Desenvolvimento do gel Malva sylvestris L. e a avaliação clínica na resposta inflamatória gengival e no biofilome dental

Abstract

In this study, a phytochemical screening and the in vitro antimicrobial and antioxidant properties of crude hydroalcoholic extract of Malva sylvestris L. (EHBM) was performed for a M. sylvestris gel formulation. Antiplaque and antigingivitis were also carried out using a partial-mouth, experimental gingivitis model in humans. Thirty subjects were chosen to participate in this crossover double-blind study, three 15-days experimental periods with a 10-days interval between each treatment. Patients were submitted to 3 treatments: Treatment 1 – placebo gel, Treatment 2 – 10% M.sylvestris gel; Treatment 3 – 2% chlorhexidine gel (positive control). The clinical parameters plaque index, modified marginal bleeding index and gingival fluid measurement were evaluated. The teeth: 15, 16, 35 and 36 were analyzed. EHBM showed the presence of mucilage (primary metabolite), steroids and/or triterpenes, coumarins, anthraquinones, flavonoids and tannins (secondary metabolites). The antioxidant activity mean was 5.75% and 26.30% compared to 100% of the total antioxidant activity attributed to ascorbic acid, respectively for EHBM and 10% M.sylvestris gel. No concentration of EHBM revealed antimicrobial effect in both agar disk and agar well diffusion tests. In the clinical study, there was no statistical difference for clinical parameters and gingival fluid measurement considering the different treatments. The primary and secondary metabolites of M. sylvestris suggest its anti-inflammatory effect. The EHBM has a reduced antioxidant activity. No influence on supragingival plaque is observed between 10% M. sylvestris gel and placebo. For gingival inflammation, no influence is verified for 10% M. sylvestris gel compared to placebo and chlorhexidine.