Talenta Conference Series: Tropical Medicine (TM)
TALENTA Conference Series: Tropical Medicine (TM) is an open access journal publishing the proceeding of conferences across all medical disciplines, including peer-reviewed full-length articles, collections of abstracts and meeting reports. The proceeding of TALENTA Conference Series: Tropical Medicine (TM) is published by TALENTA Publisher Universitas Sumatera Utara. Publishing a supplement to the proceedings of TALENTA Conference Series: Tropical Medicine (TM) is a very effective ways for disseminating conference material and scientific findings to your target readers. p-ISSN : 1234-5678 e-ISSN : 1234-1234 This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Aesthetic Crown Lengthening for Gummy Smile Treatment: A Case Report
A beautiful smile can affect a person's appearance, aesthetics, and self-confidence. One of the aesthetic concerns that dental patients often complain about is excessive gingival display, also known as a "gummy smile." A gummy smile can be caused by several factors, including Altered Passive Eruption (APE). Aesthetic crown lengthening can correct gummy smile problems by gingivectomy or bone reduction. A 23-year-old female presented to the Department of Periodontology at RSGM USU, complaining that she was not confident with her smile because the gum tissue of her upper front teeth appeared more prominent. This case report presents the treatment of a gummy smile using aesthetic crown lengthening on teeth 14, 13, 12, 11, 21, 22, 23, and 24, with an internal bevel incision. A full-thickness flap was reflected to allow for bone reduction. A gummy smile caused by APE can be treated with aesthetic crown lengthening, which involves gingivectomy and bone reduction. This treatment effectively improves a patient's smile and boosts their self-confidence. Aesthetic crown lengthening is a suitable treatment approach for patients with gummy smiles resulting from APE. This case report underscores the crucial importance of accurate diagnosis and comprehensive treatment planning in achieving optimal outcomes for gummy smile cases.
Copyright (c) 2025 Talenta Conference Series: Tropical Medicinie (TM)
Removable Partial Denture Treatment in Geriatric Patients with Dementia
Preface: Dementia is a disease that leads to a loss of cognitive function, impairment and interferes with a person's ability to carry out such daily living activities. The most common symptom of dementia is 'senility,' caused by degenerative brain disorders like Alzheimer's disease (AD), and due to the advanced stages of Parkinson's disease. This condition of dementia is generally associated with the aging process. Case Presentation: An 88-year-old female geriatric patient who has dementia, came with her son, complaining that she wanted to replace new dentures because her old dentures were no longer usable because they were damaged and loose. The patient has communication and behavioral control problems. These aspects increase difficulties in daily living activities and denture care. Treatment goal: restore the function of his oral cavity and improve his general health by creating a new removable partial denture. Denture care, in this case, is provided holistically; the results of denture treatment are achieved through visits in stages. Conclusion: This case explains that dementia patients can receive appropriate denture care through collaboration with the accompanying family and the caregiver who cares for the patient. Management of patient behavior can be done using non-pharmacological methods. After the installation of dentures, the patient's nutritional status and quality of life are highly dependent on home care and periodic visits to the dentist. This denture treatment maintains healthy oral function and improves the patient's quality of life.
Dental Management in Children with Ectodermal Dysplasia Using Removable Denture And Acrylic Crown: A Case Report
Oral manifestations of ectodermal dysplasia include the absence of tooth buds and peg shape. The aim of this paper is to report on dental management for children who have ectodermal dysplasia using removable dentures and acrylic crowns. The patient, a boy aged 10.5 years, with the absence of tooth buds 12, 21, 22 and 42 and 43, 41, 31, 32 and 33 were peg-shaped, which disturbed the child's aesthetics. Based on the anamnesis, clinical and radiographic appearances, the child was diagnosed as having hydrotic type ectodermal dysplasia. There are two stages of the treatment for the patient; the first stage of making a removable partial denture on the upper jaw and an acrylic crown on the lower jaw. The procedure for making dentures begins with taking an impression and send to the laboratory. The acrylic crowns was made by using the indirect technique. The patient was asked to undergo regular control every 3-6 months until the child's growth and development is complete, by the age of 18 years. At this age, the second stage of treatment can be carried out by making a final denture using a bridge on the upper jaw or implants and making a porcelain crown on the lower jaw. It was concluded that the choice of dental treatment for the patient depends on the age of the child and the first stage of treatment for pediatric ED patients is quite successful aesthetically.
Oral Manifestations of Anaemia and Vitamin D Insufficiency In Pediatric-Patient
Background: Anaemia is defined as a condition in which the number of red blood cells is poorly lowered. Vitamin D plays an important role in various biological systems, such as accelerating wound healing and regulating the immune system. Around 50% of the global population has vitamin D insufficiency. Both conditions in children are associated with impaired growth and developmental delay and can cause oral lesions. The aim of this paper is to report the oral manifestations related to anemia and vitamin D insufficiency in a pediatric patient. Case Report: A 6-year-old male came to the Dental and Oro Maxillofacial Unit, Universitas Indonesia Hospital, with a complaint of a canker sore on the lower gingiva since a week ago. Medical history revealed iron deficiency anemia in infancy and vitamin D deficiency. Intraoral examination showed a shallow single ulcer on the attached gingiva near the mucobuccal fold in the 71-81 region, linea alba, and mild atrophy on the tongue. Laboratory tests showed a low level of serum 25(OH)D.Case Management: A referral to a pediatrician was made. The patient was prescribed Vaseline and given hyaluronic acid gel to reduce pain. The patient was suggested to continue Vitamin D supplement and encouraged to carry out periodic control to the pediatrician. Discussion: Oral manifestations of anemia include angular cheilitis, atrophic tongue, and stomatitis. Vitamin D is confirmed to deliver strong immunomodulatory effects on both innate and acquired immunity responses in the pathogenesis of certain oral mucosal lesions. Comprehensive examination and identification of underlying conditions are very important in treating pediatric patients. Conclusion: Dentists play an important role in identifying oral disorders related to nutritional deficiencies, to further determine the appropriate treatment plan and referral. Management of oral lesions in pediatric cases requires an interdisciplinary approach with a pediatrician.
