sdj-10104

Clinical and Biochemical Effects of 1% Curcumin Solution as an Adjunct to Scaling and Root Planing on Patients with Chronic Periodontitis

Barzn A. Mirza* , Chenar A. Mohammad* , Rezan M. Omer**

* Department of Periodontics, College of Dentistry, Hawler Medical University, Erbil, Iraq.

** Department of Dental Basic Sciences, College of Dentistry, Hawler Medical University, Erbil, Iraq.

Submitted: 26/02/2020; Accepted: 19/03/2020; Published 01/06/2020

DOI: https://doi.org/10.17656/sdj.10104

Abstract

Objective: The study aimed to evaluate the effects of subgingival irrigation of curcumin as an adjunct to scaling and root planing in the treatment of chronic periodontitis.       

Methods: 60 patients aged 30-50 years with chronic periodontitis recruited; 20 patients received subgingival irrigation of 1% of curcumin solution, 20 patients received subgingival irrigation of 0.12% of chlorhexidine solution, and 20 patients received scaling and root planing only (SRP). Pocket irrigation was conducted at baseline, 3, and 7 days after scaling and root planing. Clinical parameters and blood samples were collected at baseline before therapy and after two months of treatment to estimate the levels of total protein (TP), C-reactive protein (CRP), albumin, and alkaline phosphatase (ALP) enzyme.

Results: Significant reduction of clinical and biochemical parameters after two months of treatment in the curcumin group (P<0.05). Nearly the same pattern for the chlorhexidine group (P<0.05), with non-significant differences with a baseline for albumin (P>0.05). Reduction of clinical parameters (P<0.05) and increase of CRP, ALP, and TP levels had been seen after scaling and root planing in the SRP group. No significant differences between the three main groups in relation to clinical parameters (P>0.05), with the exception of the gingival index and biochemical parameters (P<0.05).

Conclusions: Curcumin can be effectively used as an adjunct to scaling and root planing as chlorhexidine in chronic periodontitis due to the reduction of clinical parameters and inflammatory chemical markers; CRP, TP, and ALP enzyme.

                                                                                                                                                                                                                                                                                                                                             

Keywords: Periodontitis, Curcumin, Chlorhexidine, Scaling, and root planing.                                                                                                                                                                                        Full Article - PDF                                                                                                                                                                                                                                   

                                                                                                                                                                                                                                                                                                                                                   

References:

1. Eke PI, Dye BA, Wei L, Slade GD, Thornoton– Evans GO, Borrgnakke WS et al. Update on prevalence of periodontitis in adults in the United States: NHANES 2009 to 2012. J Periodontol. 2015;86 (5):611-22.

2. Haffajee AD and Socransky SS. Microbial etiological agents of destructive periodontal diseases. Periodontol 2000. 1994;5(1):78-111.

3. Slots J and Jorgensen MG. Effective, safe, practical and affordable periodontal antimicrobial therapy: Where are we going, and are we there yet? Periodontol 2000 2002;28(1):298-312.

4. Cugini MA, Haffajee AD, Smith C, Kent RL Jr, Socransky SS. The effect of scaling and root planing on the clinical and microbiological parameters of periodontal diseases: 12-month results. J Clin Periodontol. 2000;27(1):30–6.

5. Colombo AP, Teles RP, Torres MC, Rosalém W, Mendes MC, Souto RM, et al. Effects of non-surgical mechanical therapy on the subgingival microbiota of Brazilians with untreated chronic periodontitis: 9-month results. J Periodontol. 2005;76(5):778–84.

6. Paolantonio M, D’Angelo M, Grassi RF, Perinetti G, Piccolomini R, Pizzo G, et al. Clinical and microbiologic effects of subgingival controlled-release delivery of chlorhexidine chip in the treatment of periodontitis: A multicenter study. J Periodontol. 2008;79(2):271–82.

7. Soskolne WA. Subgingival delivery of therapeutic agents in the treatment of periodontal diseases. Crit Rev Oral Biol Med. 1997;8(2):164– 74.

8. Greenstein G, Tonetti M. The role of controlled drug delivery for periodontitis. The research science and therapy committee of the American academy of periodontology. J Periodontol. 2000;71(1):125–40.

9. Asari AM, Newman HN, Wilson M, Bulman JS. 0.1/0.2% commercial chlorhexidine solutions as sub gingival irrigants in chronic periodontitis. J Clin Periodontol. 1996;23(4):320–5.

10. Chattopadhyay I, Biswas K, Bandyopadhyay U, Banerjee RK. Turmeric and curcumin: Biological actions and medicinal applications. Curr Sci. 2004;87(1):44–50.

11. Menon VP, Sudheer AR. Antioxidant and anti- inflammatory properties of curcumin. Adv Exp Med Biol. 2007;595:105–25.

12. Livada R, Shiloah J, Tipton DA and Dabbous M Kh. The potential role of curcumin in periodontal therapy: a review of the literature. J Int Acad Periodontol. 2017;19(3):70– 79.

13. Habiboallah G, Nasroallah S, Mahdi Z, Nasser MS, Massoud Z, Ehsan BN, et al. Histological evaluation of Curcuma longa-ghee formulation and hyaluronic acid on gingival healing in dog. J Ethno pharmacol. 2008;120(3):335–41.

