Natural and Synthetic Drugs Approached for the Treatment of Recurrent Aphthous Stomatitis Over the Last Decade.

Recurrent aphthous stomatitis (RAS) refers to a sore and frequently recurring inflammation of the oral tissues, distinguished by the presence of small ulcers that cause significant discomfort and cannot be attributed to any underlying disease. Different treatments have been used for RAS. This review aims to provide a comprehensive overview of the treatment options over the past decade for recurrent aphthous stomatitis (RAS), encompassing both natural and synthetic treatments. It will utilize clinical efficacy studies conducted in vivo and in vitro, along with a focus on the pharmaceutical approach through advancements in drug delivery development. We conducted a thorough literature search from 2013 to 2023 in prominent databases such as PubMed, Scopus, and Cochrane, utilizing appropriate keywords of recurrent aphthous stomatitis, and treatment. A total of 53 clinical trials with 3022 patients were included, with 35 using natural materials in their research and a total of 16 articles discussing RAS treatment using synthetic materials. All the clinical trials showed that natural and synthetic medicines seemed to benefit RAS patients by reducing pain score, ulcer size, and number of ulcers and shortening the healing duration.

α-Mangostin hydrogel film with chitosan alginate base for recurrent aphthous stomatitis (RAS) treatment: study protocol for double-blind randomized controlled trial.

Background: Recurrent Aphthous Stomatitis (RAS) is a common ulcerative disease of the oral mucosa which is characterized by pain, and recurrent lesions in the oral cavity. This condition is quite painful, causing difficulty in eating, speaking and swallowing. Topical medications have been used for this condition, but the obstacle in using topical medications is the difficulty of achieving drug effects due to saliva wash out. This problem can be overcome by film hydrogel formulation which can protect the ulcer and reduce the pain to some extent. α-mangostin is a xanthone isolated from the rind of the mangosteen fruit. One of the activities of α-mangostin is anti-inflammatory effects, which operate through the characteristic mechanism of inhibiting the inflammatory response. This protocol study aims to investigate the efficacy of an α-mangostin hydrogel film with a chitosan alginate base for recurrent aphthous stomatitis (RAS) in comparison with a placebo over a period of 7 days. Study design: This is a two-arm, double blinding, randomized controlled trial enrolling patients with RAS. The efficacy test of α-mangostin Hydrogel Film will be tested against the placebo. Patients with RAS will be allocated randomly into the two arms and the hydrogel film will be administered for 7 days. The diameter of ulcer and visual analog scale (VAS) score will be used as the primary efficacy endpoint. The outcome measure will be compared between the two arms at the baseline, day 3, day 5, and at the end of 7 days. Discussion: The purpose of this clinical research is to provide scientific evidence on the efficacy of α-mangostin hydrogel film with a chitosan alginate basis in treating recurrent aphthous stomatitis. The trial is expected to improve our capacity to scientifically confirm the anti-inflammatory effectiveness of α-mangostin compounds in a final formulation that is ready to use. Trial registration: NCT06039774 (14 September 2023).

Exploring the potential of artificial intelligence in paediatric dentistry: A systematic review on deep learning algorithms for dental anomaly detection.

BACKGROUND: Artificial intelligence (AI) based on deep learning (DL) algorithms has shown promise in enhancing the speed and accuracy of dental anomaly detection in paediatric dentistry. AIM: This systematic review aimed to investigate the performance of AI systems in identifying dental anomalies in paediatric dentistry and compare it with human performance. DESIGN: A systematic search of Scopus, PubMed and Google Scholar was conducted from 2012 to 2022. Inclusion criteria were based on problem/patient/population, intervention/indicator, comparison and outcome scheme and specific keywords related to AI, DL, paediatric dentistry, dental anomalies, supernumerary and mesiodens. Six of 3918 initial pool articles were included, assessing nine DL sub-systems that used panoramic radiographs or cone-beam computed tomography. Article quality was assessed using QUADAS-2. RESULTS: Artificial intelligence systems based on DL algorithms showed promising potential in enhancing the speed and accuracy of dental anomaly detection, with an average of 85.38% accuracy and 86.61% sensitivity. Human performance, however, outperformed AI systems, achieving 95% accuracy and 99% sensitivity. Limitations included a limited number of articles and data heterogeneity. CONCLUSION: The potential of AI systems employing DL algorithms is highlighted in detecting dental anomalies in paediatric dentistry. Further research is needed to address limitations, explore additional anomalies and establish the broader applicability of AI in paediatric dentistry.

