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2017 1

PRELIMINARY SYNTHESIS OF CALCIUM CARBONATE USING CO2

BUBBLING METHOD FOR BIOMEDICAL APPLICATION

N.H. Azzakiroh1 , Z. Hasratiningsih2, I.M. Joni3, A.Cahyanto2

COMPARISON OF THE DIAMETRAL TENSILE STRENGTH OF BONE

CEMENT BASED ON CARBONATE APATITE BETWEEN MICRON AND

NANO PARTICLES CALCIUM CARBONATE AS A PRECURSOR

L. Arianti1 , E. Karlina2, A. Cahyanto2

APATITE CEMENT VERSUS CARBONATE APATITE CEMENT

A. Cahyanto1*, M.N. Zakaria2

BIOCERAMICS MATERIAL: LIFTING HOPE IN ENDODONTICS 26

M. N. Zakaria1, A. Cahyanto2 26

REVIEW ON BIOCERAMIC NANOFIBER USING ELECTROSPINNING

METHOD FOR DENTAL APPLICATION 33

N. Djustiana*, Y. Faza, A. Cahyanto 33

MICROLEAKAGE IN COMPOSITE RESTORATION DUE TO THE

APPLICATION OF CARBAMIDE PEROXIDE BLEACHING MATERIAL

WITH A CONCENTRATION OF 10%, 15% AND 20% 42

Renny Febrida1,a* , Elin Karlina1,b , Oksania Wahyuni Putri2,c 42

RECONSTRUCTION PROCEDURE USING ELASTOMER PUTTY

MATERIALS, WHAT TYPE TO CHOOSE? 49

V. Takarini1, E. Karlina1, R. Febrida1, Z. Hasratiningsih1 49

EFFECT OF BAGGASE FIBER (Saccharum oicinarum L) ON FLEXURAL STRENGTH OF COMPOSITE RESIN 56

IT. Amirah*, M. Hudiyati**, MC. Negara** 56

THE KNOWLEDGE OF BPJS HEALTH AMONG BANDUNG INFORMAL

SECTOR WORKERS AS BPJS HEALTH CARD OWNER

1Agata Ayu Pratiwi, 1Cucu Zubaedah, and 1Sri Susilawati

ORAL HYGIENE INDEX OF QUADRIPLEGIC ATHLETES IN BANDUNG

Mochamad Nur Ramadhani1, Riana Wardani2 and Cucu Zubaedah2

1-6

7-11

12-16

17-23

24-31

32-37

38-44

45-51

52-63

64-72

PROCEEDING FDI2

SEVERITY OF CHILDHOOD CARIES IN PRIMARY SCHOOL 89

Anne Agustina Suwargiani*, Dudi Aripin**, Inne Suherna Sasmita***, Sri

Susilawati* 89

THE RELATIONSHIP BETWEEN CHILDRENS MOTIVATION WITH

ORTHODONTIC TREATMENT NEED IN STUDENTS AGED 9-12 YEARS

OF SDN KEDUNGKANDANG 2 MALANG 95

Trining Widodorini1, Neny Roeswahjuni2, Vira Indah Permatasari D.N3

CUSTOMER TRUST OF OUTPATIENT ON DENTAL AND ORAL CLINIC

AT SOME HOSPITALS IN BANDUNG 105

C. Zubaedah1, F.M. Putri1, S. Tjahajawati2 , S. Susilawati1, R. Wardani1

THE SYNERGISTIC RELATIONSHIP BETWEEN HIV-1 AND

CYTOMEGALOVIRUS IN ORAL EPITHELIAL CELL MONOLAYERS: AN

IN VITRO STUDY 115

I. Suiawati1, S. M. Tugizov2 115

EVALUATION OF ANTIBACTERIAL ACTIVITY AND ACUTE TOXICITY OF

POMEGRANATE (Punica granatum L.) SEED ETHANOLIC EXTRACTS IN SWISS WEBSTER MICE 128

R. Setiadhi1, I. Suiawati1, D. Zakiawati1, W. Hidayat1, N. Nuraeny1, D. Rizali Firman2

VARIOUS ORAL LESIONS DUE TO MICRONUTRIENT DEFICIENCIES

Nanan. Nuraeny 139

THE DIFFERENCE OF SALIVARY PH AND VISCOSITY AFTER

CONSUMING WHITE RICE (Oryza sativa), CILEMBU SWEET POTATO (Ipomoea batatas cultivar Cilembu) AND PURPLE SWEET POTATO Stefanus Christian1, Sulistyani1, Dwi Prijatmoko1 146

SALIVARY FLOW IN PATIENT WITH TYPE 2 DIABETES MELLITUS

BASED ON THE CHARACTERISTICS OF THE SUBJECT 153

Mindy Frieda Anissa1, Rosiliwati Wihardja1 , Sri Tjahajawati1 153

SWEET TASTE THRESHOLD ON KRETEK FILTER-SMOKING LABORS

161

Inez Kiantoro, Sri Tjahajawati, Ervin Rizali 161

73-78

79-87

88-96

97-108

109-119

120-125

126-131

132-138

139-144

2017 3

THE RELATION OF INTERALAR WIDTH TO INTERCANINE DISTANCE

AMONG THE RACES OF MALAY, CHINESE AND INDIAN 168

Emma Rachmawati1, Nani Murniati1, Yong Jhia Yim1 168

THE EFFECTIVENESS OF WHITE CAMBODIA FLOWER EXTRACT

(Plumeria alba L.) AS A DENTURE CLEANSER TO DECREASE THE NUMBER OF Candida Albicans IN SOFT LINER

Elizabeth Luna Kania Anindita, Lusi Hidayati, Achmad Gunadi 176

ANTIBACTERIAL EFFECT OF GAMBIR EXTRACT (Uncaria gambir

[Roxb.]) TO BACTERIAL COLONIES IN MALE WISTAR STRAIN RATS 185

Rosada Sintya Dwi*, Siti Rusdiana Puspa Dewi*, Intan Ardita* 185

THE EFFECTIVENESS OF GAMBIER EXTRACT (Uncaria gambir [Roxb.]) AS AN ANTI-INFLAMMATORY AGENT IN WISTAR MALE RATS (Rattus

norvegicus L.) 194Ickman Seto, Siti Puspa Dewi, Ulfa Yasmin, Falensia Octaria 194

ANTIBACTERIAL ACTIVITY OF HIBISCUS ROSA-SINENSIS FLOWER

EXTRACT AGAINST Fusobacterium nucleatum 201

Wahyu Dwi Putra*, Shanty Chairani*, Mellani Cindera Negara** 201

THE DIFFERENCE IN ANTI-BACTERIAL ACTIVITY BETWEEN BASIL

LEAF (Occinum sanctum) ESSENTIAL OIL AND CHLORHEXIDINE GLUCONATE TOWARDS Enterococcus faecalis 209

