| |
|
|
| Year : 2015 | Volume
: 26
| Issue : 5 | Page : 528-532 |
|
| Antimicrobial and antifungal efficacy of Spilanthes acmella as an intracanal medicament in comparison to calcium hydroxide: An in vitro study |
|
|
Savitha Sathyaprasad1, Bijosh K Jose2, H Sharath Chandra1
1 Department of Pedodontics, KVG Dental College and Hospital, Dakshina Kannada, Karnataka, India
2 Practitioner, Specialist Pedodontist, International Hospital of Bahrain, Manama, Bahrain
Click here for correspondence address and email
| Date of Submission | 02-Dec-2014 |
| Date of Decision | 17-Dec-2014 |
| Date of Acceptance | 06-Aug-2015 |
| Date of Web Publication | 17-Dec-2015 |
|
|
 |
|
 Abstract | | |
Background: Repeated endodontic failures are due to pathogens like Enterococcus faecalis and Candida albicans which are resistant to the common intracanal medicaments like calcium hydroxide (Ca[OH] 2 ).
Aims: To determine the role of commonly used folk medicine, Spilanthes acmella (SPA) against root canal pathogens like E. faecalis, C. albicans, Staphylococcus aureus, Streptococcus sp, and to compare its efficacy with Ca(OH) 2 , a popularly used intracanal medicament.
Materials and Methods: Bacterial strains of S. aureus, Streptococcus sp., E. faecalis, and fungal strains of C.albicans were tested against different concentrations of SPA and Ca(OH) 2 . Seven days old cultures of test organisms were seeded onto agar plates and uniformly spread with a spreader. Five to six wells (8 mm) were made on agar plate to which different concentrations of the test solutions were added. The inoculated plates were kept in an incubator at 37°C for 48 h and inhibition zones were measured.
Statistical Analysis: Results of SPA were compared with results of Ca(OH) 2 statistically using Mann-Whitney U test.
Results: A significant zone of inhibition was obtained with SPA and was found to increase as the concentration increased for C. albicans. SPA showed a significant zone of inhibition at 2-5% and 10% whereas Ca(OH) 2 showed a zone of inhibition only at 10% for E. faecalis. SPA showed a zone of inhibition only at 10%, whereas, Ca(OH) 2 showed a significant zone of inhibition at 5% and 10% for S. aureus and Streptococcus sp., respectively.
Conclusion: SPA possesses remarkable antibacterial and antifungal activity against common root canal pathogens which are responsible for repeated endodontic failures such as E. faecalis and C. albicans when compared with medicaments like Ca(OH) 2 .
Keywords: Calcium hydroxide, intracanal medicament, Spilanthes acmella, zone of inhibition
How to cite this article:
Sathyaprasad S, Jose BK, Chandra H S. Antimicrobial and antifungal efficacy of Spilanthes acmella as an intracanal medicament in comparison to calcium hydroxide: An in vitro study. Indian J Dent Res 2015;26:528-32 |
How to cite this URL:
Sathyaprasad S, Jose BK, Chandra H S. Antimicrobial and antifungal efficacy of Spilanthes acmella as an intracanal medicament in comparison to calcium hydroxide: An in vitro study. Indian J Dent Res [serial online] 2015 [cited 2023 Sep 24];26:528-32. Available from: https://www.ijdr.in/text.asp?2015/26/5/528/172081 |
Endodontic therapy is based on nonspecific elimination of intraradicular microorganisms. [1] However, bacteria located in ramifications, isthmi, and other irregularities are likely to escape the effects of chemomechanical procedures and may remain viable, multiplying in period between treatments leading to endodontic failures. [2] Repeated endodontic failures are due to pathogens like Enterococcus faecalis and Candida albicans which are resistant to the common intracanal medicaments like calcium hydroxide (Ca[OH] 2 ). [3] Studies with flower head of Spilanthes acmella (SPA), have shown strong antimicrobial activity against common pathogens as E. faecalis, Streptococcus mutans, Staphylococcus aureus, C. albicans, Escherichia Coli, Klebsiella pneumoniae, Proteus vulgaris, Pseudomonas aeruginosa, Bacillus subtilis, and Staphylococcus albus. [4] However, no study has been done so far to test the efficacy of the SPA against the commonly occurring endodontic pathogens. This study aims at testing the antimicrobial and antifungal effect of SPA against common intracanal pathogens and comparing its efficacy with Ca(OH) 2 .
