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Objectives: The objective of this single-use, five-treatment, five-period, cross-over randomized controlled trial (RCT) was to compare the efficacy in dental plaque removal of a new Y-shaped automatic electric toothbrush (Y-brush) compared to a U-shaped automatic electric toothbrush (U-brush), a manual toothbrushing procedure (for 45 and 120 s), and no brushing (negative control). Materials and methods: Eligible participants were volunteer students randomized to the treatments in the five periods of the study. The primary outcome measure was the reduction in full-mouth plaque score (FMPS) after brushing while the secondary outcome variable was a visual analogic scale (VAS) on subjective clean mouth sensation. Mixed models were performed for difference in FMPS and VAS. Results: After brushing procedures, manual toothbrushing (120 s) showed a statistically significant reduction in FMPS than Y-brush (difference 36.9; 95%CI 29.6 to 44.1, p < 0.0001), U-brush (difference 42.3; 95%CI 35.1 to 49.6, p < 0.0001), manual brushing (45 s) (difference 13.8; 95%CI 6.5 to 21.1, p < 0.0001), and No brushing (difference 46.6; 95%CI 39.3 to 53.9, p < 0.0001). Y-brush was significantly more effective than No brushing (difference 9.8; 95%CI 2.5 to 17.0, p = 0.0030), while there was no significant difference compared to U- brush. Similar results were obtained for the differences in the Clean Mouth VAS. Conclusions: Y-brush was significantly more effective than no brushing (negative control) in removing dental plaque. When compared to manual toothbrushing for both 45 and 120 s, however, Y-brush was less effective in dental plaque removal. Clinical relevance: Modified design of automatic toothbrushing devices could improve plaque reduction, especially in patients with intellectual disabilities or motor difficulties. [ABSTRACT FROM AUTHOR]

Objectives: Root-end filling is important for the clinical outcome of endodontic microsurgery. Our previous study showed that combined application of iRoot BP Plus Root Repair Material (BP-RRM) and iRoot SP Injectable Root Canal Sealer (SP-RCS) in root-end filling exhibited better apical sealing as compared to the application of BP-RRM alone. The aim of this randomized controlled clinical trial was to evaluate the effect of the combined use of BP-RRM and SP-RCS on the prognosis of teeth with refractory periapical diseases after endodontic microsurgery. Materials and methods: 240 teeth with refractory periapical diseases scheduled for endodontic microsurgery were randomly divided into BP-RRM/SP-RCS group (n = 120) and BP-RRM group (n = 120). The patients were followed up at 3 months, 6 months, and 12 months after endodontic microsurgery. Pre- and post-operative clinical and radiographic examinations were performed to evaluate the treatment outcome. The 1-year success rate of endodontic microsurgery in BP-RRM/SP-RCS and BP-RRM groups was compared by Chi-square test. Factors that might impact the prognosis were further analyzed using Chi-square test or Fisher's exact test. Results: A total of 221 teeth completed the 12-month follow-up. The 1-year success rates of the BP-RRM/SP-RCS and BP-RRM groups were 94.5% (104/110) and 92.8% (103/111), respectively. The combined use of BP-RRM and SP-RCS achieved a clinical outcome comparable to BP-RRM alone (P = 0.784). Tooth type (P = 0.002), through-and-through/apico-marginal lesion (P = 0.049), periodontal status (P < 0.0001), and Kim’s lesion classification (P < 0.0001) were critical factors associated with the 1-year success of endodontic microsurgery. Conclusions: The combined use of BP-RRM and SP-RCS is a practicable method for root-end filling in endodontic microsurgery with a satisfactory 1-year clinical outcome. Clinical relevance: The combined application of BP-RRM and SP-RCS in EMS is an effective root-end filling method with a satisfactory 1-year clinical outcome. Trial registration: This study was registered in the Chinese Clinical Trial Registry (ChiCTR2100052174). [ABSTRACT FROM AUTHOR]

