3333

Dental Journal
(Majalah Kedokteran Gigi)

2024 March; 57(1): 33–37

Original article

Demineralized dentin characteristics after application of Mauli 
banana stem gel

Amy Nindia Carabelly1, Dewi Puspitasari2, Fitri Syahrina3, Maman Diki Wahyudi3, Dhya Aurellia Salsabila Karno3, -Shahida Mohd Said4

1Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Lambung Mangkurat University, Banjarmasin, Indonesia
2Department of Dental Material, Faculty of Dentistry, Lambung Mangkurat University, Banjarmasin, Indonesia
3Dentistry Programme, Faculty of Dentistry, Lambung Mangkurat University, Banjarmasin, Indonesia
4Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia

ABSTRACT
Background: Demineralization of dentin is a condition of dissolving minerals in peritubular dentin due to exposure to acids that release 
hydroxyapatite ions. To prevent dentin demineralization, a therapeutic agent that can inhibit the dissolution ability of hydroxyapatite 
ions is needed. One therapeutic agent that can be used is the Mauli banana (MB) stem gel. Purpose: To observe the characteristics of 
dentin demineralization after the use of MB stem extract gel. Methods: Mandibular incisor bovine teeth were demineralized with lactic 
acid pH 4.5 for 72 hours and then treated with 25%; 37.5%; 50%; and 62.5% MB gel and Chlorhexidine 2% for one minute. All samples 
were soaked in artificial saliva with 1 mg/ml saliva of collagenase enzyme for 24 hours. The characteristic of dentin demineralization 
was observed by using scanning electron microscope/electron dispersive X-ray spectroscopy (SEM-EDX). Results: The SEM image 
in the control, Chlorhexidine, 25%; 37.5%; 50%; and 62.5% MB gel groups showed dentinal tubules of about 3.67–4.94 µm; 3.55–4 
µm; 4.18–5.6 µm; 2.28–2.86 µm; 3.29–3.81 µm; and 2.42–3.17 µm in size. The EDX test found carbon (C), nitrogen (N), oxygen (O), 
sodium (Na), phosphorous (P), chlorine (Cl), and calcium (Ca) in all groups. The one-way Analysis of Variance (ANOVA) test results 
showed significant differences in the levels of C, N, O, Cl, and Ca between all groups, while the Na showed no significant differences. 
Conclusion: The MB can inhibit the demineralization of bovine dentin based on the decrease in the size of the dentinal tubules and 
increasing the C, O, P, and Ca.

Keywords: bovine teeth; dental caries; dentin demineralization; Mauli banana stem gel; SEM-EDX

Article history: Received 2 December 2022; Revised 15 March 2023; Accepted 4 April 2023; Published 1 March 2024

Correspondence: Amy Nindia Carabelly, Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Lambung Mangkurat 
University. Jl. Veteran No. 128B, Banjarmasin, Indonesia. Email: amy.carabelly@ulm.ac.id

INTRODUCTION

Dental caries is a hard tissue disease caused by the 
demineralization of tooth structure.1,2 The data from Basic 
Health Research in 2018 states that 93% of children between 
five and six years old in Indonesia experience tooth decay.3 
The Basic Health Research in 2018 also recorded a high 
prevalence of caries in Indonesia (88.%), including South 
Kalimantan alone (46.90%).3,4 This figure shows that caries 
are still a major global problem in dental and oral health. 
Dentin caries occur through a series of demineralization 
processes initiated by the dissolution of hydroxyapatite 
crystals, which are the inorganic components of dentin.5 
Therapy for the demineralization process focuses on 
inhibiting the dissolution of hydroxyapatite ions so that 

dentin loss due to demineralization can be prevented.5–7 
Collagen degradation markers can be observed through the 
levels of elements, such as carbon (C), calcium (Ca), oxygen 
(O), sodium (Na), and phosphorus (P).7,8 Currently, the gold 
standard for preventing dentin loss due to demineralization 
is administration of 2% Chlorhexidine (CHX), which is 
available in the form of mouthwash and gel.5,9,10 