| Materials and methods | |  |
Bacterial and fungal strains obtained from the Department of Microbiology, were used for the testing antibacterial and antifungal activity of SPA and Ca(OH) 2 .
Investigation design
Plant material and chemical extraction
Flower heads were air dried, and the extract was obtained with petroleum ether (40-60°C) using a Soxhlet apparatus. [5]
A Soxhlet extractor is a laboratory apparatus invented in 1879 by Franz von Soxhlet, [6] originally designed for the extraction of a lipid from a solid material [Figure 1]. However, the extraction was not limited to only lipids. Typically, a Soxhlet extraction is only required where the desired compound has a limited solubility in a solvent, and the impurity is insoluble in that solvent.
Air dried flower heads of SPA were placed inside a thimble made from thick filter paper, which was loaded into the main chamber of the Soxhlet extractor. The Soxhlet extractor was placed onto a flask containing the extraction solvent, petroleum ether (40-60°C). The Soxhlet was then equipped with a condenser.
The solvent was heated to reflux, and the vapour travelled up a distillation arm and floods into the chamber containing flower head. Some of the desired compound from flower heads then dissolved into the warm solvent. When the Soxhlet chamber was almost full, the chamber was automatically emptied by a siphon side arm, with the solvent running back down to the distillation flask. This cycle was allowed to repeat many times, over hours or days and during each of these cycles, a portion of the nonvolatile compounds dissolved into the solvent. After many cycles, the desired compound was concentrated in the distillation flask.
After extraction the solvent was removed, typically by means of a rotary evaporator, yielding the extracted compound. The nonsoluble portion of the extracted flower head remains in the thimble and was usually discarded. [7]
Different concentrations of plant extract (0.1%, 0.4%, 1%, 1.6%, 2-5%, and 10%) were made by dissolving in dimethyl sulfoxide.
Test organisms
Four test organisms, bacterial strains of S. aureus, Streptococcus sp., E. faecalis, and fungal strain of C. albicans were obtained from Department of Microbiology.
Bioassay
Agar cup bioassay was employed for testing antibacterial and antifungal activity of plant extract. The readymade Mueller-Hinton agar and Sabouraud's dextrose agar medium was suspended in distilled water and autoclaved at 121°C, pressure of 15 lb/inc 2 for 20 min. Seven days old cultures of test organisms inoculated on to peptone water and incubated for 4 h, were seeded onto a plate and uniformly spread with a spreader. Five to six wells (8 mm) were made on Mueller-Hinton agar and Sabouraud's dextrose agar plate with sterile cork borer. To each well, different concentrations of test solutions SPA extract and Ca(OH) 2 paste (0.1-l0%) were added. The inoculated plates were kept in an incubator at 37°C for 48 h and inhibition zones were measured. As a positive control, 4 plates contained just the organisms to ensure bacterial life cycle does not become inactive before 24-48 h. SPA extract and Ca(OH) 2 paste placed on two plates that had not been inoculated with bacteria and fungi were used as negative control.
Statistical analysis
All the results were expressed as mean ± standard deviation. Statistical significance was determined by Mann-Whitney U test. P < 0.05 was considered significant.
| Results | | |
The outcome of the study was that SPA extract at different concentrations has antimicrobial efficacy against E. faecalis and antifungal efficacy on C. albicans which are responsible for repeated endodontic failures when compared to Ca(OH) 2 .
It was determined by measuring the extent of the zone of inhibition on the culture medium in millimeters.
