***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: It is well known that gingivitis is a bacterially-elicited inflammation of the marginal gingiva . A number of chemical agents have been evaluated over the years with regard to their antimicrobial effects in the oral cavity ; however , all are associated with side effects that prohibit regular long-term use . Therefore , the effectiveness of a natural Mexican Sanguinaria extract ( Polygonum aviculare L. ) against gingivitis , was assessed in 60 male dentistry students between the ages of 18 and 25 years . Over a period of 2 weeks , these students used the Sanguinaria extract ( 1 mg/ml ) in oral rinse twice daily as a unique oral health measurement ( no tooth-brushing was allowed ) . The O'Leary Plaque Index and the Löe and Silness Gingivitis Index were recorded at baseline ( day 0 ) in all the subjects . Also , a complete prophylaxis was performed after both indices were obtained . The antibacterial and antiinflammatory effects of the extract were evaluated on days 7 , 11 and 14 . The results showed that the Mexican Sanguinaria extract in oral rinse significantly decreased gingivitis from day 0 ( -x=1 . 056 ) to day 14 ( -x=1.011 ) ( P</=0.05 ) . In contrast , a significant increase in dental plaque was observed from day 0 ( -x=91.38 ) to day 14 ( -x=98.69 ) ( P</=0.05 ) ; however , the consistency of this plaque permitted its mechanical flushing easily . From this study , it is concluded that the Mexican Sanguinaria extract in oral rinse can be employed supportively in the therapy of gingivitis The purpose of the present study was to establish in vitro the inhibiting effect of a herbal extract mixture on a selected number of micro-organisms and to test in vivo the effect of a mouthwash containing 6.3 mg/ml herbal extract mixture on plaque and gingivitis as compared to a minus active control mouthrinse . The herbal extract was a mixture of : Juniperus communis ( juniper ) , Urtica dioca ( nettle ) , Achillaea millefolium ( yarrow ) ; 1:1:1 . In the study , in-vitro , the effect of pure herbal extract mixture on acid production of Streptococcus mutans was tested and the minimum inhibitory concentrations ( MIC ) of the following micro-organisms were tested : Streptococcus mutans , Streptococcus mitis , Actynomyces viscosus , Actynomyces naeslundii , Actinobacillus actinomycetemcomitans , Prevotella intermedia , Campylobacter rectus , Fusobacterium nucleatum , Veillonella parvula . The MIC-values for A. viscosus and P. gingivalis were 100 mg/ml . The MIC-values for A. naeslundii and A. actinomycetemcomitans were considerably lower ( 10 mg/ml ) . S. mitis was the most susceptible of the tested organisms to the extract with a MIC value of 1 mg/ml . S. mutans , C. rectus , V. parvula , and F. nucleatum were not influenced by the extracts . No inhibitory effect of the 6.3 mg/ml herbal extract mixture was observed on the acid production of S. mutans . For the study in-vivo , 45 volunteers were selected on the basis of having moderate gingival inflammation . As efficacy parameters the plaque index , modified gingival index and angulated bleeding index were assessed . The subjects were r and omly divided among 3 experimental groups ( 2x test and 1 ' minus active ' control ) . The participants were requested to rinse with 10 ml of mouthwash twice a day for a period of three months . After 6 weeks and 3 months , the same clinical indices as at baseline were recorded . The results show no difference between the two test groups and the control group . In conclusion , the results of the present study have shown that the mixture of the 3 herbal extracts , Juniperus communis , Urtica dioca and Achillaea millefolium when used in a mouthrinse has no effect on plaque growth and gingival health Background : The key to good oral health is hidden in nature . Natural herbs like neem , tulsi , pudina , clove oil , ajwain , triphala and many more has been used since ages either as a whole single herb or as a combination against various oral health problems like bleeding gums , halitosis , mouth ulcers and preventing tooth decay . The aim of the study was to compare the efficacy of a commercially available herbal mouthrinse ( Herboral ) with that of chlorhexidine gluconate which is considered to be a gold st and ard as an anti-plaque agent . Material s and Methods : A r and omized , two-group , parallel study as a ‘ de novo ’ plaque accumulation model was carried out on 50 subjects ( 23 males and 27 females ) . At baseline , all participants received a  professional