Efficacy of Oral Melatonin Supplementation as an Adjunct in Periodontal Treatment: A Systematic Review and Meta-analysis of Randomized Control Clinical Trails

Aim: To study the effectiveness of melatonin supplements used orally as an adjunct to NSPT in the treatment of periodontitis. Materials and Methods: Using Booleans like "AND," "OR," the MesH terms "melatonin" AND "periodontitis," "melatonin" OR "periodontitis" were searched for in the databases of "Web of Science," "PubMed," and "Scopus" from 2010 till July 2023. Randomized controlled clinical trials that prescribed the oral supplementation of melatonin as an adjunct to NSPT were included. For continuous outcomes, mean differences and 95% confidence interval (CI) were used to summarize the results of each study. The meta-analysis was conducted using fixed- or random-effects methods. Fixed-effects meta-analysis was used when the heterogeneity was small (I2 < 60%, p < .05). When the heterogeneity was large (I2 > 60%, p > .05), a random-effects model analysis was undertaken. All statistical analyses were conducted using RevMan 5.4. The present systematic review and meta-analysis were registered on the PROSPERO (CRD42023455908) on September 8, 2023. Results: A total of 109 publications were found (40 PubMed, 35 Scopus, and 34 Web of Science). We eliminated 70 articles that were identical. Only seven of the 39 articles that were examined met the requirements for acceptance and were chosen for the qualitative review. In every study, periodontal metrics such as pocket depth, clinical attachment loss, and plaque index gingival index improved. Outcome data were taken from every research. Conclusions: Key periodontal indicators, including pocket depth and clinical attachment loss, have improved in individuals with periodontitis when melatonin is administered systemically. However, the presented data should be interpreted cautiously due to the substantial potential for bias. To provide stronger clinical results and indications, more carefully planned RCTs must be carried out in addition to standardizing the dosage titration, frequency, and formulation. Clinical implications: Melatonin is one possible substance that modulates the host when used as an adjunctive to non-surgical periodontal therapy.