CHX has been shown to be capable of inhibiting 
the activity of protease enzymes through a chelating 
mechanism. In this mechanism, metal ions such as zinc 
(Zn) and Ca are bound by CHX, preventing the collagen 
degradation process and stopping the demineralization 
process.11 However, continuous use of CHX in the long 
term can cause allergic reactions, have toxic effects, cause 
stains on teeth, and cause the resistance of microorganisms 

Copyright © 2024 Dental Journal (Majalah Kedokteran Gigi) p-ISSN: 1978-3728; e-ISSN: 2442-9740. Accredited No. 158/E/KPT/2021. 
Open access under CC-BY-SA license. Available at https://e-journal.unair.ac.id/MKG/index
DOI: 10.20473/j.djmkg.v57.i1.p33–37

mailto:amy.carabelly@ulm.ac.id
https://e-journal.unair.ac.id/MKG/index
https://doi.org/10.20473/j.djmkg.v57.i1.p33-37


34 Carabelly et al. Dent. J. (Majalah Kedokteran Gigi) 2024 March; 57(1): 33–37

to antibiotics.6,10,12 Therefore, it is necessary to develop 
other alternative materials, including herbal ingredients. 
Herbal ingredients have many bioactive components that 
can be used to inhibit the demineralization of teeth. One of 
the herbal ingredients that has been shown to affect caries 
and wound healing is the Mauli banana stem.13,14

Mauli banana (MB) stem is a South Kalimantan native 
plant with numerous benefits, including anti-caries activity. 
The research of Apriasari et al.14 stated that MB extract 
has effective antibacterial activity against Streptococcus 
mutans. In addition, research by Carabelly et al.15 also 
showed that this plant was able to reduce the viability 
of dual-species biofilms that cause dental caries. The 
main substance contained in MB is tannin, and many of 
the tannins found in bananas are condensed tannins or 
proanthocyanidins.16 Cinnamic acid, isoleucine, saponin, 
alkaloids, and flavonoids are among the other substances 
found in MB.14,15 The bioactive components of MB are 
known to inhibit the demineralization process in dental 
caries. This research was conducted using bovine teeth, as 
they have the same functions and biological characteristics 
as human teeth, which are 70% inorganic matter, 20% 
organic matter, and 10% water.1 Therefore, this research 
was conducted to observe the characteristics of dentin 
demineralization after the use of MB gel. 

MATERIALS AND METHODS

This research is an experimental study with a post-test 
only design with a control group design that has been 
declared ethically feasible by the Health Research Ethics 
Commission, with No.036/KEPKG-FKGULM/EC/
IV/2022. The research sample used mandibular incisor 
bovine teeth, which had intact and non-carious tooth 
crowns. The research sample was divided into six groups, 
which were treated with Mauli banana stem gel with 
the concentration of 25% (MB1); 37.5% (MB2); 50% 
(MB3); 62.5% (MB4), CHX with the concentration of 2% 
(Consepsis, USA) (CHX), and a group of with no treatment 
as a control.

MB stems were taken from Vocational High School: 
Development Agriculture (SMK-PP) Banjarbaru and 
tested for determination. The MB was taken 10 cm from 
the root corm, then cleaned, cut, and dried for three days 
using an oven at 40–60oC. The MB was then used as an 
extract by maceration method using 70% ethanol. The 
extract obtained was evaporated using a rotary vacuum 
evaporator at a temperature of 40–50oC until the resulting 
extract became thick and tested free of ethanol by adding 
potassium dichromate.2,4 The MB extract was then mixed 
with propylene, glycerin, Na-CMC, nipagin, and aquades 
and formulated into a gel.17 

The bovine incisor teeth were soaked in saline solution 
before being prepared, and then they were formed into 
dentin blocks of 10x7x4 mm. Dentin that has been 
formed into blocks is stored in a saline solution to avoid 

shrinkage. The surface of the dentin blocks was leveled 
with a carborundum disk and polished with felt paper, 
using diamond spray to keep them wet.18 The dentin blocks 
were smeared with nail polish to coat them, and an area 
of   4x3 mm remained before the demineralization stage. 
Demineralization was carried out by soaking the teeth in 
lactic acid pH 4.5 for 72 hours, and then the teeth were 
washed with deionized water and dried with absorbent 
paper.12,18 The teeth were then treated with MB1, MB2, 
MB3, MB4, and CHX therapy for one minute before being 
immersed in artificial saliva (McDougall method) with 
added collagenase enzyme (Himedia, Mumbai, India) at 
1 mg/ml saliva for 24 hours.19,20 For the negative control 
group, the teeth were immersed in artificial saliva with 
collagenase enzyme at 1 mg/ml saliva for 24 hours.

