Background: The aim of endodontic treatment is to eliminate bacteria from the root canal. Bacterial removal from the root canal can be achieved with a mechanical approach using an instrument and a disinfecting irrigation agent. Enterococcus faecalis is the most prevalent bacteria found in root canals. Research studies have also been conducted to examine irrigation systems using herbal products such as drumstick tree leaf (Moringa oleifera) instead of NaOCl. Active compounds in M. oleifera, such as flavonoids, tannins, saponins, alkaloids, phenolics, and triterpenoids, possess antibacterial effects. Objectives: The aim of this study is to assess the antibacterial effect of drumstick tree extract (M. oleifera) in several concentrations (25%, 50%, 75%, and 100%) as an irrigation solution against E. faecalis through in the root canal ex vivo. Methods: This study used 24 mandibular premolars, divided into six category groups. Group 1 received 5.25% NaOCl as a positive control, Group 2 received 25% M. oleifera extract, Group 3 received 50% M. oleifera extract, Group 4 received 75% M. oleifera extract, Group 5 received 100% M. oleifera extract, and Group 6 received irrigation using phosphate-buffered saline as a negative control. Quantitative polymerase chain reaction methods used to analyze the E. faecalis number in the root canal after treatment with M. oleifera extract. Results: A one-way ANOVA showed significant differences (P = 0.05) between the three types of irrigation solutions against E. faecalis. Among the six study groups, the most prominent efficacy was found in Groups 1, 4, and 5. Conclusion: M. oleifera extract solution at concentrations of 75% and 100% is as effective as 5.25% NaOCl. This extract may be used as an alternative irrigation agent for root canal treatment. However, further studies are warranted to examine the toxicity effect.

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Background: Periodontitis has been referred to as the sixth complication of diabetes. A number of studies found a higher prevalence of periodontal disease among diabetes patients than among healthy controls. Objective: The objective of the study was to determine the periodontal status and periodontal treatment needs (TN) of diabetes mellitus Type 2 patients attending Talaga Bodas Community Health Center, Bandung City, Indonesia. Methods: This descriptive study included 30 subjects with diabetes mellitus Type 2. The periodontal tissue status and periodontal TN were determined using the Community Periodontal Index of TN. Data on periodontal status and TN are presented in percentages based on subject, sextant, and duration of diabetes mellitus. Results: Periodontitis (53.3%) was more common than gingivitis (43.3%) among diabetes mellitus Type 2 patients. Scaling and root planing were the treatments most commonly required in the diabetes mellitus patients (n = 21.70%) and sextants (n = 81.65.9%). A longer period of diabetes mellitus was associated with a tendency toward more severe periodontal disease and more complex periodontal TN. Conclusion: The prevalence of periodontitis was higher than gingivitis among patients with diabetes mellitus Type 2. The TN of diabetes mellitus Type 2 patients comprised mostly scaling and root planing.

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Background: Mineral trioxide aggregate (MTA) is the most widely used material in endodontics, and recently, it has been used as an endodontic sealer. Bioceramic (BC) is a newly developed material based on calcium silicate, which is already used as a biocompatible root canal obturation material to overcome the weakness of MTA. However, there have been no studies comparing the materials used to seal the root canal. Objective: This study aimed to determine the apical leakage differences between BC and MTA sealers with BC-coated gutta-percha (GP) and conventional GP. Methods: In total, 40 mandibular premolars were cut coronally to 14 mm of working length. All samples were randomized and sorted into four groups: BC sealer with BC-coated GP, bioceramic sealer with conventional GP, MTA sealer with BC-coated GP, and MTA sealer with conventional GP. The samples were stored in an incubator, and nail varnish was applied to all root surfaces except for a 1 mm area from the apex. The samples were also soaked in methylene blue for 72 h before undergoing diaphanization. A stereomicroscope was used to measure the methylene blue penetration. All data were analyzed using analysis of variance. Results: There were significant differences in apical leakage between the BC and MTA sealers (P < 0.05). Conclusion: The BC sealer prevented apical leakage better than MTA. The BC-coated GP had better results than the conventional GP, but the differences were not significant, indicating that the choice of sealer is more important in preventing the apical leakage.

