Review on: - Formulation & Evaluation of Dental Gel Containing Clove Oil for the Treatment of Periodontal Disease

Periodontal disease is recognized as a major public health problem throughout the world and occurs in all groups, ethnicities, races, genders, and socioeconomic levels. It is characterized by inflammation and degeneration of the gums, supporting bone, periodontal ligament and cementum and accumulation of bacterial pathogens, mainly within the periodontal pockets the periodontal disease commonly refers to inflammatory diseases that are plaque induced i.e. gingivitis and periodontitis. Gingivitis, the moderate stage of disease caused by an accumulation of supragingival plaque and characterized by swelling. Light bleeding and redness of the marginal gingival. Gingivitis is associated with a change in the microflora, shifting from a Gram-positive anaerobic flora to a more Gram negative one. Periodontitis, a more severe stage of periodontal disease, result in the resorption of the alveolar bone and detachment of periodontal ligament supporting tooth Recent advances in the field of dentistry have promoted the use of herbal and natural products for the treatment of various oral diseases. The conventional method of treatment the periodontal disease like oral, topical, and systemic dosage forms have major disadvantages like superinfection, low or non-compliance, low gingival crevicular fluid levels of antibiotics, systemic side effects, short duration, and high relative cost  Clove oil is one such product exhibiting multiple benefits and has gained considerable importance in clinical research Since clove oil shows low intrinsic toxicity along with a wide spectrum of biological actions like analgesic, antiseptic, antispasmodic, anti-neuralgic, carminative, anti-infectious, disinfectant, insecticide, stimulant, stomachic and other useful properties, it is very useful in dentistry also  The present study was aimed to formulate dental gel containing clove oil for the treatment of periodontal diseases and then evaluated for their physicochemical properties including drug content, spread ability, extrude ability and in-vitro antibacterial activity. Medicinal plants have been used as traditional treatments for numerous human diseases for thousands of years and in many parts of the world. In rural areas of the developing countries, they continue to be used as the primary source of medicine.

Benefits of Clove Oil:

? Clove oil numbs the tooth and gives quick relief from toothache.

? It has strong germ-killing power, which helps keep the mouth clean.

? Helps decrease redness, swelling, and bleeding of gums.

? Small cuts or sores in the mouth heal faster because it fights infection.

Periodontal Disease: -

Periodontal diseases including gingivitis and periodontitis are serious infections which can lead to tooth loss when left untreated. The word periodontal literally means “around the tooth”. Periodontal diseases are infections of bone and gums that bound and support the teeth. In it’s early phase called gingivitis, gums can become inflamed and red, and they may bleed too in severe conditions. In it’s more severe form, called periodontitis, the gums can draw away from the tooth, bone can be lost, and the teeth may get loosen or even fall out. It is a local infection with primary bacterial etiology in the gingival crevices, which affects the structural organs surrounding the teeth like periodontal ligament, connective tissue and bone. The warm and moist pocket environment fastens the growth of gram – negative, anaerobic bacteria that proliferate in the subgingival space. Therapeutic approaches for periodontitis fall into two major categories: Anti-infective treatment, which is designed to stop the progression of periodontal attachment loss by removing etiologic factors; and Regenerative 1therapy, which includes anti-infective treatment and is intended to restore structures destroyed by this disease

Types of Periodontitis:

1 Mild periodontitis (gingivitis)

2.Moderate periodontitis

3.Advanced periodontitis

4.Refractory periodontitis

Signs and Symptoms –

•  Signs and Symptoms –
•  Bad breath or bad taste that won’t go away
•  Red or swollen gums
•  Tender or bleeding gums
•  Painful chewing
•  Loose teeth
•  Sensitive teeth
•  Gums that have pulled away from your teeth
•  Metallic taste
•  Any change in the way your teeth fit together when you bite
•  Any change in the way your fit together when you bite

Risk factors-

• Smoking
• Diabetes
• Poor oral hygiene
• Stress
• Crooked teeth
• Underlying immuno-deficiencies-e.g.AIDS
• Fillings that have become defective
• Taking medications that cause dry mouth
• Bridges that no longer fir properly
• Female hormonal changes, such as with pregnancy or the use of oral contraceptives.

Plant Profile:

Fig No. 1 Clove Plant

Synonyms: - Clove bud, Laung, Lavang, Caryophyllum

Biological Source: - It consists of dried flower buds of Eugenia caryophyllus (sprengel) Bullak &Harrison.

Family: - Myrtaceae

Geographical Source: - It is native to the Mollucca Island & traditionally cultivated in Tanzania (zinziber), Madagascar, Indonesia, Srilanka & India (mainly in Nilgiri hills, Kanyakumari, Kottayam & Quilon hills of Kerala.