Periodontal Regenerative Surgical Treatment in Periodontitis Patient With Diabetes Mellitus: Case Reports
Periodontal disease and DM have a close relationship. Diabetes is a predisposing factor for periodontitis, and periodontitis will worsen metabolic control in diabetic patients. This clinical case report describes the success of periodontal regenerative surgical treatment in periodontitis sufferers with diabetes mellitus. Cases: Case I was A 50-year-old male patient with uncontrolled diabetes who came with a complaint of bleeding gums when brushing teeth and uncomfortable feeling due to mobility of some teeth. Clinical and radiograph examination: periodontal pocket 6 mm on tooth 33 and vertical bone loss. HbA1c was 9.2%. Case II was a 40-year-old male patient with uncontrolled diabetes who came with complaints of frequent bleeding gums when brushing teeth and some tooth mobility. Clinical and radiograph examination: periodontal pocket 4 mm in teeth 46,45,44,43, abscess on tooth 17, furcation lesions in some teeth, and vertical bone loss. HbA1c was 7,8%. In both cases, periodontal regenerative surgery with guided tissue regeneration using bone graft and collagen membrane was performed to correct the periodontal pocket and bone destruction. Re-evaluation was done at follow- up in three months. Periodontal regenerative surgical treatment in chronic periodontitis patients with DM can still be performed to repair periodontal tissue damage. Regenerative periodontal therapy can be a potential treatment in individuals with controlled diabetes mellitus who have chronic periodontitis, resulting in increased density of the bone defect area and crest alveolar level and decreased periodontal pocket depth.
Functional Crown Lengthening: A Pre- Restorative Treatment For Long-Term Survivability
Background: Factor that become biggest challenges to achieve a good restoration result is to increase the height of clinical crown length deficiency in which establish the stability of dentogingival complex to improve retention and obtain an aesthetically pleasing final restoration. Functional crown lengthening is one of the most common surgical procedures performed to achieve result that increase clinical crown length. Case Report: In this case report, a 38-year-old female patient who required functional crown lengthening due to a fractured tooth 35 and no clinical crown remaining is discussed. The patient was referred by the prosthodontics department. Case Management: The case patient was treated with functional crown lengthening (FCL) with through calculation and consideration. Discussion: FCL is a minimally invasive surgical procedure that can prolong the teeth while maintaining healthy periodontal structure. This is known as an interdisciplinary approach in consideration of the biological and anatomical aspects of the tooth that will determine the success of the treatment. Conclusion: Goal of FCL is one of the deciding factor for restorative treatment with inadequate clinical crown, to maintain ideal biological width and build-up of the supragingival structure, to achieve a ferrule effect that improve the durability of the restoration.
Comparative Analysis of Magnetostrictive and Piezoelectric Ultrasonic Scalers In Periodontal Therapy
Non-surgical periodontal therapy, particularly scaling and root planing, serves as the cornerstone of periodontal disease management. These procedures may be performed manually or using ultrasonic instruments. Among ultrasonic scalers, magnetostrictive and piezoelectric types are the most commonly used, each operating based on distinct mechanical principles and exhibiting different biological effects. The choice of scaler can influence both treatment efficacy and patient comfort. Objective: This review aims to compare magnetostrictive and piezoelectric ultrasonic scalers in periodontal therapy, focusing on clinical effectiveness, impact on hard and soft tissues as well as patient comfort. Discussion : Both types of scalers are effective at removing biofilm and calculus. Piezoelectric scalers operate with linear motion and generate less heat, while magnetostrictive scalers utilize elliptical motion. Some studies suggest that piezoelectric devices offer greater patient comfort and cause less tissue trauma, though these differences are not always statistically significant. Conclusion: The differing mechanisms of magnetostrictive and piezoelectric scalers offer clinicians flexible options that can be adjusted to individual patient needs. A thorough understanding of each system is essential for optimizing treatment outcomes while ensuring patient safety and comfort.
The Use of Rich Platelet Fibrin (PRF) In Root Coverage
Hello there! When the gum line pulls away from the cemento-enamel junction (CEJ), exposing the tooth root, this condition is called gingival recession. Issues include root cavities, dentin hypersensitivity, trouble controlling plaque, and cosmetic concerns arise when the tooth root is exposed. The use of desensitizing materials, interventions to modify poor behaviors, and optimum plaque management are non-surgical therapy options for gingival recession. When surgical intervention is necessary, a combination of a coronally advanced flap (CAF), tunneling, and gingival graft yields satisfactory outcomes for both isolated and systemic recessions. As an adjunctive treatment to pedicle surgery, platelet-rich fibrin (PRF) represents the cutting edge of gingival surgery. Review of Existing Literature. Autogenous platelet-rich fibrin (PRF) is a biomaterial that is rich in platelets and fibrin because it is made from blood without the addition of biochemical compounds such dextrose citrate (ACD), which are anticoagulants.As growth factors and cytokines, platelets are essential for periodontal regeneration and the development of soft tissues. Final thoughts. The One alternative for recession therapy that assists with periodontal regeneration and wound healing quicker and makes patients feel better is platelet-rich fibrin (PRF).
Efficacy Of Modified Lip Repositioning for The Management Of Excessive Gingiva Display: A Scoping Review
Since the excessive gingival display (EGD) that occurs when smiling is generally thought to be unsightly, many patients are seeking therapy for this problem. Lip repositioning is one procedure employed to address excessive gingival display. The purpose of the study is to review the most recent research on surgical lip repositioning (LRS) efficacy and its modifications for managing excessive gingival display (EGD). Discussion: Out of 959 articles that were found through keyword-based search, 149 were filtered based on study design and desired period range, then became 6 of literature based on the corresponding titles and abstracts and 4 of literature based on full text. The efficacy of LRS was assessed, and four modifications were identified to manage EGD. Lip repositioning surgery (LRS) is a minimally invasive alternative for treating excessive gingival display (EGD). Modified approaches, such as myotomy and internal dual muscle traction, have shown superior results over traditional techniques. Using periosteal sutures and periosteal sutures can also significantly reduce EGD compared to standard LRS after one year, suggesting improved outcomes for correcting EGD. Conclusion: The conventional lip repositioning operation and the modified lip repositioning treatment result in positive patient outcomes at 6 and 12 months of follow-up by reducing excessive gingival display. Nevertheless, the modified technique outperforms the conventional one in terms of postoperative stability and relapse.
