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The Impact of Antioxidant Adjuncts on Periodontal Health in Type 2 Diabetes Patients: A Meta-Analysis.

  • 2025-12-01
  • Clinical and experimental dental research 11(6)
    • Sara A Abdulla
    • Bushra A Abdalla
    • Aisha Ali Muhammed
    • Hayam A Elawamy
    • Salima M Hawda
    • Najah Mohamed
    • Enass H Abduallah
    • Mustafa Y G Younis
    • Hajir Omar Alsanfaz
    • Hiba Abdelmunim Suliman

Study Design

Type
Meta-Analysis
Sample size
n = 315
Population
T2D patients with periodontitis
Methods
systematic literature search using PubMed, Embase, Scopus, Web of Science, and Google Scholar, covering publications from 2015 to 2025; antioxidants tested were melatonin, propolis, lycopene, ginger, vitamin C, omega-3 fatty acids (O3FAs), and grape seed extract; random-effects models (mean differences, 95% CIs); risk of bias assessed via Cochrane criteria

Background

The bidirectional relationship between periodontitis and type 2 diabetes (T2D) underscores the need for adjunctive therapies to enhance nonsurgical periodontal therapy (NSPT). This meta-analysis evaluates the efficacy of antioxidants in improving periodontal and glycemic outcomes in T2D patients with periodontitis.

Material and methods

A systematic literature search was conducted using PubMed, Embase, Scopus, Web of Science, and Google Scholar, covering publications from 2015 to 2025. Antioxidants tested were melatonin, propolis, lycopene, ginger, vitamin C, omega-3 fatty acids (O3FAs), and grape seed extract. Outcomes (clinical attachment level [CAL], probing depth [PD], gingival index [GI], HbA1c) were analyzed using random-effects models (mean differences, 95% CIs). Risk of bias was assessed via the Cochrane criteria.

Results

Eight randomized controlled trials (RCTs, n = 315) were identified. Adjunctive antioxidants significantly improved CAL (melatonin: SMD -2.28, 95% CI -3.01 to -1.56; propolis: SMD -3.83, -4.79 to -2.87) and PD (melatonin: SMD -2.40, -3.14 to -1.66; propolis: SMD -1.78, -2.44 to -1.11). Melatonin and propolis also reduced HbA1c (melatonin: SMD -2.28; propolis: SMD -3.83). Lycopene and ginger showed modest effects, while vitamin C and O3FAs had minimal impact. Evidence certainty was moderate for CAL/HbA1c and low for PD/GI.

Conclusion

Antioxidants, particularly melatonin and propolis, enhance periodontal and glycemic outcomes in T2D-periodontitis patients. Despite promising results, limitations include small sample sizes and heterogeneity. Larger RCTs are needed to optimize protocols.

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