Background: In the past few decades focus of research has been toward herbal medicines because of growing bacterial resistance and side effects of antimicrobial agents. The extract derived from the plants may increase the efficacy of antibiotics when used in combination against pathogenic bacteria. In the current study, the synergistic antibacterial efficacy of plant extracts in combination with antibiotics has been assessed on selected periodontal pathogens. Methods: Ethanolic extracts were prepared from Salvadora persica (Miswak) and Cinnamomum zeylanicum (Ceylon cinnamon), by the soxhalate method. Plaque samples were collected from clinical periodontitis patients to isolate and grow the periodontal pathobionts under favorable conditions. Susceptibility of bacteria to the extracts was assessed by gauging the diameter of the inhibition zones. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of plant extracts were determined against each bacterium. Synergistic activity of plants extract in combination with antibiotics against the bacteria was also assessed by measuring the diameter of the inhibition zones. Results: Ethanolic extract of both the plants showed an inhibitory effect on the proliferation and growth of all four strains of periodontal pathobionts. Maximum antibacterial activity was exhibited by C. zeylanicum against Tannerella forsythia (MIC = 1.56 ± 0.24 mg/mL, MBC = 6.25 ± 0.68 mg/mL), whereas among all the studied groups the minimum activity was reported by C. zeylanicum against Aggregatibacter actinomycetemcomitans the (MIC = 12.5 ± 3.25 mg/mL, MBC = 75 ± 8.23 mg/mL). Combination of herbal extracts with different antibiotics revealed a synergistic antibacterial effect. The best synergism was exhibited by S. persica with metronidazole against A. actinomycetemcomitans (27 ± 1.78). Conclusions: Current in vitro study showed variable antibacterial activity by experimented herbal extracts against periodontal pathobionts. The synergistic test showed significant antibacterial activity when plant extracts were combined with antibiotics.

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Influence of Functional Clinical Temperature over Compressive Strength and Diametral Tensile Strength of Various Luting Cements.

Background: Drug induced gingival enlargement is a common clinical finding among epileptic patients who are under medical care. This gingival enlargement is generally managed by different methods as scaling and polishing, surgical or substitution of drugs etc. So this study was designed to evaluate the influence of antiepileptic drugs alteration as adjunctive therapy of drug induced gingival enlargement among epileptic patients in Aseer region, Saudi Arabia. Materials and Methods: The present study was done on thirty epileptic patients (10 patients per group) between the ages of 15 and 52 years with gingival enlargement which were treated using scaling and polishing (SP) alone in group I addition chlorhexidine digluconate 0.2% in group II and alteration of drugs in group III. Plaque index (PLI), gingival index (GI) and gingival overgrowth (GO) scores were evaluated at baseline, 3 weeks and 6 weeks after therapy, then tabulated and compared statistically using SPSS and the various in proportions was calculated using Chi-square test. Statistical significance (P < 0.05) was detected in PLI, GI, GO score between baseline, 4 weeks, and 6 weeks. Friedman Test and Wilcoxon Signed Ranks Test were carried out to account the significant differences. Results: There were improvement in all clinical findings among epileptic patients in all study groups in the 1^st, 2^nd and 3^rd visit, but the improvement was most evident among the patients of group III that were treated by SP and alteration of anti epileptic drugs. Conclusions: Professional and self-plaque control also the alteration of antiepileptic drugs might be a useful in the management of drug induced gingival enlargement, consequently diminishing the necessity of surgical therapy.