Bioactivity and remineralization potential of modified glass ionomer cement: A systematic review of the impact of calcium and phosphate ion release.

This systematic review investigates the effectiveness of calcium and phosphate ions release on the bioactivity and remineralization potential of glass ionomer cement (GIC). Electronic databases, including PubMed-MEDLINE, Scopus, and Web of Science, were systematically searched according to PRISMA guidelines. This review was registered in the PROSPERO database. Five eligible studies on modifying GIC with calcium and phosphate ions were included. The risk of bias was assessed using the RoBDEMAT tool. The incorporation of these ions into GIC enhanced its bioactivity and remineralization properties. It promoted hydroxyapatite formation, which is crucial for remineralization, increased pH and inhibited cariogenic bacteria growth. This finding has implications for the development of more effective dental materials. This can contribute to improved oral health outcomes and the management of dental caries, addressing a prevalent and costly oral health issue. Nevertheless, comprehensive longitudinal investigations are needed to evaluate the clinical efficacy of this GIC's modification.

Efficacy and bone-contact biocompatibility of glass ionomer cement as a biomaterial for bone regeneration: A systematic review.

Bone regeneration is a rapidly growing field that seeks to develop new biomaterials to regenerate bone defects. Conventional bone graft materials have limitations, such as limited availability, complication, and rejection. Glass ionomer cement (GIC) is a biomaterial with the potential for bone regeneration due to its bone-contact biocompatibility, ease of use, and cost-effectiveness. GIC is a two-component material that adheres to the bone and releases ions that promote bone growth and mineralization. A systematic literature search was conducted using PubMed-MEDLINE, Scopus, and Web of Science databases and registered in the PROSPERO database to determine the evidence regarding the efficacy and bone-contact biocompatibility of GIC as bone cement. Out of 3715 initial results, thirteen studies were included in the qualitative synthesis. Two tools were employed in evaluating the Risk of Bias (RoB): the QUIN tool for assessing in vitro studies and SYRCLE for in vivo. The results indicate that GIC has demonstrated the ability to adhere to bone and promote bone growth. Establishing a chemical bond occurs at the interface between the GIC and the mineral phase of bone. This interaction allows the GIC to exhibit osteoconductive properties and promote the growth of bone tissue. GIC's bone-contact biocompatibility, ease of preparation, and cost-effectiveness make it a promising alternative to conventional bone grafts. However, further research is required to fully evaluate the potential application of GIC in bone regeneration. The findings hold implications for advancing material development in identifying the optimal composition and fabrication of GIC as a bone repair material.

Graphene oxide increases PMMA's resistance to fatigue and strength degradation.

OBJECTIVES: to characterize the effects of graphene oxide (GO) on polymethyl methacrylate's (PMMA) reliability and lifetime. The hypothesis tested was that GO would increase both Weibull parameters and decreased strength degradation over time. METHODS: PMMA disks containing GO (0.01, 0.05, 0.1, or 0.5 wt%) were subjected to a biaxial flexural test to determine the Weibull parameters (m: modulus of Weibull; σ0: characteristic strength; n = 30 at 1 MPa/s) and slow crack growth (SCG) parameters (n: subcritical crack growth susceptibility coefficient, σf0: scaling parameter; n = 10 at 10-2, 10-1, 101, 100 and 102 MPa/s). Strength-probability-time (SPT) diagrams were plotted by merging SCG and Weibull parameters. RESULTS: There was no significant difference in the m value of all materials. However, 0.5 GO presented the lowest σ0, whereas all other groups were similar. The lowest n value obtained for all GO-modified PMMA groups (27.4 for 0.05 GO) was higher than the Control (15.6). The strength degradation predicted after 15 years for Control was 12%, followed by 0.01 GO (7%), 0.05 GO (9%), 0.1 GO (5%), and 0.5 GO (1%). SIGNIFICANCE: The hypothesis was partially accepted as GO increased PMMA's fatigue resistance and lifetime but did not significantly improve its Weibull parameters. GO added to PMMA did not significantly affect the initial strength and reliability but significantly increased PMMA's predicted lifetime. All the GO-containing groups presented higher resistance to fracture at all times analyzed compared with the Control, with the best overall results observed for 0.1 GO.

