Propolis-enhanced Calcium Hydroxide Combination for Direct Pulp Capping: Impact on Oxidative Stress Markers in Wistar Rat Teeth.

Introduction: This study explored the effects of propolis extract calcium hydroxide (Ca(OH)2) combination on malondialdehyde and superoxide dismutase expression in dental pulp, aiming to assess its potential as a direct pulp capping material. Materials and Methods: Thirty male Wistar rats were randomly assigned to three groups. Mandibular molar teeth were prepared using a low-speed round bur. In Group I, no material was applied; in Group II, teeth were treated with Ca(OH)2; and in Group III, teeth were treated with Propolis extract-Ca(OH)2, followed by Cention N filling. Immunohistochemistry was conducted on pulp tissue samples obtained on the third and seventh days post-treatment to assess malondialdehyde and superoxide dismutase expression. Statistical analyses included the Shapiro-Wilk test, Levene test, ANOVA, and Tukey's HSD. Results: The samples treated with propolis extract-Ca(OH)2 combination exhibited significantly lower malondialdehyde expression on both days compared to samples treated with Ca(OH)2 (P<0.05), indicating reduced oxidative stress. Superoxide dismutase expression in the propolis extract-Ca(OH)2 group was higher (P<0.05), suggesting an enhanced antioxidant activity. The control group showed intermediate results. Statistical analyses confirmed significant differences between groups for both malondialdehyde and superoxide dismutase expressions (P<0.05). Conclusion: The study suggests that the propolis extract-Ca(OH)2 combination holds promise for direct pulp capping applications by minimizing oxidative stress and promoting antioxidant defense mechanisms in dental pulp.

The different effects of low-level laser therapy before and after overinstrumentation on the expression of substance P and interleukin-10.

Background: One of the causes of endodontic flare-ups is overinstrumentation during canal preparation. In general, to reduce the level of pain and swelling that is caused by endodontic flare-ups, patients it has taken analgesics and antibiotics after treatment. However, some patients have been reported to have allergic reactions to nonsteroidal anti-inflammatory drugs. Lasers have been reported to be significantly effective in reducing pain and inflammation after root canal treatment. Low-level laser therapy (LLLT) 650 nm pre- or post-conditioning is widely used as a therapy. Objective: This study investigated the effect of pre- or post-conditioning with a 650 nm diode laser to reduce pain caused by overinstrumentation. Methods: Thirty incisor teeth from Wistar rats were overinstrumented and exposed to a 650 nm diode laser before or after overinstrumentation and then divided into six groups. Groups I and II were control groups (30 and 120 min), groups III and IV were precondition groups (30 and 120 min) and Groups V and VI were postcondition groups (30 and 120 min). Immunohistochemical analysis was conducted to check the expression of substance P and interleukin-10 (IL-10). Result: The expression of substance P in the precondition LLLT groups was significantly lower than that in the control and postcondition groups. On the other hand, the expression of IL-10 in the precondition LLLT groups was significantly higher than that in the control and postcondition groups. Conclusion: There was a decrease in pain after preconditioning laser diode 650 nm exposure.

Biomodulator of Diode Laser Irradiation on Odontoblast-Like Cells by Expression of Vascular Endothelial Growth Factor-A and Transforming Growth Factor-ß1.

OBJECTIVE: This study aimed to prove that the effect of diode laser 650-nm irradiation to the expression of vascular endothelial growth factor (VEGF)-A and transforming growth factor (TGF)-ß1 plays important roles in dental pulp-regulating cell proliferation, differentiation, and revascularization. MATERIALS AND METHODS: The research was performed by randomized posttest only control group design using Rattus norvegicus. A total of 48 samples were provided and divided into eight groups of 6 samples each with a random-sample allocation. Each group were prepared, and perforation of maxillary first molar were done. In control groups (groups 1-4), glass ionomer cement (GIC) was used to restore the teeth, while in laser groups (groups 5-8), the teeth were irradiated with diode laser 650 nm for 40 seconds before application of GIC. Half of the groups (groups 1, 2, 5, and 6) were necropsied in 7 days, and the rest (groups 3, 4, 7, and 8) were necropsied in 14 days. Immunohistochemistry (IHC) evaluation were implemented to check the expression of both VEGF-A and TGF-ß1. STATISTICAL ANALYSIS: Both data of VEGF-A and TGF-ß1 expression were analyzed using a one-way ANOVA (α = 0.05) with SPSS statistical software. RESULTS: The study showed that the diode laser 650-nm irradiation increased expression of VEGF-A and TGF-ß1, and there was a significant difference between diode laser and control group on VEGF-A expression (p = 0.001) and TGF- ß1 (p = 0.000) on days 7 and 14. CONCLUSION: Diode laser 650 nm with 40-second irradiation time shows increment from day 7 to day 14 reflecting increase in pulp healing by modulating VEGF-A and TGF-ß1 expression since days 7 to 14.

