Effects of Antioxidant in Adjunct with Periodontal Therapy in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

Mizutani, Koji; Buranasin, Prima; Mikami, Risako; Takeda, Kohei; Kido, Daisuke; Watanabe, Kouichi; Takemura, Shu; Nakagawa, Keita; Kominato, Hiromi; Saito, Natsumi; Hattori, Atsuhiko; Iwata, Takanori

doi:10.3390/antiox10081304

Cited by 14 publications

(11 citation statements)

References 87 publications

(182 reference statements)

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“…Thereby, melatonin has been considered a relevant antioxidant, anti-inflammatory, and immunomodulatory function, beyond exerting a powerful endogenous effect as a free-radical scavenger [37], being a key molecule for periodontal protection. In addition, melatonin can protect cells from oxidative stress and neutralize up to ten molecules of reactive oxygen species (ROS), in contrast to classical antioxidants that neutralize only one molecule [38], which can be hypothesized as a reduction of oxidative stress through its application, which would be effective in the treatment of diabetes and periodontal diseases [39]. Moreover, it plays a crucial role in periodontal homeostasis by preventing and preempting periodontal destruction [14,26].…”

Section: Discussionmentioning

confidence: 99%

Effects of Melatonin in the Non-Surgical Treatment of Periodontitis: A Systematic Review

et al. 2022

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Background: Melatonin is a hormone produced by the pineal gland, an endocrine gland located at the base of the brain. It acts as a powerful antioxidant; it can bring numerous advantages to periodontal diseases, pursuing homeostasis, such as restoration of the concentration of antioxidants, reduction of periodontal inflammation with the regulation of inflammatory cytokines, reduction of oxidative stress, and significant reduction of bone resorption through the modulation of osteoclastic and osteoblastic activities. Then, the goal of this integrative review was to evaluate the literature to better understand whether the use of melatonin is feasible to improve the non-surgical treatment of periodontitis. Methods: The integrative review was based on PICO strategy and PRISMA methodology. The focus question was: “Are there significant benefits in applying melatonin for the non-surgical treatment of periodontitis?” The PubMed, B-On, and Cochrane Library databases were enrolled, using the keywords melatonin, periodontal therapy, non-surgical treatment, and periodontitis, as associated with the Boolean connectors. The inclusion criteria were (i) CCT or RCT, (ii) adult population, (iii) full-text articles available, and (iv) in the last 10 years (2012–2022). The exclusion criteria were (i) animal studies, (ii) systematic review, and (iii) no other languages than English, Spanish, Portuguese, and Italian. A risk of bias was performed to assess the articles. Results: Initially, 2705 articles were identified. However, only six articles were included. From a total of 228 patients (109F and 119M) diagnosed with periodontitis, 22 patients dropped out (9.65%). The follow-up period varied between 8 weeks, 3 months, and 6 months. For clinical and molecular parameters, the melatonin group had significant and greater improvement (intragroup) and better data than the control group, which also had favorable results. There was low risk of bias for all studies. Conclusions: Within the limitation of this study, melatonin is a reliable and feasible option as an adjunctive to the classical NSPT, obtaining a significative improvement of the periodontal parameters (PD, CAL, BOP, PI, and GI), a significative reduction of the pro-inflammatory proteins (IL-1b, IL-6, and TNF-α), and a better response for other biomarkers.

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Section: Discussionmentioning

confidence: 99%

Effects of Melatonin in the Non-Surgical Treatment of Periodontitis: A Systematic Review

et al. 2022

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“…A randomized controlled clinical trial showed that melatonin significantly enhanced the antioxidative capacity (TAC) and inhibited the MMP-9 levels in GCF [ 98 ]. A meta-analysis of two RCTs revealed that in periodontitis patients with diabetes, combined NSPT with melatonin remarkably reduce the periodontal pocket depths, with reference with NSPT alone [ 125 ]. In gingival fibroblast from Wistar rats, glutamate (GLUT) and DL-buthionine sulfoximine (BSO) treatment lead to the production of superoxide anion and cell apoptosis, which can be totally counteracted by melatonin [ 10 ].…”

