Assessment of Moringa oleifera thermoreversible gel as a supplement to nonsurgical periodontal therapy in Stage III periodontitis – A randomized controlled clinical study

Background Periodontitis is a chronic inflammatory disease resulting from microbial biofilm and host immune responses, leading to progressive loss of periodontal attachment. Although scaling and root planing (SRP) remains the primary nonsurgical treatment, adjunctive therapies may enhance clinical and biochemical outcomes. This study evaluated the efficacy of a thermoreversible Moringa oleifera (MO) gel as an adjunct to SRP in Stage III periodontitis. Material and methods Thirty patients (90 sites) with Stage III periodontitis were randomly assigned to three groups: Group I – SRP alone, Group II – SRP + tetracycline fibers, and Group III – SRP + 5% MO gel. Clinical parameters and gingival crevicular fluid biomarkers (periostin, nitric oxide [NO], and total antioxidant capacity [TAOC]) were assessed at baseline and two months post-treatment. Data were analyzed using ANOVA followed by post-hoc comparisons. Results All groups showed significant clinical improvement (p < 0.001). Adjunctive groups demonstrated greater reductions in plaque, gingival, and bleeding indices than SRP alone. The MO group showed a significantly higher increase in periostin levels compared with the tetracycline group (p = 0.029) and the largest reduction in NO concentrations (p < 0.001). TAOC increased across all groups, with numerically higher yet nonsignificant values in the MO group. Conclusion The Moringa oleifera thermoreversible gel exhibited clinical and biochemical efficacy comparable to tetracycline fibers, suggesting its potential as a safe, natural adjunct in nonsurgical periodontal therapy. Larger, long-term studies are recommended to validate these outcomes.