PENATALAKSANAAN RESESI GINGIVA DENGAN MENGGUNAKAN GINGIVA BUATAN: MANAGEMENT OF GINGIVAL RECESSION WITH THE USE OF ARTIFICIAL GINGIVA

The prevalence, extent, and severity of gingival recession increase with age and more prevalent in males. Recession is an exposure of the root surface and an apical shift of the gingival position. Recession may be localized in one tooth or a number of teeth, or it may be generalized through out the mouth. Gingival recession will be a problem when patient complained about esthetic, because teeth are seen longer . Gingival recession could happen either physiologic or pathologic. Physiologically, it usually increases with age. Pathologically, it is caused by fault tooth brushing technique, malposition, gingival inflammation, abnormal frenum attachment, and iatrogenic dentistry. Treatment of gingival recession result on esthetic problem and pain because of open dentine. Treatment could be done either with surgery or non surgery. Surgery technique can use flap non reposiotion. In this case report, patient had recession in man dible anterior region. She wanted to get esthetic appearance but she did not want to have surgery treatment. Artificial gingival was performend to cover the recession. Material of the artificial gingival is a soft liner ( chairside vinyl polysiloxane resilient denture liner ), because of good biocompatibility, nice colour and texture is invitiate real gingiva, although it has to take it off when eating and cleaning up . Main function of artificial gingival is esthetic function and cover the recession. In conclusion, after treatment showed good esthetic and patient. Beside treatment, we need to suggest patients to do plaque control and visit dentist at least twice a year

Seminar dan Pelatihan Deteksi Dini Dan Penatalaksanaan Penyakit Periodontal Dengan Obat Kumur Habatussaudah

Penyakit periodontal merupakan penyakit dengan prevalensi 67,8% berada tertinggi setelah karies gigi. Penyakit periodontal yang dibiarkan akan meningkatkan resiko penyakit sistemik seperti diabetes mellitus, penyakit jantung, dan rheumatoid arthritis. Kesehatan gigi dan mulut berpengaruh terhadap respons imun tubuh, termasuk paru-paru dan covid -19. Sebuah penelitian menyebutkan bahwa orang dengan penyakit gusi memiliki risiko lebih tinggi untuk mengalami penyakit pernapasan, seperti pneumonia, penyakit paru obstruktif kronik (PPOK), dan bronkitis. Kesehatan mulut yang tidak terjaga juga dapat meningkatkan risiko terjadinya komplikasi pernapasan pada orang dengan penyakit paru kronis. Dengan menjaga kesehatan gigi dan mulut, salah satunya dengan berkumur, dapat menurunkan risiko terkena COVID-19. Begitu masuk ke dalam rongga mulut, virus load dapat dikurangi dengan obat kumur antiseptik. Upaya inilah diharapkan dapat mengurangi resiko penyakit periodontal yang disebabkan oleh bakteri plak gigi dan resistensi host dan dapat menurunkan prevalensi penyakit periodontal dan menurunkan resiko penyakit sistemik. Melalui pelatihan dan workshop cara sederhana deteksi penyakit periodontal diharapkan dapat dapat menurunkan prevalensi penyakit periodontal dan menurunkan resiko penyakit sistemik. Universitas Airlangga memproduksi obat kumur herbal habatussaudah yang mengandung thymoquinone, flavonoid, dan minyak esensial yang berfungsi sebagai anti bakteri, antiinflamasi, anti oksidan dan diyakini dapat membunuh virus di dalam air liur orang yang terinfeksi, sehingga dapat mengurangi jumlah virus yang berkembang biak di dalam tubuh. Kebiasaan berkumur dan gargling dengan obat kumur herbal, yang disertai menyikat gigi dan flossing secara rutin, bisa menjaga kebersihan mulut dan gigi secara optimal. Dengan menjaga kebersihan rongga mulut maka resiko penyakit covid-19 dapat berkurang. Kegiatan seminar dan pelatihan berjalan lancar, antusias peserta sangat tinggi dan mengharapkan adanya kegiatan yang berkelanjutanke depannya

Inhibitory activity of jackfruit (Atrocarpus heterophyllus Lam.) leaf extract on the growth of Porphyromonas gingivalis bacteria

