AKSELERASI DIFERENSIASI OSTEOGENIK GINGIVAL MESENCHYMAL STEM CELLS DENGAN PLASMA RICH FIBRIN UNTUK EKSPANSI TULANG MAKSILA (STUDI IN VITRO)

Latarbelakang: Perawatan ortodonti dalam jangka waktu lama akan meningkatkan risiko gingivitis, resobsi akar gigi dan karies. Studi Invitro Gingival Mesenchymal Stem Cells (GMSCs) dengan Platelet Rich Fibrin (PRF) dilakukan sebagai terapi pendamping untuk mempercepat osteogenesis selama perawatan ortodonti. Tujuan: tujuan dari penelitian ini adalah mempercepat diferensiasi osteogenik GMSCs dengan PRF untuk ekspansi tulang maksila (invitro) Metode dan Material: penelitian ini merupakan penelitian eksperimental dengan desain post-test only kontrol grup. Sampel pada penelitian ini dipilih secara acak. GMSCs diisolasi dari empat tikus wistar (Rattus Novergicus) dengan berat badan 250 gram, berumur 1 bulan berjenis kelamin jantan. Jaringan gingiva rahang bawah diisolasi melalui gingivectomi. Gingiva dipotong kecil-kecil kemudian dilakukan kultur selama 2 minggu. Kultur sel dipasase setiap 4-5 hari. GMSCs pada pasase ketiga dikarakterisasi dengan marker CD34, CD45, CD44, CD73, CD90, CD105 menggunakan kromogen Fluorescein Isothiocyanate (FITC) imunositokimia (ICC) dan Flowcytometri (FC). GMSCs passase ketiga-kelima kemudian dikultur dalam enam M24 plate kultur (n=135; 3 sampel setiap grup) selama 7 hari, 14 hari, dan 21 hari dalam 3 medium kultur yang berbeda (kelompok kontrol negatif group: αModified Eagle Medium (αMEM); kelompok kontrol positif: High Glucose-Dulbecco’s Modified Eagle Medium (DMEMHG)+ medium osteogenik; kelompok perlakuan: DMEM-HG+medium osteogenik+PRF). Diferensiasi osteogenic dievaluasi melalui beberapa petanda seperti Runt-Related Transcription Factor 2 (RUNX2), Alkaline Phosphatase (ALP), Osteopontin (OSP), Osteonectin (OSN), Osteocalcin (OSC) diperiksa menggunakan ICC dan antibodi monoklonal. Hasil: GMSC mengekspresikan secara positif +CD44, +CD73, +CD90, +CD105 dan ekspresi negatif CD34, CD45. GMSC mengekspresikan secara RUNX2, BALP, OSN, OSP, OSC pada seluruh medium kultur. Pada kelompok perlakuan dijumpai ekspresi RUNX2 (14.2±1.32) dan ALP (16.1±1.12) tertinggi pada hari ketujuh sedangkan ekspresi OSC (13.5±1.29), OSP (13.00±2.00), dan OSN (14.67±2.517) tertinggi pada hari ke 21. Kesimpulan: PRF mempercepat diferensiasi osteogenik GMSCs untuk ekspansi tulang maksila (in vitro) dengan meningkatkan ekspresi RUNX2, ALP, OSN, OSP, dan OSC

Post Oral Administration of Epigallocatechin Gallate from Camelia sinensis Extract Enhances Vascular Endothelial Growth Factor and Fibroblast Growth Factor Expression during Orthodontic Tooth Movement in Wistar Rats

Background:East Java green tea leaf (Camelia sinensis) possesed active compound such as Epigallocatechin Gallate (EGCG) is well known for enhancing the bone remodelling through enhancement of Vascular Endothelial Growth Factor (VEGF) and Fibroblast Growth Factors (FGF-2). Remodelling of alveolar bone is very important to obtain optimal Orthodontic Tooth Movement (OTM) to align the tooth. Aim: To investigate the expression of VEGF and FGF-2 expression during OTM in Wistar rat after administration of EGCG from C. sinensis Extract (EGCG-CSE) Wistar rats. Material and Methods: This study was true experimental study with post-test only control group design. Twenty eight Wistar rats were randomly selected and divided into four groups accordingly; K- group which did not get both EGCGCSE administration and OTM; K+ group with OTM for 14 days, but no EGCG-CSE administration; 1 (T1) with 4 days of OTM and 7 days of EGCG-CSE administration; treatment group 2 (T2) with both 14 days OTM and EGCG-CSE administration. Ten g force/mm2 of NiTi close coil spring was installed between the upper left molars and cental insicive to move the molar mesially that induce OTM. All OTM animal model were terminated in the 14th days. Maxillary was isolated for immunohistochemistry investigation. Tukey Honest Significant Difference(HSD) was done after Analysis of Variance (ANOVA) test to investigate the significant difference betweengroups (p<0.05). Results: The highest positive VEGF expression was found in the T2 in both area. Meanwhile, the highest positive FGF-2 expression was found in the K-group in both area. There were significant different of VEGF and FGF-2 expression in both area between groups except T1 and T2. Conclusion: Post administration of EGCG-CSE can stimulate the VEGF and FGF-2 expression during OTM in Wistar rats

