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Abstract Background The downfall of formocresol as a pulpotomy medicament highlights the importance of cytotoxic evaluation and the establishment of a safe concentration of dental material prior to its usage in the oral cavity. Uncaria gambir is an herbal plant that possesses antimicrobial, anti-inflammatory and antioxidant properties, suggesting its potential as an alternative medicament for pulpotomy. However, there are not many studies published on its cytotoxicity, with some using non-standardised techniques and reported variable outcomes. Here, we investigated the concentration and time-dependent toxicity of Uncaria gambir extract towards the M3CT3-E1 cell line and compared it with the gold standard pulpotomy medicament: mineral trioxide aggregate (MTA). Methods Uncaria gambir extracts at concentrations ranging from 1000 to 7.8 µg/ml and MTA eluates at 4- and 48 h setting times were prepared. 10% dimethyl sulfoxide (DMSO) and culture media were used as positive and negative controls respectively. Cell viability on days 1, 2, 3 and 7 was analysed using Alamar Blue and Live and Dead Cell assay. Any morphological cellular changes were evaluated using transmission electron microscopes (TEM). Data were analysed using a two-way mixed Analysis of Variance (ANOVA). Results The interaction between the concentration and exposure time on the fluorescence intensity of Uncaria gambir extract and MTA 48 h was found to be statistically significant (p < 0.001). No cytotoxic effects on the cells were exerted by both MTA 48 h and Uncaria gambir extract at a concentration below 500 µg/mL. TEM analysis and Live and Dead Cell assay for both materials were comparable to the negative control. No significant differences in fluorescent intensity were observed between Uncaria gambir extract at 500 µg/mL and MTA 48 h (p > 0.05). Conclusion Uncaria gambir extracts at a maximum concentration of 500 μg/mL are non-cytotoxic over time and are comparable to the MTA.

Concerns have been raised about the usage of sodium hypochlorite (NaOCl) in endodontics following its toxic effects. Effective ecoproduce (EEP), an organic solution produced through the fermentation of fruit peels, exhibits antibacterial and antibiofilm action, suggesting its potential as an endodontic irrigant. However, studies on its cytotoxicity are limited. This in vitro study aimed to evaluate the cytotoxic effects of EEP at different concentrations and fermentation periods against the MC3T3-E1 cell. EEP derived from orange and pineapple peel waste and fermented for 3 and 6 months was prepared from 100% to 0.78% concentration. Briefly, 2.5% NaOCl was used as the comparison group. Cell viability was analysed using Alamar Blue and Live and Dead Cell assay. A transmission electron microscope (TEM) was used to evaluate ultrastructural changes to the cells. Data analysis was performed using a two-way mixed Analysis of Variance (ANOVA). EEP exhibited concentration-dependent cytotoxicity regardless of the fermentation period (p > 0.05). A concentration below 6.25% was non-cytotoxic and comparable to the negative control (p > 0.05). Live and Dead Cell assay and TEM analysis complement the findings. The mean cell viability of EEP at all concentrations for both fermentation periods was significantly higher than that of 2.5% NaOCl (p < 0.05). Conclusively, 6.25% EEP fermented for 3 and 6 months are non-cytotoxic and can serve as an alternative endodontic irrigants.

The correction of rotated malpositioned tooth/teeth into the dental arch alignment in the mixed-dentition is often a challenging task for paediatric dentists. Failure in addressing this issue can bring about detrimental effect to the developing dentition and increases the probability of a complex orthodontic treatment in later years. Factors such as severity of the malpositioned teeth, patient’s treatment compliance, limitation in specific functions of the selected appliance, availability of bone and space may dictate the success of the treatment. The combined use of a simple sectional orthodontic wire appliance and a 2×4 orthodontic appliance has been shown to produce a positive effect. The appliances resulted in derotation of the rotated malpositioned teeth and bringing them into arch alignment in two cases. This treatment option had eliminated the detrimental effects to the developing dentition and helped patients to enhance their smile and dental aesthetics.

Complicated crown-root fractures account for a small percentage of traumatic dental injuries seen in children; however, management of these injuries can be very challenging to clinicians. Factors such as complexity of the injury, patient’s age and dentition stage, patient’s cooperation, and parental demands may have some bearing on the type of treatment undertaken and its outcomes. In some children, these injuries may have significant impact on their quality of life. The purpose of this article is to describe two cases of complicated crown-root fracture which were successfully managed through orthodontic extrusion using a sectional fixed orthodontic technique. The basis for the treatment technique and its favourable outcomes were highlighted with its advantages and drawbacks.

Dens evaginatus is a dental developmental anomaly that arises due to the folding of the inner dental epithelium that leads to the formation of an additional cusp or tubercle on the occlusal surface of the affected tooth. This accessory tissue projection may carry with it a narrow and constricted pulp horn extension. Occasionally, the tubercle easily fractures, thus leading to microexposure of the pulp horn and eventual pulp necrosis. Often, the pulp necrosis occurs at a time the root development of the affected tooth is incomplete. Apexification with calcium hydroxide and mineral trioxide aggregates has been the mainstay of treatment options before root canal obturation in immature nonvital permanent teeth. Lately, regenerative endodontics (maturogenesis) is becoming one of the preferred treatment modalities to manage such teeth. The current case highlights the possibility of a bioceramic material (EndoSequence Root Repair Material, BC RRM-Fast Set Putty™, Brasseler, USA) which supposed to provide apical root closure (apexification) and could also induce continuation of root growth (maturogenesis).

Anterior crossbite is relatively a common presentation in the mixed dentition stage. If left untreated, it can lead to a host of problems and may complicate future orthodontic treatment. One of the major difficulties in performing anterior crossbite correction in young children is treatment compliance. In most cases, poor compliance is due to the unacceptability of the removable appliance used. This article describes three cases of successful correction of anterior crossbite of patients in mixed dentition using short-span wire-fixed orthodontic appliances. This sectional appliance provides an alternative method of correcting anterior crossbite of dental origin and offers many advantages compared to the use of removable appliances.

Fluoride has been the main focus of caries prevention for many years. However, anti fluoride campaigns are gaining momentum in developed countries and this may be echoed by people from developing countries. This cross sectional study assessed parental awareness and knowledge of fluoride in relation to oral health. Questionnaires (n=250) were distributed to parents at the universiti Kebangsaan Malaysia dental clinic. 200 (80%) questionnaires were returned for analysis. The results indicated 91.5% (n=183) respondents were aware and had heard about fluoride. 67.2% of the parents said fluoride strengthen teeth and prevent caries. More than 90% of parents knew that fluoride can be found in toothpastes, but only 35% of them knew public drinking water contains fluoride. 41.5% of respondents were aware that fluoride in high concentration can damage teeth. However, only 27.3% of the parents have heard about fluorosis. Most of the parents obtained information regarding fluoride through the electronic media. These findings indicated that the majority of parents' knew about the role fluoride played in caries prevention and what were the sources of fluoride. However, the vast majority of them were still unaware about the risk of high fluoride concentration to teeth and there is a need to educate them. [ABSTRACT FROM AUTHOR]