14. Guimarães MR, Coimbra LS, de Aquino SG, Spolidorio LC, Kirkwood KL, Rossa C, JR. Potent anti- inflammatory effects of systemically administered curcumin modulate periodontal disease in vivo. J Periodontal Res. 2011;46(2):269–79.

15. Armitage GC. The complete periodontal examination. Periodontol 2000. 2004;34(1):22-33.

16. McCulloch CA. Host enzymes in gingival crevicular fluid as diagnostic indicators of periodontitis. J Clin Periodontol. 1994;21(7):497–506.

17. Patil VA, Desai MH. Effect of periodontal therapy on serum c-reactive protein levels in patients with gingivitis and chronic periodontitis: A Clinico-biochemical Study. J Contemp Dent Pract. 2013;14(2):233-7.

18. Koregol AC, More SP, Koregol SC, Kalburgi N. Total protein in gingival crevicular fluid as indicators of periodontal disease activity: A clinico biochemical analysis. Drug Dev Ther. 2015;6(1):15-9.

19. Lwasaki M, Yoshihara I, Hirotomi T, Ogawa H, Hanada N, Miyazaki H. Longitudinal study on the relationship between serum albumin and periodontal disease. J Clin Periodontol. 2018;35(4):291-6.

20. Silness J, Löe H. Periodontal disease in pregnancy II. Acta Odontol Scand. 1964;22(1):121-6.

21. Löe H, Silness J. Periodontal disease in pregnancy I. Prevelance and severity. Acta Odontol Scand. 1963;21(6):533-51.

22. Newman MG, Taki HH, Klokkevold PR. Caranza FA. Caranza ́s clinical periodotology. 10th ed. Missouri: Saunders Elsevier; 2007.

23. Gottumukkala SN, Koneru S, Mannem S, Mandalapu N. Effectiveness of sub gingival irrigation of an indigenous 1% curcumin solution on clinical and microbiological parameters in chronic periodontitis patients: A pilot randomized clinical trial. Contemp Clin Dent. 2013;4(2):186-91.

24. Izui S, Sekine S, Maeda K, Kuboniwa M, Takada A, Amano A, et al. Antibacterial activity of curcumin against periodontopathic bacteria. J Periodontol. 2016;87(1):83-90.

25. Surh YJ, Chun KS, Cha HH, Han SS, Keum YS, Park KK, et al. Molecular mechanism underlying chemopreventive activities of anti-inflammatory phytochemicals: Down-regulation of COX-2 and iNOS through suppression of NF-kappa B activation. Mutation Research. 2001;480-481:243-68.

26. Ambili R, Santhi WS, Janam P, Nandakumar K and Pillai MR. Expression of activated transcription factor nuclear factor-kappa B in periodontally diseased tissues. J Periodontol. 2005;76(7):1148-53.

27. Bhatia M, Urolagin SS, Pentyala ΚB, Urolagen SB, Menaka KB and Bhoi S. Novel therapeutic approach for the treatment of periodontitis by curcumin. J Clin Diagn Res. 2014;8(12):65-9.

28. Anitha V, Rajesh P, Shanmugam M, Priya BM. Comparative evaluation of natural curcumin and synthetic chlorhexidine in the management of chronic periodontitis as a local drug delivery: A clinical and microbiological study. Ind J Den Res. 2015;26(1):53-6.

29. Gottumukkala SN, Sudarshan S, Mantena SR. Comparative evaluation of the efficacy of two controlled release devices: Chlorhexidine chips and indigenous curcumin based collagen as local drug delivery systems. Contemp Clin Dent. 2014;5(2):175-81.

30. Chandran B, Goel A. A Randomized, Pilot Study to Assess the Efficacy and Safety of Curcumin in Patients with Active Rheumatoid Arthritis, Phytother Res. 2012;26(11):1719-25.

31. Alpaslan G, Nakajima T, Takano Y. Extracellular alkaline phosphatase activity as a possible marker for wound healing: a preliminary report. J Oral Maxillofac Surg. 1997;55(1):56–62.

32. Malhotra R, Grover V, Kapoor A, Kapur R. Alkaline phosphatase as a periodontal disease marker. Indian J Dent Res. 2010;21(4):531-6.

33. Alva S, Paramesha S, Suchetha KN, Km DG, Mahesh S. Antioxidant status and serum total protein levels in elderly women. Int J Appl Biol Pharm Tech. 2011;2(3):521-4.

34. Soeters PB, Wolfe RR, and Shenkin A. Hypoalbuminemia: Pathogenesis and Clinical Significance. J Parenter Enteral Nutr. 2019;43(2):181–93.

35. Chandrashekara S. C-reactive protein: An inflammatory marker with specific role in physiology, pathology, and diagnosis. Internet J Rheum Clin Immun. 2014;2(S1):SR3.

36. Craig RG, Yip JK, So MK, Boylan RJ, Socransky SS, Haffajee AD. Relationship of destructive periodontal disease to the acute-phase response. J Periodontol. 2003;74(7):1007-16.

 © The Authors, published by University of Sulaimani, College of Dentistry

This work is licensed under a Creative Commons Attribution 4.0 International License.