Investigation of the host modulatory effectiveness of melatonin in the non-surgical periodontal treatment on patients with diabetic periodontitis

Objective: The main purpose of this clinical study is to comprehensively demonstrate the effectiveness of systemic melatonin given in addition to non-surgical periodontal therapy (NSPT) in diabetic periodontitis patients with clinical and biochemical parameters. Material and method: 55 type2 diabetic periodontitis patients were included of this randomised-controlled, double-blind study. Patients were randomise allocated in two groups: fmNSPT and fmNSPT-mel. NSPT for all patients was performed with full mouth scaling and root planning(fmSRP) procedure, time with 24 hour. Before the beginning of NSPT, clinic parameters[gingival index(GI), plaque index(PI), bleeding on probing(BOP), probing depth(PD) and clinical atachment level(CAL)] were recorded, plus, gingival crevicular fluid(GCF)and venous blood samples were collected from the patients. Unlike the fmNSPT group, patients in fmNSPT-mel group were given 3mg melatonin tablets to be taken by the patients as two tablets at bedtime for 30 days immediately after the fmSRP procedure. The fmNSPT group was not given any supplements. After the periodontal treatment, clinical periodontal indexes were recorded, GCF and venous blood were collected again in the control sessions at the 3rd (T1) and 6th months (T2). Matrix metalloproteinase-8(MMP-8), receptor activator of nücleer factor kappa-B ligand(RANKL) and osteoprotegrin(OPG) in GCF and interleukin-1beta(IL-1ß) in serum samples producing from the venous bloood were assessed as a biochemical markers. Mann Whitney U test was used for comparing intergrouply and Friedman, Wilxocon test used for analyzing time-dependent intragroup changes and Bonferroni correction was used. Correlation analyzes for all the data and for each group were performed Spearmen's correlation test. A p<0.05 level was considered istatistically significant. Results: In all clinical periodontal indexes, significant time-dependent decreases occurred in both groups after NSPT. The decrease in GI, BOP and PD values at time T1 as well as PI and BOP values at time T2 created a significant difference in the fmNSPT-mel group(p<0,05). From biochemical data, MMP-8, RANKL and IL-1ß decreased in both groups, supporting the clinical data. The decrease in MMP-8 and RANKL values at T1 and the decrease in IL-1ß value at T2 created a significant difference at the fmNSPT-mel group(p<0,05). Although OPG findings decreased with time, there was no significant difference between the groups. Conclusion: In this study, it was observed that using melatonin, in addition to NSPT of periodontitis patients with increased periodontal destruction with diabetes, improved the treatment results compared to NSPT alone.