Evaluation of the Efficacy of Topically Applied Melatonin Gel as Adjunctive Therapy in Chronic Periodontitis; Randomized Control Trail

Aim: This study was conducted to assess the benefit of locally delivered melatonin gel as adjunctive to scaling and root planning (SRP) in the treatment of chronic periodontitis. Subjects and Methods: Forty chronic periodontitis selected patients ,divided into two groups. Group I: included 20 chronic periodontitis patients, treated by conventional periodontal therapy SRP combined with intra- pocket application of Melatonin gel once weekly for 1 month begin application at the second week after initial therapy. Group II: included 20 chronic periodontitis patients, treated by SRP combined with the injection of placebo, weekly for one month. The periodontal parameters were recorded at baseline, 1week, 1and 3 months.Gingival crevicular fluid (GCF) samples were collected and a quantitative measurement of receptor activator nuclear K ligand (RANKL) was carried out by using Enzyme-Linked Immunosorbent Assay (ELISA) at baseline, 1week, 1 and 3 months. Results: We found noticeable significant reduction in all clinical parameter and in the amount of GCF RANKL in group I in all evaluation period at 1 ,3-month over group II. Conclusion: The results proved the benefit of Melatonin as a promising adjunctive therapy in improving periodontal parameters. However, further long-term studies with large sample size are needed

研究目的：本研究旨在评估局部递送的褪黑素凝胶作为龈下刮治及根面平整术（scaling and root planning，SRP）的辅助治疗手段，用于慢性牙周炎的治疗获益。研究对象与方法：选取40例慢性牙周炎患者，分为两组。第一组共20例慢性牙周炎患者，接受常规牙周治疗SRP联合龈袋内涂抹褪黑素凝胶，于初始治疗后第二周开始给药，每周1次，持续1个月。第二组共20例慢性牙周炎患者，接受SRP联合安慰剂注射给药，每周1次，持续1个月。分别于基线、1周、1个月及3个月时记录牙周各项临床参数。收集龈沟液（gingival crevicular fluid，GCF）样本，采用酶联免疫吸附测定（Enzyme-Linked Immunosorbent Assay，ELISA）在基线、1周、1个月及3个月时对核因子κB受体活化因子配体（receptor activator nuclear K ligand，RANKL）进行定量检测。研究结果：相较于第二组，第一组在1个月及3个月的所有评估周期中，各项临床参数及龈沟液中RANKL含量均出现显著降低。研究结论：本研究结果证实褪黑素作为辅助治疗手段可有效改善牙周参数，具有良好的应用前景。不过仍需开展大样本量的长期后续研究以进一步验证其效果。