Samples were observed using scanning electron 
microscopy (SEM) (Hitachi TM3000, Japan) connected 
to energy dispersive X-ray (EDX) spectroscopy. Prior 
to observation, the sample was coated with double-sided 
carbon tape for 30 minutes. The sample was then placed in 
the SEM holder, inserted into the SEM, and then observed 
at 2000x magnification. Subsequently, the samples were 
tested using the EDX program (Quorum QR15, Japan) 
and the data results were taken based on the weight 
percentage (% weight). The data were tested statistically 
using the SPSS Version 16 (SPSS Inc., Chicago, IL, USA). 
The test was carried out using the one-way Analysis of 
Variance (ANOVA) test and continued with the LSD 
test. All p-values of <0.05 were considered statistically 
significant.

RESULTS

The results of SEM observations at 2000x magnification 
are shown in Figure 1. The SEM image of the bovine teeth 
in the control group (Figure 1A) shows the appearance 
of the dentinal tubules covered by the smear layer and 
measuring around 3.67–4.94 µm. The SEM image of the 
dentin of the CHX group of bovine teeth (Figure 1B) shows 
a picture of the dentinal tubules covered by deposits with 
a size of about 3.55–4 µm; the deposits are CHX products 
deposited on the surface. The SEM image of the dentine 
of the bovine teeth in the MB group (Figure 1C-1F) shows 
the appearance of the dentinal tubules, which are covered 
by clustered globular deposits, which are products of MB. 
The dentinal tubules covered by deposits on MB stem gel 
25% group measured approximately 4.18–5.6 µm (Figure 
1C), the MB stem gel 37.5% group measured approximately 
2.28–2.86 µm (Figure 1D), the MB stem gel 50% group 
measured about 3.29–3.81 µm (Figure 1E), and the MB 
stem gel 62.5% group measuring approximately 2.42–3.17 
µm (Figure 1F).

The results of the sample observation on SEM-EDX 
contained the elements C, N, O, Na, P, Chlorine (Cl), and 
Ca. The elemental values were taken based on the mean and 
standard deviation (mean ±SD) of the weight percentages 

Copyright © 2024 Dental Journal (Majalah Kedokteran Gigi) p-ISSN: 1978-3728; e-ISSN: 2442-9740. Accredited No. 158/E/KPT/2021. 
Open access under CC-BY-SA license. Available at https://e-journal.unair.ac.id/MKG/index
DOI: 10.20473/j.djmkg.v57.i1.p33–37

https://e-journal.unair.ac.id/MKG/index
https://doi.org/10.20473/j.djmkg.v57.i1.p33-37


35Carabelly et al. Dent. J. (Majalah Kedokteran Gigi) 2024 March; 57(1): 33–37

(% weight). The elemental values (mean±SD) based on the 
LSD test are shown in Figure 2.

Based on the results of the EDX test (% weight), the 
elements contained in the dentine of bovine teeth were 
tested using a one-way ANOVA. The one-way ANOVA test 
results showed significant differences in the elements C, N, 
O, P, Cl, and Ca with a p-value of 0.00, while the element 

Na showed no significant differences with a p-value of 0.92. 
The LSD test was performed after the one-way ANOVA 
test. The results of the LSD test (Figure 2) showed that the 
elements C, O, P, and Ca present in the MB groups were 
significantly different from the control and CHX groups. 
Element C levels in the MB4 group were significantly 
increased compared to those in the control and CHX groups. 

 
  Figure 1. Scanning electron microscopy (2000x magnification). (A) Control group. (B) CHX group. (C) MB stem gel 25% group. 

(D) MB stem gel 37.5% group. (E) MB stem gel 50% group. (F) MB stem gel 62.5% group.