Objective: To evaluate the clinical relevance of using the XP-endo Finisher as a supplementary tool to improve the success of root canal treatment of posterior teeth with apical periodontitis, as assessed by 1-year follow-up. Methods: A randomized clinical trial was conducted with 92 posterior teeth with apical periodontitis. Root canal treatment was performed using a single reciprocating file, with or without the supplementary use of the XP-endo Finisher. The status of apical periodontitis was assessed using the periapical index (PAI) at baseline and 1 year follow-up. Changes on PAI indicated that the lesions were healed, healing, or not healed. Successful treatments were defined as healed or healing lesions without clinical symptoms. Chi-square analysis and logistic regression were used for data analysis (α = 0.05). Results: There was no significant difference in the distribution of healing status between the XP-endo Finisher group and the control group (p = 0.690). The success rates were also similar, with 81% in the XP-endo Finisher group and 78% in the control group. However, gender had a significant impact on success rates, with higher rates observed in females. Conclusions: The use of the XP-endo Finisher file as a supplementary tool did not affect the success rate of root canal treatment in posterior teeth with apical periodontitis. The findings indicate that the XP-endo Finisher file has limited clinical relevance in improving treatment outcomes for root canal treatment in posterior teeth with apical periodontitis. Clinical trial registration: The study protocol was registered in the Brazilian Clinical Trials Registry under identification number RBR-76w7cj (June 19, 2018). [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the short-term efficacy of low-concentration betamethasone mouthwash for severe erosive oral lichen planus (EOLP). Materials and method: In this randomized, investigator-blind, positive-controlled trial, OLP patients with erosive lesions received betamethasone mouthwash (0.137 mg/mL) or dexamethasone mouthwash (0.181 mg/mL) three times daily for 2 or 4 weeks and were followed up for 3 months to observe recurrence. The primary outcome was the week-2 reduction in erosive area. Results: Fifty-seven participants were randomized to betamethasone (n = 29) and dexamethasone (n = 28). At week 2, participants using betamethasone (n = 28) experienced a greater reduction in erosive area than gargling with dexamethasone (n = 26). Similarly, secondary outcomes, including the healing proportion of erosions, reduced pain level, reduction in atrophic area, Thongprasom score, and recurrence interval, showed the superiority of betamethasone. At week 4, betamethasone (n = 7) was not superior to dexamethasone (n = 15) in further reducing lesional area and pain level. No serious adverse events were documented. Conclusions: The 0.137 mg/mL compound betamethasone mouthwash exhibited significant efficacy in rapidly enhancing erosion healing within 2 weeks and extending the recurrence interval with a good safety profile. Clinical relevance: This study proved the significant efficacy of short-course 0.137 mg/mL betamethasone mouthwash therapy for treating erosion and pain, providing a novel topical agent for patients with severe EOLP. Trial registration: This study was prospectively registered at the International Clinical Trials Registry Platform (ChiCTR1800016507) on 5 June 2018. [ABSTRACT FROM AUTHOR]

Objective: The aim of this double-blind, randomized trial was to evaluate the influence of the occlusogingival distance (OGD) in noncarious cervical lesions (NCCLs) on the clinical performance of a regular bulk-fill resin composite and a regular nanofilled resin composite. Materials and methods: One hundred and forty NCCLs in 77 participants were randomly divided into four groups (n = 35), according to OGD (1.5 mm ± 10% or 3 mm ± 10%) and resin composites (Filtek Bulk Fill Posterior [B] or Filtek Z350 XT [C]), namely: 1.5 mm-B, 1.5 mm-C, 3 mm-B, and 3 mm-C. The restorations were bonded using a two-step self-etch adhesive (Clearfil SE Bond), applied following the manufacturer's instructions. Restorations were polished 1 week after placement. Two experienced and calibrated examiners evaluated the restorations using modified US Public Health Service criteria at baseline (7 days) and after 6, 12, 18, 24, and 30 months. Statistical analyses were carried out using Kruskal–Wallis, Friedman's repeated measures analysis of variance, and the Wilcoxon signed rank test (α = 0.05). Results: After 30 months, the recall rate was 94.2%. Eight restorations were lost (3 for 1.5 mm-C, 2 for 1.5 mm-B, 1 for 3 mm-C, and 2 for 3 mm-B). All groups resulted in a significantly worse marginal discoloration and surface texture at 30 months in comparison with the baseline (1 week). No significant difference was found for the other parameters. Conclusion: The restorations performed with both resin composites produced clinically acceptable restorations. The OGD of NCCLs did not influence the clinical performance of restorations. Clinical significance: The OGD of NCCLs did not have a significant effect on the clinical performance of a regular bulk-fill and nanofilled restorations. Both materials showed a very good performance on 30-month evaluation. [ABSTRACT FROM AUTHOR]

