THE EFFECTS OF PANORAMIC RADIOGRAPHY ON GINGIVAL CREVICULAR FLUID VOLUME IN GINGIVITIS

Background: Gingival crevicular fluid (GCF) is a biological fluid derived from the gingival sulcus and can be elevated in the inflammatory state of periodontal tissue, such as gingivitis. In previous studies, the number of GCF could also increase after panoramic radiographic exposure. Increase in GCF due to panoramic radiography is a sign of cell damage. Objective: To analyze the effects of panoramic radiography on the volume of GCF in wistar rats with gingivitis. Method: This type of research was true experimental with post test only and control group design. The sampling technique used was simple random sampling. A total of 25 wistar rats were classified into two control groups without exposure (state without gingivitis and gingivitis) and three groups treatment of exposure (state of gingivitis with 1 time, 2 times, and 3 times the exposure). GCF sampling using filter paper was carried out 10 minutes after panoramic radiographic exposure. The filter paper was stained by 2% ninhydrin solution, after that the GCF volume was calculated. Results: There was a significant difference in the number of GCF (p<0.05) in the group without gingivitis and exposure compared to all other groups, the gingivitis group without exposure compared to the gingivitis group with 3 times exposure, and the gingivitis group with 1 time exposure compared to the gingivitis group 3 times with exposure. Conclusion: Panoramic radiography can cause an increase in the volume of GCF in wistar rats with gingivitis. Keywords: GCF, gingivitis, panoramic radiography

THE EFFECT OF LACTIC ACID AND ARTIFICIAL SALIVA SOLUTION IMMERSION TO THE RELEASE OF CALCIUM IONS ON BIOACTIVE RESIN

Background: Bioactive resin can release calcium ions when contact with solution media, even in acid condition. In the oral cavity, pH may change into acid condition due to the metabolic results of Streptococcus mutans. The bacteria metabolize carbohydrates into organic acids, one of which is lactic acid. Purpose: Analyze the effect of lactic acid solution and artificial saliva on the number of the release of calcium ions of bioactive resin. Methods: Forty-two specimens (diameter 15 mm x thickness 1 mm; n= 7/group fabricated with Activa™ Bioactive Restorative (Pulpdent). The specimens that meet the criteria were divided into 6 groups. The specimen was immersed for 1 and 7 days in the incubator at 37oC. The number of calcium ion release is measured using titration method. Results: Two Way Anova test and Post Hoc Bonferonni test showed there were significant differences among all group for lactic acid 1 day (4.040 ± 0.360) µg, artificial saliva 1 day (0.640 ± 0.338) µg, distilled water 1 day (1.040 ± 0.504) µg, lactic acid 7 days (5.400 ± 0.312), artificial saliva 7 days (1.640 ± 0.215) µg, distilled water 7 days (3.520± 0.356 µg). Conclusion: There was an influence of lactic acid and artificial saliva on the number of calcium ion releases of bioactive resin. Immersion of bioactive resin in the lactic acid solution increase the calcium ion releases and artificial saliva decrease the calcium ion release compared to distilled water. Keywords: artificial saliva, bioactive resin, calcium ion release, lactic acid

THE COMPARISON OF RAMANIA (Bouea macrophylla Griff) AND BINJAI (Mangifera caesia) LEAVES EXTRACT GEL EFFECT ON COLLAGEN DENSITY

Background: The extract of ramania Bouea macrophylla Griff) and binjai (Mangifera caesia) leaf have flavonoid compounds that function as antioxidants to balance the amount of Reactive Oxygen Species (ROS) in tissues and optimize wound healing by helping synthesis of hydroxyproline which is used as a collagen synthesis material. Objective: To compare the effect of 15% concentration of ramania leaf extract gel, 15% concentration of binjai leaf extract gel on collagen density in back incision wounds of male Wistar rats on day 7 and day 14. Methods: This study used a true experimental design with a posttest-only with control group design. The study sample used male wistar rats that were healthy and active, aged 2-3 months with a body weight of 250-300 grams. The total sample was 18 rats divided into 6 groups. The 15% concentration of ramania and binjai leaves was given topically, then the rats were euthanized on the 7th and 14th day. Collagen index measurement was using hydroxyproline concentration. Results: Two-way Anova data analysis showed a significant value of 0.00 (p<0.05), which means that there was a difference in effect between the treatment gel and wound day. Bonferroni Post Hoc test showed a significant value in all treatment gel groups. Conclusion: There is a difference in the effect of 15% concentration of ramania leaf extract gel and 15% concentration of binjai extract gel on collagen density. Binjai leaf extract gel at 15% concentration is more effective for collagen density than Ramania leaf extract at 15% concentration and placebo. Keywords : Binjai Leaf Extract Gel, Collagen, Hydroxyproline, Ramania Leaf Extract Gel.

