CHAMGAP
APPROVEDReviewed and approved by the Chamgap Editorial Team (2026-07-21). The draft was written by AI, the existence of all 5 cited sources was verified at the original page, and the verdict passed blind grading and adversarial audit. Methodology v0.6.
Verdict No. 966 · Search date 2026-07-21 · Methodology v0.6

Cissus quadrangularis,
does it really help with Faster clinical and radiographic fracture union with less pain and swelling when added to fracture fixation?

30-Second Summary
C
Evidence Grade C · 40 · Safety caution
Cissus has preliminary signals for fracture pain and healing, but it is not proven to accelerate union or replace standard fixation care
What the
research shows
Cissus quadrangularis is rated C. A 2013 trial randomized 60 patients with mandibular fractures to Cissus or starch placebo under double masking and reported improved clinical and radiographic healing, so the evidence is not merely preclinical and does not belong in D. Quantitative effect reporting was weak, independent replication of the same single-ingredient intervention is limited, and later small or combination-product findings conflict, limiting the verdict to the floor of C at 40 points.
What the
ads claim
Marketing converts a traditional reputation as a fracture herb and cellular or animal osteogenic mechanisms directly into faster human fracture union. Human studies actually involve small samples of selected jaw or distal-radius fractures and cannot be generalized across Cissus-only extracts, doses, fracture types, or retail products.
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Useful facts when choosing a product

  • Cissus quadrangularis is a plant in the grape family, and supplements vary in plant part, extraction method, marker compounds, and actual content, so a retail product cannot be assumed to match a clinical-trial product.
  • Human fracture studies used different doses and formulations, and some combined Cissus with Dalbergia sissoo or Boswellia serrata, making a Cissus-only effect difficult to isolate.
  • It cannot replace reduction and fixation, infection control, adequate nutrition, smoking cessation, or follow-up imaging, and supplement use must not delay orthopedic or maxillofacial care.
  • Short studies generally found it tolerable, but gastrointestinal upset, diarrhea, and headache can occur, while long-term safety data are limited in pregnancy, breastfeeding, liver or kidney disease, and polypharmacy.
Gap Measurement · Verdict 966 · C 40
What advertising claims
What independent, higher-quality research supports
△ GAP
01

What the research actually shows

Singh 2013 randomized 60 patients with mandibular fractures to Cissus capsules or starch placebo under double masking and assessed clinical and radiographic healing plus osteopontin, reporting better healing with Cissus. Effect sizes and between-group quantitative details were limited. The Brahmkshatriya 2015 pilot included only nine patients. In the Gigi 2023 randomized open-label study of 24 patients, radiographic healing did not differ with a Cissus and Dalbergia sissoo combination. The Na Takuathung 2025 meta-analysis rated bone-biomarker evidence as very low certainty, and the positive Mungara 2026 trial was an open-label, company-linked study of a Cissus and Boswellia combination.

02

Why this is classified as C (40)

A randomized double-blind placebo-controlled trial in 60 patients reported improved clinical and radiographic healing, ruling out a preclinical D rating. Quantitative effect reporting was weak, independent replication of the same single-ingredient intervention is limited, radiographic healing was null in a 24-person open-label combination trial, and the 2025 biomarker synthesis had very low certainty. These limits yield C with 40 points. Gastrointestinal effects and product variability are safety issues kept separate from efficacy.

Counterpoint. Anyone choosing to use it should continue standard fracture care and tell the treating clinician the exact product and all ingredients. Less pain does not prove faster union, so scheduled clinical and imaging follow-up remains necessary.

Rejudgment record. Cross-check revision — Applied the floor of C because a 60-person randomized double-blind starch-placebo trial reported improved clinical and radiographic healing, ruling out D, while weak quantitative reporting, substantial surrogate emphasis, limited independent replication, and conflicting later evidence prevent a higher score

Sub-claim grades by effect

This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.

Effect (sub-claim)GradeBasis
Acceleration of clinical and radiographic fracture unionCA 60-person double-blind placebo-controlled trial reported improvement, but weak quantitative effect reporting and limited independent replication keep this at the floor of C.
Reduction of fracture painCA direct randomized trial provides a positive clinical signal, but later samples are small and effects are difficult to separate from combination ingredients or natural recovery.
Reduction of fracture swellingCThe 60-person placebo-controlled trial reported clinical improvement, but evidence is limited to selected jaw and wrist studies without adequate independent replication of Cissus alone.

