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Sarac Gul Y, Kose O, Altin A, Yemenoglu H, Arslan H, Akyildiz K, Yilmaz A. Melatonin supports nonsurgical periodontal treatment in patients with Type 2 diabetes mellitus and periodontitis: A randomized clinical trial. J Periodontol 2023. [PMID: 38055628 DOI: 10.1002/jper.23-0335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Diabetes mellitus (DM)-associated hyperinflammatory host response significantly provokes periodontal tissue destruction. In this context, the support of nonsurgical periodontal therapy in diabetics with host modulation agents is a current field of study. This clinical study aims to investigate the clinical efficacy of melatonin supplementation and discuss its possible biological mechanisms in nonsurgical periodontal treatment in patients with DM and periodontitis through some fundamental markers. METHODS In this randomized controlled and single-blind study, 27 of 55 diabetic patients with periodontitis (stage III/IV and grade C) underwent full-mouth scaling and root planing (fmSRP) alone and 28 patients underwent melatonin administration (6 mg daily, 30 days) in addition to fmSRP (full-mouth scaling and root planing plus melatonin, fmSRP-mel). The potential therapeutic contribution of melatonin was evaluated clinically and biochemically (gingival crevicular fluid RANKL, OPG, MMP-8, and serum IL-1β levels) at 3rd and 6th months. RESULTS Melatonin (tablet, 6 mg daily, 30 days) did not cause any local or systemic side effects. fmSRP alone resulted in significant reduction in serum IL-1β levels, pocket depths, gingival inflammation, and gingival crevicular fluid RANKL and MMP-8 levels (p < 0.05). Moreover, melatonin supplementation resulted in a more significant decrease in bleeding and pocket depth scores at probing, especially at 3 months (p < 0.05). Furthermore, RANKL and MMP-8 levels were significantly lower at 3 months and IL-1β levels at 6 months compared to the control group (p < 0.05). However, OPG levels were not affected significantly by the treatments (p > 0.05). CONCLUSION Melatonin, as a host modulation agent, significantly increases the clinical efficacy of fmSRP. The reduction in periodontal inflammation and pocket depths may be a result of marked suppression of RANKL-associated osteoclastogenesis and extracellular matrix damage by melatonin.
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Affiliation(s)
- Yagmur Sarac Gul
- School of Dentistry, Department of Periodontology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Oguz Kose
- School of Dentistry, Department of Periodontology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Ahmet Altin
- School of Dentistry, Department of Periodontology, Istanbul Kent University, Istanbul, Turkey
| | - Hatice Yemenoglu
- School of Dentistry, Department of Periodontology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Hatice Arslan
- School of Dentistry, Department of Periodontology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Kerimali Akyildiz
- School of Vocational Health Care Services, Department of Medical Services and Techniques, Recep Tayyip Erdogan University, Rize, Turkey
| | - Adnan Yilmaz
- School of Medicine, Department of Biochemistry, Recep Tayyip Erdogan University, Rize, Turkey
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Gegout PY, Stutz C, Huck O. Gels as adjuvant to non-surgical periodontal therapy: A systematic review and meta-analysis. Heliyon 2023; 9:e17789. [PMID: 37455970 PMCID: PMC10345361 DOI: 10.1016/j.heliyon.2023.e17789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 06/14/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023] Open
Abstract
Objective This systematic review and meta-analysis evaluated the effect of the use of available drugs loaded gels used as adjunct to non-surgical periodontal therapy. Methods Systematic research on PubMed/MEDLINE, Cochrane Central register of Controlled Trials, and Embase databases up to December 2021 was performed. Randomized clinical trials (RCT) which compared the outcomes of scaling and root planing (SRP) + local adjuvant administration (gel) versus SRP + placebo or SRP alone in Humans were included. The primary outcome measures were PPD and CAL changes at 3 months. Results After articles screening, 77 articles were included and assessed for quality. Then, a meta-analysis was conducted in studies with at least 3 months of follow-up. Clinical improvements were found to be significant for tetracyclines (-0.51 [-0.71;-0.31] p < 0.001), macrolides (-0.71 [-1.04;-0.38] p < 0.001), statins (-0.84 [-0.98;-0.70] p < 0.001), metformin (-1.47 [-1.66;-1.29] p < 0.001) and hyaluronan (-1.61 [-2.28;-0.94] p < 0.001) loaded gels, but non-significant for chlorhexidine (-0.48 [-1.10; 0.14] p = 0.13), metronidazole (-0.50 [-1.20; 0.20] p = 0.16) and bisphosphonates (-0.42 [-1.39; 0.54] p = 0.539) gels. Conclusion Adjunctive use of drugs loaded gels to non-surgical periodondal treatment could improve PPD reduction at 3 months. However, huge disparities remain when comparing the outcomes of the differents drugs used. Future comparative studies should be considered to determine precisely short and long term benefits of such treatments.
