Conservative Dentistry Journal

Forensic Identification Using Dental Restorations: A Radiographic and Material-Based Perspective

Yessy Andriani Fauziah — 2025-03-26

Background: Forensic identification is a critical aspect of criminal investigations and disaster victim identification (DVI). Dental records, particularly dental restorations, serve as essential forensic markers due to their resistance to decomposition and environmental conditions. The integration of radiographic imaging and material-based analysis enhances the accuracy of forensic identification, allowing experts to match post-mortem findings with ante-mortem records. Purpose: This literature review aims to explore the role of dental restorations in forensic identification, focusing on the radiographic techniques and material-based forensic analysis used in modern forensic odontology. Reviews: This literature discusses the durability and uniqueness of dental restorations in forensic investigations. Various radiographic techniques, including periapical, panoramic, and cone-beam computed tomography (CBCT) imaging, are examined for their effectiveness in detecting and analyzing restorations. Additionally, the forensic relevance of restorative materials—such as amalgam, composite resins, ceramics, and metal-based prosthetics—is evaluated in cases where conventional soft tissue or DNA-based identification is not feasible. The review also explores technological innovations, including machine learning algorithms and digital forensic methods, that enhance forensic odontology. Conclusion: Dental restorations remain one of the most reliable forensic markers, particularly in challenging identification cases where DNA and soft tissues are compromised. The integration of advanced radiographic imaging and material analysis significantly enhances the precision of forensic identification. Future developments in AI-driven forensic imaging and automated restoration detection will further strengthen forensic odontology as a crucial field in legal and disaster investigations.

Evaluation of the relationship between pneumatization of mastoid process, articular eminence and glenoid fossa on CBCT

Sedef Kontanli — 2025-03-26

Background: Pneumatization refers to air-filled spaces within the bone. The studies about articular tubercle/eminence pneumatization were only few in numbers with unclear information regarding the data on pneumatization in this region. PAT may become predisposed to the spread of inflammatory processes along the temporomandibular joint. Traumatic occlusion, one of the triggers of the TMJ inflammatory process, can occur during conservative dentistry treatment which requires the attention of a dentist to avoid TMJ disorder.

Objectives: This study aimed to evaluate the prevalence, characteristics and relationships of mastoid process pneumatization (MPP), articular tubercle/eminence pneumatization (PAT), and glenoid fossa pneumatization (PGF) in one population in Turkey by using cone-beam computed tomography (CBCT).

Methods: In total, 739 of CBCT images were examined retrospectively. The prevalences of the pneumatization by age, gender, laterality and locularity were detected. Independent t-test and the chi-square test for the significance of differences between variables.

Results: Apneumatic type MPP was detected in 3.1% of cases, partial pneumatic type MPP in 33.6%, pneumatic type MPP in 63.3% of cases. PGF was detected in 28.0% of the sides and PAT in 23.7% of cases. There was no statistically significant relationship found between the presence of PAT and PGF with gender and age (p>0.05). In 45 cases with a pneumatic type MPP, PGF was not observed in any of them, while no PAT was determined in 44 (97.8%) of 45 cases. Pneumatic type mastoid was detected in 309 (92.8%) of 333 cases with multilocular PGF and in 89 (82.4%) of 108 cases with unilocular PGF. There was a statistically significant relationship found between MPP and PAT with PGF types (p <0.05).

Conclusion: It is necessary to detect these air gaps before TMJ surgery to prevent complications during and after the operation. It will be more accurate if PAT and PGF are assessed on 3D technics than on 2D radiographs. Relationship between MPP pneumatization degree and PAT and PGF can help for understanding the features and functions of PAT and PGF, it has been considered useful to also determine the prevalence and characteristics of PAT in a population of traumatic patients of occlusion treatment and to examine the possible relationship between traumatic types of occlusions and pneumatized articular eminence.

