The effect of curcumin as an adjunct in the treatment of chronic periodontitis: A systematic review and meta-analysis

BACKGROUND: A large number of trials has been conducted using curcumin as the main ingredient in mouth rinses, topical oral gel, subgingival irrigant, locally delivered gel and locally delivered chips to reduce gingival inflammation and probing pocket depth. However, the results of these trials vary and are debatable. OBJECTIVE: To evaluate the effectiveness of oral curcumin products as compared to the routinely used ones in reducing gingival inflammation and probing pocket depth in adults. METHODS: Electronic databases such as Pubmed/Medline and Cochrane Library and hand searching was done for randomised controlled trials (RCTs), which yielded 148 results, of which 27 RCTs compared curcumin products with routinely used ones. Meta-analysis was conducted to check for plaque reduction, gingival inflammation and pocket depth. RESULTS: 963 participants in the 27 RCT studies were considered for a systematic review. We found that for a long-term evaluation of probing pocket depth in nine studies each with 400 participants, there was a statistically significant difference in the reduction when curcumin topical gel was used as compared with the control [SMD −0.87, 95% CI: −1.31 to −0.43]. However, in the evaluation of short-term plaque and gingival scores, we found no statistically significant differences in the reduction when curcumin mouth rinse was used [SMD −0.76, 95% CI: −2.25 to 0.73] and [MD: −0.09, 95% CI: −0.29 to 0.10]. CONCLUSION: Curcumin topical and local delivery gel, mouth rinses and sub-gingival irrigants were found to be equally effective compared to the routinely used agents for reduction of plaque and gingival inflammation. Curcumin local delivery gel had greater reduction in probing pocket depth.