RISK FACTORS OF ANGULAR CHEILITIS AT GUSTI HASAN AMAN DENTAL HOSPITAL SOUTH KALIMANTAN

Background: The second highest burden of all diseases in world population includes infectious disease with a total of 28% cases. Angular cheilitis is an infectious condition on the corner of the mouth that may initiate masticatory, facial expression and speech dysfunction due to the involvement of orbicularis oris muscle surrounding the lips. The management of angular cheilitis comprises the elimination of causative microbes using antifungal agent. Therapeutic failure reveals the disregard of any related risk factor. Purpose: To analyze the risk factors of angular cheilitis in Gusti Hasan Aman Dental Hospital year 2019. Method: This study resorted analytical descriptive design of quantitative approach using cross-sectional method. Samples were 65 dental statuses of patients in Oral Medicine Clinic of Gusti Hasan Aman Dental Hospital year 2019. Result: Univariate data analysis presented the distribution of children category aged ≤ 18 years old (75.8%), men (54.8%), not consuming vegetable and fruit behaviour (46.8%), duration of treatment 1-7 days (56.4%), and incidence of angular cheilitis (75.8%). Fisher exact test unveiled the relationship between age and angular cheilitis (p<0.05) in which age ≤ 18 years old was 4.266 fold higher to experience angular cheilitis, while the relationship between gender and angular cheilitis (p<0.05) demonstrates the predilection of male with 4.853 fold at risk than female. Conclusion: Age and gender are risk factors in the incidence of angular cheilitis at Gusti Hasan Aman Dental Hospital year 2019. Keywords : Age, Angular Cheilitis, Behavior, Gender

EFFECTS OF RED DRAGON FRUIT PEEL EXTRACT ADMINISTRATION ON NEUTROPHIL COUNTS FOLLOWING PERIAPICAL RADIOGRAPHY EXPOSURE

Background: Radiation exposure from periapical imaging can cause cell damage in various tissues due to the formation of free radicals. Cell damage in the tissue can be observed from the number of neutrophils which are immune cells. Free radicals can be suppressed by administering exogenous antioxidants. One source of natural antioxidants is red dragon fruit, especially on its peel. Objective: To analyze the effect of periapical imaging x-ray radiation exposure after the administration of red dragon fruit peel extract on absolute neutrophil counts in mice. Method: This research was a true experimental study with a post-test only and control group design using 24 mice that were divided into 6 groups. The control group was not given any treatment while P1 to P5 group were given red dragon fruit peel extract at a dose of 100 mg/kg BW and exposed to radiation with different exposures. P1 group was exposed 1 time (0.63 mGy), P2 group was exposed 4 times (1.66 mGy), P3 group was exposed 8 times (4.37 mGy), P4 group was exposed 12 times (8.19 mGy), and group P5 was given no exposure. Results: There were changes in the number of neutrophils in all groups. The LSD Posthoc test results showed a significant difference between the control group (12.470 / mm3) and the P5 group (12.470 / mm3) compared to P3 group with 8 times exposure (40.348 / mm3). Conclusion: There is an effect of periapical radiographic x-ray radiation exposure by red dragon fruit peel extract on the absolute neutrophil count in mice. Keywords: Antioxidants, Neutrophils, Periapical Radiography, Radiation, Red Dragon Fruit Peel.