Cultivation and Collection: -

Soil: -Loamy soil & also Sandy loamy & laterite soil

Climate: -Warm humid

Rainfall: - Range of 150 to 250 cm

Altitude: - 900 m from sea level

Cultivation: - August – October

Collection: - Buds change the colour from green to light pink

Chemical constituents: - 15-20% of volatile oil,10-13% of tannin (gallotannic acid), chromone and eugenin. The volatile oil contains Eugenol (about 70-90%), Eugenol acetate, methaylamylketone. Caryophyllenes and small quantities of ester and alcohols. Some Important components are; flavonoids, hidroxibenzoic acid, hydroxycinnamic acid, hidroxiphenyl propens, eugenol, phenolic acids, gallic acid, kaempferol, quercetin, caffeic acid, ferulic acid, elagic acid, salicylic acids.

Macroscopic characters: -

Colour: - Crimson red to brown

Odour: - Characteristic or aromatic

Taste: - Aromatic and pungent

Size: - Length -10-18 mm, Width-3-4 mm, Thickness -2 mm.

Shape: - Flower bud is nail shape

Uses:

 1) It is used as a Dental analgesic.

 2) It is used as a Carminative.

 3)It is used as a Stimulant.

Scientific classification of clove:

Fig No.2 Clove Buds

Classification:

Biological Activity:

Clove is an important medicinal plant due to the wide range of pharmacological effects consolidated from traditional use for centuries and reported in literature. A review of several scientific reports of the most important biological activities of clove and eugenol is presented in the following paragraphs

Antioxidant Activity:

Recently, the United States Department of Agriculture in collaboration with Universities and private companies create a database with the polyphenol content and antioxidant activity of different kind of foods. Among spices, clove showed the higher content of polyphenols and antioxidant compounds. Extracts from clove buds could also be used as food antioxidants. The shelf-life and frying stability of encapsulated and un-encapsulated eugenol-rich clove extracts were tested soybean oil. Controlled release of antioxidants could be achieved by encapsulated clove powder obtained by spray drying using maltodextrin and Arabic gum as wall material.

Antimicrobial Activity:

The antimicrobial activities of clove have been proved against several bacterial and fungal strains. Sofia et al. tested the antimicrobial activity of different Indian spice plants as mint, cinnamon, mustard, ginger, garlic and clove. The only sampled that showed complete bactericidal effect against all the food-borne pathogens tested Escherichia coli (E. coli), Staphylococcus aureus and Bacillus cereus was the aqueous extract of clove at 3%. At the concentration of 1% clove extract also showed good inhibitory action

Morphology Studies

Microscopical characters of Clove flower bud:

Transverse section of clove hypanthium below the ovary shows epidermis, cortex and columella:

1) Epidermis:

Single layered small cells with straight walls and has a very thick cuticle. Epidermal layer gets intercepted by Ranunculaceous type of stomata.

2) Cortex:

The three distinct zones or regions in the cortex can be made out. The peripheral region containing 2 to 3 layers of high ellipsoidal, schizo-lysigeno us oil glands embedded in the radially elongated parenchymatous cell. The middle region containing 1 or 2 rings of bicollateral vascular bundles associated with a few pericyclic fibres, embedded in thick-walled parenchyma. The inner region made of loosely arranged aerenchyma.

3) Cork and primary cortex- absent

4) Stelar part - phloem, phloem fibers, biseriate medullary rays and secretory cavities containing volatile oil.

5) Cortical parenchyma - starch grains

6) Columella: Forms the central cylinder containing thick wall parenchyma with a ring of bicollateral vascular bundles towards the periphery of the cylinder. Numerous sphaeraphides are seen scattered throughout the columella and to a certain extent in the middle cortical zone.

Fig no. (a) L.S of Clove

Fig.no. (b) T.S of Clove

Macroscopical characters:

The volatile oil is situated in the schizolysigenous oil glands or ducts which are present in all 1 parts of the flower buds (hypodermis).

1) Size: Length varies from 12 to 17 mm.

2) Type: Actinomorphic, bisexual, epigynous. The flower bud has a spherical head and a sub-cylindrical

hypanthium tapering at the lower end.

3) Calyx: Polysepalous, 4 hard and thick sepals with oil glands.

4) Corolla: Polypetalous, 4 petals imbricate, enclose the stamens and forms the head of the bud Androecium m-numerous stamens, free and introrsely.

5) Gymnasium: Binocular, inferior with ovules stamens, free Placentation axial. 6)Style: Single and erect.

7) Colour: Dark brown.

8) Odour: Aromatic, spicy, Strong.

