Antimicrobial Therapy in Dentistry: An Evidence-based Review of
Pomegranate Fruit Properties

Nara   Lígia   Martins Almeida; Laura Catalí      Ferreira Peralta; Vanessa      Soares Lara
doi:10.2174/012542579X282756240408073450
Abstract

Background: Phytotherapy is characterized by the use of medicinal plants in their different dosage forms. Currently, the use of this alternative medicine has increased. The raw material of herbal medicines consists of organs from medicinal plants (leaves, stems, fruits, peels, flowers and roots) with pharmacological, food, technical or cosmetic adjuvant effects. In addition, the side effects of its use appear to be reduced compared to synthetic and conventional medication.
Objective: The aim of this mini-review is to present the scientific evidence involving the properties of the pomegranate fruit for future antimicrobial applications in dentistry.
Methods: Literature searches included randomized clinical trials and in vitro studies [2000-2023] filtered mainly by the following terms [Punica granatum L.], [Pomegranate], [Dentistry], [Antimicrobial activity] and [Candida albicans].
Results: Studies have shown that Punica granatum Linn. has considerable antimicrobial activity, in addition to other pharmacological effects such as anti-cancer, antioxidant and antiinflammatory action. The use of herbal medicines, as potent antimicrobial agents against oral pathogens, has been widely reported.
Conclusion: The use of P. granatum has proven its effectiveness, as a potent antimicrobial agent against oral pathogens, especially against the fungus Candida albicans, future studies need to focus on the development of a biocompatible formulation directed to the treatment of patients with oral candidiasis.
Keywords: Phytotherapy, pomegranate, biocompatibility, oral pathogens, Candida albicans, dentistry.
[1]
Falzon CC, Balabanova A. Phytotherapy. Prim Care  2017; 44(2): 217-27.
 [http://dx.doi.org/10.1016/j.pop.2017.02.001] [PMID: 28501226]

[2]
Colalto C. What phytotherapy needs: Evidence‐based guidelines for better clinical practice. Phytother Res  2018; 32(3): 413-25.
 [http://dx.doi.org/10.1002/ptr.5977] [PMID: 29193357]

[3]
Harvey A. Strategies for discovering drugs from previously unexplored natural products. Drug Discov Today  2000; 5(7): 294-300.
 [http://dx.doi.org/10.1016/S1359-6446(00)01511-7] [PMID: 10856912]

[4]
Kayser O, Kiderlen A, Brun R. In vitro activity of aurones against Plasmodium falciparum strains K1 and NF54. Planta Med  2001; 67(8): 718-21.
 [http://dx.doi.org/10.1055/s-2001-18356] [PMID: 11731912]

[5]
Sen T, Samanta SK. Medicinal plants, human health and biodiversity: A broad review. Adv Biochem Eng Biotechnol  2014; 147: 59-110.
 [http://dx.doi.org/10.1007/10_2014_273] [PMID: 25001990]

[6]
Jurenka JS. Therapeutic applications of pomegranate (Punica granatum L.): A review. Altern Med Rev  2008; 13(2): 128-44.
 [PMID: 18590349]

[7]
Bakkali F, Averbeck S, Averbeck D, Idaomar M. Biological effects of essential oils – A review. Food Chem Toxicol  2008; 46(2): 446-75.
 [http://dx.doi.org/10.1016/j.fct.2007.09.106] [PMID: 17996351]

[8]
Carson CF, Riley TV. Non-antibiotic therapies for infectious diseases. Commun Dis Intell Q Rep  2003; 27 (Suppl.): S143-6.
 [PMID: 12807291]

[9]
Moghadam ET, Yazdanian M, Tahmasebi E, et al. Current herbal medicine as an alternative treatment in dentistry: In vitro, in vivo and clinical studies. Eur J Pharmacol  2020; 889: 173665.
 [http://dx.doi.org/10.1016/j.ejphar.2020.173665] [PMID: 33098834]

[10]
Ellse L, Wall R. The use of essential oils in veterinary ectoparasite control: A review. Med Vet Entomol  2014; 28(3): 233-43.
 [http://dx.doi.org/10.1111/mve.12033] [PMID: 24147451]

[11]
Alviano WS, Alviano DS, Diniz CG, et al. In vitro antioxidant potential of medicinal plant extracts and their activities against oral bacteria based on Brazilian folk medicine. Arch Oral Biol  2008; 53(6): 545-52.
 [http://dx.doi.org/10.1016/j.archoralbio.2007.12.001] [PMID: 18243157]

[12]
Groppo FC, Bergamaschi CC, Cogo K, Franz-Montan M, Motta RHL, Andrade ED. Use of phytotherapy in dentistry. Phytother Res  2008; 22(8): 993-8.
 [http://dx.doi.org/10.1002/ptr.2471] [PMID: 18570269]

[13]
Taheri JB, Azimi S, Rafieian N, Akhavan Zanjani H. Herbs in dentistry. Int Dent J  2011; 61(6): 287-96.
 [http://dx.doi.org/10.1111/j.1875-595X.2011.00064.x] [PMID: 22117784]

[14]
Seal M, Rishi R, Satish G, Divya KT, Talukdar P, Maniyar R. Herbal panacea: The need for today in dentistry. J Int Soc Prev Community Dent  2016; 6(2): 105-9.
 [http://dx.doi.org/10.4103/2231-0762.178744] [PMID: 27114947]

[15]
Almeida NLM, Figueiredo-Godoi LMA, Venturini J. Antimicrobial and immunomodulatory activity of pomegranate in the systemic candidiasis on Galleria mellonella. J Clin Exp Tox  2018; 2(2): 8-17.