COMPARISON OF APICAL LEAKAGE VALUE BETWEEN EUCALYPTOL AND ORANGE OIL AS GUTTA PERCA SOLVENT

Background: The success or failure of root canal treatment is influenced by anatomical factors of the root canal, bacterial infection that causes inadequate hygiene, formation and filling of root canals, iatrogenic factors and several other factors. The average success of root canal treatment is 86-95%, while the failure of canal treatment ranges from 5-14%. Root canal re-treatment can be performed in the event of failure of root canal treatment. The method that can be used is gutta percha solvent. The gutta percha solvents used were Chloroform, Eucalyptol, Orange Oil, and Xylene, but chloroform has been categorized as a carcinogenic substance. Guta percha solvent can cause the intercrystalline distance to be larger, so that it can damage the apical density at obturation. This can create a gap between the gutta percha and the sealer which can cause apical leakage. Objective: To compare the value of apical leakage after root canal re-treatment between gutta percha solvent eucalyptol and orange oil. Method: The research method used is True Experimental with post-test only with control group design. A minimum sample of 8 teeth in a group. Total samples from all groups were 24 teeth. The teeth were stained using methylene blue and measured using stereomycroscopes. Results: the highest mean apical leakage was eucalyptol (4.55±2.59), xylene (2.77±1.94), and the lowest was citrus oil (2.20 ±1.06). The results of One-Way ANOVA test showed that there were no significant differences between orange oil, eucalyptol, and xylene (positive control). Conclusion: Eucalyptol has a higher average apical leakage value compared to orange oil and Xylene after root canal re-treatment as a gutta percha solvent. There was no significant difference between orange oil, Eucalyptol, and Xylene.Keywords: Apical leakage, eucalyptol, orange oil

THE EFFECT OF PREGNANCY MILK ON THE EXPRESSION OF KALLIKREIN RELATED PEPTIDASE-4 (KLK-4) AND COLLAGEN TYPE 1 (Coll-1) IN AMELOGENESIS

Background: Tooth development during embryonic period is a complex process and requires adequate nutrients for the formation of healthy dental tissues. Kallikrein-related peptidase-4 (KLK-4) and collagen type 1 (Coll-1) are serine proteinases secreted by ameloblast during the transition and maturation stages of the amelogenesis processes, functioning to degrade the protein matrixes, so that the enamel can reach its final hardness. Pregnancy milk contains various nutrients expected to increase the KLK-4 expression of ameloblast cells in tooth development processes Purpose: This study aimed at determining the influence of pregnancy milk on the KLK-4 and collagen type 1 (Coll-1) expression of ameloblast cells in the tooth development processes.study Method The research subjects comprised of 10 pregnant female mice (Mus Musculus L.) that were divided into: control group (given sterile aquadest) and treatment group (given pregnancy milk + sterile aquadest) for 18 days followed by the collection of the tooth germ. The specimens were then stained using Imunnohistochemistry to see the KLK-4 and Coll-1 expressions. The data were analyzed using a pathway analysis. Result: The average KLK-4 and Coll-1 expression in the treatment group were higher than those in the control group. Based the pathway analysis, there were direct correlation of Pregnancy milk with Coll-1 expression and that with KLK-4 and Coll-1 expression as well as indirect correlation of pregnancy milk with KLK-4 expression. Conclusion: Pregnancy milk influences the Kallikrein-related peptidase-4 (KLK-4) and Coll-1 expression of ameloblast cells in the tooth development of the mice’s fetusesKeywords: Coll-1 pregnancy milk, Kallikrein-related peptidase-4 (KLK-4), Tooth development

THE EFFECT OF BINJAI (Mangifera caesia) LEAVES EXTRACT GEL TO FIBROBLAST CELL NUMBER ON INCISION WOUND

Background: The ethanol extract of binjai leaves contains bioactive compounds that are saponin, tannin, triterpenoid, steroid, alkaloid and flavonoid which potentially as an anti-inflammation, anti-bacterial, and antioxidant. It can fasten and control the process of scar healing. The binjai leaves extract was made into gel preparation. The binjai leaves extract gel can affect fibroblast cell number during the proliferation phase. Purpose: To analyze the effect of binjai (Mangifera caesia) leaves extract gel to the fibroblast cell number on male wistar rats (Rattus norvegicus) incision wound. Methods: This research design was a true laboratory experimental research with post-test only with control group design which used 24 male wistar rats and divided into 4 groups: the negative control group that was given the placebo gel and the treatment group that was given the binjai leaves extract gel with 5%, 10%, and 15% concentrations. Results: The result of Two-way ANOVA statistic test shows that there is a meaningful difference in the treatment group on the 7th day (p=0,000) and on the 14th day (p=0,000). The Post-Hoc Bonferroni test for fibroblast cell number on the 7th and 14th day shows that there is a meaningful difference (p<0,05) between the negative control group and the treatment group. Conclusion: Binjai leaves extract gel have an effect to the fibroblast cell number on male wistar rats incision wound with the most effective concentration of 15%. Keywords: Binjai leaves extract gel, Fibroblast cell number, Flavonoid, Incision wound healing

