Effect of local melatonin application on immediately placed implants in maxillary premolars (a biochemical and radiographic randomized controlled clinical trial)

Melatonin, a potent antioxidant and bone-regulating hormone, promotes osteoblastic activity and inhibits osteoclastic differentiation primarily through upregulation of osteoprotegerin (OPG) and suppression of the receptor activator of nuclear factor-kappa B ligand (RANKL) pathway. Given its dual osteogenic and antiresorptive effects, melatonin may enhance bone remodelling around immediately placed implants. This study aimed to evaluate the effect of locally applied melatonin on peri-implant bone remodelling by assessing changes in OPG levels and radiographic bone parameters over time.

Twenty-four patients with non-restorable maxillary premolars were divided into two groups. The melatonin group received immediately placed implants with local melatonin application, and the control group received immediately placed implants without melatonin application. Serum OPG levels were measured one and three months postoperatively, and cone-beam computed tomography (CBCT) was performed immediately after implant placement and at six months postoperatively to assess relative bone density, bone volume, and marginal bone loss.