Clinical efficacy of curcumin versus chlorhexidine as an adjunct to scaling and root planing for the treatment of periodontitis: A systematic review and meta‐analysis

Abstract

This study aims to evaluate the clinical efficacy of curcumin versus chlorhexidine as adjuncts to scaling and root planing (SRP) for periodontitis treatment. We searched PubMed, EMbase, Cochrane Library, and ClinicalTrials.gov from inception to February 18, 2021 and identified studies with relevant randomized controlled trials (RCTs) using curcumin or chlorhexidine as an adjunct to SRP. Nine RCTs involving 420 patients/sites were included. A meta-analysis with a random-effects model revealed that curcumin and chlorhexidine, as an adjunct to SRP, reduced probing pocket depth (PPD) at similar levels during a 3-, 4-, 6-, and 12-week follow-up. No significant differences were observed in reducing clinical attachment loss (CAL) between curcumin and chlorhexidine as an adjunct to SRP at 4 weeks and 6 weeks. Furthermore, gingival index (GI) and plaque index (PI) were similar using curcumin versus chlorhexidine as an adjunct to SRP at the 4-week-, 6-week-, and 12-week follow-up. Based on the available evidence in RCTs, compared with chlorhexidine as an adjunct to SRP, curcumin has a similar effect on reducing PPD, CAL, GI, and PI. The quality of evidence is low, limited by the number of studies and their limitations. Further studies are needed to firmly establish the clinical efficacy of curcumin.chlorhexidine, curcumin, meta-analysis, periodontitis, scaling and root planing (SRP) | INTRODUCTIONPeriodontitis is an infectious disease caused by periodontal pathogens, which leads to progressive tissue destruction, alveolar bone loss, and eventually tooth loss (Flemmig, 1999;Kinane, Stathopoulou, & Papapanou, 2017). Mechanical removal of bacterial biofilms to eliminate the etiological agent of periodontitis, such as by scaling and root planing (SRP), is a fundamental step in periodontal therapy (Lang et al., 2015). However, this step is insufficient, because areas such as complex root furcation and deep periodontal pockets are often difficult to access. Therefore, antimicrobial agents are commonly applied as an adjunct to subgingival mechanical debridement to enhance the efficacy of therapy.Chlorhexidine, a broad-spectrum antiseptic, has been used for over two decades and is recognized as the gold standard as an adjunct to SRP (Jones, 1997). It can bind to the bacterial cell wall for up to 12 h, while maintaining substantial antibacterial activity (Schiott, 1973).In vivo and in vitro studies have shown that chlorhexidine has a broadspectrum antimicrobial effect (Lang & Brecx, 1986;Prietto et al., 2020).Its clinical efficacy has been confirmed by several systematic reviews

Efficacy of Isolated and Combined Application of Topical Metronidazole and Chlorhexidine in the Treatment of Periodontal Inflammation a Randomized Controlled Trial

“…However, adjective use of antibiotics along with a mechanical treatment support showed remarkable improvements in clinical outcomes, studies done in past, but at the same time their adverse effects were also observed (15) . To overcome these unwanted effects, researcher had suggested different types of local drug delivery systems.…”

Zingiberaceae plants/curcumin consumption and multiple health outcomes: An umbrella review of systematic reviews and meta‐analyses of randomized controlled trials in humans

“…Relevant evidence exhibited that Cur can effectively prevent and treat oral diseases, such as oral mucositis (OM) (GRADE level: low) and chronic periodontitis (GRADE level: moderate) (Dharman et al, 2021; Guo et al, 2021; Souza et al, 2021; Terby et al, 2021; Yuan, 2019; Zhang, Tang, & Wei, 2021). However, the results of several studies failed to show a positive effect of oral disease (GRADE level: low) (Al‐Maweri et al, 2021; Oliveira et al, 2021; Zhang, Huang, et al, 2021). None of the studies mentioned above reported publication bias.…”

Clinical Effectiveness of Herbal Oral Care Products in Periodontitis Patients: A Systematic Review

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