Background: Gingivitis is a dysbiotic condition characterized by persistent inflammation caused by a disease-
associated multispecies bacterial population that has established itself in the subgingival region.

Aim: The objectives of this study are to analyze the anti-inflammatory activity of sappan wood extract cream (SWC) in Porphyromonas gingivalis induced-periodontitis rats model.

Methods: In this study, rats were infected with the gingiva with P. gingivalis as an inducer for gingivitis rats model for
14 days. The SWC were treated topically into the infected tissue. The inflammation and angiogenesis of gingival tissue was analyzed using histological examination. An immunohistochemistry (IHC) assay was used to analyze the nuclear factor kappa-B (NF-kB) protein expression. Masson Trichrome (MT) assay was used to analyze the histopathology of collagen Scores. The tumor necrosis factor-α (TNF-α), Interleukin-1 β (IL-1β), IL-6, and P38 genes expression were measured using quantitative real time-polymerase chain reaction.

Results: The induction of P. gingivalis-induced gingivitis in rats model was indicated by reddish gingiva and bacterial
plaque. MT tests showed that SWC increased collagen density, and Haematoxylin and Eosin (H&E) test showed
increased angiogenesis and in contrast, lowered inflammation score. IHC test showed that SWC decreased the expression of NF-kB protein. The TNF-α, IL-1β, IL-6, and P38 gene expression were also decreased due to the SWC treatment.

Conclusion: SWC proves that it has anti-inflammatory activity which has the potential to prevent or treat gingivitis.
Keywords: Antiinflammation, Caesalpinia sappan, Cream, Gingivitis, Oxidative stress.