For Candida albicans
The highly significant statistical difference (P < 0.05) for the zone of inhibition was observed between Ca(OH) 2 group and SPA group at all the concentrations tested. Zone of inhibition for SPA increased as the concentration increased while for Ca(OH) 2 zone of inhibition was present only at 10%. The result shows that SPA is effective against C. albicans in all concentration compared to Ca(OH) 2 [Table 1]. | Table 1: Group comparison of values for zone of inhibition of Candida albicans Ca(OH)2 and SPA showing mean and SD (P<0.05)
Click here to view |
For Enterococcus faecalis
Statistically significant difference (P < 0.05) was observed for the zone of inhibition at concentrations of 2-5% and 10% for Ca(OH) 2 group compared to SPA group. No difference was seen at concentrations of 0.1%, 0.4%, 1%, and 1.6% between the two groups. The results show that SPA is more effective than Ca(OH) 2 at concentration 2-5% and 10% [Table 2]. | Table 2: Group comparison of values for zone of inhibition of Enterococcus faecalis for Ca(OH)2 and SPA showing mean and SD (P<0.05)
Click here to view |
For Streptococcus sp.
Statistically significant difference (P < 0.05) was observed for the zone of inhibition at concentration of 5% and 10% for Ca(OH) 2 group compared to SPA group. No significant difference was seen at concentrations of 0.1%, 0.4%, 1%, 1.6%, 2%, and 3% between Ca(OH) 2 group and SPA group. The result shows that Ca(OH) 2 is more effective than SPA at concentrations of 10% [Table 3]. | Table 3: Group comparison of values for zone of inhibition of Streptococcus sp. for Ca(OH)2 and SPA showing mean and SD (P<0.05)
Click here to view |
For Staphylococcus aureus
Statistically significant difference (P < 0.05) was observed for the zone of inhibition at concentrations of 5% and 10% for Ca(OH) 2 group compared to SPA group. No significant difference was seen at concentrations of 0.1%, 0.4%, 1%, 1.6%, 2%, and 3% between Ca(OH) 2 group and SPA group. The result shows that Ca(OH) 2 is more effective than SPA at concentrations of 5% and 10% [Table 4]. | Table 4: Group comparison of values for zone of inhibition of Staphylococcus aureus for Ca(OH)2 and SPA showing mean and SD (P<0.05)
Click here to view |
| Discussion | | |
Repeated endodontic failures are said to be due to inefficiency of the root canal medicaments against few pathogens such as E. faecalis and C. albicans which are resistant to the common intracanal medicaments like Ca(OH) 2 . [3],[8]
Ca(OH) 2 , a popular intracanal medicament is known from many decades for its efficiency in eliminating both aerobic and anaerobic bacteria by its ionic dissociation into Ca + and OH− ions and for its cytotoxic effect by consequent change in the organic component and in nutrient transport. [3] However, repeated endodontic failures are reported due to the ineffectiveness of this medicament against E. faecalis and C. albicans. [3],[5],[9] According to Lana et al. even after treatment with Ca(OH) 2 , polymicrobial infections with Candida and Streptococcus persisted within the root canals. [10] Estrela et al. showed that Ca(OH) 2 had no antimicrobial effect on E. faecalis and S. aureus. [11] Behnen et al. also suggest that thin preparations of Ca(OH) 2 is not effective in the elimination of E. faecalis from root cana1. [12] Hence, in the quest to find an alternative medicament, extract of the flower head of SPA was sought to check its potential for microbial eradication when used as an intracanal medicament. Hence, the present study was done to evaluate the antibacterial and antifungal efficacy of SPA against common root canal pathogens S. aureus, Streptococcus sp., E faecalis, and C.albicans using agar well diffusion method and compare it with antibacterial and antifungal efficacy of Ca(OH) 2 .
