berberine gel in periodontal inflammation: clinical and histological effects

background and aims. previous data have demonstrated that berberine, a barberry plant alkaloid, possesses various therapeutic properties. this study histologically evaluated the clinical efficacy of a berberine-derived topical gel on periodontal inflammation in patients requiring surgery. materials and methods. this randomized clinical trial was performed on 14 patient (11 females, 3 males) presenting with moderate to severe periodontitis (pocket depth >4 mm). plaque indices (pi) and gingival indices (gi) were recorded at baseline and scaling and root planing were carried out. one week later, pi and gi values were recorded again in patients treated on respective sides of the jaw with either berberine gel or a placebo gel control at night for two weeks. pi and gi were again measured prior to periodontal surgery (three weeks after the initial visit). specimens collected from both sides of the jaw were evaluated histologically and pi and gi scores compared for statistical differences. results. gi and pi scores were significantly different between baseline and follow-up examinations but no significant differences were observed between the groups. no differences in the nature of the inflammatory cell types, degree of angiogenesis, integrity of collagen fibers and the levels of edema were observed between the groups; however, barberry gel-treated tissues presented with reduced levels of inflammatory cell infiltrates compared to placebo controls. conclusion. tissues treated with barberry gel extract had reduced numbers of inflammatory cells at the time of surgery. however, the gi and pi scores were not significantly different between the groups.