Cross-check — Codex and Claude

This verdict was drafted by Codex through literature review and source-existence checks, cross-checked through blind grading and adversarial audit, and settled by reapplying the methodology boundary rules. Cases with split grades were resolved through rejudgment.
03

Evidence Table

StudyDesignSampleFundingEndpointResultWeight
Na Takuathung M et al. 2025Systematic review and meta-analysis of randomized trials354Academic research; authors declared no competing interestsParathyroid hormone, calcium, phosphorus, alkaline phosphatase, and secondary clinical outcomesOnly parathyroid hormone increased; other bone markers were not significant, and GRADE certainty was very low for all assessed outcomes.Current synthesis with very low certainty
Gigi PG et al. 2023Three-arm randomized open-label controlled trial8Academic study using a combination tabletPain, fracture-site mobility, bite force, serum markers, and radiographic healingEarly pain relief with the Cissus and Dalbergia sissoo combination was nonsignificant, and radiographic healing did not differ significantly among groups.Small but direct conflicting and null evidence
Singh N et al. 2013Randomized double-blind placebo-controlled trial60No conflict declared; funding source unclearClinical and radiographic healing and osteopontin expressionClinical and radiographic healing was reported as better with Cissus, but effect sizes and between-group quantitative reporting were weak, and osteopontin was a surrogate.Direct positive placebo-controlled trial limited by quantitative reporting and replication
Mungara AVVP et al. 2026Multicenter randomized open-label controlled trial50Included a company medical-affairs author and evaluated a branded combinationRadius Union Scoring System, pain and swelling visual analog scores, and wrist functionStandard therapy plus the Cissus and Boswellia combination improved 60-day RUSS, visual analog, and wrist-function scores, but a Cissus-only effect could not be isolated.Current direct positive signal limited by open-label combination design
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Receipt — 5 References

All 5 cited sources were verified for existence at the original page (as of 2026-07-21).

Na Takuathung M, Aisara J, Sawong S, Koonrungsesomboon N. The effects of Cissus quadrangularis on bone-related biomarkers in humans: a systematic review and meta-analysis. BMC Complement Med Ther. 2025;25(1):286. PMID: 40707943. PMCID: PMC12288206. DOI: 10.1186/s12906-025-04995-8.
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Gigi PG, Chugh A, Chaudhry K, et al. Comparison of Teriparatide and Combination of Cissus Quadrangularis and Dalbergia Sissoo on Bone Healing Against the Control Group in Maxillofacial Fractures: A Randomized Open-label Control Trial. Craniomaxillofac Trauma Reconstr. 2023;16(1):23-33. PMID: 36824186. DOI: 10.1177/19433875211067007.
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Singh N, Singh V, Singh RK, Pant AB, Pal US, Malkunje LR, Mehta G. Osteogenic potential of cissus qudrangularis assessed with osteopontin expression. Natl J Maxillofac Surg. 2013;4(1):52-56. PMID: 24163553. PMCID: PMC3800385. DOI: 10.4103/0975-5950.117884.
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Brahmkshatriya HR, Shah KA, Ananthkumar GB, Brahmkshatriya MH. Clinical evaluation of Cissus quadrangularis as osteogenic agent in maxillofacial fracture: A pilot study. Ayu. 2015;36(2):169-173. PMID: 27011718. PMCID: PMC4784127. DOI: 10.4103/0974-8520.175542.
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Mungara AVVP, Shaik NR, M CK, Sureja VP. CL16019, A Combination of Cissus quadrangularis and Boswellia serrata Extracts Promotes the Healing of Distal Radius Fractures: A Multicentric, Randomized, Open-Label Study. J Integr Complement Med. 2026 Mar 27:27683605261435781. PMID: 41896193. DOI: 10.1177/27683605261435781.
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Draft and rewrite: Codex (AI) · Verification: Codex blind grading and adversarial audit · Final adjudication: Claude
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-07-21 · Corrections: none

Cite this verdict

Cissus quadrangularis x faster fracture union with reduced pain and swelling Evidence Grade C card
[Chamgap] Cissus quadrangularis x faster fracture union with reduced pain and swelling — Evidence Grade C·40. 5 cited sources checked. Source: https://chamgap.com/en/verdicts/joint-bone/cissus-quadrangularis-fracture-healing-pain-swelling/ · CC BY 4.0

CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.

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What this document does and does not do

Chamgap is an information source. It reports what research has and has not confirmed; it does not tell readers what to take or buy. That decision belongs to readers and, when needed, medical or legal professionals. This verdict reflects literature available up to the search date and may change as new research appears. Nothing here is medical advice.