Carbonation inhibitor by polyethylene glycol encapsulation of calcium hydroxide fine particles to improve antimicrobial and root canal penetration properties.

The carbonation of calcium hydroxide (Ca(OH)2) is affected by humidity and a saturated atmosphere. Ca(OH)2 from nature is easily carbonation and self-aggregates into calcium carbonate (CaCO3), resulting in larger particle size impairing the antimicrobial properties due to lack of penetration into the dentinal tubules and lower ion dissociation. To reduce the particle size, the wet beads milling process with distilled water as the medium is commonly used, but often results in great carbonation of the final product. Polyethylene Glycol (PEG) may inhibit the carbonation process as well as re-agglomeration. However, it requires intensive drying of the fine Ca(OH)2 particles. As an alternative, we used ethanol as a medium in the milling process, which is easily dried and compatible with PEG as a surfactant. This study aimed to evaluate PEG 400 as a dispersing agent in ethanol medium in the beads milling process to prevent carbonation of the fine Ca(OH)2 particles. The following groups were analysed CaP-PEG (Ca(OH)2-PEG) with ethanol as a medium, CaP-Eth (Ca(OH)2 with ethanol as a medium), CaP-DW (Ca(OH)2 with distilled water as a medium), CaPC (Ca(OH)2-carbonated) as the negative control and CaC (Ca(OH)2 analytical grade) as the positive control The final particle results were characterized to evaluate the crystal structure, functional groups, and particle size. The corresponding pH and antimicrobial activity against Enterococcus faecalis were assessed at 1, 3, 7, and 14 days. The penetration ability was evaluated by Scanning Electron Microscope. The data obtained were analysed by ANOVA with a significance level of 5%. PEG was able to inhibit carbonation and stabilize pH for up to 14 days, providing increased antimicrobial activity against E. faecalis. PEG also facilitates the ability of fine Ca(OH)2 particles to penetrate deeper into the dentine tubules by reducing particle size.

Bioactive Carbonate Apatite Cement with Enhanced Compressive Strength via Incorporation of Silica Calcium Phosphate Composites and Calcium Hydroxide.

Carbonate apatite (CO3Ap) is a bioceramic material with excellent properties for bone and dentin regeneration. To enhance its mechanical strength and bioactivity, silica calcium phosphate composites (Si-CaP) and calcium hydroxide (Ca(OH)2) were added to CO3Ap cement. The aim of this study was to investigate the effect of Si-CaP and Ca(OH)2 on the mechanical properties in terms of the compressive strength and biological characteristics of CO3Ap cement, specifically the formation of an apatite layer and the exchange of Ca, P, and Si elements. Five groups were prepared by mixing CO3Ap powder consisting of dicalcium phosphate anhydrous and vaterite powder added by varying ratios of Si-CaP and Ca(OH)2 and 0.2 mol/L Na2HPO4 as a liquid. All groups underwent compressive strength testing, and the group with the highest strength was evaluated for bioactivity by soaking it in simulated body fluid (SBF) for one, seven, 14, and 21 days. The group that added 3% Si-CaP and 7% Ca(OH)2 had the highest compressive strength among the groups. SEM analysis revealed the formation of needle-like apatite crystals from the first day of SBF soaking, and EDS analysis indicated an increase in Ca, P, and Si elements. XRD and FTIR analyses confirmed the presence of apatite. This combination of additives improved the compressive strength and showed the good bioactivity performance of CO3Ap cement, making it a potential biomaterial for bone and dental engineering applications.

Characterization and Analysis of Chitosan-Gelatin Composite-Based Biomaterial Effectivity as Local Hemostatic Agent: A Systematic Review.

Chitosan and gelatin were the most widely used natural materials in pharmaceutical and medical fields, especially as local hemostatic agents, independently or as a composite material with the addition of other active substances. Chitosan and gelatin have excellent properties in biocompatibility, biodegradability, non-toxicity and water absorption capacity. The objective of this review was to analyze the characteristics of chitosan-gelatin (CG) composite-based biomaterial and its effectivity as a local hemostatic agent. We used PRISMA guidelines and the PICO framework to compile this review. The findings demonstrated that the CG composite-based biomaterial had excellent physical, chemical, mechanical properties and local hemostatic agent activity by adding other active substances such as oxidized fibers (OF), silica nanoparticles (SiNPs), calcium (Ca) and biphasic calcium phosphate (BCP) or by setting the CG composite proportion ratio.

