This systematic review aims to evaluate the antimicrobial activity of α-mangostin derived from Garcinia mangostana against different microbes. A literature search was performed using PubMed and Science Direct until March 2022. The research question was developed based on a PICO (Population, Intervention, Control and Outcomes) model. In this study, the population of interest was microbes, α-mangostin extracted from Garcinia mangostana was used as exposure while antibiotics were used as control, followed by the outcome which is determined by the antimicrobial activity of α-mangostin against studied microbes. Two reviewers independently performed the comprehensive literature search following the predetermined inclusion and exclusion criteria. A methodological quality assessment was carried out using a scoring protocol and the risk of bias in the studies was analyzed. Reward screening was performed among the selected articles to perform a meta-analysis based on the pre-determined criteria. Case groups where α-mangostin extracted from Garcinia mangostana was incorporated were compared to groups using different antibiotics or antiseptic agents (control) to evaluate their effectiveness. A total of 30 studies were included; they were heterogeneous in their study design and the risk of bias was moderate. The results showed a reduction in microbial counts after the incorporation of α-mangostin, which resulted in better disinfection and effectiveness against multiple microbes. Additionally, the meta-analysis result revealed no significant difference (p > 0.05) in their effectiveness when α-mangostin was compared to commercially available antibiotics. α-mangostin worked effectively against the tested microbes and was shown to have inhibitory effects on microbes with antibiotic resistance.

Chum JD, et al. Restor Dent Endod. 2018 Nov;44:e8. https://doi.org/10.5395/rde.2019.44.e8

To investigate the current and future teaching of posterior composite restorations in undergraduate curricula in Malaysian dental schools. A 24-item validated questionnaire including closed and open questions on the teaching of posterior composites was emailed to faculty members in all 13 Dental Schools in Malaysia. Responses were compiled on Excel and analysed. All 13 dental schools responded to the survey yielding a 100 % response. All schools indicated the use of posterior composites for 2- and 3-surface cavities in premolars and molars. The didactic teaching time devoted to composites was greater than for amalgam (38 h vs 29 h). Clinically, most posterior restorations placed by students were composites (average 74.1 %, range 10 %-100 %); the remaining 25.9 % were amalgams (range, 0 %-50 %). Slot-type cavities were the preparation techniques most commonly taught (n = 11,84.6 %). The use of rubber dam for moisture control was mandatory in most schools (n = 11, 84.6 %). History of adverse reaction to composites was found to be the most common contraindication to composite placement. The phase down of teaching and use of amalgam in Malaysia is expected to occur within the next six years. The trend to increase the teaching of posterior composites reported for other countries is confirmed by the findings from Malaysian dental schools. Notwithstanding this trend, the use of amalgam is still taught, and future studies are required to investigate the implications of the phase down of amalgam in favour of posterior composites. Notwithstanding the increase in the teaching of posterior composites there is a pressing need to update and refine clinical guidelines for the teaching of posterior composites globally.

Aim: To formulate and characterize a palm-oil-in-water-based α-Mangostin nano-emulsion (PO-AMNE) endodontic irrigant, in order to evaluate its antibacterial efficacy against Enterococcus faecalis, Staphylococcus epidermidis, and Candida albicans biofilms, as well as its capacity to remove smear layer. Methods: The solubility of α-Mangostin in various oils was determined and selected, surfactants and co-surfactants were used for the nano-emulsion trial. PO-AMNE was prepared and optimized. The MIC was performed, and the antimicrobial efficacy was estimated against biofilms. The optimized 0.2% PO-AMNE irrigant antimicrobial efficacy in a tooth model was done using colony-forming units. The treated teeth were processed by scanning electron microscopic examination for debris and smear layer removal. An Alamar Blue assay was used to evaluate cell viability. The optimization of the PO-AMNE irrigant was performed using Box–Behnken statistical design. Results: The optimized 0.2% PO-AMNE irrigant was found to have a particle size of 340.9 nm with 0.246 PDI of the dispersed droplets, and a zeta potential (mV) of −27.2 ± 0.7 mV. The MIC values showed that 0.2% PO-AMNE (1.22 ± 0.02) were comparable to 2% CHX (1.33 ± 0.01), and 3.25% NaOCl (2.2 ± 0.09) had the least inhibition for E. faecalis. NaOCl (3.25%) showed the maximum inhibition of S. epidermidis (0.26 ± 0.05), whereas 0.2% PO-AMNE (1.25 ± 0.0) was comparable to 2% CHX (1.86 ± 0.07). For C. albicans, 2% CHX (8.12 ± 0.12) showed the least inhibition as compared to 0.2% PO-AMNE (1.23 ± 0.02) and 3.25% NaOCl (0.59 ± 0.02). The 0.2% PO-AMNE irrigant was then evaluated for its antimicrobial efficacy against the three biofilms, using colony-forming units. The 0.2% PO-AMNE was comparable to both 3.25% NaOCl and 2% CHX in inhibiting the growth of biofilms. The 0.2% PO-AMNE and 17% EDTA eliminated the smear layer with the lowest mean scores (p < 0.001). Finally, 0.2% PO-AMNE was shown to be biocompatible when compared to 17% EDTA, 3.25% NaOCl, and 2% CHX in immortalized oral keratinocyte cells. Conclusion: Overall, the formulated 0.2% PO-AMNE irrigant was an effective antimicrobial and biocompatible which could combat endodontic-infection-related polymicrobial biofilms.

This study evaluates the antimicrobial efficacy of gold nanogel as an endodontic medicament against Enterococcus faecalis in persistent root canal infections. It investigates whether gold nanogel can serve as an effective and biocompatible alternative to conventional medicaments in eliminating E. faecalis. Gold nanoparticles (< 100 nm) were tested against E. faecalis using the agar diffusion method. Extracted teeth inoculated with E. faecalis were treated with gold nanogel (1000 µg/mL), chlorhexidine gluconate (2%), calcium hydroxide, or saline for seven days. Antimicrobial efficacy was assessed on days 1, 3, and 7 using agar diffusion and colony-forming unit (CFU) assays. Gold nanogel significantly reduced E. faecalis biofilm viability, showing greater efficacy than calcium hydroxide and comparable results to 2% chlorhexidine. Chlorhexidine eradicated E. faecalis by day 7, while gold nanogel exhibited sustained antibacterial action with minimal CFUs remaining. Gold nanogel demonstrated superior efficacy over calcium hydroxide and comparable effectiveness to chlorhexidine gluconate (2%) against E. faecalis. Further studies are recommended to evaluate its clinical applications and long-term biocompatibility.