A Comparative Study on the Clinical Effectiveness of Mulethi and Guava Leaf Extract Gels in Treating Localised Aggressive Periodontitis

Introduction: Periodontitis, a chronic inflammatory disease caused by polymicrobial biofilms, leads to tissue destruction, tooth loss and systemic health implications. Conventional therapies such as chlorhexidine have limitations, prompting a search for safer alternatives. Plant-derived agents, specifically Psidium guajava (guava) and Glycyrrhiza glabra (mulethi), are promising due to their antimicrobial, anti-inflammatory and antioxidant properties. This study aimed to compare the clinical efficacy of guava and mulethi extracts in periodontal therapy. Materials and Methods: A 9-month randomised controlled trial included sixty Localised Aggressive Periodontitis patients (18–50 years). After ethical clearance and consent, patients were diagnosed based on clinical and radiographic signs. Participants were randomised into two groups ( n = 30 each): Group A (Mulethi gel) and Group B (Guava leaf extract). Gels were applied twice daily for 6 months, alongside standard oral hygiene. Clinical indices, in Plaque Index, Gingival Index and Probing Pocket Depth were assessed at baseline, 3 and 6 months by a blinded evaluator. Data were analysed using SPSS version 20; paired and independent t -tests with P < 0.05. Results: Both extracts significantly improved periodontal parameters and showed strong antibacterial activity against Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans ( P < 0.0001). Guava improved the mean zone of inhibition for P . gingivalis from 8.65 mm to 10.2 mm and for A . actinomycetemcomitans from 20.36 mm to 23.08 mm. Mulethi showed an increase from 9.87 mm to 11.23 mm for P . gingivalis , and from 23.11 mm to 25.07 mm for A . actinomycetemcomitans . Conclusion: Mulethi and Guava leaf extracts significantly improved gingival health and demonstrated strong antibacterial activity against key periodontal pathogens. These findings highlight their potential as effective, biocompatible alternatives in periodontal therapy, offering comparable benefits to conventional treatments with fewer side effects.