Padjadjaran Journal of Dentistry (PJD) is an open-access journal published by the Faculty of Dentistry at Universitas Padjadjaran,issued thrice annually in March, July, and November, with p-ISSN 1979-0201 and e-ISSN 2549-6212. Padjadjaran Journal of Dentistry is also affiliated with Indonesian Dental Association. Padjadjaran Journal of Dentistry is a scientific publication. It publishes original research manuscripts, systematic reviews, and case reports in the fields of Dental Assisting, Dental Hygiene, Periodontics, and Dentistry (Miscellaneous). However, articles focusing on indigenous health research and the use of natural resources in dentistry are also welcome. It provides a medium for sustained discussion of relevant issues that fall within the focus and scopes of the journal. Articles published in PJD undergo a double-blind peer-review process. All submissions must be written in English, must be original, unpublished, and not under simultaneous consideration elsewhere. The PJD Editorial Board screens submissions for plagiarism using plagiarism detection software. Manuscripts with a plagiarism level exceeding 20% are automatically rejected. The final decision regarding the acceptance of a scientific article rests with the Editorial Board, based on the recommendations of peer reviewers.Prior to submission, all authors must follow the journal template and complete the article and author metadata fully and accurately; otherwise, the article will not be considered for further processing. All submitted manuscripts are checked with Turnitin to prevent unacceptable levels of plagiarism. Reference management should preferably be performed using Mendeley, following the Vancouver superscript style. All keywords must be chosen based on terms included in MeSH. Starting February 2023, the Padjadjaran Journal of Dentistry adopted new templates for different article types: the updated research article template can be downloaded here; templates for systematic reviews can be downloaded here; and the case report template can be downloaded here. All submitted manuscripts undergo an initial editorial assessment, double-blind peer review, and editorial reviews. All editorial practices of the Padjadjaran Journal of Dentistry follow the ICMJE's Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals. The double-blind peer-review process follows the principles of RDDA (Related Discipline, Different Affiliation), under the Reviewer Guidelines of the Padjadjaran Journal of Dentistry. Our policies and publication practices are fully aligned with and strictly follow COPE’s publication ethics standards.
Starting March 2026, Padjadjaran Journal of Dentistry (PJD) has updated its licensing policy. All published articles are now licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0), replacing the previous Creative Commons Attribution 4.0 International License (CC BY 4.0). This license permits others to distribute, remix, adapt, and build upon the material in any medium or format for non-commercial purposes, provided appropriate credit is given to the original author(s).Padjadjaran Journal of Dentistry (PJD) is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. Authors who publish with Padjadjaran Journal of Dentistry agree to the following terms: The journal allows the author(s) to hold the copyright of the article without restrictions. The journal allows the author(s) to retain publishing rights without restrictions. The legal formal aspect of publication accessibility refers to the <a href="/pjd/manager/setup/"https:/creativecommons.org/licenses/by-nc/4.0/</a">Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0). This license requires that reusers give appropriate credit to the creator. It allows others to distribute, remix, adapt, and build upon the material in any medium or format for non-commercial purposes only, provided proper attribution is given to the original author(s) and the source.
Effect of adhesive techniques and preheated composite resin types as luting agents on shear bond strength of lithium disilicate: an experimental study
Introduction: The success of veneers is influenced by the cementation procedure. Preheated composite resin has been proposed as a luting material for indirect adhesive restorations because of its improved mechanical and handling properties. Composite resin bonds effectively to tooth structures using adhesive systems. This study aimed to evaluate the effect of different adhesive application techniques and types of preheated composite resin as luting materials on the shear bond strength of lithium disilicate. Methods: Twenty-eight extracted maxillary premolars were prepared on the buccal surface to expose dentin and divided into four experimental groups. Lithium disilicate discs (3 mm in diameter and 1 mm in thickness) were cemented onto the prepared surfaces according to the assigned group protocols. Group IA received preheated microhybrid composite with total-etch adhesive, IB received self-etch adhesive; IIA received preheated nanohybrid composite with total-etch adhesive, and IIB received self-etch adhesive. After cementation, the samples were immersed in artificial saliva at 37oC for 24 hours. Shear bond strength testing was conducted using a universal testing machine. Debonded samples were observed under a stereomicroscope to determine bonding failure. Data were analyzed using two-way ANOVA and post hoc LSD tests with a 95% confidence level. Results: Total-etch adhesive demonstrated higher shear bond strength (SBS) than self-etch adhesive for both composite types. The highest SBS was observed in the total-etch microhybrid group (14.03 ± 0.12 MPa), followed by the total-etch nanohybrid group (12.99 ± 0.09 MPa) and the self-etch microhybrid group (13.67 ± 0.18 MPa), while the lowest value was recorded in the self-etch nanohybrid group (10.21 ± 0.22 MPa) Conclusion: Preheated microhybrid composite resin produced higher shear bond strength with lithium disilicate than preheated nanohybrid composite resin, and the total-etch adhesive technique resulted in higher shear bond strength than the self-etch technique.