prophylaxis  and were r and omly assigned to the test ( Herbal mouthrinse ) and control ( Chlorhexidine Gluconate ) group . On the following three days , all subjects rinsed with 10 ml of the allocated mouthrinse twice daily for 1 min . They were asked to refrain from use of any other oral hygiene measures during the study . At the end of the experimental period , plaque was assessed and a question naire was filled by all subjects . Results : Chlorhexidine ( mean plaque score=1.65 ) inhibited plaque growth significantly more than the herbal mouthrinse ( mean plaque score=1.43 , P<0.001 ) . The results of the question naire showed that Herboral was preferred by patients for its taste , its convenience of use and taste duration ( aftertaste ) . However , Chlorhexidine was considered to be more effective in reducing plaque as compared to Herboral . Conclusion : Herbal mouthrinse was found to be a potent plaque inhibitor , though less effective than Chlorhexidine Gluconate . However , it can serve as a good alternative for the patients with special needs as in case of diabetics , xerostomics , and so on Background The aim of this study was to evaluate the antiplaque effect of a new alcohol free essential oil mouthwash with respect to a control of an essential oil with alcohol mouthwash , using an in vivo plaque regrowth model of 3-days . Methods The study was design ed as a double-masked , r and omized , crossover clinical trial , involving 30 volunteers to compare two different essential oil containing mouthwashes , during a 3-day plaque accumulation model . After receiving a thorough professional prophylaxis at the baseline , over the next 3-days each volunteer refrained from all oral hygiene measures and had two daily rinses with 20 ml of the test mouthwash ( alcohol free essential oil ) or the control mouthwash ( essential oil with alcohol ) . At the end of the each experimental period , plaque was assessed and the panelists filled out a question naire . Each subject underwent a 14 days washout period and there was a second allocation . Results The essential oil mouthwash with ethanol shows a better inhibitory effect of plaque regrowth in 3-days than the mouthwash test with only essential oil in the whole mouth ( plaque index = 2.18 against 2.46 , respectively , p < 0.05 ) ; for the lower jaw ( plaque index = 2.28 against 2.57 , respectively , p < 0.05 ) ; for the upper jaw ( plaque index = 2.08 against 2.35 , respectively , p < 0.05 ) ; for the incisors ( plaque index = 1.93 against 2.27 , respectively , p < 0.05 ) ; and the canines ( plaque index = 1.99 against 2.47 , respectively , p < 0.05 ) . Conclusion The essential oil containing mouthwash without alcohol seems to have a less inhibiting effect on the plaque regrowth than the traditional alcoholic solution . Trial Registration Clinical Trials.gov PURPOSE The purpose of this study was to determine the effects of two oral rinses-one 0.12 % chlorhexidine rinse ( CHX ) and one herbal rinse (HBR)-on gingival health status over time . METHODS Sixty-three participants were r and omly assigned to one of three treatment groups : CHX , HBR , or placebo . For three months , participants rinsed twice daily ( morning and evening ) with ( 1/2 ) ounce of allocated rinse after brushing and flossing . Individuals were given the same type of soft bristle toothbrush and whitening toothpaste . No attempt was made to modify participants ' routine oral care , except they were advised to refrain from use of any other oral rinse for the duration of the study . Data were collected at baseline ( B ) , month one ( 1 ) , two ( 2 ) , and three ( 3 ) utilizing the Gingival Index ( GI ) , Plaque Index ( PI ) , and bleeding on probing ( BOP ) . A full mouth periodontal probing was performed at baseline and at the completion of the study . A soft tissue oral assessment was completed at each visit . CHX , HBR , and placebo data were compared between three time intervals , B-1 , B-2 , and B-3 . Statistical analysis was conducted by means of multiple regression using generalized linear models . Paired comparison tests -- ANOVA followed by a post hoc Tukey test -- were used to confirm results . RESULTS CHX was the only oral rinse to demonstrate a statistically significant effect on the reduction of mean GI , BOP , and PI scores when compared to placebo . CHX demonstrated a 31 % reduction in the proportion of GI scores between B-2 and a 29 % reduction between B-3 ( p=.003 and p=.012 , respectively ) . CHX demonstrated a 19 % reduction of BOP sites between B-1 , 32 % reduction