Objective: This study evaluated the effect of the supplementary use of the XP-endo Finisher on postoperative endodontic pain. Methods: This study was a randomized clinical trial with a parallel design. Ninety-two posterior teeth with necrotic pulps and apical periodontitis were instrumented with a single file (Reciproc) in a reciprocating movement followed or not (control) by additional instrumentation with XP-endo Finisher. Postoperative pain was assessed 24 h, 48 h, 72 h, and 7 days after the endodontic treatment (single session) using a universal pain assessment tool. The pain level was scored as absent, mild, moderate, or severe. The occurrence of sealer extrusion and flare-up was also recorded. Data on postoperative pain were analyzed through chi-square analysis, and the odds ratio was adjusted using a logistic regression model (α = 0.05). Results: Similar levels and risks of postoperative pain were observed for both interventions, regardless of the assessment time. Approximately half of the participants presented any postoperative pain in the first 24 h after the endodontic treatment, and this occurrence reduced by less than 20% after 72 h. The extrusion of root filling material was observed in 36% of cases, and no participant presented flared-up. Conclusions: The supplementary use of the XP-endo Finisher file did not affect the incidence or level of postoperative pain reported after the endodontic treatment of posterior teeth with periapical lesions. Clinical relevance: The supplementary use of the XP-endo Finisher did not affect postoperative pain following the endodontic treatment of posterior teeth using a single-file reciprocating system. Clinical trial registration: The study protocol was registered in the Brazilian Clinical Trials Registry under identification number RBR-76w7cj (June 19, 2018). [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study is to evaluate the longevity of two fiber post cementation strategies in a prospective, multicenter, non-inferiority, double-blind randomized controlled trial. Methods: A total of 152 teeth, with adequate endodontic treatment and loss of coronal structure and bilateral simultaneous posterior occlusal contacts, were randomly allocated to receive glass fiber posts cemented with a conventional cementation strategy (CRC group: adhesive system + resin cement) (Adper Single Bond + RelyX ARC; 3 M-ESPE) or a self-adhesive cementation strategy (SRC group: self-adhesive resin cement; RelyX U100/U200; 3 M-ESPE). The patients were recalled annually for clinical and radiographical evaluation with a 93% recall rate (142 teeth, with 74 at CR groups and 68 at SRC group). The primary outcome was survival rate, considering the fiber post debonding (loss of retention). The secondary outcome included the success rate of the prosthetic treatment with crown debonding, post fracture, and tooth loss (not related to post failure). Both outcomes were evaluated annually. The Kaplan–Meier method and Cox regression with 95% confidence interval were used for the statistical analysis. Results: For the primary outcome (failures directly related to fiber posts cementation strategy), there were 4 fiber post debondings (2 per group), 8 root fractures (3 for SRC group and 5 for CRC group), and one mixed failure (debonding combined with root fracture for CRC), with both strategies presenting similar survival rates (p = 0.331), with 88.9% for the CRC group and 90.9% for the SRC group. For the secondary outcome (failures not related to fiber post cementation strategies), there were 8 crown debondings, 3 post fractures, and 3 tooth losses, with no statistically difference between groups (p = 0.701), with 77% for SRC and 82% for CRC. Conclusion: Fiber post cementation strategies with conventional or self-adhesive resin cement presents similar tooth survival and success rates. Trial registration: NCT01461239 Clinical relevance: Both adhesive cementation strategies led to high survival and success rates and are indicated for fiber post cementation, even after a long follow-up period (up to 106 months). [ABSTRACT FROM AUTHOR]

Objectives: To assess the clinical efficacy of xenogeneic collagen matrix (XCM) plus apically positioned flap (APF) in augmenting the keratinized mucosa (KM) width (KMW) and thickness (KMT) around posterior mandibular implants and compare it with free gingival graft (FGG) plus APF. Material and methods: Thirty patients with KMW ≤ 2 mm in the posterior mandibular implant site were randomly allocated to the FGG group (FGG plus APF) or the XCM group (XCM plus APF). Clinical assessments, including KMW and KMT, shrinkage rate of established KM, and peri-implant soft tissue health, were evaluated during a 6-month follow-up. Additionally, the esthetic outcomes and patient-reported postoperative morbidity were investigated. Results: At 6 months, the KMW measured 3.60 ± 0.79 mm in the FGG group and 3.28 ± 0.96 mm in the XCM group (p = 0.186). Both groups showed a tendency for graft contraction (FGG, 42.11%; XCM, 53.22%). The KMT measured 1.24 ± 0.34 mm in the FGG group and 0.95 ± 0.29 mm in the XCM group, with statistical difference (p = 0.002). No difference in the peri-implant soft tissue health was observed between the two groups (p > 0.05), but the esthetic outcomes were better in the XCM group (p < 0.05). Conclusions: XCM plus APF rendered a similar clinical efficacy in augmenting KMW as that with FGG plus APF, but with higher shrinkage. XCM plus APF was inferior with respect to FGG plus APF in augmenting KMT. The esthetic outcomes were better with XCM plus APF than FGG plus APF. Clinical relevance XCM plus APF graft was inferior with respect to FGG plus APF in augmenting KMT. Trial registration: Trial registration number: ChiCTR2200058027 and date: 03/27/2022. [ABSTRACT FROM AUTHOR]

