EFEK KITOSAN TERHADAP VIABILITAS SEL PUNCA LIGAMENTUM PERIODONTAL: EFFECT OF CHITOSAN ON THE VIABILITY OF PERIODONTAL LIGAMENT STEM CELL

Pada kerusakan tulang alveolar, pembentukan tulang baru dapat dirangsang oleh bahan yang bersifat merangsangosteogenesis. Kitosandapat sebagai interfase darah dan jaringan serta memiliki efek regeneratif sebagai scaffoldpada pertumbuhan tulang. Tujuannya mengamati efek kitosan terhadap sel punca PDL pada proses osteogenesis,diamati melalui viabilitas sel punca PDL. Sel punca dipanen dari apikal gigi molar 3 sehat dan gigi periodontitis,didentifikasi dengan Antibodi Stro-1. Kelompok eksperimental terdiri atas sel punca PDL yang dipapar kitosan0,025, 0,5, 0,1, 0,15, 0,2 dan 0,25% dan kelompok kontrol tanpa dipapar kitosan.Viabilitasnya diamati dengantehnik MTT. Sejumlah 10.000 sel punca PDL ditebar dalam plat kultur jaringan yang berisi 10% FBS, 10% NCS,penstrep, and 250µg/ml fungizone/amphoterisin B. Hasil penelitian menunjukkan viabilitas sel tertinggi terdapatpada kelompok sel punca PDL sehat yang dipapar kitosan 0,15%, artinya pada konsentrasi tersebut kitosanmemiliki efek tertinggi dalam menstimuli proliferasi sel. Kesimpulannya, kelompok sel punca PDL sehat yangdipapar kitosan menunjukkan viabilitas sel yang tertinggal dalam menstimulasi proliferasi sel

A LOW-DOSE LASER (DIODE LASER) APPLICATION REDUCES POCKET PERIODONTAL DEPTH AND CLINICAL ATTACHMENT LOSS

Objective: The initial therapy for chronic periodontitis is scaling and root planing (SRP), followed by non-surgical and surgical therapy. Recently, low-dose laser therapy was mentioned as an adjunctive therapy for periodontitis. This study aims to analyze the effect of degranulation using a low-dose laser (diode laser) after SRP for chronic periodontitis treatment with an attachment loss of ≤5 mm compared to SRP alone.Methods: A split-mouth design of in 158 tooth surfaces divided into two groups. The first group was treated with a low-dose laser (diode laser) after SRP, while the second group was treated with SRP only. Bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment loss (CAL) were all examined at baseline and 35 days later.Results: The results were statistically significant differences between the two groups were indicated in terms of PPD (p=0.000) and CAL (p=0.040). No significant difference was identified in terms of BOP.Conclusion: The application of a low-dose laser (diode laser) is effective in reducing PPD and CAL as an adjunct therapy in chronic periodontitis treatment

Association between Volatile Sulfur Compounds Prevotella intermedia and Matrix Metalloproteinase-8 Expression

Objective: To determine the correlation between levels of methyl mercaptan (CH3SH) hydrogen sulfide (H2S), the proportion of Prevotella intermedia (Pi), and matrix metalloproteinase-8 (MMP-8) gene expression levels in periodontitis patients accompanied by halitosis. Material and Methods: Samples were obtained from gingival crevicular fluid (GCF) in the deepest pocket and by swabbing in the tongue coating area in patients with periodontitis presenting with halitosis (n = 23) and healthy subjects as controls (n = 7). The values of CH3SH and H2S were obtained using Oral Chroma. The proportion of Pi and MMP-8 expression levels were evaluated using PCR-RT. All the result was statistically analyzed using SPSS software. Results: The levels of CH3SH and H2S in participants with PD ≥ 6 mm showed a robust negative correlation with the proportion of P. intermedia in GCF and tongue coating. No statistically significant association was detected between CH3SH and H2S levels and MMP-8 expression levels (p>0.05). Conclusion:  There is no association between CH3SH and H2S levels, the proportion of P. intermedia, and MMP-8 expression in patients with periodontitis accompanied by halitosis

EFEK KLINIS SETELAH SKELING DAN PENGHALUSAN AKAR KASUS PERIODONTITIS KRONIS POKET 4-6 MM: CLINICAL EFFECT AFTER SCALING AND ROOT PLANING IN CHRONIC PERIODONTITIS WITH 4-6 MM DEEP POCKET

