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Benefits of Black Cumin in the Field of Dental Health

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Nigella sativa is widely used as a traditional medicinal plant to cure various diseases. Nigella sativa extract showed significant antibacterial activity against bacteria that cause periodontitis and pulpitis. Setiawatie (2021) showed that 3% black cumin extract had the highest inhibition against periodontitis-causing bacteria, namely P gingivalis, Aggregatebacter Actinomycetemcomitans and E Faecalis compared to doxycycline 0.1% and metronidazole 1%. Antioxidant test showed that nigella sativa extract had free radical scavenging activity at a concentration of 3%. Cytotoxic test was performed on fibroblast and osteoblast cell cultures, the result was that nigella sativa 3% had viability above 90%.

Researchers have linked the health benefits of nigella sativa to its active components. The seeds consist of 28-36% protein, alkaloids and saponins and 0.4-2.5% essential oil. Many pharmacologically active compounds have been isolated from nigella sativa, but the most widely reported active constituent is thymoquinone (TQ), dithymoquinone, thymol, and thymohydroquinone. Several nutritional components are found in seeds, such as carbohydrates, fats, essential amino acids, and vitamins. The seeds are also considered a source of potassium, calcium, and iron. Several authors have reviewed nigella sativa and its active component, thimoquinone, has many pharmacological properties, such as: antimicrobial, antibacterial, anthelmintic, antifungal, and antiviral, anti-inflammatory, analgesic, histamine release inhibitor, antihypertensive, hypoglycemic, anti-cancer, antioxidant and hepatoprotective.

Many active compounds have been isolated, identified, and reported in various varieties of nigella sativa seeds. The most important active compounds are thymoquinone (30%-48%), thymohydroquinone, dithymoquinone, p-cymene (7%-15%), carvacrol (6%-12%), 4-terpineol (2%-7%), t-anethol (1%-4%), sesquiterpene longifolene (1%-8%) α-pinene,and thymol. Nigella sativa seeds contain two different types of alkaloids; i.e. alkaloids isoquinoline,for example nigellicimine and nigellicimine-N-oxide, and pyrazole alkaloids or indazole ring bearing alkaloids which include nigellidine and nigellicin. In addition, nigella sativa seeds also contain alpha-hederin, water-soluble pentacyclic triterpenes and saponins, which are potential anticancer agents. Most of the pharmacological properties of nigella sativa are mainly attributed to the quinone constituents, of which thymoquinone is the most abundant.

Nigella sativa-based toothpaste can be used to treat dental and oral diseases. In Indonesia, dental caries is still a health problem with a high number of cases affecting both adults and children. Nigella sativa toothpaste with ingredients thymoquinone (TQ) which is antibacterial in it has a role in preventing dental caries. Harzallah et al. conducted a study to assess the anticariogenic activity of nigella sativa essential oil. The study used the dilution method to evaluate the minimum inhibitory concentration (Minimum Inhibition Concentration/MIC) nigella sativa essential oil against oral cariogenic pathogenic bacteria. The results of the inhibition zone for all strains studied, especially S. mutans showed an inhibition zone of 24.5 ± 0.71 mm, and against Streptococcus (S. mitis) with 22 ± 1.41 mm. Black cumin oil extract was not only found to have a bactericidal effect against S. mutans but also has the effect of inhibiting attachment S. mutans on the tooth surface.

In the field of periodontal disease, Nigella sativa toothpaste can inhibit the growth of supragingival plaque bacteria. Research on experimental animals wistar rats treated with nigella sativa extract in drinking water had a lower periodontal index and a significantly lower number of sub-gingival bacteria compared to the control group. Studies in vivo Another study investigated the preventive role of nigella sativa extract on the development of periodontal inflammation. Oral administration of nigella sativa helps in the prevention of periodontal disease because it reduces alveolar bone resorption. The administration of periodontal chips containing nigella sativa in chronic periodontitis showed significant clinical improvement compared to the chitosan group.

