The Effect of Topical Melatonin Gel on the Oral Health and Salivary Nickel and Chromium Content of Orthodontic Patients: An In Vivo Study

Abstract

properties.It aids in the expression of MMPs, ROS, and growth factors and thereby inhibits invasion, endometriosis, and fibrosis. 8rimarily, melatonin has been shown to extensively reduce oxidative stress through various mechanisms.It is an active scavenger of exogenous and endogenous ROS and stimulates various antioxidative enzymes. 9Literature exists on the use of 1-2% melatonin in gel forms and in the form of oral supplementation in oral disease conditions, which has been shown to reduce the salivary levels of bone metabolism markers such as osteocalcin, osteopontin, acid phosphatase, and alkaline phosphatase and has found to increase the levels of osteoprotegerin (OPG) which contributes to positive bone turnover.It has also been reported to rescue the serum levels of interleukin (IL) 6 and C-reactive protein, IntroductIonThrough the course of orthodontic treatment, metal brackets, wires, and bands are exposed to varying intraoral conditions. 1 Changes in the oral temperature, humidity, fluctuations in pH, mechanical stresses, and quality of oral health are all factors that could possibly bring about deterioration in the quality of metal components and cause corrosion. 2ickel, chromium, cobalt, and titanium form the major constituents of orthodontic alloys.Corrosion occurs as a result of enzymatic, thermal, microbiological, chemical, and mechanical responses leading to ion release. 3Nickel is the most common metal ion to cause allergic reactions like contact dermatitis and discoloration.Orthodontic alloys have >50% of nickel content and thus may result in enough nickel leaching to cause potential allergies. 4Allergic reactions to chromium have also been reported.Apart from allergies, mutagenic changes, carcinogenesis, and cytotoxic effects have also been reported with ion leaching during orthodontic treatment. 5arious studies have reported on the salivary leaching of nickel and chromium ions in orthodontic patients in the past, posing as a potential cause of concern.Various attempts have been done to counter the leaching of metal ions during orthodontic treatment.One such method is the prescription of fresh herbal mouthwashes, as these herbal formulations mainly lack the presence of alcohol as a constituent and consist of natural antioxidants, which aid in decreased ion release. 6,7elatonin is secreted naturally by the pineal gland and has the primary function of regulating the circadian rhythm.It also possesses antioncotic, anti-inflammatory, and immunomodulatory 1,

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