A Systematic Review and Meta-Analysis on the Efficacy of Locally Delivered Adjunctive Curcumin (Curcuma longa L.) in the Treatment of Periodontitis

Abstract

This meta-analysis intended to assess evidence on the efficacy of locally delivered curcumin/turmeric as an adjunctive to scaling and root planing (SRP), on clinical attachment level (CAL) and probing pocket depth (PPD), compared to SRP alone or in combination with chlorhexidine (CHX). RCTs were identified from PubMed, Cochrane Library, BASE, LIVIVO, Dentistry Oral Sciences Source, MEDLINE Complete, Scopus, ClinicalTrials.gov, and eLibrary, until August 2022. The risk of bias (RoB) was assessed with the Cochrane Risk of Bias tool 2.0. A random-effects meta-analysis was performed by pooling mean differences with 95% confidence intervals. Out of 827 references yielded by the search, 23 trials meeting the eligibility criteria were included. The meta-analysis revealed that SRP and curcumin/turmeric application were statistically significantly different compared to SRP alone for CAL (−0.33 mm; p = 0.03; 95% CI −0.54 to −0.11; I2 = 62.3%), and for PPD (−0.47 mm; p = 0.024; 95% CI −0.88 to −0.06; I2 = 95.5%); however, this difference was considered clinically meaningless. No significant differences were obtained between patients treated with SRP and CHX, compared to SRP and curcumin/turmeric. The RoB assessment revealed numerous inaccuracies, thus raising concerns about previous overestimates of potential treatment effects.

A Well-Known Plant and New Therapeutic Strategies: Turmeric and Its Components in Oral Inflammatory Diseases Treatment

“…Moreover, curcumin as a naturally-derived substance is considered as safe with low risk of associated side effects, which makes it worth considering in combined therapy. Another systematic review presented by Wendorff-Tobolla et al [129] also evaluated the efficacy of curcumin as an adjunctive treatment applied locally with scaling and root planing. The analyzed parameters were attachment level and probing pocket depth, and the combined treatment with curcumin was compared to scaling and root planing alone and with chlorhexidine.…”

Exploring The Potential Of Plant-Based Remedies In Periodontal Treatment: A Mini Review

“…Honey and royal jelly also present antimicrobial activity against periodontal pathogens in vitro [38]. Purified bee venom presents anti-inflammatory effects in vitro, reducing induced periodontal bone loss in animals [39,40]. The evidence supporting the use of royal jelly, bee venom, and honey in periodontics is limited, but their promising efficacy requires further investigation.…”

In vitro study of nanoliposomes containing curcumin and doxycycline for enhanced antimicrobial photodynamic therapy against Aggregatibacter actinomycetemcomitans

“…Curcumin (Cur) is a natural photosensitizer with anti-inflammatory and antibacterial activities against various microorganisms 17 . Despite all benefits, the bioavailability of curcumin is poor due to low water solubility, rapid metabolism, rapid systemic excretion, low stability, insufficient tissue absorption, and sensitivity to physiological pH 17 , 18 . There does not appear to be a clinically relevant therapeutic effect of Cur 18 .…”

“…Despite all benefits, the bioavailability of curcumin is poor due to low water solubility, rapid metabolism, rapid systemic excretion, low stability, insufficient tissue absorption, and sensitivity to physiological pH 17 , 18 . There does not appear to be a clinically relevant therapeutic effect of Cur 18 . Several studies have shown that the encapsulation efficiency of Cur in nanoparticles, including homogeneity and stability in solution, low polydispersity and zeta potential, increased anti-biofilm activity, improved photoinactivation efficiency of bacteria and reactive oxygen species (ROS) generation with negligible dark cytotoxicity 19 – 21 .…”