The Osteogenesis Mechanisms of Dental Alveolar Bone Socket Post Induction with Hydroxyapatite Bovine Tooth Graft: An Animal Experimental in Rattus norvegicus Strain Wistar.

OBJECTIVES: Surgical endodontics (hemisection) commonly involves the alveolar bone socket and the periradicular tissue. In today's era, optimizing the bone healing process is updated by using bone graft induction. This study explores the mechanisms of bone healing of the alveolar bone socket post-dental extraction of Wistar rats after administration of a bovine tooth graft (hydroxyapatite bovine tooth graft [HAp-BTG]). MATERIALS AND METHODS: Fifty Wistar rats were randomly selected into two groups, control and treatment, and into five subgroups on days 3, 7, 14, 21, and 28. The postextraction socket was filled with polyethylene glycol (PEG) as the control and PEG + HAp-BTG as the treatment group. On days 3, 7, 14, 21, and 28, Wistar rats were sacrificed, mandibles were taken, paraffin blocks were made, cut 4 µm thick, and made into glass preparations for microscopic examination. The variable analysis was performed by staining hematoxylin-eosin for osteoblasts (OBs) and osteoclasts (OCs) and immunohistochemistry for runt-related transcription factor 2 (RUNX2), osterix (OSX), osteocalcin (OCN), bone morphogenic protein (BMP) 2. We analyzed the expressed cell count per microscope field. RESULTS: In general, the number of cell expressions in the treatment group was significantly higher and faster, except for significantly lower OC. The high variables peak occurred on day 14 for RUNX2 and OCN, on day 7 for OSX, while OB significantly increased on day 21 and remained until day 28. The decrease of OC cells occurred on day 7 and remained low until 28 days. BMP2 was first dominantly induced by HAp-BTG, then the others. CONCLUSION: HAp-BTG can induce higher and faster bone healing biomarkers. BMP2 is the dominant first impacted. On the 28th day, it did not significantly express the suppression of OC by OB, which entered the bone formation and remodeling step.

The Clinical Pattern and Prevalence of Streptococcus mutans and Streptococcus sobrinus among Adult and Children Patients with Dental Caries

Abstract Objective: To explore the clinical pattern, host factors, and presentation of Streptococcus mutans related to caries incidence among children and adults visiting Universitas Airlangga dental clinic. Material and Methods: This was an observational study with a cross-sectional approach with 50 patients in each group of carious children (6-12 years) and adults (18-35 years). Dental decay samples were taken by sterile excavator, put in a BHI's transport medium, and directly incubated overnight at 37 ºC. The next day, they were sub-cultured microbiologically in Tryptone Yeast Cystine Sucrose Bacitracin (TYCSB) selective medium. Bacterial species and serogroups were examined by PCR. All patient's data were collected from medical records and direct observation. Results: Caries were mostly media type in both children and adults. Oral hygiene (OHIS) in children was higher than in adults but not significantly different according to their DMFT. The highest scores for decay, missed and filled teeth were 16, 8 and 7, with an average of 6.82, 1.22 and 0.63, considered quite high. Conclusion: The prevalence of S. mutans was higher in children's caries than in adults, but among the adult patients the co-incidence of S. mutans and S. sobrinus was associated with higher DMFT. The mutans serotypes e, f, and d were more prevalent among children than adults.

The Inhibitory Ability of Cocoa Pod Husk Extract on Enterococcus faecalis Glucosyltransferase Enzyme Activity.

