Combination of melatonin with Hyaluronic acid for socket Preservation following extraction Of posterior teeth – A randomized controlled trial

Abstract

Background and Methodology: Tooth extraction often leads to significant alveolar bone loss, particularly within the first year due to natural remodeling processes. Up to 50% of buccolingual width can be lost, complicating prosthetic rehabilitation. Hyaluronic acid (HA) and melatonin have emerged as promising biomaterials for socket preservation, enhancing soft tissue healing and minimizing complications like dry socket. HA promotes angiogenesis and osteoblast activity, while melatonin reduces oxidative stress and inflammation, supporting osteogenesis. Earlier fewer studies suggested their synergistic potential for improving clinical outcomes, but randomized controlled trials are needed to evaluate their efficacy in posterior extraction sockets. The primary objective was to evaluate the anti-inflammatory effect of Melatonin with Hyaluronic acid on post-operative pain through Visual Analog Scale (VAS). Secondary objectives were to evaluate patient’s satisfaction towards postoperative pain control, postoperative supplemental analgesic rescue use (time and dose), wound healing potential and osteogenic potential of the combination. This was a split mouth single-blind randomized controlled trial carried out in the department of Oral and maxillofacial surgery, KLE VK Dental College, Belagavi from December 2023 to October 2024. 25 patients requiring bilateral extraction of either maxillary or mandibular premolars and molars were included. The study samples were divided into two extraction sites – wherein for the study site, post-extraction an Absorbable Gelatin sponge (AGS) soaked in Mixture of Melatonin and Hyaluronic acid was viii placed in the socket followed by routine closure. In control site post-extraction, the sockets were left for spontaneous healing. The follow up was done at 3rd day, 5th day, 7th day and 4 months post operatively.