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WO1996009834A1 - Treatment of periodontal and acute gingival infections - Google Patents

Treatment of periodontal and acute gingival infections Download PDF

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Publication number
WO1996009834A1
WO1996009834A1 PCT/GB1995/002281 GB9502281W WO9609834A1 WO 1996009834 A1 WO1996009834 A1 WO 1996009834A1 GB 9502281 W GB9502281 W GB 9502281W WO 9609834 A1 WO9609834 A1 WO 9609834A1
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WO
WIPO (PCT)
Prior art keywords
oil
treatment
plant
periodontal
melaleuca
Prior art date
Application number
PCT/GB1995/002281
Other languages
French (fr)
Inventor
Joan Louise Hibberd
Original Assignee
Joan Louise Hibberd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Joan Louise Hibberd filed Critical Joan Louise Hibberd
Priority to AU35304/95A priority Critical patent/AU3530495A/en
Publication of WO1996009834A1 publication Critical patent/WO1996009834A1/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/61Myrtaceae (Myrtle family), e.g. teatree or eucalyptus

Definitions

  • the present invention relates to substances and compositions for use in the treatment of acute necrotising ulcerative gingivitis and periodontal infections.
  • Tea tree oil also known as Melaleuca oil
  • Melaleuca oil is obtained from the leaves of the Australian tea tree, Melaleuca alternifolia.
  • the oil is sometimes referred to as Australian tea tree oil, oleum Melaleucae or ti-tree oil.
  • the oil can be used topically to treat a variety of skin disorders.
  • Tea tree oil is also known to be useful in surgery, medicine and dentistry and the oil has been included in some medicated soaps and dentrifices.
  • Tea tree oil has been used with beneficial effect in the treatment of a variety of human ailments and conditions. For example, dandruff, blisters, corns, bruises, burns, insect bites, ringworm, minor finger infections, pierced ear infections, fungal infections such as athletes foot, ingrowing hair, ingrowing toenails, warts, dermatitis, eczema, shingles, psoriasis, heat rash, itching, spots, acne, cuts, grazes, chicken pox, headache, blocked sinuses, the common cold, influenza, sprains and strains, haemorrhoids and teething in infants.
  • the oil has found use as an insect repellant and in saunas where it is dispersed into the air.
  • the oil is also known to have veterinary applications in the treatment of hot spots, flea infestation, infected flea bites, ticks, lice, hoof thrush, skin irritations and roundworm.
  • US-A-4925655 discloses a multi-component powder composition for dissolution in water to form a mouthwash for cleaning natural teeth and bonded composite filling material and to reduce the accumulation of plaque and stained pellicle.
  • One of the at least eleven components of the powder is tea tree oil, which is present in an amount of 0.5 to 10.0 percent by weight. It is stated that tea tree oil has antiseptic, germicide and gum healing properties.
  • Shapiro et al (Oral Microbiology and Immunology 9(4), 1994, 202-208 discloses a method for determining minimal inhibitory and bactericidal concentrations of plant extracts towards fastidiously and facultatively anaerobic oral bacteria. Tea tree oil was amongst the most potent essential oils tested.
  • tea tree oil is effective in the treatment of acute necrotising ulcerative gingivitis and of periodontal infections. These are conditions which would not be expected to be satisfactorily treated with conventional antiseptic, germicide and gum healing agents. Apart from an unpleasant taste, the oil has no apparent side effects.
  • Acute necrotising ulcerative gingivitis also called ANUG, Vincent's infection or trench mouth
  • ANUG Vincent's infection or trench mouth
  • Metronidazole is known to be useful in treating acute necrotising ulcerative gingivitis.
  • Metronidazole is given to the patient orally in 200 mg doses three times daily for three days. Similar doses are used in acute dental infections.
  • Metronidazole has a number of adverse effects on patients and these are generally dose-related. The most common are gastro-intestinal disturbances, especially nausea. The nausea is sometimes accompanied by headache, anorexia and vomiting. An unpleasant metallic taste may be experienced.
  • peripheral neuropathy usually presenting itself as a numbness or tingling of the extremities occurs. Also, epileptic-like seizures and serious adverse effects on the nervous system have been encountered.
  • Periodontal diseases are infections of the periodontium which may progress. Tetracycline can be used systemically in the treatment of periodontal disease but on termination of the treatment the benefits are limited. The infection can reoccur and the antibiotic does not take the place of active periodontal treatment e.g. curettage and surgery.
  • the topical application of tetracycline to an infected region is also known to be effective. In the topical treatment, absorbent fibrous material loaded with tetracycline is tied around the teeth of a patient which are associated with the infection. However, this method of treatment suffers from the drawback that it is time consuming and awkward for the patient. Systemic tetracycline administration can also give rise to side effects such as nausea, vomiting and diarrhoea.
