Clinical and Radiographic Evaluation of Immediate Loaded Dental Implants With Local Application of Melatonin: A Preliminary Randomized Controlled Clinical Trial
Immediate loading of dental implants in situations where low bone density exist, such as the posterior maxillary region, became possible recently after the introduction of biomimetic agents. This 1-year preliminary clinical trial was carried out to clinically and radiographically evaluate immediate-loaded 1-piece implants with local application of melatonin in the osteotomy site as a biomimetic material. 14 patients with missing maxillary premolars were randomized to receive 14 implants of 1-piece type that were subjected to immediate loading after 2 weeks of initial placement. Group I included 7 implants with acid-etched surface while group II included 7 implants with acid-etched surface combined with local application of melatonin gel at the osteotomy site. Patients were recalled for follow up at 1, 3, 6, and 12 months after loading. All implants were considered successful after 12 months of follow-up. Significant difference (P < 0.05) was found between both groups at 1 month of implant loading when considering the implant stability. At 1 and 3 months there were significant differences in the marginal bone level between the 2 groups. These results suggest that the local application of melatonin at the osteotomy site is associated with good stability and minimal bone resorption. However, more studies for longer follow-up periods are required to confirm the effect of melatonin hormone on osseointegration of dental implants.

Series of photographs for one-piece implant placement with local application of melatonin gel and follow-up of digital standard periapical radiographs. (a) Preoperative panoramic radiograph. (b) A photograph shows a raised flap at the implant premolar site. (c–f) shows the implant placement and local melatonin application. (g) Immediate post insertion radiograph. (h) Photograph shows final prosthetic restoration in place and in occlusion, 2 weeks after initial implant placement. (i–l) Periapical radiographs show levels of marginal bone loss around the implant after 3, 6, and 12 months, respectively.

Series of photographs for one-piece implant placement without local melatonin application and follow-up of digital standard periapical radiographs. (a) and (b) A perioperative photograph and flap reflection. (c–h) Photographs show the steps of implant placement. (i) and (j) Photograph and a radiograph show the implant in place after initial placement. (k) A photograph shows final prosthetic restoration in place and in occlusion, 2 weeks after initial implant placement. (l–o) Periapical radiographs show levels of marginal bone loss around the implant after 3, 6, and 12 months, respectively.

The pink esthetic score for study and control groups.
Contributor Notes