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"Indonesian Journal of Dentistry 2006: Edisi Khusus KPPIKG XIV: 148-154Removable Partial Denture Management on Post-Menopause Osteoporotic FemaleOsteoporosis a condition of generalized skeletal fragility caused by diminishing bone amount and disturbance in bone microarchitecture with implication that the bone ability to withstand forces is decreased.This condition leads to more bone resorption. Some researches show that this condition also affects jaw bone. Therefore we must take this condition into consideration during prosthodontic treatment. Dental prostheses are made to restore stomatognatic function as well to preserve what was left including residual alveolar bone. The ability ofdental prostheses to preserve residual alveolar bone differs according to type of prostheses. The case presented here proposing the treatment of an osteoporotic old female in Prosthodontic Clinic FKG Ul with removable partial denture. Considerations inselecting the type and design of dental prostheses and attempts to modif, factors that might play a role in bone resorption in connection with patient's physical and psychological status will be discussed. Thorough examination, careful planning and good communication with patient can provide optimum result."

"Osteoporosis is a silent disease, i.e. the disease will progress without symptoms or pain until bones start to break. Densitometry examinations to diagnose osteoporosis is relatively expensive for most people in Indonesia. Kusdhany et al have produced a mandibular density index specific for Deutero-Malay postmenopausal women (POSTUR-P). This index can be used to predict osteoporosis risk in mandibular and other bones. The objective of this research was to try out POSTUR-P before using it in the community. The study was a diagnostic test, on 31 Teratai clinic postmenopausal patients of Ciptomangunkusumo Hospital between 50-75 years of age from June to October 2014 and fulfilling inclusion criteria. Densitometry on lumbal and femur bones was used as a gold standard. The result of this study showed that POSTUR-P has high sensitivity and moderate specificity, and appears to be a good screening tool to indicate osteoporosis cases."

"Penelitian ini dilakukan dengan tujuan untuk mengetahui distribusi dan frekuensi pasien yang telah dirawat dengan gigi tiruan jembatan di klinik integrasi RSGMP FKG UI pada periode 2008 berdasarkan gigi yang digantikan, gigi penyangga, tipe GTJ, jenis kelamin pasien, dan usia. Manfaat penelitian ini adalah sebagai data base tentang distribusi dan frekuensi untuk penelitian lainnya dan sebagai bekal persiapan mahasiswa sebelum menjalani program profesi. Penelitian ini adalah penelitian deskriptif dalam bentuk survei. Data yang digunakan adalah data sekunder yang didapat dari rekam medik pasien yang telah dirawat oleh mahasiswa program profesi pesrta ujian di Departemen Prostodosia tahun 2008.Hasil penelitian yang diperoleh adalah sebagai berikut: dari 32 kartu status pasien GTJ 65% adalah perempuan dan 35% laki-laki dengan jenjang usia terbanyak 20- 39 tahun pada perempuan dan 20-29 tahun pada laki-laki. GTJ paling banyak digunakan untuk menggantikan kehilangan gigi pada region posterior rahang bawah (55%), sedangkan tipe GTJ yang paling sering digunakan adalah fixed bridge (88%). Molar pertama rahang bawah merupakan gigi yang paling sering digantikan dengan GTJ, sedangkan gigi yang paling sering dijadikan sebagai gigi peenyangga adalah gigi premolar kedua dan molar kedua rahang bawah. Sembilan puluh empat persen gigi penyangga merupakan gigi vital.

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The objective of the study was to find out the frequency and distribution of patients with Fixed Partial Denture (FPD) at the Teaching Hospital Faculty of Dentistry, University of Indonesia (RSGMP). The study done in period of 2008 referring to the missing teeth, abutment, type of FPD patient?s gender and age. The result is expected to be beneficial as data base for other study as well as information needed for student going to start their profesional education program. It was a descriptive study with secondary data obtained from patient record collected from students that were registered for formal assessment at Prosthodontics Departement.The result showed that 65% of patients with FPD were women with range of age is 20-39 years old. The type of FPD mostly used is Rigid Fixed Bridge and the mandible was the region mostly found with FPD to replace the first molar. Therefore second premolar and second molar were the most abutment teeth used. Ninety-four percent of the abutment were vital teeth."