Background: Periodontitis is an inflammation that affects the periodontal tissue, causing pocket formation, loss of attachment, and tooth mobility. Periodontitis caused by a complex interaction between the body's immune response and microorganisms in dental plaque. One of the main agents in the etiology of chronic periodontitis is Porphyromonas gingivalis. Jackfruit (Atrocarpus heterophyllus Lam.) leaf contains active compounds such as saponin, flavonoid, and tannin. Objective: This study is aimed to determine the inhibition of jackfruit leaf extract (Atrocarpus heterophyllus Lam.) on the growth of Porphyromonas gingivalis bacteria. Method: This research is an in vitro laboratory experiment. Jackfruit leaf extraction was carried out by maceration method with 70% ethanol solvent, then diluted serially by dilution to obtain various concentrations. Concentrations used include 100%; 50%; 25%; 12.5%; 6.25%; 3.125%; 1.56%; and 0.78%. Inhibition test against Porphyromonas gingivalis bacteria was carried out by spectrophotometric method and colony count. Result: Jackfruit leaf extract with a concentration of 12.5%; 25%; 50%; and 100% can kill Porphyromonas gingivalis bacterial colonies resulting in 0 colonies. A concentration of 6.25% inhibited the growth of bacteria by 91.77%. The results of statistical tests obtained a significance value of 0.001 (P <0.05). Conclusion: Jackfruit leaf extract (Atrocarpus heterophyllus Lam.) has an inhibitory effect on the growth of Porphyromonas gingivalis bacteria with MIC values at a concentration of 6.25% and MBC at a concentration of 12.5%

Expression of Osterix and SOX9 after Administration of Gourami Fish Scale Collagen in Wistar Rats

The current goal of periodontal treatments is to regenerate periodontal tissue by adding bone grafts. Various materials are being explored as bone substitutes, including type 1 collagen. Gourami fish scales are known to be an alternative source of type 1 collagen and have potential as a substitute material for bone grafts. The objective of this study was to determine whether there is an increase in the expression of Osterix (OSX) and SOX9 after the administration of gourami (Osphronemus goramy) fish scale collagen in extracted socket Wistar rats (Rattus norvegicus). The research was conducted on 32 male Wistar rats that were classified into four groups: control groups on day 7 (K7) and day 14 (K14); and treatment groups on day 7 (P7) and day 14 (P14). The expression of OSX and SOX9 was visualized by immunohistochemical staining of bone tissue preparations by anti-OSX and SOX9 monoclonal antibodies. The ANOVA results for OSX expression had a significant difference in OSX expression between that in the control and treatment groups on day 7 and day 14. The ANOVA results for SOX9 expression on day 7 had a significant difference in SOX9 expression between that in the control and treatment groups. ANOVA results for SOX9 expression on day 14 had no significant difference in the expression of SOX9 between the treatment and control groups. The conclusion of this study was administration of Gourami scale collagen can increase the expression of OSX and SOX9 in socket’s Wistar rats

Nigella sativa toothpaste promotes anti-inflammatory and anti-destructive effects in a rat model of periodontitis

Objective: Periodontitis is an infectious disease that results in gingiva tissue damage. This study aimed to evaluate the effects of Nigella sativa (N. sativa) toothpaste in a periodontitis tissue repair based on inflammation and periodontal extracellular matrix in vivo. Design: The periodontitis disease model was developed using Wistar rats infected with Porphyromonas gingivalis (P. gingivalis). The rats were divided into three main groups as follows: those that did not receive any toothpaste treatment; those that were treated with N. sativa toothpaste twice a day (simultaneously with P. gingivalis induction); and normal healthy rats. The rats were sacrificed after 1 and 7 days of animal modeling. The number of inflammatory cells, matrix metalloproteinase (MMP)1 + and MMP8 + cells, levels of cytokines (interleukin-1β (IL-1β) and prostaglandin E2 (PGE2)) and density of collagen type 1 were determined in the gingival tissues of the rats. Results: The rats treated with N. sativa toothpaste had significantly lower numbers of neutrophils, macrophages and lymphocytes than the non-treated rats after 1 and 7 days of treatment; likewise, the levels of IL-1β and PGE2 were lower in the treated experimental rats. In addition, the group treated with N. sativa toothpaste had fewer numbers of MMP1 + and MMP8 + cells and higher collagen density after 1 and 7 days of administration. Conclusions: N. sativa toothpaste exhibited anti-inflammatory effects by reducing both inflammatory cell count and activity. Additionally, N. sativa toothpaste demonstrated anti-destructive effects on the periodontal extracellular matrix. Thus, N. sativa toothpaste might be potentially used for the management of periodontitis

