Scientific Dental Journal

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Background: A chronic apical abscess is defined as an inflammatory response to pulp infection and necrosis. It is identified by a step-wise onset, almost no discomfort, and the discontinuous release of pus through a related sinus tract. Radiographically, there are regular indications of bone destruction, such as radiolucency. The source of the infection in the root canal should be eradicated by root canal treatment. The main purpose of endodontic treatment is the finished debridement of the pulp tissue from the canal combined with the shaping and sufficient obstruction of the root canal system. This case report was written to show the proper management of a tooth with a chronic apical abscess and to reveal self-bone regeneration after treatment. Case Report: A 27-year-old woman complained of a cavity on her left lower back tooth, and she wanted it to be filled. There was a history of a fistula that appeared frequently in the gums near the decayed tooth. The radiographic examination showed that the caries had reached the pulp, along with a periapical lesion and bone destruction. The canals were prepared using a file instrument and irrigation with 5.25% sodium hypochlorite, 17% ethylenediaminetetraacetic acid, and 2% chlorhexidine gluconate. Calcium hydroxide paste was used as an intracanal medicament, and the canals were obturated using a continuous wave compaction technique. At the 4-month follow-up, healing of the periapical lesion and bone regeneration was evident. Conclusion: Adequate root canal treatment can result in the healing of periapical lesions and bone regeneration in chronic apical abscesses.

Background: Fractured instruments, especially endodontic files, are a common problem in daily practice. A broken file causes a canal blockage that impedes the cleaning and shaping process. Therefore, an attempt to remove the broken file should be considered in most cases. Nowadays, with advances in technology, such as ultrasonic tips, fractured instruments can be easily retrievable. Case Report: This case report presented a 15-year-old female patient with a complaint of a large cavity in the left mandibular region who presented to the department of conservative dentistry and endodontics. The clinical diagnosis was pulp necrosis, and a root canal treatment was performed. During the shaping procedure, a file was broken in the mesiolingual canal. Conclusion: The broken file was removed using ultrasonic tips with a dental operating microscope. After the instrument was retrieved, the obturation was performed successfully.

Background: Any changes in the clinical presentation of the oral mucosa in terms of the color, size, texture, and integrity should be carefully checked. Dentists are responsible for doing a comprehensive oral examination in order to find cancer lesions at the initial stage. The prognosis of an oral squamous cell carcinoma (OSCC) is still determined by the stage of the initial diagnosis. The aim of this report was to describe a posterior tongue OSCC case in a patient who underwent general anesthesia due to the gag reflex in order to obtain a thorough clinical assessment of the primary lesion and a representative biopsy sample. Case Report: A 50-year-old woman with a 4-month history of a sore tongue was referred to the Oral Medicine Clinic of the Cipto Mangunkusumo Hospital. The intraoral examination revealed an ulcer measuring 2 cm × 0.5 cm on the right ventral side of the tongue, facing the area near teeth 46 and 47. There was also a 0.5 cm × 0.5 cm × 0.3 cm white cauliflower-like nodule at the anterior portion of the ulcer. Despite the ulcerative appearance of the lesion, the posterior border of the lesion could not be defined due to its location and the patient's high gag reflex. This patient was referred to the Oral Surgery Department for a further analysis of the clinical lesion and a biopsy. The detailed clinical examination under general anesthesia revealed a much larger lesion measuring 7 cm × 4 cm × 0.3 cm. An incisional biopsy specimen was taken, and the histopathology confirmed the diagnosis of a poorly differentiated OSCC. Conclusion: A thorough clinical examination was needed to assess the oral mucosal lesion in the posterior area of the mouth in order to provide a proper definitive diagnosis.

Background: Many odontogenic infection cases do not need antibiotic prescriptions. The excessive use of antibiotics can lead to microbial resistance. Objective: This study aims to acknowledge the rationale and varieties of antibiotic prescriptions in odontogenic infection treatment by dentists. Methods: Data were collected from 513 patients' medical records from the provincial public hospital and district public health center (PHC), Kupang City, from January to June 2016. The variables of this study were odontogenic infections treated with antibiotic therapy and the span of that antibiotic therapy. Results: Antibiotic use was not required in odontogenic infection cases: periapical abscess (27%), nonsurgery tooth extraction (20.7%), apical periodontitis (17.3%), and pulpitis (15%). Amoxicillin (76%) and clindamycin (12%) are widely used in odontogenic infection treatment. Based on the duration of therapy, it was found that the use of amoxicillin was 44% and clindamycin was 34%. Conclusion: Excessive antibiotic use is done by general dental practitioners in the treatment of odontogenic infection. Strict rules for antibiotic prescription are needed to prevent antibiotic resistance.