"ABSTRAKLatihan naik turun bangku LNTB dan latihan jalan kaki LJK adalah aktivitas bersifat weight bearing yang dapat meningkatkan massa tulang. Kedua latihan fisik tersebut memiliki karakter biomekanik yang berbeda yang akan memengaruhi proses formasi dan resorbsi tulang. Densitas massa tulang rendah berhubungan dengan polimorfisme gen TNFSF11 dan TNFRSF11B.Penelitian ini bertujuan untuk menganalisis pengaruh perbedaan peningkatan kadar osteokalsin sebagai petanda formasi dan penurunan CTX-1 sebagai petanda resorbsi setelah LNTB dan LJK dan pengaruh polimorfisme gen TNFSF11 SNPs-290C>T, -643C>T, -693G>C dan gen TNFRSF11B SNPs 163A>G, 950T>C, 1181G>C terhadap perbedaan peningkatan kedua petanda. Disain penelitian adalah studi eksperimental. Subjek penelitian adalah perempuan osteopenia sebanyak 59 orang yang diberi LNTB 30 subjek dan LJK 29 subjek dan ditentukan secara acak. Kadar osteokalsin dan serum diukur pra dan pascalatihan setelah 12 sesi selama 3 bulan latihan. Identifikasi polimorfisme gen TNFSF11 dan gen TNFRSF11B dianalisis dengan metode PCR dilanjutkan RFLP. Perbedaan peningkatan kadar osteokalsin dan CTX-1 diuji dengan uji T-tidak berpasangan. Hubungan polimorfisme dengan perubahan kadar osteokalsin dan CTX-1 dianalisis dengan odds ratio. Analisis haplotype dan uji Kruskall Wallis dilakukan untuk melihat hubungan pasangan haplotype dengan kadar osteokalsin dan CTX-1. Kadar osteokalsin dan CTX-1 setelah latihan pada kedua kelompok latihan meningkat p < 0,05 . Peningkatan CTX-1 setelah LNTB lebih kecil dibanding LJK p < 0,05 . Tidak ditemukan hubungan antara polimorfisme gen TNFSF11 dan gen TNFRSF11B dengan perubahan kadar osteokalsin dan CTX-1 p>0,05 Meskipun tidak bermakna, terdapat kecenderungan alel heterozigot/resesif berhubungan dengan peningkatan kadar osteokalsin, alel homozigot dominan berhubungan penurunan kadar CTX-1, serta haplotype gen TNFRSF11B dan haplotype gen TNFSF11 dengan perubahan osteokalsin dan CTX-1. Kedua latihan fisik terbukti dapat meningkatkan formasi tulang. LNTB mencegah resorbsi tulang lebih baik dibanding LJK. Polimorfisme mungkin memengaruhi formasi dan resorbsi tulang akibat latihan fisik. LNTB dan LJK meningkatkan osteokalsin. Peningkatan CTX-1 setelah LNTB lebih rendah dari LJK. Perubahan osteokalsin tidak berhubungan dengan polimorfisme gen TNFSF11 dan TNFRSF11B sedangkan perubahan CTX-1 tidak dipengaruhi polimorfisme gen TNFSF11 tetapi terdapat hubungan antara haplotype ATG dengan ACG dan GCC gen TNFRSF11B dengan perubahan CTX-1. Kata Kunci: gen TNFRSF11B, gen TNFSF11, karakter biomekanik, latihan naik turun bangku, polimorfisme, remodeling tulang

