Melatonin as an adjunctive treatment on dental procedures: A systematic review

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.

Influence of melatonin supplementation on tissue response of endodontic sealers in Wistar rats

“…A previous study review has shown that melatonin can reduce in ammation in dental clinical conditions [24]. Thus, melatonin may be considered as a potential reducer of the in ammatory process induced by endodontic sealers.…”

“…Melatonin is a hormone produced especially in the pineal gland. Although its main action is to regulate the circadian rhythm [34], this molecule can modulate the in ammatory process, besides regulating the oxidative stress and the proliferation of tumoral cells [15,16,24]. These effects are due to its ability to penetrate cells, acting on their DNA and cell structures, such as the plasma membrane [37,38}.…”

“…The maturation of the collagen was analyzed by the Picrosirius Red staining technique, allowing the identi cation of greenish-yellow bres, which were considered immature and thin, and yellowish-red bres which were considered mature and thick [24]. The LASQWin program was used (400X magni cation, Leica LASQWin V3, Leica Microsystems), the variation of colours was selected and automatically the marked area was calculated, indicating the percentage of each kind of bres observed [29].…”

“…In addition, melatonin can in uence the expression of pro-in ammatory and anti-in ammatory cytokines, and the recruitment of polymorphonuclear leukocytes to sites of in ammation in different pathophysiological situations [25,26]. Besides, this substance is proven to be a regulator of in ammation in dental conditions, such as periodontitis diseases, mucositis and it can potentiate the repair process in teeth extractions, implants and periodontal areas [24].…”

“…As an anti-in ammatory agent, several studies have demonstrated that melatonin can regulate the in ammatory process ceasing innumerable events within the cell cascade by the signalling of NF-kβ (Nuclear transcription factor -Kappa β), which is translocated to the nucleus of cells, binding itself to speci c elements that modulate the transcription of pro-in ammatory genes [19][20][21][22][23][24]. In addition, melatonin can in uence the expression of pro-in ammatory and anti-in ammatory cytokines, and the recruitment of polymorphonuclear leukocytes to sites of in ammation in different pathophysiological situations [25,26].…”