Immunohistochemical analysis of stem cells from human exfoliated deciduous teeth in carbonate apatite scaffold for the alveolar bone defect in Wistar rats (Rattus Novergicus)

Background: Stem cells from human exfoliated deciduous teeth (SHED) seeded in carbonate apatite scaffold (CAS) may have multiple functions that could be used to regenerate the alveolar bone defects. The purpose of this study is to examine the ability of SHED and CAS in alveolar bone defects using an immunohistochemical analysis. Methods: ten three-month-old healthy male Wistar rats (R. novergicus) that weighed between 150–250 grams (g) were used as animal models. A simple blind random sampling method was used to select the sample that was assigned to the study group for CAS and SHED seeded in CAS (n=5). The animal study model of the alveolar bone was established by extracting the anterior mandible teeth. Rodent anesthesia was applied to relieve the pain during the procedure for all test animals. Immunohistochemistry was performed after seven days to facilitate the examination of the receptor activator of NF-κβ ligand (RANKL), osteoprotegrin (OPG), transforming growth factor-β (TGF-β), vascular endothelial growth factor (VEGF), runt-related transcription factor 2 (RUNX2), alkaline phosphatase (ALP), osteocalcin, and osteopontin expression. The data was analyzed using the unpaired ttest (p<0.01) and Pearson’s correlation test (p<0.05). Results: The OPG, RUNX2, TGF-β, VEGF, ALP, osteocalcin, and ostepontin expressions were higher in SHED seeded in CAS than CAS only with a significant difference between the groups (p<0.01). Furthermore, the RANKL expression was lower in SHED seeded in CAS compared to CAS only. There was a strong reverse significant correlation between OPG and RANKL expression (p<0.05). Conclusions: The number of osteogenic marker expressing cells, suc

East Java green tea methanolic extract can enhance RUNX2 and Osterix expression during orthodontic tooth movement in vivo

Context: Alveolar bone remodeling is important to achieve an optimal Orthodontic Tooth Movement (OTM). Runt-related transcription factor (RUNX2) and Osterix (OSX) expression are important for bone Remodeling. Green tea (Camelia sinensis) can enhancing bone remodeling. Aims: To investigate the effect of a methanolic extract of green tea ( MEGT) on the OSX and RUNX2 expression during OTM in Wistar rats. Methods: The experiment with post-test only and simple random a sampling was conducted. The samples consisted of twenty-eight Wistarr ats, which were then divided into 4 groups (n=7), negative control (CN)g roup, positive control (CP) group with OTM but without MEGT administration, group with OTM for 14 days and MEGT administrationf rom day 7 to day 14 (T1), group with OTM with MEGT administration for 14 days (T2). Nickle-titanium coil spring with 10 g/mm force was placed between the incisors and the maxillary molars. MEGT was collected from East Java and identified its principal metabolite by HPLC analysis. RUNX2 and OSX expression were analyzed by utilizing Immunohistochemical analysis. Analysis of Variance (ANOVA) was performed and then continued with least significant difference (p<0.05). Results: The highest RUNX2 and OSX expression were found in the tension side of group T2 with significant difference between groups (p<0.05). The principal metabolite of the extract was identified as epigallocatechin-3-gallate (EGCG). Conclusions: Post administration of a MEGT could increase RUNX2 and OSX expression in alveolar bone of OTM Wistar rats. Part of this action could be attributed to the presence of EGCG in the extract

Computational study of Cu2+, Fe2+, Mn2+, Mn3+, Fe3+, CrO42-, Si4+, and Hg+ binding sites identification on cytokines to predict dental metal allergy: An in silico study.

