In vitro Antibiofilm Activity of Pomegranate (Punica granatum) Juice on Oral Pathogens

  Introduction: Pomegranate (Punica granatum) fruit contains valuable ingredients, such as ellagitannins and flavonoids, that have many potential effects, including antibacterial, antifungal, and anti-inflammatory functions.   Objectives: The aim of this study was to investigate the effects of pomegranate fruit juice on F. nucleatum and S. sanguinis monospecies and multispecies biofilm formation in vitro.   Methods: Pomegranate juice was obtained using a juicer and diluted using a brain heart infusion (BHI) broth into five different concentrations. The biofilm assay was performed as follows: F. nucleatum and S. sanguinis were cultured separately in the BHI broth for 48 hours at 37°C in an anaerobic atmosphere. A 200 mL bacterial suspension (107 CFU/mL) was distributed into a 96-well plate and incubated for 24 hours to form  a biofilm. Subsequently, pomegranate juice was added to the biofilm well and observed after 1 hours, 3 hours, 6 hours, and 24 hours. The biofilm mass was measured using a microplate reader (490 nm) after crystal violet staining. Chlorhexidine (0.2%) and the biofilms without treatment were used as the positive and negative controls, respectively. The data were statistically analyzed using one-way analysis of variance, with p<0.05 as the level of significance.   Result: There was a significant biofilm reduction after treatment with pomegranate juice for all the concentrations and incubation times (p<0.05). The effective concentrations to inhibit the biofilm monospecies F. nucleatum and S. sanguinis and the multispecies were 6.25% (OD 0.148±0.019), 50% (OD 0.211±0.026), and 6.25% (OD 0.024±0.209), respectively.   Conclusion: Pomegranate juice inhibits F. nucleatum and S. sanguinis biofilm formation as a monospecies and a multispecies. Future studies are needed to observe the mechanism of this active substance

The Comparison of Metronidazole, Clindamycin, and Amoxicillin Againts Streptococcus sanguinis

  Introduction: Viridans streptococci group such as Streptococcus sanguinis (S. sanguinis), an anaerobic Gram-positive bacteria is a well-known for its involvement in dry socket (alveolar osteitis)-associated infection. Systemic amoxicillin, clindamycin and metronidazole have all been shown to be effective to inhibit this bacterium. However, there has been a lack of studies identifying which are the most effective amongst these antibiotics toward Streptococcus sanguinis.   Objectives: The purpose of this study is to evaluate the effectiveness of metronidazole, clindamycin, and amoxicillin in inhibiting the growth of Streptococcus sanguinis in vitro.   Methods: This effectiveness was done by using agar well diffusion methods. S. sanguinis ATCC 10556 were cultured in Brain Heart Infusion (BHI) broth at 37°C under anaerobic condition. After 48h, bacterial cells were harvested and counted using microplate reader (490 nm) to achieve optical density of 0.25-0.30 (107 CFU/mL). Subsequently, 100 μL of bacterial suspension was cultured on BHI agar and each antibiotic suspension was added into each agar well, incubated for 72h at 37°C. The inhibition zone diameters were measured with electronic caliper. All experiments were done in triplicate, and repeated two times in separated occasions. The obtained data were statistically analyzed using one-way ANOVA test. A  p<0.05 was considered as significance.   Result: The results showed that there was a significant difference in the effectiveness, clindamycin and amoxicillin in inhibiting the growth of Streptococcus sanguinis (p<0.05), compared to metronidazole. The inhibition zone diameter with mean±SD (mm) are 13.50±2.0, 34.67±2.3 and 32.67±1.7 for metronidazole, clindamycin and amoxicillin, respectively.   Conclusion: Clindamycin and amoxicillin are more effective in inhibiting the growth of Streptococcus sanguinis compared to metronidazole in this study. However, future studies are needed to confirm this result in vivo

Effectiveness of Matricaria chamomilla Essential Oil on Aggregatibacter actinomycetemcomitans and Treponema denticola Biofilms

