Background: Root canal irrigation has an important role in removing pulp tissue, dentine debris, and microorganisms in root canals. Passive ultrasonic irrigation (PUI) Irrisafe is a high-frequency wired ultrasonic device, which is usedto obtain cleanliness of root canal from cavitation and acoustic streaming. EndoUltra is a high-frequency wireless ultrasonic device. It has advantages in terms of its ease of application. However, further research is needed to identify the variations in effectiveness between PUI Irrisafe and EndoUltra tip for dentine debris cleanliness. Objective: The aim of this study was to determine the effectiveness between the activation of PUI Irrisafe and EndoUltra tip on the dentine debris cleanliness of the apical third of a root canal. Methods: This experimental study was carried out on 50 mandibular premolar teeth with a single root canal from extracted teeth. The teeth were irrigated with 5% NaOCl with the activation of EndoUltra # 20/02 (15 and 30 s), with 5% NaOCl with the activation of the PUI tip Irrisafe # 20/02 (15 and 30 s), or with conventional irrigation (30 s). The assessment of the dentine debris score was assessed by two observers using a scanning electron microscope (SEM). Analysis of the results used the Kruskal—Wallis and Mann—Whitney U tests. Results: Differences in median cleanliness scores for the apical third of the root canal from the Irrisafe group, the EndoUltra group, and conventional group had a Kruskal—Wallis test value of P = 0.005. The results showed that there were significant differences (P < 0.05) in five groups. Conclusion: PUI activation with the EndoUltra tip had a better effectiveness on the dentine debris cleanliness of the apical third of a root canal than the Irrisafe tip at 15 and 30 s.

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Background: Limited systemic sclerosis (SSc), or scleroderma, is characterized by widespread vasculopathy, excessive multiorgan fibrosis, and autoantibody. The early stages of SSc are challenging to diagnose because of their similarity to other autoimmune conditions. Inappropriate SSc treatment can increase the risk of disability, morbidity, and mortality. Different pathogenesis pathways incur various manifestations in the skin and the oral cavity. In this scenario, dentists play an essential role in managing oral SSc manifestations. Proper oral examination, diagnosis, and therapy help to increase the confidence and patient’s quality of life. Case Report: A 24-year-old female patient with SSc was referred from the Internal Medicine Department to the Oral Medicine Department because of lip soreness for 2 weeks, resulting in difficulty eating and opening the mouth. A complete anamnesis and clinical examination were done. The patient was diagnosed with an oral ulcer caused by SSc, cheilitis exfoliative, drug-induced pigmentation, xerostomia, and acute pseudomembranous candidiasis. The oral lesion in this patient was concluded as an oral ulcer caused by SSc because the patient had already stopped using methotrexate for 2 weeks before the ulceration appeared. The oral treatment included sodium chloride (NaCl 0.9%), vaseline album, hyaluronic acid mouthwash, and nystatin. Oral lesions had a significant improvement after 3 days of treatment. Conclusion: The SSc manifestation that appeared on the oral cavity of the patient as microstomia, tongue stiffness, and oral ulcer resulted in inadequate clinical examination, and diagnosis. Treatments for this oral SSc were challenging.

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Background: Clinacanthus nutans exhibits antioxidant, anti-inflammatory, antiviral, anticancer, and anti-biofilm activities. Wounds in the oral cavity can affect the quality of life. Wound healing is a complex process to restore functions of injured tissues. The effect of C. nutans on oral mucosal burns and tongue wounds of rats is investigated. Methods: Forty male Sprague Dawley rats were divided into negative control and treatment groups with 25, 50, and 100 mg/mL of C. nutans. Oral mucosal burns and tongue wounds were observed on days 7 and 14 based on the fibroblast count and collagen deposits. Data were analyzed by analysis of variance and post hoc Tukey’s test with P < 0.05. Results: Results revealed that on day 7, the fibroblast count of mucosal burns and tongue wounds increases. The maximum mucosal burns were observed for the 100 mg/mL group, whereas the maximum tongue wounds were observed for the 25 mg/mL group. On day 7, collagen deposits were increased in case of mucosal burns. The number of collagen deposits increased on day 14, the highest mucosal burns were observed for the 100 mg/mL group, and in case of tongue wounds, the highest number was observed for the 50 mg/mL group. Conclusion: Ethanol extracts of C. nutans leaves can increase the fibroblast count on day 7 and collagen deposits on day 14 after injury in case of oral mucosal burns and tongue wounds during the wound healing of Sprague Dawley rats.

