Comparative Evaluation of Locally Delivered Aloe vera Gel as an Adjunct to Scaling and Root Planing in Patients With Periodontitis: A Randomized Clinical Trial.

BACKGROUND: Herbal adjuncts have gained increasing interest in nonsurgical periodontal therapy because of their anti-inflammatory, antimicrobial, and wound-healing properties. Aloe vera has been explored as a locally delivered therapeutic agent owing to its biological activity and favorable safety profile. AIM: To evaluate the clinical efficacy of locally delivered Aloe vera gel as an adjunct to scaling and root planing (SRP) in patients with Stage II-III, Grade B periodontitis. MATERIALS AND METHODS: This randomized split-mouth clinical trial included systemically healthy patients diagnosed with Stage II-III, Grade B periodontitis. Selected periodontal sites were randomly assigned to receive either SRP with adjunctive subgingival application of locally prepared Aloe vera gel or SRP alone. Clinical parameters including plaque index (PI), gingival index (GI), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded at baseline and at 15, 30, and 45 days. An artificial intelligence-assisted evidence mapping analysis was additionally performed as a supplementary exploratory approach to contextualize the clinical findings within the existing periodontal literature. RESULTS: Both treatment groups demonstrated statistically significant improvement in all clinical parameters over the study period. At 45 days, sites treated with adjunctive Aloe vera gel showed greater reduction in PPD and greater gain in CAL compared with sites treated with SRP alone. CONCLUSION: Adjunctive subgingival application of locally prepared Aloe vera gel may improve short-term clinical periodontal outcomes when used alongside conventional nonsurgical periodontal therapy. These findings support its potential role as a safe and economical adjunctive therapeutic option.