[16]
Normark S, Henriques Normark B, Hornef M. How neutrophils recognize bacteria and move toward infection. Nat Med  2001; 7(11): 1182-4.
 [http://dx.doi.org/10.1038/nm1101-1182] [PMID: 11689878]

[17]
Zacchino SA, Butassi E, Cordisco E, Svetaz LA. Hybrid combinations containing natural products and antimicrobial drugs that interfere with bacterial and fungal biofilms. Phytomedicine  2017; 37: 14-26.
 [http://dx.doi.org/10.1016/j.phymed.2017.10.021] [PMID: 29174600]

[18]
Hebbar SS, Harsha VH, Shripathi V, Hegde GR. Ethnomedicine of Dharwad district in Karnataka, India—plants used in oral health care. J Ethnopharmacol  2004; 94(2-3): 261-6.
 [http://dx.doi.org/10.1016/j.jep.2004.04.021] [PMID: 15325728]

[19]
Vieira DRP, Amaral FM, Maciel MCG, Nascimento FRF, Libério SA, Rodrigues VP. Plant species used in dental diseases: Ethnopharmacology aspects and antimicrobial activity evaluation. J Ethnopharmacol  2014; 155(3): 1441-9.
 [http://dx.doi.org/10.1016/j.jep.2014.07.021] [PMID: 25046828]

[20]
Colombari B, Tagliazucchi D, Odorici A, et al. Pomegranate extract affects fungal biofilm production: Consumption of phenolic compounds and alteration of fungal autoinducers release. Int J Environ Res Public Health  2022; 19(21): 14146.
 [http://dx.doi.org/10.3390/ijerph192114146] [PMID: 36361021]

[21]
Bakkiyaraj D, Nandhini JR, Malathy B, Pandian SK. The anti-biofilm potential of pomegranate (Punica granatum L.) extract against human bacterial and fungal pathogens. Biofouling  2013; 29(8): 929-37.
 [http://dx.doi.org/10.1080/08927014.2013.820825] [PMID: 23906229]

[22]
Dioguardi M, Ballini A, Sovereto D, et al. Application of the Extracts of Punica granatum in Oral Cancer: Scoping Review. Dent J  2022; 10(12): 234.
 [http://dx.doi.org/10.3390/dj10120234] [PMID: 36547050]

[23]
Guerrero-Solano JA, Jaramillo-Morales OA, Jiménez-Cabrera T, et al. Punica protopunica Balf., the Forgotten Sister of the Common Pomegranate (Punica granatum L.): Features and Medicinal Properties—A Review. Plants  2020; 9(9): 1214.
 [http://dx.doi.org/10.3390/plants9091214] [PMID: 32947914]

[24]
Kumar B, Khan SA, Jawaid Akhtar M. Phytochemicals and therapeutic potential of Punica granatum L Herbs, Spices and their Roles in Nutraceuticals and Functional Foods.  Cambridge, Massachusetts: Academic Press 2023; pp. 171-209.

[25]
Valero-Mendoza AG, Meléndez-Rentería NP, Chávez-González ML, et al. The whole pomegranate (Punica granatum. L), biological properties and important findings: A review. Food Chem Adv  2023; 2: 100153.
 [http://dx.doi.org/10.1016/j.focha.2022.100153]

[26]
Fahmy H, Hegazi N, El-Shamy S, Farag MA. Pomegranate juice as a functional food: A comprehensive review of its polyphenols, therapeutic merits, and recent patents. Food Funct  2020; 11(7): 5768-81.
 [http://dx.doi.org/10.1039/D0FO01251C] [PMID: 32608443]

[27]
Fourati M, Smaoui S, Ennouri K, et al. Multiresponse optimization of pomegranate peel extraction by statistical versus artificial intelligence: Predictive approach for foodborne bacterial pathogen inactivation. Evid Based Complement Alternat Med  2019; 2019: 1-18.
 [http://dx.doi.org/10.1155/2019/1542615] [PMID: 31737081]

[28]
Singh B, Singh JP, Kaur A, Singh N. Phenolic compounds as beneficial phytochemicals in pomegranate (Punica granatum L.) peel: A review. Food Chem  2018; 261: 75-86.
 [http://dx.doi.org/10.1016/j.foodchem.2018.04.039] [PMID: 29739608]