Fajar Fatriadi, Diani Prisinda, Ame Suciati 209

EVALUATION OF ANTIFUNGAL ACTIVITY OF Stichopus hermanii

ETHANOL EXTRACT AS ORAL CANDIDIASIS TREATMENT 214

Syamsulina Revianti* and Kristanti Parisihni* 214

THE EFFECT OF COMBINATION Sticopus hermanii AND HYPERBARIC

OXYGEN ON OSTEOBLAST AND OSTEOCLAST IN PERIODONTAL

TISSUE DIABETIC RAT 223

Dian Mulawarmanti 1, Kristanti Parisihni1, Yoifah Rizka Wedarti

DISTALIZATION OF UPPER MOLAR WITH REMOVABLE APPLIANCE

Deni Sumantri 231

145-152

153-160

161-168

169-175

176-182

183-186

187-194

195-202

PROCEEDING FDI4

ADJUNCTIVE ORTHODONTIC TREATMENT OF PATIENT WITH

PERIODONTAL DISEASE 236

Endah Mardiati 236

ORTHODONTIC PATIENT EXAMINATION AND ANALYSIS IN ORDER

TO ESTABLISH THE CORRECT DIAGNOSIS 243

Gita Gayatri1, Mediany Kriseka Putri2 243

Management of Class III Skeletal Deformity with Le fort I Osteotomy and

Bisagital Split Ramus Osteotomy 253

Indra Hadikrishna*Abel Tasman**, Seto Adiantoro *** 253

MANAGEMENT OF IMPACTED MAXILLARY CENTRAL INCISOR WITH

SURGICAL TRANSPLANTATION 264

Nyoman Ayu Anggayanti1, Melita Sylvyana2, Endang Syamsudin**

A RARE CASE OFAUTOTRANSPLANTATION OF IMPACTED TEETH IN

POST ODONTOMA SITES 270

Endang Syamsudin1 Dian Maifara2 270

OROANTRAL FISTULA CLOSURE USING BUCCAL FLAP : A CASE

REPORT 277

Teuku Ahmad Arbi, DDS, OMFS 277

TRANSMUCOSAL ATTACHMENT IN DENTAL IMPLANT 283

*Chandra Andi B **Ina Hendiani 283

SEMILUNAR FLAP FOR TREATMENT MILLERS CLASS I GINGIVAL

RECESSION ( A CASE REPORT) 292Caecilia S.W.N1, Ina Hendiani2 292

THE ROLE OF INFLAMMATORY MEDIATORS IN PERIODONTAL

DISEASE 300

Nicky Arviana*, Agus Susanto** 300

ALVEOLAR RIDGE AUGMENTATION 311

T.C Rini, I Hendiani 311

ONE VISIT FRENECTOMY AND GINGIVECTOMY 321

Y.Sidarta1, E.L.C. Kumala2 321

20-206

207-212

213-220

221-229

230-234

235-240

241-245

246-254

255-261

262-270

271-279

2017 5

CORONALLY ADVANCED FLAP FOR THE TREATMENT OF A SINGLE

RECESSION: A TWO-YEAR FOLLOW UP 327

P Metta, I Komara 327

CORRELATION BETWEEN PATIENTS WITH PARTIAL TOOTH LOSS

CHARACTERISTICS AND PATIENTS MOTIVATION TO USE DENTURES

AT RSGM OF JEMBER UNIVERSITY 332

Dewi Kristiana1, R Rahardyan Parnaadji1, Asti Widaryati2 332

DESCRIPTION OF THE MAXILLARY RESIDUAL RIDGE MORPHOLOGY

BASED ON CLASSIFICATION FOR COMPLETE EDENTULISM 340

M. Andreas1, R. Rikmasari2, A. Adenan2 340

ONE PIECE DENTAL IMPLANTS TREATMENT FOR NARROW

EDENTULOUS SPACE REHABILITATION 352

F.Mardiyantoro1, Y.Sidarta2 352

The Radiograph Fourth Molars Mandibular Impaction 361

Hadiyat Miko1, Ernawati2, Emma Kamelia3*, Yayah Sopianah4 , Fahmi

Oscandar5 361

Description of Mandible Density in Patients with Type 2 Diabetes Mellitus

using Panoramic Radiograph 368

1L Epsilawati, 2H. Polli, 2DD Dian S 3 M..S. Haris 368

COMPATIBILITY MANDIBLE GONIAL ANGLE MEASUREMENT

ON DIGITAL LATERAL CEPHALOMETRIC AND PANORAMIC

RADIOGRAPHS 377

R.J. Harahap1, B. Sam 2, F. Pramanik2 377

DESCRIPTION THE FORM OF HEAD CONDYLE IN

TEMPOROMANDIBULAR JOINT BASED ON GENDER AND AGE ON

PANORAMIC RADIOGRAPH 389

S.A Sistia*, B. Sam**, F. Pramanik** 389

Description of Microstructure in Trabecular Jaw Quality for Patient with

Smoking Habits Using Panoramic Radiograph 403

1Jing L, 2Epsilawati L, 2Azhari 403

280-285

286-290

291-296

297-305

306-313

314-320

321-329

330-339

340-350

PROCEEDING FDI6

Discription of The Normal Mandibular Alveolar Resorption Pattern Based on Gander Using Panoramic Radiograph 416

1Law SY, 2Epsilawati L, 2Azhari 416

Description of Panoramic Radiograph Failure at RSGM UNPAD 426

Mohd Shuhaimi, M.H1, Ria N Firman2, F. Pramanik2. 426

Description of Corpus Length and Ramus Height of Mandible in Patients

with Panoramic Radiograph 438

Siti Nur Aseerah1, Azhari2, Farina Pramanik2 438

Analysis of The Mandible Cortical Bone Height in Amlodipine user Patient

Using Panoramic Radiograph 449

1Farihah S, 2Epsilawati L, 2Suhardjo, 2AAG Dananjaya 449

Caries Description in Permanent Teeth Based on Mount and Hume

Classiication 457Johana Yaputri 1, Rahmi Alma Farah2, Anna Muryani3 457

DIRECT COMPOSITE RESTORATION WITH STAMP TECHNIQUE 466

Yolanda1 ; Anna Muryani1 466

INTENTIONAL ENDODONTIC IN LEFT MAXILLARY CENTRAL

INSISIVUS 474

W. Prabandari1, R. A. Farah2 474

DIRECT PULP CAPPING WITH MINERAL TRIOXIDEAGGREGATE

Wijoyo Sastro S1., Irmaleny S2 481

ONE VISIT ENDODONTIC TREATMENT OF MAXILLARY CENTRAL

INCISORS 489

Y. Dhamayanti 1, D. Aripin 2 489

NON-SURGERY TREATMENT FOR PERIAPICAL LESION ON TOOTH

21 AND 22 WITH CONVENTIONAL ENDODONTIC TECHNIQUE 499

R. Indiwina1, D. Aripin2 499

CONVENTIONAL ENDODONTIC TREATMENT OF CHRONIC

PERIAPICAL LESION ASSOCIATED WITH TRAUMATIZED LEFT

MAXILLARY INCISORS 507

S. Yumanta1, h. D. Adhita2 507

351-362

363-371

372-381

382-390

391-397

398-405

406-412

413-418

419-425

426-434

435-442

2017 7

MANAGEMENT PULP NECROSIS WITH OPEN APEX USING APICAL

PLUG MINERAL TRIOXIDE AGGREGATE 514

E. A. Sapuherni1, H. D. Adhita Dharsono2 514

HEALING OF PERIAPICAL LESION USING CALCIUM HYDROXIDE IN

NONSURGICAL ENDODONTIC TREATMENT 522

Nuni. Maharani1, Anna. Muryani2 522

NONSURGICAL ENDODONTIC RETREATMENT ON LEFT MAXILLARY

SECOND PREMOLAR WITH UNDERFILLED OBTURATION. 531

Ika Destina1 , Diani Prisinda2 531

MANAGEMENT OF SEPARATED ENDODONTIC INSTRUMENT DURING

ROOT CANAL TREATMENT WITH BYPASS TECHNIQUE 538

Nana Nurjanah1, H.D.A Dharsono2 538

MANAGEMENT OF MAXILLARY FIRST PREMOLAR WITH THREE

ROOT CANALS: A CASE REPORT 546

Zuleika1, H.D.A Dharsono2 546

NON-SURGICAL ROOT CANAL RETREATMENT ON THE MAXILLARY

LEFT SECOND PREMOLAR 557

Anna Muryani1, Irmaleny Satiil1 557

INTRA CORONAL BLEACHING ON UPPER LEFT CENTRAL INCISOR

TOOTH (CASE REPORT) 565Diani Prisinda 565

EFFECT OF FLUORIDE APPLICATION BEFORE OR AFTER BLEACHING

OF CARBAMID PEROXIDE 35 % ON BLEACHED GUIDE SCORES,

HARDNESS, AND ENAMEL BRIGHTNESS 573

Yendriwati1 , Rehulina Ginting2, Fitri Yunita Batubara2 573

THE EFFECTIVENESS OF PARACHLOROPHENOL CAMPHOR

MENTHOL AGAINST ORAL Candida albicans 585

1Ayu Trisna Hayati, 2Emma Rachmawati, 2Ame Suciati 585

DENTAL MANAGEMENT IN CHILDREN WITH LOW BIRTH WEIGHT 591

Williyanti Soewondo1 591

443-448

449-455

456-463

464-470

471-477

478-487

488-494

495-500

501-510

511-514

PROCEEDING FDI8

THE PROGRESSION RESEARCH OF ALLIUM SATIVUM IN DENTISTRY

Eriska Riyanti1, Mieke H Satari2, Meirina Gartika1 601

THE RELATION BETWEEN FREQUENCY OF TOOTHBRUSH

REPLACEMENT IN A YEAR AND DENTAL CARIES PREVALENCE OF

GRADE IV AND V STUDENTS OF JEMBER KIDUL 04 ELEMENTARY

SCHOOL 606

Sulistiyani , Kiswaluyo2, Isna Fauziah Yusuf3 606

THE RELATIONSHIP BETWEEN DENTAL CARIES AND ORAL HYGIENE

ON PATIENTS OF THE PEDIATRIC DENTAL CLINIC AT DENTAL

HOSPITAL OF JEMBER UNIVERSITY 615

Ahmad Hanif Nugroho, Dyah Setyorini, Sulistiyani 615

HALL TECHNIQUE AS A DENTAL-TREATMENT OPTION, START WITH

MINIMAL THEN END UP MAXIMAL 626

L.K. Baringbing1, R. Indriyanti2 626

DENTAL AND ORAL HEALTH PROBLEMS IN CHILDREN AS A PASSIVE

SMOKER 636

Santi Wulansari1, Yetty Herdiyati1 636

ANTIMICROBIAL EFFECTS OF CHLORHEXIDINE AGAINST

CARIOGENIC BACTERIA OF EARLY CHILDHOOD CARIES : (Literature

Study Article) 648R.Y. Sari1, E. Riyanti2 648

MECHANISM OF ZINC IN ORAL CAVITY FOR REDUCING ENAMEL

DEMINERALIZATION (LITERATURE STUDY ARTICLE) 661Wijaya I C1, Riyanti E2 661

RELATION OF PROPER BREASFEEDING LATCH ON TO THE

DENTOFACIAL STRUCTURE DEVELOPMENT 672

Trieska Annisa1, Eriska Riyanti2 672

DELAYED TOOTH ERUPTION IN CHILDREN : AN UPDATE REVIEW

FOR DENTIST (Literature Review) 684Sri Ratna Laksmiastuti 684

515-522

523-527

528-534

535-543

544-551

552-562

563-574

575-584

858-593

2017 9

TREATMENT OF INTRUSION IN ANTERIOR TEETH USING

ORTHODONTICS PROCEDURE (LITERATURE STUDY ARTICLE) 695F. I. Dini1, I.S. Sasmita1 695

THE USE OF POLYETHYLENE FIBER IN ANTERIOR PRIMARY TEETH

RESTORATION WITH EXTENSIVE DECAY 706

Ulfa Yasmin1, Willyanti Suwondo2 706

A NEW CALCIUM SILICATE-BASED CEMENT (BIODENTINE) USE IN APEXIFICATION TREATMENT (LITERATURE STUDY ARTICLE) 715Kurniaty, I. S. Sasmita 715

AMELOGENESIS IMPERFECTA EARLY TREATMENT WITH

PROGRESSIVE CONSERVATIVE ADHESIVE CONCEPT 724

Stevani Monika, Iwan Ahmad 724

CROWN RESTORATION IS AN APPROPRIATE CHOICE FOR

TREATMENT AMELOGENESIS IMPERFECTA CASES 741

Yayah Inayah1, Yetty Herdiyati2 741

PRE-EMINENCE OF GIOMER AS RESTORATION MATERIAL AND

CARIES PREVENTION IN CHILDREN: A LITERATURE REVIEW 752

Gunawan I1, Saptarini R2 752

EVALUATION OF APEXIFICATION TREATMENT ON CENTRAL INCISIVE

OF YOUNG PERMANENT TOOTH DUE TO TRAUMATIC INJURY : A

CASE REPORT 764

Faizal Hasan1, Meirina Gartika2 764

AESTHETIC REHABILITATION AND DENTAL PREVENTIVE OF THE

PRIMARY DENTITION AFFECTED BY ENAMEL HYPOPLASIA: CASE

REPORT 773

Randita Diany Yordian1, Iwan Ahmad M.2 773

EARLY CLASS III MALOCCLUSION TREATMENT USING REVERSE

TWIN BLOCK APPLIANCE : A CASE REPORT 787

Sekar Pratiwi1, Ratna Indriyanti2 787

FOLLOW UP ONLAY COMPOSITE ON THE FIRST PERMANENT

MOLAR IN CHILDREN: CASE REPORT 798

Mustika Pramidi 1, Willyanti Soewondo2 798

594-602

603-612

613-619

620-627

627-642

643-651

652-664

665-670

671-682

683-692

PROCEEDING FDI10

EARLY TREATMENT OF MILD SKELETAL CLASS III MALOCCLUSIONS

USING REVERSE TWIN BLOCK: CASE REPORT 809

Dewi Rahmawati1 , E. Riyanti2 809

PHASE OF TREATMENT AGENESIS BILATERAL CANINE MANDIBULAR

PERMANENT: A CASE REPORT 822

Intan Maulani, Yetty Herdiyati 822

DENTAL TREATMENT IN A DOWN SYNDROME ADOLESCENT BOY

PATIENT: A CASE REPORT 833

Stephanie1, Arlette Suzy P.2 833

COMPREHENSIVE TREATMENT SUCH AS: RESTORATIONS,

EXTRACTION AND SPACE MAINTAINER IN CHILDREEN WITH POOR

ORAL CONDITION: A CASE REPORT 843

Nova Elvarani1, Eriska Riyanti2 843

COMPEHENSIVE TREATMENT OF INJURED IMMATURE PERMANENT

ANTERIOR TEETH: A CASE REPORT 855

Naninda Berliana Pratidina1, Ratna Indriyanti2 855

FIBER-BRAID REINFORCED COMPOSITE LOOP SPACE MAINTAINER:

AN ALTERNATIVE DESIGN AND MATERIAL OF SPACE MAINTAINER

Yoana1, Arlette Suzy Puspa Pertiwi2 867

A TREATMENT FOR NON VITAL ANTERIOR IMMATURE PERMANENT

TEETH USING PROTAPER MANUAL SYSTEM (HAND USE) : A CASE REPORT 877

Rizka A. Zaim1 , Meirina Gartika2 877

PATERN OF CALCULUS FORMATION IN VISUALLY IMPAIRED

CHILDREN 887

Didin Erma Indahyani1, Niken Probasari2, Izzata Barid1 887

THE LEVEL OF CARE NEEDS ABNORMALITIES OF TEETH AND

PERIODONTAL TISSUES IN CHILDREN WITH SPECIAL NEEDS 896

1Niken Probosari, 2Didin Erma Indahyani, 2Izzata Barid 896

693-701

702-712

713-722

723-731

732-741

742-751

752-758

759-767

768-775

2017 11

THE RELATIONSHIP BETWEEN DENTAL ANXIETY WITH THE LEVEL

OF COOPERATIVE OF PEDIATRIC PATIENTS ON TOOTH EXTRACTION

PROCEDURE IN THE EDUCATION HOSPITAL OF BRAWIJAYA

UNIVERSITY 906

Merlya Balbeid, Ambar Puspitasari, Etika Ayu Sondang Terawati 906

RELATIONSHIP BETWEEN PERIODONTITIS WITH CONCENTRATION

OF C-REACTIVE PROTEIN (CRP) SALIVA IN CHILDREN WITH DOWN SYNDROME CLINICAL DIAGNOSE 916

Henytaria Fajrianti1, Hernayanti2, Fanni Kusuma Djati3 916

PRELIMINARY SYNTHESIS OF CALCIUM CARBONATE USING CO2

BUBBLING METHOD FOR BIOMEDICAL APPLICATION

N.H. Azzakiroh1 , Z. Hasratiningsih2, I.M. Joni3, A.Cahyanto2

776-783

784-792

793-801

2017 1

Preliminary synthesis of calcium carbonate using co2 bubbling method

for biomedical application

N.H. Azzakiroh1 , Z. Hasratiningsih2, I.M. Joni3, A.Cahyanto2

1Graduate Student at Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia2Departement of Dental Materials Science and Technology, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia3Departement of Physics, Faculty of Mathematics and Sciences, Universitas Padjadjaran, Bandung, Indonesia

ABSTRACT

INTRODUCTION : Calcium carbonate (CaCO3) is widely used in biomedical application

such as biomaterial for bone subtitute, drug delivery system, calcium supplement and others.

CaCO3 natural form can be easily found either in a limestone processing. Carbonation or

CO2 bubbling method is required to obtain CaCO

3 from bulk limestone.Objective :The

aim of this study was to synthesize CaCO3 from Palimanan limestone by CO

2 bubbling

method.Materials and methods: Limestone was calcinated at 900C to get calcium oxide

(CaO). Then, 84 gr CaO was hydrated in 1.5L water at 50C in an hour to get lime slurry

(Ca(OH)2). Lime slurry carbonated by bubbling method with temperature 60C, constant

low rate of CO2 at 10L/min and stirred at 300 rpm to obtain CaCO3 particles. Particles

of CaCO3

arethen characterized by Energy Dispersive Spectroscopy (EDS), and X-Ray

Difraction (XRD). Result : Energy Dispersive Spectroscopy showed elements forming was CaCO

3. X-Ray Difraction pattern of CaCO

3 produced trigonal calcite crystalline structure.

Conclusion : CaCO3 successfully synthesized using CO

2 bubbling method . Hopefullly this

CaCO3 particles might be used widely in biomedical application. Further study is awaited

based on these initial indings.

Keywords:Synthesize of CaCO3 , CO

2 bubbling, EDS, XRD

PROCEEDING 2

INTRODUCTION

Calcium carbonate (CaCO3) is widely used in biomedical application. Biomaterial for

bone subtitute and drug delivery system for osteomyelitis during bone surgery 1,2. CaCO3 can

be used as abrasive material in toothpaste 3. CaCO3 also can be used as therapy for dentine

hypersensitivity from prophylaxis paste. Calcite form of CaCO3 can be used as dentifrices and

polishing materials 4. CaCO3 natural form can be easily found either in a limestone

processing5. Carbonation or CO2 bubbling method is required to obtain CaCO

3 from bulk

limestone 6.

Natural CaCO3 can be found at several forms like mollusc shells and egg shells. This

shells fossil can be found in limestone which is almost 90% contain CaCO3. The worldwide

availability of CaCO3, compatibility and non-toxicity towards the human body make synthesis

of this material an interesting and attractive topic for scientists and researcher to delve into.

Therefore, so many research have been undertaken to stabilize speciic CaCO3 polymorphs at

diferent size and morphology 5.Two main CaCO

3 synthesis methods there are biomimetic method and CO

2 bubbling

method. Biomimetic method attempts to imitate natures ability to synthesize various

shapes and size by using physiological parameters and soluble organics. The current

industrial synthesis is CO2 bubbling method which use CO

2 bubble into slaked lime to get

CaCO3 particles 5.

CO2 bubbling method is very eicient at producing micro or nano sized particles which

are the most needed size in industry and research. The morphology that can mainly be

achieved are cubic or rombohedral 5.

CaCO3 have three polymorphs, they are calcite which is thermodynamically

stable, vaterite, and aragonite 1,7. An important factor during carbonation process is

temperature 8. Scalenohedral CaCO3 formed at 41-90C 9. Another research showed needle

like form aragonite formed at 60C 10. Diferent shapes can be exhibited by CaCO3

like

spheres, cubes, irregular, pyramid, hollows, and many else 5.The aim of this study was to

synthesize CaCO3 from Palimanan limestone by CO

2 bubbling method at 60C.

METHODS

Limestone was calcinated at 900C to get calcium oxide (CaO). Then, 84 gr CaO

was hydrated in 1.5L water at 50C in an hour to get lime slurry (Ca(OH)2). Lime slurry

carbonated by bubbling method with temperature 60C, constant low rate of CO2 at 10L/

min and stirred at 300 rpm until suspension reach neutral pH to obtain CaCO3 particles.

Fig.1 showed carbonation processing. Particles of CaCO3

then characterized by Energy

Dispersive Spectroscopy (EDS), and X-Ray Difraction (XRD).

2017 3

Figure 1. Carbonation or CO2 bubbling method

Hypothesis of reactions described below:

Calcination :Lime stone (CaCO3)

(s) 900CCaO

(s) +CO

2(g)

Hidration : CaO(s)

+H2O

(l) slaked lime Ca(OH)

2(s)

Carbonation : Ca(OH)2(s)

+ CO2(g)

CaCO3(s)

+ H2O

(l)

Detailed reaction of carbonation 11:

CO2(g)

CO

2(aq)

CO2(aq)

+ H2O H

2CO

3 (aq)

H2CO

3(aq) H+ + HCO

3-

HCO3

- H+ + CO3

-

Ca2+ + CO3

2- CaCO3(s)

RESULTS

Carbonation process is runfor 15 minutes until the suspension gets neutral pH (6, 5).

Initial CaO mass is 84 gr and inal CaCO3 mass is 90,90 gr.

Figure 3. Three dots, during EDS characterization

PROCEEDING 4

Table 1. EDS result of CaCO3

A B C

Element Weight% Atomic % Weight% Atomic % Weight % Atomic %

C 13,07 21,31 2,39 20,61 10,12 17,52

O 49,22 60,26 47,59 59,44 45,89 59,66

Ca 37,71 18,43 40,02 19,95 43,99 22,83

Energy Dispersive Spectroscopy showed elements forming was CaCO3.

Figure 4. XRD pattern of CaCO3

X-Ray Difraction pattern of CaCO3 produced trigonal calcite crystalline structure with

2.737g/cm3 density. Fig.4 showed that the particles are 100% CaCO3 with their peaks. The

highest peak is at 2 degree 30. This peak same as peak of CaCO3 in reference

.

DISCUSSION

CaCO3 morphology result from this research is diferent from another research which

shows that aragonite is formed at temperature 60C.Beside, in this research XRD pattern

showed calcite formation at the same temperature 12. Temperaturealso inluences particle size of CaCO

3 8. Small particle (1,5m) of CaCO

3 is formed at 25C and the size increases

due to agglomeration at 35C and at 50C particles begin non agglomerate until reach

smallest particle size 1,2 m at 60C 8.

Biomedical products that can be obtain from this research are CaCO3 and Ca(OH)

2.

These products can be utilized as dental product when the products meet each standard

like physical properties, mechanical propeties, and biocompatibilty of the materials. Futher

research is needed to investigate if these materials are eligible as the desired materials

2017 5

CaCO3 which used in dentrifrices is diferent from CaCO

3used as other dental

materials. CaCO3 is widely used as dentifrices which are act as abrasive materials to remove

plaque or stain and polish tooth surface. A discussion of dentrifrices would not be complete

without mentioning of the ADA acceptance program for these materials like abrasivity value

of 250 (also limit for ISO standard) 13.

