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Background <p>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.</p> Materials and methods <p>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.</p> Results <p>Of 79 records, 4 studies (269 participants) were included. Adjunctive melatonin significantly improved PD (mean difference [MD]: −1.38&#xa0;mm; 95% CI: −2.28 to − 0.47; <i>p</i> = 0.003) and CAL (MD: −1.17&#xa0;mm; 95% CI: −1.82 to − 0.52; <i>p</i> = 0.0004). BOP also improved (risk ratio [RR]: 0.68; 95% CI: 0.53 to 0.88; <i>p</i> = 0.003). Sensitivity analyses excluding one outlier showed larger effects and reduced heterogeneity. PI data, descriptively analyzed, favored melatonin.</p> Conclusion <p>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.</p>

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Adjunctive melatonin in periodontal therapy for type 2 diabetic patients: Systematic review and Meta-Analysis

  • 期刊论文

  • 发表日期：

    2025年10月15日

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  • Pedro Sampaio,
  • Saife Muhsin,
  • Ahmad Shoeb Hashmi,
  • Sargon Shazo,
  • Valentino Vellone,
  • Giulia Romanelli,
  • Alexandros Damalas,
  • Arwa Hussain Chaiwala,
  • Luciano Barreto Silva

摘要

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.