Results of the present study showed that SPA had a significant antibacterial action at different concentrations of 2-5% and 10% for E. faecalis (P < 0.05) whereas Ca(OH) 2 showed antibacterial action only at the higher concentration of 10%. This was in accordance with the studies done by Gomes et al., Haapasalo and Orstavik, and Safavi et al. who showed that E. faecalis was resistant to Ca(OH) 2 . [2],[13],[14] Siqueira and Uzeda demonstrated that Ca(OH) 2 was ineffective in eliminating E. faecalis cells inside dentinal tubules, even after 1-week of contact. [15] The limited effectiveness of Ca(OH) 2 is due to factors such as low solubility and diffusibility, varying alkaline potential of different formulations, dense biofilms of bacteria and the ability of E. faecalis to evade the hydroxyl ions due to their presence in ramifications, isthmuses, and irregularities. [3] Evans et al. showed that Ca(OH) 2 eliminated E. faecalis only when present in low numbers in infected teeth without previous root fillings and not in teeth with previous root fillings where E. faecalis was found in higher numbers. The probable reason that E. faecalis is able to survive intracanal treatment of Ca(OH) 2 could be (a) E. faecalis passively maintain pH homeostasis by cytoplasm's buffering capacity and by the proton pump. (b) As a result of the buffering capacity of dentin, pH of Ca(OH) 2 cannot be maintained constantly at 11.5. [16] However, studies done by Almyroudi et al. compared the susceptibility of intracanal medicaments containing Ca(OH) 2 , found that Ca(OH) 2 was effective against E. faecalis. [l7] Onçag et al. in his study to evaluate the efficacy of different intracanal medicaments also showed that Ca(OH) 2 was effective against E. faecalis. [18] These studies were contradictory to this present study which showed that Ca(OH) 2 was not effective against E. faecalis.
Microbiological investigations have revealed that yeasts can be isolated from root canal together with bacteria [19] and Waltimo et al. showed this in his in vitro study that the most common species isolated from the root-canal were C. albicans. [8] Studies done by Valera et al. and Ferguson et al. have shown that C. albicans are resistant to Ca(OH) 2 . [20],[21] Ashford et al. and Rojas et al. in their study have proved the antifungal property of SPA. [22],[23] Similarly, the effect of SPA on C. albicans was studied at various concentrations and compared with the antifungal property of Ca(OH) 2 .The results of this study showed that SPA was effective against C. albicans for all the concentrations tested (0.1%, 0.4%, 1%, 1.6%, 2-5%, and 10%) and the zone of inhibition was found to increase as the concentration increased. However, for Ca(OH) 2 the antifungal property was present only at higher concentration of 10%. The result showed statistically significant difference in the zone of inhibition between the two medicaments (P < 0.05). Thus, it can be concluded that SPA is effective against C. albicans in all concentration compared to Ca(OH) 2 which is effective only at higher concentrations.
