Anti-Inflammatory Efficacy of Curcumin as an Adjunct to Non-Surgical Periodontal Treatment: A Systematic Review and Meta-Analysis

Systematic review and meta-analysis of 18 randomized controlled trials in adults with periodontal disease undergoing nonsurgical periodontal therapy. Most studies were conducted in India, with one trial from Brazil; active curcumin arms totaled 846 patients/sites across the included studies.

Curcumin was used as an adjunct to nonsurgical periodontal treatment, delivered in multiple formulations including gels, irrigation, mouthwash, nanogel, and chips. Doses varied widely across trials, from 0.05 mg/ml to 20% curcumin, with treatment durations ranging from 3 to 24 weeks; the comparator was nonsurgical periodontal treatment alone, sometimes with saline irrigation.

Curcumin as an adjunct to nonsurgical periodontal treatment showed an overall positive anti-inflammatory effect, improving gingival inflammation and sulcus bleeding, but it did not show consistent benefit for bleeding on probing. Gingival Index favored curcumin at multiple follow-ups, including 2 weeks MD = -0.51 (95% CI -0.74 to -0.28, p < 0.0001) and 6 weeks MD = -0.33 (95% CI -0.58 to -0.08, p = 0.01). Sulcus Bleeding Index also improved, for example at 6 weeks MD = -0.82 (95% CI -0.99 to -0.65, p < 0.0001) and 24 weeks MD = -0.22 (95% CI -0.35 to -0.09, p = 0.0006). Bleeding on probing was not consistently different from control at 4, 12, or 24 weeks, and several studies reported reductions in periodontal pathogens; no adverse events were reported in the included studies.

The evidence is limited by substantial heterogeneity in curcumin formulation, dose, route, and follow-up duration across relatively small trials. Most studies were conducted in India, so generalizability is limited, and some microbiological and inflammatory marker findings were mixed. Baseline values and harms reporting were incomplete in the extracted text, and the authors called for larger, higher-quality randomized trials.