Application of pomegranate (Punica granatum Linn.) fruit extract for accelerating post-tooth extraction wound healing

Intan Nirwana

Abstract views = 105 times | views = 42 times


Background: Trauma occurring during tooth extraction can cause complications such as bleeding, infection, fracture and dry socket and constitutes an inflammatory response trigger. Pomegranate (Punica granatum Linn.) extract, which contains large amounts of punicallagin and ellagic acid, possesses various qualities, including; anti-inflammatory, anti-bacterial and anti-oxidant. Pomegranate extract can inhibit proinflammatory cytokine production, while also suppressing inflammation response thereby accelerating wound healing. Purpose: This study aimed to analyze the effect of pomegranate extract application to the tooth extraction wounds of Cavia cobaya (C. cobaya) on the expression of fibroblast growth factor-2 (FGF-2) and transforming growth factor β (TGF-β) on the fourth day of the wound-healing process. Methods: This study used 12 C. cobaya, divided into two groups, namely; control and treatment. The subjects were anesthetized, before their lower left central incisor was extracted and the entire socket filled with CMC-Na 3% in members of the control group and pomegranate extract in those of the treatment group. The twelve C. cobaya were sacrificed on day 4, their lower jaw subsequently being removed and decalcified for approximately 30 days. The mandibula tissue was stained using a immunohistochemical technique. FGF-2 and TGF-β were used to evaluate the healing process in the extracted tooth socket. Differences in the expression of FGF-2 and TGF-β were evaluated statistically by means of a t-test. Results: This study indicated a significant difference between the control and the treatment groups (p<0.05). The treatment group members whose sockets were filled with pomegranate extract showed high FGF-2 and TGF-β expression. Conclusion: This study confirmed that the administration of pomegranate extract to post-extraction tooth wounds of C. cobaya increases the expression of FGF-2 and TGF-β on day 4, thereby accelerating the wound healing process.


FGF-2; post extraction wound; Punica granatum Linn; TGF-β

Full Text:



Lodi G, Figini L, Sardella A, Carrassi A, Del Fabbro M, Furness S. Antibiotics to prevent complications following tooth extractions. Cochrane Database Syst Rev. 2012; 11: 1–62.

Maskrey BH, Megson IL, Whitfield PD, Rossi AG. Mechanisms of resolution of inflammation: a focus on cardiovascular disease. Arterioscler Thromb Vasc Biol. 2011; 31(5): 1001–6.

Brunicardi FC, Andeson DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE. Schwartz’s principles of surgery. 9th ed. New York: McGraw-Hill Medical; 2010. p. 210-9.

Dunster JL. The macrophage and its role in inflammation and tissue repair: mathematical and systems biology approaches. Wiley Interdiscip Rev Syst Biol Med. 2016; 8: 87–99.

Wynn TA, Vannella KM. Macrophages in tissue repair, regeneration, and fibrosis. Immunity. 2016; 44(3): 450–62.

Sohrab G, Nasrollahzadeh J, Zand H, Amiri Z, Tohidi M, Kimiagar M. Effects of pomegranate juice consumption on inflammatory markers in patients with type 2 diabetes: a randomized, placebo-controlled trial. J Res Med Sci. 2014; 19(3): 215–20.

Forouzanfar F, Afkhami Goli A, Asadpour E, Ghorbani A, Sadeghnia HR. Protective effect of Punica granatum L. against serum/glucose deprivation-induced PC12 cells Injury. Evidence-Based Complement Altern Med. 2013; 2013: 1–9.

Naik KK, Thangavel S, Alam A. Cytotoxicity and anti-inflammatory activity of flavonoid derivatives targeting NF-kappaB. Recent Pat Inflamm Allergy Drug Discov. 2017; 10(2): 119–32.

Umesalma S, Sudhandiran G. Differential inhibitory effects of the polyphenol ellagic acid on inflammatory mediators NF-κB, iNOS, COX-2, TNF-α, and IL-6 in 1,2-dimethylhydrazine-induced rat colon carcinogenesis. Basic Clin Pharmacol Toxicol. 2010; 107(2): 650–5.

Massagué J. TGFβ signalling in context. Nat Rev Mol Cell Biol. 2012; 13(10): 616–30.

Kubiczkova L, Sedlarikova L, Hajek R, Sevcikova S. TGF-β – an excellent servant but a bad master. J Transl Med. 2012; 10: 1–24.

Edwards JP, Thornton AM, Shevach EM. Release of active TGF-β1 from the latent TGF-β1/GARP complex on T regulatory cells is mediated by integrin β8. J Immunol. 2014; 193(6): 2843–9.

Nirwana I. The activity of pomegranate extract as a pulp capping material on IL-6, IL-10, TGFβ-1, MMP-1 and type I collagen expression on rat teeth mechanically exposured. Dissertation. Surabaya: Universitas Airlangga; 2012.

Flecknell PA. Laboratory animal anaesthesia. 3rd ed. Cambridge: Elsevier - Academic Press; 2009. p. 204-10.

Wang N, Liang H, Zen K. Molecular mechanisms that influence the macrophage M1-M2 polarization balance. Front Immunol. 2014; 5: 1–9.

Liu T, Zhang L, Joo D, Sun S-C. NF-κB signaling in inflammation. Signal Transduct Target Ther. 2017; 2: 1–9.

Gupta SC, Sundaram C, Reuter S, Aggarwal BB. Inhibiting NF-κB activation by small molecules as a therapeutic strategy. Biochim Biophys Acta - Gene Regul Mech. 2010; 1799(10–12): 775–87.

Behm B, Babilas P, Landthaler M, Schreml S. Cytokines, chemokines and growth factors in wound healing. J Eur Acad Dermatology Venereol. 2012; 26(7): 812–20.

Gonzalez AC de O, Costa TF, Andrade Z de A, Medrado ARAP. Wound healing - a literature review. An Bras Dermatol. 2016; 91(5): 614–20.

Travis MA, Sheppard D. TGF-β activation and function in immunity. Annu Rev Immunol. 2014; 32(1): 51–82.

Yun Y-R, Won JE, Jeon E, Lee S, Kang W, Jo H, Jang J-H, Shin US, Kim H-W. Fibroblast growth factors: biology, function, and application for tissue regeneration. Day R, editor. J Tissue Eng. 2010; 2010: 1–18.

Nanci A, Ten Cate AR (Arnold R. Ten Cate’s oral histology: development, structure, and function. 7th ed. China: Elsevier; 2009. p. 64-74; 379-90.

Sinno H, Prakash S. Complements and the wound healing cascade: an updated review. Plast Surg Int. 2013; 2013: 1–7.

Chao C, Mong M, Chan K, Yin M. Anti-glycative and anti-inflammatory effects of caffeic acid and ellagic acid in kidney of diabetic mice. Mol Nutr Food Res. 2010; 54(3): 388–95.

Al-Obaidi MMJ, Al-Bayaty FH, Al Batran R, Hussaini J, Khor GH. Impact of ellagic acid in bone formation after tooth extraction: an experimental study on diabetic rats. Sci World J. 2014; 2014: 1–14.

Peplow PV., Baxter GD. Gene expression and release of growth factors during delayed wound healing: a review of studies in diabetic animals and possible combined laser phototherapy and growth factor treatment to enhance healing. Photomed Laser Surg. 2012; 30(11): 617–36.


  • There are currently no refbacks.

View My Stats