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"Tujuan: Penelitian ini bertujuan untuk mengetahui perbandingan pengaruh saliva buatan dengan pH 4,5 terhadap kekerasan dari material restoratif bioaktif. Metode penelitian: Dalam penelitian ini dilakukan penelitian menggunakan material restorative bioaktif, Activa Bioactive (RMGI), Cention-N (RK Alkasit), Fuji II LC (RMGIC), Zirconomer (Zirconia reinforced Glass Ionomer) , dan Beautifill II LS (Giomer). Masing-masing specimen material tersebut dengan ukuran diameter 15 mm dengan tinggi 1 mm direndam dalam saliva buatan pH 4,5 selama 7 hari. Setelah 7 hari, specimen dilakukan uji kekerasan menggunakan Knoop Hardness test dengan 5 jejas per spesimen. Kemudian hasil pengujian dilakukan uji normalitas Shapiro-Wilk, dilanjutkan dengan One-Way Anova. Lalu dilakukan uji homogenitas Levene dan dilanjutkan uji Post-hoc Tamhane. Hasil: Terdapat perbedaan bermakna pada nilai kekerasan di antara material restoratif bioaktif yang diuji (One way anova, p<0,05). Dengan nilai tertinggi pada material Cention-N dan terendah material Activa Bioactive. Pada uji Post-hoc Tamhane didapati perbedaan bermakna, kecuali antara Beautifill II LS dengan Zirconomer. Kesimpulan: Setelah dilakukan perendaman pada saliva dengan pH 4,5, material Cention N memiliki nilai kekerasan tertinggi dan Material Activa yang terendah.

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Objective: This study aims to compare the effect of artificial saliva with pH 4.5 on the microhardness of bioactive restorative materials. Method: In this study, research was carried out using restorative bioactive materials, Activa Bioactive (RMGI), Cention N (RK Alkasit), Fuji II LC (RMGIC), Zirconomer (Zirconia reinforced Glass Ionomer), and Beautifill II LS (Giomer). Each specimen of the materials are made with a diameter of 15 mm and a height of 1 mm, and were immersed in artificial saliva pH 4.5 for 7 days. After 7 days the material was subjected to a microhardness tester using the Knoop Hardness test with 5 per specimen of materials. Statistic analysis were performed using Shapiro-Wilk normality test, followed by One-Way Anova. Then the Levene homogeneity test was carried out and continued with the Post-hoc Tamhane test. Result: There was a significant difference in the hardness value between bioactive restorative materials (One way ANOVA, p <0.05). With the highest value for the Cention-N material and the lowest for Activa Bioactive material. In the Post-hoc Tamhane test, there was a significant difference, except between Beautifill II LS and Zirconomer. Conclusion: After soaking in saliva with a pH of 4.5, the Cention N material had the highest hardness value and the lowest Activa Material."

"Latar Belakang: Saat ini, material restoratif bioaktif Giomer, komposit resin alkasit, dan semen ionomer kaca modifikasi resin (SIKMR) telah digunakan dalam praktik kedokteran gigi. Dalam rongga mulut, material restoratif bioaktif akan menahan gaya dari pengunyahan dan menghadapi perubahan pH. Oleh karena itu, dilakukan penelitian mengenai pengaruh pH saliva buatan terhadap kuat tekan material restoratif bioaktif. Tujuan: Penelitian ini bertujuan untuk mengetahui perbedaan nilai kuat tekan lima material restoratif bioaktif setelah perendaman dalam saliva buatan dengan pH 7 dan 4,5. Metode: Lima kelompok material digunakan dalam penelitian ini: Giomer Beautifil II LS, Zirconomer Improved, Cention N, Activa Bioactive Restorative, dan Fuji II LC Capsule. Dua belas spesimen berbentuk silinder dengan diameter 4 mm dan tinggi 6 mm dari tiap material dibagi menjadi dua kelompok perlakuan, yaitu perendaman dalam saliva buatan pH 7 dan 4,5 selama 7 hari. Spesimen diuji menggunakan Universal Testing Machine (Shimadzu AGS-X 5kN, Japan) dengan crosshead speed 0,5 mm/menit. Hasil: Hasil uji statistik menunjukkan hanya Activa Bioactive Restorative yang memiliki nilai kuat tekan setelah perendaman dalam saliva buatan pH 4,5 lebih rendah secara bermakna dari pH 7. Kesimpulan: Nilai kuat tekan material restoratif bioaktif Giomer, komposit resin alkasit, dan SIKMR secara umum tidak lebih rendah dalam saliva buatan pH 4,5 dibanding dengan pH 7.

