Evaluation of Efficacy of Curcumin along with Lycopene and Piperine in the Management of Oral Submucous Fibrosis

The Role of Curcumin in Oral Health and Diseases: A Systematic Review

Curcumin (Curcumin) belongs to the polyphenol family. It is extracted by drying the root of a plant of Asian origin, belonging to the Zingiberaceae family. The best-known species is Curcumincuma Longa. Curcumin has been recognized as having great therapeutic powers since ancient times. Studies on curcumin have since confirmed its powerful antioxidant properties, preventing both the formation of free radicals and their neutralization, having anti-inflammatory, antibacterial, immunological, and neuroprotective properties, as well as being a regulator of the intestinal microbiota with beneficial effects on the clinical manifestations of metabolic syndrome. Our study aimed to highlight how all these therapeutic aspects could benefit oral health, both preventing and improving the course of pathological processes. The effect of mouthwashes, and curcumin-based gels on the regulation of bacterial plaque and in the control of gingivitis, was largely comparable to that of using 0.20% chlorhexidine, with fewer side effects. Being a highly hydrophobic substance, it has a high permeability to cross the cell membrane. Bioavailability increases when combined with liposoluble substances (e.g., olive oil) and piperine, which improves absorption. Curcumin also has a negligible degree of toxicity, making it an excellent alternative to the use of gold standard products for oral disinfection.

Efficacy and Safety of Astaxanthin in the Management of Oral Submucous Fibrosis: A Preliminary Randomized Controlled Trial

BACKGROUND

Oral submucous fibrosis (OSMF) is a chronic, potentially malignant disorder characterized by progressive fibrosis of the oral mucosa, leading to restricted mouth opening and discomfort. This study investigates the efficacy and safety of astaxanthin, a potent antioxidant and anti-inflammatory carotenoid, in the comprehensive management of OSMF.

METHODS

A randomized, double-blind, placebo-controlled trial was conducted with 68 eligible participants diagnosed with OSMF. Participants were randomly assigned to the experimental group (astaxanthin capsules, 5 mg twice daily) or the control group (placebo capsules) for 12 weeks. Primary outcomes included changes in mouth opening and burning sensation assessed by Visual Analog Scale (VAS). Adverse events were monitored to evaluate safety.

RESULTS

The experimental group demonstrated a statistically significant improvement in mouth opening compared to the control group over the 12-week intervention (p < 0.001). Additionally, the experimental group reported a significant reduction in burning sensation, as indicated by VAS scores (p < 0.001). Adverse events were generally mild and comparable between groups.

CONCLUSION

This study suggests that astaxanthin may have a positive impact on mouth opening and burning sensation in individuals with OSMF. The safety profile observed supports the feasibility of astaxanthin as a potential therapeutic adjunct in OSMF management. Further research with larger sample sizes and extended follow-up periods is warranted to validate these findings.

The impact of piperine on the metabolic conditions of patients with NAFLD and early cirrhosis: a randomized double-blind controlled trial

Non-alcoholic fatty liver disease (NAFLD) is a metabolic dysfunction of the liver defined as an abnormal accumulation of fat within the liver without secondary triggers like alcohol consumption or viral hepatitis. Piperine, the bio-active ingredient of black pepper, can exert a significant function in treatment of individuals with NAFLDand early cirrhosis. We investigated the impact of piperine consumption with a duration of 12 weeks on patients with NAFLD and early cirrhosis compared toplacebo consumption. In a double-blind study, patients with NAFLD and early stage of cirrhosis were haphazardly distributed into case and control groups. They were prescribed a placebo and 5 mg of piperine for 12 weeks, respectively. The demographic and laboratory parameters of individuals were assessed as the baseline and after the duration of piperine intake. Piperine with a daily dosage of 5 mg could significantly decrease hepatic enzymes and glucose, and alleviate dyslipidemia in the case arm rather than the control arm. Moreover, HOMA levels and insulin resistance were reduced in case participants compared to the control counterparts. In the absence of approved medicinal intervention for patients with NAFLD, and regarding the favorable impact of piperine on NAFLD more studies on this subject are warranted.

Antioxidant treatments in patients with oral submucous fibrosis: A systematic review

INTRODUCTION

Oral submucous fibrosis (OSMF) is a well-known precancerous oral lesion, characterized by scarring, tissue fibrosis, and premalignant lesions. The goal of clinical treatment is to reduce inflammation and improve patients' quality of life by enhancing mouth opening among others. Antioxidant treatment has shown promising results in inducing regression of lesions and preventing OSMF in high-risk individuals. This study investigates the effectiveness of various antioxidant agents against OSMF.