  

0
5

10
15
20
25
30
35
40
45
50
55
60

C N O Na P Cl Ca

W
ei

gh
t (

%
)

C (Control) CHX (Chlorhexidine) MB1 (Mauli Banana 25%)

MB2 (Mauli Banana 37.5%) MB3 (Mauli Banana 50%) MB4 (Mauli Banana 62.5%)

a a b

c

b aa a a

ba a

c

a

a

d

a a a a a a a a ab c a a b c a b a a a
b
a a

a a b

c

b aa a a

ba a

c

a

a

d

a a a a a a a a a a a a a a a a
b
a a

d

  Figure 2. The elemental values (mean±SD) based on the LSD test. C = carbon; N = nitrogen; O = oxygen; Na = sodium; P = phosphorus;
Cl = chlorine; Ca = calcium. Identical letters represent no statistical differences (p > 0.05).

Copyright © 2024 Dental Journal (Majalah Kedokteran Gigi) p-ISSN: 1978-3728; e-ISSN: 2442-9740. Accredited No. 158/E/KPT/2021.
Open access under CC-BY-SA license. Available at https://e-journal.unair.ac.id/MKG/index
DOI: 10.20473/j.djmkg.v57.i1.p33–37

https://e-journal.unair.ac.id/MKG/index
https://doi.org/10.20473/j.djmkg.v57.i1.p33-37


36 Carabelly et al. Dent. J. (Majalah Kedokteran Gigi) 2024 March; 57(1): 33–37

Meanwhile, in the MB1 and MB2 groups, the levels were 
significantly lower than in the control and CHX groups. 
Element O, which was present in the MB1, MB2, and MB4 
groups, was significantly increased compared to the control 
and CHX groups. Element P, which was present in the MB2 
and MB3 groups, was significantly increased compared to 
the control and CHX groups. Element Ca, which was present 
in the MB2 group, was significantly increased compared to 
the control and CHX groups. Element Cl, which was present 
in the MB4 group, was significantly increased compared to 
the control, but there was no significant difference in the 
CHX group. Meanwhile, levels of the element Cl in the 
MB1 group were significantly lower than in the control 
and CHX groups. Elements N and Na, which were present 
in the MB group, were not significantly different from the 
control and CHX groups.

DISCUSSION

Demineralization is a process of dissolving mineral ions from 
the hard tissues of the teeth, and it results in the loss of the 
integrity of the tooth structure. During the demineralization 
process, hydroxyapatite crystals will dissolve first, and then 
collagen will be exposed and dissolve.6 In this study, SEM 
images showed dentinal tubules covered by a smear layer, 
which is a layer of debris formed as a result of the cavity 
preparation process. The entire dentinal tubular orifice is 
still closed.1 Administration of MB gel with concentrations 
of 25%, 37.5%, 50%, and 62.5% had an effect on the 
tooth surface after demineralization treatment. This effect 
is seen in the SEM image, which shows a deposit in the 
form of a globular formation on the dentin surface. The 
SEM observations in this study showed that the deposits 
formed by MB on the dentine surface made the size of the 
dentinal tubules in the MB 37.5% (Figure 1D), the MB 
50% (Figure 1E), and the MB 62.5% (Figure 1F) groups 
smaller than the control group (Figure 1A), and CHX group 
(Figure 1B). However, this was not the case with the MB 
25% group (Figure 1C), where the size of the dentinal 
tubules was larger than the CHX group, but still resembled 
the control group. The increased porosity of the dentinal 
tubules indicates a lot of dentine mineral loss.5

The images of SEM showing globular deposits on 
several dentin surfaces show the reaction products of the 
MB. Even though in the research procedure, after the dentin 
surface was applied, the MB stem extract was then cleaned 
and dried with cotton swab, not all of it disappeared, because 
it had reacted with the dentin surface to form a protective 
layer or physical barrier that made it more resistant to acid 
from outside. This is in line with the study of Amin et al.21 
on SEM images showing a layer of precipitate of insoluble 
complexes on the enamel surface. The reaction product 
of the grape seed extract is seen as an amorphous lump. 
Spherical globular agglomerates of different sizes were 
observed on the enamel surface. Several crystals adhered 
to each other and precipitated in the demineralized area. 

