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DEPARTEMEN KONSERVASI GIGI. FAKULTAS KEDOKTERAN GIGI, UNIVERSITAS AIRLANGGA PROF. DR. MOESTOPO 47. SURABAYA. 60132
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Conservative Dentistry Journal
Published by Universitas Airlangga
ISSN : 20871848     EISSN : 27228045     DOI : 10.20473/cdj.v10i1.2020.1-4
Core Subject : Health,
Dentistry
Journal of conservative dentistry accepts original manuscripts in the field of Endodontic other related subjects articles, including research, case reports and literature reviews. The spread of fields include: Endodontic research; Preventive, curative and rehabilitative related to endodontic field; Oral health education and promotion related to endodontic field; Endodontic and restorative clinical research; Basic sciences related to endodontic field; Endodontic healthcare management
Arjuna Subject : Kedokteran Gigi - Kedokteran Gigi (Lain-Lain)
Articles 200 Documents
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The changing golden ratio for aesthetics in dentistry Edanur Keleş
Conservative Dentistry Journal Vol. 16 No. 1 (2026): January-June
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cdj.v16i1.2026.1-8

Abstract

Background: The golden ratio (ϕ≈1.618) has long been associated with beauty and balance in art and human anatomy. In dentistry, particularly in smile design, mathematical proportions like the golden ratio have been proposed as objective tools for evaluating dental aesthetics. Purpose: This study aims to investigate the contemporary relevance and clinical applicability of the golden ratio in aesthetic dentistry, examining its integration into smile design and its relationship with perceived attractiveness. Methods: A total of 60 subjects (30 males, 30 females) with natural dentition were evaluated. Standardized frontal photographs were analyzed using digital software to measure the visible width ratios of the maxillary anterior teeth (central incisors, lateral incisors, and canines), which were then compared with the golden ratio (1.618). One-sample t-tests and Pearson correlation were used for statistical analysis. Results: The mean lateral–central incisor ratio was 0.67±0.05, and the mean canine–lateral incisor ratio was 0.63±0.06. Overall deviations from the golden ratio were statistically significant (p<0.05). No strong correlation was found between the exact golden ratio and subjective aesthetic ratings (r=0.28,p>0.05). Conclusion: The golden ratio offers a useful conceptual framework for dental aesthetics but should not be considered an absolute criterion. Aesthetic evaluation in dentistry must balance objective mathematical analysis with individualized clinical judgment and patient-specific harmony.
Smear layer removal efficacy of pineapple core extract bromelain as a candidate of novel endodontic irrigant - A scanning electron microscopic study Ketut Suardita; Muhammad Nur Alfarizi; Achmad Junaidi; Ige Frameski Radila Muga; Nur Dianawati; Daradhasih Bestari Santiaji; Masaru Ohara
Conservative Dentistry Journal Vol. 16 No. 1 (2026): January-June
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cdj.v16i1.2026.9-13

Abstract

Background: Removing the smear layer is a critical step in root canal treatment. A 17% ethylenediaminetetra acetic acid (EDTA) solution is frequently utilized as an irrigation solution; however, EDTA can cause excessive loss of calcium ions from the root dentin and may reduce dentin hardness. The potential effectiveness of bromelain in removing the smear layer within the root canal walls has not yet been extensively studied. Purpose: This research intended to assess the effectiveness of bromelain derived from a pineapple core in its capacity to eliminate the smear layer after root canal treatment Methods: Twenty one mandibular premolar were instrumented and randomly assigned to seven groups according to the irrigation protocol: Group I (aquadest), Group II (17% EDTA), Group III (12.5% bromelain), Group IV (25% bromelain), Group V (50% bromelain), Group VI (75% bromelain), and Group VII (100% bromelain). Smear layer removal was evaluated using SEM. A Kruskal Wallis test was was used for intragroup comparisons and a Mann-Whitney U test for intergroup comparisons, where a p-value < 0.05 was considered significant. Results: Notable variations were noted between the distilled water group and those treated with 25% and 50% bromelain. A notable difference was evident between the 17% EDTA group and those given bromelain at 12.5%, 75%, and 100% concentrations, while no significant difference was found with the groups receiving 25% and 50% concentrations. Conclusion: Bromelain derived from pineapple core extract effectively eliminates the smear layer from the root canal.
Controlling antimicrobial resistance in dentistry with innovative technologies and sustainable solutions Aftab Ahmed Khan; Mohammed Abdullah Alhadi; Ahmed Abdullah Alhadi
Conservative Dentistry Journal Vol. 16 No. 1 (2026): January-June
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cdj.v16i1.2026.14-17