Our results are in accordance with the studies done by Waltimo et al. who concluded that C. albicans was resistant to aqueous Ca(OH) 2 . [8] Study was done by Miglani et al. also showed that Ca(OH) 2 based sealers has less antifungal effect when compared with other sealers. [24] The probable reason could be due to the resistance shown by Candida species in a wide range of pH values. [25] In contrast, Barbosa et al. found that a saturated solution of Ca(OH) 2 was effective against C. albicans. [26]
Coagulase-negative Staphylococci, Streptococci, and P. aeruginosa were most frequently isolated microflora in endodontically treated teeth associated with asymptomatic periapical lesions. [27] Studies were done by Podbielski et al. and Adre et al. have shown the effectiveness of Ca(OH) 2 against these microorganisms. [28],[29]
The antibacterial property of SPA and Ca(OH) 2 against S. aureus and Streptococcus sp. were evaluated in the present study. The results showed SPA antibacterial activity only at 10%, whereas Ca(OH) 2 showed a significant zone of inhibition at 5% and 10%, respectively, (P < 0.05). Hence, Ca(OH) 2 was more effective than SPA on these species of S. aureus and Streptococcus sp. even in lower concentrations. This is in accordance with the study done by Podbielski et al. and Adre et al. who showed that Ca(OH) 2 is effective against Coagulase negative Staphylococci, Streptococci, and P. aeruginosa. [28],[29]
The present study has shown that the flower head extract of SPA possesses remarkable antibacterial and antifungal activity against root canal pathogens like E. faecalis and C. albicans responsible for repeated failures when compared with Ca(OH) 2 . Nakatani and Nagashiwa showed that the antibacterial and antifungal activity of different concentration of SPA extract might be due to the presence of amide spilanthol and alkamides. [30] Krishnaswami et al. and Mukharya et al. also reported the presence of nonvolatile sesquiterpenoids and saponins which may be responsible for antibacterial and antifungal activity of SPA. [31],[32]
A study done by Rani and Murty showed antifungal activity in lower concentrations of 0.1-2 mg. [5] However, our study with a concentration of 0.1-2.0 mg showed less antibacterial and antifungal efficacy. Hence a higher concentrations of 3-10 mg was used for this study. The low activity of extract at lower concentrations may be due to the crude nature of the test solution. [5]
The present study has shown that the flower head extract of SPA possesses remarkable antibacterial and antifungal activity and has the potential for development of an intracanal medicament against the common root canal pathogens that cause repeated failures in both primary and permanent dentition. However, this study is in a preliminary stage, further investigations are necessary to identify the bioactive principles and their mechanism of action on inhibition of these bacterial and fungal agents.
| Conclusion | | |
The following were the significant finding in our study group:
- Flower head extract of SPA possesses antibacterial and remarkable antifungal activity
- SPA possesses remarkable antibacterial and antifungal activity against common root canal pathogens which are responsible for repeated endodontic failures like E. faecalis and C. albicans when compared with medicaments like Ca(OH) 2
- Ca(OH) 2 was effective against S. aureus, Streptococcus sp. but ineffective against E. faecalis and C. albicans at low concentrations.
- However, further research and studies are needed to highlight the antibacterial and antifungal efficiency of SPA before its use as an ideal intracanal medicament.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Kontakiotis E, Nakou M, Georgopoulou M. In vitro study of the indirect action of calcium hydroxide on the anaerobic flora of the root canal. Int Endod J 1995;28:285-9.  |