REHABILITATION OF MASTICATION AND LACK OF SPACE TREATMENT IN NARROW EDENTULOUS WITH FIXED-FIXED BRIDGE

Background: Loss of posterior teeth can lead to disharmony in the curvature of the jaw. Antagonistic teeth and surrounding teeth will migrate to the edentulous causing reduced mastication function and TMJ disturbance. Several cases of narrow edentulous occurred due to tooth shifting caused by edentulous that was left empty for a long period. Creating a fixed-fixed bridge is aimed to restore the aesthetics, function, and comfort for patients which caused by the missing teeth. Fixed-fixed bridge consist of a retainer that function as a support to the abutment; a pontic that function to replace the missing tooth; and a connector that function to connect the pontic and the retainer. A narrow space for pontics can disrupt the aesthetic and functional aspects. Case Report: A 24 year-old male patient was referred to Prosthodontic Clinic, Gusti Hasan Aman Dental Hospital with a complain of pain on the jaw joint and missing of left lower molar for about 5 years. Patient always masticate on one side after the left lower molar was missing. Extraoral examination found the patient to be in good condition, no enlargement of major salivary glands, the vital signs were good, but upon TMJ examination there was clicking sounds on the left side. Intraoral examination showed space narrowing resulted from mesial and distal drifting of 37 and 35 but not significant, therefore it was still possible to perform rehabilitation using fixed-fixed bridge with abutments on 37 and 35 with modification of pontic shape for 36 to resemble a premolar tooth with occlusal surface resembling a molar tooth. Treatment planning for fixed prosthetic using fixed-fixed bridge with porcelain fused to metal material on 35, 36, and 37 with ridge lap pontic type modification Conclusions: Treatment was successful to provide enough space for the pontic by modification of the shape and the size of the pontic. Keywords: Fixed-fixed bridge. lack of space, mastication.

MANAGEMENT OF SEVERE XEROSTOMIA AND ORAL CANDIDIASIS IN PATIENT WITH VALVULAR HEART DISEASE: A CASE REPORT

Background: Valvular heart disease is a heart valve disorder that needs complex multiple medications by administering certain drugs that cannot be replaced with other drugs because of different mechanisms of action. Beta-blockers and Angiotensin-Converting Enzyme inhibitors are drugs of choice for valvular heart disease, with diuretics and antipsychotics can cause xerostomia. Valvular heart disease patient who has a severe infection or sepsis needs long-term antibiotic treatment. Xerostomia and long-term antibiotic treatment are predisposing factors for oral candidiasis. Objective: to discuss oral candidiasis and severe xerostomia because of multiple medications in valvular heart disease patients. Case: A 58-year-old male was referred from Cardiology and Vascular Medicine Department with a chief complaint of sore tongue and pain at swallowing since 3 days ago with dry sensation of the mouth. Extraoral examination revealed dry and exfoliative lips, intraoral examination revealed fissured and lobulated tongue and white plaques could be scraped off leaving erythematous area oropharynx and tongue. The diagnoses were oropharyngeal candidiasis and severe xerostomia score of 8 according to the Chalacombe scale. Case Management: Patient was treated with nystatin, chlorine dioxide, 0.12 % chlorhexidine digluconate mouthwash, and vaseline album. Oral candidiasis was disappeared on the 22nd day of treatment. Conclusion: Xerostomia and oral candidiasis in patients with valvular heart disease require appropriate therapy, more intensive monitoring by considering the patient's general condition, and interprofessional team collaboration in the therapy of the main disease. Keywords: Oral candidiasis, Valvular heart disease, Xerostomia