Cananga Flower ( Cananga Odorata ) Extract Gum's Efficacy In Reducing The Index Of Gingivitis-Causing Plaque Of Teuku Nyak Arif Fatih Bilingual School’s Students

5%, 10%, 20%, dan 40% diuji potensi antibakterinya dengan metode difusi sumuran. Kontrol (+) adalah tetrasiklin 30 μg dan kontrol (-) etanol 96%. Uji praklinis dilakukan dengan metode Brine Shrimp Lethality Test untuk mengetahui Lethal Concentration 50% (LC 50 ). Uji klinis dilakukan dengan metode pretest and posttest control group design selama seminggu. Berdasarkan hasil penelitian, rerata zona hambat pada konsentrasi 2,5%, 5%, 10%, 20%, dan 40% berturut – turut adalah 9,06 mm, 10,53 mm, 12,2 mm, 13,43 mm, dan 14,8 mm. Uji praklinis menunjukkan bahwa LC 50 dari bahan produk adalah 850,191 ppm. Hasil uji klinis berupa tingkat penurunan indeks plak, yaitu 0,344375 pada kelompok perlakuan. Penelitian ini menarik kesimpulan bahwa ekstrak bunga kenanga terbukti memiliki aktivitas antibakteri terhadap Porphyromonas gingivalis dan permen karet ekstrak bunga kenanga berpotensi efektif dalam mencegah dan menurunkan indeks plak penyebab gingivitis.


Introduction
Oral health is not sufficiently known among Indonesians.In 2018, 96.58% of Indonesians have gingivitis, according to the Ministry of Health.In Indonesia, 91.1% of people have brushed their teeth, yet only 7.3% of them do it correctly (1,2).Gingivitis refers to inflammation of the gingiva (gum) due to plaque buildup or biofilm formation, which is caused by the growth of bacteria on the gums, called Porphyromonas gingivalis, a Gram-negative bacterium.If it's left untreated, the risk of periodontitis will be increased, which is the next stage after gingivitis (3-6).
Because of its secondary metabolites, it effectively inhibits Porphyromonas gingivalis growth (7,8).Chewing gum's advantages in the medical field have led to its widespread expansion.A number of illnesses can be lessened and treated with herbal gum (9).It helps to stimulate saliva production, which can neutralize the acid produced by the bacteria (10,11).The purpose of this study was to determine which cananga flower compounds inhibit Porphyromonas gingivalis growth and whether chewing gum products containing cananga flower extract effectively reduce plaque in order to prevent gingivitis.This is in line with the goals of the research, which include giving the public an alternative oral cleanser to help prevent gingivitis and raising the value of cananga plants in the health and economic sectors.

Method
This study used the well diffusion method for in vitro testing and a Completely Randomized Design (CRD) for three repetitions in the laboratory.The Brine Shrimp Lethality Test (BSLT) was used for preclinical testing (toxicity test).The experimental pretest and posttest control group design method was used in the clinical test, also the Loe and Sillness measurement was used to calculate the plaque index score.
Flower samples were subjected to quantitative phytochemical testing using Gas Chromatography Mass Spectrometry (GC-MS) and flower extraction using the Soxhletation method.Porphyromonas gingivalis bacteria were first revived in vitro on Mueller Hinton Agar (MHA) medium using an inoculant suspension in accordance with the McFarland turbidity standard.The efficacy of several antibiotics was then assessed to identify the positive control.In order to determine extract's' efficacy against bacteria and inhibition zone formation, it was tested at extract concentrations of 2.5%, 5%, 10%, 20%, and 40%.As a negative control, 96% ethanol was used.Terpenoid compounds include sesquiterpenes and sesquiterpenoids.(12)(13)(14)(15).
The compounds found in cananga flower extract, known as sesquiterpenes, possess potential antimicrobial, antifungal, and antibiotic properties (16,17).Gram negative bacteria like Pophyromonas gingivalis are particularly susceptible to the antibacterial properties of terpenoids (13).The inhibition zones formed were the result of cananga flower extract's antibacterial efficacy test against Porphyromonas gingivalis.
These findings suggested that the increase in inhibition zones formed and extract concentration were directly proportional.
According to preclinical test results, the concentration of product ingredients that can have a toxic effect is 850.191ppm, which is the concentration that can kill 50% of the subjects after 24 hours of treatment.From the clinical test results, it was seen that the plaque index decreased in the treatment group by 0.344375.This showed that cananga chewing gum has proven to be potentially effective in reducing plaque that causes gingivitis.This is in accordance with research which stated that cananga essential oil, which has been utilized as a medication for periodontal disease, effectively lowers the plaque index by preventing the development of biofilm on the tooth surface, eliminating bacteria, and acting as an anti-inflammatory (18).It's concluded that cananga flower extract has antibiofilm properties.

Conclusion and Suggestion
From the research, the author drew the conclusions that cananga chewing gum can lower the treatment group's plaque index by 0.344375 and cananga flower extract has anti-biofilm properties.In order to conduct more research on the application of clinical test, male research subjects and more various ages could be included, as well as a longer implementation period and a more thorough technical implementation of the clinical test.