  Introduction: Matricaria chamomilla (chamomile) is known to possess antimicrobial, anti-inflammatory, and antioxidant properties. Objectives: The purpose of this study was to determine how effectively Matricaria chamomilla essential oil acts against Aggregatibacter actinomycetemcomitans and Treponema denticola biofilms in vitro. Methods: Aggregatibacter actinomycetemcomitans ATCC-29522 and T. denticola ATCC-35405 were separately cultured in brain heart infusion (BHI) broth at 37°C for 2 4h in anaerobic conditions. Each bacterial suspension (200 uL, 107 CFU/mL) was cultured in 96-well plates for 48 h to form a biofilm. Thereafter, biofilms were treated with chamomile essential oil at concentrations of 3.12%, 6.25%, 12.5%, 25%, 50%, and 100% in a time-dependent experiment. Readings were taken at 1 h, 3 h, 6 h, and 24 h. Biofilm mass was evaluated using crystal violet staining (for A. actinomycetemcomitans) and safranin staining (for T. denticola). Biofilms treated with chlorhexidine (0.2%) and untreated biofilms were used as positive and negative controls, respectively. Data were statistically analyzed using one-way analysis of variance (ANOVA), with the significance level set to p<0.05. Results: Chamomile essential oil significantly reduced the biomass of the biofilms (p<0.05). The most effective chamomile oil concentrations for inhibiting A. actinomycetemcomitans and T. denticola biofilms were 100% and 50%, respectively, with 24 h incubation periods. The results of ANOVA and the post hoc Least Significant Difference (LSD) test showed a significant reduction (p<0.05) in biofilm mass for all concentrations of chamomile essential oil compared to the negative control across all incubation times. Conclusion: The data suggest that chamomile essential oil can inhibit the biofilm formation of A. actinomycetemcomitans and T. denticola biofilms. It could, therefore, be useful as an alternative treatment to inhibit the biofilms composes of the bacteria tested in periodontal disease cases. However, continued researches are necessary to further explore the mechanisms of this effect

Mahkota Dewa (God’s Crown) Fruit Extract Inhibits the Formation of Periodontal Pathogen Biofilms in vitro

Introduction: Mahkota dewa (Phaleria macrocarpa) is an Indonesian fruit that contains antibacterial compounds, such as flavonoids, saponins, and tannins; it has been used as an alternative treatment for controlling infection. Objectives: This study aimed to examine the effect of mahkota dewa fruit extract on the formation of Porphyromonas gingivalis (P. gingivalis), Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), and Treponema denticola (T. denticola) biofilms in vitro. Methods: God’s crown fruit was extracted using the maceration technique, and then diluted into different concentrations (25%, 12.5%, 6.25%, 3.125%, and 1.56%) using phosphate buffered saline (PBS). P. gingivalis ATCC-33277, A. actinomycetemcomitans ATCC-29522, or T. denticola ATCC-35405 were cultured in brain heart infusion (BHI) broth, 24h (anaerobic-condition), and then each type of bacteria (108CFU/mL) was distributed into a 96-well microplate to form a biofilm. Subsequently, the fruit extracts were distributed into the biofilm-containing well plates and incubated for 1h, 6h, and 24h. A biofilm without the fruit extract and chlorhexidine-gluconate (0.2%) was used as the negative and positive control, respectively. Crystal violet (0.5%w/v) was used to determine the density of the remaining biofilm using a microplate spectrophotometer (600 nm). Data were statistically analyzed using one-way ANOVA, and p <0.05 was set as the level of significance. Results: The mahkota dewa fruit extracts significantly inhibited the formation of a biofilm for all three bacterial strains at all concentrations and for each incubation time (p <0.05) based on optical density (OD)±SD.  The best concentration of fruit extract to inhibit biofilm formation was 25% for P. gingivalis (OD=0.19±0.06), 12.5% for A. actinomycetemcomitans (OD=0.14 ± 0.16), and 25% for T. denticola (OD=1.17±0.19) in comparison to the biofilm mass of the negative control, which was 1.67±0.06, 1.17±0.34, 2.66±0.38 for P. gingivalis, A. actinomycetemcomitans, and T. denticola, respectively. Conclusion: Based on these results, mahkota dewa fruit extract can inhibit the formation of biofilm on P. gingivalis, A. actinomycetemcomitans, and T. denticola, and it may potentially be used to prevent the infection associated with periodontal disease

