Zirconia Inlay on Vital Teeth with Profunda Caries

Background: Dental caries has historically been considered the most critical component of the global burden of oral disease. Health facilities and dental health education counselling have been conducted, but public knowledge about dental caries is still low. The increasing number of dental caries is currently influenced by one of the factors of community behaviour. Most people do not realize the importance of taking care of oral and dental health. The ignorance of the community results in a decrease in productivity due to the influence of the perceived illness. Advances in dentistry since the last decade has allowed the use of conservative dental care. Modern restorative dentistry offers many methods for restoring teeth, both direct and indirect. The need for restoration of posterior teeth is related to aesthetic purposes and functional, biocompatibility and biomechanical aspects of the remaining tooth structure. Some materials that are widely used as tooth-coloured indirect restorations in posterior teeth are zirconia. Zirconia has its characteristics, especially in terms of functionality, such as mechanical strength, physical strength and aesthetics. Purpose: This study aims to determine the management of indirect restoration treatment using zirconia inlay on upper premolar. Case(s): A 46-yearold male patient complained that the filling of his upper left tooth was often loose and uncomfortable when used for eating because the food was stuck in it. The patient wants his teeth treated. The history of treatment on the tooth in question has been patched two times, but it often comes off partially. Case Management: From the examination that has been carried out, a clinical diagnosis of reversible pulpitis was established. The treatment plan that will be carried out is indirect pulpcapping using MTA and resin-modified glass ionomer cement as the base material. The planned restoration treatment is a fixed inlay restoration made of monolithic zirconia. Conclusion: Recently, zirconia has also been developed staining with improved translucency so that it becomes more aesthetic. Zirconia has a higher level of material resistance than otherrestorative materials such as composites. This is what makes zirconia the choice, especially for use as a framework for all-ceramic and partially-fixed crowns dental prosthesis.

Differences in Effectiveness of Antibacterial Power Between Cocoa Peel Extract (Theobroma cocoa L.) and Benzalkonium Chloride 0.1% Against Staphylococcus aureus (In Vitro)

Background: Staphylococcus aureus is a gram-positive bacteria play a role in the formation of dental biofilm which iscausing dental caries. During tooth preparation, to stop the growth of bacteria, a cavity cleaning agent is given using achemical, namely Benzalkonium Chloride (BAC) 0.1%, but BAC has disadvantages including allergic reactions, tolerantmicrobes, and resistance. Therefore, it is hoped that there will be herbal ingredients that can be used as an alternative.Cocoa peel extract has active compounds of tannins, flavonoids, alkaloids, terpenoids, and saponins which haveantibacterial concentration 6% according to safe concentrations. Purpose: To explain the difference in the effectivenessof the antibacterial power of 6% cocoa peel extract and 0.1% BAC against Staphylococcus aureus (in vitro). Methods:This study was a laboratory experimental in vitro with the posttest only control group design. Using the diffusion methodfor Staphylococcus aureus that divided into two parts, 6% cocoa peel extract and 0.1% BAC. Each petri dish was givendisc paper dripped with 0.01 ml of each test material, then incubated for two days and observed the diameter of theinhibition zone. Results: The average diameter of the inhibition zone formed in the 6% cacao peel extract was 11.5288mm and BAC 0.1% was 18.2925 mm against Staphylococcus aureus. Conclusion: There was a significant difference inthe effectiveness of antibacterial power (p <0.05) between 6% cacao peel extract (Theobroma cacao L.) and 0.1% BACagainst Staphylococcus aureus (In Vitro).