Abstract

Background: Antimicrobial resistance (AMR) is a significant global health threat, with dentistry contributing substantially through antibiotic misuse. Purpose: This review examines the distinct mechanisms of resistance in oral microorganisms, including biofilm formation and enzymatic degradation of antibiotics, which complicate treatment and contribute to persistent infections. Reviews: Clinical challenges encompass endodontics, periodontics, and oral surgery, which are exacerbated by inconsistent antibiotic management in dental practice. Targeted strategies like phage therapy and CRISPR-Cas, and by using advanced tools and therapeutic strategies such as quorum-sensing inhibitors, nanozyme and catalytic antibacterial systems, photodynamic therapy, RNA-based antimicrobials and magnetic or electric-responsive systems, disintegration of mature biofilms and enhanced drug penetration are possible. Conclusion: Integrating these innovations can advance sustainable antimicrobial strategies, reducing resistance spread and ensuring effective oral healthcare for future generations.
An evaluation of antibacterial potency of royal jelly as an intracanal medicament Baja Gokulkrishna Koyyur; Shruti Bhandary; Priyanka Sannappa Raju
Conservative Dentistry Journal Vol. 16 No. 1 (2026): January-June
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cdj.v16i1.2026.18-22

Abstract

Background: Enterococcus faecalis is a resistant microorganism commonly associated with persistent root canal infections and endodontic treatment failure. Therefore, effective intracanal medicaments, including natural alternatives such as royal jelly, are being investigated to enhance disinfection. Purpose: This study aimed to evaluate antibacterial efficacy of royal jelly as an intracanal medicament compared with 2% chlorhexidine gel and calcium hydroxide against Enterococcus faecalis. Methods: Fifty-one extracted single-rooted human teeth were decoronated and biomechanically prepared using the ProTaper Universal system up to the F3 file. Following sterilization, root canals were inoculated with Enterococcus faecalis (ATCC 29212) and incubated for 24 h. Specimens were randomly divided into three groups (n = 17): Group 1, royal jelly; Group 2, 2% chlorhexidine gel; and Group 3, calcium hydroxide. Intracanal medicaments were placed for seven days. Dentin samples were collected, cultured on brain–heart infusion agar, and colony-forming units (CFU) were counted to assess bacterial reduction. Statistical analysis was performed using one-way ANOVA or Kruskal–Wallis test, with significance set at p < 0.05. Results: The 2% chlorhexidine gel group showed the greatest reduction in Enterococcus faecalis CFU. Royal jelly demonstrated moderate antibacterial activity, which was significantly superior to that of calcium hydroxide but inferior to that of chlorhexidine. Calcium hydroxide exhibited the lowest antibacterial efficacy. Conclusion: Within the limitations of this in vitro study, 2% chlorhexidine gel was the most effective intracanal medicament against Enterococcus faecalis. Royal jelly showed promising antibacterial activity and may serve as a potential natural alternative, warranting further clinical investigations.
Risk based management of carious lesions in conservative dentistry: an evidence-informed review Eveline Yulia Darmadi; Yessy Andriani Fauziah; Diana Soesilo; Dwi Setianingtyas; Cindy Hendrawan; Dian Agustin Wahjuningrum
Conservative Dentistry Journal Vol. 16 No. 1 (2026): January-June
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cdj.v16i1.2026.23-27

Abstract

Background: Carious lesions remain one of the most prevalent chronic oral diseases and continue to represent a major indication for operative intervention in conservative dentistry. Variability in diagnostic interpretation and treatment thresholds may compromise long-term outcomes when lesion activity and patient-related risk factors are not systematically considered. Contemporary clinical practice increasingly emphasises risk-based management strategies to enhance biological preservation and improve restorative predictability. Purpose: This evidence-informed review aims to examine current concepts and clinical implications of risk-based diagnostic assessment and treatment planning in the management of carious lesions within conservative dentistry. Reviews: The literature indicates that integration of lesion activity evaluation, individualised caries risk profiling, structured diagnostic systems, and adjunct digital technologies contributes to more consistent and minimally invasive treatment decisions. Risk-oriented approaches support preservation of remineralizable tissues, reduce unnecessary operative procedures, and enhance restoration longevity when combined with preventive reinforcement. Contemporary frameworks encourage a shift from procedure-centred intervention toward patient-centred disease control based on susceptibility and biological criteria. Conclusion: Risk-based management provides a rational and biologically grounded foundation for treating carious lesions in conservative dentistry. Incorporation of individualised risk assessment and lesion activity evaluation into routine clinical protocols strengthens treatment predictability, promotes tissue preservation, and supports sustainable restorative outcomes.
Management of root resorption on anterior tooth after fixed orthodontic treatment Cinitra Anindya; Kun Ismiyatin; Gavrilla Wibisono; Nindhira Puspita; Alia Hani Murad; Kamila Tri Nasywarani
Conservative Dentistry Journal Vol. 16 No. 1 (2026): January-June
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cdj.v16i1.2026.28-33

