الفهرس 
Introduction.Only 14 pages are availabe for public view
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Abstract
It is critical to take into consideration the patient’s susceptibility to suffering from periodontal diseases during orthodontic treatment. So, preventive measures during this treatment to minimize dental plaque retention are recommended.
Mechanical methods of dental plaque removal are widely regarded as being a highly effective means of helping to control the progression of dental caries and periodontal diseases.
Mouth rinses are generally considered adjuncts to mechanical plaque control and are widely used in the delivery of therapeutic agents. Although the medicinal use of ALO has been reported, not much literature is available regarding its use in the field of dentistry as a mouth rinse.
Chlorhexidine is regarded as a benchmark plaque control agent. However, side effects such as staining of the teeth and the tongue, altered taste sensation, and increased calculus formation often deter its use for long periods. Hence, there was a need to develop an alternative naturally occurring, indigenous, and cost-effective oral hygiene aid, such as ALO extract.
The present randomized controlled trial was conducted for 28 days to compare the efficacy and sustainability of ALO and CHX in preventing plaque accumulation and gingival inflammation.
Clinical examination to assess plaque and gingivitis in patients with fixed orthodontic appliance was done. Plaque and gingivitis were assessed using the Plaque index, Gingival index, Gingival Bleeding index, and Stain index at baseline, 14 days (treatment period), and at 28days (free treatment period), patients were instructed to use mouthwash for 14 days. Patients were instructed not to rinse with water after the mouthwash, the participants were asked to stop using the mouthwash for 14 days and not to use any type of mouthwash during a treatment-free period.
Clinical parameters including plaque index (PI), gingival index(GI), Gingival bleeding index(GBI), and stain index(SI) were recorded at baseline, 14 days, and 28 days. Moreover, microbiological assessment of CFU was performed at baseline, 14 days, and 28 days.
Regarding the plaque index(PI)both groups showed no statistically significant difference from baseline, 14 days, and 28dayswith p-value(p> 0.05), changes in plaque index(PI)were significant after the treatment period(baseline -14)and treatment-free period (14-28)compare to baseline, meanwhile, both groups showed statistically significant changes in gingival index (GI) and Gingival bleeding index (GBI) after 14days, 28days compared to baseline, yet there was no significant difference between 14days,28days.
Both groups showed a statistically significant reduction in microbiology (CFU)at 14 days and 28 days compared to baseline and no statistically significant difference when compared to each other.
Regarding Stain index (SI), there was a statistically significant difference with a higher percentage change in group II (CHX) (9.8%) compared to group I (AlO) (0.0%). yet group II showed a statistically significant difference in percentage change between baseline -14days (9.8%), and baseline-28(9.8%), while, there was no statistically significant difference between 14days-28days (0.0%).
The result of the current study has demonstrated that both CHX and ALO mouthwashes had reduced plaque index, Gingival index, Gingival Bleeding index, and total bacterial count significantly after 14 days of use and another 14 days of treatment-free period in patients with orthodontic treatment, also ALO mouthwash is safe and well tolerated with no or very minimal side effect reported in comparison with CHX mouthwash that showed a statistically significant higher frequency of side effect in Taste disturbance(25%), Burning sensation(25%), Ulcer(20%), Staining of the tongue(35%), Allergy (10%).
It can be concluded from the present study that ALO mouthwash was equally effective as CHX in reducing plaque and gingivitis. So, it can be considered as a potential preventive home care therapy in orthodontic patients due to accessibility, affordability, availability, and sustainability.