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Background: Currently, bioactive restorative materials of Giomer, alkasite composite resin, and resin modified glass ionomer cement (RMGIC) are being used in dental practice. In the oral cavity, bioactive restorative materials will resist the load from mastication and face changes in pH. Therefore, a study on the effect of pH of artificial saliva on the compressive strength of bioactive restorative materials was conducted. Objective: This study aims to determine the differences in the compressive strength of five bioactive restorative materials after immersion in artificial saliva with a pH of 7 and 4.5. Methods: Five groups of materials were used in this study: Giomer Beautifil II LS, Zirconomer Improved, Cention N, Activa Bioactive Restorative, and Fuji II LC Capsule. Twelve cylindrical specimens with a diameter of 4 mm and a height of 6 mm of each material were divided into two groups, namely immersion in artificial saliva with a pH of 7 and 4.5 for 7 days. The specimens were tested using a Universal Testing Machine (Shimadzu AGS-X 5kN, Japan) with a crosshead speed of 0.5 mm/minute. Result:. Statistical tests showed that only Activa Bioactive Restorative had a compressive strength value after immersion in artificial saliva with a pH of 4.5 was significantly lower than pH of 7. Conclusion: The compressive strength values of bioactive restorative materials of Giomer, alkasite composite resin, and RMGIC were generally not lower in artificial saliva with a pH of 4.5 than in pH of 7."

"Penelitian ini bertujuan untuk mengetahui pengaruh lama perendaman dalam berbagai pH saliva buatan terhadap kekerasan permukaan material restoratif glass hybrid (EQUIA® FORTE Glass Hybrid Restorative System, GC Corporation, Japan). Jumlah spesimen 90 buah terbagi dalam sembilan kelompok perlakuan yaitu perendaman dalam saliva buatan dengan pH 4,5; 5,5; dan 7 dengan waktu perendaman masing-masing 1 jam, 24 jam, dan 72 jam pada suhu 37oC. Uji kekerasan permukaan menggunakan Knoop Microhardness Tester (Shimadzu HMV-G Micro Hardness Tester, Japan) dengan beban 50 gram selama 15 detik sebanyak 5 indentasi pada tiap spesimen. Hasil data dianalisis statistik dengan One-way ANOVA (p<0,05). Hasil penelitian menunjukkan terdapat perbedaan bermakna pada setiap kelompok perlakuan yaitu nilai kekerasan pada perendaman dengan larutan saliva buatan pH 4,5 dan lama perendaman 1 jam, 24 jam, dan 72 jam berturut-turut adalah sebesar 69,48 0,57 KHN, 54,76 0,23 KHN, dan 42,90 0,41 KHN. Sementara itu, nilai kekerasan dengan saliva buatan pH 5,5 dan lama perendaman 1 jam, 24 jam, dan 72 jam berturut-turut adalah sebesar 75,34 0,32 KHN, 57,45 0,47 KHN, dan 45,84 0,27 KHN. Dengan larutan saliva buatan pH 7 dan lama perendaman 1 jam, 24 jam, dan 72 jam didapatkan nilai kekerasan berturut-turut adalah 82,89 0,68 KHN, 62,49 0,37 KHN, dan 49,84 0,14 KHN. Disimpulkan bahwa dengan menurunnya pH saliva buatan dan semakin lamanya perendaman dapat menurunkan nilai kekerasan permukaan material restoratif glass hybrid.

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This study aims to determine the effect of immersion time in various pH of artificial saliva on the surface hardness of glass hybrid restorative materials (EQUIA® FORTE Glass Hybrid Restorative System, GC Corporation, Japan). There were 90 specimens (diameter 6mm, thickness 3mm), and the specimens were divided into nine groups immersed in artificial saliva with pH 4,5; 5,5; and 7 for 1 hour, 24 hours, and 72 hours at 37oC respectively. The surface hardness of each specimens were tested using Knoop Microhardness Tester (Shimadzu HMV-G Micro Hardness Tester, Japan) with 50 grams load for 15 seconds, with 5 indentations on each specimens. The statistical analysis using One-way ANOVA (p<0,05) showed that there were significant differences between each groups.