Treatment For Unilateral Closed Locked with Jog Manipulation Technique And Simplified Myofunctional Technique And Anterior Splint Reposition
Disc displacement without reduction (DDWoR) with limiting mouth opening is a condition that occurs in the inability to reduce the disc to its normal position also known as a closed lock. In general, there are 3 therapies used for this condition: non-surgical treatment/ conservative, minimally invasive (arthrocentesis), and surgical. Mandibular manipulation is the initial, conservative, and effective treatment in cases of acute. This paper aim to explain the treatment for closed lock patient using mandibular manipulation technique using jog manipulation and simplified myo-fuctional technique accompanied using anterior splint reposition. A 20-year-old male patient came to the Prosthodontics Clinic at RSGM USU with complaints of being unable to open his mouth wide and feeling pain in the right joint if he opened his mouth too wide.The patient had a complaint 1 week ago. Clinical examination of the patient showed a limited mouth opening which was 13 mm, left and right lateral movement was 1,2 mm and 5,6 mm. deflection with mouth opening. In this patient underwent the jog manipulation technique as mandibular manual therapy, combined with the use of an anterior repositioning splint, and the patient was instructed to self-treated at home with the Simplified- Myofunctional Technique (S-MFT). An effective jog manipulation technique can be successfully performed in acute closed lock conditions but must be accompanied by the use of an anterior splint that is immediately attached to the patient to restore disc morphology that was previously distorted. Home therapy exercises are an effective combination to prevent the displacement of the disc.
Periodontal Treatment Followed with Metal Frame Partial Denture For Support Periodontal Health: Two Case Report
A removable partial denture is a definitive prosthesis used in dentistry for decades to rehabilitate partially edentulous patients. Metal frame partial dentures can also function as permanent splints if the remaining periodontal tissue is compromised. Case Report: The first case was a 47-year-old woman complaining of loose lower front teeth. An intraoral examination showed that the anterior teeth had degree 2 mobility. Clinical diagnosis of generalized periodontitis stage III grade C. The patient admitted that she wanted to keep her tooth. In the second instance, a 38-year-old male complained of loss of the upper front tooth. Based on intraoral examination showed that the anterior teeth of the upper teeth had degree 2 mobility. Clinical diagnosis of generalized periodontitis stage III grade B. Case Management: In these two cases, mechanical debridement, splinting temporary, and flap surgery were held in phase I, and phase II, and maintenance therapy was carried out; after being evaluated, metal frame partial dentures were used as splints permanently according to the indication for each case. Discussion: Providing comfortable and useful removable partial dentures requires diagnosis, planning, and following a periodontal treatment sequence to avoid harm to the compromised periodontal tissues. Conclusion: After all periodontal treatment, permanent splints with metal frame dentures can stabilize the periodontal tissue. Removable partial dentures with metal frames are the best option to preserve the remaining natural teeth.
Soft Tissue Management In Periodontal Surgery To Achieve The Best Treatment: Factors Related To The Technique
To successfully perform periodontal surgery, clinicians must consider several prognostic factors when managing soft tissue conditions. There are factors related to the patient, factors related to the tooth or site, and factors related to the technique that can be used better to estimate the patient's response to specific treatment and describe the overall result and predictability of the surgical process. To determine the level of factors related to the technique that affect the achievement of soft tissue management in periodontal surgery. The gingival tissue's vascular supply during and after periodontal surgery is essential to the tissue's ability to heal. Early group of blood formation and developing a clot binding that can survive mechanical forces operating on the interface between are essential for wound healing. Since soft tissue treatment directly impacts how wounds heal, it is the most critical component of successful plastic periodontal surgery. Technique-related factors are one of the keys to successful periodontal surgery. They can affect the blood supply and wound solidity, resulting in good soft tissue management.
Crown Lengthening for The Treatment Of Gummy Smile Associated With Altered Passive Eruption: A Case Report
A harmonious smile is considered a beautiful image in today's society. An appealing smile can enhance the look so that someone is more effortlessly popular in society. In making plans for dental remedies to be carried out, aesthetic issues are very applicable due to the connection between smile and facial beauty. Altered passive eruption (APE) is a condition where the gingival margin rises due to excessive tooth wear, leading to an increased display of gingival tissue. Crown lengthening is a surgical procedure that can help address these issues. Case Report: A 34 year old female came to the Department of Periodontology at RSGM USU with a chief complaint of not being confident with her smile because of excessive gingival display (gummy smile) because of APE. Case Management: This case report presents a gummy smile treatment with crown lengthening involving bone reduction. Discussion: The patient's gummy smile was significantly improved after the crown lengthening procedure, with the gingival margin now at the same level as the incisal edge of the teeth. The procedure effectively addressed the APE, enhancing the patient's oral aesthetics and self-confidence. Conclusion: Crown lengthening is a viable treatment option for patients with gummy smiles associated with APE. This case report highlights the importance of a thorough diagnosis and treatment planning to achieve optimal outcomes in such cases.
The Entire Papilla Preservation Technique Versus Modified Minimally Invasive Surgical Technique in Regenerative Periodontal Therapy For Endo-Perio Lesions
The primary goal of "minimally invasive dentistry" is to achieve satisfactory therapeutic results with minimal trauma during the process. Minimal invasive periodontal therapy involves treatment options that cure the disease with reduced postoperative pain, improved healing, and better patient acceptance. In this case, the report aims to compare two types of MIST techniques used in regenerative periodontal therapy. In the first case, a 30-year-old female complained of pain in the anterior upper area. A ± 2 cm diameter radicular cyst was seen on the radiograph. We performed root canal treatment and periodontal regeneration surgery, utilizing the entire papilla preservation technique (EPPT). In the second case, a 22-year-old female came with a complaint of a white spot on the gingiva area. A true combined endo-perio lesion was found. Root canal treatment and periodontal regeneration surgery using a modified minimal invasive technique (M- MIST) were done. After 6 months, clinical and X-rays show a good and stable outcome where apparent bone remodeling has occurred in two cases. PPT and M-MIST are effective in regenerative periodontal therapy and show good healing of the hard and soft tissue. Both techniques show promising results as they preserve the soft tissues, increase wound stability, and reduce surgical trauma, chair time, and patient discomfort postoperatively.