Antibiofilm of Arumanis Mango Leaves (Mangifera indica L.) Ethanol Extract Against Staphylococcus aureus in vitro

  Introduction: Staphylococcus aureus is a pathogen bacteria that forms biofilm and induces acute inflammation associated with dentoalveolar abscess, which needs antibiotics such as amoxicillin for the treatment. Due to antibiotic resistance and various side effects, natural ingredients are needed as an alternative treatment. Arumanis mango leaves (Mangifera indica L.) contains mangiferin, flavonoid, and tannin which are expected to inhibit the growth of Staphylococcus aureus and its biofilm formation. Objective: The aim of this study was to determine the antibacterial and antibiofilm effects of Mangifera indica L. leaves against Staphylococcus aureus in vitro. Methods: This study was in vitro laboratory experiment with post test only control group design. Antibacterial test was carried out by plate count method and antibiofilm test was carried out by microtiter plate biofilm assay method. Staphylococcus aureus ATCC 25923 was cultured in BHI broth in 37oC for 24h with anaerobic condition. The present study used ethanol extract of Mangifera indica L. leaves in 6 different concentrations: 3,125%, 6,25%, 12,5%, 25%, 50%, and 100%. Amoxicillin was used as positive control and DMSO 10% used as negative control. Data was analyzed with Shapiro-wilk test, One-way ANOVA test, and post hoc Tukey HSD test with p<0,05 as the level of significance. Results: The most effective concentration to inhibit the growth of Staphylococcus aureus was 100% extract compared to negative control (p<0,05). The most effective concentration against Staphylococcus aureus biofilm formation was 100% extract in 3hr incubation compared to negative control (p<0,05). Conclusion: Ethanol extract of Mangifera indica L. leaves has been shown in vitro to have antibacterial and antibiofilm properties against Staphylococcus aureus

The Effect Ant-Nest Plant (Myrmecodia pendans) Extract on Streptococcus sanguinis and Treponema denticola Biofilms

Introduction: Ant-nest plant (Myrmecodia pendans) contains triterpenoid, flavonoid, saponin and tannin that acts as antibacterial substance. Objectives: This study’s aim was to analyze the effect of Myrmecodia pendans extract effect towards biofilm of Streptococcus sanguinis and Treponema denticola. Methods: Ant-nest plant was extracted using maceration technique. The obtained extract was diluted into five different concentrations using phosphate buffer saline (PBS). S. sanguinis and T. denticola ATCC 35405 were cultured in Brain Heart Infusion (BHI) broth, 48h, 37°C, anaerobic atmosphere and distributed into four 96 well-plate for 24h to form biofilm. Subsequently, the extract was distributed into the well that contained the mono-species and multispecies biofilm and then incubated for 1h, 3h, 6h and 24h. Chlorhexidine (0.2%) was used as positive control and BHI broth was used as negative control. The biofilm was stained using crystal-violet and measured by microplate reader with a wavelength of 490 nm. Data were statistically analyze using one-way ANOVA test and Post Hoc LSD test which p < 0,05 was set as significant difference. Result: The most effective concentrations to reduce mono-species biofilm were 100% in 1h incubation period for S. sanguinis (OD = 1,403 ± 0,019) and 24h for T. denticola (OD = 1,012 ± 0,037) and multispecies biofilm (OD = 0,984 ± 0,001) compared to negative control. Statistical analysis showed that ant-nest plant extract significantly reduced S. sanguinis, T. denticola and multispecies biofilm mass compared to negative control (p < 0,05). Conclusion: The ant-nest plant extract has inhibitory effects against S. sanguinis and T. denticola biofilm and it may be used as alternative for dental therapy. Future studies are needed to evaluate the potential of ant-nest plant extract in multispecies composed of other oral bacteria

Antibiofilm Effect of Rambutan Leaf Extract (Nephelium lappaceum L.) on Selected Periodontal Pathogens

