Is dietary melatonin supplementation a viable adjunctive therapy for chronic periodontitis?—A randomized controlled clinical trial

Abstract

Background and Objective Melatonin is synthesized naturally by pineal gland and responsible for regulation of sleep/waking cycle. It showed appreciated anti‐inflammatory and antioxidant properties. The aim of this randomized clinical trial (RCT) was to assess the additive effect of melatonin supplementation in insomniac individuals with generalized chronic periodontitis (gCP) after scaling and root planing (SRP). Material and Methods Seventy‐four gCP patients with primary insomnia participated in this 6‐month RCT and randomized into two groups. Melatonin group included 38 patients who were subjected to SRP with a 2‐month regimen of 10 mg oral melatonin capsule once daily before bedtime. In the control group, SRP was performed for 36 participants provided with matching placebo capsules. The primary treatment outcome was the measurement of clinical attachment level gain (CAL gain) after 3 and 6 months of therapy, whereas the measurements of pocket depth reduction (PD reduction), bleeding on probing (BOP %), and the changes in salivary TNF‐α levels and Athens insomnia scale (AIS) scores represented the secondary endpoints. Results Melatonin group showed significantly greater CAL gain and PD reduction measurements compared to the control group at 3 and 6 months of therapy, P < 0.01. Likewise, salivary TNF‐α levels and AIS scores were significantly lower in the melatonin group compared to placebo group. BOP% improved significantly in both groups without any difference. However, salivary TNF‐α levels exhibited no correlation with other clinical variables in both melatonin and placebo groups. Conclusion Daily dietary 10 mg of melatonin supplementation might serve as a viable adjunct to SRP that yielded significantly greater CAL gain and PD reduction and lower salivary TNF‐α levels and AIS scores in gCP patients with primary insomnia.

Melatonin and Hyaluronic Acid in Periodontal Disease

“…Systemic MEL supplement (10 mg oral MEL capsule once daily before bedtime) administrated for 2 months for patients with insomnia, in conjunction with scaling and root planning (SRP) yield to significantly greater clinical attachment level gain and periodontal pocket depth reduction and also lower salivary tumor necrosis factoralpha levels comparing to placebo [30]. Favorable results on periodontal parameters have been also obtained after SRP with an adjunctive dose of MEL (2 mg a day for 4 weeks) and vitamin C (60 mg for females and 75 mg for males for 4 weeks) comparing to SRP alone [31].…”

Insight into the roles of melatonin in bone tissue and bone‑related diseases (Review)

“…El-Sharkawy et al ( 153 ) reported that a daily dietary supplement of 10 mg melatonin may be an effective complementary treatment for patients with insomnia with generalized chronic periodontitis, resulting in an improved CAL and sleep quality, as well as lower PD and salivary TNF-α levels. During the entire study period, the improvement in insomnia was maintained for up to 6 months without any rebound, even though the daily dietary melatonin supplement was administered for only 2 months.…”

“…The majority of experiments used melatonin for 2-4 weeks. For clinical research, the most common route is by oral administration, with doses fluctuating between 1-10 mg/day ( 56 , 127 - 129 , 153 ). In addition, melatonin can be used locally in the form of 1% orabase cream for the treatment of periodontitis ( 137 , 138 ).…”

Autophagy in periodontal disease: Evidence from a literature review

“…Melatonin has been reported to have significant beneficial effects in animal models of PDs (Virto et al, 2018). Until today, two RCTs have ascertained the usefulness of melatonin supplementation as a SRP adjuvant in PD (El-Sharkawy et al, 2018, Bazyar et al, 2018, and another RCT evaluated a melatonin-based topical formulation providing also positive results (Cutando et al, 2015).…”