The effects of topical application of melatonin on periodontal Disease in diabetic patients

Periodontal disease is a chronic disease, affects the supporting tissues of the tooth. The clinical manifestation varies from gingivitis to periodontitis. Periodontal disease is caused by bacterial infection that release toxins. The imbalance between oxidants and antioxidants determines the progression of periodontal disease. Melatonin (MEL), (N-Acetyl-5-methoxytrittamine) is a hormone in the human body. Its production takes place in various organs including the retina, gastrointestinal tract, bone marrow, leukocytes, lymphocytes, skin, and principally pineal gland. Its main function is the regulation of the circadian and seasonal rhythm, body weight, reproduction, bone metabolism, and tumor growth. An important function of melatonin is the ability to reduce oxidative stress. The aim of this review is to evaluate the necessary effects on melatonin on the progression of periodontal disease and diabetes. The purpose of this review is to answer to the following questions using a PICO method (P: patient problem/population; I: intervention; C: comparison; O: outcome): (1) Can adding melatonin in diabetic and periodontal patients lead to improved periodontal health? (2) Does melatonin also affect the control of blood sugar levels in the diabetic patient? The study was conducted utilizing the main scientific databases (PubMed, MEDLINE, and WEB of SCIENCE). The time window considered for the electronic search was from March 1, 2007, to March 1, 2020. The following inclusion criterion was used: Articles in English, human studies and clinical trials. Two independent people search with the same keywords all article and select the article founding. The risk of bias in this phase is solved by an independent author that conduct the same search. We can hypothesize that melatonin may indirectly help control blood sugar levels. Further studies will be needed to evaluate a direct healing effect of melatonin on diabetes.