Crown Lengthening in Esthetic Zone: Case Report
Gingival tissue appearance plays a significant part in the overall structure of the look in the esthetic zone, particularly in patients with a medium or high smile line. Several methods can be performed to improve gum esthetics and enhance the smile's appearance, such as crown lengthening. Crown lengthening is a periodontal resection procedure that aims to remove a portion of the supporting periodontal tissue. Crown lengthening procedures may require only gingivectomy or additional osseous recontouring. Crown lengthening procedures may require only gingivectomy or additional osseous recontouring. This clinical case report describes crown lengthening procedures using a different gingivectomy technique and various instruments that allowed optimal results in the aesthetic zone. Cases: This case report presents a case of 25-year-old female patient with excessive gingival display (gummy smile) referred from the department of orthodontics to manage the inadequate space for bracket placement caused by Altered Passive Eruption (APE), and surgery was done by using a 3D-designed surgical guide as a template for crown lengthening and modified technique involving conventional and diode laser for gingivectomy and gingivoplasty. Discussion: Crown lengthening in the aesthetic zone requires careful planning and execution to achieve optimal results. The procedure can be challenging due to balancing functional and esthetic considerations.
The Use of Scalpel and Electrosurgery Technique In Gingival Depigmentation: A Comparison Case Report
Community awareness of esthetics and health increases the demand for esthetic dental treatments. Patients often complain of gingival pigmentation because it affects their appearance. Gingival pigmentation is treated with depigmentation. Several depigmentation techniques include chemicals, surgeries (gingival abrasion, scalpel technique), electrosurgery, and lasers. This case report aims to present depigmentation results using the scalpel technique and electrosurgery. Case: A 23-year-old woman reported to Prof. Soedomo Oral and Dental Hospital with a complaint of blackish upper and lower front side of her gingiva which caused a lack of self-confidence. Clinical findings found diffused broken black spots on the upper and lower labial gingiva from anterior to posterior. A scalpel depigmentation technique was carried out on the maxillary gingiva, followed by antibiotics, analgesics, mouthwash, and a 1-month evaluation. Electrosurgical depigmentation was carried out on the next visit to the mandibular gingiva, followed by antibiotics, analgesics, and mouthwash. Evaluation of scalpel depigmentation conducted one month after treatment found pain (-), pigmentation (-), pink coral gingiva, similar to surrounding tissues. Evaluation of electrosurgical depigmentation ten days after treatment found pain (-), pigmentation (-), and some redness in the surgical area, indicating the wound healing process. Gingival depigmentation using the scalpel and electrosurgery techniques produced an excellent gingival healing process. Therefore, these techniques can be used as healthier and esthetic gingiva alternatives.
Comparison of Efficacy of Bovine Xenograft with or Without Platelet- Rich Fibrin in Intrabony Defects: A Systematic Review
PRF has been associated with biomaterials like bovine xenograft, and it has demonstrated superior efficacy in repairing intrabony defects when compared to bovine xenograft alone, but it remains unclear. The study aims to compare the results of platelet- rich fibrin (PRF) with those of bovine xenograft and bovine xenograft alone in treating intrabony defects. All studies presented PRF with bovine xenograft group exhibited a better result in clinical and radiographic parameters compared to the bovine xenograft alone group, which were the PRF-bovine xenograft group had lower pocket depth, higher clinical attachment level, lower vertical bone loss and depth of defects. Most of the studies showed there were no significant differences in results between the PRF with bovine xenograft group and bovine xenograft alone group in the treatment of intrabony defects. Still, both groups showed a better result on all parameters when compared to baseline. Only one study presented a significant result in all clinical parameters in intrabony defects between the inter-groups, and both groups also showed a better result on all parameters when compared to baseline. Xenograft does not have bone regeneration properties, so PRF combination can promote bone formation since it has numerous growth factors. Nevertheless, the extensive mesh interconnecting pore structure of bovine xenograft facilitates osteoblast migration and angiogenesis. Centrifugation preparation of PRF and bone defect types also determines healing results. Both groups effectively treat intrabony defects, but the PRF-bovine xenograft complex achieves better outcomes than bovine xenograft alone in intrabony defects.
Treatment of Periodontitis with Furcation Lesions and Vertical Alveolar Bone Loss: Case Report
Chronic periodontitis is an inflammatory disease induced by bacterial biofilm and characterized by gingival inflammation, loss of attachment, and alveolar bone resorption. Regeneration of the periodontium is a primary goal in treating teeth affected by periodontitis. This case report describes two cases of the treatment of periodontitis with furcation lesions and vertical alveolar bone loss by xenograft bone grafting and membrane placement. This case report describes two cases with the main complaints of gingival bleeding when brushing teeth in the mandibular posterior teeth. The first case showed 46 teeth with a probing depth of 9 mm and grade 2 buccal furcation involvement, and the second showed a probing depth of 36 teeth 6 mm and grade 1 buccal furcation involvement. Based on the periapical radiographic, the two cases presented vertical bone loss. After initial therapy in both patients, it was continued with periodontal flap surgery accompanied by xenograft bone grafting and membrane placement. After four months of follow-up, no bleeding and inflammation were found in the gingiva, and a reduction in pocket depth. Periodontal regenerative surgery in periodontitis with furcation lesions accompanied by vertical bony loss can assist in relieving inflammation and reducing pockets.