[29]
Bar-Ya’akov I, Tian L, Amir R, Holland D. Primary metabolites, anthocyanins, and hydrolyzable tannins in the pomegranate fruit. Front Plant Sci  2019; 10: 620.
 [http://dx.doi.org/10.3389/fpls.2019.00620] [PMID: 31164897]

[30]
Wu S, Tian L. Diverse phytochemicals and bioactivities in the ancient fruit and modern functional food pomegranate (Punica granatum). Molecules  2017; 22(10): 1606.
 [http://dx.doi.org/10.3390/molecules22101606] [PMID: 28946708]

[31]
Xu Y, Shi C, Wu Q, et al. Antimicrobial activity of punicalagin against Staphylococcus aureus and its effect on biofilm formation. Foodborne Pathog Dis  2017; 14(5): 282-7.
 [http://dx.doi.org/10.1089/fpd.2016.2226] [PMID: 28128637]

[32]
Rosas-Burgos EC, Burgos-Hernández A, Noguera-Artiaga L, et al. Antimicrobial activity of pomegranate peel extracts as affected by cultivar. J Sci Food Agric  2017; 97(3): 802-10.
 [http://dx.doi.org/10.1002/jsfa.7799] [PMID: 27173758]

[33]
Li G, Xu Y, Wang X, et al. Tannin-rich fraction from pomegranate rind damages membrane of Listeria monocytogenes. Foodborne Pathog Dis  2014; 11(4): 313-9.
 [http://dx.doi.org/10.1089/fpd.2013.1675] [PMID: 24447173]

[34]
Mena P, Calani L, Dall’Asta C, et al. Rapid and comprehensive evaluation of (poly)phenolic compounds in pomegranate (Punica granatum L.) juice by UHPLC-MSn. Molecules  2012; 17(12): 14821-40.
 [http://dx.doi.org/10.3390/molecules171214821] [PMID: 23519255]

[35]
Haslam E. Natural polyphenols (vegetable tannins) as drugs: Possible modes of action. J Nat Prod  1996; 59(2): 205-15.
 [http://dx.doi.org/10.1021/np960040+] [PMID: 8991956]

[36]
Russo M, Fanali C, Tripodo G, et al. Analysis of phenolic compounds in different parts of pomegranate (Punica granatum) fruit by HPLC-PDA-ESI/MS and evaluation of their antioxidant activity: Application to different Italian varieties. Anal Bioanal Chem  2018; 410(15): 3507-20.
 [http://dx.doi.org/10.1007/s00216-018-0854-8] [PMID: 29350256]

[37]
Kalaycıoğlu Z, Erim FB. Total phenolic contents, antioxidant activities, and bioactive ingredients of juices from pomegranate cultivars worldwide. Food Chem  2017; 221: 496-507.
 [http://dx.doi.org/10.1016/j.foodchem.2016.10.084] [PMID: 27979233]

[38]
Singh B, Bhat TK, Sharma OP. Biodegradation of tannic in an in vitro ruminal system. Livestok Prod Sci  2001; 68: 259-62.

[39]
Chung KT, Lu Z, Chou MW. Mechanism of inhibition of tannic acid and related compounds on the growth of intestinal bacteria. Food Chem Toxicol  1998; 36: 1053-60.

[40]
Larrosa M, Tomás-Barberán FA, Espín JC. The dietary hydrolysable tannin punicalagin releases ellagic acid that induces apoptosis in human colon adenocarcinoma Caco-2 cells by using the mitochondrial pathway. J Nutr Biochem  2006; 17(9): 611-25.
 [http://dx.doi.org/10.1016/j.jnutbio.2005.09.004] [PMID: 16426830]

[41]
Harborne JB, Williams CA. Advances in flavonoid research since 1992. Phytochemistry  2000; 55(6): 481-504.
 [http://dx.doi.org/10.1016/S0031-9422(00)00235-1] [PMID: 11130659]

[42]
Cushnie TPT, Lamb AJ. Antimicrobial activity of flavonoids. Int J Antimicrob Agents  2005; 26(5): 343-56.
 [http://dx.doi.org/10.1016/j.ijantimicag.2005.09.002] [PMID: 16323269]

[43]
Vučić V, Grabež M, Trchounian A, Arsić A. Composition and potential health benefits of pomegranate: A review. Curr Pharm Des  2019; 25(16): 1817-27.
 [http://dx.doi.org/10.2174/1381612825666190708183941] [PMID: 31298147]

[44]
Eghbali S, Askari SF, Avan R, Sahebkar A. Therapeutic effects of Punica granatum (Pomegranate): An updated review of clinical trials. J Nutr Metab  2021; 2021: 1-22.
 [http://dx.doi.org/10.1155/2021/5297162] [PMID: 34796029]