| 2. | Gomes BP, Vianna ME, Sena NT, Zaia AA, Ferraz CC, de Souza Filho FJ. In vitro evaluation of the antimicrobial activity of calcium hydroxide combined with chlorhexidine gel used as intracanal medicament. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102:544-50. |
| 3. | Athanassiadis B, Abbott PV, Walsh LJ. The use of calcium hydroxide, antibiotics and biocides as antimicrobial medicaments in endodontics. Aust Dent J Endod Suppl 2007;52 1 suppl: S64-82. |
| 4. | Darokar MP, Mathur A, Dwivedi S, Bhalla R, Kanuja SP, Kumar S. Dectection of antibacterial in the floral petals of some higher plants. Curr Sci 1998;75:187-9. |
| 5. | Rani SA, Murty SU. Antifungal potential of flower head extract of Spilanthes acmella Linn. Afr J Biomed Res 2006;9:67-8. |
| 6. | Harwood LM, Moody CJ. Experimental Organic Chemistry: Principles and Practice (Illustrated edition). Wiley-Blackwell 1989. p. 122-5. |
| 7. | Soxhlet Extractor. Available from: http://www.en.wikipedia.org/wiki/Soxhlet. [Last accessed on 2014 Dec 18]. |
| 8. | Waltimo TM, Sirén EK, Orstavik D, Haapasalo MP. Susceptibility of oral Candida species to calcium hydroxide in vitro. Int Endod J 1999;32:94-8. |
| 9. | Siqueira JF Jr, Lopes HP. Mechanisms of antimicrobial activity of calcium hydroxide: A critical review. Int Endod J 1999;32:361-9. |
| 10. | Lana MA, Ribeiro-Sobrinho AP, Stehling R, Garcia GD, Silva BK, Hamdan JS, et al. Microorganisms isolated from root canals presenting necrotic pulp and their drug susceptibility in vitro. Oral Microbiol Immunol 2001;16:100-5. |
| 11. | Estrela C, Pimenta FC, Ito IY, Bammann LL. Antimicrobial evaluation of calcium hydroxide in infected dentinal tubules 1999;25:416-8. |
| 12. | Behnen MJ, West LA, Liewehr FR, Buxton TB, McPherson JC 3 rd . Antimicrobial activity of several calcium hydroxide preparations in root canal dentin. J Endod 2001;27:765-7. |
| 13. | Safavi KE, Spangberg LS, Langeland K. Root canal dentinal tubule disinfection. J Endod 1990;16:207-10. |
| 14. | Haapasalo M, Orstavik D. In vitro infection and disinfection of dentinal tubules. J Dent Res 1987;66:1375-9. [ PUBMED] |
| 15. | Siqueira JF Jr, de Uzeda M. Disinfection by calcium hydroxide pastes of dentinal tubules infected with two obligate and one facultative anaerobic bacteria. J Endod 1996;22:674-6. |
| 16. | Evans M, Davies JK, Sundqvist G, Figdor D. Mechanisms involved in the resistance of Enterococcus faecalis to calcium hydroxide. International Endodontic Journal 2002;35:221-8. |
| 17. | Almyroudi A, Mackenzie D, McHugh S, Saunders WP. The effectiveness of various disinfectants used as endodontic intracanal medications: An in vitro study. J Endod 2002;28:163-7. |
| 18. | Onçag O, Cogulu D, Uzel A. Efficacy of various intracanal medicaments against Enterococcus faecalis in primary teeth: An in vivo study. J Clin Pediatr Dent 2006;30:233-7. |
| 19. | Baumgartner JC, Watts CM, Xia T. Occurrence of Candida albicans in infections of endodontic origin. J Endod 2000;26:695-8. |
| 20. | Valera MC, de Moraes Rego J, Jorge AO. Effect of sodium hypochlorite and five intracanal medications on Candida albicans in root canals. J Endod 2001;27:401-3. |
| 21. | Ferguson JW, Hatton JF, Gillespie MJ. Effectiveness of intracanal irrigants and medications against the yeast Candida albicans. J Endod 2002;28:68-71. |
| 22. | Ashford R, Cassella JP, Gallagher J, Cassella S. Natural treatments for fungal infection of wounds. J Ethnopharmacol 1998;60:19-24. |
| 23. | Rojas JJ, Ochoa VJ, Ocampo SA, Munoz JF. Screening for the antimicrobial activity of ten medicinal plants used in Colombian folkloric medicine: A possible alternative in the treatment of non-nosocomial infections. BMC Complement Altern Med 2006;6:2. |
| 24. | Miglani R, Shankar, Indra R, Ramachandran S. J Conserv Dent 2007;10:99-103. |