Treatment of Infrabony Defects in Generalized Periodontitis Stage III Grade C Patients with Guided Tissue Regeneration: Case Reports
The application of periodontal regenerative surgery techniques can improve the long- term clinical outcomes of teeth with infrabony defects. Different surgical techniques are recommended for the treatment of infrabony defects. Guided tissue regeneration is an appropriate technique that can be used to treat deep infrabony defects. The success of the combined techniques (barrier membrane plus bone replacement graft) will lead to the healing of the vertical component of bone defect by bone fill and clinical attachment level gain. This case report aims to describe the treatment of Infrabony Defects in stage III, Grade C, generalized periodontitis with guided tissue regeneration. Case I is a 21-year- old female patient who came with complaints of bleeding gums easily over the past year. Patients also complain of bad breath. Clinical examination: 6 mm periodontal pocket and infrabony defect. Case II is a 28-year-old woman who has come with complaints of frequent bleeding gums when brushing her teeth since four years ago. Patients also complain that the molars and anterior teeth of the maxillary and mandibles are mobility. Clinical examination: 6 mm periodontal pocket and infrabony defect. Vertical infrabony defects are formed. Combined regenerative therapy (xenograft with membrane vs platelet-rich fibrin with xenograft and collagen membrane) reduces depth and achieves clinical attachment level and bone gain. The conclusion is that the clinical impact is better seen in the additional application of PRF with xenograft and membrane in treating periodontal infrabony defects than using xenograft and membrane alone
Effect Of Hydroxyapatite Nanoparticle from Unam Snail (Volegalea Cochlidium) Shell on the Concentration of Alkaline Phosphatase in Osteoblast Cells (In Vitro)
One of the complications caused by periodontitis is bone loss; the treatment is bone grafting with bone graft material. Hydroxyapatite is a bioactive ceramic commonly used in bone healing and is the primary mineral present in mammalian bones and teeth. One source of HA powder is natural biological sources such as unam snail shells (Volegalea cochlidium). This research aimed to analyze the effect of hydroxyapatite nanoparticles from the Unam Snail (Volegalea coccidium) shell on the concentration of alkaline phosphatase in osteoblast cells in vitro. The fabrication of hydroxyapatite nanoparticles from Unam snail shells using a combination of mechanical-chemical methods known as ball mill and sol-gel. Osteoblast cells were isolated from rat calvaria and grown in a DMEM medium. Osteoblast cell differentiation was proven by examination of the alkaline phosphatase concentration and then reading it with an Elisa reader. The maximum average ALP concentration value was obtained at a concentration of 1.25 mg/mL on day 7, namely 70.38 ± 7.14 µL, then followed by the concentration of 2 mg/mL and control on the same day, namely 46.41 ± 3.10 µL and 44.51 ± 6.21 µL. The highest ALP concentration on days 1, 3 and 7 of all observation groups was obtained in the treatment group given Unam Snail (Volegalea cochlidium) shell hydroxyapatite nanoparticles at 1.25 mg/mL concentration. This study shows that administration of this material can increase the activity of differentiated osteoblast cells.
The Role of Bone Morphogenetic Protein-2 On Bone Formation In Mesenchymal Stem Cells and Its Current Application
An important growth factor found in bone remodelling and repair regulation is bone morphogenetic protein-2 (BMP-2). It plays a significant role in the osteogenic differentiation of mesenchymal stem cells (MSCs), which are multipotent stromal cells capable of differentiating into various cell types, including osteoblasts. The therapeutic application of BMP-2 in tooth regeneration has shown promising results, particularly in orthopedic and dental fields. The purpose of this research is to determine how BMP-2 influences MSCs' osteogenic differentiation and to investigate its possible therapeutic uses in regenerative medicine and bone tissue engineering. The results showed that BMP-2 greatly improves MSCs' osteogenic differentiation. The mineralization of MSCs treated with BMP-2 was shown to be greater than that of control cells on in vitro studies. Animal models on in vivo investigations showed that BMP-2 enhances bone repair and increases bone growth. Patients with critical-sized bone defects have been shown to benefit from BMP-2's ability to enhance bone regeneration in clinical studies. As a powerful osteogenesis inducer in MSCs, BMP-2 is an important component of bone engineering. Significant therapeutic implications arise from its capacity to improve bone growth and repair, especially in relation to the treatment of bone defects. Future research should focus on optimizing BMP-2 delivery methods and exploring its synergistic effects with other osteogenic factors to maximize its therapeutic potential.
Osteoclast In Alveolar Bone: Maintaining Bone Homeostasis
The alveolar bone, containing hematopoietic and mesenchymal stem cells, supports tooth roots and is crucial for supporting teeth and surrounding soft tissues. The balance of osteoblasts causing bone formation and osteoclasts causing bone resorption is essential in maintaining bone homeostasis. Osteoclasts, bone cells responsible for bone remodeling and resorption of old bone, are vital to the process. Osteoclasts, derived from immature monocytic cells, monocyte-derived dendritic cells, and macrophages, are crucial in bone resorption, an essential process in bone remodeling and maintenance. Bone homeostasis depends on the balance between osteoclasts, osteoblasts, their precursors, and immune regulators. The interaction between osteoblasts and osteoclasts will manage bone remodeling. The bone remodeling cyclic process involves four stages: activation, resorption, reversal, and formation. Additionally, this review will discuss the association between osteoclasts and periodontitis. Osteoclasts play a significant part in bone remodeling and maintaining bone homeostasis. It also explores the correlation between osteoclasts and periodontitis, understanding the importance of osteoclast biology for effective treatments.
Role Of Osteoblast in Alveolar Bone Formation
Background: Bone remodeling is a dynamic process involving the regulated breakdown of residual bone and is essential for maintaining bone balance and structural integrity. Objective: This study aimed to examine the roles of osteoblasts and osteoclasts in alveolar bone formation and their interactions in the bone remodeling process. Subject: Discussion Osteoclasts, derived from monocytes/macrophages, primarily assist in bone resorption by secreting hydrochloric acid and proteolytic enzymes. In contrast, osteoblasts are distinct from mesenchymal stem cells and have dual functions in bone matrix formation and regulation of mineralization. The critical interactions between osteoblasts and osteoclasts, facilitated by direct cell-to-cell contact, cytokines, and extracellular matrix interactions, are critical for successful bone remodeling. Osteoblasts can influence osteoclast development, differentiation, or apoptosis; conversely, osteoclasts can interfere with osteoblast activity. Many signaling pathways regulate osteoblast and osteoclast functions, including the OPG/RANKL/RANK, Wnt, Hedgehog, BMP, TGF-β, and Notch pathways. Conclusion: In summary, the complex interactions between osteoblasts and osteoclasts are essential for maintaining bone balance and undergoing remodeling. Understanding the functions of these cells and their signaling pathways provides invaluable insight into the processes involved in bone production and resorption. Additional investigations in this domain may be important in advancing innovative therapeutic strategies for bone-related disorders, such as osteoporosis.
