Evaluation of the resection plane three-dimensional positional accuracy using a resection guide directional guidance slot; a randomized clinical trial.

AIM: The study was performed to compare the mandibular resection guide with a directional guidance slot with the conventional guide regarding three-dimensional positional accuracy. MATERIALS AND METHODS: Twenty-six patients with lateral segmental mandibular defects were selected, and randomly allocated into two groups. All defects were managed with preoperative virtual surgical planning. Resection in the test group was conducted using a resection guide with a directional guidance slot, while a conventional resection guide design was utilized in the control group. The linear and angular deviation of the osteotomy planes was analyzed for both groups, along with the accuracy of the insertion of the reconstruction bone block in the resected defect. Data were documented, absolute deviation was calculated, statistical analysis was performed and significance was set at the 5% level. RESULTS: The cases conducted with a directional guidance templet reported a statistically significant difference when compared to the conventional edge-cutting guide regarding the linear and angular spatial osteotomy plane position (P < 0.001). The defect span analysis reported excellent levels of agreement in both groups (ICC = 1.00, ICC = 0.995), however, the difference between the groups was statistically significant (P < 0.001). CONCLUSION: The study demonstrated the enhanced positional accuracy of the resection plane and reconstruction block placement when a directional slot is incorporated in the computer-generated resection guide.

Global scholarly output on orthodontic temporary anchorage devices (TADs): A silver jublee scientometric analysis.

OBJECTIVES: This study aimed to analyze the global scholarly production of articles related to temporary anchorage devices (TADs) from 1998-2023 in peer-reviewed dental journals indexed in the Web of Science. MATERIALS AND METHODS: A database of TADs-related articles was created via a Web of Sciences structured search. The bibliometric characteristics of the studies, including the number of citations, publication year, journal title, journal impact factor (IF), authorship, contributing institutions and countries, thematic field, and study design, were extracted. Keyword co-occurrence network analyses and the correlation between the number of citations and the article age, journal IF, and journal quartile of each article were performed. RESULTS: The top 50 cited articles were published from 1999-2016, and the total number of citations ranged from 82-602, with 160.36 citations/paper on average. Most of the articles originated from Japan (n = 12), with the most remarkable contributions from Nihon and Okayama Universities, Japan (n = 5, each). The American Journal of Orthodontics and Dentofacial Orthopedics had the most cited articles, with 196.57 citations/paper on average. A significant positive correlation occurred between the number of citations and publication age (rho = 0.392, P = 0.005). CONCLUSION: Our scientometric analysis reported the characteristics of TADs-related articles published over 25 years. Most highly-cited articles were published between 2005 and 2008. The positive correlation between articles' publication date and the number of citations might impact the top 50 within the next 5-10 years.

Evaluating free segmentation tools for CBCT-derived models: Cost-effective solutions.

OBJECTIVES: This study evaluated the segmentation accuracy and reliability of free software packages and compared them with commercial alternatives. MATERIAL AND METHODS: A total of 36 stone models were scanned using a desktop scanner and then imaged by cone beam computed tomography (CBCT). The CBCT volumes were segmented using 2 free software packages (3D Slicer and Blue Sky Plan) and 2 commercial software packages (Mimics and OnDemand3D). Stereolithography (STL) files generated by the desktop scanner were used as the control group (reference models). The accuracy of segmentation was evaluated by (1) comparing 6 linear measurements taken from each STL model generated by the 4 software packages with that obtained by the scanner, and (2) deviation analysis of each STL model generated by the 4 software packages with that obtained by the scanner. Absolute error and percentage error, repeated measures anova and Friedman test followed by post hoc analysis, intraclass correlation coefficient (ICC), and Pearson's r were used to evaluate the accuracy of the tested software packages. RESULTS: There was no statistically significant difference in all intra-arch measurements obtained using the four software packages. Measurements obtained using the free software packages and the scanner showed excellent positive correlation, ranging from 0.825 to 0.988, confirming equivalence with commercial software packages. CONCLUSION: Within the settings of the current study, accurate and time-saving segmentations with high positive correlation could be performed using the tested free segmentation software packages (3D Slicer and Blue Sky Plan). Nevertheless, further evaluation is necessary to gage their accuracy using different CBCT modalities.