Recent research showed CaCO3 role as precursor of carbonate apatite based bone

cement and drug delivery system for osteomyelitis disease 1,14. CaCO3 acts as donor of

CO3

-and Ca2+that has similarity with inorganic content of bone 14. CaCO3

shows unique

advantages due to the potentioal and its ideal biocompatibility as delivery system for

loading diferent categories of drugs. CaCO3 is nominated as suitable drug delivery carier

bacause of their accessibility, slow biodegradabability, osteoconductivity, safety, low cost,

pH-sensitive properties and biocompability 1.

Another product that can be found in this research is Ca(OH)2 which is widely known

for its application in pulp protection as cement base materials 13.

CONCLUSION

CaCO3is successfully synthesized by CO

2 bubbling method. Hopefullly this CaCO

3

particles might be used widely in biomedical application. Further study is awaited based on

these initial indings.

ACKNOWLEDGEMENT

The authors are grateful to acknowledge Nanotechnology Research and Graphene

Laboratory, Universitas Padjadjaran, Indonesia and to Departement of Dental Materials

Science and Technology, Faculty of Dentistry, Universitas Padjadjaran, Indonesia for

supporting this research.

REFERENCES

1. Dizaj SM, Barzegar-jalali M, Zarrintan MH, Adibkia K, Lotipour F. Calcium Carbonate Nanoparticles ; Potential in Bone and Tooth Disorders. Pharm Sci.

2015;98(March):175-182.

2. Ueno Y, Futagawa H, Takagi Y, Ueno A, Mizushima Y. Drug-imcorporating Calcium

Carbonate Nanoparticles for a New delivery System. Jounal Control Release.

2005;103(1):93-98.

3. Galdwin M, Bagby M. Clinical Aspect of Dental Materials Theory , Practices, and Cases.

Vol 3rd ed. New York: Wolters Kluwer; 2009.

4. Powers JM, Wataha J. Dental Materials Properties and Manipulation. Vol 9th ed.

Missouri: Mosby Elsevier; 2008.

5. Boyjoo Y, Pareek VK, Liu J. Synthesis of micro and nano-sized calcium carbonate

PROCEEDING 6

particles and their applications. J Mater Chem A. 2014;2(35):14270.

6. Bunger JW, Cogswell D, Wiser JW. Process for Purifying Highly Impure Valcium

Hydroxide and for Producing High-Value Precipitated Calcium Carbonate and Other

Calcium Product. 1998:1-12.

7. Cahyanto A, Toita R, Tsuru K, Ishikawa K. Efect of Particle Size on Carbonate Apatite Cement Properties Consisting of Calcite ( or Vaterite ) and Dicalcium Phosphate

Anhydrous. Key Eng Mater. 2015;631:128-133.

8. Thriveni T, Um N, Nam S, et al. Factors Afecting the Crystal Growth of Scalenohedral Calcite by a Carbonation Process. 2014;51(2):107-114.

9. Hernandez GM, Renard F, Geofroy N, Charlet L, Pironon J. Calcite precipitation from CO2 -H2O-Ca(OH)2 slurry under high pressure of CO2. :1-25.

10. Han YS, Hadiko G, Fuji M, Takahashi M. Factors afecting the phase and morphology of CaCO 3 prepared by a bubbling method. 2006;26:843-847. doi:10.1016/j.

jeurceramsoc.2005.07.050.

11. Hadiko G, Han YS, Fuji M, Takahashi M. Synthesis of hollow calcium carbonate

particles by the bubble templating method. 2005;59:2519-2522. doi:10.1016/j.

matlet.2005.03.036.

12. Han YS, Hadiko G, Fuji M, MT. Crystallization and transformation of vaterite at

controlled pH. 2006;289:269-274. doi:10.1016/j.jcrysgro.2005.11.011.

13. Anusavice K. Phillips Science of Dental Materials. Vol 11th ed. Missouri: Elsevier

science; 2003.

14. Cahyanto A, Maruta M, Tsuru K, Matsuya S, Ishikawa K. Fabrication of bone cement

that fully transforms to carbonate apatite. 2015;34(3):394-401. doi:10.4012/dmj.2014-

328.

2017 7

Comparison of the diametral tensile strength of bone cement based

on carbonate apatite between micron and nano particles calcium

carbonate as a precursor

L. Arianti1 , E. Karlina2, A. Cahyanto2

1Graduate Student at Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia2Departement of Dental Materials Science and Technology, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia

ABSTRACT

INTRODUCTION:Bone cement is inorganic material which can be used for bone

substitute materials. One of the bone cement which has been attracted much attention in

orthopedic and dental ields is apatite cement. As a result of apatite cement could transform to carbonate apatite (CO

3Ap) after implanted in the body, high bone replacement ability

could be developed. The current study about diametral tensile strength (DTS) value of bone

cement using calcium carbonate (CaCO3) as one of the component of CO

3Ap cement in

limited to submicron particles. There have been no data using CaCO3 reduced into nano

particles. Meanwhile, the studies about reduction of CaCO3 particles into nano particles

have been found by the precipitation and ultraine grinding. Objective: The aim of this study is to investigate the DTS value of bone cement based on CO

3Ap between micron

and nano particles using CaCO3 as a precursor.Materials and methods: The powder

phase of micron particles of CaCO3 or nano particles of CaCO

3 which was milled by beads

mill combined with dicalcium phosphate anhydrous (CaHPO4) was mixed with 1 mol/L of

disodium hydrogen phosphate (Na2HPO

4) solution in 0.5 of liquid to powder ratio. The paste

was packed into a split Telon mold, covered with glass slide and kept at 37C and 100% relative humidity for 24 hours.Results: The result showed that the diametral tensile strength

of the set CO3Ap cement using micron particles of CaCO

3was 3,7787 MPa and nano

particles of CaCO3was 2,4013 MPa. The data was analyzed statistically with t independent

test (=0,05) which showedthat the DTS between micron and nano particles of CaCO3was

statistically signiicant.Conclusion: In conclusion, the bone cement based on CO3Ap using

micron particles of CaCO3has higher DTS value than bone cement based on CO

3Ap with

nano particles of CaCO3.

Keywords:Diametral tensile strength, bone cement, carbonate apatite,calcium carbonate

PROCEEDING 8

INTRODUCTION

Bone is one of important parts in our body that support our bodies and protect vital

organs such as heart, lungs, etc. Bone has limitation for self repair. When large defect bone

occurrs, so the repair processed need an alternative materials as a bone graft [1]. Autograft

is one of the bone grafting materials which is still considered as the golden standard

compared to other grafting materials since it shows high remodelling process perfomance.

This material is harvested from healthy parts of the bones of the same patient. However,

the availability of the healthy bone in our body is limited and this may involve massive blood

loss, sepsis, and also pain [1, 2]. Therefore, the use of synthetic graft can be used as an

alternative material for bone substitute [3].

Bone cement is a synthetic bone graft material (alloplastic) which can be used for

bone substitute materials [4]. One of the bone cement which has been attracted much

attention in orthopedic and dental ields is apatite cement (AC) [5]. The AC could transform to carbonate apatite (CO

3Ap) when implanted in the body and high bone replacement ability

could be developed. Another advantages possessed by AC lies in its ability to show good

osteoconductivity and excellent tissue response [6].

The candidates of starting material for fabrication of CO3Ap cement are calcium

carbonate (CaCO3) and dicalcium phosphate anhydrous (CaHPO

4) [6]. Cahyanto et

al. reported that CO3Ap cement consisted of one of the polymorph of CaCO

3 which is

vaterite that has the smallest particle size with the highest diametral tensile strength (DTS)

[7]. However, the current study about DTS value of bone cement using CaCO3 as one

of the component of CO3Ap cement was limited. Furthermore, there was no data using

CaCO3reduced into nanoparticles as a precursor for CO

3Ap cement. Meanwhile, the study

about reduction of CaCO3 particles into nanoparticles has been found by the precipitation

and ultraine grinding [8].The aim of this study was to investigate the DTS value of bone cement based on CO

3Ap between micron and nanoparticles using CaCO

3 as a precursor.

METHODS

This research was conducted by CO3Apbased bone cement using micron and

nanoparticles of CaCO3. The nanoparticles of CaCO

3 were derived on the basis of previous

report [8]. In brief, 1.15 mL of Tween 80as the surfactant was mixed into 568.1 mL aquadest

and 5.75 g of CaCO3 using magnetic stirrer. The grinding was conducted by beads mill for 3

hours at the slurry concentration of 5%, bead size of 300 m, and the rotor speed 3000 rpm. The obtained particles were collected by dried at 40C for 24 hours. Finally, each micron particles of CaCO

3 and nanoparticles of CaCO

3 were mixed with CaHPO

4 homogeneously

on weight powder ratio 40:60 to obtain CO3Ap powder.

Powder phase of CaCO3 combined CaHPO

4 were mixed with liquid phase of 1 mol/L

Na3HPO

3using a spatula at a L/P ratio 0.5 until it became a paste. The paste was packed

into Telon mold (6 mm in diameter x 3 mm in height). Both ends of the mold was covered

2017 9

with a glass slides and clamped by a metal clip. The molds were placed inside a plastic

container containing distilled water to maintain 100% relative humidity. Finally, the plastic

container was placed into an incubator and kept at 37C for 24 hours. Upon completion of the treatment times, the samples were removed from the mold and immersed in the 99%

ethanol for 3 minutes then dried in the oven 80C for 3 hours.The mechanical strength was examined in terms of diametral tensile strength (DTS).

The samples were crushed using universal testing machine (Lloyd with Nexygen Plus

material test and analysis software, Florida, USA) at 1 mm/min crosshead speed. DTS

values were taken from an average ive samples. The data has been collected, analysed using t independent test to determine signiicances.

RESULTS

Fig. 1. DTS values of CO3Ap cement consisted of micron particles of CaCO

3 or nanoparticles of CaCO

3

and CaHPO4 mixed with 1 mol/L Na

2HPO

4 solution treated for 24 hours. At least ive samples were

measured for DTS. (p

PROCEEDING 10

Figure 2 summarizes the DTS measurement of micron particles that have higher DTS

value compared to nanoparticles sample. T-independent test showed statistically signiicant (p

2017 11

laboratory, Universitas Padjadjaran, Indonesia and to Departement of Dental Materials

Science and Technology, Faculty of Dentistry, Universitas Padjadjaran, Indonesia for

supporting this research.