Gambaran Empati Perawat Dalam Memberikan Asuhan Keperawatan Di Ruang Rawat Inap Rsup H. Adam Malik Medan
Empati merupakan suatu proses memahami perasaan orang lain dan ikut merasakan yang orang lain rasakan. Empati dibagi menjadi dua komponen utama, yaitu kognitif dan afektif. Empati secara kognitif adalah proses memikirkan suatu situasi dari sudut pandang orang lain, sedangkan secara afektif akan membuat seseorang melakukan sesuatu untuk menolong dan menunjukkan kepeduliannya pada orang lain. Oleh karena itu empati menjadi sangat penting bagi seorang perawat untuk menjalin hubungan terapeutik dan juga berkomunikasi dengan pasien. Perawat yang memiliki empati, akan lebih mudah untuk menjalin hubungan terapeutik sehingga pasien akan lebih mudah menerima tindakan asuhan keperawatan. Penelitian ini bertujuan untuk mengidentifikasi gambaran empati perawat dalam memberikan asuhan keperawatan di ruang rawat inap RSUP H. Adam Malik Medan. Penelitian merupakan penelitian deskriptif dengan sampel 141 perawat pelaksana yang dipilih secara accidental sampling. Pengumpulan data dilakukan dengan menggunakan kuisioner dengan nilai koefisien reliabel 0,86. Analisis data dengan menggunakan analisis univariat. Hasil penelitian ini menunjukkan bahwa sebanyak 120 perawat (85,1%) memiliki empati dalam kategori baik dan 21 perawat (14,9%) dalam kategori cukup baik. Rekomendasi dari penelitian ini diharapkan agar pihak manajemen keperawatan rumah sakit terus meningkatkan kualitas pelayanan keperawatan pada pasien dan dalam waktu berkala melakukan evaluasi tentang kepuasan pasien terhadap pelayanan keperawatan. Abstract Empathy is a process of understanding and participating in others’feeling. Empathy is divided into two main components, cognitive and affective. Cognitive empathy is the process of thinking from another person's point of view, while affective empathy is feeling concern for the suffering of another person and a desire to help. Therefore empathy becomes very important for nurses to establish therapeutic relationships and to communicate with patients. Nurses showing empathy to patients will have no difficulty to establish therapeutic relationships because the patients will feel more comfortable to receive the nursing care plan actions. This study aimed to determine the overview of nurses’ empathy in providing nursing care in among inpatient in H. Adam Malik Hospital Medan. This study employed a descriptive research with 141 nurses selected by using accidental sampling. For data collection, a questionnaire was used as the study instrument with Cronbach alpha of 0.86. Data were analyzed by using univariate analysis. The results of this study showed that 120 nurses (85.1%) were in good category and 21 nurses (14.9%) were in moderate category in empathy. It is recommended that the hospital nursing management improve the quality of nursing care for patients and evaluate patient satisfaction on regular basis.
IgG Anti-Toxoplasma pada Cairan Otak Pasien Terinfeksi HIV dan AIDS dengan Meningitis
Toksoplasmosis diperkirakan telah menginfeksi sepertiga populasi dunia dan dapat mengancam jiwa pasien dengan imunokompromi. Ensefalitis toksoplasma (ET) terjadi akibat reaktivasi infeksi laten T. gondii yang sering terjadi pada pasien AIDS, terutama stadium akhir. Untuk menegakkan diagnosis pasti pada pasien AIDS dengan kelainan SSP sangatlah sulit. Diagnosis ET ditegakkan hanya berdasarkan asumsi dari gejala klinis, gambaran radiologi, dan respon terhadap terapi yang diberikan. Pemeriksaan kadar IgG dari cairan organ masih jarang dilakukan. Sampel cairan otak diperoleh dari 50 pasien HIV dan AIDS yang dikumpulkan sejak Januari 2013 hingga 2014 di Laboratorium Parasitologi FKUI. Kadar CD4+, gejala klinis, hasil radiologi, diagnosis klinis, riwayat terapi profilaksis ko-trimoksazol, dan analisis cairan otak, diperoleh dari rekam medik.Dari 50 sampel, diperoleh hasil 24 (48%) positif dan 26 (52%) negatif IgG anti-Toxoplasma. Dari IgG positif, terdapat 5 (20,83%) dengan kadar tinggi, dan 19 (79,17%) dengan kadar IgG rendah. Tidak ada perbedaan bermakna antara kadar IgG antiToxoplasma dengan hasil radiologi, diagnosis klinis, maupun riwayat terapi profilaksis ko-trimoksazol. Diperoleh korelasi negatif antara kadar CD4+ dan IgG anti-Toxoplasma, walaupun kekuatannya sangat lemah. Berdasarkan hasil radiologi, diperoleh sensitivitas 56%, spesifisitas 57%, nilai duga positif 41%, dan nilai duga negatif 71%. Toxoplasmosis is estimated to infect a third of the world's population and can be life-threatening to human immunocompromised system . Toxoplasma Encephalitis (TE) is caused by reactivation of latent T. gondii infection that often occurs in AIDS patients especially those with end-stage . To establish a definite diagnosis in AIDS patients with Central Nervous System (CNS)disorders is very difficult. The diagnosis of TE is only based on the assumptions of clinical symptoms, radiological features, and responses to the therapy given. Examination of IgG levels from organ fluids is still rare. CSF samples were taken from 50 HIV/AIDS patients collected from January 2013 to 2014 at the Parasitology Laboratory at FKUI (Medical Departement of University of Indonesia). CD4 levels, clinical symptoms, radiological results, clinical diagnosis, history of co-trimoxazole prophylaxis, and SCF analysis were obtained from medical records. The results showed that IgG-anti Toxoplasma was positive in 24 patients (48%) and negative in 26 patients (52%). From the positive IgG, there were 5 patients(20.83%) with high IgG levels, and 19 patients(79.17%) with low IgG levels. There was no significant difference between the levels of IgG anti-toxoplasma and the results of radiology, clinical diagnosis, and a history of co-trimoxazole prophylactic therapy. There was a weak negative correlation between CD4 + and IgG anti-Toxoplasma levels, The results of radiology showed values of sensitivity 56%, specificity 57%, positive predictive value 41%, and negative predictive value 71%.
