Streamline characteristics using the computational fluid dynamic analysis in the flow of 18% EDTA irrigation solution to remove Ca(OH)2

The remaining calcium hydroxide (Ca(OH)2) medicaments in the root canal wall can block the penetration of filling medicaments to the dentine tubule and cause the failure in the root canal treatment. One of the ways in cleaning the root canal wall from the remains of (Ca(OH)2) is by using 18% Ethylene Diamine Tetra Acetic Acid (EDTA) irrigation solution. The cleanliness of the root canal can be examined using the Computational Fluid Dynamics (CFD) analysis. The aim of this research was to see the description of the cleanliness of the root canal wall from the (Ca(OH)2) medicament with 18% EDTA irrigation by means of CFD analysis. This is a descriptive-explorative research. Having been validated with the experimental research using test specimen in the form of block resin made in accordance with the characteristics of root canal, the description of the cleanliness of the root canal wall from the (Ca(OH)2) medicament with the 18% EDTA irrigation was analyzed using CFD method. The irrigation needle used was the side-vented type with the position of 3 mm from the tooth apical. The results of the research showed the conformity between the result of experimental research and CFD research. One of the results of this research was the characteristics of streamline of 18% EDTA in the root canal showing a unique behavior due to the characteristics of the form of side vent irrigation needle. The irrigation flow in the coronal area of the inlet (side vent irrigation needle) showed a low velocity causing the more fluid flowing out from the inlet went to apical rather to the outlet (root canal orifice). In conclusion, this research showed that 18% EDTA solution indicated the conformity of validation results between experimental research and CFD research in the frames of 5, 10, 15, and 20 secs observed from experimental research with the of frame 0,010, 0,099, 0,150 and 0,410 secs as observed from CFD research

<p>Penatalaksanaan non-bedah kasus previously initiated therapy gigi molar pertama maksila dengan lesi periapikal dan konfigurasi dua saluran akar mesiobukal<p></p> Non-surgical management of previously initiated therapy of the maxillary first molar with periapical lesions and two mesiobuccal canals configuration<p>

ABSTRAK Pendahuluan: Penatalaksanaan kasus penyakit pulpa yang disertai dengan lesi periapikal dapat dilakukan dengan perawatan saluran akar tanpa intervensi bedah. Preparasi biomekanis pada perawatan endodontik non-bedah dapat mengeliminasi bakteri dari saluran akar dan mencegah terjadinya infeksi berulang setelah dilakukannya obturasi. Kompleksitas anatomi menyebabkan keterbatasan preparasi biomekanis saluran akar, sehingga perawatan dapat mengalami kegagalan. Variasi anatomi saluran akar pada gigi molar pertama rahang atas umumnya terdapat pada bagian palatal akar mesiobukal yang disebut sebagai saluran akar mesiobukal kedua dengan insidensi 94%. Saluran akar mesiobukal kedua berukuran lebih sempit dan dangkal dibandingkan saluran akar mesiobukal pertama, sehingga dibutuhkan beberapa metode untuk menentukan lokasi orifis tersebut. Tujuan laporan kasus ini adalah membahas mengenai penatalaksanaan non-bedah gigi pasca perawatan endodontik parsial yang disertai dengan lesi periapikal. Laporan kasus: Pasien perempuan berusia 28 tahun datang dengan keluhan gigi belakang kiri atas sakit berdenyut sejak 1 bulan, gigi tersebut pernah dirawat saluran akarnya beberapa tahun sebelumnya. Pemeriksaan klinis menunjukkan terdapat tambalan permanen pada gigi 26. Pemeriksaan radiografis menunjukkan adanya gambaran radiopak pada email mesio-oklusal hingga mencapai dasar kamar pulpa, pelebaran ligamen periodontal, terputusnya lamina dura, serta lesi periapikal pada akar mesial dan palatal. Preparasi akses dilakukan pada gigi 26, dilanjutkan dengan penentuan lokasi orifis mesiobukal kedua. Empat saluran akar dipreparasi menggunakan instrumen rotary nickel titanium dengan teknik crown down dan dilakukan obturasi teknik kondensasi lateral. Restorasi definitif berupa mahkota penuh porselen. Simpulan: Lesi periapikal sembuh setelah dilakukan preparasi pada saluran akar mesiobukal kedua sehingga pengetahuan mengenai anatomi dan variasi internal saluran akar gigi sangat penting dalam keberhasilan perawatan endodontik non-bedah. Kata kunci: Perawatan endodontik non-bedah; previously initiated therapy; lesi periapical; mesiobukal kedua    ABSTRACT Introduction: The management of pulp disease cases accompanied by periapical lesions can be done by root canal treatment without surgical intervention. Biomechanical preparations for non-surgical endodontic treatment can eliminate bacteria from the root canal and prevent re-infection after obturation. However, the complexity of the anatomy limits the biomechanical preparation of the root canal so that treatment can fail. Anatomical variations of the root canal in the maxillary first molars are generally found in the palatal part of the mesiobuccal root, which is the second mesiobuccal root canal with an incidence of 94%. The second mesiobuccal root canal is narrower and shallower than the first mesiobuccal root canal, so several methods are needed to determine the location of the orifice. The purpose of this case report was to discuss the non-surgical management of teeth after partial endodontic treatment accompanied by periapical lesions. Case report: A 28-year-old female patient complained of throbbing pain in the left upper back tooth for one month. The tooth had had its root canal treated several years before. Clinical examination revealed permanent fillings on tooth 26. Radiographic examination showed the radiopaque appearance of mesio-occlusal enamel to the floor of the pulp chamber, widening of the periodontal ligament, rupture of the lamina dura, and periapical lesions of the mesial and palatal roots. Access preparation was performed on tooth 26, followed by the determination of the location of the second mesiobuccal orifice. Four root canals were prepared using a rotary nickel titanium instrument with a crown down technique and obturation with lateral condensation technique. The definitive restoration is a full porcelain crown. Conclusions: Periapical lesions healed after preparation of the second mesiobuccal root canal. This result proves that knowledge of the anatomy and internal variations of the root canal is fundamental in the success of non-surgical endodontic treatment. Keywords: Non-surgical endodontic treatment; previously initiated therapy; periapical lesions; second mesiobuccal cana

