Abstract
Background: The aim of this systematic review and meta-analysis was to analyze the additive effects of the melatonin supplementation with nonsurgical periodontal therapy (NSPT) on periodontal status in patients affected by chronic periodontitis. Methods: In December 2020, We searched PubMed, EMBASE, Web of Science, CENTRAL databases and Google Scholar databases. Four RCTs were recruited with the same inclusion criteria. PD and CAL were the primary outcome measures. Subgroup analyses were performed according to health statuses and follow-up times, and Cochran’s Q and I-square ( I2 ) tests were used to assess heterogeneity.Results: This review included four RCTs. Four studies reported probing depth (PD) and 3 studies reported clinical attachment loss (CAL). Compared with the placebo groups, the melatonin groups showed a significant reduction in PD (weighted mean difference [WMD], -1.01; 95% confidence intervals [CI], -1.67 to -0.35; I2 = 76%) and CAL (WMD, -1.08; 95% CI: -1.36 to -0.79, I2 = 0%). Subgroup analyses revealed that the use of systemic melatonin + NSPT significantly reduced PD and CAL at the 2-, 3-, and 6-month follow-ups compared to NSPT alone, and stronger treatment effects of reducing PD were observed at shorter follow-ups than at longer follow-ups when adjunctive systemic melatonin was used.Conclusions: Melatonin supplementation in adjunct with nonsurgical periodontal therapy can moderately improve the efficacy of NSPT in reducing PD and greater CAL gain in patients with periodontitis. With the limited evidence available, it is evident that additional good quality RCTs are required to demonstrate additional beneficial effects of oral melatonin supplementation on periodontal clinical parameters after NSPT.