Similar SEM images were also found in propolis-treated 
dentin which also showed that, after application of propolis 
to the dentin surface, a physical barrier was formed on the 
dentin surface, making it more resistant to acid.5,21 

Dentin consists of inorganic material (50%), organic 
components (30%), and water (20%).22,23 In the present 
study, MB can inhibit the demineralization of tooth dentin’s 
demineralisation based on C, O, P, and Ca value. This study 
significantly increased the number of elements such as C, 
O, P, and Ca in this study compared to the control group 
and CHX group. C is used as a marker for the organic 
components of dentine. The organic components of dentine 
were primarily based on carbon-based molecules, and C is 
the most abundant element in organic dentin.24 Inorganic 
dentin consists of hydroxyapatite crystals, consisting of Ca, 
P, and O, with traces of Na and Cl.1,22 P and Ca are required 
for the demineralisation and remineralization processes.22,25 
The MB could not significantly increase the amounts of Na 
and Cl. N is considered a marker protein, especially the 
amino parts of peptide bonds in the organic components of 
dentine. N is the second-most abundant element after C in 
the organic components of dentin,24 but the MB in the study 
could not significantly increase the amount of N.

MB has a tannin content of 67%, and the tannins found in 
bananas are condensed tannins or proanthocyanidins.13,16,26 
Proanthocyanidins effectively strengthen the collagen fiber 
matrix, which is the organic matrix of dentin, and keep 
collagen fibers from degradation.27 Proanthocyanidins can 
inhibit demineralization by reducing collagen degradation 
by dentine proteases, inhibiting proteolytic activity, 
and protecting dentin from enzymatic degradation.27,28 
Proanthocyanidins can also be used in the dentin 
remineralization process to maintain and protect the 
collagen matrix.27 The research of Bueno et al.29 stated 
that proanthocyanidins can reduce the amount of mineral 
loss in dentine. 

The demineralization process in the control group 
occurred due to the exposed collagen matrix and caused the 
dentin collagen to dissolve. This demineralization process 
will also continue because no compounds bind P and Ca on 
the dentin surface, so low P and Ca elements were found in 
the control group.30,31 Hence, this research concluded that 
MB could inhibit the demineralization of bovine dentin. 
According to the SEM test, the dentinal tubules in the MB 
37,5%, 50%, and 62,5% groups were smaller than those in 
the control and CHX groups. According to the EDX test, 
there was a significant increase in the number of elements 
such as carbon, oxygen, phosphorous, and calcium in the 
MB groups.

REFERENCES

 1.  Mulyawan I, Danudiningrat CP, Soesilawati P, Aulanni’am A, 
Yuliati A, Suroto H, Bramantoro T, Rizqiawan A, Moon S-Y. The 
characteristics of demineralized dentin material sponge as guided 
bone regeneration based on the FTIR and SEM-EDX tests. Eur J 
Dent. 2022; 16(4): 880–5. 

Copyright © 2024 Dental Journal (Majalah Kedokteran Gigi) p-ISSN: 1978-3728; e-ISSN: 2442-9740. Accredited No. 158/E/KPT/2021. 
Open access under CC-BY-SA license. Available at https://e-journal.unair.ac.id/MKG/index
DOI: 10.20473/j.djmkg.v57.i1.p33–37

https://e-journal.unair.ac.id/MKG/index
https://doi.org/10.20473/j.djmkg.v57.i1.p33-37


37Carabelly et al. Dent. J. (Majalah Kedokteran Gigi) 2024 March; 57(1): 33–37

 2.  Astuti ND, Apriasari ML, Nahzi MYI. The effect of mauli banana 
(Musa acuminata) stem extract on macrophage in pulp inflamation 
(In vivo study in male Wistar rat (Rattusnovergicus) teeth). Dentino 
J Kedokt Gigi. 2018; 3(1): 37–42. 

 3.  Badan Penelitian dan Pengembangan Kesehatan. Laporan nasional 
riset kesehatan dasar 2018. Jakarta: Kementerian Kesehatan 
Republik Indonesia; 2018. p. 674. 

