Objectives Evaluating the effectiveness of melatonin in prevention of radiation‐induced oral mucositis. Material and methods A randomized controlled clinical study was conducted on forty head and neck cancer (HNC) patients undergoing radiotherapy at the Department of Clinical Oncology, Alexandria University, Egypt. Patients were assigned equally to either control group who received conventional treatment or test group who received 20 mg of melatonin along with the conventional treatment. All patients were clinically evaluated for oral mucositis severity and pain at three and six weeks after the start of radiotherapy. Additionally, the total antioxidant capacity (TAC) in patients’ saliva samples was assessed at the start of radiotherapy and six weeks later. Results 92.5% of all patients have experienced oral mucositis with more severity reported in the control group (30%) compared with the test group (5%). Mean pain scores decreased significantly, in the second assessment, in test group rather than the controls. TAC values showed a significant difference between the test and controls with a significant decrease in TAC in the control group. Conclusion The administration of melatonin with conventional treatment has reduced severe oral mucositis development. It aided in decreasing pain and hindering the reduction of TAC resulting from radiotherapy among the test group compared with controls.

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Purpose This randomized controlled clinical trial compared soft tissue changes following a novel vestibular atraumatic extraction technique (test group) versus the conventional incisal atraumatic extraction approach (control group) while implementing the vestibular socket therapy for immediate implant placement. Methods Thirty patients with hopeless maxillary anterior teeth requiring atraumatic extraction were randomly assigned into two equal groups to receive either test or control. Vertical soft tissue alterations in mm were measured at baseline and 12 months post-restoration using intraoral digital scans at three reference points, distal papilla, mid-facial gingival margin, and mesial papilla, as well as pink esthetic scores (PESs) after 12 months. Results Vestibular extraction technique showed significant soft tissue improvement and creeping when compared to incisal extraction (P < 0.05). The test group showed soft tissue measurements with a mean (± SD) of 0.26 (± 0.58), 0.39 (± 0.64), and 0.05 (± 0.37) mm for the mesial papilla, mid-facial gingival margin, and distal papilla respectively. While the incisal extraction technique demonstrated gingival recession at the distal papilla, mid-facial gingival margin, and mesial papilla of − 0.37 (± 0.54) mm, − 0.32 (± 0.68) mm, and − 0.39 (± 0.59) mm respectively. The overall PESs after 12 months were 12.67 (± 1.59) in vestibular extraction group, while incisal extraction group was 11.40 (± 1.40), with significant difference between them (P = 0.03). Conclusion This investigation suggests that both studied techniques were successful in the atraumatic extraction of hopeless severely damaged teeth. The novel vestibular extraction technique might be considered an alternative reliable atraumatic extraction approach compared to the conventional incisal extraction when performing the vestibular socket protocol for immediate implant placement with soft tissue enhancement.

Background: Oral lichen planus is one of the most prevalent oral diseases. Matrix metalloproteinases have been implicated in its pathogenesis thus this study was executed to evaluate the effectiveness of matrix metalloproteinases neutralizing agents in the treatment of oral lichen planus. Methods: Patients were assigned to either control group who received topical corticosteroids and antifungal treatment, or test group who received matrix metalloproteinases neutralizing spray. All patients were evaluated for disease severity and pain at baseline, 1 week, and 4 weeks after treatment. Results: The mean pain score in test and control groups was 9.00 (0.89), and 9.33 (0.82), respectively, at baseline while it was 2.33 (1.75) and 2.83 (1.72) at 4th week follow up. The mean disease severity score was 4.33 (0.52) for test group and 4.50 (0.55) for control group at baseline and decreased to 1.83 (0.75) and 2.17 (0.98) at 4th week follow up. Despite the better results seen in test group on the expense of control group, no statistically significant differences could be detected between groups at any timepoint. Conclusion: The use of matrix metalloproteinases neutralizing agents might be an equally effective sole treatment for erosive oral lichen planus compared to the conventional treatment, without the risk of secondary candidiasis. Trial registration: The study was registered retrospectively at ClinicalTrials.gov (NCT04336488), date (07/04/2020)