Photodynamic Therapy 405 nm Diode Laser as Antibacterial for Cavity and Root Canal Sterilization

Background: The goals of caries restoration and endodontic treatment are to repair and prevent the infection fromgetting worse and if possible, heal the damaged tissue. To achieve this goal, it is necessary to control the presence ofmicrobes in the cavity or root canals with chemo mechanics prior to filling or obturation of the root canals. Disinfectionmethods using disinfectants with effective bactericidal activity are mostly used at subtoxic levels and at concentrationswhere their toxicity is a significant factor. In addition, the disinfection method is considered unable to achieve thoroughcavity cleaning and causes secondary infection. A new method to provide better disinfection without cytotoxic effectshas recently been discovered using the photodynamic method of 405 nm diode laser therapy. Research continues and isprogressing with the existence of various factors that affect the effectiveness of the 405nm diode laser as an antibacterial.Purpose: To evaluate the results of research on photodynamic diode laser therapy with a wavelength of 405 nm as acombination antibacterial therapy in cavity and root canal sterilization techniques. Review(s): Literature study in the formof narrative review using libraries obtained through the PubMed and Google Scholar databases. The optimal bacterialmortality was influenced by the form factor of the target bacteria, the energy dose and duration of laser exposure, and thetype of photosensitizer used. Conclusion: The use of a 405 nm diode laser with an energy power of 50 mW with a distanceof 20 mm can degrade biofilms Streptococcus mutans up to 100% using erythrosine photosensitizer, for 75 seconds. Andwith the same power and distance, it can degrade the biofilm of bacteria Enterococcus fecalis up to 97.51%, using aphotosensitizer chlorophyll, for 120 seconds.

Comparison of ratios combination calcium hydroxide Ca(OH)2 with red pine (Pinus densiflora) of viscosity

Background: Calcium hydroxide is a gold standard for root canal sealing material. However, there are many defects in calcium hydroxide that have prompted many researchers to look for alternative materials, including natural origin ingredients. Red pine (Pinus densiflora) is often used in dentistry for its antioxidant and antibacterial properties. The mixture of calcium hydroxide and red pine has never been achieved before. One of the criteria for material sealing is that the channel should be fully sealed with high flow ability and low viscosity. Therefore, this research is performed to analyze the viscosity value of the mixture of calcium hydroxide and red pine (Pinus densiflora). Purpose: Knowing the difference in viscosity of the combination of calcium hydroxide and red pine with a ratio of 1:1, 1:1.5, and 1:2. Methods: This study used four treatment groups, with each group consisting of 8 replications. Group 1 was a combination of calcium hydroxide and red pine with a 1: 1, group 2 the ratio was 1: 1.5, group 3 had the ratio 1: 2, and the positive control group used calcium hydroxide and a sterile aquadest. Calcium hydroxide in powder form and an extract of red pine in liquid form are mixed according to the ratio. The viscosity value is measured using a viscosity tester, namely the Brookfield Viscometer. Results: The control group had a lower viscosity than group 3, group 3, and group 2 than group 1. Conclusion: Combination of calcium hydroxide and red pine with a ratio of 1:2, the lowest viscosity was obtained compared to the ratio of 1: 1 and 1: 1.5

The Difference of Antibacterial Power Between Cocoa Peel (Theobroma cacao) Extract 6% Compared to NaOCL 5% Againts Lactobacillus acidophilus

Background: Lactobacillus acidophilus is a gram-positive rod-shaped bacteria which mostly causes chronic caries lesions. In the process of cavity preparation it is reported that it is not possible to remove all microorganisms and even bacteria can survive even after removal of the necrotic tissue. Efforts to stop the growth of these bacteria are by chemical cavity cleanser using a 5% NaOCl, but this material have disadvantages including irritating periradicular tissue, unpleasant odor, and toxicity. Due to its disadvantages, it is hoped that natural ingredients can be used as alternatives. Cocoa peel extract has active compounds of tannins, flavonoids, alkaloids, terpenoids, and saponins which have antibacterial ability with a concentration of 6% according to the non-toxic minimum kill concentration of Lactobacillus acidophilus. Purpose: To analyze the difference in antibacterial power between the extract of cocoa bark with a concentration of 6% compared to 5% NaOCl against Lactobacillus acidophilus. Methods: This study was a laboratory experimental in vitro with a post test-only control group design. Using diffusion method against Lactobacillus acidophilus grown in tubes containing BHIB, then cultured in a petridish which contains a nutrient agar and is divided into 2 parts extract cocoa peel extract 6% and NaOCl 5%, then each petridish given a paper disc that has been poured 10μl by each material, then incubated inthe incubator for 2x24 hours at 37oC and observe the diameter of the inhibition zone formed using a caliper. Results: The average diameter of the inhibition zone formed in the 6% cocoa peel extract was 11.8375 mm and NaOCl 5% was 26.0344 mm against Lactobacillus acidophilus. Conclusion: There is a difference in antibacterial power between 6% cocoa peel extract and 5% NaOCl against Lactobacillus acidophilus.

