Periodontitis is the most common and a major public health problem due to its high prevalence which is 25% to 55% worldwide, and also because it leads to tooth loss, and also degrades the quality of life. ⁽¹⁾ Periodontal therapy includes both mechanical and chemical therapeutic agents which help in the reduction or elimination of microbial biofilm.

Conventional plaque control (scaling and root planing [SRP] and ultrasonic debridement has reduced effectiveness because it lacks accessibility to micro-organisms in the
sub-gingival environment. ⁽²⁾ Adjunctive chemotherapies enhance the results at sites not responsive to conventional mechanical therapy. ⁽²⁾ The administrations of systemic antimicrobial drugs have failed to achieve the adequate concentration at the required sites and its frequent usage has led to bacterial resistance. ⁽³⁾ Local drug delivery system proves beneficial because of their ability to reach the base of the periodontal pocket and also causes sustained release of short dose of drug over a long period of time. It has shown promising results in mild and moderate chronic periodontitis. ⁽⁴⁾

Herbal medicine contains natural phytochemicals and are highly effective substitutes to antimicrobial agents which signify an alternative approach in the preventive and
therapeutic management of oral and periodontal infections. ⁽³⁾ They act holistically to improve symptoms, regress the disease progression, correct imbalance and adjust the
immune system. ⁽⁵⁾ In the arena of local drug delivery, literature also shows effective use of herbs like curcumin, green tea, aloe-vera, Acacia catechu, Azadirachta indica and pomegranate. ⁽³⁾

Aloe vera (Aloe barbadensis miller) belongs to the family: Liliaceae and is frequently being used as herbal medicine. ⁽⁶⁾ Aloe vera gel has an inhibitory effect on
Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis which were isolated from patients with periodontitis and Bacteroides fragilis isolated from patients with dental caries. ⁽⁶⁾ Aloe vera gel has also been used as local drug delivery system in periodontal pockets and has exhibited encouraging findings in clinical parameters which resulted in improvement of periodontal condition. ⁽⁷⁾

Neem tree known as Azadirachta indica belongs to family: Meliaceae. Various pharmacological activities such as antioxidant, antimicrobial, anti-inflammatory, anti
carcinogenic properties has been earlier reported by different parts of neem tree. ⁽⁸⁾ Neem gel when delivered as Local Drug Delivery has shown statistically significant
reduction in Plaque Index, Gingival Index, Pocket probing depth and a mean decrease in the gram positive cocci, gram negative cocci, gram positive bacilli and gram negative bacilli when compared to the control group. ⁽⁹⁾

There have been no reported clinical studies using a combination of Aloe vera and Neem as a Local Drug Delivery agents in periodontitis. Therefore, in the present study, the
effects of a combination gel containing Aloe vera and Neem will be evaluated and compared as an adjunct to scaling and root planing in the treatment of chronic periodontitis.