Abstract

CURCUMIN IN THE MANAGEMENT OF ORAL POTENTIALLY MALIGNANT DISORDERS

Dr. Monica Malhotra, Dr. Arpita Rai and Dr. Varun Malhotra*

Abstract

The use of herbal agents in medicine and dentistry is gaining importance worldwide. One such nutraceutical is turmeric which has come all the way from kitchen to clinic. Historically, turmeric finds a place in ancient Ayurvedic, Sidhha, Unani and Chinese systems of medicine. Although they are very popular in their day-to-day use, only few medicinal herbs have been scientifically evaluated for their potential in medical treatment. Several components, more than 100, have been isolated from turmeric. Curcumin, the principal curcuminoid, comprises of approximately 2-5% of turmeric. Curcumin is a natural polyphenolic product derived from turmeric which exhibits therapeutic activity mainly due to its chemical structure and unique physical and biological properties. Curcumin was first isolated in 1815 and its chemical structure was determined in 1973. Chemically, it is a diferuloyl methane molecule [1, 7-bis (4-hydroxy-3- methoxyphenyl)-1, 6-heptadiene-3,5- dione)] containing two ferulic acid residues joined by a methylene bridge. As a natural product, it is nontoxic and has little or no adverse effects. Safety evaluation of curcumin reveals that when curcumin was given to Wistar rats, guinea pigs and monkeys of both sexes at a dose of 300 mg/kg body weight, no pathological, behavioral abnormalities or lethality was observed. No adverse effects were observed on both growth and the level of erythrocytes, leucocytes, blood constituents such as haemoglobin, total serum protein, alkaline phosphatase, etc. Human clinical trials also indicate that curcumin has no toxicity when administered at doses of 1–8 g/day140and 10 g/day. Curcumin is not only responsible for the yellow color of turmeric but accounts for most of its pharmacological effects. It exhibits a big promise as a therapeutic agent due to its properties like antioxidant, analgesic, anti-inflammatory, antiseptic activity, anticarcinogenic activity, chemopreventive, chemotherapeutic activity, anti-tumour, antiviral, antibacterial, and antifungal and is currently in human trials for a variety of conditions. The applications of curcumin in dentistry include its use as pit and fissure sealant, dental plaque detection system, subgingival irrigant and intracanal medicament. The antioxidant, anti-carcinogenic and anti-inflammatory properties of curcumin makes it appropriate to explore the role of curcumin in oral potentially malignant disorders (OPMD). OPMD represent a family of morphological alteration amongst which some may have an increased potential for malignant transformation. Potentially malignant disorders of the oral mucosa are also indicators of risk of likely future malignancies elsewhere in (clinically normal appearing) oral mucosa and not only sites specific predictors. In this review use of curcumin in OPMD like oral submucous fibrosis (OSMF), oral leukoplakia, oral lichen planus (OLP) and lesion associated with reverse smoking will be discussed. Various formulations of curcumin, its dosage, duration of therapy, outcomes used for reporting its efficacy and safety, adverse effects, and follow up will be analyzed for each of these conditions and presented. The mechanism of action of curcumin in OPMD will be elaborated. The intended audience/readership are the researchers working in the field of pharmacology, pharmaceutical industry and pharmacotherapy. It will equally benefit the clinicians dealing with OPMD as this chapter intends to synthesize the current data on use of curcumin in OPMD and suggest evidence-based future recommendations. Additionally, researchers in the field of oncology and cancer research are potential audience for this chapter.

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