Introduction: Since ancient times, turmeric has been used in several folklore remedies against various ailments. The principal component of turmeric is curcumin and its efficacy has been advocated ...

Is curcumin bioavailability a problem in humans: lessons from clinical trials.

Periodontal disease is one of the most common causes of tooth loss among adults. Research shows that inflammation is one of the crucial components in the initiation and progression of periodontitis. Various herbal medicines have recently been receiving attention for the management of periodontitis owing to their general safety and efficacy. Curcumin, a bioactive polyphenol extracted from Curcuma longa, has been shown to possess antioxidant, antimicrobial, anti-inflammatory and analgesic properties. Several studies have assessed the efficacy of curcumin against periodontal diseases. These studies have shown equivalent or even higher efficacy of curcumin compared to the commonly used medications for the management of periodontitis such as chlorhexidine. Herein, we review the experimental and clinical findings on the anti-periodontitis effects of curcumin and the pharmacological mechanisms underlying these effects.

Curcumin for the Management of Periodontal Diseases: A Review.

Background: There is a growing interest in the correlation between antioxidants and periodontal disease. In this study, we aimed to investigate the effect of oxidative stress and the impact of two antioxidants, curcumin and rutin, respectively, in the etiopathology of experimentally induced periodontitis in diabetic rats. Methods: Fifty Wistar albino rats were randomly divided into five groups and were induced with diabetes mellitus and periodontitis: (1) (CONTROL)—control group, (2) (DPP)—experimentally induced diabetes mellitus and periodontitis, (3) (DPC)—experimentally induced diabetes mellitus and periodontitis treated with curcumin (C), (4) (DPR)—experimentally induced diabetes mellitus and periodontitis treated with rutin (R) and (5) (DPCR)—experimentally induced diabetes mellitus and periodontitis treated with C and R. We evaluated malondialdehyde (MDA) as a biomarker of oxidative stress and reduced glutathione (GSH), oxidized glutathione (GSSG), GSH/GSSG and catalase (CAT) as biomarkers of the antioxidant capacity in blood harvested from the animals we tested. The MDA levels and CAT activities were also evaluated in the gingival tissue. Results: The control group effect was statistically significantly different from any other groups, regardless of whether or not the treatment was applied. There was also a significant difference between the untreated group and the three treatment groups for variables MDA, GSH, GSSG, GSH/GSSG and CAT. There was no significant difference in the mean effect for the MDA, GSH, GSSG, GSH/GSSG and CAT variables in the treated groups of rats with curcumin, rutin and the combination of curcumin and rutin. Conclusions: The oral administration of curcumin and rutin, single or combined, could reduce the oxidative stress and enhance the antioxidant status in hyperglycemic periodontitis rats.

https://www.mdpi.com/1420-3049/26/5/1332/pdf

The Antioxidant Effect of Curcumin and Rutin on Oxidative Stress Biomarkers in Experimentally Induced Periodontitis in Hyperglycemic Wistar Rats.

Assess a single local application of curcumin-loaded nanoparticles as an adjunct to scaling and root planing (SRP) in nonsurgical periodontal treatment (NPT). Twenty healthy subjects with periodontitis received SRP+PLGA/PLA nanoparticles loaded with 50 μg of curcumin (N-Curc) or SRP+empty nanoparticles. Probing pocket depth (PPD), clinical attachment level (CAL), and bleeding on probing (BOP) were monitored at baseline, 30, 90, and 180 days. IL-1α, IL-6, TNFα, and IL-10 in the gingival crevicular fluid (GCF) were assessed by ELISA, and counts of 40 bacterial species were determined by DNA hybridization at baseline, 3, 7, and 15 days post-therapy. PPD, CAL, and BOP were similarly and significantly improved in both experimental groups. There was no difference in GCF cytokine levels between experimental groups, although IL-6 was decreased at 3 days only in the N-Curc group. NPT reduced counts of red complex bacterial species in both groups. Veillonella Parvula counts increased significantly only in N-Curc group at 7 days, whereas Aggregatibacter actinomycetemcomitans counts increased significantly only in the control group from day 3 to day 15. We conclude that a single local administration of nanoencapsulated curcumin in periodontally diseased sites had no additive benefits to NPT. Our results showed that a single local application of curcumin-loaded nanoparticles associated with nonsurgical periodontal therapy did not improve clinical outcomes. Hence, our findings do not support the use of curcumin as an adjunct to nonsurgical periodontal therapy.

Local application of curcumin-loaded nanoparticles as an adjunct to scaling and root planing in periodontitis: Randomized, placebo-controlled, double-blind split-mouth clinical trial