Section: Melatonin: Biological Functions and Beneficial Effects On Pe...mentioning

confidence: 99%

“…Moreover, systemic administration or topical application of melatonin alleviates the inflammatory condition and improves periodontal status in diabetes patients with periodontitis [ 102 , 103 , 150 ]. Periodontal pocket depths were significantly reduced when combining melatonin with NSPT in periodontitis patients with diabetes [ 125 ].…”

Section: Melatonin and Periodontitis-related Systemic Diseases: Far M...mentioning

confidence: 99%

Beneficial Effects of Melatonin on Periodontitis Management: Far More Than Oral Cavity

Wang

et al. 2022

IJMS

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Periodontitis as a highly prevalent chronic infection/inflammatory disease can eventually lead to tooth loss and masticatory dysfunction. It also has a negative impact on general health and largely impairs quality of life. The tissue destruction during periodontitis is mainly caused by the excessive immune–inflammatory response; hence, how to modulate the host’s reaction is of profound importance for effective periodontal treatment and tissue protection. Melatonin, as an endogenous hormone exhibiting multiple biological functions such as circadian rhythm regulation, antioxidant, and anti-inflammation, has been widely used in general healthcare. Notably, the past few years have witnessed increasing evidence for the application of melatonin as an adjunctive approach in the treatment of periodontitis and periodontitis-related systemic comorbidities. The detailed underlying mechanisms and more verification from clinical practice are still lacking, however, and further investigations are highly required. Importantly, it is essential to establish standard guidelines in the near future for the clinical administration of melatonin for periodontal health and general wellbeing.

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“…Diabetes has been known to affect cells in periodontal tissue, such as fibroblasts [34,35], osteoblasts, and osteoclasts, to enhance the destruction of periodontal tissue that accompanies inflammation [36,37]. Diabetes might lead to the progression of periodontitis by modifying the host response to local inflammation [38].…”

Section: Plos Onementioning

confidence: 99%

Association of type 2 diabetes with periodontitis and tooth loss in patients undergoing hemodialysis

et al. 2022

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Background Limited evidence are available regarding the influence of diabetes on periodontitis in hemodialysis patients, although the association between diabetes and periodontal disease is well-known. Objective This study aimed to investigate the influence of type 2 diabetes mellitus (T2D) and its control level on periodontal disease and the number of missing teeth in patients undergoing hemodialysis. Subjects and methods A single-center cross-sectional study was conducted on 246 Japanese patients with end-stage renal disease undergoing hemodialysis. Comprehensive medical and dental examinations were performed. The association between severity of periodontitis and T2D was examined by multiple ordered logistic regression analysis. A multiple linear regression model was fitted to assess the association of periodontal probing depth (PPD) ≥4 mm and the number of missing teeth with T2D (n = 125). A subgroup analysis involving only the patients with T2D was performed to investigate the factors associated with missing teeth among them. Results After adjusting for confounders, the classification of periodontitis severity was significantly advanced in patients with T2D (odds ratio: 1.64, 95% confidence interval [CI]: 1.02–2.65, p = 0.04). The proportion of PPD≥4 mm sites and the number of missing teeth was significantly associated with T2D (coefficient: 4.1 and 5.7, 95% CI: 0.2–8.0 and 3.4–8.0, p = 0.04 and <0.001, respectively). Subgroup analysis of T2D patients revealed that glycoalbumin levels (coefficient: 0.4, 95% CI: 0.03–0.80, p = 0.03), but not hemoglobin A1c levels (coefficient: 0.8, 95% CI: -1.0–2.7, p = 0.37), were significantly associated with the number of missing teeth. Conclusion T2D was significantly associated with periodontitis and the number of missing teeth in hemodialysis patients. Moreover, it is first documented that poor glycemic control, as determined by glycoalbumin levels, was significantly associated with the number of missing teeth in hemodialysis patients with T2D.

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Effects of Antioxidant in Adjunct with Periodontal Therapy in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

Cited by 14 publications

References 87 publications

Effects of Melatonin in the Non-Surgical Treatment of Periodontitis: A Systematic Review

Effects of Melatonin in the Non-Surgical Treatment of Periodontitis: A Systematic Review

Beneficial Effects of Melatonin on Periodontitis Management: Far More Than Oral Cavity

Association of type 2 diabetes with periodontitis and tooth loss in patients undergoing hemodialysis

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