Formulation and Evaluation of Ginger Nano Emulgel Versus Glucosamine Gel for the Treatment of Periodontitis

Background: Adjunctive local periodontal therapy is one of the best options to improve the health of the pocket tissue. The comparison of local effects of ginger essential oil and glucosamine sulphate as an aid in reinforcing the healing of periodontal tissue is a point of importance. The objective of this work was to evaluate the effectiveness of the local application of Ginger essential oil (GEO) nano emulgel versus Glucosamine sulphate (GS) gel on clinical parameters of periodontitis including the plaque index (PI), mean sulcus bleeding index (MSBI). Subjects and methods: Different formulations of nano emulsions were developed to choose the best one for preparing the GEO nano emulgel. Then, both gels formulations were prepared by the cold method using Carboxymethyl cellulose (CMC) and their formulations were evaluated for their drug content, viscosity, and in vitro dissolution studies. While GEO nano emulgel was subjected to characterization by transmission electro-microscope (TEM), particle size determination and zeta potential. Then, a randomized controlled clinical trial was conducted on thirty patients with periodontitis who were categorized into two comparative groups. Each group includes fifteen patients, the first group received treatment with GEO nano emulgel. The second group received treatment with GS gel after scaling and root surface debridement (RSD). the following clinical parameters were measured at baseline then after 3 months post operative; Mean sulcus bleeding index (MSBI) and Plaque index (PI). Results: UV-Spectrophotometer method was used to estimate the λmax of both (Gingerol) found in GEO extract and the GS. The calibration curve of GS was linear and found to have R ²=0.9987, The prepared periodontal GEO nano emulgel showed proper characteristics. The particle size was found to be of 207nm for T2 with polydispersity index (PDI) of 0.463 and the zeta potential of T2 was found to be (-46) mV. The rheology of both the formulated GEO nano emulgel and GS gel exhibited a non-Newtonian shear thinning pseudo-plastic flow pattern. The mechanism of drug release is diffusion-controlled release. In vitro dissolution studies showed that both gels could be initially released in the first four hours (burst effect) and then the release was slow till 24 hours. Moreover, the results showed statistically significant improvements in PI and MSBI in both GEO and GS groups. Conclusion: The obtained evaluation parameters indicated that the formulated GEO nano emulgel can be used as an adjunct therapy in periodontitis treatment.