Objectives: Stability values of mini-implants (MIs) are ambiguous. Survival data for MIs as supplementary abutments in reduced dentitions are not available. The aim of this explorative research was to estimate the 3-year stability and survival of strategic MIs after immediate and delayed loading by existing removable partial dentures (RPDs). Material and methods: In a university and three dental practices, patients with unfavorable tooth distributions received supplementary MIs with diameters of 1.8, 2.1, and 2.4 mm. The participants were randomly allocated to group A (if the insertion torque ≥ 35 Ncm: immediate loading by housings; otherwise, immediate loading by RPD soft relining was performed) or delayed loading group B. Periotest values (PTVs) and resonance frequency analysis (RFA) values were longitudinally compared using mixed models. Results: A total of 112 maxillary and 120 mandibular MIs were placed under 79 RPDs (31 maxillae). The 1st and 3rd quartile of the PTVs ranged between 1.7 and 7.8, and the RFA values ranged between 30 and 46 with nonrelevant group differences. The 3-year survival rates were 92% in group A versus 95% in group B and 99% in the mandible (one failure) versus 87% in the maxilla (eleven failures among four participants). Conclusions: Within the limitations of explorative analyses, there were no relevant differences between immediate and delayed loading regarding survival or stability of strategic MIs. Clinical relevance: The stability values for MIs are lower than for conventional implants. The MI failure rate in the maxilla is higher than in the mandible with cluster failure participants. Clinical trial registration: German Clinical Trials Register (Deutsches Register Klinischer Studien, DRKS-ID: DRKS00007589, www.germanctr.de), January 15, 2015. [ABSTRACT FROM AUTHOR]

Background: The current study's aim was to evaluate and compare demineralized freeze-dried bone allograft (DFDBA) with and without concentrated growth factor (CGF) membrane in the treatment of periodontal intrabony defects on both a clinical and radiographic level. Methods: 30 stage III grade B periodontitis patients with bilateral intrabony defects were involved in the split mouth randomized controlled trial, and they received either DFDBA alone (control group) or DFDBA plus CGF membrane treatment (test group). At baseline and 6 and 12 months, the gingival index (GI), plaque index (PI), probing pocket depth (PPD), clinical attachment level (CAL), and gingival recession (GR) were assessed, whereas cone beam computed tomography was used to assess the bone defect height (BDH), vertical bone loss (VBL), bone defect depth (BDD), mesio-distal bone defect width (MDBDW), bucco-lingual bone defect width (BLBDW), and bone defect volume (CBCT) at baseline and 12 months. Results: The radiographic measures BDH, BDD, MDBDW, BLBDW, and BDV in the test group likewise showed a higher reduction in PPD and gain in CAL than the control group. The results of the intergroup comparison showed that the test group had statistically significant differences in BDH, BDD, and MDBDW. Conclusion: The data show that the test group achieved better results, with greater reductions in PPD, gains in CAL, and decreases in BDH, BDD, MDBDW, BLBDW, and BDV. Clinical relevance: The use of concentrated growth factor in conjunction with demineralized freeze-dried bone allograft may be suggested for the treatment of periodontal intrabony defects. [ABSTRACT FROM AUTHOR]