Effect of Butterfly Pea Flower (Clitoria ternatea L.) Kombucha Against Streptococcus viridans

Tamara Yuanita — 2025-03-26

Background: Dental caries is a multifactorial disease driven by the formation of bacterial biofilms, particularly Streptococcus viridans, which contribute to root canal infections if not appropriately managed. Sodium hypochlorite (NaOCl) is commonly used as an irrigant in root canal therapy, but its application is limited due to its toxicity and corrosiveness. Consequently, there is a pressing need for safer and more effective natural alternatives. Kombucha derived from butterfly pea flower (Clitoria ternatea L.) has been identified as a promising candidate with antibacterial and antibiofilm properties due to its bioactive secondary metabolites. The fermentation process involving a symbiotic culture of bacteria and yeast (SCOBY) may further enhance the efficacy of these bioactive compounds. Purpose: This study conducted to analyze the effect of kombucha from butterfly pea flower (Clitoria ternatea L.) on the biofilm of Streptococcus viridans in vitro, utilizing a spectrophotometric method to assess the impact across various concentrations. Methods: An experimental laboratory study was conducted in vitro employing a post-test-only control group design. Kombucha prepared from butterfly pea flower was fermented for periods ranging from 12 to 154 days, followed by dilution into several concentrations (100%, 50%, 25%, 12.5%, 6.25%, 3.12%, and 1.56%) using the dilution method. Direct contact between the kombucha and Streptococcus viridans was established, and the resulting biofilm inhibition was assessed by measuring the Optical Density (OD) using a spectrophotometer at a wavelength of 650 nm. Results: The inhibitory percentage of butterfly pea flower kombucha against Streptococcus viridans biofilm decreased progressively with concentrations of 100%, 50%, 25%, 12.5%, 6.25%, 3.125%, and 1.56%. The highest inhibitory percentage was observed at a concentration of 100%. Conclusion: Kombucha of butterfly pea flower (Clitoria ternatea L.) demonstrated potential in inhibiting Streptococcus viridans biofilm formation, with a concentration of 25% determined as the MBIC50. However, an MBEC90 value could not be established, as no biofilm inhibition percentage exceeding 90% was observed in the test results.

The synergistic role of the immune system and stem cells in dental tissue regeneration

Eveline Yulia Darmadi — 2025-04-21

Background: Dental conservation focuses on maintaining natural teeth structure, function, and aesthetics using various techniques. Recent developments in regenerative dentistry highlight the immune system's and stem cells' crucial roles in regenerating dental tissues. The immune system is key in preserving oral health and supporting healing after treatment. Incorporating stem cell therapy presents a promising strategy for restoring damaged tissues, potentially enhancing the effectiveness of dental conservation. Purpose: This review explores the growing potential of immune system modulation and stem cell therapy in promoting tissue regeneration and optimizing clinical outcomes in dental conservation. It aims to summarize recent research while examining this evolving field's benefits, challenges, and future prospects. Reviews: Research indicates that the immune system's inflammatory response plays a dual role as it is crucial for wound healing but can lead to tissue damage if not regulated. Recent studies emphasize the importance of balancing pro-inflammatory and anti-inflammatory mechanisms to optimize tissue regeneration. Stem cells show promising potential in regenerating dentin, pulp, and periodontal tissues. Integrating stem cell therapy with immune modulation may further enhance regenerative outcomes. However, translating these approaches into clinical practice remains challenging due to concerns regarding safety, effectiveness, and ethical considerations. Conclusion: Regulating the immune system and integrating stem cell therapy offer promising advancements in dental conservation. Effectively utilizing these biological mechanisms can enhance tissue regeneration and improve treatment success. Future studies should aim to refine protocols, ensure long-term safety, and overcome practical barriers to fully incorporate these innovations into everyday clinical practice.

