Comparison of antifungal efficacy of ethanolic extracts of Woodfordia fruticosa leaf and Punica granatum peel in uncontrolled diabetic patients wearing removable dentures: A randomized controlled clinical trial

Curr Med Mycol. 2020 Sep;6(3):15-20. doi: 10.18502/cmm.6.3.3983.

Abstract

Background and purpose: The search for the development of a suitable novel antimicrobial agent for fungal diseases continues to be a key problem in the current clinical field. The present investigation was aimed to determine the antifungal effect of the ethanolic crude extracts of Woodfordia fruticosa leaf (Wfl) and Punica granatum peel (Pgp) in uncontrolled diabetic patients wearing removable dentures.

Materials and methods: The ethanolic extracts of both plants were prepared using the soxhlet extraction method, and the obtained metabolites were confirmed by thin- layer chromatography. After the preparation of the mouthwash, a total of 100 subjects were randomly divided into two groups. Each subject was given physiological saline at the baseline. Group I was provided with P. granatum mouthwash, while Group II was given W. fruticosa mouthwash. Following the administration of the mouthwash, the patients were requested to rinse the mouthwash using the oral rinse technique twice daily 5 ml/rinse for 30 sec. Subsequently, colony-forming units (CFU) were evaluated in the participants. Post-therapeutic samples were collected 1 h and 1 week after the mouthwash use.

Results: The mean reduction of CFU was calculated at the baseline, as well as 1 h and 1 week after using mouthwash. The results indicated a drastic reduction in CFU 1 h and 1 week after the application of Wfl mouthwash.

Conclusion: The obtained data revealed that Wfl had potential anticandidal activity against Candida yeast cells, probably owing to its bioactive compounds like glycosides. Therefore, this agent can be used effectively as a natural remedy for the treatment of oral candidiasis. However, the exact mechanism of action of this plant needs to be elucidated.

Keywords: Antifungal agents; Glycosides; Oral candidiasis; Punica granatum; Woodfordia fruticosa.