Hubungan Kepribadian Dengan Tingkat Prestasi Mahasiswa di Fakultas Keperawatan Universitas Sumatera Utara
Kepribadian merupakan karakteristik khusus yang dimiliki oleh setiap individu yang mencerminkan sikap dan perilaku yang dimilikinya. Kepribadian dapat mempengaruhi tingkat prestasi mahasiswa. Penelitian Hubungan Kepribadian dengan Tingkat Prestasi Mahasiswa di Fakultas Keperawatan Universitas Sumatera Utara ini menggunakan desain deskriptif korelatif yang bertujuan untuk mengetahui hubungan antara kepribadian dengan tingkat prestasi mahasiswa. Sampel pada penelitian ini berjumlah 234 mahasiswa Fakultas Keperawatan USU. Teknik sampling yang digunakan adalah proportionate stratified random sampling. Adapun hasil pengujian statistic Chi-square menyatakan adanya hubungan variabel bebas kepribadian dengan variabel terikat indeks prestasi mahasiswa dengan nilai p-value sebesar 0,043. Selanjutnya dilakukan pengujian statistic nonparametric test sperman rho yang menghasilkan kekuatan hubungan korelasi variabel kepribadian terhadap indeks prestasi sebesar 0,050. Adapun saran bagi penelitian selanjutnya adalah menyertakan variabel lain yang mempengaruhi prestasi akademik seperti minat, motivasi, guru dan cara mengajar serta faktor lingkungan sehingga dapat dilihat pengaruh dari variabel-variabel tersebut. Personality is a special characteristic possessed by a person that reflects his attitude and behavior. Personality can affect the level of academic achievement. This study employed a correlational design with 234 students of Faculty of Nursing, University of North Sumatra as samples. This study aimed to determine the relationship between personality and academic achievement. The sampling technique used was proportionate stratified random sampling. The results of the Chi-square test determined that there was a relationship between personality trait as independent variable and academic achievement index as dependent variable with p-value of 0.043. Then, a nonparametric spearman’s rho test was conducted and produced correlation relationship strength of the personality variable to the achievement index of 0.050. It is suggested that next research should consider other variables that might affect academic achievement such as interest, motivation, lecturer teaching styles, and environment.
Pengaruh Terapi Relaksasi Otot Progresif Terhadap Tingkat Kecemasan Pasien Kanker Payudara di RSUP Haji Adam Malik, Medan
Patient with breast cancer is experienced a psychological pressure with cancer diagnosis. This condition leads to anxiety and hopeless feeling toward life. One of the therapies which found effective to minimize anxiety is progressive muscle relaxation. The objective of the reasearch was to find the influence of progressive muscle relaxation therapy as the nursing intervention in reducing the anxiety level of the patient with breast cancer. The research applied quasi experiment method with pre-test and post-test control group design. The samples involved are 26 patients with breast cancer, which consist of 13 patients with intervention and 13 patient without intervention. The research instrument used to assess the anxiety level was HRS-A (Hamilton Rating Scale-Anxiety) questionnaire. The research conducted at RSUP Haji Adam Malik Medan from May to June,2016. Progressive muscle relaxation theraphy was carried out in 3 days with the frequency of 6 times exercise. The result of the research showed that t-value was -4.275 and p-value=0.000 or p-value < 0.05 (0,000) which indicated that there was the influence of progressive muscle relaxation therapy on the decrease in the level of anxiety of breast cancer patients. Therefore, nurse can use progressive muscle relaxation as non-pharmacological in coping with breast cancer patients. Patient with breast cancer mostly experienced psychological pressure . This condition leads to anxiety and hopeless feeling toward life. One of the therapies which regarded effective to minimize anxiety is progressive muscle relaxation. The objective of this study was to determine the effects of progressive muscle relaxation therapy as intervention in reducing the anxiety level of the patient with breast cancer. This study employed quasi experiment method with a pre-test and post-test control group design. The sample was composed of 26 breast cancer patients; 13 patients with intervention and 13 patients without intervention. The research instrument used to assess the anxiety level was HRS-A (Hamilton Rating Scale-Anxiety) questionnaire. The study was conducted in Haji Adam Malik Hospital Medan from May to June, 2016. Progressive muscle relaxation theraphy was carried out for 3 days, with a frequency of 6 exercises The results showed that t-value was -4.275 and p-value=0.000 indicating that there was an effect of progressive muscle relaxation therapy in reducing the level of anxiety of breast cancer patients. Therefore, nurse can use progressive muscle relaxation as non-pharmacological in coping with breast cancer patients.
Pengetahuan Dan Sikap Masyarakat Dalam Mencegah Leptospirosis di Desa Pabelan Kabupaten Sukoharjo
Leptospirosis merupakan penyakit zoonosis yang mempunyai dampak signifikan terhadap kesehatan di banyak belahan dunia beriklim sub tropis dan tropis. Bakteri Leptospira merupakan penyebab leptospirosis yang dapat menyerang hewan dan manusia. Infeksi pada manusia merupakan kejadian yang bersifat insidental, karena reservoir atau penyebar utama Leptospira adalah tikus. Air kencing tikus yang terinfeksi Leptospira terbawa banjir dan dapat masuk ke tubuh manusia melalui kulit yang terluka dan selaput mukosa. Semua kasus leptospirosis ringan (anikterik) dapat sembuh sempurna, berbeda dengan leptospirosis berat (ikterik) yang mempunyai angka Case Fatality Rate tinggi, antara 5%-40%. Upaya pencegahan merupakan salah satu cara untuk menekan angka kejadian leptospirosis, diantaranya ialah dengan menumbuhkan sikap dan pengetahuan yang baik tentang leptospirosis. Tujuan penelitian ini adalah untuk mengetahui hubungan antara pengetahuan dengan sikap masyarakat dalam mencegah leptospirosis di Desa Pabelan, Kecamatan Kartasura, Kabupaten Sukoharjo. Jenis penelitian ini adalah kuantitatif dengan menggunakan rancangan cross sectional. Sampel dalam penelitian ini adalah masyarakat Desa Pabelan sejumlah 212 responden dengan menggunakan accidental sampling. Mayoritas responden mempunyai pengetahuan yang kurang (53,3%). Sebaliknya, 80,7% dari responden mempunyai skor sikap yang baik. Leptospirosis is a zoonotic disease which has a significant effect on human health most commonly found in tropical or sub-tropical countries. Leptospira bacteria is the cause of leptospirosis which can attack animals and humans. Infection in humans is accidental, because the main reservoir or spreader of leptospira is rodents. The urine of infected rodents carried away by floodwaters can enter the human body through broken skin and mucous membranes. All patients with mild leptospirosis (anicteric) can recover completely. It is very different from patients with severe leptospirosis (jaundice) who have a high case fatality rate from 5% to 40%. Preventive measure is one way to reduce the incidence of leptospirosis by developing positive attitudes and improving good knowledge about leptospirosis. The objective of this study was to determine the relationship between knowledge and attitudes of the community concerning on the prevention of leptospirosis in Pabelan village, Sukoharjo Regency. This study employed quantitative research with a cross sectional design in a sample of 212 respondents from Pabelan village selected by using accidental sampling. Majority of respondents demonstrated moderate knowledge (53.3%). However, 80.7% of the them demonstrated good attitude scores.