EXPRESSION OF COX-2 ON DEFENSES OF THE GINGIVAL EPITHELIUM INJECTED WITH PORPHYROMONAS GINGIVALIS LIPOPOLYSACCHARIDE AFTER CURCUMIN ADMINISTRATION

The lipopolysaccharide (LPS) of Porphyromonas gingivalis is a crucial virulence factor critically involved in the regulation of immune inflammatory responses. Curcumin is a medicinal plant that can be used as an anti-inflammatory therapy. The aim of the study is to determine the role of COX-2 in the defense of the gingival epithelium in intervention by LPS P. gingivalis by administering curcumin. Forty wistar rats, aged 2-3 months divided into control and treatment group. which got 5 heads for each group. Animal production of gingivitis, performed by induction of LPS P. gingivalis is injected into the gingival sulcus of the mandibular incisor proximal portion and since 48 hours from injection of LPS P. gingivalis done giving curcumin. Days 1, 7 and 14, wistar is sacrificed according to the group and gingival epithelial tissue is taken for immunohistochemical examination procedure to determine expressions of COX-2. The result is COX-2 expression decreased after administration of curcumin in wistar treated with LPS Pg. Administration of curcumin in wistar rats after induction with LPS P. gingivalis decreased COX-2 expression. Decreased expression of inflammatory mediators can keep the gingival epithelial defenses

MEKANISME PERBAIKAN EPITEL GINGIVA TERHADAP PAPARAN LPS PORPHYROMONAS GINGIVALIS MELALUI EKSPRESI CLAUDIN-1, ECADHERIN, TLR-4, NFκB, COX-2, PGE2, DAN MMP-7 DENGAN PEMBERIAN KURKUMIN( Studi Eksperimental pada Hewan coba Rattus norvegicus Model Gingivitis )

Background : Inflammatory disease of periodontal tissue (periodontitis) is still a problem in many developing countries including in Indonesia due to its very high prevalence.The disease is an infectious inflammatory condition of the periodontal tissue caused by Porphyromonas gingivalis. Gingival epithelial plays an important role in oral tissue protection from invasion or bacterial attack. Epithelial cells act as mechanical barriers to the attack of pathogenic organisms and enhance intercellular communication through complex cell-cell junction. Administration of Curcumin is expected to increased epithelial defences. Purpose : The purpose of this study was to prove the role of Claudin-1, E-Cadherin, TLR-4, NFκB, COX-2, PGE-2, and MMP-7 in barrier epihelial in gingiva epithelium. Furthermore, recent study to examine the influence of curcumin to increased barrier epihelial in gingiva epithelium and repair the gingival epithelium damaged by exposure to LPS bacteria Pg. Methods : The experimental animals used were white rats (Rattus norvegicus), Wistar strains, males, 12 weeks old, weighing 200-250 grams. All animals adapted for 2 weeks. Then the random allocation of 40 rats divided into 8 time-based research groups. One as a healthy group and the seven others were exposed by LPS Pg. Six groups consist of three which injection by LPS Pg and three treatment groups which treatment with curcumin 1%. The other one group were control for the vehicle. Sample was taken from gingival tissue of mandibula incisors. On 1 day, 7 days and 14 days, Claudin-1, E-Cadherin, TLR-4, NFκB, COX-2, PGE-2, and MMP-7 expression were examinated by immunochemistry method. Tight junctions and adherens junction bonds were examined by Transmission Electron Microscopy (TEM). Results and discussion : In groups which injected by LPS Pg, showed an increase in TLR-4, NFκB, COX-2, PGE-2, and MMP-7 expression and decreased Claudin-1 and E-Cadherin expression (p<0,05). Administration of 1% curcumin topically can reduced TLR-4, NFκB, COX-2, PGE-2, and MMP-7 expression and increased Claudin-1 and E-Cadherin expression (p<0,05). Examination with TEM showed the bonds of tight junction (TJ) and adherent junction (AJ) in the treatment group occurred with LPS Pg showed tissue damage ie visible cell swelling, cell shrinking, and disruption of TJ and AJ. Examination with TEM showed that the bonds of tight junction (TJ) and adherent junction (AJ) in LPS Pg group with curcumin administration showed tissue repair that showed start intact cell. In this study, LPS Pg can cause decreased expression of tight junction protein, Claudin-1 and adherent junction protein, E-Cadherin. This decrease causes the tight junction and adherent junction damage that is visible from the TEM image. Administration of curcumin may increase Claudin-1 and E-Cadherin expression resulting in improved tight junction and adherent junction bonds, as seen from the TEM Conclusion : The conclusions of this study were, Claudin-1, E-Cadherin, TLR-4, NFκB, COX-2, PGE-2, and MMP-7 play an important role in barrier epithelial in gingiva epithelium. Administration of 1% curcumin topically can repair the gingival epithelium damaged by exposure to LPS bacteria Pg

