Background: Large cyst-like periapical lesions are often managed initially with conventional nonsurgical root canal treatment. However, persistent clinical signs despite adequate disinfection and obturation may necessitate endodontic microsurgery. Careful case selection, advanced imaging, and modern microsurgical techniques are essential for predictable healing. Case Presentation: A 35-year-old male presented with pain, swelling, and a draining sinus tract in the maxillary right anterior region for one month, with a history of dental trauma ten years earlier. Clinical examination revealed tenderness to percussion, purulent discharge, and negative pulp sensibility responses in teeth 11 and 12, while tooth 13 exhibited an exaggerated lingering response suggestive of symptomatic irreversible pulpitis. Cone-beam computed tomography (CBCT) demonstrated a large cyst-like periapical lesion measuring 20.1 × 12.7 × 18.5 mm with buccal and palatal cortical plate perforation, extension to the nasal floor, and involvement of the nasopalatine canal. Conventional root canal treatment was performed for teeth 11, 12, and 13. Teeth 11 and 12 underwent sequential intracanal medication using calcium hydroxide and double antibiotic paste alternatively for 5 visits. Following successful canal drying and obturation, the persistent sinus tract and extensive osseous destruction warranted endodontic microsurgery. Apicoectomy and ultrasonic root-end preparation were performed under a dental operating microscope, followed by retrograde filling with Biodentine. The osseous defect was managed using sticky bone prepared with Osseograft® and injectable platelet-rich fibrin (i-PRF), covered with a platelet-rich fibrin (PRF) membrane. At six-month follow-up, the patient was asymptomatic, with resolution of the sinus tract and radiographic evidence of progressive periapical healing. Conclusion: This case demonstrates that endodontic microsurgery is a predictable treatment option for persistent large cyst-like periapical lesions following appropriate nonsurgical root canal treatment. Integration of CBCT-based diagnosis, microsurgical techniques, bioceramic root-end filling, and regenerative adjuncts may contribute to favorable clinical and radiographic outcomes in extensive periapical defects.

Background: Immature permanent teeth with pulpal necrosis and open apices are difficult to manage because of incomplete root development and the absence of an apical constriction. Case Presentation: A 29-year-old male with a history of trauma 20 years earlier presented with discolored, fractured maxillary central incisors. Clinical and radiographic findings confirmed pulpal necrosis with chronic apical abscess and open apices. Treatment comprised chemomechanical preparation, calcium hydroxide intracanal medication, MTA apexification, thermoplasticized gutta-percha obturation, internal bleaching, and porcelain laminate veneer rehabilitation. Conclusion: A multidisciplinary approach successfully restored periapical health, function, and esthetics with satisfactory one-year follow-up.

Florid cemento-osseous dysplasia (FCOD) is a benign fibro-osseous lesion that predominantly affects middle-aged women and may occasionally be associated with simple bone cysts (SBC), posing a diagnostic challenge. A 49-year-old female presented with a three-month history of dull pain in the lower right posterior region, radiating to the head, neck, and right shoulder. Clinical examination revealed mild cortical expansion, left submandibular lymphadenitis, and tenderness over the maxillary sinuses and cervical muscles. Radiographic evaluation demonstrated multiple radiolucent areas in the mandible associated with hypercementosis and sclerotic changes. Biochemical investigations, including serum calcium, phosphorus, alkaline phosphatase, and parathyroid hormone levels, were within normal limits. Histopathological examination confirmed the diagnosis of florid cemento-osseous dysplasia associated with a simple bone cyst. The coexistence of these lesions can result in atypical clinical and radiographic features, making accurate diagnosis challenging. This case highlights the importance of integrating clinical findings with radiographic, biochemical, and histopathological investigations for the diagnosis of complex fibro-osseous lesions of the jaws. A comprehensive and multidisciplinary diagnostic approach is essential for distinguishing FCOD associated with SBC from other mixed or radiolucent jaw lesions and for guiding appropriate patient management.

