Melatonin as a Biologic Modulator in Periodontal Surgical Treatment: A Mini-Review

Periodontitis is a chronic, multifactorial inflammatory condition characterized by the progressive breakdown of tooth-supporting tissues. It is a major public health issue due to its high prevalence and consequences, including tooth loss, impaired oral function and aesthetics, increased healthcare costs, and negative effects on general health. In periodontitis, tissue breakdown is primarily driven by an exaggerated immune-inflammatory response to microbial dysbiosis, making host modulation a key therapeutic goal. Melatonin, an endogenous hormone with antioxidant, anti-inflammatory, and bone-enhancing properties, has recently gained attention as an adjunctive aid in periodontal therapy. This mini-review focuses on several clinical studies and systematic reviews that have reported favorable outcomes in periodontal parameters when melatonin is applied alongside non-surgical periodontal therapy. Despite these encouraging findings, there is currently a lack of clinical trials evaluating its role in surgical regenerative therapy used to manage intrabony defects, where the need for adjunctive agents remains significant. This mini-review summarizes the current understanding of melatonin’s mechanisms of action in periodontal tissues, highlights evidence from non-surgical applications, and underscores the gap in surgical research.