Irigasi saluran akar merupakan tahapan penting dalam menunjang keberhasilan perawatan saluran akar. Mikroorganisme paling resisten dan sering ditemukan pada kasus setelah dilakukan perawatan saluran akar adalah Enterococcus faecalis, dengan prevalensi berkisar 24-77%. Chlorhexidine digluconate dengan konsentrasi 2% digunakan untuk larutan irigasi saluran akar yang efektif, namun tidak memiliki kemampuan untuk melarutkan jaringan nekrotik. Cuka sari apel memiliki kandungan asam organik yaitu asam asetat dapat yang dapat bertindak sebagai antimikroba yang dapat menyebabkan hilangnya integritas sel. Penelitian ini menguji pengaruh antibakteri, daya hambat, kadar hambat minimum, dan kadar bunuh minimum sediaan cuka sari apel terhadap bakteri Enterococcus faecalis dengan Chlorhexidine digluconate 2% sebagai kelompok kontrol terhadap pertumbuhan Enterococcus faecalis. Hasil penelitian ini diharapkan dapat menjadi suatu dasar pengembangan cuka sari apel sebagai bahan irigasi saluran akar dan dapat mengetahui aktivitas daya hambat optimum dari sediaan cuka sari apel terhadap bakteri Enterococcus faecalis secara in vitro.Desain penelitian ini bersifat eksperimental labotratorik secara in vitro menggunakan metode difusi cakram (Tes Kirby-Bauer) dengan pengamatan zonahambat. Data yang diukur adalah diameter zona hambat dari pertumbuhan bakteri Enterococcus faecalis dengan menggunakan jangka sorong dalam satuan milimeter (mm). Kadar bunuh bakteri pada penelitian ini diadaptasi dari metode yang dikembangkan oleh CLSI (Clinical Laboratory Standart Institute, 2014) dengan modifikasi.Diameter zona hambat cuka apel meningkat seiring dengan peningkatan konsentrasi, bahkan pada konsentrasi minimal 25% dapat membunuh bakteriEnterococcus faecalis Potensi antibakteri cuka apel setara dengan Chlorhexidine digluconate 2%.

Maintaining dental pulp vitality and preventing tooth loss are two challenges in endodontic treatment. A tooth lacking a viable pulp loses its defense mechanism and regenerative ability, making it more vulnerable to severe damage and eventually necessitating extraction. The tissue engineering approach has drawn attention as an alternative therapy as it can regenerate dentin-pulp complex structures and functions. Stem cells or progenitor cells, extracellular matrix, and signaling molecules are triad components of this approach. Stem cells from human exfoliated deciduous teeth (SHED) are a promising, noninvasive source of stem cells for tissue regeneration. Not only can SHEDs regenerate dentin-pulp tissues (comprised of fibroblasts, odontoblasts, endothelial cells, and nerve cells), but SHEDs also possess immunomodulatory and immunosuppressive properties. The collagen matrix is a material of choice to provide structural and microenvironmental support for SHED-to-dentin pulp tissue differentiation. Growth factors regulate cell proliferation, migration, and differentiation into specific phenotypes via signal-transduction pathways. This review provides current concepts and applications of the tissue engineering approach, especially SHEDs, in endodontic treatment.

Currently, the challenge in dentistry is to revitalize dental pulp by utilizing tissue engineering technology; thus, a biomaterial is needed to facilitate the process. One of the three essential elements in tissue engineering technology is a scaffold. A scaffold acts as a three-dimensional (3D) framework that provides structural and biological support and creates a good environment for cell activation, communication between cells, and inducing cell organization. Therefore, the selection of a scaffold represents a challenge in regenerative endodontics. A scaffold must be safe, biodegradable, and biocompatible, with low immunogenicity, and must be able to support cell growth. Moreover, it must be supported by adequate scaffold characteristics, which include the level of porosity, pore size, and interconnectivity; these factors ultimately play an essential role in cell behavior and tissue formation. The use of natural or synthetic polymer scaffolds with excellent mechanical properties, such as small pore size and a high surface-to-volume ratio, as a matrix in dental tissue engineering has recently received a lot of attention because it shows great potential with good biological characteristics for cell regeneration. This review describes the latest developments regarding the usage of natural or synthetic scaffold polymers that have the ideal biomaterial properties to facilitate tissue regeneration when combined with stem cells and growth factors in revitalizing dental pulp tissue. The utilization of polymer scaffolds in tissue engineering can help the pulp tissue regeneration process.

Background: Apple cider vinegar potentially can be used as an alternative to irrigation solutions because of its antibacterial compounds that can inhibit Enterococcus faecalis, a pioneer bacteria that cause root canal treatment failure. One of the ideal irrigation solution requirements is that it isn't toxic to oral cavity tissues, so it's necessary to run a cytotoxicity test on apple vinegar solution. Cytotoxicity test is the initial part of the evaluation of a dental material before it can be used by humans. Cytotoxicity test was performed on fibroblast cells because the irrigation solution can contact with fibroblast, which are the main cells in the periodontal ligament around the apical. The purpose of this study was to analyze the in vitro cytotoxicity effect of ACV on fibroblast cells. Method: Apple vinegar with concentrations of 0.31%, 0.63%, 1.25%, 2.5%, and 5% was tested using the MTS assay method. Result: The results showed that there was a cytotoxicity effect of apple vinegar solution as a root canal irrigation agent against fibroblasts cell. Apple cider vinegar with concentrations of 1.25%, 2.5%, and 5% are potentially toxic because the percentage of cell viability is less than 70%. Conclusion:There is a cytotoxicity effect of apple cider vinegar solution as a root canal irrigant on fibroblast cells.

Restoration is a treatment to restore the structure of missing dental hard tissue due to caries. Flowable composite has good adaptability to the cavity wall so that it is widely used as an intermediate layer. Composite resins require an adhesive system to bond chemically with dental hard tissue. Self - adhering flowable composite combining etching, priming, and adhesive in one flowable package. This study was conducted with the aim to determine the difference in shear bond strength between Self – adhering flowable composite and flowable composite with self – etch adhesive system on dentine. The number of samples used was 38 pieces. After dentin was prepared and fixed, samples was divided into 2 groups, each group consisting of 19 samples. First group was applied with self – adhering flowable composite, second group was applied with flowable composite with self – etch adhesive system. Samples was immersed in pH 6.8 normal saline and stored for 24 hours, then dried and shear bond strength was tested using a universal testing machine. The data obtained were analyzed using independent t – test. The statistical analysis using independent t – test showed that there were significant differences in the shear bond strength between the two groups, p=0,000 (p<0.05). The study concluded that there is difference of shear bond strength between self – adhering flowable composite and flowable composite with self – etch adhesive system on dentine.