Estudo clínico de dentifrício com sangue de dragão (croton lechleri) e carvão ativado: propriedades organolépticas e efeitos sobre biofilme dentário e saúde gengival

Abstract

The increasing popularity of natural cosmetic formulations and Brazil's vast biodiversity have driven research into herbal toothpastes. A novel product combines dragon's blood sap (DBS - Croton lechleri) and activated charcoal, suggesting a synergy between bioactivity and abrasive properties. However, due to the lack of clinical evidence, its impact on oral health requires further investigation. The study aimed to evaluate the efficacy, safety, and acceptability of a toothpaste containing DBS and activated charcoal, compared to commercial toothpaste products. The research utilized an experimental design with a quantitative approach and demographic analysis, focusing on an epidemiological study conducted as a phase I randomized controlled clinical trial with parallel groups, double-blind, in accordance with CONSORT guidelines and approved by the local ethics committee before the study began. Volunteers with spontaneous demand at the UFC Sobral Dental Clinic were invited to participate, screened, and monitored from April 2023 to April 2024. Inclusion criteria included adults aged 18 to 40 years, of any gender and ethnicity, with a healthy systemic condition, non-smokers or non-alcohol consumers, with more than 24 teeth, not undergoing orthodontic treatment, and without regular use of mouthwashes or chlorhexidine-based products in the last 60 days. Each test toothpaste was packaged in opaque plastic tubes, labeled only with a code to ensure that both participants and examiners were unaware of the therapeutic agent used until data analysis. The study involved three groups, each consisting of 20 participants: G1 (with DBS and activated charcoal), G2 (with activated charcoal but without DBS), and G3 (without either DBS or activated charcoal). Two clinical assessment points were established: T0 (baseline) and T4 (4 weeks), during which clinical examinations were performed to evaluate plaque index (PI), bleeding index (BI), color measurement, sensory evaluation via a questionnaire, and exfoliative cytology. A slight whitening effect was observed exclusively in group G1. The efficacy of the toothpastes did not show significant differences in plaque and gingival indices, indicating similar effects across the products. Regarding biological safety, only seven participants reported discomfort during the first week of toothpaste use, with similar incidences across all groups. However, the use of G3 showed intragroup differences in abrasion, with a lower frequency of scales and a higher frequency of intermediate cells. Regarding toothpaste acceptability, G1 received lower scores for color compared to G2 and G3, but was comparable to the other groups in aroma, flavor, consistency, and texture. Despite its limited whitening effect, the new toothpaste with dragon's blood and activated charcoal demonstrated anti-plaque efficacy, maintained gingival health, showed good biological safety, and was well-accepted by users, similar to established commercial products. The limited whitening effect and the need for fluoride supplementation suggest that product improvements are needed to enhance its competitiveness as a multi-functional product.