The result showed that the hardness number of the groups immersed in artificial saliva pH 4,5 for 1 hour, 24 hours, and 72 hours respectively are 69,48 0,57 KHN, 54,76 0,23 KHN, and 42,90 0,41 KHN. Meanwhile, the hardness number of the groups immersed in artificial saliva pH 5,5 for 1 hour, 24 hours, and 72 hours respectively are 75,34 0,32 KHN, 57,45 0,47 KHN, and 45,84 0,27 KHN. With artificial saliva of pH 7 for 1 hour, 24 hours, and 72 hours, the hardness number are 82,89 0,68 KHN, 62,49 0,37 KHN, and 49,84 0,14 KHN. It can be concluded that the lower pH value of artificial saliva and prolonged immersion time can reduce the surface hardness value of glass hybrid restorative materials."

"Saliva di dalam rongga mulut merupakan agen perlindungan alami karena memiliki kapasitas penyangga yang mampu menetralkan asam yang dihasilkan oleh mikroorganisme asidogenik. Seiring dengan perkembangan material restoratif, beberapa material bioaktif baru dikembangkan yang memiliki kemampuan untuk bereaksi terhadap perubahan dalam lingkungan mulut, dengan melepaskan sejumlah ion kalsium, fosfat, hidroksil, dan fluor terutama dalam kondisi asam. Oleh karena itu, maka akan lebih menguntungkan jika material restoratif bioaktif memiliki karakteristik kapasitas penyangga seperti yang dimiliki oleh saliva. Hal ini dapat memicu remineralisasi gigi dan lingkungan sekitarnya, sehingga perkembangan karies akibat suasana asam dapat dikurangi. Tujuan penelitian ini dilakukan untuk mengetahui dan membandingkan kapasitas penyangga yang dimiliki oleh material restoratif bioaktif dalam larutan kariogenik (saliva buatan pH 4,7) selama 30 menit, 60 menit, 90 menit, 120 menit, dan 150 menit. Material restoratif bioaktif yang digunakan pada penelitian ini adalah Giomer, Activa (Activa Bioactive Restorative), Cention N (Alkasit Composite Resin), Fuji II LC (RMGIC), dan Zirconomer Improved. Penelitian eksperimental laboratorik menggunakan 30 spesimen yang terdiri dari 5 kelompok material restoratif bioaktif. Spesimen berbentuk lempeng dengan diameter 15 mm dan ketebalan 1 mm yang direndam dalam 10 ml saliva buatan (pH 4,7) kemudian disimpan dalam inkubator dengan suhu (37 ± 1)oC. Uji kapasitas penyangga menggunakan pH meter (Thermo Scientific Orion Star A211 Benchtop) untuk melihat perubahan nilai pH saliva buatan setiap 30 menit sampai 150 menit. Hasil penelitian menunjukkan adanya peningkatan nilai pH saliva buatan pada seluruh kelompok material seiring dengan waktu perendaman. Berdasarkan Uji One-Way ANOVA serta Post Hoc Bonferroni dan Tamhane, terdapat perbedaan bermakna antar kelima material restoratif bioaktif, seiring dengan waktu perendaman. Namun, hanya antara material Giomer dan Activa Bioactive tidak terdapat perbedaan bermakna. Berdasarkan hasil penelitian dapat disimpulkan bahwa material restoratif bioaktif, yaitu Giomer, Activa Bioactive, Cention N, Fuji II LC, dan Zirconomer Improved memiliki kapasitas penyangga yang dapat meningkatkan pH saliva buatan (pH 4,7) ke arah lebih netral dalam 150 menit perendaman.

