Efficacy of Curcumin Gel on Zinc, Magnesium, Copper, IL‐1β, and TNF‐α in Chronic Periodontitis Patients

Abstract

Curcumin exhibits antibacterial, antioxidant, and anti-inflammatory effects and has been suggested as a treatment for inflammatory diseases. The study is aimed at evaluating the effect of curcumin gel on serum levels of micronutrients (zinc, copper, and magnesium) and proinflammatory cytokines (IL-1β and TNF-α) in chronic periodontitis patients. Ninety subjects with an age of 25-54 were included in this study. From the total number, 30 subjects with healthy periodontium (control group) ( mean age = 37.30 ± 7.08 ) were employed for the sole purpose of obtaining the normal mean values of clinical, chemical, and immunological parameters, and 60 with chronic periodontitis ( mean age = 36.73 ± 6.22 ) were divided randomly into 2 groups, of which each group included 30 subjects. Group A received scaling and root planing SRP and curcumin gel injection covered by Coe pack for 7 days, and group B received SRP alone covered by Coe pack. Clinical parameters (plaque index, gingival index, bleeding on probing, pocket depth, and clinical attachment loss measurements) and blood samples were collected before and after 1 month of treatment to measure serum levels of zinc, copper, magnesium, IL-1β, and TNF-α. The results showed significant micronutrient alteration and increase of proinflammatory cytokines in the chronic periodontitis group as compared to healthy control ( P ≤ 0.05 ), and curcumin gel had a significant effect on the reduction of IL-1β, TNF-α, copper, and clinical parameters ( P ≤ 0.05 ) and increase of zinc and magnesium levels after 1 month as compared to baseline ( P ≤ 0.05 ), nearly the same pattern for group B but with nonsignificant differences for Zn ( P > 0.05 ). In conclusion, curcumin gel resulted in a more significant reduction in clinical parameters, inflammatory mediators, and copper and increase of zinc and magnesium levels as compared to SRP alone.

Anti-Inflammatory Efficacy of Curcumin as an Adjunct to Non-Surgical Periodontal Treatment: A Systematic Review and Meta-Analysis

“…From the 499 potentially relevant reports identified, 37 studies proved potentially eligible after title and abstract screening. Following full text screening, 18 RCTs ( Behal et al, 2011 ; Gottumukkala et al, 2013 ; Muglikar et al, 2013 ; Bhatia et al, 2014 ; Jaswal et al, 2014 ; Anuradha et al, 2015 ; Sreedhar et al, 2015 ; Arunachalam et al, 2017 ; Chatterjee et al, 2017 ; Singh et al, 2018 ; Jalaluddin et al, 2019 ; Kaur et al, 2019 ; Raghava et al, 2019 ; Guru et al, 2020 ; Mohammad, 2020 ; Pandey et al, 2021 ; Pérez-Pacheco et al, 2021 ; Rahalkar et al, 2021 ) involving 846 patients/sites were included in this meta-analysis. Table 1 displays the main characteristics of the 18 included studies.…”

“…Five studies ( Gottumukkala et al, 2013 ; Singh et al, 2018 ; Guru et al, 2020 ; Pandey et al, 2021 ; Pérez-Pacheco et al, 2021 ) mentioned allocation concealment. Participants and trial staff were not blinded in one study ( Jalaluddin et al, 2019 ), and 13 other studies ( Behal et al, 2011 ; Gottumukkala et al, 2013 ; Muglikar et al, 2013 ; Bhatia et al, 2014 ; Jaswal et al, 2014 ; Anuradha et al, 2015 ; Sreedhar et al, 2015 ; Arunachalam et al, 2017 ; Singh et al, 2018 ; Raghava et al, 2019 ; Mohammad, 2020 ; Pandey et al, 2021 ; Rahalkar et al, 2021 ) failed to mention blinding of participants and personnel. Only four studies ( Muglikar et al, 2013 ; Sreedhar et al, 2015 ; Kaur et al, 2019 ; Pérez-Pacheco et al, 2021 ) that reported outcome assessors were blinded.…”

“…Three RCTs ( Gottumukkala et al, 2013 ; Mohammad, 2020 ; Pérez-Pacheco et al, 2021 ) reported the BOP outcome. The results of the meta-analysis revealed that there were no statistically significant differences in reducing BOP between curcumin as an adjunct and NPT alone at 4 weeks (MD = 0.82, 95%CI 0.55 to 1.24, p = 0.35), 12 weeks (MD = −0.30, 95%CI 0.09 to 1.03, p = 0.06), and 24 weeks (MD = 0.64, 95%CI 0.27 to 1.50, p = 0.30) ( Figure 6 ).…”

“…However, whether curcumin could strengthen the effectiveness of NPT in periodontal therapy is still controversial. Some studies reported that curcumin, as an adjunctive treatment, could improve gingival inflammation ( Gottumukkala et al, 2013 ; Guru et al, 2020 ; Mohammad, 2020 ), whereas other studies did not observe any improvement ( Jalaluddin et al, 2019 ; Kaur et al, 2019 ; Pérez-Pacheco et al, 2021 ). Thus, this systematic review aims to perform a meta-analysis to explore whether curcumin as an adjunctive to NPT yields better clinical outcomes in terms of reducing periodontal inflammation than NPT alone.…”

Effect of Non-surgical Periodontal Therapy on Levels of Inflammatory Markers in Gingival Crevicular Fluid and Serum of Patients With Breast Cancer and Periodontitis.

“…Similarly, serum concentrations of IL-1β, TNF-α and IL-17 showed a slight tendency to decrease (p>0.05). Previous studies that assessed clinical periodontal parameters and biomarkers in serum, before and after NSPT evidenced improvement in clinical parameters and diminished IL-1β, TNF-α and IL-17 levels in normosystemic patients with periodontitis [32,33].…”