PRINSIP DASAR PERAWATAN RESESI GINGIVA: BASIC PRINCIPLE IN THE TREATMENT OF GINGIVAL RECESSION

Resesi gingiva ditandai dengan terbukanya permukaan akar akibat migrasi marginal gingiva ke arah apikal. Kondisi initerjadi akibat kehilangan perlekatan periodontal. Resesi gingiva dapat terjadi antara lain akibat: kebersihan mulut yangburuk, cara menyikat gigi yang salah, permukaan akar yang menonjol, perlekatan frenulum yang terlalu tinggi dan traumaoklusi. Resesi gingiva umumnya menyebabkan masalah estetik bila terjadi pada gigi anterior atas. Selain itu, resesigingiva cenderung mengakibatkan peningkatan resiko hipersensitif dentin. Perawatan resesi gingiva dapat dilakukanmelalui prosedur bedah dan non bedah. Prinsip dasar perawatan resesi gingiva adalah menutup permukaan akar yangterbuka untuk memperbaiki estetik dan mengurangi hipersensitif dentin

PRINSIP DASAR PERAWATAN RESESI GINGIVA

Resesi gingiva ditandai dengan terbukanya permukaan akar akibat migrasi marginal gingiva ke arah apikal. Kondisi ini terjadi akibat kehilangan perlekatan periodontal. Resesi gingiva dapat terjadi antara lain akibat: kebersihan mulut yang buruk, cara menyikat gigi yang salah, permukaan akar yang menonjol, perlekatan frenulum yang terlalu tinggi dan trauma oklusi. Resesi gingiva umumnya menyebabkan masalah estetik bila terjadi pada gigi anterior atas. Selain itu, resesi gingiva cenderung mengakibatkan peningkatan resiko hipersensitif dentin. Perawatan resesi gingiva dapat dilakukan melalui prosedur bedah dan non bedah. Prinsip dasar perawatan resesi gingiva adalah menutup permukaan akar yang terbuka untuk memperbaiki estetik dan mengurangi hipersensitif denti

Less Invasive Vestibule Access Tunneling with Platelet-rich Fibrin Membrane for the Treatment of Gingival Recession

Aim: The aim of this study was to introduce the less invasive vestibule access tunneling in combination with platelet-rich fibrin (PRF) membrane for gingival recession treatment. Materials and methods: Seven subjects with Miller’s class I or II buccal gingival recession were selected for this study. All subjects were treated with mucogingival surgery using the less invasive vestibule access tunneling in combination with PRF membrane. Clinical examination performed on each subject and the height of gingival recession was recorded preoperatively (baseline), and at 1 and 3 months postoperatively. The data were statistically analyzed using analysis of variance (ANOVA) with post hoc Tukey’s LSD test to determine the significant difference between groups. Statistical significance level was set at 0.05. Results: The results showed that there were significant differences in recession height between baseline and both 1 month and 3 months postoperatively (p 0.05). All patients reported satisfactory esthetic results both at 1 and 3 months postoperatively. Conclusion: Mucogingival surgery using the less invasive vestibule access tunneling in combination with PRF membrane for gingival recession treatment provided optimal root coverage. Clinical significance: This article introduces a new tunnel technique in combination with PRF membrane for gingival recession treatment. Previous studies tried to make access using the tunnel technique performed through gingival sulcus. In this study, the access is performed through the vestibule region. Access from the vestibule can minimize the damage of gingival margin integrity, especially in patients with thin gingival biotype

The Effect of Papaya Seed Ethanol Extract in Vivo on The Number of Osteoblasts Cells of Periodontitis-Induced Rats

The papaya seed ethanol extract is rich in antioxidant ingredients, such as flavonoids and phenolic acids. One of the main factors causing chronic inflammatory in periodontitis is oxidative stress. Administration of papaya seed extract is assumed to increase the number of rat osteoblast cells induced periodontitis. This research was conducted to analyze the effect of papaya seed extract on osteoblasts cells of rat induced periodontitis. This research represented an experimental laboratory-based investigation involving 35 rats of the Rattus norvegicus strain divided into 5 treatment groups (K, P1, P2, P3, P4). Control group (K) was not induced by periodontitis and was not given an extract, while group P induced periodontitis using LPS Phorphyromonas gingivalis (P.gingivalis) for 7 days and continued wire mesh installation around the mandibular incisors in the form of number “8” for 7 days. P1 group was given feed only without extract, while the rest were given extract of 200 mg/kgBB, 300mg/kgBB, and 400mg/kgBB. The data obtained were analyzed with a one-way ANOVA test. The results showed that the average number of osteoblasts varied significantly between the groups. There was an increase in the average number of osteoblast cells in rat induced periodontitis after given papaya seed extract

