Objectives Considering the prevalence of oral mucositis, we aimed to use the analgesic effects of doxepin with antimicrobial and bio-adhesive nature of chitosan to fabricate a nano-formulation for treatment of chemotherapy-induced oral mucositis. Materials and Method Nanogel was fabricated via ionic gelation and characterized. Sixty patients were randomly divided and received four different treatments for 14 days: diphenhydramine + aluminum-magnesium mouthwash (control), doxepin mouthwash (DOX MW), chitosan nanogel (CN), and doxepin/chitosan nanogel (CN + DOX). Lesions were assessed with four indices, national cancer institute (NCI), world health organization (WHO), and corld conference on clinical and research in nursing (WCCNR) and visual analogue scale (VAS) before and 3, 7, and 14 days after interventions. Kruskal Wallis test was used for pairwise comparison. Results CN had semisolid consistency, uniform spherical shape, an average size of 47.93 ± 21.69 nm and a zeta potential of + 1.02 ± 0.16 mV. Three days after intervention CN + DOX reduced WHO, WCCNR and VAS scores significantly more than control. Seven days after intervention CN + DOX reduced NCI and WCCNR significantly more than control; and it reduced WCCNR significantly more than CN. Fourteen days after intervention CN + DOX reduced NCI significantly more than control. Conclusion Chitosan-based doxepin nano-formulation might be a promising alternative for routine treatments of oral mucositis.

Objectives We aimed to assess the therapeutic effects of a topical probiotic nano-formulation derived from Lactobacillus reuteri on treating recurrent aphthous stomatitis. Materials and Methods 60 participants were randomly allocated into two groups (control and probiotic). Probiotic group administered topical probiotic nano-formulation three times a day for seven days. The control group administered a standard analgesic oral rinse. The size of ulcer(s) and pain severity were recorded on days 0, 3, 5, and 7 after intervention. Results Before the intervention, the groups had no significant differences in pain severity and lesion size. Both groups reduced pain severity and lesion size during the intervention. After one week, the probiotic group had a significantly larger lesion size reduction (7.41 ± 1.79 mm) than the control (5.94 ± 1.59 mm). The probiotic group also significantly reduced pain severity (6.54 ± 1.56 scores) than the control (5.82 ± 1.66 scores). Conclusions Applying topical probiotic nano-formulation derived from Lactobacillus reuteri three times a day decreased lesion size and pain severity in RAS patients faster than the local analgesic oral rinse. Clinical relevance : Lactobacillus reuteri-derived probiotic nano-formulation might be a promising treatment option for RAS.

Odontogenic myxoma (OM) is a rare benign painless, slow-growing lesion with local aggressive behavior. Pain and sensory disturbance and fibro-osseous appearance in histopathology have been rarely reported in OM. The authors reported a 52-year-old male case presented with a large gingival mass around a mobile mandibular right first molar extended to the distal aspect of the third molar. Microscopic examination of the incisional and excisional biopsy revealed an OM with numerous newly formed bone or cementum-like material present throughout the specimen like those seen in fibro-osseous lesions. For avoiding to recurrence, a segmental mandibulectomy was performed and a metal plate was inserted to the right mandible defect under general anesthesia. Rehabilitation was completed with the placement of implants. We review and discuss about this variety.