Context: Metal allergy is a general term to describe allergic diseases due to the release of metal ion reactions in the body which are mediated by T cells and involve inflammatory cytokines that can cause morbidity and mortality. Molecular docking is an analysis that can be used to assess the interaction of ligand bonds with target proteins that are used to predict metal allergies caused by metal ions that stimulate cytokines. Aims: To analyze the binding sites of Cu2+, Fe2+, Mn2+, Mn3+, Fe3+, CrO42-, Si4+, and Hg+ ions on cytokines to predict dental metal allergy through a bioinformatics approach, in silico. Methods: Metal ion particles consisting of Cu2+, Fe2+, Mn2+, Mn3+, Fe3+, CrO42-, Si4+, and Hg+ were predicted to bind tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), interleukin (IL) IL-1b, IL-2, IL-4, IL-10, IL-13, IL-17, IL-23, and IL-33 act as target proteins were examined. Results: The blind docking simulation succeeded in identifying the comparison of the binding activity of metal ion particles on cytokines target proteins. The docking simulation results show that the metal ion with the most negative binding affinity value binds to the IL-17 protein. Conclusions: Metal ion particles consisting of Cu2+, Fe2+, Mn2+, Mn3+, Fe3+, CrO42-, Si4+, and Hg+ have the most negative binding affinity values for binding to IL-17 protein, which can cause allergic reactions predicted by molecular docking, in silico

The Effectiveness of Photodynamic Therapy as An Adjunct to Mechanical Debridement in Peri-Implantitis Treatment

Background: Peri-implantitis is one of many factors that can cause implant failure, with common cases ranging from 1%-47% and the highest incidence ranging from 10.7%- 47.2%. Mechanical debridement (MD) is currently the standard for peri-implantitis treatment. However, MD has limitations in the removal of infected tissue. Moreover, the rough texture of the implant’s surface and bacteria adhesion and colonization increases the difficulty in performing MD. To overcome these limitations, adjunct therapy is needed to increase peri-implantitis treatment effectiveness. One of those adjunct therapies, photodynamic therapy (PDT), is used to destroy bacterial cells and significantly reduce inflammatory cell infiltration around the implant. Purpose: To describe the effectiveness of PDT as an adjunct therapy to MD in periimplantitis treatment through narrative review. Review: PDT is effective in reducing the number of bacteria, plaque index (PI), bleeding on probing (BOP), probing depth (PD), crestal bone loss (CBL), and excessive proinflammatory cytokines (IL-6, IL-1β, TNF-α) in patients. However, the effectiveness of PDT can be influenced by several factors, including patients’ conditions, such as diabetes and smoking habits, types of photosensitizers used, and exposure time. Conclusion: PDT is an effective adjunctive therapy to MD in peri-implantitis treatment since it can improve clinical parameter values, significantly reduce P. gingivalis, and decrease proinflammatory cytokines

Profil Angular Cheilitis pada penderita HIV/AIDS di UPIPI RSUD Dr. Soetomo Surabaya 2014

Profile of Angular Cheilitis in HIV/AIDS Patients at UPIPI RSUD Dr. Soetomo Surabaya 2014. For over twenty years, human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) have become a significant public health concern, and the epidemic continues to challenge humanity. HIV related oral lesions can be used as markers of the immune status. Angular Cheilitis (AC) which is one of the seven oral manifestations which are strongly associated with HIV Infection, has been identified and internationally calibrated. The purpose of this research is to identify the Angular Cheilitis and its association with reduced Cluster of Differentiation 4 (CD4+) count in HIV/AIDS patients at Unit Perawatan Intermediet Penyakit Infeksi (UPIPI) RSUD Dr. Soetomo Surabaya. This was an Analytic observasional research with cross-sectional and total sampling method. The samples consisted of 88 HIV/AIDS patients treated in UPIPI RSUD Dr. Soetomo Surabaya from July to August 2014. The Diagnosis of Angular Cheilitis was based on clinical appearance; the oral cavities of the research subjects were examined by dentists specialized in Oral Medicine. CD4+ counts were obtained from the patient’s medical record. Eighty Eight HIV/AIDS patients were examined and there were 120 cases of oral manifestation. There were 31 cases of Angular Cheilitis (25,83%). Angular Cheilitis was found to be significantly correlated to the decrease in CD4+ cell count below 200 cells/mm3 (P< -,245). Risk Relative anaylsis concludes that HIV/AIDS patients with Candidiasis Oral 7.5 more often suffer from AC. There is a correlation between AC and OC (p<0,357). Angular Cheilitis may be used as an alternative to predict CD4+ count at field-based settings to diagnose the immunocompromised status of HIV-infected individuals

Correlation Linear Gingival Erythema, Candida Infection and CD4+ Counts in HIV/AIDS Patients at UPIPI RSUD Dr. Soetomo Surabaya, East Java, Indonesia