Background Effective and selective oral rinses are required in the daily medical and dental practice. Currently mouthwashes used have substantial side effects. Objectives Our aim was to evaluate the efficacy of chlorine dioxide-containing mouthwashes in comparison with other previously established mouth rinses in healthy adults using oral hygiene indices. Methods This work was registered in PROSPERO (CRD42018099059) and carried out using multiple databases and reported according to the PRISMA statement. The search terms used were "chlorine dioxide" AND "oral", and only randomised controlled trials (RCTs) were included. The primary outcome was the alteration of the plaque index (PI), while the secondary outcomes were the gingival index (GI) and bacterial counts. For the risk of bias assessment, the Cochrane Risk of Bias Tool was used. Statistical analysis for data heterogeneity was performed by Q-value and I2-tests. Results 364 articles were found in the databases. After the selection process, only five RCTs were eligible for meta-analysis. Data heterogeneity was low. There were no statistical differences in effectiveness between chlorine dioxide and other effective mouth rinses in PI (0.720±0.119 vs 0.745±0.131; 95%; confidence intervals (CIs): 0.487-0.952 vs 0.489-1.001, respectively) and GI (0.712±0.130 vs 0.745±0.131; 95% CIs: 0.457-0.967 vs 0.489- 1.001, respectively) and also in bacterial counts. Conclusion Chlorine dioxide reduces both plaque and gingival indices and bacterial counts in the oral cavity similar to other routinely used oral rinses, however, the evidence supporting this outcome is very limited. Therefore, further large scale RCTs are needed to decrease the risk of bias.

Effects of Chlorine Dioxide on Oral Hygiene - A Systematic Review and Meta-analysis.

Background: HsCRP (Highly sensitive C reactive protein) is a global indicator for future vascular events in adults detected in blood stream 48 hours before the cardiovascular event. Periodontal disease may increase blood levels of inflammatory markers like IL-6, CRP and HsCRP. Hence the aim of the present study is to evaluate the presence of elevated HsCRP levels in chronic periodontitis patients. Material and Methods: 100 patients who reported for cardiac master health check up were enrolled in the study. The periodontal status was assessed using periodontal probing pocket depth and clinical attachment level. The decayed, missing and filled tooth was recorded using DMFT index. The venous samples of these patients were obtained for recording HsCRP levels. Results: Pearson correlation was used to analyze the relationship between HsCRP level and probing pocket depth, clinical attachment loss and DMFT. The correlation value was 0.051, 0.025 and 0.101 respectively, the correlation is statistically significant for probing pocket depth and clinical attachment level (P>0.05). Chi- square test was performed to study the association between gender and HsCRP, Diabetes Mellitus and HsCRP and Hypertension and HsCRP; the results showed that there is no significant association between any of the above mentioned factors and HsCRP level in blood. Conclusions: We found an increased level of HsCRP in patients with chronic periodontitis which revealed the susceptibility of these patients to cardiac diseases like myocardial infarction and stroke. Hence present day focus in the line of management of cardiac patient has changed from the periodontal perspective.

Estimation of high sensitivity C‑reactive protein in patients with periodontal disease and without coronary artery disease.

Introduction: The choice of career is one of the most important decisions in one's life. However, the choice of dentistry becomes forceful at times by peer pressure, cultural thrust or inability to procure medicine. The dental students may be discontented with the profession or income in the present scenario due to the growing competition. The aim of the present survey is to assess the various careers perspectives opted by Indian dentists post under-graduation. Materials and Methods: This was a cross-sectional, descriptive survey. A customized questionnaire was administered to the study group of 500 dentists regarding the reasons for choice of dental course, career options, obstacles faced post-completion of under-graduation, satisfaction with current profession, income and clinical practice. Results: Data were analyzed using counts and percentages. The study constituted of 49% male and 51% female participants. The most popular reasons for choosing dentistry were inability to get medical seat as well as out of own interest and family pressure. The participants planned to do post-graduation (41%) or work at private clinic (22%) after graduation. Most of the dentists 430 (90%) reported being satisfied with their profession while only 136 (28%) were satisfied with their income. 26% of the participants wanted to quit dentistry. Conclusions: The need for the hour is to uplift the quality of dental profession in India by increasing the number of post graduate seats in proportion to the undergraduate seats, to increase the income, job opportunities and status of the dental professionals in par with medical professionals.

Career perspective among dental professionals in Tamil Nadu

Background of the Study: The aim of this study is to evaluate the efficacy of natural curcumin in the management of chronic periodontitis as local drug delivery in comparison to synthetic chlorhexidine, which is the gold standard. Materials and Methods: Thirty chronic periodontitis patients with an age range of 20-50 years with probing pocket depth (PPD) of 4-6 mm were included. Curcumin and chlorhexidine gel was applied in the contralateral disease sites at baseline and day 15. The clinical parameters like PPD, clinical attachment level (CAL), gingival index (Loe and Silness) and plaque index (Turesky Gillmore modification of Quigley Hein) were recorded and colony forming units (CFU) were assessed microbiologically at baseline, 15 and 30 days. Results: There was a significant reduction of the clinical parameters (PPD, CAL) and microbiological parameters CFU at 15 and 30 days for both the groups. Curcumin group showed a greater reduction in the clinical parameters when compared with chlorhexidine group. Both groups had a significant reduction in parameters when compared with baseline. Conclusion: Although curcumin has equivalent benefit to chlorhexidine, curcumin being an ayurvedic herb is an excellent alternative to chlorhexidine due to minimal side-effects.

Comparative evaluation of natural curcumin and synthetic chlorhexidine in the management of chronic periodontitis as a local drug delivery: a clinical and microbiological study.

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Estimation of high sensitivity C‑reactive protein in patients with periodontal disease and without coronary artery disease.

Career perspective among dental professionals in Tamil Nadu

Comparative evaluation of natural curcumin and synthetic chlorhexidine in the management of chronic periodontitis as a local drug delivery: a clinical and microbiological study.