Background: Root canal irrigation is an important stage in root canal treatment as it is requires to eliminate necrotic and debris tissue as well as root canal wetting. Unfortunately, root canal irrigation can cause the material utilised to pass into the apical foramen leading to periapical complications. Consequently, the irrigation solution should have low toxicity. Sodium hypochlorite (NaOCl) is a commonly used irrigation solution since it has antibacterial properties. Moreover, NaOCl is also known to have the ability to dissolve necrotic tissue, vital pulp tissue and organic components of dentin and biofilms. Nevertheless, it can still cause damage when coming into contact with periapical tissues. On the other hand, Mangosteen peel extract (Garcinia mangostana L.), also has antibacterial activities. Hence, Mangosteen peel extract is assumed to be employable as an alternative irrigation solution. Purpose: This research aimed to reveal the toxicity levels of NaOCl and Mangosteen peel extract (Garcinia mangostin L.) used as irrigation solution in human periodontal ligament fibroblast cells (HPdLFc). Methods: HPdLFc were obtained from periapical tissues taken from one third of the first premolar teeth cultured. These cells were subsequently divided into several groups exposed to NaOCl and Mangosteen peel extract at certain concentrations. A toxicity test was then conducted using MTT assay. The results were analyzed with an Elisa reader. Cell deaths and LC50 were then calculated. Results: NaOCl became toxic at a concentration of 0.254 µl/ml or 0.025%, while Mangosteen peel extract became so at one of 2.099 ug/ml or 0.209%. Conclusion: NaOCl can be toxic at a concentration of 0.254 µl/ml or 0.025% and Mangosteen peel extract at one of 2.099 μg/ml or 0.209%.

Background: The smear layer is attached to dentine and occludes the orifice and, consequently, must be removed in order to improve the success of inroot canal treatment. The ideal irrigation material removes both the organic and inorganic smear layers. Ethylene diamine tetra-acetic acid (EDTA) is one of the most commonly used root canal irrigation materials, but removes only inorganic smear layer. To overcome this problem, Pineapple (Ananas comosus L. Merr.) peel extract, which contains saponins, bromelain, polyphenol and flavonoid, is used during root canal irrigation. Purpose: The study aimed to analyze the difference in smear layer removal between the use of 6.25% pineapple peel extract and 17% EDTA. Methods: 27 samples of mandibular premolar teeth with straight root canals were divided randomly into three groups (n = 9) and subsequently prepared using protaper. Irrigation was performed on the control group (aquadest), group I (17% EDTA) and group II (6.25% pineapple peel extract). The samples were dried, temporarily compressed and cut horizontally from the apical to the coronal. Samples were fixed with holder before the smear layer was observed through a scanning electron microscope (SEM). The resulting data was analyzed by means of an ANOVA test. Results: The highest score of root canal hygiene was recorded by group II, followed by group I and, finally, the control group. There were significant differences between the groups (p< 0.000). Conclusion: 6.25% pineapple peel extract produces a higher smear layer removal effect than 17%EDTA on the apical 1/3 of the root canal.

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Background. The prevalence of Enterococcus faecalis bacterial infection caused the failure of root canal treatment between 24%-77%. This is due to various factors resistance and virulence of Enterococcus faecalis. This research to find alternative materials that have antibacterial properties and by utilizing natural ingredients that can later be used as a root canal irrigation. Antibacterial activity of the Averrhoa bilimbi linn leaf extract against Enterococcus faecalis bacteria can be determined by Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC). Purpose. The aim of this study was to determine the concentration of Averrhoa bilimbi linn leaf extract that has antibacterial activity against bacteria Enterococcus faecalis. Method. This research is a labolatory experimental with post test only control group design which use diluted Enterococcus faecalis ATCC 29212 according Mc. Farland standard 1,5 x 108 CFU/ml. With treatment Averrhoa bilimbi linn leaf extract on concentration 50%, 45%, 40%, 35%, 30%, and 25% given to each of 0,05 ml  Enterococcus faecalis and using Brain Heart Infusion Broth (BHIB) as planting media. Result. At the concentration 30% of Averrhoa bilimbi linn leaf extract, showed that colony’s growth less than 10%. At the concentration 35% was not revealed any bacterial growth. Conclusion. The Averrhoa bilimbi linn leaf extract has antibacterial effect on bacteria Enterococcus faecalis. The MIC was at 30% and MBC was at 35%.