Effectiveness of Nipah leaf extract (Nypa fruticans) against Streptococcus mutans biofilm as cavity cleanser

Yosef Kevin Handriutomo — 2025-04-21

Background: Streptococcus mutans is the primary bacterium responsible for dental caries, found in the biofilm on the tooth surface, known as dental plaque. Before restorative treatment or cavity care for carious teeth, a cavity cleanser is necessary to remove residual bacteria that could cause secondary caries or restoration failure. Nipah leaf extract contains phenol, flavonoids, saponins, and steroids, which can destroy bacteria by denaturing proteins and damaging bacterial cell membranes. Objective: To determine the antibiofilm activity of Nipah leaf extract against Streptococcus mutans biofilm. Materials and Methods: The materials used were Nypa fruticans leaf extract prepared using the maceration method at concentrations of 1%, 5%, 10%, and 15%, with chlorhexidine gluconate as the positive control and distilled water as the negative control. Bacteria cultured in BHI media were inoculated into a 96-well flat-bottomed plastic tissue culture plate and incubated for 24 hours at 37°C. Optical Density (OD) was measured using an ELISA reader. Results: KM: 0.039; K (-): 0.887; K (+): 0.085; P1: 0.727; P2: 0.463; P3: 0.347; P4: 0.169. The Mann-Whitney test results showed significant differences between K (+) and P1 (0.000), K (+) and P2 (0.000), K (+) and P3 (0.000), K (+) and P4 (0.005), P1 and P2 (0.000), P1 and P3 (0.000), and P1 and P4 (0.000). The results were significant as p < 0.05. Conclusion: Nipah leaf extract (Nypa fruticans) can inhibit the biofilm formation of Streptococcus mutans bacteria.

Human dental pulp mesenchymal stem cells regenerative potential

Menza Fadiyan Amriel — 2025-05-28

Background: Stem cells can be divided into mono-potent, oligopotent, multipotent, pluripotent, and totipotent. Dental and oral stem cells are stem cells found in the teeth and mouth that has the potential to develop into various cell types. The rapid development of regenerative dentistry has resulted in the exploration of stem cells, including dental pulp mesenchymal stem cells. Mesenchymal stem cells, have important regenerative potential in repairing dental and surrounding tissues. One of dental stem cells source that have been discovered is dental pulp mesenchymal stem cells. Purpose: This article aims to review the regenerative potential of human dental pulp mesenchymal stem cells (HDPMSCs). Review: HDPMSCs are potential for regenerative dentistry, including regenerative endodontics due to their multipotency, ease of collection, and ability to support tissue repair, immunomodulation, and regeneration across dental, orthopedic, neurological, and cardiovascular applications. Conclusion: The regenerative potentials of HDPMSCs on various treatments are vastly explored by many studies.

Antibiofilm activity of probiotic bacteria Lactobacillus plantarum FNCC 0020 against Streptococcus mutans serotype c

Nirawati Pribadi — 2025-05-28

Background: Streptococcus mutans (S. mutans) is a Gram-positive bacterium that plays a role in dental caries. Plaque and biofilm formation can be chemically cleaned using mouthwash, such as chlorhexidine gluconates (CHX) 0.2%, which is the gold standard. Another alternative can be developed to inhibit S. mutans biofilm formation by using Lactobacillus plantarum probiotic, which has antibiofilm potency by producing antimicrobial substances. Purpose: This study tested the biofilm inhibition to determine the Inhibitory Concentration that can inhibit 50% of biofilm formation. Methods: This research was conducted as an in vitro experimental laboratory study. Biofilm inhibition testing was performed by using the microdilution method on biofilms formed in 96 well microplates with 0,1% crystal violet staining. Lactobacillus plantarum FNCC 0020 was diluted to several concentrations: 12.5%, 25%, and 50% against Streptococcus mutans biofilm induced by 3% sucrose. The test results in optical density were read using a spectrophotometry with a wavelength of 650 nm. were determined using the GraphPad Prism sigmoidal dose-response method. Results: There is antibiofilm activity of Lactobacillus plantarum FNCC 0020 against Streptococcus mutans, and the inhibitory effect against Streptococcus mutans biofilm showed of 42.43%. Conclusion: Lactobacillus plantarum FNCC 0020 at 50% has biofilm inhibitory activity compared to other concentrations but is less effective than 0.2% CHX.