9) Taste: Pungent, aromatic

Botanical Description of Syzygium Aromaticum

Syzygium aromaticum is an evergreen, medium-sized aromatic tree belonging to the family Myrtaceae. It usually grows 10–20 meters in height and has a straight trunk with dense, conical branching. The leaves are opposite, simple, leathery, and elliptic-lanceolate with a smooth, glossy surface and prominent oil glands that give a characteristic clove aroma. The flowers are borne in terminal clusters and consist of a long tubular hypanthium topped with four thick, spreading petals. The unopened flower buds, which constitute the commercial clove, are bright crimson to pink when mature and turn dark brown on drying. The fruits are berry-like, fleshy, and purplish when ripe. The plant has a strong aromatic odor due to the presence of essential oils, mainly eugenol, present in the leaves, buds, and bark.

Mechanical Action of Clove Oil:

The mechanical action of clove oil is mainly attributed to its ability to penetrate dental tissues and precipitate proteins within the dentinal tubules. Due to its oily and low-viscosity nature, clove oil diffuses easily through dentin, physically blocking the tubules and thereby reducing dentinal fluid movement, which helps decrease tooth sensitivity. When combined with zinc oxide, it forms a hard, protective layer that acts as a mechanical seal over the cavity, minimizing microleakage and protecting the underlying pulp. Additionally, clove oil exerts a mild counter-irritant effect, creating a soothing sensation that mechanically distracts pain pathways. These combined actions contribute to its effectiveness in dental application

Therapeutic Applications of Clove Oil in Dentistry

1. Analgesic (Pain reliever) – Provides quick relief from toothache and pulpitis.

2. Anti-inflammatory agent – Reduces inflammation in gums and oral tissues.

3. Antiseptic and antimicrobial – Effective against oral bacteria, fungi, and viruses.

4. Used in Zinc Oxide–Eugenol (ZOE) cement – Works as a temporary restorative material, cavity liner, and base.

5. Sedative effect on the pulp – Calms irritated or inflamed pulp tissue.

6. Obturating agent – Used in root canal fillings and as an intracanal medicament.

7. Reduces dentin hypersensitivity – Blocks dentinal tubules and decreases pain.

8. Used in periodontal therapy – Helps control periodontal pathogens and inflammation.

9. Management of oral ulcers – Provides soothing and antiseptic action.

10. Anti-fungal effect – Useful in treating oral candidiasis.

Rationale for Formulation of Clove Oil Dental Gel

1. Controlled release of clove oil – Gel base allows slow and sustained release of eugenol for prolonged action.

2. Reduced irritation – Gel form minimizes direct irritation of pure clove oil on gums and mucosa.

3. Better retention – Gel spreads easily and adheres well to gingiva and periodontal pockets.

4. Targeted delivery – Ensures localized action directly at the affected site.

5. Improved patient comfort – Smooth, non-runny consistency makes application easy and comfortable.

6. Enhanced stability – Formulation prevents evaporation and degradation of clove oil.

7. Moisturizing effect – Humectants like glycerin prevent dryness and improve gel feel.

MATERIALS AND METHOD

MATERIALS: 

Chemical: Active pharmaceutical ingredients, Gelling agent, Co-solvent, Drug solubilize, Preservative, Sweeting agent, Vehicle

Apparatus: Apparatus such as beaker, glass slide, measuring cylinder, test tube, mortar pestle volumetric flask, so nicator apparatus.  Instruments: pH meter, Mechanical stirrer, Viscometer, Incubator, Auto-clave

MATERIALS AND ITS FUNCTION

METHODS

Physico-chemical characteristics of clove oil:

1. Acid Value: The acid value is defined as the number of milligrams of Potassium hydroxide required to neutralize the free fatty acids present in one gram of fat. It is a relative measure of rancidity as free fatty acids are normally formed during decomposition of triglycerides.

Chemicals: Oil sample, phenolphthalein indicator, ethanol, sodium hydroxide

Apparatus: Burette, stand, conical flask, measuring cylinder

Formula for acid value: (Mol.wt×N×V)/Ws

2. Saponification Value: Saponification value is defined as the number of milligrams of KOH required to neutralize the fatty acids resulting from complete hydrolysis of 1 gm of sample of oil or fat.

Chemicals: Oil sample, ethanol, phenolphthalein indicator, 0.1N KOH,0.1N HCL.

Apparatus: Conical flask, pipette, burette, beaker, round bottom flask, water bath, reflux condenser.

Calculation and Observations:

Saponification value = mg of KOH consumed by 1 g clove oil

Weight of KOH = Normality of KOH× Equivalent weight ×volume of KOH in litres

Volume of KOH consumed by 1 g of oil = [blank- test]

Method Formula for Saponification value=((B-T) ×N×56.1))/Wt of oil

3. Ester value

Ester value = Saponification value - Acid value Solubility

4. Density:

Density=Mass of oil/Volume of oil

Formulation of Dental Gel of Clove Oil

Composition of Dental Gel