Melatonin supports nonsurgical periodontal treatment in patients with Type 2 diabetes mellitus and periodontitis: A randomized clinical trial

IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE
Yagmur Sarac Gul, Oguz Kose, Ahmet Altin, Hatice Yemenoglu, Hatice Arslan, Kerimali Akyildiz, Adnan Yilmaz
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引用次数: 0

Abstract

Background

Diabetes mellitus (DM)-associated hyperinflammatory host response significantly provokes periodontal tissue destruction. In this context, the support of nonsurgical periodontal therapy in diabetics with host modulation agents is a current field of study. This clinical study aims to investigate the clinical efficacy of melatonin supplementation and discuss its possible biological mechanisms in nonsurgical periodontal treatment in patients with DM and periodontitis through some fundamental markers.

Methods

In this randomized controlled and single-blind study, 27 of 55 diabetic patients with periodontitis (stage III/IV and grade C) underwent full-mouth scaling and root planing (fmSRP) alone and 28 patients underwent melatonin administration (6 mg daily, 30 days) in addition to fmSRP (full-mouth scaling and root planing plus melatonin, fmSRP-mel). The potential therapeutic contribution of melatonin was evaluated clinically and biochemically (gingival crevicular fluid RANKL, OPG, MMP-8, and serum IL-1β levels) at 3rd and 6th months.

Results

Melatonin (tablet, 6 mg daily, 30 days) did not cause any local or systemic side effects. fmSRP alone resulted in significant reduction in serum IL-1β levels, pocket depths, gingival inflammation, and gingival crevicular fluid RANKL and MMP-8 levels (p < 0.05). Moreover, melatonin supplementation resulted in a more significant decrease in bleeding and pocket depth scores at probing, especially at 3 months (p < 0.05). Furthermore, RANKL and MMP-8 levels were significantly lower at 3 months and IL-1β levels at 6 months compared to the control group (p < 0.05). However, OPG levels were not affected significantly by the treatments (p > 0.05).

Conclusion

Melatonin, as a host modulation agent, significantly increases the clinical efficacy of fmSRP. The reduction in periodontal inflammation and pocket depths may be a result of marked suppression of RANKL-associated osteoclastogenesis and extracellular matrix damage by melatonin.

褪黑素支持2型糖尿病和牙周炎患者的非手术牙周治疗:一项随机临床试验
背景:糖尿病(DM)相关的高炎症宿主反应显著地引起牙周组织破坏。在这种情况下,支持使用宿主调节剂对糖尿病患者进行非手术牙周治疗是当前研究的一个领域。本临床研究旨在通过一些基础标志物探讨褪黑素在糖尿病合并牙周炎患者非手术牙周治疗中的临床疗效,并探讨其可能的生物学机制。方法:在这项随机对照单盲研究中,55名患有牙周炎的糖尿病患者(III/IV期和C级)中有27名患者单独接受了全口洗牙和牙根刨平(fmSRP)治疗,28名患者在fmSRP(全口洗牙和牙根刨平加褪黑素,fmSRP-mel)治疗的基础上接受了褪黑素治疗(每天6 mg, 30天)。在第3个月和第6个月对褪黑素的潜在治疗作用进行临床和生化评估(龈沟液RANKL、OPG、MMP-8和血清IL-1β水平)。结果:褪黑素(片剂,每日6毫克,30天)未引起任何局部或全身副作用。单用fmSRP可显著降低血清IL-1β水平、龈袋深度、牙龈炎症、龈沟液RANKL和MMP-8水平(p 0.05)。结论:褪黑素作为宿主调节剂,可显著提高fmSRP的临床疗效。牙周炎症和牙袋深度的减少可能是褪黑素显著抑制rankl相关的破骨细胞生成和细胞外基质损伤的结果。
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来源期刊
Journal of periodontology
Journal of periodontology 医学-牙科与口腔外科
CiteScore
9.10
自引率
7.00%
发文量
290
审稿时长
3-8 weeks
期刊介绍: The Journal of Periodontology publishes articles relevant to the science and practice of periodontics and related areas.
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