  • Chlorhexidine mouthwash or dental gel is known to be a useful treatment.
  • Chlorhexidine at 0.1% (w/v) to 0.2% (w/v) used two or three times daily is known to reduce gingivitis and periodontal disease.
  • Chlorhexidine suffers from the disadvantage that its use is limited by its unpleasant taste and staining properties.
  • the present invention provides the use of an oil obtained from a plant of the genus Melaleuca in the manufacture of a medicament for the treatment of acute necrotising ulcerative gingivitis or periodontal infections, especially destructive periodontal disease.
  • the plants are preferably those which are commonly known as tea trees.
  • the plants may also be known by the name Australian Melaleuca.
  • the plants may be one or more of Melaleuca alternifolia. M. uncinata. M. caiputi. M. viridiflora, M. ⁇ uin ⁇ uenervia and M_ bracteata.
  • the oil may be obtained from a single plant or from a number of individual plants.
  • the plants are preferably of the same species.
  • the plants may comprise more than one species of Melaleuca.
  • the oil is preferably obtained from the leaves of the plants but the oil may also be obtained from any other oil bearing parts such as whole shoots and stems.
  • the oil may also be obtained from any other oil bearing parts such as whole shoots and stems.
  • the oil is distilled from the oil bearing parts. Prior to distillation the oil bearing parts may be pressed or crushed in order to release the oil from the plant. Alternatively, the plant parts may comminuted and extracted with water or an organic solvent before distillation.
  • Melaleuca oil which is a preferred oil is known to comprise about 50 to 60% by weight of terpenes, up to 10% by weight cineole and some terpineol.
  • Other oils which may be used in the present invention may comprise terpenes, cineole and terpineol in different proportions to that found in Melaleuca oil.
  • the medicament is preferably in the form of a liquid comprising tea tree oil, water and a pharmaceutically acceptable surfactant.
  • the surfactant is preferably a non- ionic surfactant although a suitable ionic surfactant may be used. More than one surfactant may be present and both ionic and non-ionic surfactants may be present together.
  • a preferred non-ionic surfactant is nonylphenol.
  • the medicament may further comprise an alcohol and a preferred alcohol is ethanol.
  • Other pharmaceutically acceptable alcohols may be used instead of ethanol or in combination with ethanol.
  • the medicament may also further comprise an ethoxylate.
  • the present invention also provides a method of treating acute necrotising ulcerative gingivitis and periodontal infections comprising exposing diseased areas of the patient to an oil obtained from a plant of the genus Melaleuca.
  • the oil is preferably in the form of a medicament as hereinbefore described.
  • the medicament may be applied in the form of a mouthwash.
  • the medicament is to be used as a mouthwash it is preferably diluted to a suitable working strength with water.
  • the medicament may be applied directly to the infected areas of the patient using an absorbent material such as cotton wool, an interdental appliance or various types of dental floss.
  • the tea tree oil solution also comprises water, nonylphenol, an ethoxylate and ethanol.
  • a mouthwash of tea tree oil solution was made up by diluting 1 part of solution from the bottle with approximately 1 part tap water.
  • the patient took a mouthful of mouthwash and agitated this in his mouth for approximately 2 minutes after which time the mouthwash was released by the patient from his mouth.
  • the mouthwash treatment was repeated twice daily for 28 days accompanied by good oral hygiene maintenance by the patient.
  • the periodontal infection was resolved.
  • the gingivae had a normal appearance and the periodontal pockets had reduced 3-5 mm in areas which were previously severely infected.
  • the gum tissue was swollen, bleeding and painful.
  • the infected area was treated repeatedly by the direct application of tea tree oil on an interdental appliance over a period of two days.
  • the lesion totally resolved after two days treatment and did not recur.

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  • Health & Medical Sciences (AREA)
  • Natural Medicines & Medicinal Plants (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Alternative & Traditional Medicine (AREA)
  • Biotechnology (AREA)
  • Botany (AREA)
  • Medical Informatics (AREA)
  • Medicinal Chemistry (AREA)
  • Microbiology (AREA)
  • Mycology (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Epidemiology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Medicines Containing Plant Substances (AREA)
  • Cosmetics (AREA)

Abstract

An aqueous solution of oil obtained from plants of the genus Melaleuca is useful in the treatment of acute necrotising ulcerative gingivitis and periodontal infections. In particular, tea tree oil obtained from M. alternifolia is used as a mouthwash to treat patients suffering from acute necrotising ulcerative gingivitis and periodontal infections.