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Background: Dental trauma is relatively common, with its incidence and prevalence varying not only within countries and states but also within different socioeconomic groups. A primary goal in oral health care is to prevent dental trauma. Objectives: The aim of the present study was to determine the prevalence of anterior tooth trauma (ATT) and to analyze factors associated with ATT among schoolchildren aged 10—19 years in Mewat district, an underdeveloped and underprivileged area in Haryana state, India. Methods: A cross-sectional study was conducted among 3043 schoolchildren residing in Mewat district. They were divided into the following age groups: 10—13, 14—16, and 17—19 years. Dental injuries to anterior teeth were recorded according to Ellis and Davey’s classification. Data were collected using a specifically designed questionnaire. The data were analyzed using IBM Statistical Package for Social Sciences for Windows (version 20.0). Categorical variables are presented as proportions (%), and Pearson’s χ² test was used to analyze these variables. Tests were conducted at the significance level of 5%. Results: Of the 3043 schoolchildren (males, n = 2178; females, n = 865) examined in the study, 362 schoolchildren had experienced dental trauma, giving a prevalence rate of 11.89%. Males were more prone to ATT (13.36%), and an Ellis Class I fracture was the most frequent type of ATT (78%). The most common causes of ATT were falls (49.44%), followed by road traffic accidents. In addition, children with partial lip coverage and an overjet of more than 3 mm had an increased risk of ATT. Conclusion: The prevalence of ATT among schoolchildren in Mewat district was 11.89%, and the major etiological factor was a fall. There is an increased need for awareness of dental trauma in school-aged children.

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Background: A space maintainer is an appliance used to maintain the jaw space due to the premature loss of deciduous teeth. Moyer’s method is used to determine the need for a space maintainer by measuring the discrepancy. Objective: The aim of this article is to determine the difference between measurements using Moyer’s method on a dental study model and on panoramic radiographs. Methods: Researchers measured the available space in 60 dental study models using two methods—the segmental method and contouring of the jaw arch using a 0.6 mm diameter arch wire. Moyer’s prediction table was used to predict the mesial-distal width of the permanent canines and premolars. Software ImageJ (SIJ) was used to measure the available space and required space on panoramic radiographs. We performed image calibration so that the measurement results could be presented in millimeters. Results: There was no significant difference (P = 0.935) in the discrepancy prediction between the panoramic radiographs and the dental study model. The Bland—Altman test result showed no significant difference, and the conformity between the panoramic radiographs and the dental study model was 0.02770. The sensitivity and specificity values of the panoramic radiographs and dental study model were above the 50% line. The area under curve values of the panoramic radiographs and dental study model were considered to be very good. Conclusion: Application of Moyer’s method to panoramic radiographs using SIJ to determine space maintainer requirements can be performed on pediatric patients to predict special discrepancies.

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Background: Plaque accumulation on teeth surfaces and prosthetic or orthodontic appliances present a serious challenge for the maintenance of oral health. Copper nanoparticles (NPs) can be incorporated into coatings and applied to restorative materials to prevent plaque formation and the progression of periodontal diseases. Objective: The aim of this article is to evaluate the antimicrobial efficacy of copper NPs against selected periodontal pathogens (Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans). Methods: The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of copper NPs were determined using broth dilution assay. Copper NPs (size: 30—50 nm, purity: 99.9%) were used for the study. Results: Both P. gingivalis and A. actinomycetemcomitans were sensitive to copper NPs. Nano-copper had a bactericidal effect against P. gingivalis at a concentration of 0.8 μg/mL and a bacteriostatic effect against the bacterium at a concentration of 0.4 μg/mL. For A. actinomycetemcomitans, nano-copper had a bactericidal effect at a concentration of 3.12 μg/mL and a bacteriostatic effect at a 1.6 μg/mL concentration. Conclusion: Nano-copper exhibits an antibacterial effect against periodontal pathogens. Future studies are needed to explore the applicability of these copper-based antimicrobial agents in clinical settings.

