Background: Oral diseases affect over 3.5 billion people globally, with children in low- and middle-income countries disproportionately impacted. This study aimed to evaluate the effectiveness of an oral health curriculum in reducing dental caries increment and improving oral hygiene behavior among high school students in the Ernakulam district of Kerala, India. Methods: A cluster-randomized, parallel-group trial was conducted in six English-medium high schools in Ernakulam, Kerala, India, involving 1707 students aged 13–15 years. Schools were assigned to receive an oral health curriculum delivered either by a dental professional or a trained schoolteacher. The “Everlasting Smiles” curriculum was implemented over 24 months through six sessions with periodic reinforcement, covering key oral health topics. Outcomes assessed at baseline, 12, and 24 months included the primary outcome (decayed, missing, and filled teeth [DMFT]) and secondary outcomes (oral hygiene index simplified [OHI-S] and oral health-related knowledge, attitude, and behavior scores). Results: Significant improvements in oral health-related knowledge (mean: 8.03–8.76), attitude (2.77–3.23), and behavior (2.38–2.64) scores over 24 months (P < 0.001), postintervention. Dental caries levels decreased, with DMFT reducing from 1.65 to 1.47 (P = 0.011) and DMFS from 2.01 to 1.81 (P = 0.018). Dentist-led interventions consistently showed greater improvements than teacher-led ones. Oral hygiene scores improved substantially, with OHI-S declining from 1.06 to 0.74 (P < 0.001). Conclusions: A structured school-based oral health curriculum significantly reduces dental caries and improves oral hygiene behaviors. Integrating it into schools provides a scalable, cost-effective way to promote lifelong oral health and lasting public health benefits. Trial registration number: Clinical Trial Registry of India (CTRI/2022/09/045410), registered on September 12, 2022.
Predictable root coverage in gingival recession requires stable flap positioning and controlled coronal advancement. Conventional suturing techniques, while effective, exhibit certain shortcomings. This case report presents the trivector traction suturing technique to enhance flap stabilization and coronal advancement. Two systemically healthy females with multiple RT1, RT2, and RT3 recession defects underwent minimally invasive tunneling with xenogenic volume–stable collagen matrix. A three-point anchorage system combining interdental modified vertical mattress and buccal horizontal mattress sutures embedded in composite stops was used. Sutures were retained for 21 days. In case 1, complete root coverage (CRC) was achieved by 3 months. In case 2, CRC was observed at 6 months. Outcomes remained stable at 12 months, with increased gingival thickness and resolution of hypersensitivity. Within the limitations of this two-case report, the technique demonstrated sustained coronal stability and favorable 12-month outcomes. Controlled trials are required to validate reproducibility and effectiveness.
Localized gingival enlargement (epulis) demonstrates variable recurrence rates, yet the clinical significance of recurrence timing has received limited attention. Regrowth may occur gradually due to persistent irritation or more rapidly when residual periodontal ligament or periosteal tissue remains after excision. A 74-year-old female with systemic comorbidities presented with fibrous epulis in the lower left anterior region. Histopathological examination following initial periodontal therapy and gingivectomy confirmed the diagnosis. The lesion recurred at the same site within 4 months. Management was modified to include open flap debridement with thorough curettage and repeat excision, after which no recurrence was observed during 1 year of follow-up. Early relapse may reflect persistence of the residual lesion rather than irritation-related regrowth. This case suggests recurrence timing may assist clinicians in considering the extent of surgical management and potentially reduce repeated interventions, particularly in geriatric patients.
Rehabilitation of maxillofacial defects following oncological surgery remains a clinical challenge. Patients undergoing extensive ablative procedures often present with complex intraoral and extraoral defects that severely compromise function, esthetics, and quality of life. This case report describes the prosthetic rehabilitation of a 61-year-old male patient with a combined intraoral and extraoral defect secondary to surgical resection and radiotherapy for carcinoma of the right buccal mucosa. The patient was rehabilitated with a maxillary obturator prosthesis and a silicone extraoral facial prosthesis. A mechanical retention system was employed by fabricating a slot in the obturator and a corresponding mechanical plug in the silicone prosthesis, enabling functional retention, esthetics, and improved patient comfort. This report discusses the clinical approach, challenges faced, and the resultant impact on the patient’s quality of life.
Objectives: This study aimed to compare the clinical and radiographic effects of EndoSeal mineral trioxide aggregate (MTA) and MTA for pulpotomy of primary teeth. Materials and Methods: This split-mouth randomized clinical trial evaluated 45 pairs of bilateral asymptomatic severely carious primary molars requiring pulpotomy in children between 3 and 8 years. The teeth in each patient were randomly assigned to two groups to undergo pulpotomy with MTA and EndoSeal MTA (n = 45 in each group). After application of the pulpotomy agent on the radicular pulp tissue, the pulp chamber was filled with zinc oxide eugenol, and the tooth was restored with a stainless-steel crown. The teeth were clinically and radiographically assessed after 3 and 6 months using the Zurn and Seale modified scale. Data were analyzed using the Wilcoxon signed-rank test and a generalized estimating equation model. Results: Both groups demonstrated a 100% clinical success rate at 3 and 6 months. Radiographic success rates were 95.6% (3 months) and 93.3% (6 months) for the MTA group, and 93.3% (3 months) and 91.1% (6 months) for the EndoSeal MTA group. The difference in radiographic success was not statistically significant (P = 0.631). Conclusion: Within the limitations of this study, EndoSeal MTA demonstrated comparable clinical and radiographic success to MTA for pulpotomy of primary molars, suggesting it may be a suitable alternative material.