between B-2 , and 29 % reduction between B-3 ( p=.028 , p=.000 , and p=.005 , respectively ) . CHX demonstrated a 20 % reduction in PI scores between B-1 , and a 28 % reduction between B-2 ( p=.005 and p=.032 , respectively ) . The effects of HBR on reducing mean GI , BOP , and PI scores were not statistically greater than placebo at any time during the study OBJECTIVE The purpose of the present investigation was to determine if antimicrobial mouthrinses with different formulations could affect the composition of the subgingival microbiota and clinical parameters of adjacent tissues in periodontal maintenance subjects . METHODS One-hundred and sixteen subjects , who had been treated for chronic periodontitis and were in a maintenance program , were r and omly assigned one of four mouthrinses , to be used twice daily for three months . The mouthrinses were herbal 1 , herbal 2 , essential oil , and chlorhexidine .  Clinical measurements and subgingival plaque sample s were taken at baseline and at three months . Plaque sample s were individually evaluated for 18 test species/taxa using checkerboard DNA-DNA hybridization . Significance of differences between baseline and three months for both microbiological and clinical parameters were determined using the Wilcoxon Signed Ranks test . Significance of difference among groups for change in clinical and microbiological parameters was determined using analysis of covariance ( ANCOVA ) , adjusting for baseline values . RESULTS Shifts in species proportions differed significantly for 9/18 test species/taxa among the four mouthrinse groups . Streptococcus and Capnocytophaga species were reduced most in the herbal rinse groups , while Veillonella parvula was reduced most in the essential oil and chlorhexidine groups . Actinomyces were also markedly reduced in the chlorhexidine group . Mean Plaque ( PI ) and Gingival Indices ( GI ) were reduced between baseline and three months in each group . Results emphasize that chlorhexidine ( p < 0.001 ) and herbal ( p < 0.05 ) rinses significantly reduced PI . Some subjects in each group responded better than others . CONCLUSION All four mouthrinses tested produced shifts in the composition of subgingival microbiota , although the results differed among the groups . The observed microbial changes were accompanied by improvements in clinical parameters in the periodontal maintenance subjects In the treatment of periodontal disease initial therapy aims at reducing marginal inflammation so allowing assessment of residual disease and further treatment options . The aim of the present study was to determine whether the use of a dentifrice and oral rinse containing sanguinaria extract led to a more rapid resolution of gingival inflammation following initial therapy . Thirty-four subjects , r and omly assigned to one of two treatment groups , took part in this r and omized double-blind parallel study . All subjects received initial therapy including oral hygiene instruction and scaling and root planing as required . One group also received an active dentifrice and oral rinse containing sanguinaria extract ( an antiplaque agent ) and zinc chloride . The other group received a placebo dentifrice and oral rinse . The gingival index ( GI ) , plaque index ( PLI ) and probing pocket depths ( PD ) were recorded at six sites per tooth at baseline , two weeks after initial therapy and six weeks after initial therapy . There was no significant difference between the groups for any of the parameters at the baseline examination . Two weeks following initial therapy both groups showed a statistically significant increase in the number of sites with PLI of 0 or 1 ( p < 0.0001 ) and a statistically significant increase in the number of sites with a GI of 0 or 1 ( that is , no bleeding on probing ) , ( p < 0.0001 ) . Also there was a statistically significant increase in the number of sites with probing depths < or = 3 mm ( p < 0.0001 ) compared with baseline . These changes were maintained through to six weeks post therapy . There was no significant advantage to the sanguinaria group . Results demonstrate that initial therapy in the form of oral hygiene instruction , scaling and 
    Output:
    
Conclusions Evidence proving the effectiveness of NCCM as an adjunct to unsupervised oral hygiene for plaque and gingivitis control is still insufficient .
Clinical relevance This review provides an overview of the strength of clinical evidence regarding the effectiveness of natural compounds containing mouthrinses in promoting gingival health