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Affiliation(s)
- Pierre-Yves Gegout
- Université de Strasbourg, Faculté de Chirurgie Dentaire, Periodontology, Strasbourg, France
- Hôpitaux Universitaires de Strasbourg, Pôle de Médecine et Chirurgie Bucco-dentaires, Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Céline Stutz
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Olivier Huck
- Université de Strasbourg, Faculté de Chirurgie Dentaire, Periodontology, Strasbourg, France
- Hôpitaux Universitaires de Strasbourg, Pôle de Médecine et Chirurgie Bucco-dentaires, Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
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Gonde NP, Rathod SR, Kolte AP. Comparative evaluation of 1% melatonin gel in the treatment of intrabony defect: A randomized controlled clinical trial. J Periodontol 2022; 93:1878-1888. [PMID: 35238041 DOI: 10.1002/jper.21-0515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 01/28/2022] [Accepted: 02/24/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND The present study aims to evaluate and compare the efficacy of locally delivered 1% melatonin gel as an adjunct to non-surgical periodontal therapy (NSPT) in treatment of intrabony defect in Stage III periodontitis, clinically, and radiographically using cone-beam computed tomography (CBCT). METHODS This split-mouth clinical trial randomly allotted 44 bilateral intrabony defect (in 22 patients) into two groups where Group I was treated with NSPT with locally delivered placebo gel while Group II was treated with NSPT with 1% melatonin gel. The intrabony defect fill measured from cemento-enamel junction (CEJ)-base of the defect (BD), and the difference in the measurement values of CEJ-BD from baseline to 6 months denoting the bone fill and bone volume evaluated at 6 months using CBCT were the primary outcome measures. Secondary outcome measures were change in probing depth (PD), clinical attachment level (CAL), plaque index, and modified sulcus bleeding index recorded at baseline, 3 months, and 6 months. RESULTS Both the study groups showed improvements in assessed parameters, however, a significant gain in intrabony defect fill was observed in Group II (1.46 ± 0.58) as compared with Group I (0.50 ± 0.38) and change in bone volume for Group I was 21.4645 ± 8.8980 mm3 and for Group II was 51.8418 ± 30.2329 mm3 with P < 0.0001.The mean reduction in PD and gain in CAL was 3.90 ± 0.78 and 2.94 ± 0.80 in Group II and in Group I it was 3.23 ± 0.90 and 1.96 ± 0.80 (P < 0.0001). CONCLUSION The use of 1% melatonin gel as an adjunct to NSPT is more beneficial in achieving better clinical and radiographic outcome at 6 months which indicates that adjunct use of melatonin gel to NSPT as a local drug delivery is preferred when compared with NSPT and placebo gel alone.
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Affiliation(s)
- Noopur P Gonde
- Department of Periodontics & Implantology, VSPM Dental College and Research Center, Nagpur, India
| | - Surekha R Rathod
- Department of Periodontics & Implantology, VSPM Dental College and Research Center, Nagpur, India
| | - Abhay P Kolte
- Department of Periodontics & Implantology, VSPM Dental College and Research Center, Nagpur, India
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Wang C, Wang L, Wang X, Cao Z. Beneficial Effects of Melatonin on Periodontitis Management: Far More Than Oral Cavity. Int J Mol Sci 2022; 23:ijms232314541. [PMID: 36498871 PMCID: PMC9739298 DOI: 10.3390/ijms232314541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/17/2022] [Accepted: 11/19/2022] [Indexed: 11/24/2022] Open
Abstract
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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Affiliation(s)
- Chuan Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST KLOS) & Key Laboratory of Oral Biomedicine Ministry of Education (KLOBME), School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
- Department of Periodontology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Leilei Wang
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Xiaoxuan Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST KLOS) & Key Laboratory of Oral Biomedicine Ministry of Education (KLOBME), School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
- Department of Periodontology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Zhengguo Cao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST KLOS) & Key Laboratory of Oral Biomedicine Ministry of Education (KLOBME), School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
- Department of Periodontology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
- Correspondence:
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KUNDAK K, YARAT A, DOĞAN B, KURU L. Effect of Non-surgical Periodontal Therapy on Salivary Melatonin Levels. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2022. [DOI: 10.33808/clinexphealthsci.1053211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Objective: Melatonin, a hormone secreted predominantly by pineal gland in a circadian manner, has antioxidant and anti-inflammatory effects. The current research is conducted to explore the influence of non-surgical periodontal therapy (NSPT) on levels of salivary melatonin in subjects with gingivitis and periodontitis. Methods: Sixty systemically healthy participants were included in this study; the groups are as follows: gingivitis (G), chronic periodontitis (CP), generalized aggressive periodontitis (GAP) and periodontally healthy (H). NSPT was applied to G group patients for 2 sessions, to CP and GAP group patients for 4 sessions. Plaque and gingival indices, probing depth (PD), bleeding on probing (BOP), and clinical attachment level (CAL) were documented at baseline and 3 months post – treatment and early morning salivary samples were collected. ELISA was used to detect melatonin levels in saliva. Pittsburgh Sleep Quality Index (PSQI) questionnaire was performed to evaluate of sleep quality of patients. Results: At baseline, significant difference in gingival index, PD, BOP and CAL values was detected among all groups (p