Management of high frenulum and palatal gingival enlargement with frenectomy and gingivectomy

Objective : In this article, we would like to present the case management and the results obtained from an elevated frenulum combined with gingival enlargement in the midline palatal area of the maxillary central incisor. Methods: A female patient aged 24 came to RSGM UNAIR with a complaint that there was a distance between her upper front teeth that interfered with her appearance and wanted to be straightened. In the upper jaw, the patient complains of getting stuck in food too. The patient wanted treatment because after that he wanted braces treatment. The patient admitted that he had put braces on in February 2021 at the dentist and a few moments later the upper front gums were swollen and red, then the braces were removed. The last patient cleaned tartar a year ago. The patient admitted that he regularly brushes his teeth 2 times a day while bathing and that his gums sometimes bleed. Results: The surgical procedure for raising the frenulum was also approved by the patient for gingivectomy in the palatal area of the maxillary midline incisors. The procedure is performed under local anaesthesia. Control was carried out 14 days after the procedure to remove the sutures, and 1 month for monitoring, the patient did not complain of pain and there were no complaints of food being stuck between the maxillary incisors. Conclusion: management of high frenulum with frenectomy, needs to be done to prevent the continuation of diastema as well as gingival enlargement in the patient's palatal area. patients are satisfied with the results of the treatment and it is easier to clean their teeth

Application of Natural Hydroxyapatite-chitosan Powder with Concentration70:30 and 30:70 on Osteoblast Proliferation

Background: Combination of hydroxyapatite with chitosan has been concerned in local bone regeneration. Some researches have shown that combination of hydroxyapatite and chitosan has biocompability and good osteoconductivity. Neverthelles, there is no exact concentration between hydroxyapatite and chitosan which is efective on ost eoblast proliferation. Purpose: The aim of this study is comparing HA:CS with concentration 70:30 and HA:CS with concentration 30:70 on osteoblast proliferation in rabbit’s tibia. Methods: Defect was made with a diameter of 1.5 mm and a depth of 1 mm in 2 0 local rabbits. Rabbits were divided into 2 groups which are defect in group 1 received HA-CS 70:30 and defect in group 2 received HA:CS 30:70. Each of that groups was divided into 2 groups, they are 7 days and 14 days. Rabbits were sacrificed at 7 days and 14 days. The number of osteoblasts was evaluated using histologist preparations. These preparations are formed by cutting the tibia longitudinally, stained with hematoxylin eosin, and observed under light microscope. Outcome data was analyzed using statistical test One Way Anova and continued with LSD. Results: Application of HA:CS 70:30 14 days had the biggest influence on osteoblast proliferation. Conclusion: There is a significant increasement of osteoblast cell on HA:CS 70:30 application in 14 days comparing to 7 days and HA:CS 70:30 application in 14 days comparing to HA:CS 30:70 application in 14 days due to the increasement of alkaline phospatase and osteocalcin activity in high hidroxyapatite concentration. Keywords: hydroxyapatite -chitosan 70:30, hydroxyapatite-chitosan 70:30, osteoblast