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Effectiveness of rambutan honey toothpaste on IL-6 gene expression during acute inflammatory phase of gingivitis in a Wistar rat model: an experimental study
Introduction: Gingivitis is a reversible form of periodontal disease characterized by gingival inflammation due to dental plaque accumulation and increased inflammatory mediators such as IL-6. Rambutan honey (Nephelium lappaceum) contains bioactive compounds with potential as natural anti-inflammatory agents. This study aimed to analyze the effectiveness of rambutan honey toothpaste on IL-6 gene expression during acute inflammatory phase of gingivitis in a Wistar rat model. Method: This study used a true experimental design with a post-test only control group design. A total of 30 male Wistar rats were randomly divided into three groups: negative control (toothpaste base/NC), positive control (commercial herbal toothpaste/PC), and treatment (rambutan honey/TPRH). The gingivitis rat model was established using a ligature technique with silk thread and inoculation of Porphyromonas gingivalis and Streptococcus mutans. Treatment was administered twice daily for seven days, and gene expression was evaluated on days 0, 3, 5, and 7 using qRT-PCR. Data were analyzed using ANOVA and post hoc Tukey tests (p<0.05). Result: The rambutan honey toothpaste group showed a decreasing pattern of IL-6 expression compared to the base and commercial toothpaste groups, particularly on day 3 (p=0.038). These findings suggest that rambutan honey toothpaste may reduce IL-6 expression. This effect may be related to the presence of flavonoid and phenolic compounds in rambutan honey, which have been associated with anti-inflammatory activity. Conclusion: Rambutan honey toothpaste was associated with reduced IL-6 gene expression during the early acute inflammatory phase of experimental gingivitis in Wistar rats, indicating a potential anti-inflammatory effect at the molecular level. Further studies, including clinical, histological, and protein-level assessments, are needed to confirm its relevance in gingival healing.
Periodontal disease risk factors in elderly and older adults with diabetes mellitus comorbidity using the PRECEDE–PROCEED framework: a cross-sectional study
Introduction: Diabetes mellitus (DM) increases the risk and severity of periodontal disease, particularly among elderly populations. Behavioral and contextual determinants may further exacerbate periodontal vulnerability in individuals with DM. This study aimed to describe periodontal disease risk factors among elderly and older adults with diabetes mellitus using the PRECEDE framework, focusing on predisposing, reinforcing, and enabling factors. Methods: A descriptive cross-sectional study was conducted among 33 elderly and older adults with confirmed diabetes mellitus at the Dukuh Kupang Primary Health Center, Surabaya, Indonesia. Data were collected using structured questionnaires assessing predisposing (knowledge, dietary adherence, physical activity, medication use), reinforcing (family and healthcare support), and enabling factors (health service utilization), alongside clinical periodontal examination using the Harald Löe Plaque Index. Data were analyzed descriptively and presented as frequencies and percentages. Results: Periodontal risk was categorized as moderate in 51.5% and high in 48.5% of respondents. Predisposing factors showed that 72.7% did not regulate food portions, 54.5% did not adhere to physician-recommended diets, 42.4% did not exercise regularly, and 21.2% did not consistently take antidiabetic medication. Reinforcing factors indicated that 39.4% reported limited family support for medication adherence and 18.2% reported insufficient health education support. Enabling factors revealed that 15.2% did not undergo regular blood glucose examinations and 18.2% did not routinely record glucose levels. Clinically, 57.6% had plaque index scores above the mean, indicating substantial plaque accumulation. Conclusion: Periodontal vulnerability among elderly individuals with diabetes mellitus is characterized by a convergence of unfavorable predisposing (21.2–72.7%), reinforcing (18.2–39.4%), and enabling (15.2–18.2%) factors. Strengthening behavioral modification strategies, social support systems, and structured diabetes monitoring within primary healthcare settings may be important to reduce the burden of periodontal disease.