Background: Unsightly opaque white impaired enamel may ruin a great aesthetic orthodontic outcome. This study aims to evaluate effectiveness of Clinpro Tooth Crème (0.21% w/w NaF anti-caries dentifrice with 950 ppm fluoride and f-TCP) and MI Varnish with RECALDENT™ (CPP-ACP) for treatment of white spot lesions (WSLs). Materials and methods: This was a randomized (1:1:1), single-blind, 3-armed, active-controlled, parallel-group trial. The study comprised three groups of 35 patients randomly assigned in blocks of 3 or 6 to one of the three following arms of the study- Group I: Clinpro™ Tooth Crème 0.21% Sodium Fluoride Anti-Cavity Paste with functional–Tri Calcium Phosphate(f-TCP) group. Group II: Fluoride varnish group (MI Varnish with RECALDENT™). Group III: Home-care group (control). For the subjective assessment, a blinded panel of 4 dental experts rated the improvement in WSLs over the eight weeks using a visual analog scale (VAS). Results: In total, 240 WSLs were identified, with maxillary lateral incisors and canines showing the highest incidence. Group I achieved the highest success rate of 67.61 (%) followed by group II (60.59%). There were no significant differences between the success rates of treatment in groups I and II. A minimum decline in WSLs was found in the control group, with a success rate of only 32.43%, significantly less than the first two groups (P <.001). Conclusion: Both the test agents in consideration were comparable in their remineralization potential. Clinpro Tooth Crème provides additional protection against decalcification of enamel compared to MI Varnish with RECALDENT™ (CPP-ACP). Trial/project registration no. and date: 4857/2017 on 21 June 2017. [ABSTRACT FROM AUTHOR]

Aim: The current randomized controlled trial assessed for the first time the effect of a low-speed platelet-rich fibrin (PRF) with open flap debridement (OFD) versus OFD alone in the treatment of periodontal intra-osseous defects of stage-III periodontitis patients. Methods: Twenty-two periodontitis patients with ≥ 6 mm probing depth (PD) and ≥ 3 mm intra-osseous defects were randomized into test (PRF + OFD; n = 11) and control (OFD; n = 11) groups. Clinical attachment level (CAL)–gain (primary outcome), PD-reduction, gingival recession depth (GRD), full-mouth bleeding scores (FMBS), full-mouth plaque scores (FMPS), radiographic linear defect depth (RLDD), and radiographic bone fill (secondary-outcomes) were examined over 9 months post-surgically. Results: Low-speed PRF + OFD and OFD demonstrated significant intra-group CAL-gain and PD- and RLDD-reduction at 3, 6, and 9 months (p < 0.01). Low-speed PRF + OFD exhibited a significant CAL-gain of 3.36 ± 1.12 mm at 6 months (2.36 ± 0.81 mm for the control group; p < 0.05), and a significantly greater PD-reduction of 3.36 ± 1.12 mm at 3 months, of 3.64 ± 1.12 mm at 6 months and of 3.73 ± 1.19 mm at 9 months (2.00 ± 0.89 mm, 2.09 ± 1.04 mm, and 2.18 ± 1.17 mm in the control group respectively; p < 0.05). No significant differences were notable regarding GRD, FMPS, FMBS, RLDD, or bone fill between both groups (p > 0.05). Conclusions: Within the current clinical trial's limitations, the use of low-speed PRF in conjunction with OFD improved CAL and PD post-surgically, and could provide a cost-effective modality to augment surgical periodontal therapy of intra-osseous defects of stage-III periodontitis patients. Clinical relevance: Low-speed PRF could provide a cost-effective modality to improve clinical attachment gain and periodontal probing depth reduction with open flap debridement approaches. [ABSTRACT FROM AUTHOR]

Objectives: To investigate whether an educational intervention could improve antibiotic prescribing among Lebanese dentists and assess antibiotic prescribing patterns regarding international guidelines. Materials and methods: An interventional randomized controlled trial was conducted from the first of April to the end of August 2017. This was an oral presentation of about 20 min based on a review of the literature and the international guidelines. Sixty dentists specializing in oral dental surgery or general practitioners participated in this study. All the patients who took a consultation over 2 months were involved. Results: In this study, 950 antibiotic prescriptions were analyzed. A change was found only in antibiotics prescribed for tooth extraction and tooth extraction (impacted tooth). The intervention was impactful in raising the mean percentage of prescriptions compliant with indication and with the choice regarding antibiotics prescribed for prophylactic reasons. A dentist in the intervention group would have after the intervention period a mean percentage of prescriptions compliant with indication and with choice of 31.7% and 20.7%, respectively, above one in the control group. Despite the decrease in the overall number of antibiotics prescribed by dentists in the intervention group over time, this does not suggest that this was solely due to the effect of the intervention. Conclusion: This study highlights the importance of continuing medical education to optimize antibiotic use in dentistry. Clinical relevance: This study can serve as the basis for a future audit, training, and feedback intervention to increase dentists' awareness of recommended guidelines and optimal antibiotic use. [ABSTRACT FROM AUTHOR]

