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

Abdulla SA, Abdalla BA, Muhammed AA, Elawamy HA, Hawda SM, Mohamed N, Abduallah EH, Younis MYG et al.

Clinical and experimental dental research, 2025

315 participants · 1 citation

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…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 315 participants or records.

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