Melatonin significantly increases efficacy of full-mouth scaling and root planing in patients with diabetes and periodontitis

The randomized controlled, single-blind study involved 55 diabetic patients with periodontitis, with 27 undergoing full-mouth scaling and root planing (fmSRP) alone and 28 receiving melatonin supplementation (6 mg daily for 30 days) in addition to fmSRP (full-mouth scaling and root planing plus melatonin, fmSRP-mel). The impact of melatonin was assessed clinically and biochemically through the analysis of gingival crevicular fluid RANKL, OPG, MMP-8, and serum IL-1β levels at the 3rd and 6th months.

Findings:

• Results from the study indicated that melatonin, administered in tablet form at 6 mg daily for 30 days, did not induce any local or systemic side effects.
• FmSRP alone demonstrated a significant reduction in serum IL-1β levels, pocket depths, gingival inflammation, and gingival crevicular fluid RANKL and MMP-8 levels (p < 0.05).
• Interestingly, melatonin supplementation led to a more pronounced decrease in bleeding and pocket depth scores during probing, particularly at the 3-month mark (p < 0.05).
• Furthermore, RANKL and MMP-8 levels exhibited a significant reduction at 3 months, while IL-1β levels decreased at 6 months compared to the control group (p < 0.05).
• Notably, OPG levels were not significantly affected by the treatments (p > 0.05).

In conclusion, melatonin, as a host modulation agent, demonstrated a significant enhancement in the clinical efficacy of fmSRP. The observed reduction in periodontal inflammation and pocket depths is attributed to melatonin's marked suppression of RANKL-associated osteoclastogenesis and extracellular matrix damage. This breakthrough offers a promising avenue for improved periodontal treatment outcomes in diabetic individuals, showcasing melatonin's potential as a therapeutic adjunct in managing periodontitis in this specific patient population.                         

Further reading: Melatonin supports nonsurgical periodontal treatment in patients with Type 2 diabetes mellitus and periodontitis: A randomized clinical trial. Doi: https://doi.org/10.1002/JPER.23-0335