Effect of diabetes mellitus as a modifier with periodontitis severity and oral health–related quality of life in older adults: a cross-sectional study
Introduction: The main complication of diabetes mellitus (DM) in the oral cavity is periodontitis. Periodontitis is one of the conditions that affects quality of life because it causes psychological discomfort, stress, interpersonal relationship problems, and difficulties in daily activities. The objective of this study was to analyze the effect of diabetes mellitus as a modifier with periodontitis severity and oral health–related quality of life in older adults. Methods: This study is a cross-sectional study, where this design can be used to provide the groundwork to infer preliminary evidence for a causal relationship. The subjects were 302 elderly individuals aged ≥ 60 years who still had at least 6 teeth representing 6 regions. The study variables were the severity of periodontitis, Oral Health-Related Quality of Life (OHRQoL), and diabetes mellitus (DM). Periodontitis was diagnosed using the classification from the American Association of Periodontology (AAP) and the European Federation of Periodontology (EFP) in 2018, using the Clinical Attachment Loss (CAL) indicator. The Geriatric Oral Health Assessment Index (GOHAI) was used to measure OHRQoL. DM status was diagnosed using HbA1c levels. Data analysis was performed using multiple linear regression with a significance level of 0.05. Results: The majority of participants had severe periodontitis (73.8%) followed by moderate periodontitis (22.2%) and mild periodontitis (4%). The results of multiple linear regression analysis showed that there was an interaction between uncontrolled DM and periodontitis on OHRQoL (Adj.β = -11, p=0.05). Conclusions: Diabetes mellitus acts as a modifier effect on the relationship between the severity of periodontitis and OHRQoL. The more severe the periodontitis, the lower the OHRQoL. Uncontrolled DM influences the direct relationship between periodontitis severity and OHRQoL. The relationship between periodontitis severity and OHRQoL is stronger and more pronounced in uncontrolled DM
Cytotoxicity of β-tricalcium phosphate chitosan gelatin composite scaffold as a bone substitute: in vitro study
Introduction: Beta-tricalcium phosphate (βTCP) has higher solubility than hydroxyapatite (HA), allowing it to be more easily resorbed and replaced by newly formed bone. This higher solubility enables the release of calcium and phosphate ions that play important roles in bone remodeling and osteoblast activity; however, excessive ion release may lead to cytotoxic effects. Limestone, mainly composed of calcium carbonate (CaCO₃), can serve as a calcium source for the fabrication of βTCP. βTCP scaffolds can be combined with organic components such as chitosan and gelatin to form composite scaffolds for bone tissue engineering. Therefore, this study aimed to analyze the cytotoxicity of a β-tricalcium phosphate–chitosan–gelatin composite scaffold as a bone substitute. Methods: Type of research was experimental laboratory. Freeze-drying method was used to produce a composite scaffold which was divided into two groups: chitosan-gelatin scaffold as control group and βTCP-chitosan-gelatin scaffold (each group consisted of three samples) To evaluate cytotoxicity, composite scaffolds were tested on osteoblast cells and the MTT assay was measured and assessed based on time evaluation at 24 hours and 72 hours. Cytotoxicity was determined based on the percentage of viable cells obtained from the MTT assay. Results: Viable cells percentage on the chitosan-gelatin scaffold was 70.32% at 24 h and increased to 99.52% at 72 h. While on the chitosan-gelatin-βTCP scaffold there were 85.11% viable cells at 24 h and increased to 89.54% at 72 h. Statistical analysis using one-way ANOVA showed no significant difference among all groups (p>0.05). However, Fisher’s LSD test indicated a significant difference in cell viability between 24 hours and 72 hours within the chitosan gelatin group. Conclusion: The βTCP-chitosan-gelatin composite scaffold demonstrated no cytotoxic effect on osteoblast cells, indicating its biocompatibility and potential suitability as a bone substitute material.
Sensitivity and specificity of DentMA teledentistry in dental caries detection: screening in vulnerable communities
Introduction: Teledentistry offers a practical solution to limited access to dental care by enabling remote screening using smartphone-based technology. Vulnerable populations such as pregnant women, children who rely on parental assistance, and the elderly have a high prevalence of dental caries and often face barriers to routine dental visits due to mobility limitations, time constraints, and dependence on caregivers. These characteristics make them priority targets for teledentistry-based screening. DentMA teledentistry is a smartphone-based application developed by the research team, integrating intraoral photographic capture, deep learning–assisted caries detection, and remote dentist evaluation to support early dental screening. This study aimed to evaluate the sensitivity and specificity of DentMA teledentistry for dental caries screening in vulnerable community populations. Methods: This was a prospective study with a cross-sectional design. Intraoral photographs were obtained using a smartphone camera and then uploaded to an Internet of Dental Things (IoDT)-based platform. Intraoral images were reviewed by dental professionals and compared with clinical examinations by co-assistants and dental nurses during activities outside the health center. Photographic assessments carried out by dentists were compared to clinical assessments by co-assistents and dental nurses. Data analysis included sensitivity, specificity, and accuracy, accompanied by Cohen’s kappa values >0.60 Results: 90 participants were included in this study, consisting of 30 pregnant women, 30 elderly individuals, and 30 children. All photographic views showed high sensitivity of 85.54% (95% CI, 77.0% to 93.1%) and specificity of 86.60% (95% CI, 79.8% to 93.4%) in detecting email-dentin caries and PUFA, with an accuracy of 86.11%. The agreement between the results of clinical examinations and photographic methods (assessed by dentists) was considered strong, with kappa scores ranging from 0.74-0.80. Conclusion: Assessment of intraoral photographs using DentMA teledentistry for caries detection demonstrated clinically acceptable accuracy when compared with visual clinical examination, based on sensitivity and specificity values. This strategy has implications for supporting remote dental health services for vulnerable communities (pregnant women, the elderly, and children) without access to healthcare facilities.