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Saliva in the oral cavity is a natural protective agent because it has a buffering capacity that is able to neutralize acids that produced by acidogenic microorganisms. Along with the development of restorative materials, several new bioactive materials were developed with the ability to react changes in the oral environment, by releasing a number of calcium, phosphate, hydroxyl and fluoride ions especially in acidic conditions. Therefore, it would be more advantageous if the bioactive restorative material had the buffer capacity characteristic as owned by saliva. This can induce remineralization of the teeth and the surrounding environment, so that the development of caries due to an acidic condition can be reduced. The aim of this research was to observe and compare the buffer capacity owned by bioactive restorative materials in cariogenic solutions (artificial saliva pH 4.7) during 30 minutes, 60 minutes, 90 minutes, 120 minutes, and 150 minutes. The bioactive restorative materials used in this study were Giomer, Activa (Activa Bioactive Restorative), Cention N (Alcasite Composite Resin), Fuji II LC (RMGIC), and Improved Zirconomers. The experimental research laboratory used 30 specimens consisting of 5 groups of bioactive restorative materials. Disk-shaped specimens with a diameter of 15 mm and a thickness of 1 mm were immersed in 10 ml of artificial saliva (pH 4.7) and then stored in an incubator at a temperature of (37 ± 1)oC. Buffer capacity test was conducted using a pH meter (Thermo Scientific Orion Star A211 Benchtop) to see changes in the pH value of artificial saliva every 30 minutes until 150 minutes. The results showed an increase in the pH value of artificial saliva in all groups of materials along with the immersion time. Based on the One-Way ANOVA also Post Hoc Bonferroni and Tamhane tests, showed that there were significant differences between the five materials along with the immersion time. However, only between Giomer and Activa Bioactive material there were no significant differences. Based on the research results, it can be concluded that the bioactive restorative material, namely Giomer, Activa Bioactive, Cention N, Fuji II LC, and Improved Zirconomer have a buffering capacity that can increase the pH of artificial saliva (pH 4.7) towards a more neutral direction within 150 minutes of immersion"

"Tujuan: Penelitian ini bertujuan untuk mengetahui perbedaan nilai kekerasan resin komposit microhybrid G-aenial Posterior™ setelah perendaman dalam saliva buatan dengan pH 4,5; 5,5; dan 7 selama 1 hari dan 7 hari.Metode Penelitian: Dalam penelitian ini digunakan 36 spesimen resin komposit microhybrid G-aenial Posterior™ berbentuk silinder dengan ukuran diameter 6 mm dan tebal 2 mm. Selembar mylar strip diletakkan diatas permukaan resin komposit sebelum dilakukan proses curing. Polimerisasi dilakukan menggunakan Light Curing Unit (LED DBA iLed) selama 10 detik dengan irradiansi 1200 mW/cm2. Setelah polimerisasi, spesimen direndam dalam akuades pada suhu 37oC selama 24 jam. Spesimen dibagi menjadi enam kelompok (n = 6) yaitu; perendaman pada saliva buatan pH 4,5 selama 1 hari, saliva buatan pH 5,5 selama 1 hari, saliva buatan pH 7 selama 1 hari, saliva buatan pH 4,5 selama 7 hari, saliva buatan pH 5,5 selama 7 hari, dan saliva buatan pH 7 selama 7 hari. Spesimen diuji menggunakan HMV-G Series Micro Vickers Hardness Tester (Shimadzu, Jepang) dengan beban 50 gram selama 15 detik untuk mendapatkan nilai kekerasan. Data dianalisis dengan uji statistik One-Way ANOVA dan Post-Hoc Bonferroni. Hasil Penelitian: Hasil uji statistik menunjukkan penurunan bermakna nilai kekerasan material G-aenial PosteriorTM setelah dilakukan perendaman selama 1 dan 7 hari dalam saliva buatan dengan pH 4,5; 5,5; dan 7. Nilai kekerasan tertinggi terlihat pada resin komposit microhybrid G-aenial Posterior™ setelah perendaman 1 hari pada pH saliva buatan pH 7 yaitu sebesar 19,14 ± 0,61 VHN. Sedangkan nilai kekerasan terendah terlihat pada resin komposit microhybrid G-aenial Posterior™ setelah perendaman 7 hari pada pH saliva buatan pH 4,5 yaitu sebesar 14,37 ± 0,31 VHN. Kesimpulan: Disimpulkan bahwa dengan pertambahan waktu perendaman, dan penurunan pH saliva buatan didapatkan nilai kekerasan yang menurun pada resin komposit microhybrid G-aenial PosteriorTM.