[45]
Hwang EI, Ahn BT, Lee HB, et al. Inhibitory activity for chitin synthase II from Saccharomyces cerevisiae by tannins and related compounds. Planta Med  2001; 67(6): 501-4.
 [http://dx.doi.org/10.1055/s-2001-16487-2] [PMID: 11509967]

[46]
Yordanov M, Dimitrova P, Patkar S, Saso L, Ivanovska N. Inhibition of Candida albicans extracellular enzyme activity by selected natural substances and their application in Candida infection. Can J Microbiol  2008; 54(6): 435-40.
 [http://dx.doi.org/10.1139/W08-029] [PMID: 18535628]

[47]
Brunskole M, Zorko K, Kerbler V, et al. Trihydroxynaphthalene reductase of Curvularia lunata—A target for flavonoid action? Chem Biol Interact  2009; 178(1-3): 259-67.
 [http://dx.doi.org/10.1016/j.cbi.2008.10.023] [PMID: 19010313]

[48]
Endo EH, Ueda-Nakamura T, Nakamura CV, Filho BPD. Activity of spray-dried microparticles containing pomegranate peel extract against Candida albicans. Molecules  2012; 17(9): 10094-107.
 [http://dx.doi.org/10.3390/molecules170910094] [PMID: 22922280]

[49]
Labsi M, Khelifi L, Mezioug D, Soufli I, Touil-Boukoffa C. Antihydatic and immunomodulatory effects of Punica granatum peel aqueous extract in a murine model of echinococcosis. Asian Pac J Trop Med  2016; 9(3): 211-20.
 [http://dx.doi.org/10.1016/j.apjtm.2016.01.038] [PMID: 26972390]

[50]
Almeida NLM, Saldanha LL, da Silva RA, et al. Antimicrobial activity of denture adhesive associated with Equisetum giganteum - and Punica granatum -enriched fractions against Candida albicans biofilms on acrylic resin surfaces. Biofouling  2018; 34(1): 62-73.
 [http://dx.doi.org/10.1080/08927014.2017.1407408] [PMID: 29250982]

[51]
Hajifattahi F, Moravej-Salehi E, Taheri M, Mahboubi A, Kamalinejad M. Antibacterial effect of hydroalcoholic extract of Punica granatum Linn. petal on common oral microorganisms. Int J Biomater  2016; 2016: 1-6.
 [http://dx.doi.org/10.1155/2016/8098943] [PMID: 26884763]

[52]
Rajesh G, Rajesh G, Rao A, Shenoy R. B H MP. Antimicrobial efficacy of Punica granatum mesocarp, Nelumbonucifera leaf, Psidiumguajava leaf and Coffeacanephora extract on common oral pathogens: An in-vitro study. J Clin Diagn Res  2014; 8(7): ZC65-8.
 [http://dx.doi.org/10.7860/JCDR/2014/9122.4629] [PMID: 25177642]

[53]
Gulube Z, Patel M. Effect of Punica granatum on the virulence factors of cariogenic bacteria Streptococcus mutans. Microb Pathog  2016; 98: 45-9.
 [http://dx.doi.org/10.1016/j.micpath.2016.06.027] [PMID: 27354207]

[54]
Kunte S, Kadam N, Patel A, Shah P, Lodaya R, Lakde L. Comparative evaluation of antimicrobial properties of pomegranate peel extract against Streptococcus mutans and Lactobacillus - An in vitro study. Int Dent Med J Adv Res  2018; 4(1): 1-6.
 [http://dx.doi.org/10.15713/ins.idmjar.88]

[55]
Van Leeuwen MPC, Slot DE, Van der Weijden GA. Essential oils compared to chlorhexidine with respect to plaque and parameters of gingival inflammation: A systematic review. J Periodontol  2011; 82(2): 174-94.
 [http://dx.doi.org/10.1902/jop.2010.100266] [PMID: 21043801]

[56]
Ferrazzano GF, Scioscia E, Sateriale D, et al. In vitro antibacterial activity of pomegranate juice and peel extracts on cariogenic bacteria. BioMed Res Int  2017; 2017: 1-7.
 [http://dx.doi.org/10.1155/2017/2152749] [PMID: 29209624]

[57]
Umar D, Dilshad B, Farhan M, Ali A, Baroudi K. The effect of pomegranate mouthrinse on Streptococcus mutans count and salivary pH: An in vivo study. J Adv Pharm Technol Res  2016; 7(1): 13-6.
 [http://dx.doi.org/10.4103/2231-4040.173266] [PMID: 26955605]

[58]
Abdollahzadeh Sh, Mashouf R, Mortazavi H, Moghaddam M, Roozbahani N, Vahedi M. Antibacterial and antifungal activities of Punica granatum peel extracts against oral pathogens. J Dent (Tehran)  2011; 8(1): 1-6.
 [PMID: 21998800]

