Melatonin as a Topical/Systemic Formulation for the Management of Periodontitis: A Systematic Review

Thodur Madapusi Balaji; Saranya Varadarajan; Raghunathan Jagannathan; Jaideep Mahendra; Hammam Ibrahim Fageeh; Hytham N Fageeh; Shazia Mushtaq; Hosam Ali Baeshen; Shilpa Bhandi; Archana A Gupta; A Thirumal Raj; Rodolfo Reda; Shankaragouda Patil; Luca Testarelli

doi:10.3390/ma14092417

Melatonin as a Topical/Systemic Formulation for the Management of Periodontitis: A Systematic Review

Materials (Basel). 2021 May 6;14(9):2417. doi: 10.3390/ma14092417.

Authors

Affiliations

¹ Department of Dentistry, Bharathiraja Hospital and Research Institute, Chennai 600017, India.
² Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India.
³ Department of Periodontology, Tagore Dental College and Hospital, Chennai 600127, India.
⁴ Department of Periodontology, Meenakshi Ammal Dental College, Meenakshi Academy of Higher Education and Research, Chennai 600095, India.
⁵ Department of Preventive Dental Science, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia.
⁶ Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh 11362, Saudi Arabia.
⁷ Department of Orthodontics, College of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia.
⁸ Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia.
⁹ Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital Dr. D. Y. Patil Vidyapeeth, Pune 411018, India.
¹⁰ Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy.
¹¹ Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia.

Abstract

Objectives: To qualitatively and quantitatively review the use of melatonin as a topical/systemic formulation for the management of periodontitis.

Materials and methods: PubMed; Scopus; and Web of Science databases were searched using the MesH terms "melatonin" and "periodontitis". Title and abstracts were screened to eliminate irrelevant and duplicate articles. The full text data of the screened articles were assessed using the selection criteria.

Results: Of 176 identified articles (PubMed-66; Scopus-56; Web of Science-52; Cross-reference-2), only 12 studies qualified to be included in the systematic review. Four studies assessed the independent effect of 1% topical melatonin formulation while 8 articles assessed the adjunctive use of systemic melatonin formulation (1-10 mg) following scaling and root planing (SRP). All studies showed an improvement in periodontal parameters such as pocket depth, clinical attachment loss, periodontal disease index, community periodontal index, gingival bleeding scores, and prognostic marker levels in saliva and serum. A meta-analysis of data from 2 studies revealed that 1-2 mg (systemic) melatonin supplementation reduced pocket depth; although the difference was not statistically significant and hence cannot be interpreted or used for conclusive evidence. Risk of Bias Assessment tool (RoBANS) and Cochrane Collaboration RoB tool elicited a high risk of bias in the included studies. GRADE (recommendation assessment, development, and evaluation) inferred a weak recommendation for the use of melatonin in periodontitis management.

Conclusions: Melatonin supplementation (topical and systemic) in periodontitis patients improved key periodontal parameters including pocket depth and clinical attachment loss.

Clinical relevance: Melatonin could be a potential host modulatory agent for periodontitis management; although the data from the present review should be interpreted carefully due to the associated high risk of bias.

Keywords: melatonin; periodontitis; pocket depth; systemic; topical.

Publication types

Review