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Objective: The aim of this study was to determine the difference of Microhybrid G-Aenial Posterior™ Composite Resin hardness value after immersion in artificial saliva with pH 4.5; 5.5; and 7 for 1 day and 7 days. Method: 36 specimens of Microhybrid G-Aenial Posterior™ Composite Resin were used in this study. All materials were prepared into disk-shaped specimens of 6 mm in diameter and 2 mm in thickness. A piece of mylar strip was placed on the top of the specimens just before the polymerization. Polymerization was done using LED curing unit (LED DBA iLed) in 10 seconds with irradiance 1200 mW/cm2. After polymerization, specimens were immersed in 37C aquadest solution for 24 hours. Specimens were divided into six groups (n=6) immersed with artificial saliva pH 4,5 in a day; pH 5,5 in a day; pH 7 in a day; pH 4,5 in 7 days; pH 5,5 in 7 days; and pH 7 in 7 days. Specimens were tested with HMV-G Series Micro Vickers Hardness Tester (Shimadzu, Japan) with 50 gram indentation in 15 seconds. Data were analyzed using One-Way ANOVA and Post-Hoc Bonferroni to assess the significant differences among groups. Result: The result showed hardness significant decreased of G-aenial PosteriorTM after were immersed in 1 and 7 days in 4,5; 5,5; dan 7 pH of artificial saliva. The highest and lowest hardness value seen in microhybrid G-aenial Posterior™ composite resin after were immersed in one day with pH 7 of artificial saliva (19,14 ± 0,61 VHN) and 7 days with pH 4,5 (14,37 ± 0,31 VHN) respectively. Conclusion: It was concluded that the increased immersion time and the decrease in the pH value of the artificial saliva decreased the hardness value of the G-aenial PosteriorTM microhybrid composite resin."

"ABSTRAKDalam penggunaannya di rongga mulut, resin komposit dapat mengalami degradasi oleh asam, terutama pada pasien dengan resiko karies tinggi. Resin komposit alkasit merupakan material dual-cured yang berbasis UDMA dan mampu melepaskan ion fluor, kalsium, dan hidroksida. Adanya ion hidroksida yang dilepaskan diketahui dapat menetralkan suasana asam. Namun, belum diketahui bagaimana pengaruh pH saliva buatan terutama pH kristis hidroksiapatit dan fluoroapatit terhadap sifat kekerasan resin komposit alkasit. Penelitian ini dilakukan untuk melihat pengaruh pH saliva buatan terhadap kekerasan resin komposit alkasit polimerisasi kimia dan cahaya. Penelitian berupa eksperimental laboratorik dengan menggunakan masing-masing 48 spesimen resin komposit alkasit (Cention-N, Ivoclar-Vivadent, Liechstenstein) polimerisasi kimia dan cahaya. Spesimen berbentuk silindris dengan diameter 6 mm dan tinggi 2 mm yang dibagi menjadi 16 kelompok perendaman. Perendaman dilakukan pada pH saliva buatan 4,5 dan 5,5 dengan lama perendaman 1, 3, 5, dan 7 hari di dalam inkubator dengan suhu 37°C. Uji kekerasan menggunakan Knoop Microhardness Tester (HMV-G Shimadzu). Hasil penelitian menunjukkan adanya penurunan kekerasan pada resin komposit alkasit polimerisasi kimia dan cahaya setelah dilakukan perendaman selama 1, 3, 5, dan 7 hari dalam saliva buatan dengan pH 4,5 dan 5,5. Nilai kekerasan tertinggi terlihat pada resin komposit alkasit polimerisasi cahaya setelah perendaman 1 hari pada pH saliva buatan 5,5 yaitu 58,41±0,23 KHN. Sedangkan nilai kekerasan terendah terlihat pada resin komposit alkasit polimerisasi kimia setelah perendaman 7 hari pada pH saliva buatan 4,5 yaitu 47,38±0,49 KHN. Berdasarkan uji statistik One-way Anova terdapat perbedaan bermakna (p<0,05) antar kelompok lama perendaman pada pH saliva buatan 4,5 dan 5,5. Hasil uji statistik Independent T-test menunjukkan terdapat perbedaan bermakna (p<0,05) antar kelompok pH saliva buatan dan antar kelompok metode polimerisasi. Dapat disimpulkan bahwa terdapat penurunan nilai kekerasan resin komposit alkasit seiring dengan semakin rendahnya pH saliva buatan dan semakin lamanya perendaman dengan penurunan terbesar pada perendaman 1 hari pertama.