Correlation of knowledge, dietary, and caries prevention behavior with dental caries experience among adolescents: a cross-sectional study
Introduction: Adolescents are a high-risk group for dental caries, influenced by changes in dietary patterns and inadequate oral hygiene practices. Most interventions focus solely on improving knowledge; empirical evidence linking knowledge about cariogenic foods to actual behaviors related to caries experiences in adolescents is still limited in Indonesia. This study aims to analyze the correlation between knowledge of cariogenic foods, dietary behavior, and caries prevention behavior and dental caries experience in adolescents. Methods: This study used a cross-sectional analytical method with a correlational approach, involving 149 students aged 15-18 years from Senior High School of Jatinangor, Sumedang, West Java, Indonesia. The sample was selected through simple random sampling. Data were collected using a newly developed questionnaire that had been tested for validity and reliability. The questionnaire consisted of 11 items each on knowledge of cariogenic foods and dietary behavior, and 13 items on caries prevention behavior (oral hygiene behavior index). Dental caries experience was measured using the DMF-T index. Data were analyzed using the Spearman Correlation test. Results: Regarding knowledge of cariogenic foods, the majority of adolescents, 73 (48.99%), were categorized as having good knowledge. For dietary behavior, 103 (69.13%) adolescents were in the moderate category, and for caries prevention behavior, 99 (66.44%) adolescents were also in the moderate category. The average DMF-T index score was 8.11. The analysis showed no significant relationship between knowledge of cariogenic foods and dental caries experience (p = 0.264, r = 0.179). However, there was a significant relationship between dietary behavior (p = 0.000, r = 0.696) and caries prevention behavior (p = 0.000, r = 0.582) with dental caries experience. Conclusion: Dietary and caries prevention behaviors correlate with caries experience. However, knowledge about cariogenic foods does not correlate with caries experience.
Effectiveness of the dento activity book on preschool children's dental health knowledge: a quasi-experimental study
Introduction: Poor dental health in early childhood is a significant concern. Data from the 2023 Indonesian Health Survey indicates that the prevalence of dental and oral problems among the population aged 3 years and older reached 56.9%, with a large proportion being caries. One of the contributing factors is knowledge. Education is essential for enhancing awareness and understanding. To aid understanding, various media are employed. The Dento Activity Book serves as an educational tool, designed as an activity book that aims to teach children about dental and oral health. This study aimed to analyze the effectiveness of the Dento Activity Book in improving preschool children's dental knowledge. Methods: This research utilized a quasi-experimental design that features a pre-post test with a non-equivalent control group. A total of 46 children from Permata Hati Islamic Kindergarten were selected as participants. Knowledge was assessed through a structured interview administered before and after the educational intervention. The data were analyzed using the Mann-Whitney U test. Results: The average knowledge score for the treatment group increased by 1.96, while the control group saw an increase of 0.30, yielding a significant value of 0.00 (p<0.05). Conclusion: The Dento Activity Book effectively enhances preschool children's understanding of how to maintain their dental and oral health.
The effectiveness of nanotechnology toothbrush bristles in maintaining oral hygiene of children aged 9–12 years: a quasi-experimental
Introduction: Dental caries remains a common oral health problem among school-aged children and is associated with oral hygiene practices and plaque control. In Indonesia, its high prevalence highlights the need for effective preventive strategies. Conventional toothbrushes rely mainly on mechanical plaque removal, which may be limited in children due to variations in brushing technique. Recent developments have introduced nanotechnology in toothbrush bristles, where nanosilver is incorporated into the bristle material and has been reported to exhibit antibacterial and anti-biofilm properties that may support plaque control during brushing. However, evidence of its effectiveness in children remains limited. This study aimed to analyze the effectiveness of nanotechnology toothbrush bristles in maintaining oral hygiene among children aged 9–12 years. Methods: This study employed a quasi-experimental design with a control group pre-test and post-test approach. A total of 62 children aged 9–12 years were included: the experimental group using nanosilver-bristled toothbrushes (n=31) and the control group using conventional toothbrushes (n=31). All participants received the same toothbrushing instruction at baseline. Oral hygiene was assessed using the Patient Hygiene Performance (PHP) index on selected index teeth representing anterior and posterior sextants, measured at baseline and after a 21-day intervention. As the data were not normally distributed, the Wilcoxon signed-rank test and Mann–Whitney U test were used. Results: Baseline PHP scores were comparable between groups (p>0.05). After the intervention, the mean PHP score in the experimental group decreased from 3.87 ± 1.074 to 1.51 ± 1.040 (61.0% reduction; p<0.05). In the control group, the mean PHP score decreased from 3.38 ± 0.734 to 2.88 ± 0.799 (14.8% reduction; p<0.05). The reduction in PHP scores was significantly greater in the experimental group (p<0.05). Conclusion: Toothbrushes with nanosilver bristles were more effective than conventional toothbrushes in improving oral hygiene among children aged 9–12 years.
