Therapeutic Potential of Guava Leaf (Psidium guajava) Gel in Localized Aggressive Periodontitis Treatment: A Prospective Clinical Study

Abstract

Background:
Localized aggressive periodontitis (LAP) is a severe form of periodontal disease characterized by rapid destruction of periodontal tissues. Conventional treatments focus on mechanical debridement and adjunctive antimicrobial therapies. However, recent studies have explored natural compounds as potential adjuncts in periodontal therapy. Guava leaf (Psidium guajava) gel has demonstrated anti-inflammatory and antimicrobial properties, making it a promising candidate for managing periodontal disease.

Aim:
The aim of this study was to evaluate the clinical efficacy of guava leaf gel in the treatment of localized aggressive periodontitis compared to a placebo.

Materials and Methods:

This was a prospective, randomized, controlled clinical study. A total of 60 patients diagnosed with localized aggressive periodontitis were randomly allocated into two groups: the intervention group (n=30), which received guava leaf gel, and the control group (n=30), which received a placebo gel. Both groups underwent scaling and root planing (SRP). Clinical parameters, including plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL), were recorded at baseline and 6 months.

Results:
At the 6-month follow-up, the guava leaf gel group showed significant reductions in PI (2.68 ± 0.30 to 1.45 ± 0.18), GI (2.90 ± 0.34 to 1.50 ± 0.20), BOP (87.50% to 23.60%), PPD (6.25 ± 0.30 mm to 3.30 ± 0.25 mm), and CAL (5.85 ± 0.35 mm to 2.90 ± 0.28 mm), compared to the placebo group (PI: 2.65 ± 0.33 to 1.82 ± 0.29, GI: 2.88 ± 0.29 to 1.80 ± 0.25, BOP: 86.00% to 30.80%, PPD: 6.15 ± 0.35 mm to 4.20 ± 0.33 mm, CAL: 5.80 ± 0.30 mm to 3.85 ± 0.30 mm). The guava leaf gel group had statistically significant improvements across all clinical parameters compared to the placebo (p < 0.05).

Conclusion:
The findings suggest that guava leaf gel is an effective adjunctive therapy for localized aggressive periodontitis, significantly improving periodontal health when used in combination with SRP. Its anti-inflammatory and antimicrobial properties contribute to improved clinical outcomes, making it a promising natural alternative in periodontal therapy. Further studies are needed to explore its long-term efficacy and broader applicability.