Abstract

Background: The application of orthodontic mechanical forces on maturing teeth can disrupt Hertwig’s epithelial root sheath (HERS) morphology and induce orthodontically induced inflamatory root resorption (OIIRR), characterized by apical bending and decreased cell proliferation, resulting in a shortened root with an open apex that necessitates apexification to stimulate calcified barrier formation in cases of necrotic pulps. Purpose: This case report aims to describe apexification case on tooth 22 with Mineral Trioxide Aggregate (MTA). Case(s): A 27-year-old female patient presented to the Clinic of Conservative Dentistry, University Airlangga Dental Hospital, with a chief complaint of cavities in her upper front tooth so that the patient felt shy when smiling. That tooth felt uncomfortable when biting and she wanted to treat her tooth. Case Management: The root canal exploration revealed a gauging size of 50, confirming the presence of a wide apical foramen. This finding is consistent with the radiographic examination, which shows that tooth 22 with open apex. The treatment plan is endodontic treatment in the form of apexification using Mineral Trioxide Aggregate (MTA) material. The obturation technique was performed using thermoplastic (backfill) and the fixed restoration using a fiber post with composite resin. Conclusion: In this clinical case, based on a gauging size of 50 and radiographic findings showing an open apical foramen, the patient was treated with apexification using MTA to create an apical plug, followed by a post insertion and a composite resin restoration.
The effect of butterfly pea flower (Clitoria ternatea L.) kombucha solution as an antibiofilm agent against Porphyromonas gingivalis Tamara Yuanita; Naia Naurora Sabilla; Awang Bagus Firmansyah; Devi Eka Juniarti; Setyabudi Goenharto; Eric Priyo Prasetyo; Daniyal Lazuardi Ramadhan
Conservative Dentistry Journal Vol. 16 No. 1 (2026): January-June
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cdj.v16i1.2026.34-40

Abstract

Background: Porphyromonas gingivalis is one of the predominant pathogens found in 28% infected root canal cases. This bacterium is capable of forming biofilms that increase its resistance to antimicrobial agents. Sodium hypochlorite (NaOCl) 2.5% is commonly used as an endodontic irrigant due to its strong antimicrobial activity; however, it can be cytotoxic and cause periapical tissue irritation if extruded beyond the apex. Kombucha contains bioactive compounds such as flavonoids, alkaloids, tannins, saponins, and terpenoids, as well as organic acids from fermentation that may inhibit microbial growth. This study investigated the antibiofilm potential of butterfly pea kombucha against P .gingivalis. Purpose: This study aimed to evaluate the effectiveness of butterfly pea kombucha in inhibiting and eradicating P . gingivalis biofilm through the determination of MBIC₉₀ and MBEC₉₉ values. Methods: This laboratory experimental study used a post-test only control group design with nine groups: kombucha concentrations of 100–70%, positive control (NaOCl 2.5%), and negative control. Biofilm inhibition was assessed by the microtiter plate assay with crystal violet staining and optical density reading at 540 nm. Data were analyzed using One-way ANOVA and Tukey HSD (p<0.05). Results: The results showed that MBIC₉₀ was achieved at the 100% concentration, demonstrating biofilm inhibitory activity comparable to the positive control based on the Tukey HSD test (p > 0.05). Conclusion: These findings indicate that high concentration butterfly pea kombucha has potential as a natural antibiofilm agent against Porphyromonas gingivalis.
Apexification of maxillary anterior teeth with a history of trauma Nirawati Pribadi; Linawati; Wulan Tri Maulinda; Galih Sampoerno; Widya Saraswati; Radixtio Auzan Fepiosandi; Febriastuti Cahyani
Conservative Dentistry Journal Vol. 16 No. 1 (2026): January-June
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cdj.v16i1.2026.41-47