Description

TREATMENT OF PERIODONTAL AND ACUTE GINGIVAL INFECTIONS
The present invention relates to substances and compositions for use in the treatment of acute necrotising ulcerative gingivitis and periodontal infections.
Tea tree oil, also known as Melaleuca oil, is obtained from the leaves of the Australian tea tree, Melaleuca alternifolia. The oil is sometimes referred to as Australian tea tree oil, oleum Melaleucae or ti-tree oil. The entry for Melaleuca oil on page 1385 of Martindale - The Extra Pharmacopoeia (13th edition) ed. Reynolds J.E.F., The Pharmaceutical Press, London (1993) states that the oil is reported to have bactericidal and fungicidal properties. The oil can be used topically to treat a variety of skin disorders.
Tea tree oil is also known to be useful in surgery, medicine and dentistry and the oil has been included in some medicated soaps and dentrifices.
Tea tree oil has been used with beneficial effect in the treatment of a variety of human ailments and conditions. For example, dandruff, blisters, corns, bruises, burns, insect bites, ringworm, minor finger infections, pierced ear infections, fungal infections such as athletes foot, ingrowing hair, ingrowing toenails, warts, dermatitis, eczema, shingles, psoriasis, heat rash, itching, spots, acne, cuts, grazes, chicken pox, headache, blocked sinuses, the common cold, influenza, sprains and strains, haemorrhoids and teething in infants.
There are a number of commercially available preparations which include tea tree oil. These preparations are Secader produced by Fisons for the treatment of chilblains, Soothene produced by Lane for the treatment of minor skin disorders and Tuberol syrup produced by Bouteille (France) for the treatment of coughs.
The oil has found use as an insect repellant and in saunas where it is dispersed into the air. The oil is also known to have veterinary applications in the treatment of hot spots, flea infestation, infected flea bites, ticks, lice, hoof thrush, skin irritations and roundworm.
US-A-4925655 discloses a multi-component powder composition for dissolution in water to form a mouthwash for cleaning natural teeth and bonded composite filling material and to reduce the accumulation of plaque and stained pellicle. One of the at least eleven components of the powder is tea tree oil, which is present in an amount of 0.5 to 10.0 percent by weight. It is stated that tea tree oil has antiseptic, germicide and gum healing properties.
Shapiro et al (Oral Microbiology and Immunology 9(4), 1994, 202-208 discloses a method for determining minimal inhibitory and bactericidal concentrations of plant extracts towards fastidiously and facultatively anaerobic oral bacteria. Tea tree oil was amongst the most potent essential oils tested.
It has surprisingly now been found that tea tree oil is effective in the treatment of acute necrotising ulcerative gingivitis and of periodontal infections. These are conditions which would not be expected to be satisfactorily treated with conventional antiseptic, germicide and gum healing agents. Apart from an unpleasant taste, the oil has no apparent side effects.
Acute necrotising ulcerative gingivitis, also called ANUG, Vincent's infection or trench mouth, is an oral infection in which fusiform bacteria and spirochaetes are present. Metronidazole is known to be useful in treating acute necrotising ulcerative gingivitis. Metronidazole is given to the patient orally in 200 mg doses three times daily for three days. Similar doses are used in acute dental infections. Metronidazole has a number of adverse effects on patients and these are generally dose-related. The most common are gastro-intestinal disturbances, especially nausea. The nausea is sometimes accompanied by headache, anorexia and vomiting. An unpleasant metallic taste may be experienced. Where high doses or prolonged treatments are undertaken, peripheral neuropathy, usually presenting itself as a numbness or tingling of the extremities occurs. Also, epileptic-like seizures and serious adverse effects on the nervous system have been encountered.
Periodontal diseases are infections of the periodontium which may progress. Tetracycline can be used systemically in the treatment of periodontal disease but on termination of the treatment the benefits are limited. The infection can reoccur and the antibiotic does not take the place of active periodontal treatment e.g. curettage and surgery. The topical application of tetracycline to an infected region is also known to be effective. In the topical treatment, absorbent fibrous material loaded with tetracycline is tied around the teeth of a patient which are associated with the infection. However, this method of treatment suffers from the drawback that it is time consuming and awkward for the patient. Systemic tetracycline administration can also give rise to side effects such as nausea, vomiting and diarrhoea. The patient can become resistant to this antibiotic with continual topical treatment. In less severe cases of gingivitis, a chlorhexidine mouthwash or dental gel is known to be a useful treatment. Chlorhexidine at 0.1% (w/v) to 0.2% (w/v) used two or three times daily is known to reduce gingivitis and periodontal disease. Chlorhexidine suffers from the disadvantage that its use is limited by its unpleasant taste and staining properties.
