Melatonin in oral and maxillofacial surgery: a narrative literature review

Abstract

Objective: To describe, through a narrative review, the biological mechanisms of melatonin, analyze its clinical relevance in the surgical context, and integrate the available evidence regarding its use as an adjuvant in oral and maxillofacial surgery.

Methods: A search was conducted in PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials up to April 30, 2026, with no language restrictions. Original articles, clinical trials, quasi-experimental studies, and preclinical studies with translational relevance were included. Primary outcomes were postoperative pain and inflammation/edema; secondary outcomes included neurosensory recovery, perioperative anxiety, and bone regeneration and implantology parameters.

Results: Twenty-eight studies were included, covering third molar surgery, maxillofacial trauma, orthognathic surgery, dental implantology, and bone regeneration. Melatonin showed anxiolytic and analgesic effects in third molar surgery, with preservation of cognitive function compared to midazolam. In maxillofacial trauma and orthognathic surgery, more favorable neurosensory recovery and reduced oxidative stress were observed. In implantology and bone regeneration, studies with topical application reported greater periimplant bone gain, better implant stability, and reduced marginal bone loss in the first months of follow-up.

Discussion: Studies show significant heterogeneity in dosages, routes of administration, evaluated outcomes, and follow-up duration. Most have small sample sizes, which limits direct comparison between studies and the formulation of uniform clinical recommendations.

Conclusion: Available evidence suggests that melatonin is a promising perioperative adjuvant in oral and maxillofacial surgery.