Background: Melatonin has anti-inflammatory and antioxidant properties relevant to periodontal therapy. However, its effectiveness as an adjunct in patients with type 2 diabetes and periodontitis remains uncertain. This meta-analysis evaluated its clinical impact in this population. Materials and methods: We searched PubMed, Embase, and the Cochrane Library through June 2025 for studies comparing adjunctive melatonin plus scaling and root planing (SRP) versus SRP alone or placebo in patients with type 2 diabetes and periodontitis. Primary outcomes were probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP). Secondary outcome: plaque index (PI). Meta-analyses used a random-effects model (Review Manager 5.4), and risk of bias was assessed with the Cochrane RoB 2 tool. Results: Of 79 records, 4 studies (269 participants) were included. Adjunctive melatonin significantly improved PD (mean difference [MD]: −1.38 mm; 95% CI: −2.28 to − 0.47; p = 0.003) and CAL (MD: −1.17 mm; 95% CI: −1.82 to − 0.52; p = 0.0004). BOP also improved (risk ratio [RR]: 0.68; 95% CI: 0.53 to 0.88; p = 0.003). Sensitivity analyses excluding one outlier showed larger effects and reduced heterogeneity. PI data, descriptively analyzed, favored melatonin. Conclusion: Adjunctive melatonin improves clinical periodontal parameters and reduces inflammation in patients with type 2 diabetes and periodontitis. These findings suggest melatonin may serve as a biologically plausible and well-tolerated adjunct, though current evidence remains limited and should be interpreted with caution. Further high-quality trials are needed to confirm these outcomes.
Adjunctive melatonin in periodontal therapy for type 2 diabetic patients: Systematic review and Meta-Analysis
Vellone, Valentino;
2025-01-01
Abstract
Background: Melatonin has anti-inflammatory and antioxidant properties relevant to periodontal therapy. However, its effectiveness as an adjunct in patients with type 2 diabetes and periodontitis remains uncertain. This meta-analysis evaluated its clinical impact in this population. Materials and methods: We searched PubMed, Embase, and the Cochrane Library through June 2025 for studies comparing adjunctive melatonin plus scaling and root planing (SRP) versus SRP alone or placebo in patients with type 2 diabetes and periodontitis. Primary outcomes were probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP). Secondary outcome: plaque index (PI). Meta-analyses used a random-effects model (Review Manager 5.4), and risk of bias was assessed with the Cochrane RoB 2 tool. Results: Of 79 records, 4 studies (269 participants) were included. Adjunctive melatonin significantly improved PD (mean difference [MD]: −1.38 mm; 95% CI: −2.28 to − 0.47; p = 0.003) and CAL (MD: −1.17 mm; 95% CI: −1.82 to − 0.52; p = 0.0004). BOP also improved (risk ratio [RR]: 0.68; 95% CI: 0.53 to 0.88; p = 0.003). Sensitivity analyses excluding one outlier showed larger effects and reduced heterogeneity. PI data, descriptively analyzed, favored melatonin. Conclusion: Adjunctive melatonin improves clinical periodontal parameters and reduces inflammation in patients with type 2 diabetes and periodontitis. These findings suggest melatonin may serve as a biologically plausible and well-tolerated adjunct, though current evidence remains limited and should be interpreted with caution. Further high-quality trials are needed to confirm these outcomes.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
