Effectiveness of Azadirachta indica (neem) mouthrinse in plaque and gingivitis control: a systematic review

AbstractObjectivesThe aim of this systematic review was to evaluate the effectiveness of Azadirachta indica (neem)‐based herbal mouthrinse in improving plaque control and gingival health.MethodsLiterature 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.ResultsOf 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.ConclusionDespite 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.