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

In a groundbreaking clinical study addressing the intricate relationship between diabetes mellitus (DM) and periodontitis, researchers have unveiled a promising breakthrough that could transform the landscape of nonsurgical periodontal therapy. This innovative investigation delves into the clinical efficacy of melatonin supplementation as a host modulation agent in diabetic patients with periodontitis, providing a unique perspective on its potential as a therapeutic adjunct.

The study results were published in the Journal of Periodontology. 

Diabetes mellitus (DM) has long been associated with an exaggerated inflammatory response, exacerbating periodontal tissue destruction. Literature shows that the application of host modulation agents to enhance nonsurgical periodontal therapy in individuals with diabetes is an actively researched area. Hence, researchers conducted a study to investigate the clinical efficacy of melatonin supplementation and shed light on its underlying biological mechanisms by examining fundamental markers.

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