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Systematic Review

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

1
Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo, Tokyo 113-8549, Japan
2
Department of Conservative Dentistry and Prosthodontics, Faculty of Dentistry, Srinakharinwirot University, Bangkok 10110, Thailand
3
Department of Oral Diagnosis and General Dentistry, Dental Hospital, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan
4
Department of Biology, College of Liberal Arts and Sciences, Tokyo Medical and Dental University (TMDU), Chiba 272-0827, Japan
*
Author to whom correspondence should be addressed.
Both authors contributed equally to this work.
Academic Editors: Francesca Santilli, Maurizio Crestani and Victor M. Victor
Antioxidants 2021, 10(8), 1304; https://doi.org/10.3390/antiox10081304
Received: 2 June 2021 / Revised: 6 August 2021 / Accepted: 12 August 2021 / Published: 18 August 2021
This review investigated whether the adjunctive use of antioxidants with periodontal therapy improves periodontal parameters in patients with type 2 diabetes. A systematic and extensive literature search for randomized controlled trials (RCTs) conducted before April 2021 was performed on the PubMed, Cochrane Library, and Web of Science databases. The risk of bias was assessed using the Cochrane risk-of-bias tool. A meta-analysis was performed to quantitatively evaluate the clinical outcomes following periodontal therapy. After independent screening of 137 initial records, nine records from eight RCTs were included. The risk-of-bias assessment revealed that all RCTs had methodological weaknesses regarding selective bias, although other risk factors for bias were not evident. This meta-analysis of two RCTs showed that periodontal pocket depths were significantly reduced in the groups treated with combined non-surgical periodontal therapy and melatonin than in those treated with non-surgical periodontal therapy alone. The present systematic review and meta-analysis suggest that the adjunctive use of melatonin, resveratrol, omega-3 fatty acids with cranberry juice, propolis, and aloe vera gel with periodontal therapy significantly improves periodontal disease parameters in patients with type 2 diabetes, and melatonin application combined with non-surgical periodontal therapy might significantly reduce periodontal pocket depth. However, there are still limited studies of melatonin in combination with non-surgical periodontal therapy in Type 2 diabetic patients, and more well-designed RCTs are required to be further investigated. View Full-Text
Keywords: antioxidant; diabetes; melatonin; meta-analysis; periodontal disease; systematic review antioxidant; diabetes; melatonin; meta-analysis; periodontal disease; systematic review
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MDPI and ACS Style

Mizutani, K.; Buranasin, P.; Mikami, R.; Takeda, K.; Kido, D.; Watanabe, K.; Takemura, S.; Nakagawa, K.; Kominato, H.; Saito, N.; Hattori, A.; Iwata, T. Effects of Antioxidant in Adjunct with Periodontal Therapy in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis. Antioxidants 2021, 10, 1304. https://doi.org/10.3390/antiox10081304

AMA Style

Mizutani K, Buranasin P, Mikami R, Takeda K, Kido D, Watanabe K, Takemura S, Nakagawa K, Kominato H, Saito N, Hattori A, Iwata T. Effects of Antioxidant in Adjunct with Periodontal Therapy in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis. Antioxidants. 2021; 10(8):1304. https://doi.org/10.3390/antiox10081304

Chicago/Turabian Style

Mizutani, Koji, Prima Buranasin, Risako Mikami, Kohei Takeda, Daisuke Kido, Kazuki Watanabe, Shu Takemura, Keita Nakagawa, Hiromi Kominato, Natsumi Saito, Atsuhiko Hattori, and Takanori Iwata. 2021. "Effects of Antioxidant in Adjunct with Periodontal Therapy in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis" Antioxidants 10, no. 8: 1304. https://doi.org/10.3390/antiox10081304

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