[59]
Agarwal N, Chaturvedi Y, Mishra P, Chaturvedi Y, Suohu T. Comparison of Punica granatum, Terminalia chebula, and Vitis vinifera seed extracts used as Mouthrinse on Salivary Streptococcus mutans levels in children. J Contemp Dent Pract  2019; 20(8): 920-7.
 [http://dx.doi.org/10.5005/jp-journals-10024-2617] [PMID: 31797848]

[60]
Singla S, Malhotra R, Nd S, Saxena S. Antibacterial efficacy of mouthwash prepared from pomegranate, grape seed and guava extracts against oral Streptococci: An in vivo study. J Clin Pediatr Dent  2018; 42(2): 109-13.
 [http://dx.doi.org/10.17796/1053-4628-42.2.5] [PMID: 29087796]

[61]
Goel D, Bansal A, Nigam AG, Goenka P, Goel D. Effect of achyranthes aspera, 0.2% aqueous chlorhexidine gluconate and punica granatum oral rinse on the levels of salivary Streptococcus mutans in 8 to 12 years old children. J Contemp Dent Pract  2015; 16(11): 903-9.
 [http://dx.doi.org/10.5005/jp-journals-10024-1779] [PMID: 26718299]

[62]
de Medeiros N, Roberta D, Santos L. A randomized, controlled clinical trial on the clinical and microbiological efficacy of Punica granatum Linn mouthwash. Pesqui Bras Odontopediatria Clin Integr  2015; 15(1)

[63]
Deepak JC, Samuel SR. Effectiveness of pomegranate mouthrinse in reducing bacterial plaque, gingival inflammation and total salivary proteins over a period of 90 Days: A Double-blind randomized trial. J Int Acad Periodontol  2018; 20(3): 110-4.
 [PMID: 31522167]

[64]
Dabholkar CS, Shah M, Kathariya R, Bajaj M, Doshi Y. Comparative evaluation of antimicrobial activity of pomegranate-containing mouthwash against oral-biofilm forming organisms: An in vitro microbial study. J Clin Diagn Res  2016; 10(3): ZC65-9.
 [http://dx.doi.org/10.7860/JCDR/2016/16478.7475] [PMID: 27135005]

[65]
Srilekha M, Jayashri P. Comparing the antimicrobial effectiveness of Punica granatum and chlorhexidine-containing mouthwash: A single-blind randomized clinical trial. Drug Inv Today  2018; 10(8): 1544-9.

[66]
Jacob B, Malli Sureshbabu N, Ranjan M, Ranganath A, Siddique R. The antimicrobial effect of pomegranate peel extract versus chlorhexidine in high caries risk individuals using quantitative real-time polymerase chain reaction: A randomized triple-blind controlled clinical trial. Int J Dent  2021; 2021: 1-14.
 [http://dx.doi.org/10.1155/2021/5563945] [PMID: 34512759]

[67]
Batista ALA, Diógenes Alves Uchôa Lins R, de Souza Coelho R, do Nascimento Barbosa D, Moura Belém N, Alves Celestino FJ. Clinical efficacy analysis of the mouth rinsing with pomegranate and chamomile plant extracts in the gingival bleeding reduction. Complement Ther Clin Pract  2014; 20(1): 93-8.
 [http://dx.doi.org/10.1016/j.ctcp.2013.08.002] [PMID: 24439653]

[68]
Eltay EG, Gismalla BG, Mukhtar MM, Awadelkarim MOA. Punica granatum peel extract as adjunct irrigation to nonsurgical treatment of chronic gingivitis. Complement Ther Clin Pract  2021; 43: 101383.
 [http://dx.doi.org/10.1016/j.ctcp.2021.101383] [PMID: 33862350]

[69]
Avadhani M, Kukkamalla MA, Bhat KG. Screening of Punica granatum extract for antimicrobial activity against oral micro organisms. J ayurv Herb Med  2020; 6(2): 73-7.
 [http://dx.doi.org/10.31254/jahm.2020.6211]

[70]
DiSilvestro RA, DiSilvestro DJ, DiSilvestro DJ. Pomegranate extract mouth rinsing effects on saliva measures relevant to gingivitis risk. Phytother Res  2009; 23(8): 1123-7.
 [http://dx.doi.org/10.1002/ptr.2759] [PMID: 19170139]

[71]
Sedigh-Rahimabadi M, Fani M, Rostami-chijan M, Zarshenas MM, Shams M. A traditional mouthwash (Punica granatum var pleniflora) for controlling gingivitis of diabetic patients. J Evid Based Complem Altern Med  2017; 22(1): 59-67.
 [http://dx.doi.org/10.1177/2156587216633370] [PMID: 26922436]

[72]
Mahboubi A, Asgarpanah J, Sadaghiyani PN, Faizi M. Total phenolic and flavonoid content and antibacterial activity of (Punica granatum var pleniflora)flowers (Golnar) against bacterial strains causing foodborne diseases. BMC Complement Altern Med  2015; 15(1): 366.
 [http://dx.doi.org/10.1186/s12906-015-0887-x] [PMID: 26470879]

