دراسة مقارنة في تأثير زيت القرنفل على سرعة التئام قرح الفم القلاعية المتكرره

 

 

د. سماره موفق العبدلي

 

 قسم الفارماكولوجي

كلية طب الاسنان/ جامعة بغداد

 

A Comparative Study of the Effect of Eugenol Oil on the Healing Rate of Recurrent Aphthous Ulceration

 

 

SAMARA M. ABDALLI*

B.D.S. MSc (pharmacy)

Department of Pharmacology, College of Dentistry, Baghdad University, Baghdad , Iraq 
 

الخلاصة

 

     هذه هي دراسة مقارنة في تاثير زيتالقرنفل، على سرعة التئام تقرحات الفم القلاعية المتكررة.

اخذت العينة من 40 مريضا مصابا بتقرح الفم القلاعي المتكرر ، تم اجراء الفحوصات السريرية والمختبرية الكاملة لكل مريض للتاكد من سلامته من بقية الامراض التي قد تسبب تقرح الفم.

تم تقسيم هذه العينة الى قسمين؛ المجموعة الاولى تم علاجهم بزيت القرنفل موضعيا  ثلاث مرات يوميا، المجموعة الثانيه تم اعطاؤهم الكليسيرين موضعيا ثلاث مرات يوميا.

تم تخفيف زيت القرنفل بالكليسيرين بنسبة 10 %.

تم تقييم الحاله لكل مريض بواسطة الفهرست البياني الفموي الطبي الذي استحدث في قسم الامراض الجلدية والزهريه في مستشفى بغداد التعليمي مره قبل العلاج ، 4 ايام بعد العلاج واخيرا 8 ايام بعد بداية العلاج.

تم اجراء التحليلات الاحصائية اللازمه على البيانات المستحصلة من كل مريض وتم استنتاج ما يلي:

يوجد تاثير ملحوظ في زيت القرنفل على سرعة التئام تقرحات الفم القلاعية المتكررة لكن لا يوجد تاثير للكليسيرن على سرعة الالتئام مما يدل على انه كان عنصر غير فعال وان المادة الفعالة هي زيت القرنفل فقط.

يعتبر زيت القرنفل علاج جديد يؤثر وبشكل ملحوظ على التئام تقرحات الفم القلاعية المتكررة مع الاخذ بنظر الاعتبار خلوها من التاثيرات الجانبية التي تخلفها بقية الادوية.

Background Eugenol occurs widely as a component of essential oils and is a major constituent of clove oil. It has been used since at least the nineteenth century, primarily as a flavouring agent, in a variety of foods and pharmaceutical products, and as an analgesic in dental materials.

 

Objective To show the effect of Eugenol oil on the cure rate of recurrent aphthous ulceration (RAU) and to compare with that of glycerin (control group).

 

Materials and Methods: Forty patients with RAU having no other systemic manifestations were included in this study.

Those patients were divided into two groups of 20 patients each. The first group was treated by Eugenol oil 10% in glycerin 3 times daily, while the second group was treated with glycerin 3 times daily. All those patients were assessed by Oral Clinical Manifestation Index (OCMI).

 

Results: 17 (85%) patients of those treated with eugenol showed complete cure effect after five days.

 

Conclusion: Eugenol oil is recorded as new topical treatment modality; it has a narrow spectrum of use since it can not be recommended to patients with any previous hypersensitivity.

 

Keywords: Eugenol, recurrent aphthous ulceration (RAU)

 

INTRODUCTION

 

RAU is the most common oral mucosal disease known to human beings ⁽¹⁾ which could be defined as a chronic inflammatory disease characterized by a painful recurrent necrotizing ulceration of non- keratinized oral mucous membrane ⁽²⁾.

  RAU is a manifestation of many local and general disorders and the hypotheses of its pathogenesis are numerous ^{(3), (1)}. It remains a clinical problem because there is no specific treatment and the management strategies depend on the symptoms, duration, severity and the associated systemic conditions ⁽¹⁾. (RAU) are classified in three categories depending on the clinical presentation of the lesion into minor, major and herpitiform ⁽⁴⁾.

