Antioxidant, Antimicrobial, and Anti-inflammatory Properties of Clitoria Ternatea Gel as a Caries Removal Agent: An In Vitro Analysis

Introduction: Dental caries is a common oral health issue in children. Clitoria ternatea, which is gaining emerging focus due to the bioactive and biocompatible properties of its plantbased compounds, offers a promising natural alternative for Chemomechanical Caries Removal (CMCR) as a non invasive approach. Aim: To evaluate the in-vitro bioactivity of Clitoria ternatea gel in caries removal, focusing on its antioxidant, antimicrobial and anti-inflammatory properties. Materials and Methods: This in-vitro study was conducted over a three-month period in July 2024 at the Blue Laboratory, SIMATS University, Chennai, Tamil Nadu, India, in collaboration with Saveetha Dental College and Hospital. The research involved the formulation and analysis of Clitoria ternatea gel, evaluating its phytochemical composition, antioxidant activity, antimicrobial efficacy and anti-inflammatory properties. The study was performed on a sample of 12 gel extracts. The statistical tests used included independent paired t-tests, correlation analysis, effect size analysis using Cohen’s d and Hedges’ correction and multivariate analysis. Results: The Clitoria ternatea gel demonstrated significant antioxidant, antimicrobial and anti-inflammatory effects. In the 2,2-Diphenyl-1-Picrylhydrazyl (DPPH) assay, antioxidant activity increased from 39.75 µg/mL at 100 µg/mL to 65.06 µg/ mL at 500 µg/mL, while the Nitric Oxide (NO) assay showed similar improvements, increasing from 7.49 µg/mL to 39.99 µg/ mL. The gel exhibited effective antimicrobial activity against cariogenic bacteria; however, it was significantly less effective than the control (p<0.001). Additionally, it demonstrated a concentration-dependent anti-inflammatory effect, with activity rising from 16.36 at 100 µg/mL to 58.78 at 500 µg/mL, along with strong correlations with standard treatments. Conclusion: The Clitoria ternatea gel demonstrates strong potential as a natural CMCR agent, offering effective antioxidant, antimicrobial and anti-inflammatory properties. This formulation could serve as a biocompatible and minimally invasive option for removing dental caries.