actinomycetemcomitans ATCC43718 and Porphyromonas gingivalis W50 and could reduce oral malodour for 8-day treatment

[95]

Randomized controlled trials

Orthodontic patients (n = 34)

Melaleuca gel: Gel developed with the essential oil of Melaleuca alternifolia

Colgate total

The melaleuca gel was more effective in decreasing the dental biofilm and the numbers of bacteria colonies

[96]

Randomized controlled trials

Caries and periodontal diseases (n = 30)

G1: A commercially available dentifrice

G2: Dentifrice containing mineral oil (Nujol®)

G3.: Dentifrice containing vegetable oil (Alpha Care®)

Both mineral oil and vegetable group exhibited improved biofilm control and could significantly decrease dental biofilm formation in clinical

[97]

Randomized controlled trials

Patients with subclinical or uncomplicated recurrent UTI (r-UTI) (n = 72)

Placebo (n = 36)

Cranberry extract (PAC-A, proanthocyanidin-A) (n = 36)

The overall efficacy and tolerability of standardized cranberry extract containing (PAC-A) as a food supplement were superior to placebo in terms of reduced bacterial adhesion; biofilm development; urine pH reduction; and in preventing r-UTI (dysuria, bacteriuria and pyuria)

[98]

Single-blinded, randomized and controlled pilot study

Patients with indwelling urinary catheters (n = 83)

Control (n = 35)

CISTIMEV PLUS®: Solidago, orthosiphon, birch and cranberry extracts (n = 48)

CISTIMEV PLUS® significantly reduced microbial accumulation in patients

[99]

A pilot randomized controlled trial

P. aeruginosa related lung cystic fibrosis (n = 34)

Placebo group

Garlic or olive oil treatment group

Both garlic and olive oil capsules were tolerated, but no significant effect was found in antibacterial activities

[100]