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Affiliation(s)
- Kübra KUNDAK
- MARMARA UNIVERSITY, INSTITUTE OF HEALTH SCIENCES
| | - Ayşen YARAT
- MARMARA ÜNİVERSİTESİ, DİŞ HEKİMLİĞİ FAKÜLTESİ
| | - Başak DOĞAN
- MARMARA ÜNİVERSİTESİ, DİŞ HEKİMLİĞİ FAKÜLTESİ
| | - Leyla KURU
- MARMARA ÜNİVERSİTESİ, DİŞ HEKİMLİĞİ FAKÜLTESİ
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Liu RY, Li L, Zhang ZT, Wu T, Lin S, Zhang XT. Clinical efficacy of melatonin as adjunctive therapy to non-surgical treatment of periodontitis: a systematic review and meta-analysis. Inflammopharmacology 2022; 30:695-704. [PMID: 35290552 DOI: 10.1007/s10787-022-00959-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 02/24/2022] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This study aimed to evaluate the effect of adjunctive melatonin supplementation on clinical outcomes after non-surgical periodontal treatment. METHODS PubMed, Embase, and Web of Science databases were systematically searched for randomised controlled trials (RCTs) of melatonin adjuvant therapy for periodontitis from inception until May 2021. The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered on The International Prospective Register of Systematic Reviews (PROSPERO) (CRD42021250630). The risk of bias of included studies was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions. The pooled effect estimates were calculated by a random-effects model, and results were expressed as weighted mean differences (WMD). RESULTS Seven RCTs comprising 412 participants were included in the meta-analysis. The pooled results showed that adjuvant use of melatonin for non-surgical periodontal treatment significantly improved the probing depth (PD) [WMD = - 1.18, 95% CI (- 1.75, - 0.62) I2 = 85.7%], clinical attachment loss (CAL) [WMD = - 1.16, 95% CI (- 1.60, - 0.72) I2 = 76.7%] and gingival index (WMD = - 0.29, 95%CI [- 0.48, - 0.11], I2 = 63.6%) compared with non-surgical treatment alone. In addition, subgroup analysis showed that higher doses of melatonin (3-10 mg) significantly improved PD [WMD = - 1.32, 95%CI (- 2.31, - 0.15) I2 = 93%] and CAL [WMD = - 1.30, 95%CI (- 1.80, - 0.81) I2 = 73.7%] compared with lower doses of melatonin (< 3 mg). CONCLUSIONS We found that adjunctive melatonin supplementation can significantly improve the periodontal status after non-surgical treatment, suggesting that melatonin may be a new adjuvant therapy for periodontitis when non-surgical periodontal treatment alone cannot achieve the desired improvement.
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Affiliation(s)
- Ru-Yue Liu
- VIP Department, School of Stomatology, China Medical University, Shenyang, China
| | - Lin Li
- VIP Department, School of Stomatology, China Medical University, Shenyang, China
| | - Zhong-Ti Zhang
- VIP Department, School of Stomatology, China Medical University, Shenyang, China.
| | - Ting Wu
- VIP Department, School of Stomatology, China Medical University, Shenyang, China
| | - Shuang Lin
- VIP Department, School of Stomatology, China Medical University, Shenyang, China
| | - Xu-Tong Zhang
- VIP Department, School of Stomatology, China Medical University, Shenyang, China
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de Oliveira PHC, Lemos CAA, Cantiga-Silva C, Faria FD, Cintra LTA, Pellizzer EP. Melatonin as an adjunctive treatment on dental procedures: A systematic review. Oral Dis 2021; 28:1770-1782. [PMID: 34152659 DOI: 10.1111/odi.13941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 05/17/2021] [Accepted: 06/06/2021] [Indexed: 11/29/2022]
Abstract
The systematic review tried to answer the following question: Does the melatonin administered systemically or topically ameliorate patients involved with oral health conditions or dental procedures? The systematic review has been registered in the PROSPERO (2021CRD42021095959). Eligibility criteria included only randomized controlled clinical trials (RCTs) with at least 10 participants that compared patients that received melatonin as a treatment before and/or after their oral intervention topically or systemically, with control patients. A search was performed in PubMed/MEDLINE, Web of Science, Cochrane Library, and Academic Google databases for articles up to February 2021. The Cochrane risk-of-bias tool for randomized clinical trials was used and revealed that the studies included presented low risk of bias for the majority of criteria assessed. It was selected 25 articles, of which only six did not demonstrate positive effects and three presented null effects with the use of melatonin. Melatonin has improved the inflammatory response in periodontal disease, dental surgeries, and mucositis of head and neck oncologic irradiated patients. In addition, it showed anxiolytic potential in patients that were submitted to dental procedures. In conclusion, melatonin favored the treatment of oral changes when used topically and systemically.
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Affiliation(s)
| | - Cleidiel Aparecido Araujo Lemos
- Department of Dentistry (Division of Prosthodontics), Campus Governador Valadares, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Cristiane Cantiga-Silva
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp, Araçatuba, Brazil
| | - Flávio Duarte Faria
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp, Araçatuba, Brazil
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp, Araçatuba, Brazil
| | - Eduardo Piza Pellizzer
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (Unesp, Araçatuba, Brazil
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