Immunoglobulin-G level on aggressive periodontitis patients treated with clindamycin

Background: Aggressive periodontitis might occur as a result of complex interplay between bacteria and host defence, therefore, the host susceptibility plays important role. Antimicrobial agents that could enhance host defence are required. Clindamycin might influence host defence. Purpose: The purpose of this study was to determine the influence of clindamycin on level of Immunoglobulin-G (IgG) patients with aggressive periodontitis, and its mechanism. Methods: This study used the pre-test post-test control group design. Eighteen aggressive periodontitis patients were divided into 2 groups at random. Group 1 (treatment): 9 aggressive periodontitis patients were given with clindamycin of 150mg orally, 4 times a day, for 7 days. Group 2 (control): 9 aggressive periodontitis patients were given with tetracycline of 250mg orally, 4 times a day for 12 days, and then metronidazole of 200mg orally, 3 times a day for 10 days. Blood sample was collected from vena cubiti mediana. Level of IgG was measured at base line and day 28. Data were analyzed statistically by using t-test (a = 0.05). Result: Examination for IgG level showed there was significant difference between pre-test and post-test (p &lt; 0.05). Level of IgG was significantly increased after therapy, both in treatment and control group. The increase of IgG level in treatment group was not different significantly from control group (p&gt;0.05). Conclusions: This study shows that clindamycin can be used as drug of choice for the treatment of aggressive periodontitis since clindamycin can improve the immunity status of aggressive periodontitis patients.</span

Anti-inflammatory role of papaya seed extracts in inhibiting osteoclastogenesis of rats with Periodontitis

Some previous studies mentioned that papaya seed extract has anti-inflammatory activity because it contains polyphenols including phenolic and flavonoid acids. Polyphenols of the papaya seed extracts are known to inhibit the severity of periodontitis. It can prevent the release of excessive osteoclastogenesis which may promote bone resorption aggravating periodontitis. Hence, this study aims to determine the role of papaya seed extract in reducing the number of osteoclasts in rats with periodontitis. Twenty-eight male Wistar rats were divided into 4 groups of induced periodontitis using lipopolisakarida (LPS) Porphyromonas gingivalis (P. Gingivalis) and followed by wire ligature in “8” placed around the mandible mandibular incisor. The first group was given standard food without any papaya extract, while each rat in three other groups with periodontitis (P2, P3, P4) was given with Papaya seed extracts of 200 mg/kgBW, 300 mg/kgBW, and 400 mg/kgBW. Seven rats in one group were not induced by periodontitis and were fed with standard food as a control group. On the 30th day, the rat was sacrificed, and its transverse pieces of alveolar bone around the mandibular incisor were stained with Hematoxylin-Eosin. The data analyzed by one way ANOVA indicated a significant result. Thus, it is conclusive that extract of papaya seed ethanol inhibited osteoclastogenesis in Wistar rats induced with periodontitis

Bleeding management after frenectomy

Background: An Aberrant frenum is one of the predisposing factors of periodontal tissue destruction such as gingival recession. The management of an aberrant frenum can be accomplished by frenectomy procedure. The goal of frenectomy is frenum attachment repositioning. Some complications can occur after frenectomy such as pain and bleeding. The purpose of this case report is to explain the management of bleeding after frenectomy. Case: A 20 years old female feels aesthetically discomfort of upper lip. Intraoral examination found a high attachment of frenulum at the upper lip ucosal. One week after scaling frenulum is repositioned with frenectomy procedure. Methods: local anesthesia in the operating area, frenulum is incised with V shape incision using a scalpel no. 15, remove the muscle attachment, then suturing the gingiva with 4.0 silk suture. Patient were instructed restrict the movement of the lips and were prescribed antibiotics, analgesics and mouthwash. One hour after frenectomy bleeding happened in the area of operation. After evaluation on the area of operation, found bleeding with moderate intensity from the gap between gingiva that had been sutured. Case Management: Application of eriodontal dressing in the region of postoperative area to obtain a good adaptation and to cover a narrow area that is still open, thus minimizing the risk of bleeding. Control I day 11, dressing is unattached,sutures are still attached properly. Gingiva’s colour is normal. Conclusion: Periodontal dressing after frenectomy should be done to avoid the occurrence of postoperative bleeding