Different wavelengths of laser: are they significant for treatment of denture stomatitis?: an in-vitro study.

BACKGROUND: Denture stomatitis (DS) is an inflammatory disorder that affects the mucosal surface underneath the dentures and frequently causes oral mucosal irritation, discomfort, and altered taste perception, which prevents people from consuming enough nutrients. One of the main causes of DS is an overgrowth of the fungus Candida albicans (C. albicans). A possible alternative treatment for Candida infections is thought to be laser therapy. The aim of this study was to evaluate how different wavelengths of laser would affect growth and pathogenic properties of Candida albicans. METHODS: A concentration of 106 viable cells/ml of Candida albicans were used in the preparation process. Four groups were created from the specimens. Culturing of the control group was completed with no intervention. The other 3 groups received laser radiation for 60 seconds at a power of 1W. The 2nd and 3rd groups were irradiated with diode laser at a wavelength of 940 nm and 980 nm respectively. The 4th group was irradiated with Nd-YAG laser at a wavelength of 1064 nm. Turbidimetric growth was defined as variations in the optical density of fungal growth. These measures were made at three different times: baseline, 48 hours, and 72 hours. RESULTS: In both groups of diode laser, the growth of Candida albicans showed no remarkable differences at baseline, after 48 and 72 hours using a power of 1 W and duration of 60 seconds. The Nd-YAG group showed significant increase in optical density after 48 hrs then significant decrease after 72 hrs. The optical density values in the control group showed no notable difference between the control and diode study groups at different time periods. However, the Nd:YAG group showed a statistically significant difference compared to the control and the 2 diode laser groups. CONCLUSIONS: Different laser parameters have a different effect on growth and pathogenic properties of Candida albicans. Diode laser therapy with wavelengths 940 and 980 nm used in continuous mode with power of 1 W for duration of 60 seconds can result in proliferation of Candida albicans instead of destroying them. Nd:YAG laser, used in pulsed mode, with power of 1 W for a duration of 60 seconds can be used to destroy Candida albicans and therefore, can be used as an effective treatment for denture stomatitis.

#clearaligners and social media: An in-depth analysis of clear aligners' content on Instagram.

BACKGROUND AND OBJECTIVES: Clear aligners-related posts are popularized on social media platforms to educate patients and peers and to market aligners in dental practices. This study aimed to characterize the account credentials and content of the top-performing posts to understand the spread of clear aligners-related information on Instagram. MATERIALS AND METHODS: This cross-sectional web-based study analysed 13 Instagram clear aligners-related hashtags. Content analysis was performed for the "Top 10 posts" listed under the "Top" section for each hashtag within Instagram, as sorted by Instagram's algorithm. Data were analysed for the poster's background, credentials, role, post format, content, and engagement level ratio. Duplicate posts and those not relevant to clear aligners were excluded. Quantitative and qualitative analyses of the collected data were conducted. RESULTS: A total of 29 192 596 posts mentioned the selected hashtags, of which 130 posts were screened in this study. Most posts were authored by dentists (n = 84), 79.8% of them were orthodontic specialists. Self-promotional posts comprised 90.2%, while educational posts accounted for only 8.9%. Interestingly, the number of likes and comments received on posts by patients (n = 19, median = 112, IQR = 340) was significantly higher than those posted by dentists (n = 84, median = 93, IQR = 81.75) (P = .004). CONCLUSION: More than 29 million posts about clear aligners were identified on Instagram. Orthodontists are the leading authors of aligners hashtags. However, the majority of the posts are self-promotional and have nonfactual information. Social media awareness among orthodontic specialists may help provide more evidence-based content about clear aligners and can act as an interactive networking and health communication platform.