  Introduction: In Indonesia, periodontal disease is one of the dental and oral diseases with the highest prevalence. Bacteria in subgingival plaque can cause periodontal disease, such as Porphyromonas gingivalis and Fusobacterium nucleatum. Herbal medicine has potential as an alternative in the treatment of periodontal disease, for example, rambutan leaves (Nephelium lappaceum L.) are known to have antibacterial properties because they contain flavonoids, tannins, and saponins. Objective: To determine the effects of rambutan leaf extract (Nephelium lappaceum L.) on development of Porphyromonas gingivalis and Fusobacterium nucleatum biofilms. Methods: This study was carried out using the biofilm assay method with crystal violet staining and rambutan leaf extract (Nephelium lappaceum L.) with concentrations of 100%, 50%, 25%, 12.5%, 6.25%, and 3.125% were used as the test material. A microplate reader with a wavelength of 490 nm was used to measure the biofilm density of Porpyromonas gingivalis ATCC 33277 and Fusobacterium nucleatum ATCC 25586. The data obtained were then analyzed statistically using one-way analysis of variance (ANOVA), with a significance level of p<0.05. Results: The most effective concentration of rambutan leaf extract for inhibiting biofilm development at 24 hours incubation was a 100% concentration with an average optical density (OD) of 0.147 against Porphyromonas gingivalis and a 100% concentration with an average OD of 0.077 against Fusobacterium nucleatum. Conclusion: Rambutan leaf extract (Nephelium lappaceum L.) is capable of inhibiting the development of Porphyromonas gingivalis and Fusobacterium nucleatum biofilms, respectively

Correlation between Dental Environment and Perceived Stress Scale among Dental Students during the COVID-19 Pandemic in Indonesia

Academic stressors in a medical educational environment are related to two factors. This study was carried out in order to analyze the correlation between the dental environment and perceived stress among dental students during the COVID-19 pandemic. The respondents were 422 undergraduate dental students and the validated Modified Dental Environmental Stress (DES) and Perceived Stress Scale (PSS) questionnaires were used. Furthermore, the Spearman correlation analysis was used to measure the correlation between DES and PSS score. The result showed that five dental stressors were noted to have the strongest correlations with PSS (p-value >0.40). They include expectation towards dental school (p-value = 0.431), lack of confidence to be a successful dentist (p-value = 0.424), lack of confidence to become a successful dental student (p-value = 0.408), dental school regulations (p-value = 0.401) and criticism of school work (p-value = 0.400). In addition, all six DES categories showed a positive correlation with the PSS. Therefore, the dental students collectively displayed moderate perceived stress scores. The overall discoveries from this study showed a positive correlation between the DES and PSS among dental students during the COVID-19 pandemic

Efficacy of World Health Organization-Recommended Homemade Hand Sanitizer Against Bacteria and Fungus

  Introduction: Handwashing is among the best practices to prevent the transmission of various diseases especially during the pandemic. Handwashing with soap can reduce respiratory tract infections. The World Health Organization (WHO) released guidelines for making homemade hand sanitizer. Objective: This study aimed to analyze the effectiveness of antibacterial hand- rub, as recommended by WHO, containing ethanol, hydrogen peroxide, and glycerol in varying concentrations against bacteria and fungus. Methods: This experimental laboratory study was designed to assay the efficacy of hand sanitizer ingredients—96% ethanol, 3% hydrogen peroxide, and 98% glycerol, as recommended by WHO—against Escherichia coli, Staphylococcus aureus, and Candida albicans. Commercial hand rubs were used in this study for comparison. Result: Minimum inhibitory concentration (MIC) testing showed that the WHO hand rub at 25% concentration inhibited E. coli and S. aureus growth, while 12,5% concentration inhibited C. albicans. Conclusion: The WHO-recommended homemade hand sanitizer containing ethanol, hydrogen peroxide, and glycerol at a concentration of 50% is effective in eliminating Escherichia coli, Staphylococcus aureus, and concentration of 25% is effective on Candida albicans. Further study is needed to analyse these materials against other bacteria and viruses

