Managing a bleeding patient can be a challenge during dental surgery. Profuse hemorrhage due to platelet defects, coagulation disorders, vascular anomalies, medication-induced patients, as well as inherited bleeding ailments result in soft tissue hematoma, septic shock, compromised airway, and in some severe cases, death could occur. A vast array of surgical hemostatic agents are available to stop bleeding, including chitosan-based hemostatic agents. Chitosan has an advantage over other topical hemostatic materials for its ability to promote shorter bleeding times and assist in healing. Massive behind-the-scene research and development efforts are ongoing to increase the performance of chitosan as a hemostatic agent. Numerous studies on chitosan use in dental hemostasis have registered it as being safe, biodegradable, biocompatible, promoting healing, antimicrobial and bioactive. This article reviews the application of chitosan in managing hemostasis in dental patients.

The role of Treponema denticola in the periodontitis alveolar bone damage: Systematic review

Previously, we reported the serious game HistoRM as an innovative learning approach for an oral histology course. This study aimed to examine the impact of HistoRM on summative assessment and the enablers and barriers factors affecting HistoRM as an interactive learning strategy in an oral histology course. A crossover randomized controlled trial was performed. Study participants were first-year dental students at the Universitas Indonesia. The average final grades of students who participated in HistoRM serious game were significantly higher than those of students who did not participate in this trial (p < 0.001). Positive responses of HistoRM were observed in the learning content, games and learning experience domains. The enabler factors most recognized by the students were the game method, which helped students to understand the learning materials; the immediate feedback provided following each gameplay; as well as the fun and interesting gameplay. The barrier factors most recognized by the students were some challenges of the gameplay, which resulted in a longer time needed to study. While the HistoRM serious game can stimulate student motivation and engagement in learning oral histology, overcoming the barriers is essential for the implementation of serious games as a complementary learning approach in the dental curriculum.

Fusobacterium nucleatum is implicated in periodontitis, a chronic inflammatory disease that destroys the periodontal tissue and alveolar bone due to host-microbe dysbiosis. This study focuses on understanding how F. nucleatum contributes to bone destruction in periodontitis. The literature search was conducted using PubMed and Scopus databases based on Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines by entering preselected keyword combinations of inclusion and exclusion criteria. Qualifying literature was evaluated based on four inclusion criteria: research articles, published in English, within the last ten years, and available in full text. The literature search yielded five articles exploring the mechanism of bone resorption by F. nucleatum. It was found that the bacteria increases the production of inflammatory mediators, such as interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor-alpha, C-C motif chemokine ligand (CCL) 2, CCL20, and C-X-C motif chemokine ligand 1, which leads to the destruction of alveolar bone. During infection, biomechanical stress also raises levels of prostaglandin E2 and cyclooxygenase-2. The elevated levels of inflammatory mediators and enzymes generate an imbalance in the receptor activator of nuclear factor kappa-B ligand to osteoprotegerin ratio, hindering osteogenic differentiation and heightening bone destruction. In conclusion, F. nucleatum infection promotes alveolar bone destruction by inducing inflammatory responses and inhibiting osteogenic differentiation stimulated by biomechanical loading. More research is essential to explore the connection between F. nucleatum virulence and its alveolar bone degradation mechanisms.

This study evaluated the physicochemical properties of toothpaste from combined Caulerpa racemosa and Thunnus fish bone (Toothpaste Caulerpa and Thunnus or TCT) and its antibacterial activity towards the colonization of selected cariogenic and periodontal bacterias. Four forms of toothpaste which contained C. racemosa extract and calcium carbonate or bone isolates of tuna and control (F1 (1.5:45); F2 (3:45); F3 (4.5:45); F4 (0:45)) were compared and analyzed for antioxidant activity (DPPH assay), organoleptic (sensory), homogeneity, viscosity, pH, and foamability. Antibacterial activity tests were conducted on Streptococcus mutans, Staphylococcus aureus, and Porphyromonas gingivalis. The antioxidant activity of the group’s (F1, F2, F3, F4) p=0.0001 differed considerably (CI 95%). F3 was the most antioxidant-active formula, with 27.46 ± 3.09%. F3 also had good sensory tests, adequate homogeneity, optimal pH 7.64 ± 0.68, an increased viscosity level of 443.07 ± 0.12, and the least foam formations of 19.28 ± 0.07, all of which are significantly different (p<0.05) from other variations of TCT formulas. Interestingly, F3 has greater inhibition against the activity of selected bacterias. In conclusion, formula 3 (F3) is a recommended toothpaste, made from combined C. racemosa and Thunnus fish bone, and has promising physicochemical and antibacterial properties. A further clinical study is urgently needed.

Chronic periodontitis is an oral disease in which the destruction of periodontal tissue leads to tooth loss. Regenerative therapy for attachment cannot be applied to one wall bone defects owing to the minimal existing healthy bone. Tissue engineering in the form of cell sheets has been developed to overcome this limitation. In a previous study, cell sheet application to a one wall bone defect in Macaca nemestrina showed good clinical results. To evaluate the effectiveness of cell sheet application histologically, the level of periostin expression in the gingival crevicular fluid (GCF) of M. nemestrina was determined. Periostin is a 90-kDa protein that regulates coordination and interaction for regeneration and tissue repair. A laboratory observation study was performed to see the differences in periostin levels in samples collected from M. nemestrina's GCF, where a cell sheet was applied to the bone defect. Gel electrophoresis with SDS-PAGE was performed to detect periostin expression based on its molecular weight and to compare the expression band between the cell sheet and the control at 1, 2, and 3 weeks after treatment. The gel electrophoresis result shows different thicknesses of the protein band around the molecular weight of periostin between the cell sheet groups.