REFERENCES

1. Ohtsuki C, Kamitakahara M, Miyazaki T. Bioactive ceramic-based materials with

designed reactivity for bone tissue regeneration. Journal of the Royal Society Interface.

2009 Jan 1:rsif-2008. S349.

2. Schnettler R, Stahl JP, Alt V, Pavlidis T, Dingeldein E, Wenisch PD. Calcium phosphate-

based bone substitutes. European Journal of Trauma. 2004 Aug 1;30(4):219-29.

3. Moore WR, Graves SE, Bain GI. Synthetic bone graft substitutes. ANZ journal of

surgery. 2001 Jun 8;71(6):354-61.

4. Dumitrescu AL. Bone grafts and bone graft substitutes in periodontal therapy. Chemicals

in Surgical Periodontal Therapy. 2011:73-144.

5. Oda M, Takeuchi A, Lin X, Matsuya S, Ishikawa K. Efects of liquid phase on basic properties of. ALPHA.-tricalcium phosphate-based apatite cement. Dental materials

journal. 2008;27(5):672-7.

6. Cahyanto A, Maruta M, Tsuru K, Matsuya S, Ishikawa K. Fabrication of bone cement

that fully transforms to carbonate apatite. Dental materials journal. 2015;34(3):394-401.

7. Cahyanto A, Toita R, Tsuru K, Ishikawa K. Efect of Particle Size on Carbonate Apatite Cement Properties Consisting of Calcite (or Vaterite) and Dicalcium Phosphate

Anhydrous. InKey Engineering Materials 2015 (Vol. 631, pp. 128-133). Trans Tech

Publications.

8. Cho K, Chang H, Kil DS, Kim BG, Jang HD. Synthesis of dispersed CaCO 3 nanoparticles

by the ultraine grinding. Journal of Industrial and Engineering Chemistry. 2009 Mar 31;15(2):243-6.

9. Chow LC, Hirayama S, Takagi S, Parry E. Diametral tensile strength and compressive

strength of a calcium phosphate cement: efect of applied pressure. Journal of biomedical materials research. 2000 Sep 1;53(5):511-7.

10. LeGeros RZ. Calcium phosphate-based osteoinductive materials. Chemical reviews.

2008 Nov 12;108(11):4742-53.

PROCEEDING 12

Apatite cement versus carbonate apatite cement

A. Cahyanto1, M.N. Zakaria2

1Department of Materials Science and Technology, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia2Department of Endodontology and Operative Dentistry, Study Program of Dentistry, University of General Achmad Yani, Cimahi, IndonesiaE-mail : a*[email protected]; [email protected]

ABSTRACT

Apatite cement (AC) is one of innovations utilized for bone reconstruction. It has been

used in clinical application including craniofacial surgery for several decades due to it self-

setting property. AC will set and form hydroxyapatite upon setting reaction. Consequently,

AC shows excellent tissue response and good osteoconductivity. However, the archetype

has been shifting to carbonate apatite (CO3Ap) cement. Researchesproved that AC will

transforms to CO3Ap in physiological body condition. The formation of CO

3Ap has been

proposed as one of the keys for the replacement of AC to new bone since CO3Ap will

be resorbed by osteoclasts and replaced to new bone. This review will focus on recent

research of advance improvements in AC and CO3Ap cement reported by in vitro, in vivo,

and clinical study.

Keywords:Apatite cement, carbonate apatite cement

INTRODUCTION

Brown and Chow in 1986 reported an equimolar mixture of tetracalcium phosphate

(TTCP: Ca4(PO

4)

2O) and dicalcium phosphate anhydrous (DCPA: CaHPO

4) or dicalcium

phosphate dehydrate (DCPD: CaHPO42H

2O) set to form hydroxyapatite (HAp) in 30-60

minutes at an ambient temperature.1,2 Apatite Cement (AC) invented by Brown and Chow

is composed of two kind ofcalcium phosphate sources, TTCP and DCPA, and the setting

reaction becomes more complex compared with gypsum or -TCP. However, the setting mechanism of TTCP-DCPA based AC is the same with these gypsum or -TCP based AC. In other words, they are based on dissolution-precipitation reaction.

2017 13

When TTCP and DCPA, powder phase of TTCP-DCPA AC is mixed with an aqueous

solution, both Ca2+ and PO4

3- will be supplied, since both TTCP and DCPA have appropriate

solubility. The resultant aqueous solution willbe supersaturated with respect to HAp since

the solubility of HAp at neutral and alkaline region is very small. As a result, HAp crystals

willbe precipitated and then interlocked to each other to form the set mass.

From diferent point of view, the replacement of AC by new bone formation is still is still debated.3-17 These diferences could be caused diferent animal experimental, diferent bone defect area and size, diferent composition of the AC or diferent powder and liquid mixing ratio. For example, one report concluded that the size of a cranial defect is one of the

factor afecting resorption and replacement to new bone.10

Although detailed mechanism of ACs replacement to bone has not been clariied up to date, it is clear that AC would be replaced to bone at certain condition. The replacement

of AC to bone relates to the formation of CO3Ap. Thus, formation of CO

3Ap may be one of

the keys for the replacement of AC to new bone since CO3Ap is known to be resorbed by

osteoclasts and replaced to new bone. The aim of the present study is to give a brief review

of AC and CO3Ap cement as substitution material of bone.

DISCUSSION

First advantage of AC or CO3Ap cement is its self-setting ability in physiological

condition. Since the paste of AC or CO3Ap cement can be set and harden in bone defects,

the bone defect can be illed with AC or CO3Ap cement without leaving a gap to adjacent

bone. The cells in bone such as osteoblasts cannot migrate if there is a gap between

bone substitutes and adjacent bone. Second, AC or CO3Ap cement paste showed good

injectability that allows AC or CO3Ap cement to be implantedby minimal invasive surgery

techniques, that are less traumatic, reduced blood loss, shorter hospital stay and faster

recovery. Third, AC or CO3Ap cement showed excellent osteoconductivity, as a consequence

of the transformation of AC to HAp or CO3Ap upon setting reaction. Fourth, AC or CO

3Ap

cement isreplaced by new bone with time even in some period of time. This property is very

attractive, since sintered HAp cannot be replaced to bone. Bone are crucial not only for their

mechanical role but also it biological role, such as blood formation. Therefore, bone graft

that can be replaced to bone is a great deal. Fifth, the AC or CO3Ap cement can be used

to deliver drugs such as growth factor, antibiotic, anti-inlammatory, since set AC or CO3Ap

cement have micro porosity and are able to set at physiological condition.

Besides the beneits possessed by AC or CO3Ap cement, they also have disadvantages.

The lower mechanical properties of AC or CO3Ap cement becomes an issue, limiting the

use of AC or CO3Ap cement only for non-load bearing area in clinical application. Therefore,

AC or CO3Ap cement may be better to be used in non-load bearing area such as cranial

bone substitute or alveolar bone augmentation.

One of interesting manners reported for AC is the formation of CO3Ap on the surface

of AC. When TTCP-DCPA based AC was implanted at tibia of rat, CO3Ap was found at

PROCEEDING 14

the surface of set AC after eight weeks implantation, despite no carbonate source was

incorporated in the TTCP-DCPA based AC.17 Since no carbonate was incorporated in the

cement composition, carbonate contained in the CO3Ap was thought to be supplied from the

surrounding environment such as body luid, blood, air, etc.It should be noted that bone apatite is the CO

3Ap with other trace element such

as Na+, K+, F- as shown in Table 1.18-19 Also, preparation of CO3Ap powder is easy since

CO3Ap the most stable phase thermodynamically.20-22 However, apatite powder including

CO3Ap powder causes inlammatory response called crystalline inlammatory response.

Therefore, CO3Ap should be used as cement, block or granular to arrest the response.

Although CO3Ap is the most stable calcium phosphate phase at physiological condition, it

is unstable at high temperature required for sintering process and thermally decomposed to

other calcium phosphate.

Table 1.Bone compositions of the human adult18-19

Compositions Bone

Ca2+ 34.8

PO4 as P 15.2

Na+ 0.9

Mg2+ 0.72

K+ 0.03

CO3

2- 7.4

F- 0.03

Cl- 0.13

Bone remodeling is a lifelong process where mature or old bone tissue is replaced

by newly formed bone. In this process, two cells known as osteoclasts and osteoblasts

play an imperative role. Osteoblasts forms new bone and this has close relationship

with osteoconductivity of apatite. On the other hand, osteoclasts remove matured bone.

Osteoclast create Howships lacuna where inside of the lacuna is made with acidic condition

(~pH 4.5).23 It has been reported that carbonate content in apatitic structure has close

relationship with the solubility of apatite in acidic condition.24 Therefore, it is reasonable to

say that CO3Ap is replaced to bone even though HAp is stable at the bone defect. In fact,

CO3Ap granules fabricated based on dissolution-precipitation reaction, and implanted into

the cranial bone of rats, after implantation were found to be replaced to the newly formed

bone 24 weeks.25Therefore; CO3Ap may be a key factor for bone replacement.

CONCLUSION

Although AC has theability to transforms to HAp, the CO3Ap cement are more

beneicial than AC, because they are already in CO3Ap form, which are more easily to

replace by bone.

2017 15

REFERENCES

1. Brown WE, Chow LC. A new calcium phosphate, water-setting cement, In: Brown P W,

Cement Research Progress, Ed.; Brown, P.W., Westerville, USA. 1986; pp. 351-379.

2. Brown WE, Chow LC. Combination of sparingly soluble calcium phosphate cements in

slurries and paste as mineralizers and cements. 1986; U.S. Patent No. 4,612,059.

3. Miyamoto Y, Ishikawa K, Takechi M, Toh T, Yuasa T, Nagayama M, Suzuki K. Histological

and compositional evaluations of three types of calcium phosphate cements when

implanted in subcutaneous tissue immediately after mixing. J Biomed Mater Res: Appl

Biomater. 1999; 48(1): 3642.

4. Mai R, Reinstorf A, Pilling E, Hlawitschka M, Jung R, Gelinsky M, Schneider M, Loukota

R, Pompe W, Eckelt U, Stadlinger B. Histologic study of incorporation and resorption of

a bone cement-collagen composite: an in vivo study in the minipig. Oral Surg Oral Med

Oral Pathol Oral Radiol Endod 2008; 105: e9-e14.