PANDUAN DOKTER GIGI DALAM ERA NEW NORMAL

KATA PENGANTAR PENGURUS BESAR PERSATUAN DOKTER GIGI INDONESIA Dimulai akhir Desember 2019 terjadi wabah virus baru di dataran china terkhusus di daerah Wuhan, yang secara cepat menyebar diluar China bahkan dalam waktu 2 bulan hampir seluruh dunia terinfeksi COVID-19, sehingga WHO menyatakan Outbreak COVID-19 Global Pandemic. Pada tanggal 2 maret 2020 Indonesia mengumumkan dimulainya kejadian wabah di wilayah Jakarta, Jawa Barat, dan Bali, dalam waktu singkat kurang 1 bulan, 34 provinsi terdeteksi COVID-19. Oleh karena Presiden RI menyatakan bencana nasional non alam, maka dibentuklah Gugus Tugas Percepatan Penanganan COVID-19 yang diawali oleh BNBP dari tingkat pusat hingga wilayah provinsi. Dengan adanya beberapa korban dokter gigi yang meninggal dunia akibat COVID-19, maka Kepala BNPB dan Kementerian Kesehatan menghimbau agar dokter gigi yang berisiko tinggi tertular COVID-19 saat memberikan pelayanan kesehatan gigi dan mulut, untuk sementara menghentikan pemberian pelayanan kecuali untuk kasus-kasus emergensi. Hampir 4 bulan para dokter gigi tidak praktik, tidak memberikan pelayanan langsung ke pasien, dan tidak dapat mengamalkan ilmu dan kompetensi dalam bentuk pengabdian kepada masyarakat. Banyak permintaan dan keluhan dari masyarakat, klinik, rumah sakit dan institusi pelayanan kesehatan agar para dokter gigi segera dapat berpraktik kembali, karena masyarakat kesulitan mendapatkan perawatan. Seiring dengan wacana Pemerintah menerapkan Kehidupan Normal Baru, atau Adaptasi Kebiasaan Baru yang dikenal dengan sebutan era New Normal, PB-PDGI memberikan kesempatan kepada dokter gigi seluruh Indonesia untuk memulai praktik kembali dengan berbagai ketentuan yang harus ditaati. Ketentuan-ketentuan ini dimaksudkan untuk melindungi dokter gigi dan tenaga kesehatan pendukung agar tidak tertular COVID-19, serta menghindari adanya infeksi silang di ruang tempat praktik. Dengan diterbitkan dan diberlakukannya Buku Panduan Dokter Gigi Dalam Era New Normal, maka dimulailah para dokter gigi Indonesia untuk berpraktik kembali. Buku ini memuat panduan secara lengkap, selain ketentuan berpraktik kembali di era new normal, tetapi juga tentang manajemen pembiayaan dan upaya promotif Kesehatan Gigi dan Mulut, yang didukung oleh literatur ilmiah yang kuat, sehingga dapat menjadi referensi bagi siapapun untuk penulisan ilmiah maupun penelitian. Ketua umum PB-PDGI memberikan apresiasi yang setinggi-tingginya kepada tim penulis buku Panduan Dokter Gigi Di Era New Normal, dengan dedikasi yang tinggi pula dan jerih payahnya mencari literatur, siang dan malam menyusun kata demi kata yang dirangkai menjadi kalimat-kalimat hingga terwujudnya buku ini yang menjadi pedoman bagi dokter gigi se-Indonesia untuk berpraktik di era new normal. Dengan penuh harapan, agar dokter gigi Indonesia dapat menggunakan buku ini secara bijak dan tidak menjadi keterpaksaan. Semoga Allah SWT selalu melindungi kita semua dan memberikan yang terbaik.. Aamiin...Aamiin... Ya Robbal ‘alamin. Demikian terima kasih. Jakarta, 30 Juni 2020 Dr. RM Sri Hananto Seno, drg., SpBM(K),MM Ketua Umum PB-PDGI   Editor: 1. Indrayadi Gunardi, drg., Sp.PM 2. Dr. Armelia Sari Widyarman, drg., M.Kes. PBO 3. Prof. Rahmi Amtha, drg., MDS., Sp.PM, Ph.D. 4. Iwan Dewanto, drg., MMR., Ph.D &nbsp