Background and Objective Melatonin is synthesized naturally by pineal gland and responsible for regulation of sleep/waking cycle. It showed appreciated anti‐inflammatory and antioxidant properties. The aim of this randomized clinical trial (RCT) was to assess the additive effect of melatonin supplementation in insomniac individuals with generalized chronic periodontitis (gCP) after scaling and root planing (SRP). Material and Methods Seventy‐four gCP patients with primary insomnia participated in this 6‐month RCT and randomized into two groups. Melatonin group included 38 patients who were subjected to SRP with a 2‐month regimen of 10 mg oral melatonin capsule once daily before bedtime. In the control group, SRP was performed for 36 participants provided with matching placebo capsules. The primary treatment outcome was the measurement of clinical attachment level gain (CAL gain) after 3 and 6 months of therapy, whereas the measurements of pocket depth reduction (PD reduction), bleeding on probing (BOP %), and the changes in salivary TNF‐α levels and Athens insomnia scale (AIS) scores represented the secondary endpoints. Results Melatonin group showed significantly greater CAL gain and PD reduction measurements compared to the control group at 3 and 6 months of therapy, P < 0.01. Likewise, salivary TNF‐α levels and AIS scores were significantly lower in the melatonin group compared to placebo group. BOP% improved significantly in both groups without any difference. However, salivary TNF‐α levels exhibited no correlation with other clinical variables in both melatonin and placebo groups. Conclusion Daily dietary 10 mg of melatonin supplementation might serve as a viable adjunct to SRP that yielded significantly greater CAL gain and PD reduction and lower salivary TNF‐α levels and AIS scores in gCP patients with primary insomnia.

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Recent investigations have demonstrated the positive therapeutic effects of omega-3 polyunsaturated fatty acids (PUFAs) on several chronic inflammatory diseases such as rheumatoid arthritis, chronic inflammatory bowel diseases and periodontitis. The objective of the present study was to evaluate the impact of omega-3 PUFAs in conjunction with initial periodontal therapy (IPT) on periodontal clinical parameters and salivary markers in patients with chronic periodontitis. Thirty four systemically healthy individuals with advanced chronic periodontitis were enrolled and randomly assigned into two groups. The control group (IPT, n=17) was treated with IPT alone whereas the test group (IPT+omega-3, n=17) was treated with IPT and daily dietary supplementation of omega-3 PUFAs (in the form of 2 grams of fish oil capsules per day)for three months. Clinical parameters were recorded at baseline and 3 months following therapy for both groups. Saliva samples were collected at the same time points and analyzed for visfatin and tumor necrosis factor-α (TNF-α). After 3 months, clinical periodontal parameters of advanced chronic periodontitis were significantly improved in both groups. The omega-3 group showed significant greater pocket depth (PD) reduction and clinical attachment (CAL) gain compared to the control group after therapy. Salivary TNF-α levels showed a statistically significant decrease in the omega-3 group at 3 months compared to the control group. Salivary visfatin levels were reduced significantly at 3 months in both groups without any significant variation. It was concluded that dietary supplementation with omega-3 PUFAs could be a potential viable adjunct to IPT that significantly improves all periodontal parameters and reduces salivary visfatin and TNF-α levels in advanced chronic periodontitis. Interestingly, salivary visfatin could be a useful periodontal biomarker to monitor responses to periodontal therapy.

Aim: This study aimed to assess the validity of CBCT in the detection of VRF and its orientation in human extracted teeth and to analyze the effect of gutta-percha (GP) endodontic obturation. Finally, to compare different CBCT voxel sizes in VRF diagnosis in both GP obuturated and nonobturated teeth. Materials and Methods: Sixty human teeth were divided into: group I included 30 endodontically treated and GP obturated teeth, group II include 30 endodontically treated but not obturated teeth. Then, VRFs were mechanically induced in all teeth and the teeth were scanned with i-CAT CBCT machine with different voxel sizes of 0.125, 0.2, 0.25 mm. Then, the teeth were inspected by stereomicroscope to confirm the presence of fracture and to detect the orientation of the fractures to act as the gold standard. Result: Different CBCT voxel sizes of 0.125, 0.2 & 0.25mm were found to have the same validity in the VRF diagnosis with 100% sensitivity, 96.4% accuracy and 50% specificity. There was no significant difference between GP obturated and non obturated groups. VRFs occurred mostly in the bucco-lingual direction. Conclusions: VRF detection and its orientation can be accurately assessed by different CBCT voxel sizes imaging, thus using CBCT 0.25 voxel with less radiation dose is preferred. The presence of GP did not hinder the VRF orientation.

Background: Aloe vera (AV) gels with different concentrations are available in the market. In this study, we evaluate the efficacy of AV gel with two different concentrations in the treatment of oral lichen planus (OLP) compared with placebo. Materials and Methods: A total of 21 females suffering from the clinical signs and symptoms of OLP were grouped into Group (I) patients receiving AV gel divided into two subgroups, subgroup (A) received AV 70% concentration (7 patients) and subgroup)B) received AV 90% concentration (7 patients) and Group (II) control group received placebo (7 patients).Results: There was no statistically significant difference between ulcer sizes at all points of follow-up in Egyptian and Australian AV compared to placebo. The degree of change was higher in Egyptian than Australian AV regarding size, erythema, reticulation, and total area of lesion. However, there was no statistically significant difference between two types of treatment as regards all measured parameters (P > 0.05). Conclusions: AV gel whether Egyptian or Australian is statistically significantly more effective than placebo in inducing marked improvement clinically of OLP. Therefore, AV gel can be considered a safe alternative treatment for patients with OLP. Clinical Significance: AV gel can be considered a safe alternative treatment for patients with OLP.