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ABSTRACT

In its application in the oral cavity, composite resins can be degraded by acids, especially in patients with a high caries risk. Alkasite composite resin is a dual-cured material based on UDMA and capable of releasing fluoride, calcium, and hydroxide ions. The presence of hydroxide ion which released to its environtment can neutralize the acidic condition. However, it has not yet determined how saliva pH, especially the critical saliva pH for hydroxyapatite and fluoroapatite, affects the hardness properties of alkasite composite resins. The aim of this study was to determine the effect of artificial saliva pH on the hardness of self-cured and dual-cured alkasite composite resin. This laboratory study used 48 cylindrical-shaped specimens with 6 mm in diameter and 2 mm in thickness of alkasite composite resin specimens (Cention-N, Ivoclar-Vivadent, Liechstenstein) for each polymerization methods. The specimens were divided into 16 groups for immersion in artificial saliva pH 4.5 and 5.5 and then stored in an incubator at 37°C for the next 1, 3, 5, 7 days. The hardness test was performed using a Knoop Microhardness Tester (HMV-G Shimadzu). The results showed that the hardness of self-cured and dual-cured alkasite composite resins decreased after immersion. The highest hardness value was seen in dual-cured alkasite composite resin after 1 day immersion in artificial saliva pH of 5.5 (58.41 ± 0.23 KHN). While the lowest hardness value was seen in the self-cured alkasite composite resin after 7 days immersion in artificial saliva pH 4.5 (47.38 ± 0.49 KHN). Based on the One-way Anova statistical test, there were significant differences (p <0.05) between the different immersion time groups in each artificial saliva pH. The results of the Independent T-test statistical test showed that there were significant differences (p <0.05) between the artificial saliva pH groups and between polymerization methods groups. It was concluded that there was a decrease in the hardness of alkasite composite resin along with the lower pH of artificial saliva and the increasing immersion time. The greatest decrease occured in the first day of immersion."

"Penelitian ini bertujuan untuk mengetahui pengaruh pH saliva buatan terhadap surface gloss resin komposit Giomer Bulk-Fill. Uji surface gloss menggunakan glossmeter dengan sudut pengukuran 60 . Jumlah spesimen 63 buah terbagi dalam sembilan kelompok perlakuan yaitu perendaman dalam saliva buatan dengan pH 4,5; 5,5; dan 7 dengan waktu perendaman masing-masing 1 jam, 24 jam, dan 72 jam. Hasil analisis One-way ANOVA menunjukkan perbedaan bermakna pada setiap kelompok perlakuan. Disimpulkan bahwa dengan menurunnya pH saliva buatan dapat menurunkan nilai gloss pada permukaan resin komposit Giomer Bulk-Fill.

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This study aims to determine the effect of artificial salivary pH to surface gloss of Giomer Bulk Fill composite resin restorative materials. The surface gloss were tested using glossmeter with measurement angle of 60 . The number of specimens are 63, divided into nine groups with immersion in artificial salivary pH of 4.5, 5.5, and 7 for 1 hour, 24 hours, and 72 hours at 37 C. Statistical analysis using One way ANOVA showed significant difference in each treatment group. This result suggested that the pH value reduction of artificial saliva can reduce the gloss value on the surface of giomer bulk fill composite resin."

"Penelitian ini bertujuan untuk mengetahui pengaruh lama perendaman dalam saliva buatan terhadap perubahan pH-nya dan kekasaran permukaan resin komposit Giomer Bulk-Fill. Jumlah spesimen 63 buah dibagi dalam sembilan kelompok perlakuan yaitu perendaman dalam saliva buatan pH 7; 5,5; dan 4,5 selama masing-masing 1 jam, 24 jam, dan 72 jam pada suhu 370C. Perubahan pH saliva buatan diukur menggunakan pH meter dan pengujian kekasaran permukaan spesimen menggunakan surface roughness tester. Hasil menunjukkan bahwa terdapat perbedaan yang bermakna pada setiap kelompok perlakuan.

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This study aimed to determine the effect of immersion time on artificial saliva pH changes and surface roughness of Giomer Bulk Fill composite resin. Sixty three specimens were divided into nine groups with immersion in artificial saliva pH 7, 5.5, and 4.5 for 1 hour, 24 hours, and 72 hours at 370C respectively. The changes in artificial saliva pH were measured using a pH meter and the surface roughness measured using surface roughness tester. The results showed that there were significant differences between each groups."