Psychometric analysis and reliability of the dental treatment motivation scale for Indonesian pregnant women.

This study aimed to obtain the results of psychometric analysis and reliability of the dental treatment motivation scale (DTMS), which was adapted cross-culturally for pregnant women in Indonesia. A descriptive survey was conducted with 149 pregnant women at a maternal clinic in Bandung City, Indonesia, in December 2020. Convenience sampling was chosen as the sampling technique after the inclusion and exclusion criteria had been fulfilled. Two English experts initially translated the DTMS questionnaire from English into Indonesian and the translated questionnaire was then reviewed by four expert panels, which were modified afterwards. The validity test was carried out using the exploratory and confirmatory factor analyses and goodness of fit index (GFI). The internal reliability analysis used Cronbach's alpha, and the test-retest was conducted using Pearson's correlation coefficient. The psychometric analysis results were obtained from four testing stages. The first stage was the initial eigenvalue assessment, and the cumulative percentage value was >60%. The second stage was the exploratory factor analysis, with a loading factor of >0.3. The third stage consisted of the confirmatory factor analysis, forming two components of the factor structure (intrinsic and extrinsic motivations). Finally, the fourth stage was the GFI assessment, which showed the good fit model with a value of 0.903. Very high internal consistency reliability ranged from 0.985 to 0.990; the test-retest p-value of Pearson's correlation coefficient was 0.000. In conclusion, the Indonesian version of the DTMS proved to be a reliable and valid instrument to measure Indonesian pregnant women's motivation to seek oral health treatment.

Psychometric analysis and reliability of the dental treatment motivation scale for Indonesian pregnant women

Abstract: This study aimed to obtain the results of psychometric analysis and reliability of the dental treatment motivation scale (DTMS), which was adapted cross-culturally for pregnant women in Indonesia. A descriptive survey was conducted with 149 pregnant women at a maternal clinic in Bandung City, Indonesia, in December 2020. Convenience sampling was chosen as the sampling technique after the inclusion and exclusion criteria had been fulfilled. Two English experts initially translated the DTMS questionnaire from English into Indonesian and the translated questionnaire was then reviewed by four expert panels, which were modified afterwards. The validity test was carried out using the exploratory and confirmatory factor analyses and goodness of fit index (GFI). The internal reliability analysis used Cronbach's alpha, and the test-retest was conducted using Pearson's correlation coefficient. The psychometric analysis results were obtained from four testing stages. The first stage was the initial eigenvalue assessment, and the cumulative percentage value was >60%. The second stage was the exploratory factor analysis, with a loading factor of >0.3. The third stage consisted of the confirmatory factor analysis, forming two components of the factor structure (intrinsic and extrinsic motivations). Finally, the fourth stage was the GFI assessment, which showed the good fit model with a value of 0.903. Very high internal consistency reliability ranged from 0.985 to 0.990; the test-retest p-value of Pearson's correlation coefficient was 0.000. In conclusion, the Indonesian version of the DTMS proved to be a reliable and valid instrument to measure Indonesian pregnant women's motivation to seek oral health treatment.

Structure and phase analysis of calcium carbonate powder prepared by a simple solution method.

This paper focused on the analysis of the crystal structure and phase transformation of CaCO3 synthesized by simple solution method from 0.5 M Ca(NO3)2 precursor and 0.5 M Na2CO3 precipitant at ambient temperature (300 K). The pH of the sample solution at various reaction times of 5, 10, 15, and 30 min were measured and correlated with the supersaturating condition in the presence of the Na2CO3 which is responsible for vaterite phase formation. The formation of the polymorph structure of obtained CaCO3 powders was characterized using powder X-ray diffraction patterns and their crystal structure and phase transformation were evaluated using the Rietveld refinement method. Moreover, the qualitative analysis of the CaCO3 powders phase was conducted by Fourier Transform Infrared (FTIR) spectroscopy to evaluate the effect of reaction time correlated with their crystal formation. The XRD analysis showed that the vaterite formation was 89 % at a reaction time of 15 min and confirmed also by FTIR that the amount of vaterite increased due to the effect of increasing reaction time. The crystallite size of vaterite was stable at 36 nm at the reaction time of 15 and 30 min. The morphology of the CaCO3 powders obtained from Scanning Electron Microscope (SEM) was spherical with sizes of 2-5 µm. It was highlighted that the supersaturating condition started occurred at a reaction time of 15 min at pH 7.88 which was responsible for vaterite formation took place. It was concluded that the amount of precipitant (Na2CO3) and reaction times play an important role to determine the saturation of carbonate source to allow vaterite phase formation of CaCO3 powders to occur.