East Java has been 2nd highest province with HIV/AIDS cases in Indonesia on 2013. Oral manifestations are among the earliest and most important indicator of HIV infection progression. Linear Gingival Erythema (LGE) is the one of seven oral manifestation which associated with HIV Infection. Clinical feature of LGE is a distinctive fiery red band along the margin of the gingiva. The etiology and pathogenesis of LGE are still questionable, but a candidal infection and decreased of CD4+ counts has been suggested. The aim of this study was to investigate LGE with its correlation with Candida infection and decreased level of CD4+ in HIV/AIDS patient. This study was an analytical observational research with cross-sectional and total sampling method. The samples consisted of 88 HIV/AIDS patients treated in UPIPI RSUD Dr. Soetomo Surabaya from July-August 2014 were recruited for Candida microbial screening on LGE lesion. Clinical specimens including oral swabs were collected. Diagnosed of LGE by clinical appearance, the oral cavity of research subjects examined by oral medicine specialist. CD4+ counts obtained from patient's medical record. 88 HIV/AIDS patients were examined, there were 7 cases (5,83%) LGE, 7 from 7 gingival margin found Oral Candidiasis (OC) (100%). LGE was found to be significantly correlated to OC and decreased CD4+ counts < 200 cells/mm3 (p<0.05). LGE related to candida infection and decreased CD4+ counts in HIV/AIDS patients

Combination of anthocyanin ternatin and hydroxyapatite/β-tricalcium phosphate coralline as a socket preservation biomaterial in dental implant: A narrative review

Background: Tooth extraction is surgical treatment with clinical manifestation is alveolar bone resorption of 11-63% which potentially fails dental implant treatment. Socket preservation is bone regeneration treatment to minimize bone morphological changes in post-extraction using bone graft. Anti-inflammatory biomaterial is needed to modulate inflammatory cascade in the lesion. Anthocyanin ternatin is a flavonoid derived from butterfly pea (Clitoria ternatea) as an anti-inflammatory and antioxidants agent. Hydroxyapatite/β-Tricalcium Phosphate coralline (HA/β-TCP coralline) is a combination of bioceramic material from calcium carbonate heating of Porites spp. coral which has potential to induce osteogenesis, osteoinduction, and osteoconduction. Combination of Anthocyanin ternatin and HA/β-TCP coralline applied to the defect area in dried powder form to induce hard tissue regeneration. Purpose: To describe the potential of combination of Anthocyanin ternatin and HA/β-TCP coralline as a socket preservation biomaterial in dental implant. Review: Combination of Anthocyanin ternatin and dried powder HA/β-TCP coraline is applied in dental socket. Anthocyanin ternatin suppresses ROS and iNOS then inhibit NF-kB signaling pathway. Downregulation of the pathway decreases TNF-α and IL-1β/6 expression so the expression of RANKL is inhibited. Lowering of ROS followed by upregulated Ca2+ level from HA/β-TCP coralline causes the increase in DKK1 and PTEN expression so Akt and Wnt expression is induced. Upregulation of the proteins induces the BMP2/TGF-β/Smad1/5/8 signaling pathway activation manifest in the increase of Runx2, OCN, and Osx then the preosteoblast differentiation to osteoblast is increased. Conclusion: Combination of Anthocyanin ternatin and HA/β-TCP coralline is potential as socket preservation biomaterial in dental implant

High Mobility Group Box 1 and Heat Shock Protein-70 Expression Post (-)-Epigallocatechin-3-Gallate in East Java Green Tea Methanolic Extract Administration During Orthodontic Tooth Movement in Wistar Rats

Objective: To investigate the expression of High Mobility Group Box 1 (HMGB1) and Heat Shock Protein-70 (HSP-70) during orthodontic tooth movement (OTM) after (-)- Epigallocatechin-3-Gallate(EGCG) in East Java Green Tea (Camelia Sinensis) Methanolic Extract (GTME) administration in vivo. Material and Methods: 28 Wistar rats (Rattus Novergicus) was used and divided into 4 groups accordingly: K- without EGCG and OTM; K+ with OTM, without EGCG for 14 days; T1with OTM for 14 days and EGCG for 7 days; treatment group 2 (T2) with OTM and EGCG for 14 days. OTM animal model was achieved through the installation of the OTM device by means of NiTi close coil spring with 10g force placed between the first incisor and first maxillary molars. The samples were terminated on Day 14. The pre-maxillary was isolated for the immunohistochemical examination. Analysis of Variance (ANOVA) then continued with Tukey Honest Significant Difference (HSD) (p<0.05) was performed to analyze the data. Results: The highest HMGB1 and HSP-70 expression were found in the K+ group pressure side, meanwhile the lowest HMGB1 and HSP-70 expression were found in K- group tension side in the alveolar bone. There was a significant decrease of HMGB1 and HSP-70 expression in T2 compared to T1 and K+ with significant between groups (p<0.05; p=0.0001). Conclusion: The decreased expression of HMGB1 and HSP-70 in alveolar bone of OTM wistar rats due to post administration of GTME that consisted EGCG