Single visit biomimetic restoration with multilayered direct composite technique on maxillary central incisor

Alfajri — 2025-05-28

Background: Biomimetic restoration with multilayered composite gives the highest aesthetic result with the least invasive tooth structure. The goal of these techniques is to restore teeth while closely mimicking the micro- and macrostructure, chromatic properties, and tooth symmetry of the original dentition. These techniques need extra instruments and the clinician's experience. Purpose: This case study aims to describe a technique for repairing anterior defects in just one appointment. Case: A 24-year-old man complained about the color, asymmetry, and fracture of his anterior teeth. However, he does not have much time to wait for the indirect restoration procedure. A single-visit treatment was preferred for this case. Case Management: A manual wax-up for the palatal index followed by multilayered composite restoration was nicely done in a single appointment. Defects in anterior teeth could be repaired in a single appointment using multilayer direct composite restoration. This method could effectively replicate the teeth's morphology, symmetry, micro-macro structure, and chromatic properties. The quick manual wax-up and layering steps are critical to this procedure. Discussion: Currently, direct restorations for anterior teeth are completed in three stages: incisal edge and palatal wall shaping; interproximal wall creation utilizing a pre-contoured matrix technology; and buccal surface application of multilayered composite. Multilayered direct composite restoration technique with manual palatal index can be an alternative procedure to create immediate natural-looking anterior restoration. This technique offered a reduction of chairside time in a single-stage appointment, laboratory cost savings, and more predictable results.

Effect of nano calcium carbonate from Anadara granosa shell induced odontoblast-like cells as a pulp capping material candidate

Widya Saraswati — 2025-05-28

Background: Vital pulp therapy is a treatment to repair and maintain pulp vitality. Calcium hydroxide is the gold standard in pulp capping materials. Calcium hydroxide has advantage antibacterial. However, calcium hydroxide has some disadvantages such form a layer liquefaction necrosis. Blood clam shells contain 98.7% calcium carbonate. Calcium carbonate (CaCO₃) content becomes a good source of calcium can be used as a bone repair material. Purpose: To review effect nano CaCO₃ from Anadara granosa shell induced odontoblast-like cells as a pulp capping candidate. Nanoparticles CaCO₃ has advantages such as high surface area, low toxicity, biocompatibility, biodegradability, pH-sensitivity, and osteoconductivity. Reviews: Nano CaCO₃ from Anadara granosa are promising to promote odontoblast-like cells formation. Conclusion: Nano CaCO₃ its potential to influence odontoblast-like cells, which play a crucial role in dentin regeneration and repair.

Epigallocatechin-3-gallate (EGCG) and tricalcium silicate (C_3 S) combination as an antibacterial agent against Enterococcus faecalis

Kun Ismiyatin — 2025-05-28

Background: Dental caries affects 57.6% of the Indonesian population, with Enterococcus faecalis found in 80% of deep caries cases. Conventional materials used in vital pulp therapy (VPT), such as calcium hydroxide, have limitations including transient antibacterial action and poor sealing capacity. This prompts the exploration of alternative materials like epigallocatechin-3-gallate (EGCG), a polyphenol from green tea with antimicrobial activity, and tricalcium silicate (C₃S), a bioactive cement known for dentin regeneration potential. Purpose: This review evaluates the synergistic antibacterial potential of EGCG and C₃S combinations against E. faecalis, and assesses their feasibility as an alternative in VPT. Review: EGCG disrupts bacterial membranes, inhibits biofilm formation, and suppresses virulence factors, but lacks remineralization capability. Conversely, C₃S promotes dentin repair and creates an alkaline antibacterial environment, though its efficacy diminishes over time. Their combination compensates for each other’s limitations: EGCG enhances antimicrobial potency while C₃S provides long-term alkalinity and regenerative support. Conclusion: The EGCG–C₃S combination exhibits synergistic antibacterial and regenerative effects, offering a promising alternative to current VPT materials.