Objectives: Minimally invasive flap designs have been introduced to enhance blood clot stability and support wound healing. Limited data appear to suggest, that in intrabony defects, better clinical outcomes can be achieved by means of minimally invasive flap compared to more extended flaps. The aim of this study was to evaluate the healing of intrabony defects treated with either minimally invasive surgical flaps or with modified or simplified papilla preservation techniques in conjunction with the application of an enamel matrix derivative (EMD). Materials and methods: Forty-seven subjects were randomly assigned to either test (N = 23) or control (N = 24) procedures. In the test group, the intrabony defects were accessed by means of either minimally invasive surgical technique (MIST) or modified minimally invasive surgical technique (M-MIST) according to the defect localization while the defects in the control group were treated with either the modified or simplified papilla preservation (MPP) or the simplified papilla preservation technique (SPP). EMD was used as regenerative material in all defects. The following clinical parameters were recorded at baseline and after 12 months: full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), probing depths (PD), clinical attachment level (CAL), and gingival recession (GR). Early healing index (EHI) score was assessed in both groups 1 week following the surgery. CAL gain was set as primary outcome. Results: After 12 months follow-up, the CAL gain was 4.09 ± 1.68 mm in test group and 3.79 ± 1.67 mm in control group, while the PD reduction was 4.52 ± 1.34 mm and 4.04 ± 1.62 mm for test and control sites. In both groups, a minimal GR increase (0.35 ± 1.11 mm and 0.25 ± 1.03 mm) was noted. No residual PDs ≥ 6 mm were recorded in both groups. CAL gains of 4–5 mm were achieved in 30.4% and in 29.2% of test and control group, respectively. Moreover, CAL gains ≥ 6 mm were recorded in 21.7% of experimental sites and in 20.8% of control sites. No statistically significant differences in any of the evaluated parameters were found between the test and control procedures (P > 0.05). After 1 week post-surgery, a statistically significant difference (P < 0.05) between the groups was found in terms of EHI score. Conclusions: Within the limits of this pilot RCT, the results have failed to show any differences in the measured parameters following treatment of intrabony defects with EMD, irrespective of the employed surgical technique. Clinical relevance: In intrabony defects, the application of EMD in conjunction with either MIST/M-MIST or M-PPT/SPPT resulted in substantial clinical improvements. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to investigate the effectiveness of motivational interviewing (MI) in changing health behaviors (snack and toothbrushing) and preventing dental caries among adolescents. Methods: Five hundred and twelve adolescents with unfavorable caries-related behaviors ("snacking three times or more a day" and/or "toothbrushing less often than twice a day") were randomly assigned to three groups. Group I received prevailing health education (oral health talks and pamphlets). Participants in group II joined a one-on-one face-to-face MI session. In group III, a patient communication tool (Cariogram) was incorporated to facilitate the MI process. At baseline and 24 months post-intervention, a self-administered questionnaire gathered information of participants' sociodemographic characteristics and oral health self-efficacy and behaviors. Their oral hygiene and tooth status were assessed by a blinded examiner. Results: After 24 months, 460 (89.8%) participants were followed up. Compared with group I, (i) restriction of frequent snacking was more likely in group II [OR (95% CI): 3.91 (1.48–10.33)] and group III [OR (95% CI): 6.33 (2.46–16.27)], whereas group III tended to adopt the behavior of toothbrushing twice a day [OR (95% CI): 4.80 (1.79–12.85)]; (ii) no significant between-group difference in plaque score reduction was found (p > 0.05); and (iii) groups II and III developed fewer cavitated teeth (△DICDASII 3-6MFT) [β (95% CI): − 0.19 (− 0.37, − 0.01) and − 0.20 (− 0.38, − 0.02), respectively], whereas increment of total carious lesions (△DICDASII 1-6MFT) was lower in group III [β (95% CI): − 0.63 (− 1.24, − 0.02)]. Conclusion: MI outperformed prevailing health education in improving oral health behaviors and preventing dental caries among adolescents. Clinical relevance: Incorporating MI into dental care for caries-prone adolescents contributes to optimal health outcomes. Trial registration: HKUCTR-1852 (http://www.hkuctr.com/) (Hong Kong, 2013) [ABSTRACT FROM AUTHOR]