 4.  Apriasari ML, Pramitha SR, Puspitasari D, Ernawati DS. Anti-
inflammatory effect of Musa acuminata stem. Eur J Dent. 2020; 
14(2): 294–8. 

 5.  Firouzmandi M, Shafiei F, Jowkar Z, Nazemi F. Effect of silver 
diamine fluoride and proanthocyanidin on mechanical properties 
of caries-affected dentin. Eur J Dent. 2019; 13(2): 255–60. 

 6.  Mitthra S, Narasimhan M, Shakila R, Anuradha B. Demineralization 
– An overview of the mechanism and causative agents. Indian J 
Forensic Med Toxicol. 2020; 14(4): 1173–8. 

 7.  Sabel N, Robertson A, Nietzsche S, Norén JG. Demineralization of 
enamel in primary second molars related to properties of the enamel. 
Sci World J. 2012; 2012: 1–8. 

 8.  Younis SH, Obeid RF, Ammar MM. Subsurface enamel 
remineralization by Lyophilized Moringa leaf extract loaded varnish. 
Heliyon. 2020; 6(9): e05054. 

 9.  Khunkar S, Hariri I, Alsayed E, Linjawi A, Khunkar S, Islam S, 
Bakhsh TA, Nakashima S. Inhibitory effect of Salvadora persica 
extract (Miswak) on collagen degradation in demineralized dentin: 
In vitro study. J Dent Sci. 2021; 16(1): 208–13. 

10.  Puspitasari D, Herda E, Soufyan A. Effect of 2% chlorhexidine 
gluconate on the degradation of resin composite–dentin bond 
strength when using self-etch adhesive systems. Int J Appl Pharm. 
2018; 9(Special Issue 2): 45–50. 

11.  Maske TT, Kuper NK, Cenci MS, Huysmans M-CDNJM. 
Chlorhexidine, a matrix metalloproteinase inhibitor and the 
development of secondary caries wall lesions in a microcosm biofilm 
model. Caries Res. 2019; 53(1): 107–17. 

12.  Iovan A, Stoleriu S, Ghiorghe CA, Pancu G, Topoliceanu C, 
Moldovanu A, Iovan G, Andrian S. Effect of silver diamine 
fluoride and potassium iodide on artificial root caries subjected to 
demineralization. Rom J Oral Rehabil. 2021; 13(3): 82–91. 

13.  Nindia A, Aspriyanto D, Apriasari ML, Rizky S. The toxicity of 
mauli banana (Musa Acuminata) stem water extract on bone marrow 
mesenchymal stem cell in vitro. Int J Appl Pharm. 2019; 11(1): 
184–6. 

14.  Apriasari ML, Fadhilah A, Carabelly AN. Aktivitas antibakteri 
ekstrak metanol batang pisang mauli (Musa sp) terhadap 
Streptococcus mutans Antibacterial activity of methanol extract 
of mauli banana (Musa sp)stems against Streptococcus mutans. J 
Dentofasial. 2013; 12(3): 148–51. 

15.  Carabelly AN, Salsabila Karno DA, Erlita I, Trianuanty AP. Viability 
of dual-species biofilm of Streptococcus mutans and Lactobacillus 
acidophilus after application of mauli banana stem gel. Dentino J 
Kedokt Gigi. 2022; 7(1): 55–61. 

16.  Zeng X, Ding X, Pu Y, Jiang H, Du Z, Jiang W. Banana condensed 
tannins scavenge glyphosate in aqueous solution through non-
covalent interactions. LWT - Food Sci Technol. 2020; 131(March): 
109697. 

17.  Wahyudi MD, Syahrina F, Carabelly AN, Puspitasari D, 
Wasiaturrahmah Y. Formulasi dan stabilitas fisik gel ekstrak batang 

pisang mauli (Musa acuminata). Dentin J Kedokt Gigi. 2022; 4(3): 
161–5. 

18.  Boteon AP, Kato MT, Buzalaf MAR, Prakki A, Wang L, Rios D, 
Honório HM. Effect of proanthocyanidin-enriched extracts on the 
inhibition of wear and degradation of dentin demineralized organic 
matrix. Arch Oral Biol. 2017; 84: 118–24. 