5. Constantz BR, Ison IC, Fulmer MT, Poser RD, Smith ST, Van Wagoner M, Ross J,

Goldstein SA, Jupiter JB, Rosenthal DI. Skeletal repair by in situ formation of the mineral

phase of bone. Science. 1995; 267: 1796- 1799.

6. Yuan H, Li Y, de Bruijn JD, de Groot K, Zhang X. Tissue responses of calcium phosphate

cement: a study in dogs. Biomaterials. 2000; 21: 1283-1290.

7. Cancian DCJ, Vieira EH, Marcantonio RAC, Garcia Jr IR. Utilization of autogenous

bone, bioactive glasses, and calcium phosphate cement in surgical mandibular bone

defects in cebus apella monkeys.Int J Oral Max Impl. 2004; 19: 73-79.

8. Gosain AK, Riordan PA, Song L, Amarante M, Kalantarian B, Nagy PG, Wilson CR, Toth

JM, McIntyre BL. A 1-year study of osteoinduction in hydroxyapatite-derived biomaterials

in an adult sheep model: part II. Bioengineering implants to optimize bone replacement

in reconstruction of cranial defects.Plast Reconstr Surg. 2004; 114: 1155-1163.

9. Maniker A, Cantrell S, Vaicys C. Failure of hydroxyapatite cement to set in repair of a

cranial defect: case report. Neurosurgery. 1998; 43: 9534.

10. Constantino PD, Friedman CD, Jones K, Chow LC, Sisson GA. Experimental

hydroxyapatite cement cranioplasty. Plast Reconstr Surg. 1992; 90: 174-185.

11. Friedman CD, Constantino PD, Jones K, Chow LC, Pelzer HJ, Sisson GA. Hydroxyapatite

cement. II: Obliteration and reconstruction of the cat frontal sinus. Arch Otolaryngol

Head Neck Surg. 1991; 117: 385-389.

12. Shindo ML, Constantino PD, Friedman CD, Chow LC. Facial skeletal augmentation

using hydroxyapatite cement. Arch Otolaryngol Head Neck Surg. 1993; 119: 185-190.

13. Friedman CD, Costantino PD, Takagi S, and Chow LC. BoneSourceTM hydroxyapatite

cement, a novel biomaterial for craniofacial skeletal tissue engineering and

reconstruction. J Biomed Mater Res. 1998; 43: 428-432.

14. Rey C, Toighi A, Mounic S, Combes C, Lee D. Biomimetism and calcium phosphate cements, In: Actualits en Biomatriaux, Mainard D, Louis J P. Eds. Editions Romillat:

PROCEEDING 16

Paris, France, 2002; Vol. 6, pp. 27-37.

15. Yuasa T, Miyamoto Y, Ishikawa K, Takechi M, Nagayama M, Suzuki K. In vitro resorption

of three apatite cements with osteoclasts. J Biomed Mater Res. 2001; 54: 344-350.

16. Puricelli E, Corsetti A, Ponzoni D, Martins GL, Leite MG, Santos LA. Characterization of

bone repair in rat femur after treatment with calcium phosphate cement and autogenous

bone graft. Head and Face Medicine. 2010; 6: art.

17. Miyamoto Y, Ishikawa K, Takechi M, Toh T, Yoshida Y, Nagayama M, Kon M, Asaoka

K. Tissue response to fast-setting calcium phosphate cement in bone. J Biomed Mater

Res.1997; 37: 457-464.

18. Legeros RZ. Apatites in biological systems. Prog Cryst Growth Characterization. 1981;

4: 1-45.

19. Ishikawa K. Calcium phosphate cement. In Bioceramics and Their Clinical

Application;Kokubo, T., Ed.; CRC Press: NY, USA.2008; pp. 438463.

20. Cahyanto A, Tsuru K, Ishikawa K. Carbonate Apatite Formation during the Setting

Reaction of Apatite Cement. Advances in Bioceramics and Porous Ceramics V.

Ceramics Engineering and Science Proceeding. 2013; Vol. 33, No. 6, 7-10.

21. Cahyanto A, Maruta M, Tsuru K, Matsuya S, Ishikawa K. Fabrication of Bone Cement

that Fully-Transform to Carbonate Apatite. Dent Mater J. 2015; Vol. 34, No.3, 394-401.

22. Cahyanto A, Tsuru K, Ishikawa K. Transformation of Apatite Cement to B-Type

Carbonate Apatite Using Diferent Atmosphere. Key Engineering Materials. 2016; Vol. 696, pp. 9-13.

23. Kierszenbaum AL, Tres LL. Histology and cell biology: An introduction to pathology.

Elsevier: Philadelphia, USA. 2012; 3: pp. 252-254.

24. Dorozhkin SV. Dissolution mechanism of calcium apatites in acids: A review of literature.

World J Methodol. 2012; 2(1): 1-17.

25. Ishikawa K. Bone substitute fabrication based on dissolution-precipitation reactions.

Materials.2010; 3: 1138-1155.

2017 17

Bioceramics material: lifting hope in endodontics

M. N. Zakaria1, A. Cahyanto2

1Department of Endodontology and Operative Dentistry, Study Program of Dentistry, Jenderal Achmad Yani University, Cimahi, Indonesia2Department of Dental Materials Science and Technology, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia

E-mail : a*[email protected]; [email protected]

ABSTRACT

Achieving good and predictable results in endodontic treatment relates to awareness

in science, techniques, material and procedural skills. In vital pulp therapies, the main goal

of the treatment is to maintain the vitality of the pulp, as a consequence, the chosen material

must provide good sealing and stimulation to the pulp cells to repair it self. Whilst in necrotic

pulp, particularly in cases with periapical disease, treatment emphasizes eliminating the

source of infection by proper disinfection and creating a hermetic seal in the root canal to

induce healing of the periapical tissue. To achieve these goals, endodontic treatment can

not be separated from disinfection and repair materials that should have good antimicrobial

activity, dimensional stability, good handling characteristics, adequate adherence ability to

tooth structure to provide good seal, biocompatible and able to induce tissue repair. However,

until this present time, no material available could meet the needs of all ideal dental material

properties. Therefore, studies to provide better material are still on going. Bioceramics

has been a promising material widely used in medicine, combining biocompatibility and

bioactivity. Recent delicate studies also suggested the use of bioceramics in dentistry, which

has been promising in stimulating regeneration of broken tooth due to its biocompatibility

and bioactive properties. This brief review will focus on advance improvements in dental

materials particularly in endodontics using bioceramics including calcium hydroxide, mineral

trioxide aggregates (MTA), Biodentine, iRoot SP, and BioAggregate that has been reported

by laboratory and clinical studies to improve the quality of endodontic treatment.

Keywords:Bioceramics, endodontics, regeneration, material, biocompatible

PROCEEDING 18

INTRODUCTION

In recent years, the term bioceramics has been commonly mentioned in publications

or even dental product advertising, with promising outcome for the used of these materials

in medical and dentistry ield. In medical and dental perspective, bioceramics, refers to all ceramic materials that are designed for used in medical and dental practice, this

includes; alumina and zirconia, bioactive glass, glass ceramics, coatings and composites,

hydroxyapatite and resorbable calcium phosphates.1,2 The superior properties of bioceramics

are biocompatibility and the ability to conduct hard tissue formation, in other words,

these materials have great tissue response and stimulates damaged mineralized tissue

regeneration. The superior properties makes these materials remarkable to be applied in

orthopedics applications such as artiicial hip joint and bone reconstruction materials.3 In dentistry, bioceramics has been used as implant coatings and bone repair materials, more

particular in endodontics, a wide range of application has been proposed from pulp capping

materials, endodontic sealers, root end restoration material, to furcation or dentin repair

materials. This review will present a brief discussion about bioceramics materials proposed

in endodontics, from calcium hydroxide, MTA, Biodentin, iRoot SP, BioAggregate cements

based on laboratory and clinical studies.

Calcium hydroxide

In endodontics, calcium hydroxide is believed to be the most frequently material used

in clinical practices for the past years. Its biocompatibility to dental tissue, antibacterial

properties and its ability to stimulate hard tissue formation has been favorable properties to its

used in endodontics. The liberation of hydroxyl and calcium ions was believed to be its basic

mechanism of action leading to antibacterial efect (due it high pH) and activation of alkaline phosphates (ALP) involved in hard tissue formation.3 Hard tissue formation is initiated by

an inlammation process in the supericial layer of the injured pulp, that leads to supericial necrosis that eventually leads to stimulation of the pulp cells to form a repair reaction.4, 5

Moving from the favorable properties of calcium hydroxide, studies also have

reported some limitations of this compound including high solubility, degradation of material

over time, weak dentinal barrier formation, poor adhesion property to tooth structure, and

long uncontrolled chronic inlammation to the pulp.5,6,7 Lack of adhesion also lead to poor seal which contributes to failure of this material to act as a bacteriometic seal.6 Moderate

inlammation with no dentinal bridge formation was also observed in human premolar after 15 days capped with calcium hydroxide (Dycal) and most of the Dycal specimens showed

incomplete bridge formation with more inlammation of the pulp tissue.7

In this present time, calcium hydroxide comes in diferent forms speciically designed for diferent purpose, an injectable calcium hydroxide commonly used for inter-appointment dressings in root canal treatment, a paste-paste form with base and catalyst to facilitate

controlled setting reaction in pulp capping treatment, or in a combination with resin to be

light cured and used as liners or pulp capping treatment.

2017 19

Mineral Trioxide Aggregate (MTA)

MTA is a multifunctional cement design for multipurpose in endodontics, namely for

pulp capping materials, pulpotomy dressings, root end illings, furcation repair materials, dentin repair materials and apexogenesis or apexiication treatment. Since irstly introduced, MTA has been intensively investing by many studies, most studies concluded that this

material shown good cell growth ibroblast, osteoblast like cells and pulp cells. A study on rat dental pulp cells also showed that MTA induced reparative dentin formation with

minimum apoptosis compared to calcium hydroxide.9,10

Figure 1. Dentin bridge formation in rat molar at 14 days after direct pulp capping with MTA: H-E staining (a),

immunohistochemistry of nestin (b), and osteopontin (c). (a) A thin layer of ibrous matrix (arrows) is followed by a dentin-like matrix (*) with tubular structures pulpally lined with odontoblast-like cells. (b) The odontoblast-like

cells intensely express nestin, an intermediate ilament expressed in diferentiated odontoblasts. Their processes also show immunoreactivity for nestin in the tubular matrix (*). (c) Osteopontin immunoreactivity is detected in

the supericial ibrous matrix (arrows), but not in tubular dentin-like matrix (*).8

Biodentine

Biodentine is a calcium silicate based material consists of tricalcium silicate, dicalcium

silicate, calcium carbonate and oxide iller, iron oxide shade, and zirconium oxide. The liquid used for biodentin are composed of a hydrosoluble polymer and a calcium chloride as

accelerator. This material is suitable for perforation repair, retrograde illing, pulp capping, and pulptomy dressings. The strength of this material compared to other bioceramics material

such as MTA is the improvement in setting time, mechanical properties and radiopacities.11

Shorter setting time is a favorable property especially in the used for retrograde illing and perforation repair, this was achieve by adding calcium chloride in the liquid.

