The adjunctive effect of locally delivered spirulina gel versus spirulina nanoparticles gel to nonsurgical treatment of stage II, grade B periodontitis: a randomized, controlled, clinical trial

Background One of the cornerstone adjunctive properties for delivering an antimicrobial agent in nonsurgical periodontal therapy is to achieve sufficient concentration and proper durability. This study was conducted to evaluate and to compare the effect of spirulina gel versus spirulina nanogel clinically and immunologically in the nonsurgical treatment of stage II, grade B periodontitis. Methods 30 patients with a diagnosis of (stage II, grade B periodontitis) were randomly selected and divided into three groups, 10 patients in each group. Group (A) received scaling and root planing SRP with placebo gel 'methyl cellulose', group (B) received SRP with spirulina gel, and group (C) received SRP with spirulina nanogel. All the patients received one session full mouth SRP and immediate placement of the gel followed by frequent application after 1, 2, and 4 weeks. The following clinical parameters: bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) were evaluated at baseline (before treatment), 3 and 6 months. Also, immunological assessment of tumor necrosis factor-α (TNF-α) using enzyme linked immunosorbent assay (ELISA) was done. Results There was statistically significant clinical improvement in favor to group B and C at all-time intervals follow-up periods when compared with group A where (P < 0.05). The immunological assessment showed statistically significant difference in group B and C when compared with group A at 6 months. Conclusion Adjunctive application of spirulina gel or spirulina nanogel to conventional mechanical therapy improved the clinical and immunological parameters over the traditional treatment alone. However, the strategy of spirulina nanogel may represents a promising natural product as an adjunctive treatment of chronic periodontitis.