Assessment of Licorice Extract as an Adjunctive Therapy to Mechanical Debridement in Stage II Periodontitis

Assessment of Licorice Extract as an Adjunctive Therapy to Mechanical Debridement in Stage II Periodontitis Clinical and Laboratory Study

To assess the clinical effectiveness of the locally delivered licorice extract as an adjunctive therapy to mechanical debridement in stage II periodontitis patients. To assess the impact of the locally delivered licorice extract as an adjunctive therapy to mechanical debridement on the level of interleukin-6 in the GCF in stage II periodontitis patients .

Study Overview

• Status: Completed
• Conditions: Interleukin 6
• Intervention / Treatment: Other: Mechanical Debridement; Drug: Mechanical debridement will be performed for 20 stage II periodontitis patients followed by local application of licorice gel.

Detailed Description

Periodontitis is a chronic multifactorial inflammatory disease associated with dysbiotic plaque biofilms and characterized by progressive destruction of the tooth-supporting apparatus. Its primary features include the loss of periodontal tissue support, manifested through gingival bleeding, presence of periodontal pocketing, clinical attachment loss and radiographically assessed alveolar bone loss (1).

Treatment of periodontal disease consists of plaque and calculus removal by scaling and root planing and good oral hygiene. Due to the bacterial etiology and inflammatory pathogenesis of periodontitis, the additional use of local or systemic antimicrobial agents and/or host response modulating agents has been proposed (2).

Locally applied therapy has received considerable attention due to the presence of a site-specific pattern of destruction in periodontal infections. It also provides effective local drug concentrations in the periodontal pocket and avoids potential side effects of systemic antimicrobial agents (2).

Conventional synthetic agents have some potential limitations like extrinsic teeth stains, altered taste sensation, and development of bacterial resistance that hinder its long-term usage (3). Herbal extracts are gaining attention since they contain phytochemicals which are naturally occurring ingredients that can achieve the desired antimicrobial and anti-inflammatory effects (4).

An example of such herb, with significant therapeutic value is "licorice (Glycyrrhiza glabra)". Licorice, is inherent to Mediterranean regions and few parts of Asia. The main active constituent of licorice is Glycyrrhetinic acid (GA), which is obtained from the extract of licorice root. Glycyrrhiza glabra shows anti-inflammatory effects due to the similarity in its chemical structure with glucocorticoids by initiation of glucocorticoid receptor signaling and also by inhibiting the classical complement pathway (5).

Licorice flavonoid components include chalcones, flavones, and isoflavones, which show antimicrobial (6), antiviral (7), anti-inflammatory (8), antidiabetic, antitumor, immunoregulatory (9), hepatoprotective (10) and neuroprotective activities (11).

The advantageous properties of licorice can be ascribed to several mechanisms. In vitro studies have established that licorice prevents cyclooxygenase activity and prostaglandin synthesis as well as indirect inhibition of platelet aggregation and all components in the inflammatory cascade (8). Licorice components possess important antioxidant properties. At the area of inflammation, licorice prevents the neutrophils from producing reactive oxygen species (12). Bioactive phytoconstituents of G. glabra inhibit the growth of periodontopathogens and reduce the inflammatory markers at the site of infection (13). It also ceases osteoclastic activity that contributes to alveolar bone destruction in periodontitis and promote the synthesis of osteoblasts for new bone formation (13).

• Study Type: Interventional
• Enrollment (Actual): 50
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Al Mansurah, Egypt
    • Mansoura University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Patients with Stage II Periodontitis (mainly horizontal bone loss with maximum probing depth ≤ 5 mm and with 3-4 mm clinical attachment loss).
• Age range (30 - 50) years.
• Good compliance with the plaque control instructions following initial therapy.
• Availability for follow up and maintenance program.

Exclusion Criteria:

• Smoking.
• Systemic diseases which could influence the outcome of the therapy (According to Cornell Medical Index-Health Questionnaire).
• Pregnant and lactating females.
• Vulnerable groups of patients' e.g (prisoners, disabled patients and decisionally impaired individuals).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Ten subjects with healthy periodontium will be selected for this group.
Placebo Comparator: Mechanical debridement will be performed for 20 stage II periodontitis patients.	Other: Mechanical Debridement; • Mechanical debridement will be performed using suitable ultrasonic and hand instruments
Experimental: Mechanical debridement will be performed for 20 stage II periodontitis patients followed by local ap	Drug: Mechanical debridement will be performed for 20 stage II periodontitis patients followed by local application of licorice gel.; Adequate amount of prepared licorice gel will be inserted into the selected periodontal pockets.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To assess the clinical effectiveness of the locally delivered licorice extract gel as an adjunctive therapy to mechanical debridement in Stage II periodontitis patients	Patients diagnosed with periodontitis underwent meticulous full-mouth debridement in a single session using ultrasonic scalers and site-specific Gracey curettes. All participants were instructed to maintain optimal oral hygiene practices without any additional prescribed therapeutic agents during the study.In the study group, a standardized licorice extract gel containing 5% glycyrrhizin was applied to selected periodontal pockets. These targeted sites were gently irrigated with normal saline and left for 10 minutes to achieve hemostasis. The gel was then applied using a plastic syringe fitted with a wide-gauge needle to facilitate effective delivery . After proper isolation, the needle tip was inserted into the base of the pocket, and the gel was dispensed slowly while gradually withdrawing the needle to ensure uniform distribution along the pocket depth. This application was repeated twice weekly for six weeks, after ensuring the absence of local deposits on the treated tooth .	samples will be collected at Base line then after 3 months by using periopaper strips

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To assess the impact of the locally delivered licorice extract gel as an adjunctive therapy to mechanical debridement on the level of IL-6 in the GCF in Stage II periodontitis patients.	Assessment of crevicular fluid IL-6 was based on sandwich enzyme- linked immunosorbent assay (ELISA) technology	samples are collected at baseline and after 3 months using peiopaper strips

Collaborators and Investigators

• Sponsor: Mansoura University
• Investigators: Study Director: Mohamed m Anes, Professor, Faculty of Dentistry - Mansoura University

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2025
• Primary Completion (Actual): July 15, 2025
• Study Completion (Actual): August 12, 2025

Study Registration Dates

• First Submitted: January 29, 2026
• First Submitted That Met QC Criteria: February 13, 2026
• First Posted (Actual): February 20, 2026

Study Record Updates

• Last Update Posted (Actual): February 20, 2026
• Last Update Submitted That Met QC Criteria: February 13, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: A0204023OM

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No