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Background: Fluoride varnish (FV) is a common dental health treatment for the prevention of early childhood caries. Application of FV with a flavoring agent promotes comfort and acceptance by patients, especially children, and facilitates an effective treatment time. Objective: Flavored FV with a pleasant flavor should allow a faster treatment time, especially with children. The aim of this research was to study basic FV formulations containing different flavors of essential oils (LorAnn) and variations in the concentrations of flavor oils to determine the optimum formulation to enhance the in vitro fluoride release time. Methods: The independent variables were the flavors (apple, melon, and peppermint) and the concentrations (1, 1.5, 2, or 2.5%) of the flavor that gave the best fluoride release (peppermint). The amounts of fluoride ions released in 6 h into deionized water were assessed at 37°C using an ion-selective electrode with the addition of fluoride total ionic strength adjustment buffer solution to strengthen the ion reading. The cumulative ion release was analyzed for normality and equality of variance, and the means were compared using a general linear model test and Statistical Package for Social Sciences version 23.0 software. The significance level was set at α = 0.05. Results: At the same concentration of 2% for the apple, melon, and peppermint flavors, the peppermint formulation gave the best fluoride release, at 173.22 mg/L. A peppermint oil concentration of 2.5% showed the highest fluoride ion release, at 178.95 mg/L. Conclusions: The addition of peppermint flavor oil at a concentration range of 1—2.5% revealed an increasing release of fluoride ions with an increasing peppermint oil concentration. Further investigations are still needed using artificial saliva to replicate actual conditions in the oral cavity.

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Background: The Gram-negative bacterium Porphyromonas endodontalis is one of the causes of endodontic infections. Irrigation in root canal treatment was intended to eliminate bacteria. The garlic extract (Alium sativum Linnaeus) (Amaryllidaceae) is a natural material believed to have antimicrobial effects and may be used as an alternative irrigation solution. Objectives: The aim of this article is to evaluate the effect of garlic extract on the eradication of P. endodontalis biofilms. Methods: The A. sativum extract with concentrations of 100%, 50%, and 25%, NaOCl 5.25%, CHX 2% as a positive control, and sterile Aquadest as a negative control were used as irrigation solutions. A random sample of six groups was tested for P. endodontalis ATCC^® 35406D-5^TM biofilm eradication by irrigation of the A. sativum extract. Results: It was shown with a one-way analysis of variance that there was a significant difference in optical density (OD) between the results of biofilm eradication using A. sativum with concentrations of 100%, 50%, and 25% and NaOCl 5.25%, CHX 2%, and Aquadest (P < 0.05). With Tukey′s post hoc test, it was shown that the OD value from the eradication of A. sativum with concentrations of 100%, 50%, and 25% did not differ significantly compared with NaOCl 5.25% or CHX 2% (P > 0.05). Conclusion: The garlic extract (A. sativum) is effective in eradicating the biofilm of P. endodontalis in vitro.

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Background: Malocclusion is a significant dental health problem in Indonesia. Malocclusion has multifactorial causes, including nutrition. Malnutrition may have an adverse effect on mandibular length and lead to tooth malposition. Objective: The aim of this article is to investigate the relationship between nutritional status and mandibular length in subjects aged 10–16 years. Methods: This was an observational analytic study with a cross-sectional design. The sampling method was purposive sampling. The subjects were 100 children (50 children with normal nutrition and 50 children with nutrition lower than normal) aged 10–16 years from Al-Ikhlas Islamic Elementary School and Advent 2 School in Medan, with no history of orthodontic treatment and facial trauma and not wearing prostheses. All the subjects were photographed with their heads held in a natural position. The photographs were analyzed using a computer program CorelDraw X7 to measure the length of the mandible. All statistical analyses were performed using SPSS. Univariate analyses were performed to obtain the mean and standard deviation (SD) values of all parameters. Descriptive statistics were obtained, and data were tested for normality using the Kolmogorov–Smirnov test for distribution. Variables that conformed to a normal distribution were analyzed using unpaired t-tests. Results: The mean mandibular length in those with nutritional status lower than normal was 94.52 ± 5.89 mm, whereas it was 109.44 ± 4.85 mm in those with normal nutritional status. The results of an unpaired t-test (P = 0.001) revealed that there was a difference of mandibular length between subjects with normal nutrition status and lower than normal nutrition status. Conclusion: There was a relationship between nutritional status and mandibular length in subjects aged 10–16 years.

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