MATERIALS AND METHODS

The study followed PRISMA guidelines and searched three scientific databases: PubMed, Web of Science, and Scopus, using specific algorithms related to "antioxidant treatment," "burning sensation," and "mouth opening." The quality assessment of controlled clinical studies adhered to Cochrane guidelines.

RESULTS

The analysis included 19 clinical trials comparing different treatments, including various antioxidants. Aloe vera, curcumin, and lycopene, among others, showed positive outcomes in treating OSMF by improving burning sensation, mouth opening, tongue protrusion, and cheek flexibility.

CONCLUSION

Antioxidant therapies are found to be effective in treating OSMF, even when compared to conventional treatments such as corticosteroids. The study highlights the need for further research and standardization of clinical protocols.

Curcumin-piperine co-supplementation and human health: A comprehensive review of preclinical and clinical studies

Curcumin is extracted from the rhizomes Curcuma longa L. It is known for its anti-inflammatory and anti-oxidant activities. Despite its safety and potential for use against various diseases, curcumin's utility is restricted due to its low oral bioavailability. Co-administration of curcumin along with piperine could potentially improve the bioavailability of curcumin. The present review aimed to provide an overview of the efficacy and safety of curcumin-piperine co-supplementation in human health. The findings of this comprehensive review show the beneficial effects of curcumin-piperine in improving glycemic indices, lipid profile and antioxidant status in diabetes, improving the inflammatory status caused by obesity and metabolic syndrome, reducing oxidative stress and depression in chronic stress and neurological disorders, also improving chronic respiratory diseases, asthma and COVID-19. Further high-quality clinical trial studies are needed to firmly establish the clinical efficacy of the curcumin-piperine supplement.

Correlation of Clinical Features in Oral Submucous Fibrosis: A 9-Year Retrospective Study

BACKGROUND

Oral Submucous Fibrosis is a chronic debilitating disease and potentially malignant disorder of the oral cavity known in medical literature for a long time. The study aims to correlate the clinical staging of Oral Submucous Fibrosis with various clinical findings of the oral mucosa like hyperpigmentation, erosions, ulcerations, VAS score, tongue protrusion, and cheek flexibility.

METHODS

A retrospective observational study was undertaken and records of 1267 clinically diagnosed cases of OSMF were included in the study. Clinical grading was done as per criteria by Lai DR et al. The observations were tabulated and subjected to statistical analysis using SPSS software.

RESULTS

In our study, the incidence of hyperpigmentation, erosions, and ulcerations was higher in Group C OSMF. Visual analog scores in the range of 5-6 was noted in 40.9% of the total subjects, out of which 36.2% belonged to Group C OSMF. Tongue protrusion of less than 25 mm was seen in 10.65% of the subjects. Cheek flexibility of less than 0.6 cm was seen in 19.62% of the subjects, most of which belonged to Group D.

CONCLUSION

In our study, we found an increase in the occurrence and severity of symptoms with an increase in grades of OSMF, but this increase was not observed to be consistent. Hence classification based on a single clinical entity cannot be sufficient and correlations to other clinical findings should be studied over a large population and a multi-tier classification could be proposed in the future.

From Simple Mouth Cavities to Complex Oral Mucosal Disorders-Curcuminoids as a Promising Therapeutic Approach

Oral diseases are among the most common encountered health issues worldwide, which are usually associated with anomalies of the oral cavity, jaws, and salivary glands. Despite the availability of numerous treatment modalities for oral disorders, a limited clinical response has been observed because of the inefficacy of the drugs and countless adverse side effects. Therefore, the development of safe, efficacious, and wide-spectrum therapeutics is imperative in the battle against oral diseases. Curcumin, extracted from the golden spice turmeric, is a well-known natural polyphenol that has been extensively studied for its broad pleiotropic attributes and its ability to modulate multiple biological processes. It is well-documented to target pro-inflammatory mediators like NF-κB, ROS, COX-2, IL-1, IL-2, TGF-β, growth factors, apoptotic proteins, receptors, and various kinases. These properties make curcumin a promising nutraceutical in the treatment of many oral diseases like oral submucous fibrosis, oral mucositis, oral leukoplakia, oral erythroplakia, oral candidiasis, aphthous stomatitis, oral lichen planus, dental caries, periodontitis, and gingivitis. Numerous in vitro and in vivo studies have shown that curcumin alleviates the symptoms of most of the oral complications, including the inhibition of the progression of oral cancer. In this regard, many clinical trials have been completed, and many are ongoing to investigate the "curcumin effect" in oral maladies. Therefore, the current review delineates the mechanistic framework of curcumin's propensity in curbing oral diseases and present outcomes of the clinical trials of curcumin-based therapeutics that can provide a breakthrough in the clinical management of these diseases.