<p>Perawatan saluran akar pada gigi molar pertama kanan mandibula dengan pulpitis ireversibel simtomatik</p><p>Root canal treatment of mandibular right first molar with symptomatic irreversible pulpitis</p>

Pendahuluan: Pulpitis ireversibel simtomatik ditandai dengan hipersensitivitas terhadap stimulus termal, yang menyebabkan nyeri spontan atau rasa sakit yang bertahan 30 detik atau lebih setelah stimulus dihilangkan, nyeri yang parah, persisten, dan sulit dilokalisir, dapat menjalar ke telinga, pelipis, mata atau leher. Kondisi pulpa yang terinflamasi tidak dapat kembali pulih dan perawatan saluran akar merupakan pilihan perawatan. Tujuan laporan kasus ini membahas mengenai perawatan saluran akar dengan pulpitis ireversibel simtomatik untuk menghentikan inflamasi pulpa dan mempertahan gigi. Laporan kasus: Pasien laki-laki berusia 35 tahun datang ke klinik dengan keluhan gigi belakang kanan bawah terasa sakit berdenyut sejak 1 minggu yang lalu. Gigi tersebut pernah dilakukan penambalan sementara 4 bulan sebelumnya dan tambalan tersebut patah serta nyeri spontan. Pemeriksaan radiologis gigi 46 menunjukkan gambaran radiolusen pada bagian mahkota hingga mencapai tanduk pulpa, terdapat 2 akar, dengan akar mesial dilaserasi ke arah distal dan akar distal lurus, serta saluran akar yang menghilang pada 2/3 dan 1/3 saluran akar distal dan mesial, tidak terdapat pelebaran membran periodontal, lamina dura normal dan tidak terdapat kelainan periapikal. Gigi 46 dilakukan anestesi lokal, dilanjutkan pembukaan akses dan ekstirpasi pulpa, kemudian preparasi saluran akar menggunakan nikel titanium rotary ProTaper Next® (Maillefer, Switzerland) dengan teknik crown down dan pengisian saluran akar. Restorasi follow up overlay komposit indirek pada gigi 46. Simpulan: Pulpitis ireversibel simtomatik pada gigi molar dengan akar dilaserasi terbukti dapat ditangani dengan perawatan saluran akar yang adekuat, ditandai dengan hilangnya keluhan pada pasien dalam kasus ini. Kata kunci: Pulpitis ireversibel simtomatik, perawatan saluran akar, teknik crown down.   ABSTRACT Introduction: Symptomatic irreversible pulpitis is characterised by hypersensitivity to the thermal stimuli, which causes spontaneous pain that lasts 30 seconds or more after the stimulus removed, severe, persistent and difficult to localise, can radiate to the ears, temples, eyes, or neck. The inflamed pulp does not recover; thus, root canal treatment is the treatment option. This case report was aimed to discuss the root canal treatment for symptomatic irreversible pulpitis to stop the pulp inflammation and preserve the teeth. Case report: A 35-year-old male patient came to the clinic with complaints of pulsating pain in the mandibular right molar since one week prior. The tooth had a temporary filling four months earlier, and the filling was fractured, and the pain was spontaneous. Radiological examination of tooth 46 showed radiolucent images on the crown until the pulp horn, there were found two roots, with mesial roots dilated distally and straight distal roots, and root canals that disappeared in the two-third and one-third of the distal and mesial root canals, no dilation of the periodontal membrane, normal lamina dura and no periapical abnormalities. Tooth 46 was subjected to local anaesthesia, followed by access opening and pulp extirpation, then the root canal preparation was performed using the ProTaper Next® rotary nickel-titanium (Maillefer, Switzerland) with the crown-down technique and root canal filling. Indirect composite overlay follow-up restoration was conducted of tooth 46. Conclusion: Symptomatic irreversible pulpitis in molars with dilacerated roots proved to be manageable with adequate root canal treatment, marked by the loss of the patients’ complaints. Keywords: Symptomatic irreversible pulpitis, root canal treatment, crown-down technique

