Melatonin was expressed in GCF. Salivary and GCF melatonin levels varied from clinically healthy subjects (group 1) to subjects with periodontitis (group 3). Both salivary and GCF melatonin levels decreased in group 3 subjects compared to group 1 subjects, indicating that melatonin may have a protective role against periodontal disease, although further research is required to validate this hypothesis.

A systemically healthy 23-year-old male patient reported to the Department of Periodontics, College of Dental Sciences, Davangere, Karnataka, India with the chief complaint of pain in his upper front tooth since one week which aggravated on biting. Past dental history revealed a self-fall and trauma to the upper front tooth region, two months back. Clinical examination revealed inflamed gingiva, pus exudation, extrusion, Miller's Grade III mobility, pocket depth of 14mm mesio-, mid-and distolabially; 10mm mesio-and distopalatally in relation to left maxillary central incisor. The tooth was nonresponsive to pulp sensitivity test. Intra-Oral Periapical Radiograph (IOPA) revealed severe bone loss [Table/ Fig-1]. The diagnosis of true combined lesion was established and periodontally hopeless prognosis assigned. Hereafter, the patient was advised to undergo extraction, followed by replacement options such as Removable Partial Denture (RPD), Fixed Partial Denture (FPD) or implants. However, due to financial constraints patient was reluctant for extraction and keen on retaining his natural tooth. Therefore, a treatment plan consisting of intentional replantation with Guided Tissue Regeneration (GTR) was formulated. The success rate of treatment and complications were explained to patient and a written consent was obtained.Case Management: Phase I therapy including scaling, root planning and splinting with wire and composite [Table/ Fig-2] was carried out, no occlusal interferences were noted. This was followed by endodontic treatment involving placement of calcium hydroxide dressing for two weeks followed by obturation with guttapercha. Surgery was scheduled four weeks after completion of endodontic treatment.Replantation procedure: After obtaining adequate anesthesia using Lignocaine hydrochloride 2%, a full thickness mucoperiosteal flap was reflected which revealed periodontal destruction extending beyond the root apex [Table/ Fig-3]. Splint removal was followed by atraumatic tooth extraction. Extracted tooth was root planed with Gracey's curettes for removal of calculus, remaining periodontal ligament and necrotic cementum and was immediately placed in a solution of tetracycline (500 mg of tetracycline dissolved in 20 ml saline) for 5 min.After debridement of the defect site, autologous Platelet Rich Fibrin (PRF) was obtained as follows: Around 5 ml of whole Intentional replantation is generally contraindicated in periodontally compromised teeth however, there are reports suggesting that it can be a successful treatment alternative for periodontally involved hopeless teeth. Currently there is dearth of evidence regarding the success of this therapy, especially evidence for the effectiveness of autologous platelet rich fibrin is lacking. We present a case report of a 23-year-old male patient with periodontally hopeless left maxillary central incisor having bone loss extending beyond root apex. The tooth was gently extracted and replanted utilizing root conditioning and combined regenerative therapy (Xenograft, PRF a...

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