Effect of curcumin compared to chlorhexidine on clinical variables of periodontal health: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND

Chlorhexidine is effective in managing periodontal diseases but has side effects. Curcumin is a natural alternative with anti-inflammatory properties. This meta-analysis aimed to compare the efficacy of curcumin and chlorhexidine on clinical variables in periodontal diseases.

METHODS

This study included only randomized controlled trials. The primary outcomes were differences in mean plaque index (PI) and gingival index (GI); the secondary outcomes were differences in probing depth (PD), attachment loss (AL), and bleeding index (BI). Data were analyzed by Stata software.

RESULTS

Twenty-six randomized controlled trials comprising 1266 subjects were included. Twenty-four studies had a high risk of bias, and 2 studies had some concerns. The pooled data revealed comparable efficacy of curcumin and chlorhexidine in reducing PI (I2 = 83.3%; standardized mean difference [SMD]: -0.041, 95% confidence interval [CI, -0.245-0.163], P = .692), GI (I2 = 87.8%; SMD: 0.033, 95% CI [-0.216-0.281], P = .797), and BI (I2 = 77.7%; SMD: -0.044, 95% CI [-0.208-0.295], P = .735). However, the efficacy of chlorhexidine was found to be superior to curcumin in reducing PD (I2 = 93.7%; SMD: 0.883, 95% CI [0.419-1.347], P < .001) and AL (I2 = 90.1%; SMD: 0.539, 95% CI [0.019-1.058], P = .042). As for the subgroup analyses of follow-up term, there was a nonsignificant difference between curcumin and chlorhexidine in PI, GI, and BI. As for PD and AL, the subgroup analyses of follow-up term showed different results from the overall pooled analysis: the short term (≤ 1 month) showed the superior efficacy of chlorhexidine over curcumin; however, the long term (> 1 month) showed similar efficacy.

CONCLUSION

Curcumin could be an alternative to chlorhexidine and adjunctively used in reducing clinical variables of periodontal diseases, especially with regard to plaque accumulation and gingival inflammation.