الفهرس 
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Abstract
Periodontal disease is a chronic destructive inflammatory disease affecting the
tooth-supporting tissues and is one of the most prevalent chronic infections in
humans. The disease is caused by dental plaque, a biofilm in which gram-negative
anaerobic microorganisms dominate.
Treatment of periodontal diseases principally focus on addressing the etiologic
bacteria or biofilm. The bacterial biofilm is disrupted and removed via scaling and
root planning (SRP) procedures. Because mechanical means alone have limitations
especially in the interproximal areas, greater interest has shown in chemical means.
Therefore, chemotherapeutic agents can play a vital role as adjuncts of
mechanical plaque control methods. Chlorhexidine is considered the gold standard
agent largely used as a mouth-rinse for its clinical efficacy in chemical plaque
control. However, it is expensive and has unwanted side effects such as extrinsic
tooth staining, unpleasant taste, taste disturbance, sensitivity changes in tongue, and
pain. Thus, the treatment with natural products could be used.
Among the known natural antibacterial agents is Punica granatum
(pomegranate) which also has an anti-inflammatory, antioxidant properties.
Therefore, the goal of this study was to investigate the possible antimicrobial
efficacy of different concentrations of pomegranate peel extract on bacterial plaque
and to compare the clinical and microbiological effects of its use as a mouthrinse
versus chlorhexidine mouthrinse as an adjunctive therapy to scaling and root
planing in the treatment of chronic gingival and periodontal diseases.