The Difference of Antibacterial Power between Cocoa Peel (Theobroma Cacao L.) Extract 6% compared to Chlorhexidine Digluconate 2% Againts Streptococcus mutans (In vitro)

Background: Before restoration, it is necessary to clean the cavity from the smear layer and residual bacteria such as Sreptococcus mutans using a 'gold standard' cavity cleanser, namely 2% Chlorhexidine digluconate (CHX), however CHX 2% has a disadvantage of having a toxic effect on fibroblasts, osteoblasts, myoblasts, odontoblast-like cells, Chinese hamster ovary cells, and buccal epithelial cells. The shortcomings of the 2% CHX triggered researchers to look for alternative cavity cleansers that are more biocompatible, namely cocoa peel extract because it contains of antibacterial compounds including alkaloids, flavonoids, tannins, saponins, and terponoids with a non-toxic 6% concentration. Purpose: To analyze the difference of antibacterial activity between cocoa peel extract with a concentration of 6% compared to chlorhexidine digluconate 2% against Streptococcus mutans. Methods: This research was an in vitro laboratory experimental study with the posttest only control group design which included two treatment groups, namely 6% cocoa peel extract and 2% CHX. This research was conducted using the inhibition zone diffusion method against S. mutans to see the antibacterial power of each sample. Results: There was a significant difference (p <0.05) in the mean diameter of the inhibition zone between 6% cacao peel extract, namely 11.5406 mm and CHX 2%, namely 13.2156 mm. Conclusion: Chlorhexidine digluconate 2% has a greater antibacterial power than 6% cocoa peel extract (Theobroma cacao L.) against Streptococcus mutans.

Effectiveness of Sealer Combination Zinc Oxide (ZnO) with Red Pine (Pinus densiflora) on Viscosity and Solubility (Laboratory Experimental)

Background: Failure of endodontic treatment is caused by 60% of poor obturation. Sealers have an important role in the obturation process, that is filling the root canals and the space between the dentin and the core material. Sealers must have low viscosity so that they can flow easily and fill the entire root canal space so can form a good seal and have physical properties that are not easily soluble to oral fluids to prevent sealer degradation which can cause gaps during filling and become a medium for bacterial proliferation. Red pine extract is a natural ingredient that contain flavonoid and phenolic acid that are effective in reducing the viscosity and solubility of the sealer combination ZnO with red pine. Purpose: To determine the effectiveness of sealer combination ZnO with red pine in reducing viscosity and solubility. Methods: Red pine (Pinus densilora) extract with a concentration of 100% was diluted to a concentration of 0.78% using the dilution formula M1.VI = M2.V2. Viscosity test was done by mixing ZnO with red pine extract 0.78% 1: 1 and calcium hydroxide (Ca(OH)2) with 1: 1 sterile aquadest as a comparison, then each sample was measured for viscosity using a brookfield viscometer. The solubility test was carried out by placing the paste on a disc with a diameter of 15 mm x 3 mm and then being set and immersed in distilled water for 24 hours then the percentage of solubility was calculated. Results: The viscosity value of combination ZnO with red pine is 19.89 Pa.s and the solubility is 0.0075%, while Ca(OH)2 with sterile aquadest had a viscosity of 23.32 Pa.s and a solubility is 0.029%. Conclusion: The combination of ZnO with red pine is effective in reducing the viscosity and solubility of the combination sealer. The viscosity and solubility of the combined sealer is lower than Ca(OH)2 with sterile aquadest.