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Bench step exercise BSE and walking exercise WE have a different biomechanical characteristics that can affect bone formation and resorbtion. Low bone mass density was associated with TNFSF11 SNPs 290C T, 643C T, 693G C and TNFRSF11B 163A G, 950T C, 1181G C genes polymorphism.The purpose of the studi is to analyze the difference effect of BSE and WE on changes in bone formation osteocalcin and bone resorbtion CTX 1 markers and the association of TNFSF11 and TNFRSF11B genes polymorphism. This is an experimetal study involving 59 postmenopausal women with osteopenia. Participants were grouped randomly according to the type of exercise bench step exercise 30 subjects and walking exercise 29 subjects . Subjects performed exercise for 12 sessions in 3 months. Osteocalcin and CTX 1 serum was measured pre and post exercise. The TNFSF11 gene and TNFRSF11B gene polymorphism was identified by PCR and RLFP methods. The difference in changes on osteocalcin and CTX 1 between groups were analysed by independent T test. Association between changes in osteocalcin and CTX 1 polymorphism and haplotype were analysed using odss ratio and Kruskall Wallis, respectively. Osteocalcin and CTX 1 increased significantly after BSE and WE P 0.05 , with no difference between group. BSE increased CTX 1 lower than WE P 0.05 . There is no association between polymorphism and the changes on osteocalcin and CTX 1 levels after BSE and WE P 0.05 . However, some tendencies were observed. Heterozygous recessive alleles had association with increased osteocalcin, homozygous dominant alleles had association with decreased CTX 1, haplotype TNFRSF11B gene had associaton with changes in osteocalcin and CTX 1 levels, whereas haplotype TNFSF11 gene with changes in CTX 1 level only. This results indicate that both BSE and WE increased bone formation. TNFSF11 gene polymorphism did not affect changes in formation and resorbtion after BSE and WE. Both exercises increased osteocalcin but was not different even though level of CTX 1 in BSE is lesser compared to WE. TNFSF11 gene polymorphism did not associate to the changes in osteocalcin and TNFRSF11B gene polymorphism did not associate to the changes in osteocalcin despite haplotype ATG had association with ACG and GCC in TNFSF11B gene for the changes in CTX 1 level after BSE and WE. Keywords Bench step exercise, biomechanical character, bone remodelling, gene TNFRSF11B, gene TNFSF11, polymorphism"

"Today jawbone radiographic studies have shifted to 'bone quality'. The jawbone quality indicator which is often used is trabeculation density. To obtain accurate interpretation, analysis of jawbone quality needs modern radiographic imaging modalities that still very limited in Indonesia. In prosthetic dentistry analysis of tarabecular bone density in postmenopause women is very important to anticipate the possibility of osteoporotic cases. Because of inadequacy of human eye sight, information obtained from plain conventional radiographic is very limited. With digitized conventional radiogram, dentist could obtain more accurate information to analyze radiographic trabeculation density in Indonesia. The aim of this study is to get more quantitative radiographic data from digitized conventional radiogram comparing those obtained from conventional radiogram. 112 conventional radiograms were evaluated using grading of trabeculation density. The same radiograms then digitized to obtain the quantitative numeric data of trabeculation density. The result showed that each grade from conventional radiogram has a range of numeric value in the digitized radiogram. This result could provide higher accuracy of trabeculation density analysis than the value obtained by using human eyes that will be beneficial for the dentist, especially prosthodontist in Indonesia."