Deep learning convolutional neural network algorithms for the early detection and diagnosis of dental caries on periapical radiographs: A systematic review.

PURPOSE: The aim of this study was to analyse and review deep learning convolutional neural networks for detecting and diagnosing early-stage dental caries on periapical radiographs. MATERIALS AND METHODS: In order to conduct this review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Studies published from 2015 to 2021 under the keywords (deep convolutional neural network) AND (caries), (deep learning caries) AND (convolutional neural network) AND (caries) were systematically reviewed. RESULTS: When dental caries is improperly diagnosed, the lesion may eventually invade the enamel, dentin, and pulp tissue, leading to loss of tooth function. Rapid and precise detection and diagnosis are vital for implementing appropriate prevention and treatment of dental caries. Radiography and intraoral images are considered to play a vital role in detecting dental caries; nevertheless, studies have shown that 20% of suspicious areas are mistakenly diagnosed as dental caries using this technique; hence, diagnosis via radiography alone without an objective assessment is inaccurate. Identifying caries with a deep convolutional neural network-based detector enables the operator to distinguish changes in the location and morphological features of dental caries lesions. Deep learning algorithms have broader and more profound layers and are continually being developed, remarkably enhancing their precision in detecting and segmenting objects. CONCLUSION: Clinical applications of deep learning convolutional neural networks in the dental field have shown significant accuracy in detecting and diagnosing dental caries, and these models hold promise in supporting dental practitioners to improve patient outcomes.

Synthesis and Characterization of Porous CaCO3 Vaterite Particles by Simple Solution Method.

Appropriately engineered CaCO3 vaterite has interesting properties such as biodegradability, large surface area, and unique physical and chemical properties that allow a variety of uses in medical applications, mainly in dental material as the scaffold. In this paper, we report the synthesis of vaterite from Ca(NO3)2·4H2O without porogen to obtain a highly pure and porous microsphere for raw material of calcium phosphate as the scaffold in our future development. CaCO3 properties were investigated at two different temperatures (20 and 27 °C) and stirring speeds (800 and 1000 rpm) and at various reaction times (5, 10, 15, 30, and 60 min). The as-prepared porous CaCO3 powders were characterized by FTIR, XRD, SEM, TEM, and BET methods. The results showed that vaterite with purity 95.3%, crystallite size 23.91 nm, and porous microsphere with lowest pore diameter 3.5578 nm was obtained at reaction time 30 min, temperature reaction 20 °C, and stirring speed 800 rpm. It was emphasized that a more spherical microsphere with a smaller size and nanostructure contained multiple primary nanoparticles received at a lower stirring speed (800 rpm) at the reaction time of 30 min. One of the outstanding results of this study is the formation of the porous vaterite microsphere with a pore size of ~3.55 nm without any additional porogen or template by using a simple mixing method.

Synthesis, Characterization, and Antibacterial Evaluation of a Cost-Effective Endodontic Sealer Based on Tricalcium Silicate-White Portland Cement.

Mineral trioxide aggregate (MTA) is an ideal yet costly endodontic sealer material. Tricalcium silicate-white Portland cement (TS-WPC) seems to have similar characteristics to those of MTA. This work aims to characterize a modified TS-WPC and evaluate its antibacterial properties as a potential endodontic sealer material. The modified TS-WPC was synthesized from a 4:1 mixture of sterilized Indocement TS-WPC and bismuth trioxide using a simple solution method with 99.9% isopropanol. The mixture was stirred until it was homogenous, centrifuged, and dried. The material was then characterized using infrared spectroscopy, X-ray diffraction, and electron microscopy and subjected to antibacterial evaluation against Enterococcus faecalis using a Mueller-Hinton agar inhibition test. The results showed that the material was characterized by main functional groups of hydroxyls, silicate, bismuth trioxide, and tricalcium silicate, like those of a commercial MTA-based sealer, both tested after hydration. Modified TS-WPC before hydration showed similar powder morphology and size to the commercial one, indicating the ease of manipulation. Both materials exhibited antibacterial activity due to calcium dihydroxide's ability to absorb carbon dioxide, which is essential for the anaerobic E. faecalis, with minimum inhibitory effect and bactericidal concentrations of 12,500 ppm and 25,000 ppm, respectively. The modified TS-WPC has the potential to become a cost-effective alternative endodontic sealer material.