Terapi periodontitis kronis poket 4-6 mm biasanya dilakukan kuretase atau operasi flep. Skeling dan penghalusan akar(SPA) dapat mengubah kondisi klinis. Tujuan penelitian untuk mengetahui efek kllinis setelah SPA pada periodontitiskronis poket 4-6 mm. Empat puluh tiga penderita periodontitis kronis dilakukan SPA pada kunjungan awal, hari ketujuh,hari ke-14, hari ke-21, bulan kedua, bulan ketiga, dan bulan keenam. Pada kunjungan awal, bulan kedua, ketiga, dankeenam, sebelum dan setelah SPA dilakukan pemeriksaan kedalaman poket dan Indeks perdarahan gingiva (PBI). Hasilpenelitian menunjukkan terdapat penurunan kedalaman poket dan indeks perdarahan gingival ( p < 0,05) antara sebelumdan sesudah SPA. Sebagai kesimpulan, SPA dapat meningkatkan kondisi klinis pada terapi periodontitis kronis poket 4-6mm

Evaluasi Pemberian Bahan Allograft dan Alloplast pada Penderita Periodontitis Agresif Menyeluruh dengan Genotipe Positif Alel 2 (+3954) Interleukin-1 Beta

Generalized aggressive periodontitis is a disease or a disorder of periodontium that occurs in people below 30 years old. These patients usually have several immune response disorders, such as defects in chemotaxis, phagocytic of neturophils and monocytes, and genetic defect. Clinically, there are generalized losses of tissue attachment with extensive, rapid and progressive alveolar bone resorption. In order to repair bone destruction, treatment that produce bone regeneration is needed, i.e. full thickness flap with bone grafting. In these cases, allograft and alloplast bone grafts were used. Allograft is derived from subjects within the same species but different individuals, whereas alloplast is foreign body embedded into the tissue (e.g. hydroxylapatite). In this report, pocket depth, papillae bleeding index (PBI), and clinical attachment were evaluated. Six month after surgery and bone grafting, there were + 4 mm decrease of pocket depths, bleeding on probing index and 3-4 mm increase of clinical attachment. Unstimulated wholes saliva were also collected for DNA isolation. The IL-1beta(+3954) genotypes were performed by Polymerase chain reaction, digested with TagI restriction enzyme and separated by gel electrophoresis. Results showed both patients bearing allele 2 homozygous of IL-1B+3954 genotype. This genotype has been identified as the one of immunogenetic factor that could affect the severity of periodontal disease. Successful treatment depends on the adequacy of oral hygiene. Patients were advised to maintain optimal oral hygiene and to do periodic check every 2-3 months.DOI: 10.14693/jdi.v15i2.7

The Role of Type-2 Diabetes Mellitus in the Progressivity of Periodontitis Stage IV Grade C: A Case Report

Background: According to the American Academy of Periodontology (AAP)’s classification of periodontal disease in 2017, diabetes mellitus is one of the grade modifiers of the progressivity of the disease, which is determined by the HbA1c level of a patient. Systemic condition is often considered as a risk factor that aggravates periodontal tissue breakdown. However, the progressivity of periodontal disease can also be found in healthy (nondiabetic) patients. Objective: To identify the role of type-2 diabetes mellitus and its effect on the severity of periodontal breakdown in periodontitis stage 4 grade C patients. Case Report: This case report describes the condition of female patients, aged 30–40 years, who presented to the periodontology clinic in RSKGM FKG UI, with the chief complaint of severe tooth mobility. The patients reported were healthy and diabetic (type-2 diabetes mellitus) patients diagnosed with periodontitis stage 4 grade C. Initial therapies were carried out, such as, such as scaling, occlusal adjustment and dental splint. Results: Clinical outcomes after one week showed no inflammation, no oedematous, no redness on gingiva and less mobility on several teeth. Both groups showed extended and aggressive progress of the disease, however, the systemic conditions also played a critical role in the overall periodontal tissue breakdown. Conclusion: Management of systemic disease is crucial in order to prevent periodontal breakdown or complications that could happen in periodontal therapies. Keywords: periodontitis, systemic disease, diabetes mellitus, case repor

RELATIONSHIP OF METHYL MERCAPTAN AND HYDROGEN SULFIDE LEVELS WITH TANNERELLA FORSYTHIA QUANTITY IN PERIODONTITIS PATIENTS WITH HALITOSIS AND DIABETES MELLITUS