Biodentine was proven to be biocompatible and highly bioactive.11,12 In a 6 weeks

evaluation in human maxillary and mandibular intact molar, with deliberate mechanical pulp

exposure and capped with biodentine, there was no inlammatory response and a complete dentinal bridge formation.13The ability of Biodentine to form reparative dentin could also be

due to modulation of pulp cell TGF-1 secretion. When implanted in subcutaneous tissue of rats, it exhibited moderate inlameation in the irst 7 days, and mild or no inlammation after 14 days, the study concluded that biodentine was biocompatible with tissue after the

14th day.12

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BioAggregate

BioAggregate is a ine nanoparticle size, material, aluminum-free powder that is mixed with deionized water to form a bioceramic paste. The powder consists of SiO

2 (13.70%),

P2O

5 (3.92%), CaO (63.50%), and Ta

2O

5 (17%), the latter was to improve the radioopacitiy

of the material (tantalum oxide).14BioAggregate is indicated as pulp capping material,

perforation repair as well as root-end illings, where many in vivo reports concluded that BioAggregate are comparable to MTA.14,15,16

Figure 2. Efects of PMTA, BA, MMTA, and IRM on adhesion in HDPCs by MTT assay and SEM, respectively. An OS containing 50 mg/mL ascorbic acid and 10 mmol/L b-glycerophosphate was used

as the positive control. Cells were incubated for 3, 7, and 14 days with the materials. SEM observation

(original magniication, 1000) of HDPCs exposed to various materials was completed 2 days after incubation. Arrows indicate pulp cells. These data indings are representative of 3 independent

experiments. Statistically signiicant diference compared with each group (P < 0.05).17

As for biocompatibility, on one study comparing BioAggregate (BA) to Micromega

MTA (MMTA), ProRoot MTA (PMTA) and Intermediate Restorative Material (IRM) by using

human dental pulp cells and concluded that the irst three material exhibited equally good biocompatibility whereas IRM showed cytotoxicity (Figure 2).17 BioAggregate also increased

the alkaline phosphatase activity, promote mineralization and enhance the expression of

osteogenic/odontogenic markers (ALP, osteopontin, osteocalcin, dentin sialophosphoprotein

and dentinal matrix protein-1.17,18 Collectively, the biocompatibility, odontogenic potentials,

and inlammatory response of BioAggregate and MTA are equal. 17,18,19

2017 21

iRoot SP

iRoot SP is another bioceramics material similar to MTA, it composed mainly by

calcium silicates. iRoot SP are injectable, biocompatible, hydrophilic, radiopaque and

insoluble and indicated for root canal sealers. In the presence of water, this material can

generate calcium silicate hydrates and have highly alkaline pH which provide a detrimental

environment for bacterial growth. MTA and iRoot SP also induced human Tooth Germ

Stem Cells (hTGSCs) to diferentiate into odontoblast like cells, while calxiym hydroxide (Dycal) caused cytotoxicity.20 However according to the the same study, MTA provide more

inductive potentiall and hard generate more hard tissuer deposition than iRoot SP.

Figure 3. Immunocytochemistry staining of (a) MTA and odontogenic medium-treated cells, (b) iRoot SP

and odontogenic med- ium-treated cells, (c) odontogenic diferentiation medium-treated cells (PC) and (d) undiferentiated hTGSCs (NC) with DSP and COL1A antibodies. Scale bar: 100 lm.20

CONCLUSION

The trend of biocompatible endodontics material has shifted from bioinert to bioactive

and biodegradable materials in which the propose materials not only restore the broke

part but also to stimulate the body itself to regenerate and fulill acceptable physical and mechanical properties.

REFERENCES

1. Best SM, Porter AE, Thian ES, Huang J. Bioceramics: past, present and for the future.

J Eur Ceram Soc. 2008; 28:1319-1327.

2. Nasseh A. The rise of bioceramics. Endodontic Practice. 2009;2:17-22.

3. Ishikawa K. Calcium phosphate cement. In Bioceramics and Their Clinical Application;

PROCEEDING 22

Kokubo, T., Ed.; CRC Press: New York, NY, USA, 2008; pp. 438463.

4. Zakaria MN. Save the pulp: the essential issues on pulp capping treatment. Journal of

Dentomaxillofacial Science. 2016;2:301-305.

5. Enkel B, Dupas C, Armengol V, Adou A, Bosco J, Daculsi G, Jean A, Laboux O, LeGeros

RZ, Weiss P. Bioactive materials in endodontics. Expert Rev. Med. Devices. 2008;5(4):

475-494.

6. Cox CF, Subay RK, Ostro E, Suzuki SH. Tunnel defects in dentin bridges: their formation

following direct pulp capping. Oper Dent. 1996;21:411.

7. Parolia A, Kundabala M, Rao NN, Acharya SR, Agrawal P, Mohan M, Thomas M. A

comparative histological analysis of human pulp following direct pulp capping with

Propolis, mineral trioxide aggregate and Dycal. Australian Dental Journal. 2010;55:

5964.

8. Okiji T, Yoshiba K. Reparative Dentinogenesis Induced by Mineral Trioxide Aggregate:

A Review from the Biological and Physicochemical Points of View. International Journal

of Dentistry. 2009;1-12.

9. Asgary S, Eghbal MJ, Parirokh M, Ghanavati F, Rahimi H. A comparative study of

histologic response to diferent pulp capping materials and a novel endodontic cement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:60914.

10. Masuda-Murakami Y, Kobayashi M, Wang X, Yamada Y, Kimura Y, Hossain M,

Matsumoto K. Efects of mineral trioxide aggregate on the diferentiation of rat dental pulp cells. Acta Histochem. 2010 Sep;112(5):452-8.

11. Koubi G, Colon P, Franquin JC, Hartmann A, Richard G, Faure MO, Lambert G. Clinical

evaluation of the performance and safety of a new dentine substitute, Biodentine, in

the restoration of posterior teeth - a prospective study. Clin Oral Investig. 2013 Jan;

17(1):243-9.

12. Mori GG, Teixeira LM, de Oliveira DL, Jacomini LM, da Silva SRBiocompatibility

evaluation of biodentine in subcutaneous tissue of rats. J Endod. 2014 Sep;40(9):1485-

8.

13. Nowicka A, Lipski M, Parainiuk M, Sporniak-Tutak K, Lichota D, Kosierkiewicz A, Kaczmarek W, Buczkowska-Radliska J. Response of human dental pulp capped with biodentine and mineral trioxide aggregate. J Endod. 2013 Jun; 39(6):743-7.

14. Park JW, Hong SH, Kim JH, Lee SJ, Shin SJ. X-Ray difraction analysis of white ProRoot MTA and Diadent BioAggregate. Oral Surg Oral Med Oral Pathol Oral Radiol

Endod. 2010;109:1558.

15. El Sayed MA, Saeed MH. In vitro comparative study of sealing ability of Diadent

BioAggregate and other root-end illing materials. J Conserv Dent. 2012 Jul-Sep; 15(3): 249252.

16. Guven EP, Tas PN, Yalvac ME, Soiev N, Kayahan MB, Sahin F. In vitro comparison of induction capacity and biomineralization ability of mineral trioxide aggregate and a

bioceramic root canal sealer. International Endodontic Journal, 46, 11731182, 2013.

17. Chang SW, Lee SY, Kum KY, Kim EC. Efects of ProRoot MTA, Bioaggregate, and

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Micromega MTA on Odontoblastic Diferentiation in Human Dental Pulp Cells. J Endod. 2014;40(1):113-118.

18. Yuan Z, Peng B, Jiang H, et al. Efect of bioaggregate on mineral-associated gene 19. expression in osteoblast cells. J Endod 2010;36:11458.

20. Yan P, Yuan Z, Jiang H, et al. Efect of bioaggregate on diferentiation of human peri- odontal ligament ibroblasts. Int Endod J 2010;43:111621.

21. Guven Y, Tuna EB, Dincol ME, Ozel E, Yilmaz B, Aktoren O. Long-Term Fracture

Resistance of Simulated Immature Teeth Filled with Various Calcium Silicate-Based

Materials. Biomed Res Int. 2016; 2016:2863817.

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Review on bioceramic nanoiber using electrospinning method for dental application

N. Djustiana*, Y. Faza, A. Cahyanto

Department of Dental Materials Science and Technology, Faculty of Dentistry, Padjadjaran University, Bandung, 40132, Indonesia

ABSTRACT

Electrospinning method has been widely explored as a useful method for making

ibers network. Electrospinning can produce nano size iber from various materials and provide opportunities for application in the various ields, especially in dentistry. Furthermore, this technique has been also extended to fabricate nanoibers made of bioceramics and composite materials.Bioceramics which are brittle material had been used as a iber in combination with a polymer to improve properties of that material. The objective of this

review is about the fabrication of bioceramic nanoibers with various compositions and properties by electrospinning process in the ield of dentistry. Although some articles had covered about nanoiber applications in dentistry, however, this review not only will explore particularly bioceramic nanoiber that recently research but also inform the potential of the material properties which used in dentistry.

Keywords:Electrospinning, Nanoibers, Bioceramic

INTRODUCTION

Bioceramics are ceramic materials which are employed to repair and reconstruction

of disease and damage part of the body and produced in a variety of forms and phase.

Bioceramics have several advantages such as bioinert, bioresorbable and bioactive based

on the properties of remaining unchanged, dissolving or actively taking part in a physiological

process. Calcium phosphates, silica glass, zirconia, alumina, titania, and pyrolytic carbons

were classiied as bioceramics materials1,2,3.Nowadays ceramics nanostructured are much more attractive to study then bulk

counterparts because nano size have been proven to have improved properties and

characteristic thus allowing for opportunities in various applications 4,5.