Comparison Adhesive strength of Resin Composite between Total-etch and Self-etch Techniques on Enamel After Fluoride Application

Background : White Spot Lesion (WSL) is caused by Streptococcus Mutan which causes demineralization of teeth. One of the treatments of WSL is topical application of fluoride which aims to remineralize the teeth. However, if topical fluoride treatment does not give satisfactory results, alternative treatments can be made using restorative treatments, one of which is veneers. The procedure for applying veneers requires the application of an adhesive system. The adhesive system used to apply veneers is self-etch and total-etch. Several references state that the application of fluoride which aims to remineralize teeth can influence the adhesiv strength of the restorative material using self etch and total-etch techniques. Purpose : To determine the effect of composite resin adhesion strength between total-etch and self etch techniques on enamel after fluoride application. Review : Literature sources used in the preparation of the article through several databases with descriptions of the effects of fluoride application before total-etch and/or self etch administration. From the existing references, it was found that the application of fluoride before the total-etch system had a less significant effect on the adhesiv strength. Whereas in the self etch system, fluoride application has a significant effect on the adhesiv strength. Conclusion : More references say that the application of fluoride before the total-etch system has a better adhesive strength than the application of fluoride before the self etch system

The Role of Propolis in Pulp Pain by Inhibiting Cyclooxygenase-2 Expression

Background: Inflammation of the pulp can lead to elicit pain. Pain in inflammation is induced by the cyclooxygenase-2 enzyme (COX-2) which induces prostaglandin E2 (PGE2) resulting in pain. Pain in the pulp can be relieved by eugenol. In its application, eugenol is toxic to pulp fibroblasts. Due to the side effect, it is worth considering other biocompatible materials with minimal side effects, such as propolis. Flavonoids and phenolic acids that contained in propolis can inhibit COX-2. Therefore, an analysis outlined in the literature review is needed to examine the results of research related to the role of propolis as pulp pain relief by inhibiting COX-2 expression. Purpose: To analyze the role of propolis in pulp pain by inhibiting COX-2 expression. Reviews: Propolis extract that extracted by ethanol, water, and hydroalcohol has pain relief properties in the pulp by inhibiting COX-2 by directly binding to the COX-2 receptors and by reducing the production of proinflammatory cytokines which are COX-2 inducers, proven through in vivo, in vitro, and in silico studies in various target cell organs. Conclusion: Propolis extract has high prospect as inflammatory pain inhibitor in the pulp by inhibit COX-2 expression.

BULKFILL TECHNIQUES WITH INTERMEDIATE LAYER TO MARGINAL ADAPTATION RESTORATION OF CLASS II COMPOSITE RESIN

Background: Dental caries is a hard tissue disease caused by bacterial metabolic activity that causes demineralization, teeth that have caries should be filled in order to function again. One of the restorative materials closer to natural teeth is composite resin because it is the same colour as natural teeth and is easy to shape. As for the placement technique, bulkfill is also used because it is more time-efficient, and irradiation is accompanied by applying the restoration material in one batch. However, the bulkfill technique often causes micro-leakage of dental caries deposition. The intermediate layer is an intermediate layer used to prevent micro-leakage at the edges of the restoration as a base layer for restoration to create a good adaptation before applying packable composite resin. Therefore, bulkfill coating technique with the intermediate layer can reduce the risk of microleakage. Purpose: To describe the bulkfill technique with an intermediate layer against marginal adaptation with class II composite resin restorations. Review: The literature sources used in the preparation of the articles through several databases with descriptions. More journals say that micro-leakage in class II cavity deposition with the intermediate layer technique is better than the bulkfill technique because the intermediate layer technique has better bond strength than the bulkfill technique. If the Bulkfill technique is modified with the Intermediate layer technique, it can show good correlation and internal adaptation. Conclusion: Bulkfill technique with an intermediate layer against marginal adaptation with class II composite resin restorations can reduce the microleakage rate by reducing the polymerization's shrinkage strain.