Efficacy of Curcumin Gel Versus Hyaluronic Acid as Adjuvants to Scaling and Root Planing on IL-1β Levels in Smokers With Chronic Periodontitis

TL;DR

This study compares curcumin and hyaluronic acid gels as adjuvants to scaling and root planing in smokers with periodontitis, finding better results in former smokers.

Contribution

The study evaluates the efficacy of curcumin and hyaluronic acid as local drug delivery agents in smokers with periodontitis, a population with limited treatment options.

Findings

Former smokers with periodontitis showed significant improvement with hyaluronic acid gel.

Current smokers did not benefit from curcumin or hyaluronic acid gels as adjuvants.

Placebo-treated non-smokers showed moderate improvements compared to other groups.

Abstract

Background: Periodontitis is triggered by plaque biofilm interacting with microorganisms and the host, causing destruction of the periodontal tissues and, ultimately, the loss of the tooth or teeth involved. Though scaling and root planing (SRP) is the cornerstone of periodontal intervention, it is understandable that adjuvant therapy would be beneficial in smokers with periodontitis. The use of systemic antibiotics as adjuncts in smokers has been deferred due to their innumerable side effects. This has paved the way for the administration of local drug delivery (LDD) agents. This study aimed to understand and compare the benefits of curcumin and hyaluronic acid LDD agents when used as adjuncts in smokers with periodontitis.

Material and methods: A total of 36 patients attending the outpatient Department of Periodontics from a referral care hospital, who were diagnosed clinically with chronic periodontitis and willing to participate, were included, and the study was conducted from January 2021 to April 2021. The subjects were equally divided into three groups, each group comprising 12 individuals. Group I included current smokers with chronic periodontitis (n=12) who underwent SRP followed by local drug delivery of curcumin gel in subgroup IA (n=6) and hyaluronan gel in subgroup IB (n=6). The patients in Group II were former smokers with chronic periodontitis (n=12) who underwent SRP, followed by local drug delivery of curcumin gel in subgroup IIA (n=6) and hyaluronan gel in subgroup IIB (n=6). In Group III patients with chronic periodontitis only (n=12) underwent SRP, followed by local delivery of placebo gel. The clinical parameters like Plaque Index and probing pocket depth were assessed at baseline, eight weeks, and 12 weeks after SRP, using a William's probe. The gingival crevicular fluid (GCF) samples for IL-1β levels were collected at baseline and six weeks after nonsurgical periodontal therapy.

Results: All the groups showed improvement in both clinical and biochemical parameters when a comparison was made within and between the groups, but significant results were seen only in relation to Group IIB.

Conclusion: Group II patients (former smokers with periodontitis) showed better improvements in the variables evaluated. Patients in Group III (control group) were the next to follow. However, patients in Group I (current smokers with periodontitis) did not benefit from the administration of LDD agents.

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