Rule Of Gingivectomy In Orthodontic Treatment. Case Report

Background: Gingival enlargement is a condition that commonly develops during orthodontic treatment. Orthodontic appliances are irritation and retention plaque factors holding up oral hygiene and control of gingival inflammation. Aims: This surgical procedure aims to change the bracket position apically and to control the patient’s plaque. In this case, a 16 years old man, undergoing orthodontic treatment with fixed appliances are described and treated by gingivectomy. Discussion: Periodical controls in child and adolescent are required for healthy periodontium during orthodontic therapy. Conclusion: Collaboration between orthodontist and periodontist is one of the most important keys to successful treatment

Manajemen Kosmetik Hiperpigmentasigingiva Dan Gummy Smile Untuk Mengoptimalkan Komposisi Senyum

Background: Gingival hyperpigmentation and gummy smile are major cause of patient dissatisfaction while smiling. Gingival melanin hyperpigmentation isn’t a disease, but it’s a displeasing condition because the brown-ish gingival discoloration. This problem is aggravated in patients with high smile line, called gummy smile. There are some treatments for these conditions, one of it is periodontal plastic surgery. Periodontal plastic surgery is especially rewarding in such individuals with compromised esthetics. The purpose of this case report is to explain the management and the outline of surgical procedure for this displeasing condition. Case: A18 years old woman has smile esthetic problem due to brown-ish gums and square-ish maxilla front teeth. No confidence of smiling. Patient is aesthetic demanding. Patient agrees with periodontal plastic surgery, using gingivectomy and gingival depigmentation. Case management: Gingivectomy “reverse-beveled” incision was performed first using 15C blade following bleeding point evaluation. Counturing the interdental and marginal gingiva for normal gingival curvature, then gingival depigmentation was performed using 15C blade, followed by saline irrigation. Periodontal pack was placed to protect the surgical area. Conclusion: Cosmetic management with gingivectomy and gingival depigmentation provides good results for gingival hyperpigmentation accompanied by gummy smil

Gingival Scraping untuk Depigmentasi Gingiva

Tingginya kebutuhan pasien akan penampilan yang baik, menjadikan perawatan estetik di bidang kedokteran gigi semakin berkembang dan diminati masyarakat. Salah satu perawatan estetik tersebut adalah depigmentasi gingiva. depigmentasi adalah perawatan yang bertujuan mengoreksi hiperpigmentasi gingiva yang disebabkan oleh deposisi melanin yang berlebihan oleh melanosit. Tujuan utama dari tulisan ini untuk mengetahui teknik penatalaksanaan hiperpigmentasi gingiva yang disebabkan oleh deposisi pigmen melanin. Pasien berumur 23 tahun datang dengan keluhan gusi depan berwana kehitaman. Pasien mengeluhkan warna kehitaman tersebut karena mengganggu estetik ketika tersenyum. Pasien mengaku tidak merokok. Depigmentasi dilakukan pada regio gingiva anterior atas menggunakan scalpel nomor 15. Bagian interdental dihaluskan menggunakan pisau orban kemudian irigasi dengan larutan salin steril. Pack periodontal pada daerah operasi. Gingiva depigmentasi adalah prosedur bedah yang paling sering digunakan pada kasus pigmentasi dan perawatan ini dapat mengembalikan estetika gingiva. Penyembuhan pada gingiva dalam perawatan ini cukup baik tanpa adanya infeksi dan rasa sakit berlebihABSTRACT: Gingival scraping for gingiva depigmentation. The patients high demand for making excellent appearance, make good aesthetic treatments in the field of dentistry and the growing public interest. One of these is the aesthetic treatment is gingival depigmentation. gingival pigmentation is a treatment aimed at correcting the gingival hyperpigmentation caused by excessive deposition of melanin by melanocytes. The main purpose of this paper to learn management techniques gingival hyperpigmentation caused by deposition of melanin pigment. 22-year-old patient came to the front of the black-colored gum complaints. Patients complained about the black color because it disturbs the esthetic when smiling. Patients admitted to not smoke. Gingival pigmentation performed on upper anterior region using a scalpel number 15. The interdental smoothed using a knife orban then irrigated with sterile saline solution. Periodontal pack on the area of operation. Gingival pigmentation is a surgical procedure that is most often used in cases of pigmentation and this treatment can restore the gingival aesthetic. Healing of the gingiva in this treatment quite well without the presence of infection and excessive pain