Abstract

Background: Traumatic dental injury in immature permanent teeth may lead to pulpal necrosis and disrupted root development, resulting in open apices and thin root walls. These conditions complicate conventional endodontic treatment and require management strategies that support healing and long-term tooth preservation. Purpose: To present the clinical management of a maxillary central incisor with pulp necrosis and open apex due to trauma. Case: A 20-year-old female presented with a defective restoration on tooth #11 and a history of dental trauma sustained 11 years previously. Clinical and radiographic examinations revealed a non-vital immature permanent tooth with a wide root canal, open apex, and diffuse periapical radiolucency. Tooth #11 was diagnosed with pulp necrosis and asymptomatic apical periodontitis. Case Management: Rubber dam isolation, access cavity preparation and working length determination were performed. Cleaning and shaping were carried out using circumferential hand filing with copious irrigation. The canal was medicated with calcium hydroxide and temporarily sealed. At the second visit, the medicament was removed and a 3 mm bioceramic apical plug was placed and radiographically verified. At the third visit, obturation was completed using thermoplasticized gutta-percha and bioceramic sealer. A fiber post and core build-up were subsequently placed, followed by restoration with a lithium disilicate crown. Conclusion: Apexification is considered a reliable treatment approach for immature teeth with necrotic pulp associated with long-standing trauma. The use of bioceramic materials promotes healing and enables safe and predictable restoration of the affected tooth.
Management of anterior dental caries and gingival pigmentation Salsabila Nunki Widona; Arihta Putri; Nanik Zubaidah; Sri Kunarti; Adioro Soetojo; Ira Widjiastuti
Conservative Dentistry Journal Vol. 16 No. 1 (2026): January-June
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cdj.v16i1.2026.48-54

Abstract

Background: Severe carious lesion and gingival pigmentation of anterior teeth can also make a patient's self-confidence level lower, so treatment in a complex aesthetics would be performed. Purpose: Elucidate the challenging aesthetic treatment and to restore shape, position, function, and aesthetics of patient’s anterior dental teeth. Case: A 20-year-old male patient came to Universitas Airlangga RSGMP with complaints of cavities in his front teeth and dark gums. Clinical examination revealed caries of teeth 12, 11, 21, 22, 23; rotation of tooth 22; and gingival pigmentation. Case Management: The patient's facial profile, teeth, and soft tissue were assessed using Digital Smile Design (DSD) before treatment. Furthermore, the treatment plans were as follows: 13, 21 = crown lengthening; maxillary and mandibular anterior = gingival abrasion; 11, 21, 22 = root canal treatment; 11, 21 = fiber post and porcelain fused to zirconia (PFZ) crown; 22 = customized metal post and PFZ crown; 23 = vital PFZ crown; and 12 = direct composite restoration. Discussion: Complex aesthetic treatment was performed comprehensively to restore shape, position, function, and aesthetics. DSD results showed gingival zeniths of teeth 13, 21 that did not match their contralateral teeth, necessitating crown lengthening. Restoration of tooth 22 with a customized metal post was chosen to correct the rotation of tooth 22. PFZ crowns were adjusted according to the DSD to be ideally positioned in the dental arch and to mimic natural teeth color.
Ethical challenges of informed consent in patient related social media content Yessy Andriani Fauziah; Eveline Yulia Darmadi; Dwi Setianiningtyas; Dian Agustin Wahjuningrum; Dany Agus Susanto; Farouk Al-Ghazaly
Conservative Dentistry Journal Vol. 16 No. 1 (2026): January-June
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cdj.v16i1.2026.55-60

Abstract

Background: Social media has become a dominant platform for healthcare communication and promotion, particularly in aesthetic dentistry, where visual treatment outcomes are frequently shared. Patient photographs, procedural videos, and testimonials are widely used to attract public attention. However, traditional informed consent was primarily developed for clinical decision making and may not fully address the ethical implications of digital publication, including permanent online visibility, algorithm-driven dissemination, and potential secondary commercial use. Purpose: This literature review aims to analyze the ethical challenges associated with obtaining informed consent for patient-related social media content and to evaluate whether existing consent practices adequately protect patient autonomy, privacy, and professional integrity in digital environments. Reviews: Conventional informed consent emphasizes disclosure, comprehension, voluntariness, competence, and authorization. In the context of social media, additional concerns arise. Patients may experience subtle pressure to agree due to trust in the practitioner or fear of affecting their care relationship. Risk explanations often overlook long term digital exposure, uncontrolled redistribution, identity recognition despite anonymization, and reuse of content for marketing purposes. These issues create ethical tension between respect for autonomy, non-maleficence, beneficence, justice and professional responsibility. Current regulatory guidance in many settings does not clearly distinguish between clinical consent and consent for public digital dissemination. Conclusion: Existing informed consent models are insufficient to address the complexities of patient-related content on social media. A digitally adapted and transparent consent framework is essential to ensure voluntary participation, clear risk disclosure, and stronger protection of patient privacy in contemporary healthcare promotion.

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