Calcium hydroxide [Ca (OH)2] has been the gold standard for endodontic medicament as inter-appointment dressing, due to its ability to act as antimicrobial agent and to promote hard tissue healing. The main mechanism of this material is the release of Ca2+ and OH- ions through its vehicle, providing high alkaline pH. Indonesia, has many potential resources, namely limestone (CaCO3), that can be utilized as raw material for Ca (OH)2. The objective of this present study is to investigate the synthesis and characterization of Ca (OH)2 from Indonesian limestone as endodontic intra-canal medicament. Limestone were taken from Palimanan area in West Java, Indonesia. CaCO3 was calcined at 900°C for 4h resulting CaO powder. CaO powder were mixed with distilled water using a rotary stirrer for 24h and produce Ca (OH)2 paste. The Ca (OH)2 paste was dried at 80°C, then crushed using a mortar and pestle to obtain Ca (OH)2 powder. The powder samples were thus subjected for characterization by X-Ray Diffraction (XRD) and Fourier-Transform Infrared (FTIR) Spectroscopy. The XRD patterns revealed that the high peak of Ca (OH)2 crystallinity was successfully achieved in this study. The FTIR spectroscopy also showed bands at 3640 cm-1 which belongs to OH- stretching vibration of the Ca (OH)2. The results indicate that the synthesize of Indonesian limestone as Ca (OH)2 by this method was attained. Indonesian limestone is a potential raw material that can be used as a precursor for synthesis of Ca (OH)2 as endodontic material.

Apatite cement is ideal self-setting cement for bone substitute material, however its use is limited only to areas that receive minimum load bearing because mechanical strength of apatite cement is low. Silica-calcium phosphate nanocomposite (SCPC50) is material having good mechanical strength and has an important role in bone remodeling (bone metabolism), mineralization, synthesis of cartilage, collagen production, proliferation and differentiation of bone cells. However, the unsetting and granule’s physical shape of SCPC50 limits the application. The purpose of this study is to determine the effect of various mixtures of SCPC50 and apatite cement to manipulative index (setting time and handling property), and mechanical properties. The experimental results show that the setting time of apatite cement mixture with 5% and 10% SCPC50 was 40% higher (p<0.05). The mechanical strength evaluated by Diametral Tensile Strength showed that the addition of both 5% silica and 10% SCPC50 composition to apatite cement mixture increased the mechanical strength of apatite cement mixture (p<0.1). The handling property of cement paste was significantly increased between the apatite cement without SCPC50 and apatite cement with both 5% SCPC50 and 10% SCPC50 (p<0.05). It is concluded that the addition of SCPC50 to apatite cement mixture could improve the mechanical properties and it is expected to improve its bioactivity.

Recurrent endodontic infections of treated teeth are mainly linked to microbial persistency in the root canal system. Enterococcus faecalis is a bacterium that is often identified in these recurrent infections. Calcium hydroxide (Ca(OH)2) is a widely used root canal medicament and is now being developed to be produced from natural materials. Ca(OH)2, which is synthesized from natural limestone from Palimanan, Indonesia, has a structure similar to Ca(OH)2, which is often used as a root canal medicament. The purpose of this study was to determine the antimicrobial property of Ca(OH)2 paste synthesized from natural limestone compared to conventional Ca(OH)2 paste. This study is an in vitro experimental study consists of 3 groups (n=24, namely, conventional Ca(OH)2 paste, limestone synthesized Ca(OH)2 paste, and saline as the negative control, for 2 intervals of time and evaluated by Total Plate Counting (TPC) method. Samples were mandibular first premolar root canal prepared by root canal preparation and contaminated with E. faecalis (ATCC 29212). The infected root canals of each group were treated by the medicaments, and samples from the root canals were taken on day 7 (n=4) and 14 (n=4). Results showed that both Ca(OH)2 groups had antimicrobial activities against E. faecalis. The limestone Ca(OH)2 paste group had the least amount of bacterial colonies on the 7th day compared to other groups. In contrast, on the 14th day, the conventional Ca(OH)2 paste had the least bacterial colonies. It can be concluded that the Ca(OH)2 paste synthesized from natural limestone has an antimicrobial effect on E. faecalis, the antimicrobial effect was higher on the 7th day but decreases on the 14th day, whereas the conventional Ca(OH)2 had a higher antimicrobial effect on day 14 compared to day 7. Further studies are expected to improve the long-term antimicrobial effectiveness and sustainability of the natural limestone synthesized Ca(OH)2 paste.

The chronological age of a person can not provide sufficient information. We can use the dental age in panoramic radiographs to know the growth process appropriately compared to The London Atlas of the Alqahtani method. Children aged 6-12 years have various factors that can affect the velocity in tooth growth and development, such as male and female. This study aims to determine the chronological patient's age differences with dental age based on the Alqahtani method on a panoramic radiograph at Unjani Dental and Oral Education Hospital. This type of research is Analytical Observational with the Cross-Sectional Study method. Research subjects were obtained from all medical records panoramic radiographs with 72 panoramic radiographs aged 6-12 years, divided into 36 male patients and 36 female patients. Differences in chronological age with dental age were analyzed statistically using the Mann-Whitney test and Wilcoxon test, previously tested for the normality using Kolmogorov- Smirnov. The results showed a significant difference between chronological age and dental age by gender and in all patients at the Unjani Dental and Oral Education Hospital (p<0,05). Based on the analysis of the data obtained, all patients in RSGMP Unjani aged 6-12 years have different dental developmental growth processes, and the dental development growth of female patients was faster than male patients. It can be concluded that the dental age is not always comparable with chronological age because of various factors such as gender, genetics and environment, which can affect the dental age.

Hydrophilicity of apatite cement was increased after O3 gas treatment on apatite cement (AC) powder. It results on the improvement of the handling and mechanical properties of set AC. Behavior of osteoblastic cells to O3-treated set AC was evaluated including initial cell attachment, morphology of the attached cells and proliferation using rat bone marrow cell (RBM). Cells’ response to the set AC was the same regardless of O3 treatment. The cells well attached and spread with filopodial extensions even over the O3-treated set AC specimens. The rates of cell proliferation on set AC were also the same regardless of O3 treatment. The result indicated O3 treatment of AC powder would not affect to the osteoblast cell response of set AC.