Objectives: This systematic review assessed the dentoskeletal effects of Twin Block (TB) and Invisalign clear aligners (CAs) with mandibular advancement features in peripubertal patients compared to Class II non-treated individuals, using lateral cephalography. Materials and Methods: In this modified systematic review, data were collected electronically by searching PubMed Central, Google Scholar, and Cochrane electronic databases. The outcome measures included SNA, SNB, ANB, Wits appraisal, SN^Gn, U1^PP, L1^MP, overbite, and overjet measured at the onset (T1) and at the end (T2) of functional appliance therapy. Results: Nine eligible papers were reviewed: 6 on TB and 4 on CAs (1 study included both appliances). Patients’ mean age ranged from 11.2 to 13.15 years for the intervention groups, and 10.7 to 13.07 years for non-treated controls. An improvement in sagittal intermaxillary relationships was observed, primarily at the mandibular level, when patients were treated at puberty. This was confirmed by an increase in the SNB angle and a corresponding reduction in the ANB angle between the pre- and post-treatment phases, in comparison to non-treated controls, slightly more pronounced with the TB. Mandibular advancement was associated with an increase in mandibular length (CoGn), significantly greater in both treatment modalities compared to non-treated controls. Conclusion: This systematic review showed that both appliances produce significant skeletal effects when applied during the pubertal growth phase, emphasizing mandibular protrusion and skeletal growth. The biological timing of intervention may be a critical factor in understanding the divergent findings reported in the literature.

Background: Periodontal health is a critical component of overall well-being, yet its importance often remains underexplored among future healthcare providers. This study aimed to assess the knowledge, awareness, and practices regarding periodontal health among undergraduate medical students in Puducherry. Methods: A descriptive, cross-sectional online survey was conducted among 660 undergraduate medical students (aged 18–25) at Sri Venkateshwara Medical College Hospital and Research Centre. Data were collected using a validated 25-item close-ended questionnaire covering knowledge, attitudes, and oral hygiene practices. Statistical analysis was performed using SPSS version 27. Results: While 94.7% of participants recognized that oral hygiene is mandatory for overall health, significant gaps in practice and specific knowledge were identified. Although 53.94% of respondents reported brushing twice daily, 49.09% utilized the less effective horizontal brushing technique. Usage of interdental cleaning aids was low, with only 8.64% reporting the use of dental floss. Furthermore, 58.94% of students had never visited a dentist in the past 12 months. Regarding disease progression, 36.36% were unaware that untreated periodontal disease could lead to tooth loss. Awareness of the link between oral health and systemic conditions, such as PCOS (61.21%) and medication-induced gingival enlargement (70.15%), showed room for improvement. Conclusion: Despite a general awareness of the importance of oral health, medical students exhibit significant gaps in evidence-based periodontal practices and preventive care. Integrating structured oral health education into the medical curriculum is essential to prepare future clinicians for holistic patient care.

Local halitosis affects a substantial proportion of adults and is predominantly of intraoral origin. Volatile sulfur compounds, principally hydrogen sulfide and methyl mercaptan, are generated by anaerobic bacteria acting on sulfur-containing amino acids within periodontal pockets and tongue biofilms. Periodontal disease, tongue coating, reduced salivary flow, carious lesions, and prosthetic factors are the main local contributors. This review provides dental clinicians with a concise, evidence-based overview of the etiological factors and their underlying mechanisms.

The research is among the serious health issues that can result in significant serious systemic illness like high blood pressure, diabetes mellitus type 2 and heart issues. Most of the obesity is attributed to a parson failing to acquire healthy life style i.e. eating unhealthy foods and failing to exercise periodically; this leads to highest levels of mortality among a parson. The objectives of the study are to determine a percentage of obesity among the students of the 5th year dentistry department in Al Hikma University College by selecting 30 cases of men and women in terms of systematic random table numbers based on the body mass index (BMI) as an indicator of obesity. This paper reveals five cases of males and four cases of female in each group of study which equate to 17 percent and13 percent respectively. Health education is therefore advisable to ensure that people acquire healthy life style to eliminate obesity and its complication.