[73]
Gavanji S, Larki B, Bakhtari A. The effect of extract of Punica granatum var. pleniflora for treatment of minor recurrent aphthous stomatitis. Integr Med Res  2014; 3(2): 83-90.
 [http://dx.doi.org/10.1016/j.imr.2014.03.001] [PMID: 28664082]

[74]
Salgado ADY, Maia JL, Pereira SLS, Lemos TLG, Mota OML. Antiplaque and antigingivitis effects of a gel containing Punica granatum Linn extract: A double-blind clinical study in humans. J Appl Oral Sci  2006; 14(3): 162-6.
 [http://dx.doi.org/10.1590/S1678-77572006000300003] [PMID: 19089066]

[75]
Palomo F, Wantland L, Sanchez A, Volpe AR, McCool J, DeVizio W. The effect of three commercially available dentifrices containing triclosan on supragingival plaque formation and gingivitis: A six month clinical study. Int Dent J  1994; 44(1) (Suppl. 1): 75-81.
 [PMID: 8021040]

[76]
Gallas JA, Pelozo LL, Oliveira WP, Salvador SL, Corona SM, Souza-Gabriel AE. Characterization, antimicrobial activity, and antioxidant efficacy of a pomegranate peel solution against persistent root canal pathogens. Cureus  2023; 15(8): e43142.
 [http://dx.doi.org/10.7759/cureus.43142] [PMID: 37692706]

[77]
Raoof M, Zadeh MH, Nejad ZE, Sharififar F, Khodashenas M, Fereidooni R. Antimicrobial efficacy of different herbal extracts against root canal pathogens - An in vitro study. Indian J Dent Res  2023; 34(2): 204-8.
 [http://dx.doi.org/10.4103/ijdr.ijdr_625_22] [PMID: 37787214]

[78]
Prasetyo EP, Saraswati W, Goenharto S, et al. White pomegranate (Punica granatum) peels extract bactericidal potency on Enterococcus faecalis. Conserv Dent J  2021; 11(2): 84-8.

[79]
Sousa MN, Macedo AT, Ferreira GF, et al. Hydroalcoholic leaf extract of Punica granatum, alone and in combination with calcium hydroxide, is effective against mono- and polymicrobial biofilms of Enterococcus faecalis and Candida albicans. Antibiotics (Basel)  2022; 11(5): 584.
 [http://dx.doi.org/10.3390/antibiotics11050584] [PMID: 35625228]

[80]
Mansourian A, Boojarpour N, Ashnagar S, Momen Beitollahi J, Shamshiri AR. The comparative study of antifungal activity of Syzygium aromaticum, Punica granatum and nystatin on Candida albicans; An in vitro study. J Mycol Med  2014; 24(4): e163-8.
 [http://dx.doi.org/10.1016/j.mycmed.2014.07.001] [PMID: 25442923]

[81]
Lavaee F, Motaghi D, Jassbi AR, Jafarian H, Ghasemi F, Badiee P. Antifungal effect of the bark and root extracts of Punica granatum on oral Candida isolates. Curr Med Mycol  2018; 4(4): 20-4.
 [http://dx.doi.org/10.18502/cmm.4.4.382] [PMID: 30815613]

[82]
Nair R, Chanda S. Anticandidal activity of Punica granatum. Exhibited in different solvents. Pharm Biol  2005; 43(1): 21-5.
 [http://dx.doi.org/10.1080/13880200590903309]

[83]
Aboammo M, Islam T, Farghaly A. Evaluation of antibiofilm efficacy of different nanoherbal medications on multispecies bacterial infected root canals: An in vitro study. Al-Azhar J Dent Sci  2018; 21(5): 413-9.
 [http://dx.doi.org/10.21608/ajdsm.2018.71657]

[84]
Hannah VE, O’Donnell L, Robertson D, Ramage G. Denture stomatitis: Causes, cures and prevention. Prim Dent J  2017; 6(4): 46-51.
 [http://dx.doi.org/10.1308/205016817822230175] [PMID: 29258641]

[85]
Barbeau J, Séguin J, Goulet JP, et al. Reassessing the presence of Candida albicans in denture-related stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod  2003; 95(1): 51-9.
 [http://dx.doi.org/10.1067/moe.2003.44] [PMID: 12539027]

[86]
Gowda GV. Efficacy of Punica Granatum (Pomegranate) in the management of oral candidiasis – a randomized controlled study. J Indian Acad Oral Med Radiol  2023; 35(1): 15-20.
 [http://dx.doi.org/10.4103/jiaomr.jiaomr_174_21]

[87]
Garcia CR, Ueda TY, da Silva RA, et al. Effect of denture liners surface modification with Equisetum giganteum and Punica granatum on Candida albicans biofilm inhibition. Ther Deliv  2022; 13(3): 157-66.
 [http://dx.doi.org/10.4155/tde-2021-0074] [PMID: 35195016]

[88]
Najafi S, Mahgoli HA, Bahrami M, Faraji Z, Gholizadeh N. Comparing the effect of Punica Granatum linn gel and nystatin in the treatment of denture stomatitis(double blind clinical trial study). J Dentomaxillofacial Radiol. Pathol Surg  2021; 10(1): 13-9.