Root canal treatment failure is mostly caused by the elimination of bacteria and their products improperly. Besides, the root canal treatment failure can also be caused by both external objects, such as filling material and traumatic injury. [1] E. faecalis are Gram-positive bacteria commonly found in the root canal of chronic apical periodontitis. [2] Lipoteichoic acid (LTA) is the main virulence component of Enterococcus faecalis which can induce inflammation and generate immune response by the host. [3] The bond of Toll Likr receptor 2 and LTA then triggers a signaling for activation of the natural immune response through activation and transcription of nuclear factor-kappa beta (NF-κβ) factor, the main regulator of the inflammatory response. [4] NF-κβ is also considered as a complex protein controlling proinflammatory cytokines. NF-κβ can be activated in inflammatory and neoplastic conditions. [5] The expression of NF-κβ will result in stimulation of pro-inflammatory cytokines. These proinflammatory cytokines then can stimulate bone damage. The main cells that play a role in bone resorption are osteoclasts. [6] Osteocalcin is a noncollagen protein derived from bone and dentine. Osteocalcin plays a role in calcium ionization and homeostasis. Osteocalcin is a biomarker of bone resorption

Background: Risk factors for developing secondary caries are similar to those resulting in primary caries. The marginal seal of a restoration is one of the important factors predicting clinical success. The antibiofilm effect of materials used for the luting cement of oral function affects oral health. Antibiofilm properties of dental luting materials such as Glass Ionomer Cement (GIC) and Resin Modified Glass Ionomer Cement (RMGIC) may improve the restorative treatment outcome. Purpose: This experiment evaluates the antibiofilm effect of GIC and RMGIC on Lactobacillus acidophilus in vitro. Method: Lactobacillus acidophilus served as test microorganism. The quantitative microtiter plate biofilm assays were used to evaluate the antibiofilm effect of the dental luting materials on early-stage biofilm using a direct contact test (DCT) then continued by reading of Optical Density (OD) of biofilm using ELISA reader at a wavelength of 570nm. Result: GIC and RMGIC showed a decrease of OD value from negative control in all groups. The materials’ elute had effect on both bacterial growth with GIC higher then RMGIC to inhibit Lactobacillus acidophilus biofilm formation. Conclusion: The antibiofilm effect of GIC more effective than RMGIC to inhibit Lactobacillus acidophilus biofilm formation.

Background: Preparation, one of the stages in root canal treatment, always producesdebrisas aresultof instrumentation onroot canalwalls. Debrisconsistsoforganicand inorganicmaterials. Irrigation need to be performed in every preparation so that debrisandmicroorganisms can be removed from root canal wallsthrough flushingmechanism. NaOCl 2.5% is the most popular irrigant used in root canal treatment. However, NaOCl2.5% onlyworks onorganic tissue. Mangosteenpeel extractcontainsvariousactive compounds, such as saponin. Saponin acts assurfactantso as tolower thesurface tension and remove debris from the root canalwalls. Purpose: to compare the cleanliness of root canal walls following irrigation with NaOCl 2.5% and mangosteen peel extract. Method: Eighteen mandible premolar extracted for orthodontics necessity were used in this study. The teeth were divided into three groups, in which each group consists of six teeth. All of them were instrumented with ProTaper for Hand Use and irrigated. Group 1 used aquadest as irrigant, group 2 used NaOCl 2,5%, and group 3 used mangosteen peel extract 400 ug/ml. The roots were split longitudinally into halves and in 1/3 of apex. The surface of the canal walls were examined using scanning electron microscope. Photomicrographs were scored by three independent observers and statistically tested. Result: There were significant differences between three groups (p<0.05). Group 3, irrigated with mangosteen peel extract 400 ug/ml, had the smallest median score that was 1. Conclusion: Mangosteen peel extract is moreeffective thanNaOCl 2.5% incleaningroot canalwall from debris.