Dhingra K, Vandana K L
Department of Periodontology, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India.
Department of Periodontology and Implantology, College of Dental Sciences, Davangere, Karnataka, India.
Int J Dent Hyg. 2017 Feb;15(1):4-15. doi: 10.1111/idh.12191. Epub 2016 Feb 15.
The aim of this systematic review was to evaluate the effectiveness of Azadirachta indica (neem)-based herbal mouthrinse in improving plaque control and gingival health.
Literature search was accomplished using electronic databases (PubMed, Cochrane Central Register of Controlled Trials and EMBASE) and manual searching, up to February 2015, for randomized controlled trials (RCTs) presenting clinical data for efficacy of neem mouthrinses when used alone or as an adjunct to mechanical oral hygiene as compared to chlorhexidine mouthrinses for controlling plaque and gingival inflammation in patients with gingivitis.
Of the total 206 articles searched, three randomized controlled trials evaluating neem-based herbal mouthrinses were included. Due to marked heterogeneity observed in study characteristics, meta-analysis was not performed. These studies reported that neem mouthrinse was as effective as chlorhexidine mouthrinse when used as an adjunct to toothbrushing in reducing plaque and gingival inflammation in gingivitis patients. However, the quality of reporting and evidence along with methods of studies was generally flawed with unclear risk of bias.
Despite the promising results shown in existing randomized controlled trials, the evidence concerning the clinical use of neem mouthrinses is lacking and needs further reinforcement with high-quality randomized controlled trials based on the reporting guidelines of herbal CONSORT statement.
本系统评价旨在评估印楝（印度楝树）草本漱口水在改善牙菌斑控制和牙龈健康方面的有效性。
通过电子数据库（PubMed、Cochrane对照试验中心注册库和EMBASE）以及手工检索，检索截至2015年2月的随机对照试验（RCT），这些试验提供了印楝漱口水单独使用或作为机械口腔卫生辅助手段时与氯己定漱口水相比在控制牙龈炎患者牙菌斑和牙龈炎症方面的疗效临床数据。
在总共检索到的206篇文章中，纳入了三项评估印楝草本漱口水的随机对照试验。由于在研究特征中观察到明显的异质性，未进行荟萃分析。这些研究报告称，在牙龈炎患者中，印楝漱口水作为刷牙的辅助手段在减少牙菌斑和牙龈炎症方面与氯己定漱口水效果相当。然而，报告质量、证据以及研究方法总体存在缺陷，偏倚风险不明确。
尽管现有随机对照试验显示出有前景的结果，但关于印楝漱口水临床应用的证据仍然缺乏，需要根据草药CONSORT声明的报告指南通过高质量的随机对照试验进一步加强。