Accordingly, the present invention provides the use of an oil obtained from a plant of the genus Melaleuca in the manufacture of a medicament for the treatment of acute necrotising ulcerative gingivitis or periodontal infections, especially destructive periodontal disease.
The plants are preferably those which are commonly known as tea trees. The plants may also be known by the name Australian Melaleuca.
The plants may be one or more of Melaleuca alternifolia. M. uncinata. M. caiputi. M. viridiflora, M. σuinσuenervia and M_ bracteata.
The oil may be obtained from a single plant or from a number of individual plants. When the oil is obtained from a number of individual plants, the plants are preferably of the same species. However, the plants may comprise more than one species of Melaleuca.
The oil is preferably obtained from the leaves of the plants but the oil may also be obtained from any other oil bearing parts such as whole shoots and stems. Preferably,
4 the oil is distilled from the oil bearing parts. Prior to distillation the oil bearing parts may be pressed or crushed in order to release the oil from the plant. Alternatively, the plant parts may comminuted and extracted with water or an organic solvent before distillation. Melaleuca oil which is a preferred oil is known to comprise about 50 to 60% by weight of terpenes, up to 10% by weight cineole and some terpineol. Other oils which may be used in the present invention may comprise terpenes, cineole and terpineol in different proportions to that found in Melaleuca oil.
The medicament is preferably in the form of a liquid comprising tea tree oil, water and a pharmaceutically acceptable surfactant. The surfactant is preferably a non- ionic surfactant although a suitable ionic surfactant may be used. More than one surfactant may be present and both ionic and non-ionic surfactants may be present together. A preferred non-ionic surfactant is nonylphenol.
The medicament may further comprise an alcohol and a preferred alcohol is ethanol. Other pharmaceutically acceptable alcohols may be used instead of ethanol or in combination with ethanol. The medicament may also further comprise an ethoxylate.
The present invention also provides a method of treating acute necrotising ulcerative gingivitis and periodontal infections comprising exposing diseased areas of the patient to an oil obtained from a plant of the genus Melaleuca. The oil is preferably in the form of a medicament as hereinbefore described.
Preferably, the medicament may be applied in the form of a mouthwash. When the medicament is to be used as a mouthwash it is preferably diluted to a suitable working strength with water. Alternatively, the medicament may be applied directly to the infected areas of the patient using an absorbent material such as cotton wool, an interdental appliance or various types of dental floss. The invention will now be described with reference to the following Examples.
EXAMPLE 1
The treatment of acute destructive periodontal disease (Periodontitis Complex Type IV) with Australian Melaleuca oil.
An elderly male patient suffering from severe periodontal disease (Periodontitis Complex Type IV) was treated with tea tree oil. The oil used was the commercially available Thursday Plantation tea tree oil antiseptic, mild strength formulation, comprising 15% (v/v) Australian Melaleuca oil (tea tree oil) . (Thursday
Plantation P/L. , Pacific Highway, Ballina 2478, Australia.) The tea tree oil solution also comprises water, nonylphenol, an ethoxylate and ethanol.
A previous attempt at treating the patient's condition with a standard treatment of oral hygiene and visits to a dental hygienist for a period of 28 days was unsuccessful. At the start of the tea tree oil treatment the patient had deep pockets of infection around his teeth and his gums were swollen, painful and bleeding. Several teeth were loose. Surgical intervention was proposed in order to remove the swollen and infected periodontal tissues throughout the periodontium. At this time root and epithelial curettage were also planned to further remove the infected tissues and the infected root surface.
As an alternative to the surgical intervention, a mouthwash of tea tree oil solution was made up by diluting 1 part of solution from the bottle with approximately 1 part tap water. The patient took a mouthful of mouthwash and agitated this in his mouth for approximately 2 minutes after which time the mouthwash was released by the patient from his mouth. The mouthwash treatment was repeated twice daily for 28 days accompanied by good oral hygiene maintenance by the patient. At the end of the treatment the patient's teeth and gums appeared to be in a healthy condition. The periodontal infection was resolved. The gingivae had a normal appearance and the periodontal pockets had reduced 3-5 mm in areas which were previously severely infected.
EXAMPLE 2
A female patient aged 63, a periodontist, noted a periodontal infection between the lower right lateral and cuspid teeth. The gum tissue was swollen, bleeding and painful.
The infected area was treated repeatedly by the direct application of tea tree oil on an interdental appliance over a period of two days. The lesion totally resolved after two days treatment and did not recur.