Background: The proper method for cleaning dentures is important to prevent an increase in the surface roughness average (Ra). An average roughness value above 0.2 μm can increase bacterial colonization. Objective: The aim of this study was to investigate the effects of brushing and immersion in denture cleanser on the surface roughness of polymethyl methacrylate (PMMA) materials. Methods: Fifty PMMA samples (18 mm × 10 mm × 2 mm) were randomly divided into five groups (n = 10 each): immersion in distilled water (Group A), brushing without toothpaste (Group B), brushing with toothpaste (Group C), immersion in denture cleanser and brushing without toothpaste (Group D), and immersion in denture cleanser and brushing with toothpaste (Group E). The surface roughness was measured using a surface roughness tester before and after the treatment. The results were obtained by calculating the difference between the initial and final surface roughness values. The data were analyzed using Welch's one-way analysis of variance and the Games–Howell post hoc test. Results: The mean Ra values were 0.033 ± 0.024 μm for Group A, 0.057 ± 0.018 μm for Group B, 1.551 ± 1.234 μm for Group C, 0.102 ± 0.026 μm for Group D, and 1.695 ± 1.158 μm for Group E. There were statistically significant differences among the groups, with the exception of Groups A and B and Groups C and E. Conclusion: Brushing without toothpaste had the least effect on increasing the surface roughness, whereas brushing with toothpaste and immersion in denture cleanser greatly increased the surface roughness.

Background: The storage condition of a toothbrush can influence the growth of bacteria. Indonesia as a developing country has a low awareness of the importance of toothbrush hygiene. Thus, an efficient and economic toothbrush storage solution is needed. Objective: The aim of this study was to evaluate the effect of soaking toothbrushes in mouthwash solution on the total number of Streptococcus mutans and Fusobacterium on the toothbrush. Methods: Eighteen toothbrushes were provided to healthy individuals aged 19–23-years. For 1 month, each toothbrush was soaked in disinfectant solution (25 mL) for 20 min after brushing, with Group 1 using mouthwash and Group 2 using sterile tap water. The real-time polymerase chain reaction (PCR) method was used to evaluate the number of microorganisms on each toothbrush. The total number of DNA targets was identified using real-time PCR followed by SYBR Green reagents and 16S rRNA-gene specific primers for S. mutans and Fusobacterium. A paired sample t-test was used for statistical analysis, and the level of significance was set at P < 0.05. Results: There were significant differences in the total bacterial numbers of S. mutans and Fusobacterium on toothbrushes after soaking with mouthwash solution. The average scores (Log10-CFU/mL ± standard deviation) of the total bacteria (2.66 ± 0.39), S. mutans (1.21 ± 0.18), and Fusobacterium (10.35 ± 6.02) on toothbrushes in Group 1 were significantly decreased compared to the average scores of the total bacterial load (5.19 ± 0.41), S. mutans (2.71 ± 1.59), and Fusobacterium (18.96 ± 4.26) in Group 2. Statistical evaluation brought statistically significant difference of total bacteria numbers and S. mutans between Group 1 and Group 2 (P < 0.05). Conclusion: Soaking toothbrushes in mouthrinse solution reduce the total number of bacterial load, S. mutans, and Fusobacterium. Further studies are needed to explore the effects of mouthwash solution against other oral pathogens.

Background: Tooth extraction is the most frequently conducted dental care procedure. In Indonesia, there is an extremely high utilization of dental and oral health services for tooth extraction, reaching 79.6%. Pain is a side effect of extraction. Pain due to extraction wounds can be treated with analgesic drugs, but alternative drugs with minimal or no side effects are still being researched. An herbal active beluntas leaf substance can reduce pain from extraction wounds. The beluntas plant not only aids in healing wounds but also exhibits anti-inflammatory and antipyretic effects. Objectives: In this study, the aims were to determine the 50% inhibitory concentration (IC₅₀value) and examine the viability effect of an ethanol extract of beluntas leaves on fibroblast cell cultures in vitro. Methods: Laboratory experiments were carried out. Beluntas leaves were obtained; their leaf extracts were prepared using ethanol as the solvent; phytochemical tests were performed. Triplicate measurements for the viability of 3T3 BALB/c fibroblast cells were carried out using the Methylthiazol sulfophenyl (MTS Assay) method. The extract concentrations were 500, 250, 125, 62.50, 31.25, 15.63, and 7.81 μg/mL. Results: Data analysis was carried out by one-way analysis of variance statistical test. Analysis results revealed that extract concentrations of 500, 31.25, 15.63, and 7.81 μg/mL exhibit a significant difference in the effect of cytotoxicity (P < 0.05) on fibroblast cells, and the IC₅₀value is 265.388 μg/mL. Conclusion: A significant difference in the cytotoxicity effect between the concentrations of the ethanol extract of beluntas (P. indica) leaves on the fibroblast cell cultures in vitro was observed. The beluntas leaf extract at an IC₅₀value of 7.81 μg/mL did not affect cell viability; hence, it is considered safe.

Online since 15^th March 2019.