Melatonin levels in periodontitis vs. the healthy state: A systematic review and meta‐analysis

Abstract

The aim was to provide a comprehensive qualitative and quantitative assessment of any potential differences in melatonin levels in periodontitis vs. the healthy state.The keyword combination "melatonin" AND "periodontitis" was searched in Web of Science, PubMed, and Scopus. Qualitative analysis and quantitative analysis were | Inclusion criteriaOriginal research in English language assessing the melatonin levels in saliva, plasma, gingival crevicular fluid, or gingival tissue samples of humans with and without periodontitis was included in the study. | Exclusion criteriaReviews, letters, conference abstracts, articles in a language other than English, articles based on animal models, and articles wherein sufficient details on the melatonin level in periodontitis could not be elucidated were excluded from the study. | Focus question"Do the melatonin levels vary between healthy individuals and patients with periodontitis?" | Search strategyThe keyword combination "melatonin" AND "periodontitis" was searched on June 22nd, 2020, in Web of Science, PubMed, and Scopus. The identified articles were manually cross-referenced for potential articles. The search results in the databases are presented as Supporting information. | Study selection and data extraction1. The identified articles were screened using their titles and abstracts for potential duplicates and relevance to the topic Radioimmunoassay Mean melatonin levels in plasma Controls: 14.33 ± 4.05 picograms/ml Cases: 9.46 ± 3.18 picograms/ml A significant lowering of melatonin was observed in the plasma of cases compared with controls (p < .001) Negative correlation between age and plasma melatonin in controls observed (r = −0.672, p < .001). No correlation was observed in cases. Mean melatonin levels in saliva Controls: 4.22 ± 0.87 picograms/ml Cases: 2.55 ± 0.99 picograms/ml A significant lowering of melatonin was observed in the saliva of cases compared with controls (p < .001) Mean salivary to plasma melatonin ratio Controls: 0.30 ± 0.06 Cases: 0.31 ± 0.07 No significant difference in cases and controls (p > .05) Plasma melatonin levels increase in patients with CPI scores of 3 and 4 CD4 + counts in plasma had a negative correlation with both plasma and salivary melatonin levels in cases (p

Melatonin as a Topical/Systemic Formulation for the Management of Periodontitis: A Systematic Review

“…Studies on melatonin levels in periodontitis have reported significantly lower levels in saliva [ 19 ], gingival tissue samples [ 18 ], and GCF [ 20 ]. However, a recent systematic review highlighted a significantly low level of salivary melatonin in patients with periodontitis versus healthy individuals [ 21 ]. Since melatonin levels are lowered in periodontitis, an augmentation of the same by exogenous supplementation has been implemented in recent years.…”

“…Melatonin has been assayed in saliva [ 19 ], gingival crevicular fluid (GCF) [ 20 ], and gingival tissues [ 18 ], and its overall levels were found to be lowered in patients with periodontitis than healthy controls. A recently published systematic review performed by some of us, found a depletion of salivary melatonin levels in patients with periodontitis versus healthy individuals [ 21 ]. This finding is significant as it highlights the need for melatonin supplementation in the management of periodontal disease.…”

The Role of Inflammasome NLPR3 in the Development and Therapy of Periodontitis

“…Melatonin levels are associated with the severity of periodontitis. A systematic review by Balaji TM et al has shown an initial reduction in melatonin levels followed by elevation with worsening of periodontitis 128 . The application of melatonin as a topical/systemic formulation to treat periodontitis was also reported by Balaji TM et al Apart from the level and application of melatonin in periodontitis, melatonin is demonstrated to regulate immune response and prevent periodontal tissue from damage.…”

Osteoporosis and Alveolar Bone Health in Periodontitis Niche: A Predisposing Factors-Centered Review

“…Melatonin insufficiency contributes to aging, menopause and diabetes-associated osteoporosis, and supplementation of which helps improve bone status [ 82 , 83 ]. However, the results of studies focusing on the relationship between periodontitis and melatonin are conflicting [ 84 ]. Clinical studies indicate that oral melatonin supplementation arrests periodontitis progression and alveolar bone destruction, evidenced by improved clinical parameters and reduced salivary RANKL/OPG ratio, regardless of the application of nonsurgical periodontal therapy [ 85 ].…”