Whilst a diverse bacterial species were observed in the persistent apical lesions, some characteristic patterns of bacterial community were found in the symptomatic lesions. The diverse variation of community indicates that bacterial combinations as a community may cause persistent inflammation in periapical tissues rather than specific bacterial species.

Candida albicans, C. glabrata, and C. dubliniensis dominated the oral mycobiome in Japanese community-dwelling elderly. Lower BMI might signify compromised health status and thus could result in susceptibility to specific candidiasis by C. glabrata and C. dubliniensis.

Vitality of the pulp is a major key for the tooth to physiologically functioning in the mouth. Exposed pulp can be saved by pulp capping treatment diminishing the need for more complicated treatment such as root canal treatment or extraction. To induce tissue repair essentials factors must be considered namely proper case selection, method, material, adequate isolation and techniques. This literature review will discuss relevant issues and matters on pulp capping treatment based on evidence and findings from previous studies to achieve more predictable outcome of pulp capping treatment.

Carbonate apatite (CO3Ap) cement is a biocompatible material with the ability to induce osteogenesis and is widely studied as the bone substitute material. The similarity of bone to tooth structure in their organic and inorganic composition offers a good prospect of the application of CO3Ap for regeneration of dentin and pulp tissue repair. This study is a sequel of the previous study in the development of CO3Ap cement for dental application, particularly in pulp capping treatment. In this study, the CO3Ap cement is used to cover an exposed dental pulp in rats and histological evaluation was carried out to evaluate the formation of reparative dentin, which is one of the signs of positive pulp capping treatment outcome. The CO3Ap cement was made by combining 60% dicalcium phosphate anhydrous (DCPA) and 40% vaterite with 1 mol/L Na2HPO4 aqueous solution at liquid to powder ratio of 0.5 and conventional calcium hydroxide [Ca(OH)2], which is the golden standard for pulp capping material was used for control. The coronal part of dental pulp in Wistar Rat was exposed with a small dental bur until bleeding were visible. The CO3Ap cement was applied to the exposed pulp and covered with light cured glass ionomer cement. The same protocol was applied to the control groups using Ca(OH)2. The Evaluation of formation of reparative dentin was done in 3 weeks after application by histological observation. Reparative dentin was histologically visible for all samples in CO3Ap group, as well as in the Ca(OH)2 groups. None of the dental pulps were necrotic and the pulp showed no heavy chronic inflammation. The CO3Ap cement was able to maintain the vitality of the pulp with no sign of chronic inflammation. The formation of reparative dentin was observable in 3 weeks of evaluation. Investigation on other properties and in vivo studies in different types of perforation and animal are to be carried out for further development of this material in dental application.