Altering maternal calcium and phosphorus dietary intake induces persistent sex-specific changes in the dentition of the offspring.

BACKGROUND: The maternal diet is essential to offspring development, but the specific effects on tooth morphology are still unknown. The aim of this study was to evaluate the effects of altering maternal calcium (Ca) and phosphorus (P) supplementation during gestation and lactation on offspring dentition. METHODS: Pregnant mice were fed an experimental diet containing a threefold increase in Ca and a threefold decrease in P compared to the standard mouse chow diet at embryonic Day 0.5 (E0.5). Offspring mice were maintained on standard or experimental diets from post-natal Day 0 to weaning, then fed control diets until 6 weeks of age. Six-week-old offspring heads were collected and scanned using micro-computed tomography. Dental morphometrics of offspring maxillary and mandibular first and third molars (n = 5-6 per diet/per sex) were determined. A two-way ANOVA test was employed to verify the existence of any significant differences between groups. The significance level was set at P < .05. RESULTS: A two-way ANOVA revealed a statistically significant interaction between the effects of diet and sex on the upper and lower dentition. Moreover, experimental diet-fed female offspring exhibited smaller molars with shorter mesiodistal width and larger pulp chambers relative to controls, while experimental diet-fed male offspring possessed larger molars with wider mesiodistal width and smaller pulp chambers. CONCLUSION: Our findings reveal that altering the maternal and offspring dietary Ca:P ratio during gestation, lactation and weaning led to significant, sex-specific changes in the offspring dentition. The differences in dentition appeared to be correlated with the sex-specific changes in the craniofacial skeleton.

Erosive tooth wear and salivary parameters among competitive swimmers and non-swimmers in Egypt: a cross-sectional study.

INTRODUCTION: Competitive swimmers spend considerable time practicing their sport. Prolonged exposure to chlorinated water can alter salivary parameters and might compromise oral health. This study aimed to determine erosive tooth wear status and its related risk factors among competitive swimmers as compared to non-swimmers. MATERIALS AND METHODS: A cross-sectional study consisting of 180 athletes (90 competitive swimmers versus 90 competitive rowers "non-swimmers") was conducted. Participants were interviewed on the common erosion risk factors. The Basic Erosive Wear Examination system was used to assess the status of erosive tooth wear. Stimulated saliva sample was collected before and after a training session and pool pH was evaluated using pH strips for 7 days. Data were analyzed using descriptive statistics and multivariable analysis. RESULTS: The prevalence of dental erosion was significantly higher among competitive swimmers (60%) with higher BEWE scores compared to non-swimmers (25.6%). The salivary flow rate was reduced significantly after training sessions in both groups while salivary pH increased among swimmers. Evaluation of pool water revealed a continuous reduction in the pH level, reaching a very acidic pH level of 3.24. CONCLUSION: Erosive tooth wear is more prevalent among competitive swimmers. Years of practice and regular consumption of acidic drinks increase the odds of developing erosive lesions. A high incidence of erosive lesions may be attributed to a reduction in swimming pool pH level. Salivary parameters showed variations between groups after training sessions.

Articaine versus Lidocaine in only buccal infiltration anesthesia for the extraction of mandibular anterior teeth. A prospective split-mouth randomized-controlled clinical study.