[89]
César de Souza Vasconcelos L, Sampaio MCC, Sampaio FC, Higino JS. Use of Punica granatum as an antifungal agent against candidosis associated with denture stomatitis. Mycoses  2003; 46(5-6): 192-6.
 [http://dx.doi.org/10.1046/j.1439-0507.2003.00884.x] [PMID: 12801361]

[90]
Vasconcelos LCS, Sampaio FC, Sampaio MCC, Pereira MSV, Higino JS, Peixoto MHP. Minimum inhibitory concentration of adherence of Punica granatum Linn (pomegranate) gel against S. mutans, S. mitis and C. albicans. Braz Dent J  2006; 17(3): 223-7.
 [http://dx.doi.org/10.1590/S0103-64402006000300009] [PMID: 17262129]

[91]
Silva PMB da, Chocano APC, et al. Efeitos benéficos de três produtos naturais para o tratamento da estomatite protética: Um ensaio clínico randomizado. Arquivos Em Odontologia  2022; 57: 141-8.

[92]
Maria PY, de Mendonça Guimarães D, Sampaio MH, Barbosa CE, Aparecida BA, de Lima JA. Efficacy of a 0.5% Propolis -0.9% pomegranate buccal spray treatment compared with 2% miconazole gel for denture stomatitis treatment in elderly patients: A randomized clinical trial. J Dent (Shiraz)  2022; 23(4): 25.

[93]
Wischer G, Boguhn J, Steingaß H, Schollenberger M, Rodehutscord M. Effects of different tannin-rich extracts and rapeseed tannin monomers on methane formation and microbial protein synthesis in vitro. Animal  2013; 7(11): 1796-805.
 [http://dx.doi.org/10.1017/S1751731113001481] [PMID: 23915496]

[94]
Wang D, Özen C, Abu-Reidah IM, et al. Vasculoprotective effects of pomegranate (Punica granatum L.). Front Pharmacol  2018; 9: 544.
 [http://dx.doi.org/10.3389/fphar.2018.00544] [PMID: 29881352]

[95]
Anibal PC, Peixoto ITA, Foglio MA, Höfling JF. Antifungal activity of the ethanolic extracts of Punica granatum L. and evaluation of the morphological and structural modifications of its compounds upon the cells of Candida spp. Braz J Microbiol  2013; 44(3): 839-48.
 [http://dx.doi.org/10.1590/S1517-83822013005000060] [PMID: 24516425]

[96]
Catão RMR, Antunes RMO, Arruda TA, et al. Atividade antimicrobiana in vitro do extrato etanólico de Punica granatum Linn. (romã) sobre isolados ambulatoriais de Staphylococcus aureus. Revista Brasileira de Análises Clínicas  2006; 38(2): 111-4.

[97]
Meccatti VM, Santos LF, de Carvalho LS, et al. Antifungal action of herbal plants’ glycolic extracts against Candida Species. Molecules  2023; 28(6): 2857.
 [http://dx.doi.org/10.3390/molecules28062857] [PMID: 36985829]

[98]
Chandu GN, Pai MBH, Prashant GM, Murlikrishna KS, Shivakumar KM. Antifungal efficacy of Punica granatum, Acacia nilotica, Cuminum cyminum and Foeniculum vulgare on Candida albicans: An in vitro study. Indian J Dent Res  2010; 21(3): 334-6.
 [http://dx.doi.org/10.4103/0970-9290.70792] [PMID: 20930339]

[99]
Endo EH, Garcia Cortez DA, Ueda-Nakamura T, Nakamura CV, Dias Filho BP. Potent antifungal activity of extracts and pure compound isolated from pomegranate peels and synergism with fluconazole against Candida albicans. Res Microbiol  2010; 161(7): 534-40.
 [http://dx.doi.org/10.1016/j.resmic.2010.05.002] [PMID: 20541606]

[100]
Bassiri-Jahromi S, Pourshafie MR, Mirabzade Ardakani E, et al. In vivo comparative evaluation of the pomegranate (Punica granatum) peel extract as an alternative agent to Nystatin against Oral candidiasis. Iran J Med Sci  2018; 43(3): 296-304.
 [PMID: 29892147]

[101]
Madugula P, Reddy S, Koneru J, Rao AS, Sruthi R, Dalli DT. “Rhetoric to Reality”- efficacy of Punica Granatum peel extract on oral candidiasis: An in vitro study. J Clin Diagn Res  2017; 11(1): ZC114-7.
 [http://dx.doi.org/10.7860/JCDR/2017/22810.9304] [PMID: 28274059]

