Managing perimucositis and peri-implantitis with melatonin: A new approach

Melatonin (n-acetyl-5-methoxytryptamine) is a substance secreted by multiple organs including the pineal gland, retina, bone marrow, the gastrointestinal track, and the immune system. Its main function is the regulation of the circadian rhythm (day–night cycles). It plays an anti-inflammatory, antioncotic, and immunomodulatory role by scavenging free-radicals and through interactions with cell membrane and intracellular proteins. Melatonin is capable of entering the oral cavity by diffusing into the saliva from blood. As the majority of the melatonin remains bound to serum albumin, the amount of melatonin in saliva is approximately one-third of that present in the blood. The existence of MT1 receptors on healthy and cancerous oral mucosal cells is suggestive that melatonin may act as an anti-inflammatory or antioncotic agent in the oral cavity; for example, its anti-inflammatory effects have been reported on human gingival fibroblasts. Furthermore, intraperitoneal melatonin has been reported to reduce periodontitis in diabetic rats. Similarly, topical application of melatonin in diabetic patients has diminished the progression of periodontal bone loss as evident by the downregulation of pro-inflammatory factors. Hence, it has been suggested that melatonin may be used in the management of perimucositis and peri-implantitis in the field of dental implants. The aim of this review is to critically analyze and summarize the research focusing on the potential of melatonin in the fields of oral implantology.