Antibacterial activity of mangosteen (garcinia mangostana linn.) leaf ethanol extract against oral pathogenic bacteria: a laboratory experimental study
Introduction: Nature-based medicines are multi-component agents that work in a multi-targeted manner with minimal side effects. Mangosteen leaves (Garcinia mangostana L.) contain flavonoids, tannins, and saponins that serve as antibacterial agents. This research aimed to analyze alternative agents to chlorhexidine mouthwash derived from natural ingredients. Methods: This laboratory experimental study observed the inhibition zone diameters of mangosteen leaf ethanol extract at concentrations ranging from 3.125% to 100% against P. gingivalis, A. actinomycetemcomitans, and S. sanguinis using the disc diffusion method. One-Way ANOVA followed by Tukey HSD tests were used to analyze the statistical differences among the bacterial groups across all concentrations. Results: The 100% concentration exhibited the largest inhibitory zones: 14.78 ± 0.60 mm for P. gingivalis, 11.08 ± 0.02 mm for A. actinomycetemcomitans, and 10.55 ± 0.48 mm for S. sanguinis. One-Way ANOVA and Tukey HSD tests showed a p-value of 0.000, indicating a significant antibacterial effect against P. gingivalis, A. actinomycetemcomitans, and S. sanguinis. Conclusion: Ethanol extract of mangosteen leaves (Garcinia mangostana L.) exhibits significant antibacterial activity, with the highest inhibitory effect observed at a 100% concentration.
Role of cassava starch (Manihot esculenta Crantz) in reducing candida albicans adhesion on soft denture liners: an experimental study
Introduction: Soft denture liners can be an alternative solution for various removable denture problems, but they still have several limitations, such as promoting Candida albicans adhesion to dentures. Modifications incorporate cassava starch. The aim of this result is toanalyze the role of cassava starch in reducing Candida albicans adhesion on soft denture liners. Methods: This laboratory experimental study used twenty-seven disc-shaped heat-cured acrylic plates with a diameter of 10 mm and a thickness of 2 mm divided into three groups: acrylic plate without a coating (negative control group), acrylic plate coated with soft denture liners (positive control group), and acrylic plate coated with a soft denture liner containing cassava starch 15% (treatment group). The samples were soaked in artificial saliva for 1 hour, then contaminated with Candida albicans by placing them in a test tube containing a Candida albicans suspension, and incubated for 24 hours at 37°C. Samples were rinsed twice with PBS, then placed in a test tube containing 10 mL of Sabouraud's broth and vortexed for 30 seconds. The turbidity of the released Candida albicans was measured using a spectrophotometer. Absorbance data were analyzed using one-way ANOVA and post hoc LSD. Results: Turbidity testing using a spectrophotometer at 600 nm showed the average absorbance values were 0.013 for negative control group, 0.028 for the positive control group, and 0.019 treatment group. The results of the one-way ANOVA test showed a p-value of 0.004 (<0.05), indicating a significant difference between the groups. Further post hoc LSD tests showed that the positive control group had the highest absorbance value. At the same time, there was no significant difference between the negative control group and treatment group. Conclusion: Cassava starch inhibits Candida albicans adhesion to the soft denture liners.
The effect of adrenaline concentration in lidocaine on prehypertension patients during tooth extraction: an observational analysis
Introduction: Prehypertension refers to a systolic value 120–139 mmHg or diastolic value 80–90 mmHg. Studies have shown that the prevalence of prehypertension is over 30% among young adults. The extraction procedure was performed using lidocaine and adrenaline as anesthetics. The purpose of this study was to analyze the effect of adrenaline concentration in lidocaine on prehypertension patients during tooth extraction. Methods: This is a prospective analytical observational study with a pre–post measurement design. This study was conducted on 36 prehypertensive patients who were divided into 3 groups. Blood pressure was measured before and less than 5 minutes after administration of lidocaine 2% local anesthesia with either 1:80,000, 1:100,000 or 1:160,000 adrenaline, using a calibrated digital tensimeter (TensiOne 1A). Data were analyzed using paired t-tests. Results: Homogeneity test: systole before 0,033, systole after 0,329, diastole before 0,174, diastole after 0,274. Anova test: systole before 0,685, systole after 0,837, diastole before 0,03, diastole after 0,058. Post hoc results showed there were statistically significant differences in diastolic blood pressure in the 1:100.00 and 1:160.000 group before diastole. Before performing the one-way ANOVA and paired t-test, the data were assessed for normality using the Shapiro–Wilk test, which indicated a normal distribution (p > 0.05). Statistical analysis was then conducted using paired t-tests and one-way ANOVA, followed by post hoc testing. Conclusion: The administration of 2% lidocaine with adrenaline concentrations of 1:80,000, 1:100,000, and 1:160,000 did not produce meaningful changes in blood pressure in prehypertensive patients undergoing closed-method dental extraction
Differences of oral health knowledge, attitude, and practice among orphan residents: a cross-sectional study
Introduction: Oral health is essential to the general health and well-being of all children and adults. The implementation of oral health behaviour is expected to start at an early age in the family environment, although the orphaned are often neglected. This study aimed to analyze differences of oral health knowledge, attitude, and practice differences of oral health knowledge, attitude, and practice among orphan residents. Methods: This analytical study used a cross-sectional method, comprising 346 orphaned residents from 27 orphanages in Makassar City. A total of 24 items; a closed-ended structured questionnaire was used to assess oral health knowledge, attitude, and practice among orphans. Furthermore, a stratified random sampling method was used for sample selection. Data analysis was conducted with the Mann-Whitney U statistical test. Results: The results showed that 65% of orphan residents had sufficient knowledge, 80% possessed a good attitude, and 53.8% had sufficient behaviours regarding oral health. Significant differences were observed in oral health knowledge, attitude, and practice based on age groups (p<0.05). Notably, there were also significant differences in knowledge and attitude (p<0.05) related to oral health among orphan residents. Conclusion: There were differences in knowledge and practices, and generally good attitudes towards oral health. Moreover, orphanage caretakers should be educated and trained in oral health practice.
Correlation between demographic and environmental factors and dental caries prevalence in a remote Indonesian coastal community: a cross-sectional study
Introduction: Dental caries is a significant global health concern. Factors such as socioeconomic status, diet, oral hygiene, and access to dental care influence its prevalence. Limited information exists on dental health in remote sea-floating villages. This study aimed to analyze the correlation between demographic and environmental factors and dental caries prevalence in a sea-floating community. Methods: This cross-sectional study was conducted in Malahing Village, a sea-floating village located adjacent to the Makassar Strait, 4 km east of Bontang city. Seventy-two respondents aged 5–59 years were examined for the DMFT index, while intrinsic factors (demographic and dental health behaviors) and extrinsic factors (environmental and dental health services) were collected via questionnaires. Data were analyzed using descriptive univariate analysis to determine variable characteristics and Spearman’s correlation analysis. Results: Dental caries prevalence was 98.61%, with a DMFT index of 10.01. Age (r=0.564, p=0.001), education (r=0.370, p=0.002), and occupation (r=0.273, p=0.020) showed strong, moderate, and weak positive correlations, respectively. Rainwater exposure (r=-0.353, p=0.003) showed a moderate negative correlation. Sex, dental health behaviors, water source, and dental visits were not significantly correlated with caries prevalence. Adults showed highest prevalence (66.67%) but low DMFT index (1.00). Government employees had high DMFT scores (4.61). Twice-daily brushing was uncommon (66.67%) among individuals with high DMFT scores (6.15). Patients who never visited a dentist (44.44%) showed high DMFT scores (8.33). Conclusions: In this underserved coastal community, demographic disadvantages and environmental exposures, particularly water sources, combined with limited dental care contribute to an elevated caries burden compared to the national and international levels. Despite complex associations with environmental factors, rainwater exposure showed negative correlation with caries prevalence, highlighting measurement challenges. The high proportion of patients never visited a dentist, low oral health awareness, and nonstandard water management highlight critical service gaps.
Multi-target potential of moringa oleifera-derived compounds against cariogenic and endodontic virulence proteins revealed by molecular docking: an in silico experimental study
Introduction: Dental infections are multifactorial diseases involving bacterial biofilms and host immune responses. Natural compounds with antibacterial activity, such as Moringa oleifera, have been explored as alternatives to conventional antibiotics. This study aimed to evaluate the interaction profiles of four Moringa oleifera–derived compounds against multiple virulence-associated proteins of cariogenic and endodontic pathogens using in silico molecular docking. Methods: This study was an in silico experimental study using molecular docking simulations to evaluate the binding energy of four M. oleifera-derived compounds (eugenol, trans-anethole, arachidonic acid, and phytosphingosine) with five key virulence-associated proteins of cariogenic and endodontic pathogens (Cystalysin, SrpA, FimA, RadD, and Ddl). AutoDock 4.0 was used for the docking simulations. Docking results were analyzed based on binding energy (ΔG) and inhibition constant (Ki) values. The best binding conformations were selected according to the lowest binding energy and visualized to identify key ligand–protein interactions using Discovery Studio Visualizer. Results: The phytosphingosine-Ddl exhibited the lowest binding energy of -7.42 kcal/mol, followed by eugenol with three different receptors (Cystalysin, SrpA, and FimA) and arachidonic acid-RadD. The lowest inhibition constant was shown by the phytosphingosine-Ddl complex at 3.61 µM. Each compound interacted with various targets, but phytosphingosine exhibited the most consistent and widespread predicted binding via hydrogen bonds with Glu222, Arg291, Glu306, Asp293, Lys251, and hydrophobic interactions of Phe295, Phe245, Phe175, and Leu145. Conclusion: This in silico molecular docking study demonstrated that Moringa oleifera–derived compounds, particularly phytosphingosine, exhibit strong binding affinity toward key virulence-associated proteins of cariogenic and endodontic pathogens. These findings highlight the potential of M. oleifera as a natural source of antibacterial agents and support further experimental validation of its therapeutic applications in oral infections.
Correlation between nutritional status values based on World Health Organization child growth standard values and serum albumin levels with wound healing: an observational study
Introduction: Cleft lip and/palate (CL±P) is a congenital disorder that affects the orofacial area, and often associated with problems like feeding difficulties, which may lead to poor nutritional status. Management of cleft lip (CL) requires surgical procedures and wound healing process. Factors influencing wound healing include nutritional status and albumin status. The aim of this study was to analyze the correlation between nutritional status values based on World Health Organization child growth standard values and serum albumin levels with wound healing as measured by Healing Index Scale. Method: This study was conducted on 40 patients with unilateral CL±P who underwent palatoplasty procedure. Participants were selected using a non-probability purposive sampling technique. Saliva samples were collected before palatoplasty and on postoperative day 7 to assess albumin levels, while wound healing was evaluated on day 7 using the Healing Index Scale. Data were analyzed using the Spearman rank correlation test. Results: The nutritional status of patients was predominantly normal in both preoperative (75%) and postoperative day 7 (60%) assessments. Wound healing on day 7 showed that most patients were in the good category (72.5%), while 11 patients (27.5%) were classified as poor. Correlation analysis revealed a very weak and non-significant relationship between WHO child growth standard scores and salivary albumin levels, as well as non-significant relationship between WHO CGS nutritional status and the day 7 healing index in patients undergoing palatoplasty. Conclusion: No significant correlation was found between nutritional status, salivary albumin levels, and wound healing outcomes in patients undergoing palatoplasty.
Design modification of a porcelain-fused-to-metal (PFM) adhesive bridge for a mandibular molar with a short clinical crown: A case report
Introduction: Replacement of a single missing posterior tooth can be effectively achieved using a fixed dental prosthesis (FDP). Resin-bonded FDPs provide a conservative alternative to conventional full-coverage FDPs because they require minimal tooth reduction and preserve the remaining tooth structure while maintaining function and aesthetics. However, short clinical crowns and lingually inclined mandibular molars may compromise retention, resistance, and the path of insertion. This case report describes the use of a modified porcelain-fused-to-metal (PFM) resin-bonded FDP with onlay metal wings and adhesive bonding to manage a mandibular molar with a short clinical crown and a lingually inclined abutment. Case report: A 25-year-old male patient was referred to the Prosthodontics Clinic for replacement of a missing mandibular right first molar. The tooth had been extracted approximately one year previously. Intraoral examination showed that tooth 47 was lingually inclined and had a short clinical crown. Panoramic radiography showed adequate bone support and no pathological findings, indicating that the abutment teeth were suitable for prosthetic treatment. The treatment plan involved a modified PFM adhesive bridge with a sanitary pontic replacing tooth 46 and onlay metal wings on teeth 45 and 47. Retention was achieved through a combination of mechanical interlocking, chemical bonding, and adhesive cementation. At the one-week follow-up after FDP insertion, the prosthesis demonstrated satisfactory fit and occlusion, and the patient reported no discomfort or functional problems. Conclusion: A modified onlay-wing design for a lingually inclined abutment with a short clinical crown, combined with adhesive resin cementation to a metal framework, may provide a simplified and predictable approach for replacing a mandibular molar using a resin-bonded FDP.
Management of anterior crossbite in mixed dentition using sloped composite resin: a case report
Introduction: Dental-type anterior crossbite is a malocclusion involving an individual tooth, in which the maxillary incisor is positioned lingual to the mandibular incisor without skeletal discrepancy. Its most common aetiology is persistence of a primary tooth, which may disrupt the eruption path and lead to palatal eruption of the permanent successor. Sloped composite resin is a simple and effective method for correcting an anterior crossbite. In the cases presented, the dental crossbite was corrected by applying a 3-4 mm bonded resin-composite inclined plane to the incisal edge of the mandibular incisors at an angle of approximately 45° to the long axis of the tooth. This case report aimed to describe the management of dental-type anterior crossbite involving individual teeth using sloped composite resin in children during the mixed dentition period. Case report: Three cases of anterior crossbite were managed in three paediatric patients. The first case involved an 8-year-old boy with a crossbite affecting teeth 11 and 21. The second case involved an 8-year-old boy with a crossbite of tooth 21, and the third case involved a 7-year-old girl with a crossbite affecting teeth 11 and 21. All patients had good oral hygiene and no deleterious oral habits. The available arch space exceeded the mesiodistal width of the affected incisors. Sloped composite resin was applied to the antagonist mandibular incisors, either directly or indirectly, at an angle of approximately 45° to the long axis of the tooth. On average, the crossbites were corrected within two weeks. Conclusion: This case report demonstrates that direct and indirect sloped composite resin applications can provide rapid and consistent correction of dental-type anterior crossbite during the mixed dentition period. The technique was effective, minimally complex and clinically practical, with an average correction time of two weeks.
Analysis of failure rates among calcium hydroxide, biodentine, and mineral trioxide aggregate in direct pulp capping procedures: a systematic review
Introduction: Direct pulp capping is a conservative treatment approach aimed at preserving pulp vitality following pulp exposure. Calcium hydroxide (Ca(OH)₂), mineral trioxide aggregate (MTA), and Biodentine are commonly used materials for this procedure. This systematic review aimed to compare the clinical, radiographic, and histological outcomes associated with these materials in direct pulp capping procedures. Method: A systematic literature search was conducted in PubMed, Scopus, ScienceDirect, and Google Scholar for studies published between 2015 and 2025. Only in vivo human clinical studies involving permanent teeth treated with Ca(OH)₂, MTA, or Biodentine were included. Study selection followed PRISMA guidelines. Data extraction focused on clinical success, pulp vitality, dentin bridge formation, and follow-up outcomes. Due to heterogeneity among the included studies, results were synthesized narratively. Results: Six clinical studies met the inclusion criteria and were included in the qualitative synthesis. Reported success rates for Ca(OH)₂ ranged from 13% to 37% in long-term follow-up. MTA demonstrated success rates exceeding 80% in studies with follow-up durations of at least 12 months. Biodentine showed comparable or slightly higher success rates than MTA in short- to medium-term observations. Radiographic and histological outcomes indicated more continuous dentin bridge formation in the MTA and Biodentine groups compared to Ca(OH)₂. Conclusion: Based on the available evidence, calcium silicate–based materials such as MTA and Biodentine appear to provide more favorable clinical and biological outcomes than calcium hydroxide for direct pulp capping procedures. Material selection should consider both biological performance and clinical handling characteristics to optimize treatment outcomes.
Augmented reality interventions in oral health promotion and education: a systematic review
Introduction: Augmented reality (AR) is an innovative technology being increasingly utilized in oral health promotion and education. This systematic review aimed to map and describe the types of augmented reality interventions, target populations, outcomes, and implementation challenges in oral health promotion and education. Methods: This systematic review was conducted in accordance with PRISMA-ScR guidelines. A systematic literature search was performed across Google Scholar, ScienceDirect, and PubMed, to identify articles published between 2020 and 2024. Studies were included based on predefined criteria focusing on augmented reality interventions for oral health promotion and education. Exclusion criteria comprised review articles, editorials, commentaries, and studies without full-text availability. Study selection was conducted independently by two reviewers. Results: A total of 456 articles were identified, of which nine studies met the inclusion criteria. Most studies targeted children (55.5%) and used non-randomized designs (77.8%). Augmented Reality interventions included smart toothbrushes, serious games, and mobile applications. Overall, these interventions improved oral health knowledge, motivation, oral hygiene status, and brushing skills. Conclusion: This systematic review underscores the potential of AR as an innovative tool in oral health education. AR interventions have shown effectiveness in improving knowledge, motivation, self-efficacy, and health behaviors across diverse populations, particularly among children and vulnerable groups. However, while the findings are promising, limitations related to study design, sample sizes, and intervention durations necessitate further research.