Enhancement of α-Mangostin Wound Healing Ability by Complexation with 2-Hydroxypropyl-ß-Cyclodextrin in Hydrogel Formulation.

α-Mangostin (α-M), one of the active compounds in Garcinia mangostana peel, has been effectively used in wound healing. However, its poor solubility in aqueous solution causes low bioavailability for skin ulcers, hindering its application in wound healing. The aim of this study was to improve the solubility of α-M through complex formation with 2-hydroxypropyl-ß-cyclodextrin (α-M/HP-ß-CD CX) and to evaluate the healing activity of the complex. The α-M/HP-ß-CD CX was incorporated in a sodium carboxymethylcellulose hydrogel (α-M/HP-ß-CD CX HG), and the in vivo healing activity was examined in mice. Evaluation of α-M/HP-ß-CD CX HG, including organoleptic evaluation, homogeneity, pH, spreadability, swelling ratio, consistency, scanning electron microscopy (SEM), and in vitro drug release, was carried out. The complex formation of α-M/HP-ß-CD CX was confirmed by FTIR and PXRD analysis. The solubility of the α-M/HP-ß-CD CX in water linearly increased about 11.7-fold compared to α-M alone, and by 3.5-fold compared to the α-M/HP-ß-CD physical mixture (α-M/HP-ß-CD CX PM). The α-M/HP-ß-CD CX HG was homogenous, the pH was found to be in the neutral range, the spread area was 5 cm, and the consistency was stable until 14 days. SEM analysis showed that α-M/HP-ß-CD CX HG surged due to the porous structure of the HG. In addition, in vitro release of α-M from α-M/HP-ß-CD CX HG was considerably increased compared to α-M/HP-ß-CD PM HG and α-M HG. Notably, in vivo evaluation in mice showed that α-M/HP-ß-CD CX HG significantly accelerated the wound healing ability compared to other HGs. Thus, α-M/HP-ß-CD CX HG has potential as a new formulation of α-M for wound healing therapy.

Matrix levels of metalloproteinase-2 (MMP-2) and toxicity evaluation of carbonate apatite-based endodontic sealer in rat subcutaneous implantation.

OBJECTIVE: The aims of this study is to investigate the matrix metalloproteinase-2 (MMP-2) levels and the toxicity evaluation to determine the safety of carbonate apatite material that will be used as an endodontic sealer. METHODS: Carbonate apatite as endodontic sealer material is fabricated with a size of 2 × 2 × 1 mm, sterilized, and then implanted in the subcutaneous area on the murine back. Total of 28 rats was divided into 2 groups: the implantation group and the control group (positive and negative). We observed behavior, macroscopic and microscopic images (through hematoxylin-eosin/HE staining) and MMP-2 levels in the serum (through ELISA examination) to determine the reaction of implant material in experimental animals. RESULTS: Behavioral test shows impaired motor function within 2-24 h in all rats, autonomic behavioral test does not show any disturbance, macroscopic images show appearance of tumor and rubor within 2-72 h in all rats, microscopic images shows an increase in the mean neutrophils number with the highest point located in the 24 h (3.92×103/µL) and lymphocytes with the highest point in the 14 days (15.31×103/µL). The average value of MMP-2 levels of the negative control group was 1.33 ng/ml, 1.29 ng/ml of the positive control group, and 7.32 ng/ml of the implantation group. Level of MMP-2 in rats with visible implants increased on day 3 (0.75 ng/ml), day 10 (1.49 ng/ml) and day 14 (17.67 ng/ml). CONCLUSION: The implantation of carbonate apatite material did not cause behavioral disorders or abnormalities in the tissues surrounding of the implant site and did not show signs of toxicity or death.

Fabrication and Characterization of Chitosan-Collagen Membrane from Barramundi (Lates Calcarifer) Scales for Guided Tissue Regeneration.