Claims

1. The use of an oil obtained from a plant of the genus Melaleuca in the manufacture of a medicament for the treatment of acute necrotising ulcerative gingivitis or periodontal infections.
2. A use as claimed in Claim 1, wherein the plant is a tea tree.
3. A use as claimed in Claim 2, wherein the plant is an Australian Melaleuca.
4. A use as claimed in Claim 1, wherein the plant is selected from Melaleuca alternifolia. M. uncinata. M. caiputi. M_ viridiflora. M. σuinσuenervia and M^. bracteata.
5. A use as claimed in Claim 1, wherein the oil is obtained from the leaves of the plant.
6. A use as claimed in Claim 5, wherein the oil is distilled from the leaves.
7. A use as claimed in Claim 1, wherein the medicament is a solution comprising the oil, water and a pharmaceutically acceptable surfactant.
8. A method of treating acute necrotising ulcerative gingivitis or periodontal infections comprising exposing diseased areas of the patient to an effective amount of an oil obtained from a plant of the genus Melaleuca.
PCT/GB1995/002281 1994-09-27 1995-09-25 Treatment of periodontal and acute gingival infections WO1996009834A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU35304/95A AU3530495A (en) 1994-09-27 1995-09-25 Treatment of periodontal and acute gingival infections

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB9419571A GB2293547A (en) 1994-09-27 1994-09-27 Compositions containing tea tree oil
GB9419571.6 1994-09-27

Publications (1)

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WO1996009834A1 true WO1996009834A1 (en) 1996-04-04

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WO (1) WO1996009834A1 (en)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20230048169A1 (en) * 2020-07-20 2023-02-16 Javad Ghoreishi Oral hygiene compositions

Families Citing this family (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
AUPN815696A0 (en) * 1996-02-20 1996-03-14 Stacey, T.K. Anti-microbial composition
US5826546A (en) * 1997-04-23 1998-10-27 Miraclecorp Of Australia Method for shampooing a pet using a foam-dispensed pet shampoo composition
AU7040498A (en) * 1998-03-24 1999-10-18 Farmila-Farmaceutici Milano S.R.L. Antifungal and antibacterial compositions containing melaleuca essential oil
US6168794B1 (en) * 1998-11-03 2001-01-02 Safe 'n Sound Solutions, Inc. Compositions comprising oleum Melaleuca
AU2003902823A0 (en) 2003-06-04 2003-06-26 Athol Gillies Turner Biologically active oils
TN2017000478A1 (en) * 2015-05-14 2019-04-12 Roberto Logi Compositions for treating and/or preventing psoriasis, prickly heat, dermatitises, neurofibromatosis type 1 and other pathologies of the dermis, mucosae, and oral cavity.

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
AU559001B2 (en) * 1980-09-05 1987-02-19 Sedgewick, S.E. Skin cream containing tea tree oil
FR2618670A1 (en) * 1987-07-28 1989-02-03 Philip Gerard Medicinal preparation based on essential oils, as well as toothpaste and chewing gum containing it
US4925655A (en) * 1988-03-04 1990-05-15 Robell Research Powder composition for forming a mouthwash
FR2705571A1 (en) * 1993-05-24 1994-12-02 Perez Adrien Guy Combination of a fatty oil and one or more aromatic essential oils

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
AU559001B2 (en) * 1980-09-05 1987-02-19 Sedgewick, S.E. Skin cream containing tea tree oil
FR2618670A1 (en) * 1987-07-28 1989-02-03 Philip Gerard Medicinal preparation based on essential oils, as well as toothpaste and chewing gum containing it
US4925655A (en) * 1988-03-04 1990-05-15 Robell Research Powder composition for forming a mouthwash
FR2705571A1 (en) * 1993-05-24 1994-12-02 Perez Adrien Guy Combination of a fatty oil and one or more aromatic essential oils

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
C. F. CARSON ET AL.: "ANTIMICROBIAL ACTIVITY OF THE ESSENTIAL OIL OF MELALEUCA ALTERNIFOLIA.", LETTERS IN APPLIED MICROBIOLOGY, vol. 16, no. 2, pages 49 - 55 *

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20230048169A1 (en) * 2020-07-20 2023-02-16 Javad Ghoreishi Oral hygiene compositions

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Publication number Publication date
GB9419571D0 (en) 1994-11-16
GB2293547A (en) 1996-04-03
AU3530495A (en) 1996-04-19

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