HERBS Evaluation of Osteogenic Potential of Cissus quadrangularis on Mandibular Alveolar Ridge Distraction Boswellia serrata Order: Sapindales Family: Burseraceae Genus: Boswellia Species: serrata English name: Indian Frankincense Sanskrit name: Shallaki Morphology and Habitat Boswellia serrata is a deciduous tree that grows up to 18 m tall. The leaves are lanceolate or ovate, and the flowers are white. B serrata commonly grows in the dry and hilly regions of India, northern Africa, and the Middle East.1,2 Principal Phytoconstituents Boswellic acids are the main biologically active phytoconstituents found in the resin of B serrata and have promising anti-inflammatory activity.3 Pharmacologic Actions In a study, patients with knee osteoarthritis (OA) were administered B serrata extract (containing Cissus quadrangularis Order: Vitales Family: Vitaceae Genus: Cissus Species: quadrangularis English name: Winged Treebine Sanskrit name: Hadjod Morphology and Habitat Cissus quadrangularis is a perennial climber. The stem is stout, fleshy, and quadrangular and dichotomously branched, and the leaves are reniform. C quadrangularis grows extensively in tropical and subtropical countries including India, Sri Lanka, South Africa, Thailand, Java, and the Philippines.1 Principal Phytoconstituents The major phytoconstituents of C quadrangularis are flavonoids, iridoids, anabolic steroids, triterpenoids, stilbene derivatives, phytosterols, and α- and β-amyrins.2 The plant also contains ascorbic acid, carotene A, ketosteroid, and calcium.1 3-acetyl-11-keto-β-boswellic acid with β-boswellic acid) or placebo for 120 days. The B serrata group reported significantly improved functional ability and reduced pain and stiffness of the knee joint compared with the placebo group. Radiographic assessments in the B serrata group showed a distinct change in the OA condition, wherein there was an increase in the knee joint gap and decrease in the osteophytes. They also had significantly reduced levels of serum high-sensitive C-reactive protein, a potential inflammatory marker associated with knee OA. Thus, B serrata exerts antiarthritic and antiinflammatory activities.4 References 1. Siddiqui MZ. Indian J Pharm Sci. 2011;73(3):255–261. 2. Sultana A, et al. Int J Pharm Sci Res. 2013;4(6):2106–2117. 3. Iram F, et al. Asian Pac J Trop Biomed. 2017;7(6):513–523. 4. Majeed M, et al. Phytother Res. 2019;33(5):1457–1468. Pharmacologic Actions A study evaluated the effect of C quadrangularis (500 mg capsules) on the healing process of maxillofacial fractures in patients treated through open reduction internal fixation. Upon follow-up of these patients, an acceleration in the healing of fractured jaw bones and a reduction in pain and swelling were noted.3 C quadrangularis promotes fracture healing by increasing the uptake of minerals such as calcium, strontium, and sulfur by the osteoblasts.4 In ovariectomized mice, the administration of C quadrangularis extract prevented bone loss in the cancellous and cortical bones of the femur and the proximal tibia.5 References 1. Zaki S, et al. Int J Clin Microbiol Biochem Technol. 2020;3:49–53. 2. Sundaran J, et al. Bioinformation. 2020;16(8):579–585. 3. Brahmkshatriya HR, et al. Ayu. 2015;36(2):169–173. 4. Ghouse MS, Baig MS. Int J Pharmacog. 2015;2(11):527–531. 5. Banu J, et al. J Osteoporos. 2012;2012:101206. This randomized clinical trial was designed to evaluate the osteogenic potential of Cissus quadrangularis in alveolar distraction to facilitate implant installation. Twenty patients with atrophic ridge were treated through alveolar distraction. After completing distractor activation, the patients were randomly divided into 2 equal groups—the placebo group and the C quadrangularis or study group. After a consolidation period, distractors were removed, and implants were inserted. Clinical evaluation was done to assess wound healing and stability of the distractor and the implant. Histologic evaluation was performed at the time of implant insertion. Radiographic evaluation was performed to assess the bone volume and density after distraction as well as the density and bone loss around the implant. Radiographic and histologic evaluation results showed that the bone formation and maturation were faster in the study group than that in the control group. There was a significant increase in the bone density in the distracted area and around the implant in the study group than in the control group. There was a significant bone loss by the end of the consolidation Source: Altaweel AA, et al. BMC Oral Health. 2021;21:491. period and around the implant by the end of the study in the control group than in the study group. C quadrangularis administration during the consolidation period is associated with an increased osteogenic potential in the distracted bone. The histologic and radiographic findings of this study proved that C quadrangularis not only enhances the rate of new bone formation but also increases bone density to withstand the biomechanical requirements of implant placement in a shorter time. Brand names with tagline Open type Curved Septilin® Builds the body’s own defense mechanism Evecare® Ensures complete uterine care ShallakiHimalaya The key to healthy joints HadjodHimalaya Accelerates fracture healing and increases bone strength Brand names with tagline Open type Cu ved Septilin® Builds the body’s own defense mechanism Evecare® Ensures complete uterine care ShallakiHimalaya The key to healthy joints Hadj Himalaya Accelerates fracture h al and increases bo strengt Brand names with tagline Open type Curved Septilin® Builds the body’s own defense mechanism Evecare® Ensures complete uterine care Sha lakiHimalaya The key to healthy joints HadjodHimalay Accelerates fracture healing and incr ases bone stren
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