There are many therapeutic trials that have been shown beneficial to relieve oral aphthosis like antibiotics, anti-inflammatory, and immunomodulators, anesthetics and alternative (herbal) remedies ⁽⁵⁾.

 

Eugenol, (common name is (cloves), botanical name is syzygium aromaticum) is a pyramidal ever green tree of hot countries, grows at a height of 30 to 40 feet. It begins flowering in about seven years and continues to produce for another 80 or more years ⁽⁶⁾.

In recent medicine, eugenol prescribed as anti-pyretic sterilizing agent, analgesic, curing skin ulcers. For headache, epilepsy, promote gastric function….etc. ⁽⁶⁾.

Materials and Methods

Eugenol flowers were collected during its maturation time, isolated from the other parts of the plants, cleaned then Eugenol oil extraction was prepared by using hot method; then mixed with glycerin to obtain the 10 % oil preparation

Forty Iraqi patients of different age groups suffering from recurrent oral aphthosis were included in this study. Full clinical assessment, investigations and consultations to other physicians were performed to each patient to prove that they were otherwise healthy. Those 40 patients were divided into two groups, 20 patients for each. 1^st group was given topical eugenol oil preparation 3 times daily; the second group (control) group was given glycerin 3 times daily. All these remedies were given for four days were they had been assessed according to the OCMI (table1) then re-assessment was conducted 4 days later.

 

 

 

 

 

Table (1)    Oral Clinical Manifestation Index

 

 

 

Data were analyzed using a computer system via (Epi info) software versions 6, 4.2.2 -2004. An expert statistical advice was sought for. Age and sex distributions were also analyzed.

An association was considered statistically significant whenever P value was less than (0.05) level of significance.

 

Results

Regarding age distribution, 30-39 years have the highest ratio among both study groups while ages below 20 years have the least.

In table (2), Eugenol oil preparation showed significant effect in the records before treatment in which they ranged between 10 and 21, while after 4 days of treatment ranged between 7 and 19 and ranged between 0 and 21 after 8 days.

By examining table (3) no significant effect was obtained by using glycerin as topical treatment which means that the only effect is obtained by eugenol oil and glycerin was only diluting agent. 

 

Table No. (2)The effect of therapeutic trial using Eugenol for the treatment of RAU (Range, Mean, ± SD of OCMI).

 

 

Table No. (3)The effect of therapeutic trial using Glycerin for the treatment of RAU (Range, Mean, ±SD of OCMI).

 

Discussion

In this study eugenol proved to be effective in the treatment of RAU. The therapeutic effect of eugenol could be related to its chemical caustic effect on the ulcer and for this reason it was used by ancient Egyptians in treating chronic skin ulcerations ⁽⁶⁾. In this study eugenol was extracted and prepared by using another oil , sunflower oil, because it is volatile then diluted in glycerin to minimize its burning sensation and irritant nature, 10% oil preparation was obtained, which was the least ratio that gives us the maximum effect.

 Slight burning sensation was recorded which was acceptable and this was due to the chemical cautery action of eugenol on ulcerated area which is the main function.

References:

1.                Ship J A. (1996) Recurrent aphthous stomatitis: An update. Oral Surg Oral Med Oral pathol. 81(2): 141-147.

2.                Correll W.R, Westcott B W and Jensen L J (1981) Recurring painful oral ulcers, JADA, 103:497-498.

3.                Hoover CI, Olson J A and Greenspan J S (1986) Humoral responses and cross reactivity to viridance streptococci in recurrent aphthous ulceration. J. Dent. Res 65(8): 1101-1104.

4.                Burket L W (1994) The patients with recurrent oral ulcers, oral medicine, diagnosis and treatment. Part II. Oral mucosal diseases. 9th edition. J.B. Lippincott Company. Philadilphia. Page 26.

5.                Mcbridge DR .Management of aphthous ulcers.Am Fam. Physician.jul.2000:62(1):149-54; 160.

6.                Qudama A. (1982): Dictionary for nutrition and treatment by herbs (translated); second edition Beirut. PP 528- 529.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Figure: 1: The Effect of Eugenol oil preparation on recurrent oral ulceration; A) Before treatment. B) After treatment