Evaluation of the Anti-inflammatory Effect of Nanocinnamon Gel on Oral Health

فادهلأا  مييقت ىلا ةساردلا فدهت:  ةيمنت و ةيئايميكويزيفلا صاوخلا ىلع يومفلا ةفرقلا ملاه نم ةيونانلا تائيزجلا ريثات محفلا ةةحص  . رطو داوملا قئا لمعلا  ( زيكرتب يومفلا يونانلا ةفرقلا ملاه ريضةت مت : 2 % ( حهئاهص احخب ةحساراو يوناحنلا ةحفرقلا قوةسم نم ) ينورتكللاا لاقتنلاا ىحلع ةحساردلا ترحل . ةح للا لاحهتلا ىحلع احهريثات ميحيقتو) ةيضماةلا اهابلا سايق و ءارمةلا تةت ةخشلاا,يرهجملا ( 45 ( نيحب مهرامعأ حوارتت نمزملا ة للا لاهتلأب ايرم ) 18 50 ةنحس) ,  رح ع ةحسمص محضت ةحعومجم وحك يماحجم ةحثلاث ىحلا اومحسق مو ة للا وماخم, سلكلا وماخم سايق ذصا مت , اضيرم لاحخلا ذصا وبق ةعومجم وكل ة لل نمزملا لاهتللأل يريرسلا فزنلا وماخ و دحخب 7  و مايأ 21  ةحعومجملاف, يئاودحلا لاحخلا محث ااحيخلا يحف فانحسسا حيملتو فيظنتل يكيناكيم لاع نمضتت تناك ةجلاخملا , لاخلا نم موي , طقف يكيناكيملا لاخلل ضرختت ىلولاا  ةحعومجملا احما يخحضوملا نيديسكيهورولكلا ملاه مادختساو يكيناكيم لاع ةينا لا ةعومجملا دحمل وحقلاا ىحلع ياحقا رح ع ىحقبي موحيلا يحف نيترم لاخلا مدختسي ,يخضوملا يونانلا ةفرقلا ملاه مادختسا مث يكيناكيم لاخف ة لا لا ا جماربلا مادختساب تانايبلا ويلةت مت . يباسا ثلاث .ةيملخملالا تارابتصلأل وكسورك: ةيئاهحس ئئاتنلا :  سلكلارحشؤم فا جئاتنلا ترهظأ دخب ة لا لا ةعومجملا يف ايونخم افخنا ة للا ىلع تابسرتلا وا 21  احضافخنا ةح للا لاهتلا رشؤم ضافخنأ ىلا ةفاضساب, لاخلا نم موي دخب ة لا لا ةعوجملا يف ايونخم 7  و 21  لاخلا نم موي . تسلأا تئجئتن دحض احهريثأت ترحهظأ يوحمفلا ةحفرقلا ملاحه نم ةيونان تائيزل فأ: . ةيريرسلا اهتارشؤم ويلقتو نمزملا ة للا لاهتلا  ABSTRACT Aims: This study aimed to evaluate the physicochemical characteristics and anti-inflammatory effects of nanocinnamon gel on oral health. Materials and Methods: prepared nanocinnamon gel 2% concentration from nanocinnamon powder and study some of its properties (TEM , IR , pH) and evaluate its effects on gingivitis. The study was carried out on the randomized clinical trial of chronic gingivitis comprises of 45 patients of age between (18-50) years old. They were divided into three groups, fifteen for each group and have been measured the plaque index, gingival index and bleeding for each group at baseline, after 7 and 21 days of treatment, treatment involved mechanical therapy by scaling and polishing at dental clinic and drug treatment in which the first group applied to the mechanical treatment alone, , second group received chlorhexidine gel topically and third group received nanocinnamon gel topically , the treatment used twice daily at least ten minute for three weeks. Data were analyzed using kruscal wallis -test for nonparametric data. Results: the results showed that plaque index were decreased significantly in nanocinnamon group after 21 days of treatment . Gingival index levels decrease significantly in nanocinnamon group after 7 and 21days of therapy.Conclusion: Noancinnamon gel has anti-inflammatory effect that decrease clinical parameter of gingivitis.


