Suharni Mohamad

Background: Orthodontic patients are at an elevated risk for gingivitis due to the challenges of maintaining oral hygiene with fixed appliances. This network meta‐analysis evaluates the comparative effectiveness of various mouthwashes in managing gingivitis among these patients. Objectives: To assess the efficacy of different mouthwashes on Plaque Index and Gingival Index scores in orthodontic patients, utilizing both direct and indirect evidence from randomized controlled trials. Search Methods: Comprehensive searches were conducted in PubMed, Embase, Cochrane Library, Web of Science, Ovid, and grey literature for studies published up to November 2024. Selection Criteria: Only randomized controlled trials involving mouthwash use in orthodontic patients were included. Data Collection and Analysis: Data extraction was performed independently by two reviewers and the methodological quality of included studies was assessed using the Cochrane Risk of Bias tool. Results: Nine RCTs involving 376 participants were included. Aloe vera and Persica showed the highest SUCRA values (both 91.7%), followed by Chlorhexidine and NaF (74.4%). In the PI network, Persica ranked highest (90.0%), followed by Aloe vera (77.6%) and Chlorhexidine and NaF (74.8%). For PI, node‐splitting identified two estimable comparisons and did not detect significant inconsistency between direct and indirect evidence. For GI, no estimable node‐splitting comparison was available in the final network. Conclusions: Within the limitations of the available evidence, Aloe vera and Persica ranked highest for reducing gingival inflammation, while Persica ranked highest for reducing plaque accumulation in orthodontic patients with fixed appliances. However, these findings should be interpreted cautiously because the evidence base was limited and heterogeneous. Trial Registration: The study protocol was registered with PROSPERO (ID CRD42023472995) on 27/10/2023

Aims: This study investigates the antimicrobial potential of aqueous extracts from the leaves and stems of Cymbopogon citratus on the root canal pathogens of E. faecalis and S. sanguinis . Material and Methods: The sample extraction was constructed by reflux condensation, frozen at −20 °C and lyophilised under a freeze dryer at −50 °C to obtain a powder form. The chemical structure was analysed under Fourier-Transform Infrared Spectroscopy (FTIR) in transmission mode, wavenumber range from 400 to 4000 cm ⁻¹ with a spectral resolution of 4 cm ⁻¹ . The C. citratus extract powder was observed and viewed under a Scanning Electron Microscope (SEM). The extract powder was subjected to serial dilutions of 480 mg/mL, 240 mg/mL, 120 mg/mL, 60 mg/mL and 30 mg/mL. These concentrations were evaluated against Enterococcus faecalis and Streptococcus sanguinis under minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) assays. Result: Both leaf and stem extracts demonstrated concentration-dependent antibacterial activity, with efficacy observed against S. sanguinis than E. faecalis in concentrations ranging from 120 mg/mL to 480 mg/mL. Conclusions: These findings suggest that C. citratus extracts have promising potential as a natural antibacterial agent for root canal irrigation. However, further studies are necessary to explore its bactericidal mechanisms, optimise formulation, and assess its clinical applicability in root canal disinfection.

Oral protozoans, specifically Entamoeba gingivalis and Trichomonas tenax, have been identified in the oral cavity of individuals with periodontitis, frequently known as gum disease. Periodontitis is characterised by inflammation and degradation of the periodontal tissues and has been associated with the aggravation of systemic noncommunicable diseases. Although the importance of oral protozoans in periodontitis progression is often overlooked, their occurrence in individuals with periodontitis has reportedly been linked to the same modifiable risk factors contributing to numerous systemic noncommunicable diseases (NCDs). This article aims to provide a comprehensive overview of the occurrence patterns and potential connections among oral protozoans, periodontitis, and systemic NCDs while presenting the existing methods for the detection and identification of E. gingivalis and T. tenax.

This research assessed the mutagenicity and DNA damage of a novel type of nano-hydroxyapatite-silica glass ionomer cement (nano-HA-SiO₂-GIC) and a conventional GIC (cGIC) using Ames and Comet assays. Cell viability was tested on human periodontal ligament fibroblasts (HPLFs) using 3.125 mg/ml, 6.25, 12.5, 25, 50, 100 and 200 mg/ml, on both types of GICs employing MTT assay. For the Comet assay, HPLFs were treated with IC₅₀, IC₂₅ and IC₁₀ of test materials and the tail moments were measured. In the Ames test, four genotypic variants of strains of Salmonella typhimurium (TA100, TA98, TA1537 and TA1535) and a strain of Escherichia coli (WP2 uvrA) were employed. The material tested was extracted using sterile distilled water (0.2 g per ml) at 37 °C for 72 h. This was considered as 100 %, which was diluted to 50, 25, 12.5 and 6.25 % utilizing sterile distilled water. These five concentrations were incubated with the bacterial strains with and without metabolic activation (S9), along with appropriate positive controls. The number of revertant colonies was used to evaluate the outcome. The highest cell viability (159.4 %) for nano-HA-SiO₂-GIC was noticed at 3.125 mg/ml, while the lowest (24.26 %) was observed at 200 mg per ml. IC₅₀, IC₂₅ and IC₁₀ values were 95.27, 51.4 and 20.1 mg/ml for cGIC, 106.9, 55.8 and 22.9 mg/ml for nano-HA-SiO₂-GIC, respectively. The IC₁₀ of both test materials showed no significant DNA damage compared to that of the negative control based on the Comet assay. The plate treated with nano-HA-SiO₂-GIC showed less than double the average number of revertant colonies compared to that of negative control with regard to the Ames test. It can be concluded that nano-HA-SiO₂-GIC is non-mutagenic based on the Ames test and did not cause DNA damage at the lowest concentration of IC₁₀ based on the Comet assay.

The purpose of this in vivo study was to evaluate and compare the dentin–pulp complex response following occlusal and cervical restorations in rat molars restored with nano-hydroxyapatite silica glass ionomer cement (nano-HA-SiO₂-GIC) and conventional glass ionomer cement (c-GIC). In total, 64 maxillary first molars of 32 male Wistar rats were restored using Fuji IX (c-GIC) and nano-HA-SiO₂-GIC using a split-mouth design. Half of them were reserved for the occlusal type of restoration while the other half was for cervical restorations. After one week and one month, rats were euthanized and were stained with hematoxylin and eosin, Masson’s trichrome, and Brown and Brenn techniques for histological examination. Parameters such as disorganization of the pulp tissue, inflammatory cell infiltration, detection of bacteria, and tertiary dentin deposition were measured for each group. One week after sacrifice, the odontoblastic layer was disrupted, and moderate inflammation in the pulp area close to the cut dentin was observed in both types of restorations. Nano-HA-SiO₂-GIC showed significantly superior properties when assessed based on tertiary dentin formation as compared to c-GIC. One month after sacrifice, there was no evidence of disruptions of the odontoblast layer, which exhibited a normal palisade appearance in both groups. In terms of inflammation, the pulp tissue recovered in almost all cases except one of c-GIC, but a few cases of the nano-HA-SiO₂-GIC group still displayed mild-to-moderate inflammatory reactions, especially of the occlusal type. Both c-GIC and nano-HA-SiO₂-GIC exhibited favorable responses in terms of biocompatibility. Nano-HA-SiO₂-GIC exerted more inflammation but encouraged better tertiary dentin formation compared to c-GIC.