2017 25

Electrospinning constitute a unique technique that uses electrostatic forces to

produce ine ibers. Interestingly, electrospinningcan easily fabricate one-dimensional nanostructures such as nanoibers with diameters, compositions, and morphologies could be controlled5,6. Meanwhile, producing bioceramic nanoiber by electrospinning technique ofers challenges to the process and control of the orientation7.

Electrospinning is relatively inexpensive technique that able to produce nanoibers of polymers, composites, semiconductors and ceramics. The most common electrospun

material is polymer but the ceramic iber have also been electrospun with or without the addition of polymers 8,9. Ceramic nanoiber produced by electrospinning nanoparticle along polymer followed by calcination at higher temperatures to remove polymer residues also reported7.

Basic equipments for electrospinning consist of high-voltage power supply, aluminium

foil as collector, syringe pump and metallic needle/spinneret. Beginning with load the

solution into the syringe, viscous solution will be held in the end of syringe because its

surface tension. Once high electrostatic voltage is imposed than exceeds a critical value ,

the electrostatic force overcome the solution surface tension then distort into conical shape,

well-known taylor cone. Latter, a jet will be formed then undergoes a whipping motion

due to bending instability than quickly transformed into a solid iber as a result of solvent evaporation. Eventually, the iber will deposited on collector 5,10,11.

Structure and properties of nanoiber resulted from electrospinning are inluenced by applied voltage, spinneret-collector distance, polymer low rate, spinning environment, solution concentration, solution conductivity and volatility of solvent6. The challenging to

produce bioceramics nanoiber started from preparation of a suitable solution and controlling dispersion of the nanoparticle ceramic in the solution to achieved low acceptably viscosity

before electrospinning process9.

DISCUSSION

Bioceramic nanoiber properties and application in dentistryRecently, materials with one-dimensional nanoscale have attracted the attention of

researchers due to roles of dimensionality and size that enable development an optical,

electrical, and mechanical properties and alsohave sophisticated applications12. The

advantages of nanoiber compared regular and bulk iber are mechanical and thermal properties that marked diferences while its biological properties for medical application are largely determined by the materials properties itself and nature 6,7.

In dentistry, nanoiber have been potential and progreessed for many applications e.c regeneration of pulp dentin complex, guided tissue regeneration for periodontium,

caries prevention, modiication of resin composite, implant surface modiication, cartilage regeneration, drug delivery and repair wound and oral mucosa. Most of them use polymer

as main material electrospinning13. A brief discussion about bioceramic material on some of

the applications in dentistry include the properties of the material itself will be given in the

following section.

PROCEEDING 26

Calcium phosphate

Calcium phosphate classiied into -tricalcium phosphate, -tricalcium phosphate, tetracalcium phosphate and hydroxyapatite (HAp) (Ca

10(PO

4)

6(OH)

2). The most widely

studied amongs them is hydroxyapatite because it is thermodynamically stable at

physiological pH and main mineral constituent of teeth and bone thus suitable for hard

tissue replacement implant. The irst bioceramic nanoiber were obtained by Wu et al,they produced hydroxyapatite (Ca10(PO4)6 (OH)2 (HAp) ibers by electrospinning precursor mixture of Ca(NO3)2 _ 4H2O, (C2H5O)3PO, and a polymer additive. Then they acquired pure

HAp nanoiber after calcination at 600C for 1 hour14,15. Electrospinning HAp nanoparticle and Polyvinyl alcohol had been conducted by Kim. et al, they gained HAp rod-like nanoiber which have unique physiochemical feature and promising to possess dentin regenerative

properties16. Further, composite HAp/Polycaprolactone/poly (lactid acid) nanoiber had been prepared for material scafold. It showed signiicantly higher cell proliferation of osteoblast-like cells. It concludes that this composite bioceramic nanoiber could enhance bone regeneration therefore it shows a tremendous prospect as scafold for bone tissue engineering17. Moreover,Titanium dental implants coated by poly( lactic-co-glycolic acid)

(PLGA) /collagen iber/hydroxyapatite nanoibers had been conducted and revealed much enhanced the adhesion of mesemchymal stem cells. It leads to increase the process of

osseointegration for the dental implant treatment18. On the other hand, Jose et al. tried to

improve the mechanical properties of composite PLGA/nano-HAp nanoiber for scafolds application 19. However, HAp positively inluences adhesion and proliferation of osteoblast but the mechanical properties of amorphous HAp have been reported to be unsuitable for

load-bearing applications thus it is commonly combined with natural polymer20,21.

Silica glass nanoiberSilica amorphous phases /glass is the most usually used inorganic iber for

reinforcement of dental composite. It has index refraction that greatly close to the dental

resin, equipping the composite with semitransparant surface. Silica glass nanoiber with diameter of about 400 nm is much excelled than traditional glass iber in tension and impact test. It is also raise the tensile strength, yougs modulus, and work of fracture by 12%, 33%,

and 52% respectively in comparison with epoxy resin22,23. Meanwhile, Gao et al. exhibited

improvement lexural strength and modulus as much as 44% and 29 % respectively while substitutions of traditional glass iller24.

Silica glass that incorporated in a group of surface reactive biocompatible ceramic

is named bioactive glass. It is developed at very irst time by Larry Hench and colleagues at the University of Florida in the late 1960s25. The irst electrospinning of bioactive glass is reported by Kim et al with variable diameter using a sol-gel precursor of the composition

70SiO225CaO5P2O5. It showed excellent bioactivity and osteogenic potential in

vitro by a bioactivity test and cellular response assay26. Furthermore, scafold bioactive glass nanoiber has been produced by mixing tetraethyl ortosilicate and calsium nitrate then undergo electrospinning process. Later, the nanoiber is calcinated to 600-700C to decomposed residual organic or inorganic group27. While extensively investigated for

2017 27

bone repair, bioactive glass is also researched for regeneration of soft tissue. It has shown

the ability to promote angiogenesis thus optimistically could be applied to healing the

soft tissue wounds28. Composite nanoiber made of biopolymer blend polycaprolactone-gelatin and nanoparticle bioactive glass was investigated to study the efects of materials toward odontogenic diferentiation on human dental pulp cells. The result concludesthat the composite is considered to be promising scafold for culture of human dental pulp cells and dental tissue engineering29.

Zirconia

Zirconia iber are an important category of advanced material for high strength reinforcement. There were many studies have been investigated for preparation of zirconia

iber using sol-gel spinning method and blowing spinnig but only zirconia iber 3-20 m is diameter have been prepared. Zhang and Edirisinghe did eletrospinning zirconia in instance,

iber from a suspension. The suspension containig zironia particle 5-10 nm and combined PEO and PEG and calcinated at 1200 C for 1 hour. Eventually,They gained zirconia

iber down to about 200nm with 150 nm size grain of zirconia were found 30. Zirconia, which is studied as an alternative material alumina, it possessed good biocompatibility as

ZrO2 implant then shiwed direct bone apposition as well1,31. On the other hand, Xu et al

produced zirconia-yttria (ZY), zirconia-silika (ZS) and zirconia-yttria-silica ( ZYS) nanoiber as reinforcing materials for dental composite2.

Alumina

Alumina (Al2O3) is a bioinert ceramic with the characteristics of high abrasion

resistance and chemical inertness. The biocompatibility of alumina has made it clinically

reliable for more than 30 years32. Alumina nanoiber has been produced and shown increase osteoblast adhesion compared another form nanosphere alumina and promising

as potensial material for dental application and bone tissue implant33. Alumina iber had been conducted using PVP and aluminium acetate as precursor. It resulted -alumina crystallite phase which is the the strongest, stifnest and the most stable then another phase. The diameter of the iber are found in the range of 100-500 nm by TEM study. -alumina crystalize phase had been conirmed at 1000C by XRD analysis 34,35. Moreover hao yu et al showed alumina nanoiber with diameter ranging 150-500 nm after calcining at 1200 C . Using TEM the resulting alumina iber were conirmed to be -alumina crystallite phase with crystallite size were approximately 10 nm 36.

Titania

Lim et al had successfully produced Immobilized TiO2 nanoiber by electrospinning of sol comprising PVP and TiP for implant application37. Later, Li et al. reported the

biocompatibility of BaTiO3 to have enhanced efects on the bioactivity of the nano-titania ceramics, which made the osteoblasts proliferate faster on the nano-titania ceramics in cell

culture experiments38. Silica-doped titania (SiO2/TiO2) was later reported to be biocompatible

PROCEEDING 28

with potential implant applications39. Antimicrobial activity of Zn-doped titania by Anna et al

showed the lowest concentration of Zn-doped titania nanoiber solution inhibiting the growth of S. aureus and E. coli40.

Carbon

Carbon exists in a variety of forms, including vitreous carbon and pyrolytic carbon.

Intrinsic brittleness and low tensile strength limit its use in major load bearing applications.

The key properties of pyrolytic carbon, such as biocompatibility, thrombo-resistant, good

durability, wear resistance and strength, has made it applicable in the ield of biomedical engineering41. Electrospun carbon nanotubes and nylon ibers have been successfully used to reinforce resin composites42.

CONCLUSION

There have been many researchs proved the application of nanotechnology could

greatly improve the mechanical and biological properties of materials. Electrospinning method

which can produce nano size iber gained popularity nowadays and provide opportunities for application in various ield especially in dentistry. Electrospinning is able to produce nanoiber from a various material, one of them is bioceramic. Bioceramic which have shown good biocompatibility with dental tissue were fabricated based on the need and application.

Bioceramic nanoiber has been used to reinforce the dental composite restoration. The mechanism is when the restoration under external pressure, it is susceptible to undergo

microcrack in the body of dental matrix. When the crack is coming, the gap between crack

planes bearing load constantly until bioceramic naniber are broken completely. So, the crack expansion is inhibited by the bioceramic nanoiber. Bioceramic nanoiber which are promising material not only to restore or replace the damage of the hard tissue such

as dentin, enamel and bone but also to heal wound of soft tissue like pulp and mucosal

tissue in scafold form. The mechanical response of scafold bioceramic nanoiber is the key for repair of loaded bone. The scafold should have mechanical properties approach the properties of the tissue to be replaced. Bioactive glass with compressive strength and

elastic modulus whice are comparable to human cortical bone, have potential application in

regeneration of load bearing bone. The mechanical properties of nanoiber depend on type of material, the microstructure and the fabrication method.

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