OBJECTIVE: To investigate the effectiveness of a single labial infiltration of 4% articaine versus 2% lidocaine for the extraction of mandibular anterior teeth without an additional lingual injection. PATIENTS AND METHODS: A prospective, randomized-controlled, split-mouth clinical study was implemented. Healthy adult patients seeking bilateral extraction of mandibular anterior teeth were included in this study. Teeth extractions were randomly assigned to two equal groups, where one mandibular anterior tooth was extracted using a solitary labial infiltration of either 4% articaine (the study group) or 2% lidocaine (the control group). After 14 days, the other mandibular anterior tooth was extracted using the other local anesthetic agent. The selection of the anesthetic agent injected in the first session was done in a randomized fashion. After 5 min of local anesthetic injection, the tooth was extracted, and each patient was asked to record the intensity of the extraction pain using the Visual Analogue Scale (VAS). RESULTS: Thirty-one patients were included in the study. The efficacy of a single labial injection for mandibular anterior teeth extraction was established by the fact that none of the patients in the study or control group required re-administration of local anesthesia. The mean VAS for pain control during tooth extraction was 1.16 ± 0.93 for the articaine group and 1.71 ± 0.90 for the lidocaine group. The pain score showed a statistically significant decrease in the articaine group compared to that in the lidocaine group (P = 0.017). CONCLUSION: Although the anesthetic effects of only buccal infiltration of 4% articaine and 2% lidocaine for extraction of mandibular anterior teeth were comparable, the use of 4% articaine would have more effective and predictable outcomes. CLINICALTRIALS: ORG: (ID: NCT05223075) 3/2/2022.

Immediate Implant Placement in Intact Fresh Extraction Sockets Using Vestibular Socket Therapy Versus Partial Extraction Therapy in the Esthetic Zone: A Randomized Clinical Trial.

PURPOSE: This randomized clinical trial aimed to assess esthetic and soft and hard tissue outcomes 6 months after immediate implant placement using vestibular socket therapy (VST) (test) versus partial extraction therapy (comparator) in intact thin-walled fresh extraction sockets in the esthetic zone. MATERIALS AND METHODS: Twenty-four patients with hopeless maxillary anterior teeth requiring immediate implant placement were randomly assigned to two equal groups to receive either VST or partial extraction therapy. Definitive restorations were delivered after 3 months. Pink esthetic scores (PESs) and vertical soft tissue alterations in millimeters were measured 6 months after restoration using intraoral digital scans of the distal papilla, midfacial gingival margin, and mesial papilla. Facial bone thickness was measured using CBCT scans at baseline and after 6 months. Implant survival and peri-implant pocket depth were assessed. RESULTS: Both groups showed 100% implant survival after 6 months. The overall PESs after 6 months were 12.67 (± 1.3) in the VST group, while the partial extraction therapy group score was 13.17 (± 1.19), with no significant difference between them (P = .02). The mean (± SD) vertical soft tissue measurements for the VST group were 0.08 (± 0.55), 0.01 (± 0.73), and -0.03 (± 0.52) mm, and for the partial extraction therapy group, they were -0.24 (± 0.25) mm, -0.20 (± 0.10) mm, and -0.34 (± 0.13) mm for the mesial papilla, midfacial gingival margin, and distal papilla, respectively. No significant differences were observed between the groups at any of the reference points (P ± .05). Both techniques demonstrated a significant gain in millimeters of labial bone thickness after 6 months compared to baseline (P ± .05). Regarding VST, the apical, middle, and crestal mean bone gain was 1.68 (±± 2.73), 1.62 (±± 1.35), and 1.33 (±± 1.22) mm, respectively, while partial extraction therapy showed 0.58 (± 0.62), 1.27 (± 1.22), and 1.53 (± 1.24) mm, respectively, with no significant difference detected between them (P ≥ .05). Additionally, the mean (± SD) peri-implant pocket depth after 6 months for VST was 2.16 (± 0.44) and 2.08 (± 1.02) mm for partial extraction therapy with no significant difference between them (P = .79). CONCLUSION: This investigation suggests that both VST and partial extraction therapy preserved alveolar bone structure and peri-implant tissues following immediate implants. The novel VST might be considered a predictable alternative treatment approach for immediate implant placement in intact thin-walled fresh extraction sockets in the esthetic zone. Int J Oral Maxillofac Implants 2023;38:468-478. doi: 10.11607/jomi.9973.

Histologic and histomorphometric evaluation of Aloe vera adjunctive to ß-tricalcium phosphate in class II furcation defects in dogs.