Pola Penyakit Degeneratif, Tingkat Kepuasan Kesehatan dan Kualitas Hidup pada Lansia (Lanjut Usia) di Kota Medan
Jumlah penduduk usia diatas 60 tahun diperkirakan akan terus meningkat, pada tahun 2025 diperkirakan mencapai jumlah 36 juta. Peningkatan populasi lansia ini diikuti oleh peningkatan risiko untuk menderita penyakit degeneratif yang dapat mempengaruhi status kesehatan dan kualitas hidup lansia. Penelitian cross sectional study pada 100 orang lansia yang diambil dengan teknik consecutive sampling ini, untuk menilai pola penyakit degeneratif melalui pemeriksaan skrining dan menilai tingkat kepuasan serta kualitas hidup lansia berdasarkan kuesioner kualitas hidup WHO WHOQoL-BREF. Penelitian ini dilakukan di Posyandu Lansia di Kecamatan Medan Amplas. Penyakit yang dijumpai pada lansia menunjukkan lansia mengalami hipertensi sebanyak 69%, hipercholesterolemia 55%, diabetes mellitus 20%, hiperurisemia 20% dan proteinuria 13%. Di masa usia lanjut ini berbagai penyakit dapat mengenai lansia, 16% lansia mengidap paling sedikit 3 jenis penyakit, 31% lansia mengidap 2 jenis penyakit dan 33% lansia yang hanya terkena 1 jenis penyakit. Meskipun demikian, tingkat kepuasan mereka terhadap kesehatannya cukup baik, dimana hanya 21% yang menyatakan kurang puas dengan kesehatannya. Penilaian kualitas hidup secara umum, 63% lansia menyatakan kualitas hidupnya biasa-biasa saja, 28% lansia merasa kualitas hidupnya baik dan hanya 8% yang menyatakan kualitas hidupnya buruk. Umumnya lansia mengalami hipercholeterolemia dan hipertensi, dan paling sedikit rata-rata lansia mengidap 2-3 jenis penyakit degeneratif, meskipun demikian mayoritas lansia menyatakan kualitas hidupnya relatif baik. Kelompok lansia merupakan kelompok yang berisiko untuk mengalami penyakit degeneratif. Untuk itu diperlukan upaya promotif dan preventif untuk meningkatkan kesadaran lansia dalam mengantisipasi penyakit tersebut. The number of people aged over 60 years is projected to grow and estimated to reach 36 million in 2025. The increase in the elderly population is associated with the increase of risk of suffering from degenerative disease that can affect the health status and quality of life of the elderly. A cross-sectional study of 100 elderly was taken with consecutive sampling technique to assess the patterns of degenerative disease through screening examinations, the level of satisfaction, and quality of life of the elderly based on WHO WHOQoL-BREF quality of life questionnaire. This research was conducted at the Elderly Posyandu (Integrated Health Service Post) in Medan Amplas sub-district. The results showed that 69% of the elderly suffered from hypertension, 55% suffered from hyperlipidemia, 20% suffered from diabetes mellitus, 20% suffered from hyperuricemia, and 13% suffered from proteinuria. In this advanced age various diseases can affect the elderly, 16% of the elderly suffered from at least 3 types of diseases, 31% of the elderly suffered from 2 types of diseases and 33% of the elderly only suffered from one disease. Nevertheless, their levels of satisfaction with their health were quite good. 21% of the elderly were not satisfied with their health. The assessment of quality of life in general showed that 63% of the elderly stated that their quality of life was mediocre, 28% of the elderly felt that their quality of life was good and only 8% stated that their quality of life was poor. Generally, elderly suffered from hyperlipidemia and hypertension, and the elderly suffered from at least 2-3 types of degenerative joint diseases. However, the majority of elderly stated that their quality of life was relatively good. Because elderly has a high risk of degenerative diseases,it is imperative that promotive and preventive programs be established to increase the awareness of disease occurence.
Resiliensi Pasien Yang Mengalami Penyakit Kronis di RSUP H. Adam Malik Medan
Penyakit kronis merupakan masalah kesehatan yang menjadi penyebab utama kematian di dunia. Penyakit kronis mengakibatkan stres berat dan kecemasan yang tinggi bagi hampir semua penderita karena kondisi ini akan terus berkembang secara perlahan selama bertahun-tahun, sehingga dibutuhkan adanya resiliensi dalam menghadapi penyakitnya. Penelitian ini bertujuan mengidentifikasi gambaran resiliensi pasien yang mengalami penyakit kronis di RSUP. H. Adam Malik Medan. Populasi dalam penelitian ini adalah pasien dengan penyakit kronis dengan sampel berjumlah 60 orang dimana pengumpulan data dengan menggunakan accidental sampling. Data dikumpulkan melalui kuesioner dan dianalisis dengan distribusi frekuensi. Hasil penelitian diperoleh data bahwa 35 dari 60 respoden berada pada resiliensi tinggi yaitu 58,3%. Berdasarkan hasil penelitian dapat disimpulkan bahwa pasien yang mengalami penyakit kronis di RSUP H. Adam Malik Medan memiliki resiliensi yang baik dalam mengatasi stres dan kecemasan yang dialaminya. Peneliti mengharapkan agar perawat memberikan asuhan keperawatan yang optimal untuk menunjang kemampuan resiliensi pasien untuk mengurangi dampak psikososial negatif pasien. Chronic disease is a health problem which is also the main cause of death worldwide. Chronic disease causes severe stress and high anxiety for almost all sufferers because this condition will continue to develop slowly over the years, thus resilience is needed in dealing with the disease. This study aimed to determine the resilience of patients with chronic disease in H. Adam Malik Hospital Medan. The population was 60 patients with chronic disease which recruited using accidetal samplign method . Data were collected using questionnaires and frequency distribution is analyzed. The results showed that 35 of the 60 respondents with high resilience (58.3%). This study concluded that patients with chronic disease at H. Adam Malik Hospital Medan had good resilience in dealing with stress and anxiety. It is expected that nurses provide optimal nursing care to support patient resilience to reduce the patient's negative psychosocial effects.