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<p>The objective of this review was to evaluate the impact of melatonin supplementation in addition to NSPT on periodontal variables, blood sugar control, inflammation and oxidative stress markers, and bone metabolism biomarkers among people with chronic periodontitis (CP) and type 2 diabetes mellitus (T2DM). This systematic review followed the guidelines by The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) and was registered with PROSPERO (Registration number: CRD420251124310). The criteria for inclusion were RCTs involving adults (≥ 18 years) diagnosed with CP and T2DM, in which systemic melatonin was administered orally as an adjunct to periodontal therapy or compared with placebo or standard treatment. Studies involving type 1 or gestational diabetes, animal or in vitro models, topical/local melatonin treatments, melatonin analogues, case reports, case series, and studies that lacked a comparator or appropriate data for analysis were excluded. Only full-text papers were considered, with no restrictions on publication year. A systematic search was conducted across five databases: PubMed Central, Scopus, Web of Science, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL), using Medical Subject Headings (MeSH) and free-text terms. Data extraction was performed using a pre-structured and tested data extraction form created in Microsoft Excel. The risk of bias in individual studies was assessed using the RoB2 tool. Four RCTs were selected based on the inclusion criteria, and a total of 197 participants were included. The included studies showed that adjunctive melatonin therapy significantly improved periodontal variables (lower PD, CAL, and BOP) and glycemic control (especially lower HbA1c and fasting blood glucose levels) (<i>p</i> &lt; 0.001). The analysis of biomarkers also revealed decreased levels of RANKL, IL-1β, and MMP-8, indicating favorable modifications in bone metabolism. Systemic melatonin therapy enhances both periodontal and systemic outcomes in T2DM patients with CP, suggesting its potential as an effective host-modulation agent. Nevertheless, further comprehensive, prospective RCTs are essential to validate the results and create standard treatment protocols.</p>

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Adjunctive systemic melatonin in patients with periodontitis and type 2 diabetes mellitus: a systematic review of clinical and biomarker outcomes from randomized controlled trials

  • 期刊论文

  • 发表日期：

    2026年3月31日

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  • Anjan Thyagaraajen,
  • Jitin Varghese Mathew,
  • Gunjan Agrawal,
  • Diya Kamdar,
  • Maryam Altuhafy,
  • Junad Khan

摘要

The objective of this review was to evaluate the impact of melatonin supplementation in addition to NSPT on periodontal variables, blood sugar control, inflammation and oxidative stress markers, and bone metabolism biomarkers among people with chronic periodontitis (CP) and type 2 diabetes mellitus (T2DM). This systematic review followed the guidelines by The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) and was registered with PROSPERO (Registration number: CRD420251124310). The criteria for inclusion were RCTs involving adults (≥ 18 years) diagnosed with CP and T2DM, in which systemic melatonin was administered orally as an adjunct to periodontal therapy or compared with placebo or standard treatment. Studies involving type 1 or gestational diabetes, animal or in vitro models, topical/local melatonin treatments, melatonin analogues, case reports, case series, and studies that lacked a comparator or appropriate data for analysis were excluded. Only full-text papers were considered, with no restrictions on publication year. A systematic search was conducted across five databases: PubMed Central, Scopus, Web of Science, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL), using Medical Subject Headings (MeSH) and free-text terms. Data extraction was performed using a pre-structured and tested data extraction form created in Microsoft Excel. The risk of bias in individual studies was assessed using the RoB2 tool. Four RCTs were selected based on the inclusion criteria, and a total of 197 participants were included. The included studies showed that adjunctive melatonin therapy significantly improved periodontal variables (lower PD, CAL, and BOP) and glycemic control (especially lower HbA1c and fasting blood glucose levels) (p < 0.001). The analysis of biomarkers also revealed decreased levels of RANKL, IL-1β, and MMP-8, indicating favorable modifications in bone metabolism. Systemic melatonin therapy enhances both periodontal and systemic outcomes in T2DM patients with CP, suggesting its potential as an effective host-modulation agent. Nevertheless, further comprehensive, prospective RCTs are essential to validate the results and create standard treatment protocols.