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Background: Maldistribution of health workers, including dentists, is a global issue faced by not only poor and developing countries but also developed countries due to the mobility of health workers, who prefer working in urban areas. The World Health Organization (2012) released global policy recommendations that cover education, regulation, incentives, and personal and professional support to overcome this issue. However, they have not been able to completely solve the issue, as is shown by a description of Indonesia's Health Profile (2018), which highlights that 43.53% of public health center lack of dentists. The number of studies concerning the real condition experienced by dentists working in rural and remote areas of Indonesia is still limited. Objectives: To analyze job satisfaction and factors affecting dentists' retention in rural and remote areas of Indonesia. Methods: This study used questionnaire to collect data which was designed based on seven major themes and inserted in Google Form. The link was distributed to dentists who work in rural and remote areas of Indonesia. The sample was selected based on random sampling techniques. Result: The study showed that 45.90% of respondents were not satisfied working in rural and remote areas. Most of the respondents claimed that working conditions, incentives, career and professional development, living conditions, and personal characteristics influenced their interest in working permanently in remote and rural areas. However, political and cultural factors did not give a high impact. Conclusion: The description of job satisfaction and factors affecting dentists' retention in rural and remote areas of Indonesia is expected to have a positive impact on formulating policy regarding dentists' maldistribution.

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Background: Home bleaching with carbamide peroxide is commonly used due to its high success rate and minimum side effects. Although home bleaching is safe, it causes structural changes in surface enamel, thereby facilitating Streptococcus mutans attachment on the enamel surface. Objectives: This study aimed to determine the effect of carbamide peroxide concentration on surface enamel structural changes and S. mutans attachment. Methods: Healthy, caries-free, and calculus-free upper first premolars were divided into 10%, 15%, and 35% carbamide peroxide concentration groups, with five samples in each group. Structural changes in the surface enamel of the teeth before and after the bleaching procedure were assessed subjectively based on observations using a stereomicroscope at × 40. The samples were inoculated in S. mutans culture and incubated for 24 h (37°C) in anaerobic conditions. The samples were then washed with phosphate-buffered saline, and bacterial attachment was released by vortexing for 1 min. Bacterial attachment was assessed using a turbidimetry test and total plate count test. Result: Structural changes in enamel were observed in the samples exposed to carbamide peroxide 35%. The results of an analysis of variance test revealed a significant difference (P < 0.05) in the bacterial attachment test. The samples exposed to carbamide peroxide 35% exhibited the highest amount of bacterial attachment (3 × 10^[6] CFU/mL, optical density: 0.06). Conclusion: The concentration of carbamide peroxide plays a role in structural changes in enamel and S. mutans attachment.

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Background: Worn dentition has become a common and crucial issue, especially in the older generation. Beyond esthetics, functional diminution can create a serious impact on the overall well-being of the individual. The etiology of the worn dentition can be multifactorial; therefore, the treatment approach should be systematic and must not only address the existing problem but also prevent any recurrence. Case Report: Rehabilitation of a patient with worn dentition requires proper clinical, radiographic examination and recording of the occlusal vertical dimension (OVD). In this case report, a 65-year-old male patient presented with worn out and missing teeth in his upper and lower jaws. An arbitrary face-bow transfer was conducted, and the diagnostic casts were articulated. A mock full contoured wax up with a raised OVD of approximately 4 mm was completed. After 3 months of interocclusal splint therapy with the raised OVD, temporary restoration was cemented. After a follow-up period of 3 months, when the patient was devoid of any signs and symptoms, permanent restorations fabricated using computer-aided design and computer-aided manufacturing were cemented. An interocclusal splint was provided to preserve the restorations. Conclusion: Rehabilitating patients with worn dentition involves careful decision-making during the diagnosis as it will direct the entire treatment sequence. This case report and the resulting steps involved might serve as guidelines for other clinicians while treating similar patients.

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Background: Porcelain veneer restoration is the primary choice for indirect restoration, especially for anterior teeth, given its high esthetic properties and lower failure rate than resin composites. Glass-based ceramics such as IPS e.max Press and Vintage LD Press are a choice for veneer due to its superior physical properties. Resin cement is used to attach the veneer restoration to the teeth. The polymerization of resin cement used in veneer restoration affects the stability, mechanical properties, and resistance of the restoration. The composition and thickness of the porcelain material affect the light-curing unit to cured resin cement. Objectives: The aim of this study was to evaluate the influence of porcelain thickness, light intensity, and exposure time in the hardness of resin cement. Methods: Porcelain samples measuring 5 mm in diameter with three types of thicknesses of IPS e.max Press and Vintage LD Press were used in the study. Resin cement in a metal mold was placed under a porcelain sample before curing with a light-emitting diode (LED) intensity of 1300 or 1700 mW/cm². The hardness test was then carried out on the bottom of the resin cement. Result: The highest hardness value was obtained from a Vintage LD Press with a thickness of 0.7 mm (cured at 1300 mW/cm² for 20 s). A four-way ANOVA test showed significant differences for brands, thicknesses, and times of exposure (P < 0.05) as well as insignificant difference for LED intensity. Conclusion: The study indicates that polymerization of resin cement with lower thickness presented higher hardness values. Irradiation time affected hardness, while LED intensity did not.

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