Talenta Conference Series: Tropical Medicine (TM)

Role Of Osteoblast in Alveolar Bone Formation

Edward Gozali — 2025-07-31

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.

Osteoclast In Alveolar Bone: Maintaining Bone Homeostasis

Ayu Melisa — 2025-07-31

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.

The Role of Bone Morphogenetic Protein-2 On Bone Formation In Mesenchymal Stem Cells and Its Current Application

Wydiavei — 2025-07-31

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.

Effect Of Hydroxyapatite Nanoparticle from Unam Snail (Volegalea Cochlidium) Shell on the Concentration of Alkaline Phosphatase in Osteoblast Cells (In Vitro)

Muhammad Irfan Siregar — 2025-07-31

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.

Treatment of Infrabony Defects in Generalized Periodontitis Stage III Grade C Patients with Guided Tissue Regeneration: Case Reports

Kristina Silaban — 2025-07-31

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

Treatment of Periodontitis with Furcation Lesions and Vertical Alveolar Bone Loss: Case Report

Filya Suri Risky N — 2025-07-31

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.

Comparison of Efficacy of Bovine Xenograft with or Without Platelet- Rich Fibrin in Intrabony Defects: A Systematic Review

Karisha Hanna Sulviati Ashari — 2025-07-31

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.

The Use of Scalpel and Electrosurgery Technique In Gingival Depigmentation: A Comparison Case Report

Raden Revita Yosita Iyos — 2025-07-31

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.

Crown Lengthening in Esthetic Zone: Case Report

Verawati Ashari — 2025-07-31

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 Entire Papilla Preservation Technique Versus Modified Minimally Invasive Surgical Technique in Regenerative Periodontal Therapy For Endo-Perio Lesions

Wilson — 2025-07-31

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 for The Treatment Of Gummy Smile Associated With Altered Passive Eruption: A Case Report

Fahrur Rozi Lubis — 2025-07-31

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.

Soft Tissue Management In Periodontal Surgery To Achieve The Best Treatment: Factors Related To The Technique

Shelly Mayvira — 2025-07-31

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.

Periodontal Treatment Followed with Metal Frame Partial Denture For Support Periodontal Health: Two Case Report

Savana Ersa — 2025-07-31

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.

Treatment For Unilateral Closed Locked with Jog Manipulation Technique And Simplified Myofunctional Technique And Anterior Splint Reposition

Siti Coryniken — 2025-07-31

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.

Efficacy Of Modified Lip Repositioning for The Management Of Excessive Gingiva Display: A Scoping Review

Lina Maria — 2025-07-31

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.

The Use of Rich Platelet Fibrin (PRF) In Root Coverage

Shabirah Inas Ferrina Siregar — 2025-07-31

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).

Comparative Analysis of Magnetostrictive and Piezoelectric Ultrasonic Scalers In Periodontal Therapy

patient comfort — 2025-07-31

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.

Functional Crown Lengthening: A Pre- Restorative Treatment For Long-Term Survivability

Fithra Faizal Fariz — 2025-07-31

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.

Periodontal Regenerative Surgical Treatment in Periodontitis Patient With Diabetes Mellitus: Case Reports

Eka Putri Sihotang — 2025-07-31

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.

Oral Manifestations of Anaemia and Vitamin D Insufficiency In Pediatric-Patient

Edria Benita Tampubolon — 2025-07-31

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.

Dental Management in Children with Ectodermal Dysplasia Using Removable Denture And Acrylic Crown: A Case Report

Essie Octiara — 2025-07-31

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.

Removable Partial Denture Treatment in Geriatric Patients with Dementia

Susi R Puspita Dewi — 2025-07-31

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.

Aesthetic Crown Lengthening for Gummy Smile Treatment: A Case Report

Dian Anggraini — 2025-07-31

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.