BACKGROUND: The presence of Enterococcus faecalis in root canal is considered as one of the factors causing root canal treatment failure since the bacteria are capable of producing glucosyltransferase enzymes that play a role in forming endodontic biofilms. Hence, the bacteria are resistant to antibiotics. On the other hand, cocoa pod husk extract which is rich in chemical components especially flavonoids, tannins, and saponins, is thought to have an ability to inhibit Enterococcus faecalis glucosyltransferase enzyme activity. AIM: The aim of this research is to analyze the inhibitory ability of cocoa pod husk extract against E. faecalis glucosyltransferase enzyme activity. MATERIALS AND METHODS: A total of 27 research samples were divided into three groups, namely, positive control (chlorhexidine gluconate 2%), negative control (aquades), and cocoa pod husk extract 3.12%. Next the enzymatic activity of each sample group was calculated based on the size of the fructose area read by high-performance liquid chromatography (HPLC) expressed in percent (%) and then converted to µmol/mL fructose which was considered as 1 unit of glucosyltransferase enzyme activity. Subsequently, the data were analyzed statistically using Kruskal-Wallis test. RESULTS: The results of data analysis using the Kruskal-Wallis test showed significant differences between groups of samples (p <0.05). CONCLUSION: Cocoa pod husk extract of 3.12% has inhibitory effect on E. faecalis glucosyltransferase enzyme activity. CLINICAL SIGNIFICANCE: The use of cocoa pod husk extract meets the requirements and is proven useful as an irrigation agent in the treatment of root canals, because it contains antibacterial properties against E. faecalis.

East java extract propolis as potential intracanal medicament in experimentally induced chronic apical periodontitis.

INTRODUCTION: A persistent infection after cleaning and shaping root canal is the main etiology of root canal treatment failure. Enterococcus faecalis has been considered as one of the most resistant species in root canal treatment. E. faecalis can stimulate receptor activator of nuclear factor-kappa B ligand (RANKL) which can increase nuclear factor of activated T-cell (NFATc1) in chronic apical periodontitis. East Java propolis has antibacterial effects and is biocompatible with in vitro effects. AIM: This study is aimed to analyze the East Java propolis extract as potential intracanal medicament in chronic apical periodontitis caused by E. faecalis bacterial infection. MATERIALS AND METHODS: This study used 30 Wistar rats divided into three groups. In Group I, the first upper right molar tooth as healthy tooth was used for negative control group. In Group II, the first upper right molar tooth was used for a prepared root canal, and 10 ml brain heart infusion broth containing E. faecalis ATCC29212 106 CFU was injected into the canal and restored with glass-ionomer cement (GIC) for the experimentally induced chronic apical periodontitis group. In Group III, after root canal preparation, E. faecalis ATCC 29212 106 CFU was injected, and then, 10 µl propolis applied and tooth restored with GIC. It took 21 days for the periapical lesions to develop after pulp infection. The rats were then sacrificed to conduct immunohistochemical examinations in order to measure the expressions of RANKL and NFATc1. RESULTS: The average of RANKL and NFATc1 expression in Group III was significantly lower than those in the experimentally induced chronic apical periodontitis group (P < 0.05). CONCLUSION: It can be concluded that East Java propolis extract is a potential intracanal medicament through the study of experimentally induced chronic apical periodontitis caused by E. faecalis infection in Wistar rats.

Expression of Osteoprotegrin and Osteoclast Level in Chronic Apical Periodontitis Induced with East Java Propolis Extract.

INTRODUCTION: The objective of this animal study was to promote East Java propolis as a potential natural intracanal medicament for periapical chronic apical periodontitis bone resorption through evaluating the expression of osteoprotegrin (OPG) and osteoclast level. METHODS AND MATERIALS: Propolis extract was produced using a maceration procedure. Thirty Wistar rats were divided into three groups. In group I, the control group, the first upper right molar constituted a healthy tooth. In group II, containing rodents with experimentally chronicapical periodontitis, infection with Enterococcus faecalis ATCC29212 106 CFU was performed. In group III, the treatment group, after being injected with E faecalis, 10 µL propolis was applied. It required 21 days to induce post-pulp chronic apical periodontitis infection. The rats were euthanised for immunohistochemical examination in order to measure the expression of OPG and to count histologically the number of osteoclast. RESULT: The expression of OPG and osteoclast constituted 17.5±1.58 and 6.4±0.96 in group I, 10±2 and 16.2±1.31 in group II and 17±1.69 and 7.5±1.08 in group III. Group I presented the highest level of OPG expression but the lowest level of osteoclast expression. There were significant differences between groups II and III and group I regarding OPG and osteoclast expression (P<0.05). CONCLUSION: East Java Propolis was a potential intracanal medicament promoting an increase in osteoprotegerin expression and a decrease in the number of osteoclasts thereby inhibiting osteoclastogenesis.