[102]
Rizwan R, Shaheen S, Memon Z, Afridi F, Zaib M. In-vitro comparison of antifungal activity of herbs (Darehald and Pomegranate) with Azoles. Int J Clin Med  2018; 9(9): 703-15.
 [http://dx.doi.org/10.4236/ijcm.2018.99059]

[103]
Samlin SS, Prem Kumar KS, Siva B, Sudharshan R, Vignesswary A, Divya K. Punica granatum as a salutiferous superfruit in the treatment of oral candidiasis – An in-vitro study. J Oral Maxillofac Pathol  2020; 24(1): 188-9.
 [http://dx.doi.org/10.4103/jomfp.JOMFP_268_19] [PMID: 32508479]

[104]
Aviram M, Dornfeld L, Rosenblat M, et al. Pomegranate juice consumption reduces oxidative stress, atherogenic modifications to LDL, and platelet aggregation: Studies in humans and in atherosclerotic apolipoprotein E–deficient mice. Am J Clin Nutr  2000; 71(5): 1062-76.
 [http://dx.doi.org/10.1093/ajcn/71.5.1062] [PMID: 10799367]

[105]
da Silva RA, Ishikiriama BLC, Ribeiro Lopes MM, et al. Antifungal activity of Punicalagin–nystatin combinations against Candida albicans. Oral Dis  2020; 26(8): 1810-9.
 [http://dx.doi.org/10.1111/odi.13507] [PMID: 32583467]

[106]
Aviram M, Dornfeld L. Pomegranate juice consumption inhibits serum angiotensin converting enzyme activity and reduces systolic blood pressure. Atherosclerosis  2001; 158(1): 195-8.
 [http://dx.doi.org/10.1016/S0021-9150(01)00412-9] [PMID: 11500191]

[107]
Tavangar A, Aslani A, Nikbakht N. Comparative study of Punica granatum gel and triadent oral paste effect on recurrent aphthous stomatitis, a double blind clinical trial. J Dent (Shiraz)  2019; 20(3): 184-9.
 [http://dx.doi.org/10.30476/DENTJODS.2019.44913] [PMID: 31579693]

[108]
Darakhshan S, Malmir M, Bagheri F, et al. The effects of pomegranate peel extract on recurrent aphthous stomatitis. Curr Issues Pharm Med Sci  2019; 32(3): 115-20.
 [http://dx.doi.org/10.2478/cipms-2019-0021]

[109]
Tavangar A, Soleymani B, Ghalayani P, Zolfaghary B, Farhad AR. The efficacy of Punica granatum extract in the management of recurrent aphthous stomatitis. J Res Pharm Pract  2013; 2(2): 88-92.
 [http://dx.doi.org/10.4103/2279-042X.117389] [PMID: 24991610]

[110]
BenSaad LA, Kim KH, Quah CC, Kim WR, Shahimi M. Anti-inflammatory potential of ellagic acid, gallic acid and punicalagin A&B isolated from Punica granatum. BMC Complement Altern Med  2017; 17(1): 47.
 [http://dx.doi.org/10.1186/s12906-017-1555-0] [PMID: 28088220]

[111]
Saeed M, Naveed M, BiBi J, et al. The promising pharmacological effects and therapeutic/medicinal applications of Punica Granatum L. (Pomegranate) as a functional food in humans and animals. Recent Pat Inflamm Allergy Drug Discov  2018; 12(1): 24-38.
 [http://dx.doi.org/10.2174/1872213X12666180221154713] [PMID: 29473532]

[112]
Prasad D, Kunnaiah R. Punica granatum: A review on its potential role in treating periodontal disease. J Indian Soc Periodontol  2014; 18(4): 428-32.
 [http://dx.doi.org/10.4103/0972-124X.138678] [PMID: 25210254]

[113]
Souza JAS, Alves MM, Barbosa DB. Study of the activity of Punica granatum-mediated silver nanoparticles against Candida albicans and Candida glabrata, alone or in combination with azoles or polyenes. Med Mycol  2019; 58(4): 564-7.
 [http://dx.doi.org/10.1093/mmy/myz094] [PMID: 31509195]

[114]
Tavazo Zadeh E, Aref P, Askarizadeh N, Emadi F. In vitro antimicrobial effect of punica granatum extract versus chlorhexidine on streptococcus sobrinus, streptococcus sanguinis, and candida albicans. J Res Dent Maxillofacial Sci  2023; 8(1): 18-27.
 [http://dx.doi.org/10.52547/jrdms.8.1.18]

[115]
Bhadbhade SJ, Acharya AB, Rodrigues SV, Thakur SL. The antiplaque efficacy of pomegranate mouthrinse. Quintessence Int  2011; 42(1): 29-36.
 [PMID: 21206931]
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DOI https://dx.doi.org/10.2174/012542579X282756240408073450	Print ISSN 2542-579X
Publisher Name Bentham Science Publisher	Online ISSN 2542-5803
Current Dentistry

Antimicrobial Therapy in Dentistry: An Evidence-based Review of Pomegranate Fruit Properties

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