Objective: Halitosis may be caused by several factors, including various types of food, periodontal diseases, layer of tongue bacteria, and systemicdisorders such as diabetes mellitus (DM), which is a chronic disease that affects the health of periodontal tissue. The present study aimed to assessthe association between the quantity of Tannerella forsythia bacteria and the levels of methyl mercaptan and hydrogen sulfide in periodontitis patientswith type 2 DM (T2DM).Methods: Gingival crevicular fluids (GCF) were collected from 20 patients who were divided into those with periodontitis and who were normoglycemic(n=8); those with periodontitis and T2DM (n=8); and healthy controls (n=4). The patients underwent intraoral periodontal tissue examination,including pocket depth, attachment loss, plaque index, calculus index, and papilla bleeding index. The quantity of T. forsythia bacteria was evaluatedusing quantitative real-time reverse transcription–polymerase chain reaction. The relationship between the number of T. forsythia bacteria and thelevels of methyl mercaptan and hydrogen sulfide in the patients was analyzed by Spearman’s correlative tests.Results: There is a weak and non-significant correlation (p>0.05) between the levels of methyl mercaptan and hydrogen sulfide and the quantity ofT. forsythia in the GCF and tongue coating of periodontitis patients with halitosis regardless of the presence of T2DM.Conclusion: This study suggests no significant relationship between the levels of methyl mercaptan and hydrogen sulfide and the quantity ofT. forsythia in periodontitis patients with halitosis and DM

PROBIOTIC LACTOBACILLUS REUTERI EFFECT’S ON THE LEVELS OF INTERLEUKIN-4 IN PERIODONTITIS PATIENTS AFTER SCALING AND ROOT PLANING

Objective: Periodontal disease is an inflammatory disease principally caused by a complex interaction between pathogenic bacteria and immuneresponses. Probiotics stimulate the immune system of the oral mucosa by increasing the production of anti-inflammatory cytokines. Interleukin-4 (IL-4) isthe anti-inflammatory cytokine that is most closely associated with the pathogenesis of periodontitis. This study assessed the effect of Lactobacillus reuteri(L. reuteri) containing probiotic lozenges toward clinical attachment loss (CAL) and IL-4 levels in periodontitis patients after scaling and root planing.Materials and Methods: Clinical samples were collected from the gingival crevicular fluid of 16 periodontitis patients with pocket depth (PD) of6 mm. The samples were divided into two groups. The non-probiotic group included periodontitis patients treated through scaling and root planing(SRP) only (n=8), whereas the probiotic group included periodontitis patients treated through SRP and probiotics (n=8). The measurements of theclinical parameters of PD and CAL were included as diagnostic criteria. Probiotic lozenges were given daily for 14 days. IL-4 levels were measured inboth groups using the enzyme-linked immunosorbent assay (ELISA) method.Results: IL-4 levels decreased in the non-probiotic group and increased in the probiotic group, but there was no statistical difference between thegroups. CAL decreased in both groups and was significantly different.Conclusion: SRP with the consumption of probiotic-containing L.reuteri in periodontitis patients resulted in decreased CAL and increased IL-4 levelscompared with SRP only

Adjunctive Intracoronal Splint in Periodontal Treatment: Report of Two Cases

Reduction of the amount of tooth roots which are embedded in their periodontium could cause tooth mobility. Splinting a weaker tooth with a more stable one, and using the principle of the multiple-root stabilization is one way to overcome tooth mobility. Temporary splinting aims to prevent pathological migration, restore masticatory function, stabilize teeth before/after surgery, and evaluate the prognosis of periodontal treatment. The use of intracoronal splint is still controversial because there are only a few studies that have evaluated the effect of splinting on periodontal health. We report two cases to evaluate the effect of intracoronal splint on periodontal treatment. Two periodontal cases that use intracoronal splint before, during, and after periodontal regenerative therapy using bone graft. Causes of tooth mobility were removed and the splinting principles, terms and guidelines were mastered to get the maximum results of periodontal treatment. Both cases were evaluated radiographically 10 months after treatment. In these cases, intracoronal splint has supported the therapy before, during, or after surgery. Splinting is only for adjunctive therapy, and does not serve as the sole method in getting occlusal stability.DOI: 10.14693/jdi.v21i3.19