Melatonin as an Adjunctive Therapy for Chronic Periodontitis.

Summary

Background: Melatonin is an endogenous indoleamine synthesized mainly by pineal gland and showed anti-inflammatory and antioxidant properties. Moreover, melatonin promotes osteoblastic differentiation and suppresses osteoclastic formation. This randomized clinical trial (RCT) was aimed to assess the additive effect of melatonin supplementation in generalized chronic periodontitis (gCP) patients with insomnia who received scaling and root planing (SRP). Methods: Seventy four gCP patients with primary insomnia participated in this 6-month RCT and randomly distributed between two groups. Melatonin group (MTN+SRP group, n=38) included patients who were subjected to SRP with a 2- month regimen of 10 mg oral melatonin supplementation capsule once daily at bed-time. In the control group (Placebo+SRP group, n=36), SRP was performed for participants provided with matching placebo capsules. The primary treatment outcome included the clinical attachment gain (CAG) after 3 and 6 months of therapy, whereas, the changes in pocket depth ,bleeding on probing (BOP%) and salivary tumor-necrosis factor-α (TNF-α) levels represented the secondary outcomes.

Timeline

Start

2016-07-04

Primary completion

2017-06-08

Completion

2017-09-07

Publications

• Background Wara-aswapati N, Pitiphat W, Chanchaimongkon L, Taweechaisupapong S, Boch JA, Ishikawa I. Red bacterial complex is associated with the severity of chronic periodontitis in a Thai population. Oral Dis. 2009 Jul;15(5):354-9. doi: 10.1111/j.1601-0825.2009.01562.x. Epub 2009 Apr 7.
• Background Lamster IB, Smith QT, Celenti RS, Singer RE, Grbic JT. Development of a risk profile for periodontal disease: microbial and host response factors. J Periodontol. 1994 May;65(5 Suppl):511-20. doi: 10.1902/jop.1994.65.5s.511.
• Background Kantarci A, Van Dyke TE. Lipoxin signaling in neutrophils and their role in periodontal disease. Prostaglandins Leukot Essent Fatty Acids. 2005 Sep-Oct;73(3-4):289-99. doi: 10.1016/j.plefa.2005.05.019.
• Background Page RC. The role of inflammatory mediators in the pathogenesis of periodontal disease. J Periodontal Res. 1991 May;26(3 Pt 2):230-42. doi: 10.1111/j.1600-0765.1991.tb01649.x.
• Background Van Dyke TE, Serhan CN. Resolution of inflammation: a new paradigm for the pathogenesis of periodontal diseases. J Dent Res. 2003 Feb;82(2):82-90. doi: 10.1177/154405910308200202.
• Background Bhatavadekar NB, Williams RC. Modulation of the host inflammatory response in periodontal disease management: exciting new directions. Int Dent J. 2009 Oct;59(5):305-8.
• Background Williams RC. Host modulation for the treatment of periodontal disease. Compend Contin Educ Dent. 2008 Apr;29(3):160-2, 164, 166-8 passim.
• Background Novak MJ, Donley TG. Using host response modifiers in the treatment of periodontal disease. Pract Proced Aesthet Dent. 2002 Nov-Dec;14(9):suppl 3-10; quiz 11.
• Background Krayer JW, Leite RS, Kirkwood KL. Non-surgical chemotherapeutic treatment strategies for the management of periodontal diseases. Dent Clin North Am. 2010 Jan;54(1):13-33. doi: 10.1016/j.cden.2009.08.010.
• Background Moreno Villagrana AP, Gomez Clavel JF. Antimicrobial or subantimicrobial antibiotic therapy as an adjunct to the nonsurgical periodontal treatment: a meta-analysis. ISRN Dent. 2012;2012:581207. doi: 10.5402/2012/581207. Epub 2012 Oct 22.
• Background Rocha ML, Malacara JM, Sanchez-Marin FJ, Vazquez de la Torre CJ, Fajardo ME. Effect of alendronate on periodontal disease in postmenopausal women: a randomized placebo-controlled trial. J Periodontol. 2004 Dec;75(12):1579-85. doi: 10.1902/jop.2004.75.12.1579.
• Background Kos M, Kuebler JF, Luczak K, Engelke W. Bisphosphonate-related osteonecrosis of the jaws: a review of 34 cases and evaluation of risk. J Craniomaxillofac Surg. 2010 Jun;38(4):255-9. doi: 10.1016/j.jcms.2009.06.005. Epub 2009 Jul 9.
• Background Pandi-Perumal SR, BaHammam AS, Brown GM, Spence DW, Bharti VK, Kaur C, Hardeland R, Cardinali DP. Melatonin antioxidative defense: therapeutical implications for aging and neurodegenerative processes. Neurotox Res. 2013 Apr;23(3):267-300. doi: 10.1007/s12640-012-9337-4. Epub 2012 Jun 28.
• Background Joshi N, Biswas J, Nath C, Singh S. Promising Role of Melatonin as Neuroprotectant in Neurodegenerative Pathology. Mol Neurobiol. 2015 Aug;52(1):330-40. doi: 10.1007/s12035-014-8865-8. Epub 2014 Aug 27.
• Background Maria S, Witt-Enderby PA. Melatonin effects on bone: potential use for the prevention and treatment for osteopenia, osteoporosis, and periodontal disease and for use in bone-grafting procedures. J Pineal Res. 2014 Mar;56(2):115-25. doi: 10.1111/jpi.12116. Epub 2014 Jan 15.
• Background Gulle K, Akpolat M, Kurcer Z, Cengiz MI, Baba F, Acikgoz S. Multi-organ injuries caused by lipopolysaccharide-induced periodontal inflammation in rats: role of melatonin. J Periodontal Res. 2014 Dec;49(6):736-41. doi: 10.1111/jre.12156. Epub 2013 Dec 19.
• Background Cutando A, Lopez-Valverde A, de Diego RG, de Vicente J, Reiter R, Fernandez MH, Ferrera MJ. Effect of topical application of melatonin to the gingiva on salivary osteoprotegerin, RANKL and melatonin levels in patients with diabetes and periodontal disease. Odontology. 2014 Jul;102(2):290-6. doi: 10.1007/s10266-013-0122-5. Epub 2013 Aug 11.
• Background Srinath R, Acharya AB, Thakur SL. Salivary and gingival crevicular fluid melatonin in periodontal health and disease. J Periodontol. 2010 Feb;81(2):277-83. doi: 10.1902/jop.2009.090327.
• Background Soldatos CR, Dikeos DG, Paparrigopoulos TJ. The diagnostic validity of the Athens Insomnia Scale. J Psychosom Res. 2003 Sep;55(3):263-7. doi: 10.1016/s0022-3999(02)00604-9.
• Background Ito E, Inoue Y. [The International Classification of Sleep Disorders, third edition. American Academy of Sleep Medicine. Includes bibliographies and index]. Nihon Rinsho. 2015 Jun;73(6):916-23. Japanese.
• Background Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol. 1999 Dec;4(1):1-6. doi: 10.1902/annals.1999.4.1.1.
• Background LOE H, SILNESS J. PERIODONTAL DISEASE IN PREGNANCY. I. PREVALENCE AND SEVERITY. Acta Odontol Scand. 1963 Dec;21:533-51. doi: 10.3109/00016356309011240. No abstract available.
• Background SILNESS J, LOE H. PERIODONTAL DISEASE IN PREGNANCY. II. CORRELATION BETWEEN ORAL HYGIENE AND PERIODONTAL CONDTION. Acta Odontol Scand. 1964 Feb;22:121-35. doi: 10.3109/00016356408993968. No abstract available.

Drugs

Indications