Virgin Coconut Oil

Virgin coconut oil (VCO)
VCO contains lauric acid, caprylic acid, and capric acid, which have antiviral, antibacterial, antifungal,
and antiprotozoal effects. The numerous advantages of lauric acid, that is, the largest component of
VCO, could eliminate various microorganisms whose cell membranes contain fat, including
Streptococcus sp., Gram-positive bacteria, and Gram-negative bacteria. The VCO used in this research
study was developed using the fermentation method to achieve a concentration of 12.5%. This
concentration was chosen based on the research by Hasriati et al., who found that the antibacterial
effect of VCO starts to decrease after a concentration of 12.5%. Ogbolu et al. proved that VCO
concentrations of 0.79%, 50%, and 100% have antifungal effects on various Candida fungi. According to
Saputry, gargling using VCO with a concentration of 20% is not effective in reducing the amount of
colonies of dental plaque bacteria in subjects with normal oral health.
P. gingivalis
The bacteria associated with chronic periodontitis are P. gingivalis [24]. Such bacteria are rod-shaped,
non-motile, anaerobic, Gram-negative, and asaccharolytic, and they produce black-pigmented colonies.
These bacteria are incorporated within the red complex associated with bleeding following probing and
dominant over the development of advanced plaque. One of the pathogenic factors of P. gingivalis is the
gingipains, which are proteinase enzymes specific to arginine and lysine. Gingipains influence the
progression of periodontal disease by increasing vascular permeability and stimulating cells to produce
inflammatory mediators and accumulate neutrophils. The accumulation of neutrophils will increase the
activation of the gingival crevice fluid granular proteinase and damage the bonding tissue, thereby
creating a conducive environment for the development of subgingival bacteria.
T. denticola
T. denticola is anaerobic spirochete and also a Gram-negative and spiral-shaped bacteria. Their presence
is increased in cases of chronic periodontitis. The hallmark of spirochete infection is its ability to invade
tissue [25]. T. denticola induces and degrades the cytokines. Further, T. denticola causes the inhibition
of migration from the fibroblasts and neutrophils by means of interfering with the neutrophils’ ability to
eliminate pathogenic bacteria and affecting the fibroblasts’ activity in wound healing. The virulence
factors of T. denticola bacteria include some proteins associated with flagella synthesis, chemotaxis
proteins, denticillin, and proteases shaped like chymotrypsin.
METHODS
This study was conducted using a clinical experimental method. The subjects were using metal-porcelain
full veneer crown(s) who were treated at the Prosthodontics Clinic of University Dental Hospital, Faculty
of Dentistry, University of Indonesia (RSKGM FKG UI), between January and March 2017.
RESULTS
This study was conducted on 23 subjects with metal-porcelain full veneer crown(s) who were included in
the study based on inclusion and exclusion criteria. The research was conducted from January 2017 to
March 2017, and the ethical approval for the study was granted by the Ethics Commission of the Faculty
of Dentistry, University of Indonesia. Sampling was conducted at the Prosthodontics Clinic of University
Dental Hospital Faculty of Dentistry, University of Indonesia. The primary data collection involved
questionnaires, the signing of an informed consent form, examination of the subjects’ periodontal
status, and sampling of their subgingival plaque. The subgingival plaque sampling was performed on all
subjects with 4 mm pocket depth criteria to obtain a total of 23 subgingival plaque samples. The
subjects were instructed to rinse with 12.5% VCO twice daily for 4 days after brushing their teeth in the
morning and at the night before bed. They were told to gargle for 30 s using the dosage provided and
then remove the VCO without rinsing with water. A laboratory examination involving a real-time
polymerase chain reaction (RT-PCR) was performed in the Oral Biology Laboratory Faculty of Dentistry
University of Indonesia. Fig. 1 presents the results of the univariate analysis comparing the total overall
bacterial count with the number of P. gingivalis and T. denticola bacteria. The figure shows that the
computed tomography (CT) mean of the T. denticola is higher than the CT mean of the total bacteria
and also higher than the CT mean of the P. gingivalis (30.22), although the CT mean of the total bacteria
is lower than the CT mean of the P. gingivalis and the CT mean of the T. denticola (20.43). Fig. 2
illustrates the mean overall value of the data obtained from the 23 subjects. The figure shows that the
highest CT mean was obtained for subject 6, with the CT mean of the P. gingivalis being 35.53. Overall, it
can be seen that the total CT mean is always lower than the CT mean of the P. gingivalis and the CT
mean of the T. denticola in all subjects.
DISCUSSION
This study was a clinical experimental study in which each subject served as the control for him/herself.
The purpose of this study was to analyze the influence of the use of 12.5% VCO in decreasing the
number of P. gingivalis and T. denticola bacteria on the metal-porcelain full veneer crown margins.
Samples were taken from the subjects at the beginning of the study, and the subjects were given four 30
ml bottles of 12.5% VCO to be used for 4 days. They were instructed to rinse twice daily for 30 s
according to the dosage and removed the VSO without rinsing with water. After 4 days, the subjects
returned so that a control sample could be taken. The subgingival sampling could be performed with a
scaler, a curette, or paper points. Loomer reported that samples taken with paper points differ from
those obtained using a curette. Curettage takes plaque from all areas of the pocket, including the most
apical area, while paper points only take the outside of the coronal plaque. The plaque sampling in this
study was conducted using paper points to reduce the likelihood of bleeding during sampling. The
disadvantage of using paper points was the inability to reach the bottom of the pocket.
Pocket depth measurements were performed for all study subjects. The pocket depth was measured on
six tooth surfaces (mesiobuccal, midbuccal, distobuccal, mesiolingual, midlingual, and distolingual) using
a periodontal probe [21]. A measurement depth of 4 mm was selected for the subgingival plaque
sampling. The selection of the pocket depth was based on the study by Passariello et al., who found that
P. gingivalis and T. denticola are most commonly found in subgingival plaques at pocket depths >4 mm.
T. denticola is found on the surface of the plaque at a depth of 4–6 mm, while P. gingivalis is found in
the deeper layers [35]. In Fig. 1, the total bacteria test results concerning the P. gingivalis and T.
denticola indicate large numbers of bacteria in the subgingival region. In Fig. 2, subject six has the
highest mean value of P. gingivalis bacteria (35.53).
VCO contains lauric acid, caplyric acid, and capric acid, which have antiviral, antibacterial, antifungal,
and antiprotozoal effects. Lauric acid could serve to eliminate various microorganisms whose cells
membranes contain fat, including Streptococcus sp., Gram-positive bacteria, and Gram-negative
bacteria. The use of 12.5% VCO significantly decreased the amount of P. gingivalis and T. denticola
bacteria on the metal-porcelain full veneer porcelain margin. The VCO concentration of 12.5% was
chosen based on the study by Hasriati et al., who noted that the antibacterial effect of 12.5% VCO
showed a decrease in bacterial colonization. Dewi et al. found that VCO 12.5% VCO have a significant
effect when compared with aquadest, while decreasing the gingival index of bridge restoration users.
According to Saputry, VCO mouthwash with a concentration of 20% does not effectively decrease the
amount of plaque bacterial colonization in subjects with normal oral hygiene.
CONCLUSION
Based on the results of this study, it can be concluded that the usage of VCO mouthwash with a
concentration of 12.5% effectively decreases the amount of P. gingivalis and T. Denticola bacterial
colonization on the metal-porcelain full veneer crown margins.

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