OBJECTIVES: The aim of this study was to evaluate the synthesis, mechanical strength, and morphology of chitosan-collagen membranes from barramundi scales for guided tissue regeneration technique. MATERIALS AND METHODS: Collagen was extracted from barramundi scales by immersion in acetic acid. The resulting wet collagen was later dried. The membrane was fabricated by mixing chitosan with collagen from barramundi scales. Membrane characterization parameters were measured using Fourier transform infrared (FTIR), scanning electron microscopy (SEM) and mechanical property. RESULTS: The FTIR spectrum showed the typical peak of the mixture of chitosan and collagen. The tensile strength and elongation at break of the membrane in dry condition were 0.28 MPa and 8.53%, respectively, while in the wet condition these were 0.12 MPa and 25.6%. The membrane porosity test result was 38.85%; SEM result showed a porous membrane surface with size varying around 16 to 100 µm. CONCLUSION: The chitosan-collagen membrane from the barramundi scale showed the fibrous membrane surface that has ideal porous size as guided tissue regeneration membrane and the lower mechanical strength.

Calcium release and physical properties of modified carbonate apatite cement as pulp capping agent in dental application.

BACKGROUND: Carbonate apatite (CO3Ap) and silica-calcium phosphate composite (SCPC) are bone substitutes with good prospect for dental application. SCPC creates a hydroxyapatite surface layer and stimulate bone cell function while, CO3Ap induce apatite crystal formation with good adaptation providing good seal between cement and the bone. Together, these materials will add favorable properties as a pulp capping material to stimulate mineral barrier and maintain pulp vitality. The aim of this study is to investigate modification of CO3Ap cement combined with SCPC, later term as CO3Ap-SCPC cement (CAS) in means of its chemical (Calcium release) and physical properties (setting time, DTS and pH value). METHODS: The study consist of three groups; group 1 (100% calcium hydroxide, group 2 CO3Ap (60% DCPA: 40% vaterite, and group 3 CAS (60% DCPA: 20% vaterite: 20% SCPC. Distilled water was employed as a solution for group 1, and 0.2 mol/L Na3PO4 used for group 2 and group 3.Samples were evaluated with respect to important properties for pulp capping application such as pH, setting time, mechanical strength and calcium release evaluation. RESULTS: The fastest setting time was in CO3Ap cement group without SCPC, while the addition of 20% SCPC slightly increase the pH value but did not improved the cement mechanical strength, however, the mechanical strength of both CO3Ap groups were significantly higher than calcium hydroxide. All three groups released calcium ions and had alkaline pH. Highest pH level, as well as calcium released level, was in the control group. CONCLUSION: The CAS cement had good mechanical and acceptable chemical properties for pulp capping application compared to calcium hydroxide as a gold standard. However, improvements and in vivo studies are to be carried out with the further development of this material.

Effect of setting atmosphere on apatite cement resorption: An in vitro and in vivo study.

OBJECTIVES: The aim of this present study was to investigate the effect of setting atmosphere on replacement of apatite cement with new bone both in vitro and in vivo. MATERIAL AND METHODS: Apatite cement consisting of an equimolar mixture of tetracalcium phosphate and anhydrous dicalcium phosphate was mixed with distilled water and allowed to set at 37 °C and 100% relative humidity under 0%, 5%, and 100% CO2 atmospheres. X-Ray diffraction and Fourier Transform Infrared Spectroscopy were employed to confirm the carbonate apatite formation. Micro-CT and histological evaluation was made at 1 and 6 month(s) using twelve 10-week-old specific-pathogen-free male Wistar rats. RESULTS: B-type carbonate apatite was found when the apatite cement was set under 100% CO2 and 5% CO2. More carbonate apatite was formed in the case of 100% CO2 when compared with 5% CO2, and none was formed under 0% CO2. Interestingly, unreacted tetracalcium phosphate was significant when apatite cement was set under 0% CO2, indicating the formation of Ca-deficient hydroxyapatite. When a bone defect of rat tibia was reconstructed in these conditions of apatite cement and sintered hydroxyapatite, replacement of the apatite cement was confirmed 6 months after implantation, whereas no replacement was observed in the case of sintered hydroxyapatite. The amount of replacement of apatite cement with bone was greater, on the order of 100% CO2 and 5% CO2, followed by 0% CO2. CONCLUSION: The results obtained in the present study demonstrated that setting atmosphere clearly plays an important role in the replacement of set apatite cement with bone.