TNF and periodontitis: Overexpressed cytokines and chemokines (including IL-1, TNF, and MMPs), elevated ROS levels, a high receptor activator of nuclear factor kappa beta/osteoprotegerin ratio, and other factors contribute to inflammation.26 Periodontopathogen-induced infection elimination is important for minimizing inflammatory cytokine expression levels, managing reactive oxygen species levels in periodontal tissue, and reestablishing normal bone metabolism to regulate periodontitis and diminish tissue breakdown.27 Melatonin has a variety of biological properties that make it an effective periodontal therapy.28