| 25. | Sen BH, Safavi KE, Spångberg LS. Growth patterns of Candida albicans in relation to radicular dentin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;84:68-73. |
| 26. | Barbosa SV, Spangberg LS, Almeida D. Low surface tension calcium hydroxide solution is an effective antiseptic. Int Endod J 1994;27:6-10. |
| 27. | al-Khatib ZZ, Baum RH, Morse DR, Yesilsoy C, Bhambhani S, Furst ML. The antimicrobial effect of various endodontic sealers. Oral Surg Oral Med Oral Pathol 1990;70:784-90. |
| 28. | Podbielski A, Spahr A, Haller B. Additive antimicrobial activity of calcium hydroxide and chlorhexidine on common endodontic bacterial pathogens. J Endod 2003;29:340-5. |
| 29. | Mickel AK, Wright ER. Growth inhibition of Streptococcus anginosus (milleri) by three calcium hydroxide sealers and one zinc oxide-eugenol sealer. J Endod 1999;25:34-7. |
| 30. | Nakatani N, Nagashiwa M. Pungent alkamides from Spilanthes acmella. Biosci Biotechnol Biochem 1992;56:759-62. |
| 31. | Krishnaswami NR, Prasanna S, Seahadri TR, Vedantham TNC. α and β- Amyrin esters and sitosterol glucoside from Spilanthes acmella. Phytochemistry. 1975;14:1666-7. |
| 32. | Mukharya DKK, Ansari AH. Olean-12-en-3-O-ß D-Galactopyranosyl (1- 4)-O-a-l- rhamnopyranoside: A new triteropenoidal saponin from the roots of Spilanthes acmella (Murr). Indian J Chem 1986;26:81-7. |
Correspondence Address:
Savitha Sathyaprasad
Department of Pedodontics, KVG Dental College and Hospital, Dakshina Kannada, Karnataka
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0970-9290.172081
[Figure 1]
[Table 1], [Table 2], [Table 3], [Table 4] |
|
| This article has been cited by | | 1 |
Clinical Uses and Scope of Spilanthes acmella in Dentistry : A Narrative Review |
|
| Muskaan Sachdev, Sunnypriyatham Tirupathi, Lamea Afnan | | Journal of Natural Remedies. 2023; : 397 | | [Pubmed] | [DOI] | | | 2 |
A Systemetic and Scientific Review on the Acmella oleracea and its Traditional Medical and Pharmacological uses |
|
| Priti B. Savant, Manjusha S. Kareppa | | Asian Journal of Pharmaceutical Research. 2022; : 71 | | [Pubmed] | [DOI] | | | 3 |
Spilanthes acmella flowers and painful swelling of the lips |
|
| S. Mumtaz,K. Ravi-Shankar,M. Swati,J. Thiruchelvam | | British Journal of Oral and Maxillofacial Surgery. 2019; 57(3): 295 | | [Pubmed] | [DOI] | | | 4 |
Spilanthes acmella flowers and painful swelling of the lips |
|
| S. Mumtaz,K. Ravi-Shankar,M. Swati,J. Thiruchelvam | | British Journal of Oral and Maxillofacial Surgery. 2019; 57(3): 295 | | [Pubmed] | [DOI] | | | 5 |
Activity of preparations from Spilanthes oleracea
, propolis, Nigella sativa
, and black garlic on different microorganisms involved in oral diseases and on total human salivary bacteria: A pilot study |
|
| Christian Vlachojannis,Sigrun Chrubasik-Hausmann,Elmar Hellwig,Kirstin Vach,Ali Al-Ahmad | | Phytotherapy Research. 2018; 32(10): 1992 | | [Pubmed] | [DOI] | | | 6 |
Activity of preparations from Spilanthes oleracea
, propolis, Nigella sativa
, and black garlic on different microorganisms involved in oral diseases and on total human salivary bacteria: A pilot study |
|
| Christian Vlachojannis,Sigrun Chrubasik-Hausmann,Elmar Hellwig,Kirstin Vach,Ali Al-Ahmad | | Phytotherapy Research. 2018; 32(10): 1992 | | [Pubmed] | [DOI] | | | 7 |
Spilanthes acmella inhibits inflammatory responses via inhibition of NF-?B and MAPK signaling pathways in RAW 264.7 macrophages |
|
| Young-Chang Cho,Tran The Bach,Ba Reum Kim,Huong Lan Vuong,Sayeon Cho | | Molecular Medicine Reports. 2017; 16(1): 339 | | [Pubmed] | [DOI] | |
|
|
|
|
|
|
|
|
|
|
|
|
| Article Access Statistics | | | Viewed | 9878 | | | Printed | 566 | | | Emailed | 0 | | | PDF Downloaded | 213 | | | Comments | [Add] | | | Cited by others | 7 | | |
|
|
Users online:
