Makassar Dental Journal

Content of Volume 15 Issue 2 August 2026

Makassar Dental Journal — Sun, 23 Aug 2026 00:00:00 +0700

Content of Volume 15 Issue 2 August 2026

Emergency management of maxillofacial infections: a retrospective evaluation of treatment protocols and patient outcomes in dental practices

Adhe Ismunandar — Wed, 19 Aug 2026 00:00:00 +0700

Maxillofacial infections pose significant challenges in the management of dental emergencies, particularly when accompanied by airway obstruction and se-vere bleeding. Rapid and effective management is crucial for improving treatment outcomes in life-threatening situations. This article investigates the proto-cols followed by dental professionals in managing maxillofacial infections, focusing on airway management, infection control, and facial trauma stabilisation, as well as their outcomes. This retrospective observational study analysed data from 50 dental professionals working in various healthcare settings. Treatment me-thods, including the Advanced Trauma Life Support (ATLS) protocol, imaging techniques, and infection control measures, were evaluated for their effective-ness in stabilising patients. A total of 90% of patients experienced airway obstruction requiring immediate intervention, and 80% had infections in the subman-dibular and sublingual spaces. The ATLS protocol was applied in all cases, focusing on airway management and infection control; a high success rate of 85% was achieved in stabilisation, whilst 70% of cases required referral to a specialist care facility for surgical intervention. It was concluded that effective mana-gement of maxillofacial infections requires timely airway intervention and infection control measures. The implementation of the ATLS protocol at all levels of care is crucial for successful patient outcomes.

The relationship between parenting styles and the severity of dental caries in children aged 5–6 years

Wed, 19 Aug 2026 00:00:00 +0700

Dental caries in young children remains a common oral health problem that can affect a child’s quality of life. One factor thought to be associated with the se-verity of dental caries in children is parental child-rearing practices, as these play a role in shaping oral health care behaviours. This study examines the rela-tionship between parental parenting styles and the severity of dental caries in children aged 5–6 years using an analytical observational study with a cross-sectional design. The study involved 95 pairs of children and parents at the Integrated Early Childhood Education Pertiwi Dharma Wanita Persatuan Regio-nal Secretariat of South Sulawesi Province. Parental parenting styles were classified as authoritarian, democratic, and permissive based on a questionnaire. The severity of dental caries in children was measured using the dmf-t and PUFA indices. Data were analysed using the Kruskal-Wallis test and the Mann–Whitney test, which indicated a relationship between parenting styles and the severity of dental caries in children (p<0.05). This association was demonstra-ted by differences in the severity of dental caries between the parenting style groups. The highest dmf-t and PUFA index values were found in children with a permissive parenting style, whilst the lowest values were found in the democratic parenting style. It was concluded that a permissive parenting style is associated with a higher severity of dental caries.

The relationship between malocclusion and psychological conditions of high school adolescents in Makassar City

Eddy Heriyanto Habar, Isriani Uslah — Wed, 19 Aug 2026 00:00:00 +0700

Malocclusion is a dental and oral health problem that not only impacts oral function but also psychosocial aspects, especially in adolescents who are expe-riencing self-identity development. This study aims to determine the relationship between malocclusion and psychological conditions in high school adoles-cents in Makassar City. An observational analytical study with a cross-sectional design was conducted on 30 students aged 14–16 years at SMAN 4 and SMAN 21 Makassar. The severity of malocclusion was measured using the Occlusion Feature Index (OFI), while psychological conditions were measured using the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). Data analysis used the Chi-square test and Pearson correlation. The results showed that the majority of respondents experienced mild malocclusion (83.3%) and poor psychological conditions (56.7%). There was a significant rela-tionship between malocclusion characteristics and psychological conditions (p = 0.002). A strong positive correlation was found between malocclusion se-verity and psychological scores (r = 0.773; p < 0.05). It was concluded that malocclusion is significantly related to adolescent psychological conditions. The more severe the malocclusion, the worse the psychological condition.

Antibacterial activity of ethanol extract of Malay apple leaves (Syzygium malaccense) against Staphylococcus aureus

Wed, 19 Aug 2026 00:00:00 +0700

One plant that can be used as an herbal medicine is malay apple leaf (Syzygium malaccense), which is rich in phenolic compounds and flavonoids and pos-sesses antioxidant, anti-inflammatory and antibacterial properties due to its secondary metabolites. This study explored the antibacterial inhibitory activity of MAL ethanol extracts against Staphylococcus aureus. The laboratory experiment was conducted in vitro using a post-test only control group design. The samples consisted of 5%, 10% and 15% MAL ethanol extracts and S.aureus bacteria, with a positive control of 1% clindamycin and a negative control of aquadest; the Kruskal-Wallis test was used, followed by the Mann-Whitney test. The 5% MAL extract yielded an average inhibition zone of 3.9, the 10% ex-tract yielded an average of 5.25, and the 15% extract yielded an average of 5.95; the non-parametric Kruskal-Wallis test yielded a significance value of 0.000<0.05. It was concluded that the inhibitory activity of MAL ethanol extracts against S.aureus at concentrations of 5%, 10% and 15% was weak.

A computer-based analysis of the accuracy of bite mark identification using cheese blocks among batch 2022 students at the Faculty of Dentistry, Baiturrahmah University

Eliyana Nolpita, Firdaus, Resti Iswani, Satria Yandi — Wed, 19 Aug 2026 00:00:00 +0700

Bite marks are a forensic identification method that involves analysing bite marks resulting from trauma to the human body. Bite marks are frequently found in cases of sexual assault, murder, child abuse, and on food remains at crime scenes. However, few victims report these marks due to feelings of shame, psy-chological trauma, fear of being blamed, and a lack of understanding that bite marks can serve as valid legal evidence. This study analysed the accuracy of using a computer-based method for bite mark identification on cheese blocks through quantitative analytical observation using a cross-sectional design, involving 50 samples obtained via purposive sampling. Data were analysed using IBM SPSS version 30.0 and the Kruskal-Wallis statistical test, which indicated good accu-racy, particularly in classifications from class 2 to class 5; characterised by a high number of excellent matches. Statistical tests showed a significant level of accuracy (p=0.000; p<0.05). It was concluded that the use of computer-based methods has a significant level of accuracy for forensic identification.

Comparison of caries and gingivitis occurrence between children and adults: findings from dental and oral health screening at Saraswati Dental Hospital Denpasar

Wed, 19 Aug 2026 00:00:00 +0700

Dental caries and gingivitis remain public health issues with high prevalence in Indonesia across various age groups. This study analysed differences in the incidence of caries and gingivitis between children aged 6-10 years and adults aged 30-36 years based on screening activities at the Saraswati Dental and Oral Hospital in Denpasar. Using an analytical observational design and a cross-sectional approach, 89 respondents were selected via purposive sampling, comprising 44 children and 45 adults who met the inclusion criteria. Data were collected through clinical examinations using the def-t index for children, the DMF-T index for adults, and the Gingival Index (GI) to assess gingival condition. Data were analysed descriptively and bivariately using the Mann-Whitney test, showing that the caries index was significantly higher in the adult group (DMF-T 297) compared to children (def-t 129) (p<0.05). Gingivitis in both groups was classified as moderate, with a slightly higher proportion in children (28%) compared to adults (25%). It was concluded that caries is cumulative with in-creasing age, whilst gingivitis is more influenced by current oral hygiene practices; therefore, promotive and preventive strategies tailored to age-specific cha-racteristics are required to improve oral health.

The effectiveness of watermelon (Citrullus Lanatus Var. Lanatus) consumption and mouthwash use on plaque index and salivary pH in children aged 6-12 years

Yayah Inayah, Fajriani, Andi Sri Permatasari, Raniah Khairunnisa Arfan — Wed, 19 Aug 2026 00:00:00 +0700

Dental caries is a problem that requires special attention, particularly among primary school children aged 6–12 years. Chemical control of caries using mouthwash and natural control can be achieved by consuming watermelon. This study explored the effectiveness of watermelon consumption and mouth-wash on plaque index and changes in saliva pH in children aged 6–12 years. A true experimental study with a pre-test post-test two-group design was conducted using a sample of 60 children aged 6–12 years at Baraya State Primary School, divided into two groups: watermelon and mouthwash. Plaque index and saliva pH were measured using the PHP-M plaque index and pH strips. A paired t-test showed a significant difference in plaque index in children aged 6–12 years before and after consuming watermelon and mouthwash. A Friedman test showed a significant difference in saliva pH in children aged 6–12 years before and after consuming watermelon and mouthwash. It was concluded that watermelon and mouthwash are effective in reducing plaque index and increasing saliva pH in children aged 6–12 years.

Antibacterial activity test of papaya seed extract (Carica papaya L.) as an irrigation agent against Prevotella intermedia

Wed, 19 Aug 2026 00:00:00 +0700

Root canal infections are one of the main problems in endodontics, largely caused by Gram-negative anaerobic bacteria, like Prevotella intermedia, which is frequently found in necrotic pulp, periapical abscesses and chronic root canal infections. Root canal irrigation is essential for eliminating microorganisms; however, conventional agents such as sodium hypochlorite have several side effects, necessitating the use of safe and effective natural, one of which is pa-paya seed extract (Carica papaya L). This study investigated whether papaya seed extract, when used as an irrigant, can inhibit the growth of P.intermedia. This laboratory experimental study, employing a post-test control design, utilised samples of 5%, 20% and 30% papaya seed extract, alongside 2.5% sodium hypochlorite and distilled water as the control. The disc diffusion method was employed to assess inhibitory activity on Mueller-Hinton agar media inoculated with P.intermedia, with five replicates for each treatment. Data were analysed using one-way ANOVA and LSD post hoc tests. Pa-paya seed extract at all concentrations exhibited inhibitory activity against the growth of P.intermedia, the greatest was observed at the 15% concentration, followed by 10% and 5% (p<0.05). It is concluded that papaya seed extract effectively inhibits the growth of P.intermedia and has the potential to be used as an alternative irriga-gation agent in root canal treatment.

The relationship between gender and dental caries status based on the def-t Index among first-grade elementary school students in Denpasar

Wed, 19 Aug 2026 00:00:00 +0700

The caries in primary teeth is assessed by def-t index. One factor thought to be associated with caries status is gender, although findings on this are inconsis-tent. This study employed an observational design with a descriptive quantitative approach. A total of 31 pupils from Class 1B at Saraswati 1 Primary School in Denpasar were selected using purposive sampling. A direct examination of the pupils’ primary teeth was carried out by dental health personnel using the 2018 Riskesdas Dental Health Survey form. The caries status among boys was predominantly in the very low category, whereas among girls, the distribu-tion of caries status was more even. The Spearman’s test showed a correlation coefficient of r=0.225 with p=0.224 (p>0.05), indicating no significant associa-tion between gender and caries status based on the def-t index. It was concluded that there was no significant association between gender and the def-t In-dex category among Year 1B pupils at Saraswati 1 Primary School in Denpasar. The more dominant factors included children’s health behaviours. Further-more, parents’ roles in oral health literacy, supervision of toothbrushing, as well as environmental and economic factors were found to be more decisive in determining children’s caries scores than gender.

The effectiveness of the integrated UKGS–UKGM Programme based on community leader empowerment for improving oral health in the City of Parepare

Nursyamsi Djamaluddin, Adam Malik Hamudeng, Erni Marlina — Wed, 19 Aug 2026 00:00:00 +0700

The School Dental Health Programme (SDHP) and Community Dental Health Programme (CDHP) have long been implemented in Indonesia; however, their im-plementation remains fragmented, meaning their impact has not yet been optimal. This community service project evaluates the effectiveness of integrating the UKGS and UKGM in improving knowledge, attitudes, behaviour, and oral hygiene status in the city of Parepare. The method used was a one-group pretest–post-test design involving 20 primary school pupils, 7 posyandu cadres, and 30 posyandu participants. The intervention was carried out through interactive education, mass toothbrushing training, clinical examinations using the Oral Hygiene Index-Simplified (OHI-S), and the empowerment of posyandu cadres as health promo-motion agents. Data analysis was performed using a paired t-test and Pearson’s correlation test. The results showed a significant improvement in knowledge (pupils: 65.2%; cadres: 58.7%), attitudes, and oral health behaviour (p<0.001), accompanied by an improvement in the OHI-S from the moderate category to the good category in all groups (p<0.001). Changes in oral health behaviour were strongly correlated with improvements in OHI-S scores (r=?0.72 among students and r= ?0.68 among the community). It was concluded that the UKGS–UKGM integration model based on volunteer empowerment proved effective as a sustainable and replicable promotive-preventive model.

Differences in the attitudes of dental students in West Sumatra towards dental photography

Tasya Azzahra Putri, Leny Sang Surya, Dina Auliya Amly — Wed, 19 Aug 2026 00:00:00 +0700

Dental photography is one of the applications of digital technology in dentistry involving the use of a camera to take pictures of the oral cavity as it really is using photography techniques. Dental photography can be used for diagnosis, treatment planning, evidence of events in the legal and forensic domains, case study research articles, patient information, interactions between laboratory technicians, patients, and dentists, and patient motivation. This study aims to see the differences in attitudes of dental profession students in West Sumatra regarding dental photography. This quantitative research with cross section-al design was conducted on month November 2024 with a sample size of 120 taken by simple random sampling. Data collection was carried out using an online questionnaire (Google Form) with 15 attitude statements. Based on the results of the study, 56.7% of students at Baiturrahmah University and 55% of students at Andalas University had a good attitude towards dental photography. Statistical analysis showed no significant difference between the two uni-versities (p-value=0.854). It is concluded that most dental profession students in West Sumatra have a good attitude towards dental photography. The curri-culum on dental photography should be included to improve students' understanding and attitudes towards the need for dental photography.

Unresolved cheilitis revisited: the importance of identifying allergic triggers in exfoliative cheilitis

Wed, 19 Aug 2026 00:00:00 +0700

Exfoliative cheilitis (EC) is a chronic inflammation of the lips characterised by recurrent and persistent desquamation; its aetiology is varied, and its clinical presentation resembles that of other forms of cheilitis, making accurate diagnosis and appropriate treatment challenging. Failure to identify the cause, parti-cularly allergies, increases the likelihood of recurrence. This article emphasises the evaluation of triggering factors, particularly the role of allergy, in cases of EC. A 58-year-old woman presented with complaints of cracked lips, easy bleeding, and pain (VAS 6) for the past year. Extraoral examination revealed des-quamation accompanied by irregular haemorrhagic crusts on the vermilion border. Routine blood tests revealed an elevated eosinophil count, suggesting an allergic reaction. Management involved the administration of topical steroids, chlorhexidine gluconate, multivitamins, and antihistamines. It was concluded that allergies can be a trigger for persistent EC. Early identification of allergic factors is necessary for appropriate management and prevention of recurrence.

Clinical management of palatal supernumerary teeth in pediatric patients

Anie Apriani, Linda Sari Sembiring, Clairy Theodora, Hanifah Nur Ghasani — Wed, 19 Aug 2026 00:00:00 +0700

Hyperdontia, or supernumerary teeth, is a dental malformation characterised by an increased number of teeth. The aetiology of this condition is not yet fully understood, but there are various theories, including dental bud dichotomy, localised hyperactivity of the dental lamina, tooth division during the bud stage, and hereditary factors that may be associated with syndromes. Case 1 involved a 12-year-old girl presenting with a complaint of teeth on the her palate. Case 2 in-volved a 7-year-old boy who presented with his mother complaining of supernumerary teeth in the upper front region. Both patients attended Maranatha Den-tal Hospital, where non-surgical extraction of the supernumerary teeth was performed. Mesiodens is one of the most commonly found types of supernumera-ry teeth; however, cases of multiple supernumerary teeth remain clinically rare. This case demonstrates various types of supernumerary teeth occurring in chil-dren; follow-up care after extraction consists of observation without orthodontic treatment. It is concluded that supernumerary teeth frequently occur in the maxil-la, and their management must be carried out accurately, taking complications into account to ensure that the development of other teeth is not disrupted.

Root canal treatment of a right mandibular first molar with periapical abscess and furcation lesion

Christina Mahardika, Mutia Nurul Fauziah, Julian Pratama — Wed, 19 Aug 2026 00:00:00 +0700

Root canal treatment (RCT) is the primary therapy for preserving teeth with pulp infections and periapical lesions. This article describes RCT performed on a right lower molar with a periapical abscess and a bifurcation lesion, using the crown-down technique with hand instruments. A 22-year-old woman presented at the UNIMUS Dental Hospital complaining of a blackened and decayed right lower molar, without pain, but with a history of spontaneous pain that subsided after taking analgesics. Radiographs revealed periapical radiolucency and slight radiolucency in the bifurcation area. The diagnosis was established as pulp necrosis with a chronic periapical abscess. RCT preparation was performed using the crown-down technique with large-tapered instruments, irrigation, calcium hydroxide medication, and gutta-percha obturation. Clinical and radiographic evaluation showed no symptoms and evidence of healing of the lesion. It was concluded that non-surgical RCT using the crown-down hand instrumentation technique is effective for cases of periapical abscess involving the bifurcation.

Management of cancrum oris in a HIV-infected patient

Wed, 19 Aug 2026 00:00:00 +0700

Cancrum oris, or noma, is a progressive orofacial gangrene with a high mortality rate that commonly occurs in individuals with severe immunosuppression, in-cluding those with human immunodeficiency virus (HIV) infection. This case report describes the management of noma in a 40-year-old woman with stage III HIV and a CD4 count of 18 cells/µL, who presented with a progressive necrotic lesion at the left commissure of the mouth, accompanied by septic shock, severe anaemia, electrolyte disturbances, and acute kidney injury. Clinical examination revealed a blackish necrotic lesion, oedema, haemorrhage and pus, consistent with the gangrenous phase of noma. Management was undertaken through a multidisciplinary approach, comprising haemodynamic stabilisation, correction of anaemia and electrolyte imbalances, broad-spectrum antibiotics, enteral nutritional support, local wound care, as well as debridement and primary closure. It was concluded that a rapid and integrated multidisciplinary approach is effective in improving the clinical condition and limiting the progress-ion of tissue destruction in HIV-associated noma.

Efficacy of dental pulp stem cell-derived extracellular vesicles and scaffold combination for bone regeneration in pre-clinical animal models

Abdul Gany, Irene Edith Rieuwpassa, Nurlinda Hamrun — Wed, 19 Aug 2026 00:00:00 +0700

The regeneration of bone damage is a major challenge in regenerative therapy and requires effective strategies for bone repair and reconstruction. Extracellular vesicle (EV)-based therapy has emerged as a promising cell-free approach due to its role in intercellular communication. This systematic review evaluates the efficacy of dental pulp stem cell-derived extracellular vesicles (DPSC-EVs) combined with scaffolds for bone regeneration, focusing on preclinical evi-dence. An electronic search of PubMed, Scopus, and ScienceDirect was conducted up to October 2025, following PRISMA guidelines, and risk of bias was assessed using SYRCLE. Of the 489 articles identified, 9 met the inclusion criteria. The findings indicate that DPSC-EV combined with a scaffold enhances the osteogenic response and promotes bone repair in preclinical models. It is concluded that DPSC-EV has potential as a novel and effective cell-free therapy for bone regeneration. However, further standardisation in EV preparation, long-term studies in large animals, and early-phase clinical trials are required to support clinical translation.

Current advances based-chitosan-hydroxyapatite nanocomposite and PRF-hydroxyapatite bone graft for alveolar and maxillofacial bone regenaration

Muhammad Irfan Rasul, Tyas Nadya Wahdaniah, Sri Putri Marhaeni, Husnul Khotimah — Wed, 19 Aug 2026 00:00:00 +0700

Maxillofacial bone loss commonly occurs due to congenital disorders, tumors, trauma, and inflammatory processes, including alveolar bone loss resulting from periodontitis, endodontic pathology, and tooth extraction. Following extraction, a significant reduction in alveolar ridge height and width occurs. Autologous bone grafting remains the gold standard for bone regeneration; however, it is limited by donor site availability and associated complication risks. Biomaterials have been developed as alternatives, including chitosan–hydroxyapatite nanocomposites, which are biocompatible and osteoconductive, and platelet-rich fibrin, which is rich in growth factors supporting osteogenesis and tissue healing. This literature review aims to compare the effectiveness of both biomaterials in alveolar bone regeneration and maxillofacial reconstruction.

Marine-derived polymers and bioceramics in functional dental materials

Wed, 19 Aug 2026 00:00:00 +0700

Marine-derived polymers and bioceramics such as chitosan, chitin, alginate, marine collagen and hydroxyapatite are attracting increasing attention in the field of dentistry due to their biocompatibility, bioactivity and sustainability. These materials offer promising alternatives to conventional biomaterials for restorative and regenerative applications. This systematic review examines the use of marine-derived biomaterials in enhancing the mechanical and biological proper-ties of dental regenerative and restorative materials, based on literature published over the past decade. This systematic review analysed 18 articles (2020–2025) from PubMed, ScienceDirect, ProQuest, and Springer, focusing on in vitro, in vivo, and clinical applications. Marine-derived polymers and biocera-mics have been shown to demonstrate improved mechanical strength, bioactivity, and regenerative capacity in various dental treatment applications. It is concluded that marine polymers and bioceramics show significant potential for the field of dental regenerative and restorative medicine.

Biocompatibility and application of calcium carbonate from blood crush shells for dentin remineralization

Sun, 23 Aug 2026 00:00:00 +0700

Dentin demineralization is a major challenge in dentistry, requiring effective and biocompatible remineralization methods. An ideal remineralization material must be able to release calcium and phosphate ions to support structural repair. It is concluded that blood clam shells (Anadara granosa) have a high calci-um carbonate (CaCO?) content as a natural source of calcium ions. This CaCO₃ has great potential as a biomaterial for remineralization and pulp capping ap-plications because it has been proven to be biocompatible, inexpensive, and capable of stimulating the regenerative process (dentin bridge), making it a su-perior alternative to materials such as calcium hydroxide and MTA.

Comparison of Class II malocclusion treatment using Twin Block and prefabricated Myobrace appliances

Ardiansyah S. Pawinru, Yusnita Damayanti — Wed, 19 Aug 2026 00:00:00 +0700

Class II malocclusion is one of the most prevalent orthodontic anomalies and may adversely affect masticatory function, facial aesthetics, and the patient’s psychosocial well-being. Various functional appliances, including the Twin Block and Myobrace, have been utilized to modify mandibular growth and improve maxillomandibular relationships. This literature review aims to compare the effectiveness of these two appliances based on changes in ANB angle, overjet, and facial profile, from clinical trials and systematic reviews. Myobrace has demonstrated improvement in myofunctional habits, with an average overjet re-duction of approximately 2-2.5 mm and a decrease in ANB angle of around 1°. Meanwhile, the Twin Block appliance exhibits more pronounced skeletal ef-fects, achieving an overjet reduction of up to 4-5 mm and an ANB decrease of 1.5-2°, along with more evident enhancement of facial profile aesthetics. I tis concluded that both appliances are effective for the treatment of Class II malocclusion during growth periods; however, Twin Block provides superior ske-letal correction, whereas Myobrace is more beneficial in improving orofacial muscle function.

Natural shell-based bioceramics from marine sources in dental applications: biological and mechanical properties

Wed, 19 Aug 2026 00:00:00 +0700

Seashells are a natural biomaterial that is abundant, environmentally friendly and biocompatible, and therefore have potential as dental bioceramics, although their use remains limited. This review presents the latest scientific evidence regarding the biological and mechanical properties of seashells, as a basis for as-sessing their potential as an alternative bioceramic in dental applications. This systematic review followed the PRISMA guidelines, with a literature search con-ducted in Scopus, PubMed, and ScienceDirect (2015-2025). Inclusion criteria comprised in vitro, in vivo, or comparative studies evaluating the biological, me-chanical, or physical properties of marine shell bioceramics for dental applications. The studies demonstrated high biocompatibility and antimicrobial activity, me-chanical properties equivalent to or better than those of commercial materials, and physical properties that remain competitive. It was concluded that marine shell-based bioceramics show promise as a sustainable alternative dental material with competitive biological and mechanical properties.

The potential of xylitol chewing gum as a preventive strategy for plaque index and saliva pH in fixed orthodontic appliance users

Nasyrah Hidayati, Nurul Ilmi — Wed, 19 Aug 2026 00:00:00 +0700

The use of fixed orthodontic appliances increases the risk of iatrogenic factors such as massive plaque accumulation and a decrease in saliva pH, which trig-gers enamel demineralisation. The main challenges in plaque control are behavioural factors and patient compliance due to complex and time-consuming cleaning procedures. This systematic review examines the potential of xylitol chewing gum as a low-barrier, intervention-based preventive strategy to con-trol plaque index and salivary pH in orthodontic patients. Biochemically, xylitol inhibits the growth of Streptococcus mutans via a ‘futile metabolic cycle’, re-ducing bacterial colonisation by up to 47.12%. Physiologically, the act of chewing stimulates saliva flow and increases bicarbonate concentration, thereby helping 78.1% of patients achieve a neutral saliva pH. From a health promotion perspective, xylitol chewing gum offers an enjoyable approach, making it ea-sier to integrate into daily life compared to rigid conventional hygiene instructions. It is concluded that xylitol chewing gum is effective as a mechanochemi-cal adjuvant capable of bridging clinical needs with patients’ psychological dynamics to improve the quality of life for orthodontic patients.

Host modulation therapy as an adjunct in peri-implantitis treatment

Wed, 19 Aug 2026 00:00:00 +0700

Peri-implantitis is an inflammatory condition surrounding dental implants that often persists following mechanical debridement. Host modulation therapy (HMT) targets the destructive host response and has been proposed as an adjunctive therapy; however, its role remains unclear. In accordance with PRISMA 2020, a search was conducted in PubMed, ScienceDirect, the Cochrane Library and Google Scholar for human studies (2015–2025) evaluating HMT as an adjunct to peri-implantitis therapy. Methodological quality was assessed using the Joanna Briggs Institute checklist. The protocol was registered with PROSPERO (CRD420261322132). Seven studies (four RCTs, one retrospective cohort, one retrospective comparative study, one case series; 579 participants) were in-cluded. Three HMT approaches were tested: topical tetracyclines (doxycycline gel, minocycline microspheres/ointment, tetracycline fibres), systemic sub-anti-microbial dose doxycycline (SDD), and the probiotic Lactobacillus reuteri. Topical tetracyclines demonstrated the most consistent short-term improvements in probing depth, bleeding on probing, plaque, suppuration, and pro-inflammatory biomarkers. SDD was associated with long-term peri-implant stability in one case series, whilst probiotics only reduced the plaque index. It was concluded that adjunctive HMT, particularly topical doxycycline and minocycline, provides short-term clinical benefits in peri-implantitis.

Utilization of gelatin from fish skin as a scaffold for gingival tissue regeneration

Wed, 19 Aug 2026 00:00:00 +0700

Periodontal disease is a highly prevalent oral health problem that often leads to tooth loss. Conventional therapies such as scaling and root planing only halt disease progression but fail to regenerate lost tissue. Tissue engineering approaches offer a solution by utilizing scaffolds as 3D frameworks to support cell adhesion, proliferation, and differentiation. Fish skin gelatin is a promising alternative biomaterial because it is biocompatible, biodegradable, hydrophilic, free from zoonotic risks, and ethically and religiously acceptable. Various in vitro and in vivo studies have shown that fish gelatin-based scaffolds can increase gi-ngival fibroblast viability, type I collagen expression, and angiogenesis, as well as accelerate the epithelialization process with minimal inflammatory response. Chemical modifications such as crosslinking and 3D printing technology have been shown to improve mechanical stability and optimize the porous proper-ties of the scaffold. Thus, fish skin gelatin has great potential as a scaffold for gingival tissue regeneration.

The use of fig latex as a dentine deproteinisation agent prior to adhesive restoration procedures

A. Abdillah, Aliyah Rajab, Agrista Aulia Amrin, Christine Anastasia Rovani — Wed, 19 Aug 2026 00:00:00 +0700

The success of adhesive restorations is greatly influenced by the quality of the bond between the restorative material and the dentine. A deproteinising agent is required to remove denatured collagen without damaging the dentine structure. Fig latex (Ficus carica), which contains the proteolytic enzyme ficin, is be-ing developed as a natural alternative material due to its ability to degrade proteins, its biocompatibility, and its antibacterial and anti-inflammatory proper-ties. This article evaluates the potential of ficin as a dentine deproteinisation agent prior to adhesive restoration procedures by analysing its effect on adhesive bond strength, hybrid layer quality, and the effectiveness of dentine deproteinisation. A search for scientific articles was conducted in the Google Scholar, Web of Science, and PubMed databases using keywords related to ficin, proteolytic enzymes, and dentine deproteinisation. Articles meeting the inclusion cri-teria were then systematically analysed in accordance with the PRISMA guidelines. Based on research and clinical reports, it appears that ficin, as a proteo-teolytic enzyme, is effective when used as a deproteinisation agent on enamel and dentine surfaces prior to adhesive procedures; it is capable of improving bond quality, optimising hybrid layer formation, and serving as a safe and efficient alternative in restorative dental procedures.

Second class functional treatment: Activator Andreasen versus Twin Blok

Ardiansyah S. Pawinru, Tyas Nadya Wahdaniah — Wed, 19 Aug 2026 00:00:00 +0700

Class II malocclusion is one of the most common orthodontic problems associated with mandibular retrusion. Various functional treatment modalities have been developed to manage this condition, particularly the use of removable orthodontic appliances designed to stimulate mandibular growth and correct skele-tal and dental relationships. The most widely recognised appliances are the Andreasen Activator and the Twin Block. The activator operates on a passive prin-ciple, requiring long-term wear to gradually influence mandibular development and occlusal correction. In contrast, the Twin Block is a more active functional appliance, allowing for normal masticatory function during wear, thereby improving patient compliance. Clinical evidence suggests that both appliances are effective in reducing overjet and overbite, as well as improving facial profile aesthetics. However, the Twin Block is reported to be more efficient at producing mandibular changes within a shorter treatment period than the activator. Factors such as the patient’s age, growth potential, the severity of the malocclusion, and compliance must be carefully considered to achieve optimal treatment outcomes. It is concluded that individualised treatment planning is essential, with the selection of functional appliances tailored to the specific clinical situation.

The potential of Stichopus hermanii as a marine biomaterial for bone regeneration in dentistry

Asmawati Amin, Audrey Nathalie Alicyandrina Sitindaon, Ade Lola Zafira — Wed, 19 Aug 2026 00:00:00 +0700

This systematic review aims to evaluate the potential of Stichopus hermanii as a natural biomaterial for bone regeneration. A systematic literature search was conducted via PubMed, Scopus, ScienceDirect and Google Scholar using keywords related to S.hermanii, bone regeneration, socket healing and biomaterials. Article selection followed the PICOS framework, encompassing both in vitro and in vivo studies. S.hermanii holds great potential as a natural biomaterial to support alveolar bone regeneration due to its osteoconductive and osteoinductive properties. Bioactive components such as collagen, glycosaminoglycans, chondroitin sulphate and essential minerals have been shown to enhance new bone formation, increase the number of osteoblasts, suppress osteoclast activity and accelerate the healing process, particularly when used in conjunction with scaffolds such as collagen or hydroxyapatite. It is concluded that S.hermanii has potential as a natural, osteoconductive and bioactive biomaterial to support alveolar bone regeneration, particularly in applications following tooth extraction, periodontal therapy and implant procedures.

Antibacterial potential of chitosan extract from crustacean shells against periodontal disease bacteria

Wed, 19 Aug 2026 00:00:00 +0700

Periodontal disease is one of the most common dental and oral conditions in the general population. Data from the 2018 Riskesdas survey show that 57.6% of the Indonesian population suffer from dental and oral problems, yet only 10.2% receive medical treatment, whilst the prevalence of periodontitis among those aged 15 years and over stands at 67.8%. Periodontal disease can be a manifestation of systemic diseases such as diabetes mellitus and anaemia; its primary cause is the accumulation of pathogenic bacterial plaque, such as Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, which damages the gingival tissue and leads to loss of attachment. Conventional therapy involves debridement through scaling and root planing, which is now often combined with antibiotics such as tetracycline, doxycycline, metronidazole and amoxicillin to enhance the effectiveness of treatment. In recent developments, natural sub-stances such as chitosan have begun to be utilised due to their bacteriostatic properties, which are capable of inhibiting the growth of various pathogenic mi-croorganisms. It is concluded that chitosan, derived from the chitin of marine animals and insects, offers a promising alternative therapy for the management of periodontal disease.

The relationship between pain at the beginning of fixed orthodontic treatment and patient compliance at the Dental and Oral Teaching Hospital of Hasanuddin University

Eddy Heriyanto Habar, Nur Isnaeni — Wed, 19 Aug 2026 00:00:00 +0700

Understanding the relationship between pain at the start of orthodontic treatment and treatment compliance is crucial for improving the success of therapy. This paper explores the relationship between pain at the start of fixed orthodontic treatment and patient compliance at the Hasanuddin University Educational Dental and Oral Hospital (RSGMP Unhas). This quantitative study, employing an analytical observational design with a cross-sectional approach, involved 30 patients wearing fixed orthodontic appliances who were undergoing treatment at RSGMP Unhas and were selected using purposive sampling. Data were collected via a questionnaire assessing the level of pain at the start of fixed orthodontic treatment and patient treatment compliance. The relationship between varia-bles was analysed using Spearman’s rank correlation test. The majority of respondents experienced moderate pain (36.7%), whilst the highest level of com-pliance was in the ‘highly compliant’ category (43.3%). There appeared to be a strong and significant relationship between pain levels at the start of fixed ortho-dontic treatment and patient treatment compliance (r=0.610; p<0.001). The lower the level of pain experienced, the higher their level of compliance with or-thodontic treatment. It is concluded that there is a significant relationship between pain levels at the start of fixed orthodontic treatment compliance.

The efficacy of papaya (Carica papaya L.) seed extract in inhibiting Actinomyces spp.

Wed, 19 Aug 2026 00:00:00 +0700

Actinomyces spp. is one of the dominant bacteria frequently found in root canal infections. Standard irrigation solutions such as sodium hypochlorite (NaOCl) are effective as antibacterial agents, although they have limitations in eliminating Actinomyces spp. and are toxic at a concentration of 5.25%. Papaya (Carica papaya L.) seeds have potential as an antibacterial agent because their active compounds disrupt the integrity of bacterial cell membranes. This laboratory-based experimental study, employing a post-test design with a control group, aimed to determine the effectiveness of PS extract against Actinomyces spp., as well as its most effective concentration. The antibacterial activity was tested using the disc diffusion method at concentrations of 30%, 40% and 50%, with 2.5% NaOCl as the positive control and aquadest as the negative control. The mean inhibition zone diameters increased with rising extract concentrations. The mean inhibition zone diameter for the 30% concentration was 17.536 mm, for 40% it was 18.298 mm, and for 50% it reached 19.272 mm. All tested ex-tract concentrations fell within the ‘strong inhibitory activity’ category. It was concluded that the administration of PS extract is effective as an antibacterial agent against the growth of Actinomyces spp., but the 50% was the most effective.

The potential of marine organism–derived chitosan as an antimicrobial biomaterial against oral pathogens in dentistry

Muhammad Irfan Rasul, Andini Safhira Wahyudi, Muh.Ibra Ikhza — Wed, 19 Aug 2026 00:00:00 +0700

The use of conventional antimicrobial agents, such as chlorhexidine and antibiotics, whilst effective, often leads to side effects and the risk of microbial resis-tance; consequently, there is a need for antimicrobial biomaterials that are safer, biocompatible and sustainable. This systematic review aims to assess the potential of marine-derived chitosan as an antimicrobial biomaterial against oral pathogens in the field of dentistry, using a systematic review approach based on the PRISMA 2020 guidelines. A literature search was conducted in the PubMed, Scopus, ScienceDirect and Google Scholar databases for articles pu-blished between 2020 and 2026. Of the 287 articles identified, 15 primary studies met the inclusion criteria and were analysed qualitatively. The results of the synthesis indicate that chitosan derived from shrimp waste, crustaceans, and squid beaks exhibits significant antimicrobial and antibiofilm activity against va-rious oral pathogens. Several studies also show that chitosan-based mouthwash and oral spray formulations are as effective as chlorhexidine, whilst causing less enamel staining. Furthermore, chitosan-based scaffolds demonstrate high biocompatibility and the ability to support tissue and alveolar bone regenera-tion. It is concluded that chitosan derived from marine organisms holds great potential as an antimicrobial and regenerative biomaterial in dentistry.

Early two-stage implant placement in region 46

Aditya Priagung Prakosa, Elfina Sara Raharjo, Rizki Bagus Priharnanto — Wed, 19 Aug 2026 00:00:00 +0700

The presence of infection at the extraction site can affect the timing of implant placement and the success of treatment. This case report describes the ma-nagement of the loss of the right lower first molar using the early two-stage implant placement technique following a change in the treatment plan. A 25-year-old man presented with a residual root of tooth 46 and wished to undergo rehabilitation using implants. Clinical examinations and CBCT scans were performed for treatment planning. Immediate implant placement was initially planned; however, an abscess was discovered during extraction, leading to a change in the plan to early implant placement. Following an eight-week healing period, the implant was placed using a two-stage surgical technique, followed by the place-ment of a healing abutment and a final restoration in the form of a screw-retained crown. Clinical and radiographic evaluation demonstrated good healing and implant stability. It was concluded that the early two-stage implant placement technique yields good clinical results in areas with a history of local infection when supported by an appropriate treatment plan and an adequate healing period.

Exosomes and secretome from third molar tooth germs: regenerative potential and their applications in modern dentistry

Wed, 19 Aug 2026 00:00:00 +0700

Third molar (M3) dental buds contain mesenchymal stem cells with high regenerative potential that are capable of producing exosomes and secretomes, two paracrine products that play a key role in tissue regeneration. This systematic review analyses the scientific evidence regarding exosomes and secretomes derived from M3 dental bud stem cells in terms of their regenerative therapeutic potential and their applications in dentistry. The review was conducted in ac-cordance with the PRISMA guidelines using the PICO approach. Literature was retrieved from three databases (PubMed, ScienceDirect, and Google Scholar) covering the period 2015-2025 using a combination of relevant keywords. Of the 246 articles identified, 6 met the inclusion criteria. The results of the review indicate that exosomes and secretomes from M3 dental pulp stem cells (DPSCs) have potential in angiogenesis, osteogenesis, immunomodulation, neuro-protection, and wound healing. This cell-free approach is considered safer, easier to standardise, and carries minimal risk compared to direct cell therapy. It is concluded that exosomes and secretomes from M3 dental pulp stem cells are strong candidates for future regenerative therapies in the fields of dentistry and medicine.

Marine-derived 9-octadecenoic acid and a-tocopherol acetate as antioxidant and anti-inflammatory agents in oral health

Wed, 19 Aug 2026 00:00:00 +0700

Natural bioactive compounds such as a-tocopherol and 9-octadecenoic acid (OOA), both found in Stichopus hermanii, have demonstrated potential antioxi
dant and anti-inflammatory properties. This article reviews systematically and compare the biological activities of a-tocopherol and OOA in managing oxida
tive and inflammatory processes relevant to the oral cavity. A descriptive-comparative literature review was conducted using PubMed, ScienceDirect, MDPI,
and Google Scholar (2015-2025). Inclusion criteria covered in vitro, in vivo, clinical, and in silico studies evaluating the antioxidant and anti-inflammatory effects
of a-tocopherol or OOA. a-tocopherol primarily acted by enhancing antioxidant defenses and suppressing inflammatory signaling, while OOA modulated pro
inflammatory pathways and epigenetic mechanisms. It is concluded that a-tocopherol and OOA exhibit complementary mechanisms in reducing oxidative
stress and inflammation. Their combined use and marine-derived origin from S.hermanii offer promising directions for future research and therapeutic applica
tion in oral health.

A comparison of the effectiveness of 17% EDTA and 6.25% pineapple peel extract in removing the smear layer in the apical third of the root canal

Noor Hikmah, Rianti, Nurhayaty Natsir, Juni Jekti Nugroho — Wed, 19 Aug 2026 00:00:00 +0700

The smear layer is a thin layer consisting of organic and inorganic substances that can potentially cause microleakage. Therefore, the removal of the smear layer is crucial to the success of root canal treatment. This study compared the effectiveness of smear layer removal between 17% EDTA and 6.25% pineap-ple peel extract (PPE) (Ananas comosus L. Merr). A total of 32 upper premolars with intact crowns and root canals were divided into two groups: 17% EDTA and 6.25% PPE. The samples were prepared using the crown-down pressureless technique, rinsed according to their respective groups, and analysed for smear layer removal using SEM at 1000x magnification at the apical third of the root canal. A t-test revealed a significant difference in the effectiveness of smear layer removal between the two groups. Pineapple peel extract demonstrated superior performance in removing the smear layer at the apical third com-pared with 17% EDTA. It was concluded that 6.25% PPE is a promising alternative to 17% EDTA for root canal irrigation.

Management of epulis fissuratum in geriatric patients with hypertension complicated by hematoma

Mukhtar Nur Anam, Hadira — Wed, 19 Aug 2026 00:00:00 +0700

Epulis fissuratum is a benign gingival enlargement caused by chronic irritation, commonly seen in users of ill-fitting dentures and frequently observed in ge-riatric patients. This report describes the management of epulis fissuratum in a geriatric patient with hypertension to minimize the risk of postoperative vascu-lar complications. A 72-year-old woman complained of a lump on her upper gum that had been growing larger over the past month or so. The patient had been using a complete set of dentures for about 7 years, which now felt loose. Clinical examination revealed a pedunculated lesion in the labial vestibule and buccal mucosa. Excision was performed under general anesthesia. Postoperatively, the patient developed a hematoma that was managed conservatively and showed clinical improvement by day 14. It was concluded that appropriate management of geriatric patients with hypertension is crucial for preventing complications and supporting optimal healing.

Marine-derived chitosan composites in restorative dentistry: antibacterial and mechanical properties

Wed, 19 Aug 2026 00:00:00 +0700

Conventional composite resins often show limited antibacterial activity and are susceptible to degradation, potentially leading to secondary caries. Chitosan, a natural polysaccharide, exhibits biocompatible, biodegradable, and antibacterial characteristics, offering potential improvement in composite resin perfor-mance. This review evaluates the effect of chitosan incorporation on the mechanical and antibacterial properties of composite restorations. A systematic re-view following PRISMA guidelines was conducted using PubMed, ScienceDirect, and Elsevier databases (2015-2025). Inclusion criteria covered in vitro and in vivo studies analyzing chitosan-modified composite resins. Five eligible studies were reviewed based on chitosan concentration, resin type, and outcomes. Chitosan (0.1-2%) enhanced hardness, fracture resistance, and surface stability while providing notable antibacterial activity against S.mutans. Antibacte-rial effects increased up to 2-5%, though higher concentrations (>5%) could reduce some mechanical strength. It is concluded that marine chitosan appears to be an effective additive for restorative composites, improving antibacterial properties and mechanical stability without compromising adhesion. Further cli-nical trials are needed to validate its long-term benefits and optimal concentration for dental applications.

Utilization of biopolymers from palm oil waste in dental innovation

Sun, 23 Aug 2026 00:00:00 +0700

Oil palm biomass (OPB) has emerged as a highly promising lignocellulosic resource. Utilizing OPB waste to produce advanced biomaterials, such as nano-nocellulose and lignin, offers opportunities for transformative innovation in sustainable dental materials. This literature review was compiled based on inclu-sion criteria that focused on primary and secondary studies published in leading scientific journals (not theses or non-peer-reviewed articles) that addressed the use of oil palm waste-derived biopolymers OPB, particularly nanocellulose and lignin, in biomedical and dental applications. These materials exhibit good biocompatibility, are biodegradable, and actively support tissue regeneration (as evidenced by increased ALP activity). The use of palm oil enables the deve-lopment of smart materials that combine structural support (from cellulose/lignin) with therapeutic functions (antimicrobial and antioxidant properties from palm oil derivatives) to prevent biofilm infection and oxidative damage.

Potential utilization of marine-based natural biomaterials

Ainun Rezky Ramadhani, Jessica Adam Panggalo, Fadillah Ilmi, Acing Habibie Mude — Wed, 19 Aug 2026 00:00:00 +0700

Biomaterials are natural or synthetic materials used to repair, replace, support, or restore tissue function in the human body. Marine-derived biomaterials, such as collagen, alginate, and chitosan, possess biocompatible, bioactive, and biodegradable properties, making them widely used in dentistry, particularly in rege-nerative therapies. This literature review evaluates the potential utilization of marine-based biomaterials as natural agents in the development of regenera-tive dentistry therapies and their clinical applications. It is concluded that marine-based biomaterials such as collagen, alginate, chitosan, coral, and carragee-nan show promising potential in regenerative dentistry and may be applied in various clinical settings. However, further studies and clinical trials are required to confirm their effectiveness, safety, and standardization for clinical application.

The potential of oral microneedle patches as a delivery system for golden sea cucumber collagen and snakehead fish albumin for oral mucosal wound healing

Wed, 19 Aug 2026 00:00:00 +0700

This review analyses the potential for synergistic integration between golden sea cucumber (Stichopus hermanni) collagen and snakehead fish (Channa striata) albumin via a mucoadhesive oral microneedle patch delivery system to accelerate wound healing. This study employs a comprehensive literature review, exploring the biology of mucosal wound healing, the biochemical profiles of the golden sea cucumber and snakehead fish components, and the mechanism of microneedle technology. Type I collagen from the golden sea cucumber acts as a structural scaffold and a provider of proliferative signals through its in-teraction with integrins. Meanwhile, catfish albumin functions as an anti-inflammatory agent, an osmotic pressure balancer, and a provider of essential me-tabolic nutrients (such as zinc and amino acids) that support the proliferation phase. The use of dissolving microneedle technology enables precise, pain-free penetration through the epithelial barrier, whilst delivering the effects of percutaneous collagen induction therapy via mechanical microtrauma that sti-mulates the healing cascade. The design of a double-layered hybrid patch with a mucoadhesive layer has been shown to maintain drug retention in the moist oral cavity environment. The integration of S.hermanni collagen and C.striata albumin into the oral microneedle system promises a revolutionary therapeutic approach to the management of mucosal wounds through the simultaneous modulation of the NF-?B and TGF-?1 signalling pathways.

Author Guideline

Makassar Dental Journal — Wed, 19 Aug 2026 00:00:00 +0700

Author Guideline