Ocimum Species: A Review on Chemical Constituents and Antibacterial Activity

Infection by bacteria is one of the main problems in health. The use of commercial antibiotics is still one of the treatments to overcome these problems. However, high levels of consumption lead to antibiotic resistance. Several types of antibiotics have been reported to experience resistance. One solution that can be given is the use of natural antibacterial products. There have been many studies reporting the potential antibacterial activity of the Ocimum plant. Ocimum is known to be one of the medicinal plants that have been used traditionally by local people. This plant contains components of secondary metabolites such as phenolics, flavonoids, steroids, terpenoids, and alkaloids. Therefore, in this paper, we will discuss five types of Ocimum species, namely O. americanum, O. basilicum, O. gratissimum, O. campechianum, and O. sanctum. The five species are known to contain many chemical constituents and have good antibacterial activity against several pathogenic bacteria

Effectiveness of Bioactive Compound as Antibacterial and Anti-Quorum Sensing Agent from Myrmecodia pendans: An In Silico Study

Background: antibiotic resistance encourages the development of new therapies, or the discovery of novel antibacterial agents. Previous research revealed that Myrmecodia pendans (Sarang Semut) contain potential antibacterial agents. However, specific proteins inhibited by them have not yet been identified as either proteins targeted by antibiotics or proteins that have a role in the quorum-sensing system. This study aims to investigate and predict the action mode of antibacterial compounds with specific proteins by following the molecular docking approach. Methods: butein (1), biflavonoid (2), 3″-methoxyepicatechin-3-O-epicatechin (3), 2-dodecyl-4-hydroxylbenzaldehyde (4), 2-dodecyl-4-hydroxylbenzaldehyde (5), pomolic acid (6), betulin (7), and sitosterol-(6′-O-tridecanoil)-3-O-β-D-glucopyranoside (8) from M. pendans act as the ligand. Antibiotics or substrates in each protein were used as a positive control. To screen the bioactivity of compounds, ligands were analyzed by Prediction of Activity Spectra for Substances (PASS) program. They were docked with 12 proteins by AutoDock Vina in the PyRx 0.8 software application. Those proteins are penicillin-binding protein (PBP), MurB, Sortase A (SrtA), deoxyribonucleic acid (DNA) gyrase, ribonucleic acid (RNA) polymerase, ribosomal protein, Cytolysin M (ClyM), FsrB, gelatinase binding-activating pheromone (GBAP), and PgrX retrieved from UniProt. The docking results were analyzed by the ProteinsPlus and Discovery Studio software applications. Results: most compounds have Pa value over 0.5 against proteins in the cell wall. In nearly all proteins, biflavonoid (2) has the strongest binding affinity. However, compound 2 binds only three residues, so that 2 is the non-competitive inhibitor. Conclusion: compound 2 can be a lead compound for an antibacterial agent in each pathway

<strong>Antibacterial activity of strawberry fruit extract against <em>Streptococcus sanguinis</em> (ATCC 10556)</strong>

Introduction: Streptococcus sanguinis is a facultative anaerobic Gram-positive bacteria known as a pioneer that plays a role in creating the biofilm in the oral cavity. Strawberry fruit (Fragaria x ananassa) is an edible fruit widely used for the study as their active compound synergy to improve health. This study aims to analyse the antibacterial activity of strawberry fruit against S. sanguinis (ATCC 10556). Methods: An explorative study was conducted with high concentration methanol extract from strawberry fruit. Antibacterial activity was tested on the methanol extract; afterwards, the extract was fractionated and divided into three fractions: water, ethyl acetate, and hexane. Zone of inhibition was used to assess the most effective fraction among those three, then continued by testing for Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC). Results: Inhibitory zone of the ethyl acetate fraction from strawberry fruit 1%, 2%, 3% ,4% and 5% sequentially were 7.3 mm,10.2 mm, 12.3 mm, 16.3 mm and 16.1 mm. Ethyl acetate fraction of 4% was the most effective to create the zone of inhibition with a size of 16.3 mm compared to the others. The Minimum Inhibitory Concentration (MIC) value was 0.25%. It was obtained by diluting a 4% ethyl acetate fraction on a microplate. The Minimum Bactericidal Concentration (MBC) was 2%. Conclusion: Ethyl acetate fraction was an effective fraction from strawberry fruit and had antibacterial activity against S. sanguinis with the inhibitory zone in the concentration of 4%, MIC of 0.25%, and MBC of 2%