In the field of endodontics, intracanal antisepsis is considered as one of the fundamental steps in root canal therapy. Antimicrobial irrigation solutions and disinfectant agents and other drugs used locally play an important role in inhibiting bacteria in the dentinal tubules. The ideal root canal irrigation should have high antibacterial activity against microorganisms in the biofilm and hidden root canals. Currently root canal irrigants using sodium hypochlorite (NaOCl) show excellent antimicrobial activity but often cause toxic effects on periapical tissues. Therefore, an irrigation fluid that is antibacterial and non-toxic is needed. The herbal product Nigella sativa mouthwash has been shown to significantly inhibit E faecalis bacteria equivalent to 2.5% and 5% NaOCl solutions (Setiawatie, 2021).

Clinical trials evaluating the antibacterial power of nigella sativa extract showed that nigella sativa extract had a bactericidal effect with a maximum inhibition zone of 26 mm in diameter for Enterobacter cloacae, 22 mm in diameter for Streptococcus oralis, diameter 21 mm for Streptococcus anginosus, diameter of 20 mm for Staphylococcus epidermides, and 16 mm for Enterobacter cloacae, Streptococcus oralis, Streptococcus anginosus, Staphylococcus epidermides and Enterococcus faecalis lingers (MI. Nader et al., 2010).

Another study investigated a new pulp capping drug in pediatric dentistry to replace formocresol due to reported side effects. This study compared histopathological pulp responses with nigella sativa oil and formocresol in experimental animals. The results showed that histologically, nigella sativa showed mild to moderate vasodilation with few inflammatory cells and a continuous odontoblastic layer. On the other hand, the formocressol group showed advanced inflammation with severe vasodilation and inflammatory cell infiltration and degeneration. Thus, the application of nigella sativa oil can maintain pulp vitality, so that it can be developed into a good pulpotomy agent in clinical practice (OM Omar et al., 2012).

In the field of oral medicine, oral ulceration is a common painful lesion associated with a variety of conditions, ranging from mild local trauma to significant systemic conditions, such as haematological, gastroenterological, dermatological, immunological, and malignant diseases such as cancer. Topical Nigella sativa oil has a beneficial therapeutic effect for the healing of chemically induced oral ulcers. Nigella sativa oil accelerates the healing of lesions, as it inhibits the growth of pathogenic organisms at the site of the lesion, which can slow down the healing process. In addition, the content of flavonoids and other components in nigella sativa can improve the healing process for the better.

In the field of oral surgery, nigella sativa extract was reported to induce bone healing in the extracted tooth socket and result in more rapid formation of bone trabeculae. An experimental animal study by Al Hijazi and Mohammed in 2013 demonstrated the therapeutic effect of both the powder form and nigella sativa oil on healing. socket. Samples of 24 male rabbits were given nigella sativa powder extract and nigella sativa oil material on post-extraction teeth, and compared healing with the other side of the mouth (control group).

The post-extraction socket area was examined radiographically and histologically after one and 6 weeks. The results showed the detection of osteoid formation in the first week and trabecular bone formation in the 6th week in the sockets given the extract Nigella sativa (powder and oil). Herbal plants can be used as a mixture of graft materials because they can increase osseointegration. A study in vivo by Al Najar and Mohammed (2009) was carried out to investigate the effect of black seed oil extract on the mechanical and histological properties of bone implant surfaces. The results showed that over different time periods, NS-coated implants had significantly better torsion resistance than uncoated implants, and histologically showed early osseointegration with osteophilic surfaces, as well as no adverse tissue reactions.

Nigella sativa extract shows important antioxidant, anti-bacterial, anti-inflammatory and cytoprotective potential, so that it has potential in herbal medicine in dentistry, namely as toothpaste, mouthwash, root canal irrigant, pulp capping material and dental implant coating. The development of nigella sativa formulations in nano biotechnology can be analyzed for the development of dental materials in the future.

Author: Ernie Maduratna Setiawatie

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