19.  Aditya G, Nuraini H, Sekarini WA. Pengaruh material konservasi 
kolostrum terhadap pelepasan ion Ni. J Teknosains. 2019; 9(1): 
12–20. 

20.  Liu R-R, Fang M, Zhang L, Tang C-F, Dou Q, Chen J-H. Anti-
proteolytic capacity and bonding durability of proanthocyanidin-
biomodified demineralized dentin matrix. Int J Oral Sci. 2014; 
6(3): 168–74. 

21.  Amin R, Awad S, Abd El Sattar E. Evaluation of remineralization 
of grape seed extract versus sodium fluoride on demineralized 
primary anterior teeth: An in-vitro study. Egypt Dent J. 2019; 65(3): 
1977–84. 

22.  Shahmoradi M, Bertassoni LE, Elfallah HM, Swain M. Fundamental 
structure and properties of enamel, dentin and cementum. In: Ben-
Nissan B, editor. Advances in calcium phosphate bomaterials. Berlin, 
Heidelberg: Springer; 2014. p. 511–47. 

23.  Normayanti N, Soetojo A, Pribadi N. The difference between residual 
monomer dentin bonding HEMA and UDMA with acetone and 
ethanol solvent after binding to type I collagen. Dent J. 2018; 51(4): 
169–72. 

24.  Farzad P, Lundgren T, Al-Asfour A, Andersson L, Dahlin C. 
Integration of dental implants in conjunction with EDTA-conditioned 
dentin grafts: An experimental study. Dent J. 2021; 9(6): 63. 

25.  Irianti AN, Kuswandari S, Santoso AS. Effect of formula milk on 
the roughness and hardness of tooth enamel. Dent J. 2021; 54(2): 
78–81. 

26.  Apriasari ML, Pramitha SR, Puspitasari D, Ernawati DS. 
Expression of fibroblast growth factor-β and transforming 
growth factor-β in mauli banana stem (Musa Acuminate) extract 
gel - treated traumatic ulcer. Trop J Pharm Res. 2021; 18(3):                                                                         
527–31. 

27.  Epasinghe DJ, Kwan S, Chu D, Lei MM, Burrow MF, Yiu CKY. 
Synergistic effects of proanthocyanidin, tri-calcium phosphate and 
fluoride on artificial root caries and dentine collagen. Mater Sci Eng 
C. 2017; 73: 293–9. 

28.  Jowkar Z, Firouzmandi M, Tabibi S. The effect of proanthocyanidin 
and casein phosphopeptide‐amorphous calcium phosphate on the 
bond strength durability to caries‐affected dentin. Clin Exp Dent 
Res. 2021; 7(3): 338–43. 

29.  Bueno T, da Silva T-A-P, Rizzante F-A-P, Magalhães A-C, Rios D, 
Honório H-M. Evaluation of Proanthocyanidin-based dentifrices on 
dentin-wear after erosion and dental abrasion - In situ study. J Clin 
Exp Dent. 2022; 14(4): e366–70. 

30.  Prasetyo AI, Kunarti S, Soetojo A, Prasetyo EA. Chemical bond 
strength difference between 4-meta bonding agents with ethanol 
and acetone solvent on type I Collagen. J Int Dent Med Res. 2018; 
11(2): 567–71. 

31.  Zubaidah N, Widjiastuti I, Pribadi N, Putri FK, Muljadi RP, 
Charyadie FL, Khotimah K. The expression of tumor necrosis factor 
alpha and alkaline phosphatase due to induction of combination 
calcium hydroxides and propolis. J Int Dent Med Res. 2021; 14(2): 
543–8. 

Copyright © 2024 Dental Journal (Majalah Kedokteran Gigi) p-ISSN: 1978-3728; e-ISSN: 2442-9740. Accredited No. 158/E/KPT/2021. 
Open access under CC-BY-SA license. Available at https://e-journal.unair.ac.id/MKG/index
DOI: 10.20473/j.djmkg.v57.i1.p33–37

https://e-journal.unair.ac.id/MKG/index
https://doi.org/10.20473/j.djmkg.v57.i1.p33-37