Aloe vera has antimicrobial activity and enhances the osseointegration process, thus it may have the potential in treating periodontal defects. This study aimed to evaluate the effect of Aloe vera as an adjunction to Beta-tricalcium phosphate (ß-TCP) bone graft in Grade II furcation defects. A randomized study was conducted on six healthy mongrel dogs' premolars. A total of twenty-four Grade II furcation critical-sized defects were surgically created after reflecting a full-thickness flap, twelve defects were filled with ß-TCP while the other twelve defects were filled with Aloe vera mixed with ß-TCP and both covered by collagen membrane. Animals were euthanized at the end of the fourth and eighth week and defects were analyzed histologically and histomorphometrically. Histologically, Aloe vera mixed with ß-TCP resulted in more bone formation and new PDL fibers compared to ß-TCP alone. After 2 and 4 weeks, the experimental group had significantly higher newly formed interradicular bone height (p < 0.0001, and p < 0.0001, respectively), bone thickness (p < 0.0001, and p < 0.0001, respectively), and percentage of the surface area (p = 0.009, and p = 0.023, respectively). Aloe vera gel adjunctive to ß-TCP is an effective bioactive agent that enhances periodontal tissue regeneration and bone formation in critically sized defects.

Accuracy of virtual surgical planning in mandibular reconstruction: application of a standard and reliable postoperative evaluation methodology.

OBJECTIVE: The purpose of this study was to determine the accuracy of virtual surgical planning for mandibular reconstruction, along with the implementation of a postoperative evaluation methodology. MATERIALS AND METHODS: The study is a prospective case series for computer-assisted mandibular reconstruction surgery. Analysis of the degree of agreement between virtual measurements and postoperative actual outcomes was performed. The reliability of the proposed evaluation methodology was assessed and analyzed using the Inter-Class Coefficient (ICC) test. Statistical significance was set at the 5% level. RESULTS: Nine consecutive patients were selected. The analysis of all angular and linear parameters reported a highly statistically significant degree of agreement between the preoperative and postoperative measurements (P < 0.001). Furthermore, an extreme degree of reliability was reported when the evaluation methodology was scrutinized (ICC = 0.9). CONCLUSION: The excellent degree of agreement between the virtual plan and the actual outcome reported in this study validated the surgical accuracy of virtually assisted mandibular reconstruction. This study pointed out the reliability and reproducibility of the standardized evaluation protocol in an attempt to obtain a tolerable value for the acceptable postoperative results regarding the accuracy of computer-assisted surgery.

A novel atraumatic extraction technique using vestibular socket therapy for immediate implant placement: a randomized controlled clinical trial.

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.

Does Grafting the Jumping Gap in Immediately Placed Anterior Implants Using Vestibular Socket Therapy Influence the Labial Bone Thickness?

PURPOSE: There is no consensus in the literature on whether grafting the jumping gap (the distance between the inner surface of the labial bone plate and the implant surface) in immediately placed implants influences the thickness of the labial bone plate. This study aimed to compare the efficacy of particulate bone graft filling material and spontaneous bone healing following blood clot formation when placing immediate implants in the esthetic zone. METHODS: A double-blind randomized controlled clinical trial was conducted in a private practice on patients scheduled for immediate implant placement using the vestibular socket therapy between November and December 2019. Participants were assigned to 2 groups. In Group 1, the jumping gap was filled with a mixture of 75% autogenous bone chips and 25% deproteinized bovine bone mineral (DBBM). In Group 2, the gap was unfilled. The regenerated facial bone thickness was evaluated using CBCT. Measurements were taken at baseline before tooth extraction and 12 months postoperatively. The Mann Whitney U test was used for between group comparisons and Wilcoxon signed-rank test for within-group comparisons. RESULTS: Twenty-two patients (8 men and 14 women; mean age, 45.22 years) were randomly assigned to Group 1 or Group 2, with 11 patients each. A statistically significant difference in bone thickness was found between groups (P = .008). The mean (SD) overall bone thickness was 2.95 (0.97) mm for the particulate bone group compared to 1.45 (0.92) mm preoperatively. While, for the unfilled group, the mean (SD) overall bone thickness was 1.98 (0.56) mm compared to 0.79 (0.49) mm preoperatively. CONCLUSIONS: The results suggested that grafting the jumping gap with particulate bone graft when implementing the vestibular socket therapy enhanced the thickness of the labial bone plate of immediately placed implants in the esthetic zone.