INTRODUCTION
Gingivitis is the most visible sign of periodontal disease, it is characterized by inflammation of the gingival tissues and the most common cause of gingivitis was plaque,thus removal of plaque and prevention of gingivitis is the mainstay in the prevention of periodontal diseases [1] .The therapeutic mouthwashes or gel contain chemical active ingredients that help control bad breath, plaque and gingivitis. Chlorhexidine is the gold standard for the prevention of dental plaque, however, it has some side effects such as altered taste sensation , staining of the teeth, and the tongue [2] . Since the search for alternative products and natural phytochemicals isolated from plants as used in herbal medicines is considered a good alternative to synthetic chemicals especially for prolonged use in periodontal disease and routine application [3] .  [7] . Therefore the aim of this study was to prepare a nanocinnamon gel 2% concentration , to study some of its physiochemical properties ( TEM ,IR, pH) and also to evaluate its anti-inflammatory effect on periodontal parameters in oral health such as plaque index, ,gingival index and bleeding index scores. and January 2020. Each participant was given verbal and written information that described the nature of the study, and each signed an informed consent form before registration in the study.

Preparation of cinnamon nanoparticales and nanocinnamon gel2%
Oral gel was prepared as a concentration of 2% according to the pilot study.

Morphology of powder nanoparticle
Transmission Electron Microscopy (TEM) was carried out to visualize the size, shape and morphology of the cinnamon powder nanoparticles.

Fourier Transmittance Infra Red (FTIR)
The infrared spectra recorded the vibration of bonding atoms for pure nanocinnamon powder and nanocinnamon gel in the region (400-4000cm-1) wavenumber.

pH Determination of Nanocinnamon Gel
Nanocinnamon gel pH was determined by putting the electrode of pH meter inside the container which contains a few amount of the preparation. The determination of pH value was done immediately after preparation and three months interval.

Present study
A pilot study was done on 3 patient groups to limit the minimum effective

Measuring of Plaque Index: (Silness and
Loe, 1964) [25] Plaque Index for the tooth is the moderate accumulation of soft deposit within the gingival pocket, or the tooth and gingival margin which can be seen with the naked eye. According to the Plaque index: Score 0 -tooth surface is clean Score 1 -tooth looks clean but materials can be removed from the gingival Score 2 -visible plaque on the tooth Score 3 -tooth surface covered with abundant plaque.

Silness, 1963) [24]
The severity of gingivitis is assessed separately at the four smooth surfaces of the teeth, wherever it is massaged with the side of the periodontal probe. According to the gingival index: Score 1 -no bleeding

RESULTS
Morphology and structure ofthe nanoparticles of cinnamon were determined by transmission electron microscopy (TEM) which demonstrating the spherical shape of nanoparticles of cinnamon and confirmed the nanometric particle diameter between(10-35) nanometer. [11] The vibrational response was represented in Figure   Determination the pH of nanocinnamon gel was done immediately after preparation and after three months represented (6.27 , 6.36) respectively and for chlorhexidine gel was (7, 6.9) respectively according to time shown in Table (1).

Statistical analysis
Kruscal -Wallis H test in spss was applied among the data of the three groups at the indicated interval times of non parametric values.

The results of plaque index
The results showed that there is statistical significant difference of the levels of       identical diagram for the two materials with slight increase or decrease in frequency and intensity. We can see an increase in the activity for the cinnamon after adding it to a gel because the presence of the phenolic group. In addition to that , the disappearance of two peaks which that refer to aliphatic (C-H) group in a gel compared to the pure cinnamon, may be attributed to a gel concentration that was more than a pure cinnamon concentration [13] .The pH of the gel was nearby to chlorhexidine gel and still the pH almost constant even with long period of preparation, indicating that nanocinnamon gel was pH stable even in long period [14] .
In our study ,clinically significant