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

source extracted confidence: high 2026-04-09
#humans #diabetes-mellitus-type-2 #antioxidants #periodontitis #randomized-controlled-trials-as-topic

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

Abdulla et al., 2025 | Clin Exp Dent Res | Meta Analysis

Citation

Abdulla Sara A, Abdalla Bushra A, ... Suliman Hiba Abdelmunim. The Impact of Antioxidant Adjuncts on Periodontal Health in Type 2 Diabetes Patients: A Meta-Analysis. Clin Exp Dent Res. 2025-Dec;11(6):e70215. doi:10.1002/cre2.70215

Abstract

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.

Key Findings

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 CA

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population periodontitis
Sample Size 315
Age Range See abstract
Condition diabetes

MeSH Terms

  • Humans
  • Diabetes Mellitus, Type 2
  • Antioxidants
  • Periodontitis
  • Randomized Controlled Trials as Topic
  • Glycated Hemoglobin
  • Melatonin

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: vitamin-c

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09