Dental practice closure during the first wave of COVID-19 and associated professional, practice and structural determinants: a multi-country survey.

BACKGROUND: The coronavirus outbreak (COVID-19) in China has influenced every aspect of life worldwide. Given the unique characteristics of the dental setting, the risk of cross-infection between dental practitioners and patients is high in the absence of adequate protective measures, and dentists may develop severe anxiety in relation to the current pandemic. The limited provision of services and widespread closure of dental practices have raised concerns among dental professionals about the financial impact. The present study assessed the frequency of dental practice closure during the pandemic's first wave in several countries and whether closures and their associated factors differ between the private and non-private sectors. METHODS: An electronic cross-sectional survey questionnaire was sent to dentists in several countries, from April to May 2020. The survey assessed professional, practice related and country-level structural factors elucidating the reason for practice closure. Multilevel logistic regression was used to assess the association between practice closure and these factors, and differences were evaluated by sector type. RESULTS: Dentists from 29 countries (n = 3243) participated in this study. Most of the participants (75.9%) reported practice closure with significantly higher percentage in the private sector than the non-private sector. Greater pandemic-related fears were associated with a significantly higher likelihood of practice closure in the private (odds ratio [OR] = 1.54, 95% confidence interval [CI] 1.24, 1.92) and non-private (OR = 1.38, 95% CI 1.04, 1.82) sectors. Dentists in non-private rural areas (OR = 0.58, 95% CI 0.42, 0.81), and those in hospitals (overall OR = 0.60, 95% CI 0.36, 0.99) reported a low likelihood of closure. A high likelihood of closure was reported by dentists in the academia (OR = 2.13, 95% CI 1.23, 3.71). More hospital beds at the country-level were associated with a lower likelihood of closure in the non-private sector (OR = 0.65, 95% CI 0.46, 0.91). Private- sector dentists in high- income countries (HICs) reported fewer closures than those in non-HICs (OR = 0.55, 95% CI 0.15, 1.93). CONCLUSIONS: Most dentists reported practice closure because of COVID-19, and greater impacts were reported in the private sector than in the non-private sector. Closure was associated with professional, practice, and country-levels factors.

Dentist availability in Egypt: a 20-year study of supply, potential demand and economic factors.

BACKGROUND: Egypt is one of the most populated countries in the Eastern Mediterranean Region with historically large numbers of trained professionals providing services in and outside the country. Data about dentist availability are needed to plan for workforce production and training. AIMS: We assessed dentist availability in Egypt including (1) changes over 20 years; (2) spatial distribution; and (3) association with supply, potential demand for care and economic conditions. METHODS: In an ecological study (1995-2014), we used data from the Central Agency for Public Mobilization and Statistics. The outcome variable was dentist availability (dentists per 1000 population). The explanatory variables were: (1) population size; (2) number of dental graduates; (3) previous dentist availability; (4) increase in wages; and (5) percentage of population migrating internally seeking jobs. We assessed variation in availability using statistical process control and spatial autocorrelation. The impact of explanatory variables was assessed using general linear models with partial η2 to measure effect size. RESULTS: Dentists per 1000 population were randomly distributed over the country and the ratio reached 0.18 in 2014, indicating a shortage despite the increasing number of dental graduates since 1995 (667.1%). Previous dentist availability (η2 = 0.60) and increase in wages (η2 = 0.48) had the greatest impact on dentist availability. CONCLUSIONS: Egypt faces a problem of dentist shortage that has not been offset by the increase in dental graduates. Improving the economic conditions and incorporating health care into the national development plan may improve the situation.

Efficacy of Melatonin in prevention of radiation-induced oral mucositis: A randomized clinical trial.

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.