"Pendahuluan: Salah satu faktor risiko penyakit osteoporosis pada wanita menopause adalah faktor genetik polimorfsme Tumor Necrosis Factor Alpha TNF-α. Tujuan: Penelitian ini bertujuan untuk melihat ada atau tidaknya polimorfisme dan perbedaan polimorfisme gen TNF-α-308G/A pada wanita pascamenopause dengan osteoporosis. Metode: 100 bahan biologis tersimpan 50 sampel wanita pascamenopause dengan osteoporosis dan 50 sampel individu sehat dianalisa menggunakan teknik PCR-RFLP dengan enzim retriksi NcoI, selanjutnya data diuji secara statistik menggunakan uji Chi-square. Hasil: Ditemukan banyak genotip AG baik pada kelompok osteoporosis dan kontrol. Pada kelompok osteoporosis tidak ditemukan genotip GG dan terdapat 76 genotip AG serta 24 genotip AA. Pada kelompok kontrol, terdapat 8 genotip GG, 82 genotip AG, dan 5 genotip AA. Kesimpulan: Terdapat polimorfisme genetik TNF-α-308G/A pada wanita menopause dengan osteoporosis, namun tidak terdapat perbedaan bermakna pada polimorfisme antara wanita pascamenopause dengan osteoporosis dan individu sehat p = 0.117 di populasi Indonesia.

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Introduction: One of the risk factor for osteoporosis in postmenopausal woman is genetic polymorphism factor which is Tumor Necrosis Factor Alpha TNF.

Objectives: This research aims to look for genetic polymorphism and differentiate the distribution TNF 308G A gene polymorphism in postmenopausal woman with osteoporosis.

Methods: 100 stored biological samples 50 samples of postmenopausal woman with osteoporosis and 50 healthy control samples were analyzed with PCR RFLP technique using NcoI restriction enzyme, and subsequently assessed with statistical analysis using Chi square test.

Result: AG genotype was found with the highest amount in both samples. The postmenopausal group has 76 of AG genotype, 24 of AA genotype, and no GG genotype was found. The healthy control group has 8 of GG genotype, 82 of AG genotype, and 5 of AA genotype. Based on Fisher Extract test, there is no significant association between TNF 308G A and postmenopausal osteoporosis p value 0.117.

Conclusion: The genetic polymorphism of TNF 308G A in postmenopausal woman was found, but the polymorphism didn rsquo t have any association with osteoporosis in Indonesia populations. "

"Candidal leukoplakia pada pasien dengan gigi tiruan lepasan. Infeksi kandida merupakan masalah yang umum terjadi pada pasien dengan gigi tiruan lepasan, dengan bentuk tersering adalah denture stomatitis. Namun, bentuk lain dari infeksi candida juga dapat terjadi pada pasien dengan gigi tiruan lepasan, seperti halnya candidal leukoplakia. Kami melaporkan seorang pasien wanita berusia 61 tahun yang mengeluhkan adanya lesi yang sakit di bawah gigi tiruan rahang bawahnya. Pemeriksaan klinis menunjukkan adanya plak putih yang tidak dapatdiangkat di atas ulkus pada daerah lingual prosesus alveolaris di bawah plat gigi tiruan lepasan rahang bawah dan area eritematous pada palatum durum di balik plat gigi tiruan rahang atas. Pasien diduga mengalami candidal leukoplakia pada rahang bawah dan denture stomatitis pada palatum. Perawatan pasien meliputi suspensi oralmengandung nistatin, larutan klorheksidin, multivitamin, disertai penggantian gigi tiruan dan pendidikan kesehatan mulut. Semua lesi membaik dalam terapi selama 2 bulan. Perawatan infeksi kandida pada pasien dengan gigi tiruan tidak hanya memerlukan terapi medikasi ataupun penggantian gigi tiruan, namun diperlukan juga kepatuhanpasien untuk memperoleh hasil yang maksimal.

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Candida infection is a common problem in patients using removable dentures, with the most frequent type is denture stomatitis. But other type of candidal infection could also happen in these patients, such as candidal leukoplakia. We reported a 61 years old female patient who complained a painful lesion under her lower removable denture. Oral examination revealed white plaque that could not be rubbed over an ulcer on the lingual part of alveolar processes under the lower removable denture plate, and also an erythematous area on palatum durum above the upper full denture. The patient was suspected to have candidal leukoplakia on the lingual part of the mandible and denture stomatitis on the palate area. The treatment consisted of nystatin oral suspension, chlorhexidine solution, multivitamins, along with denture replacement and oral health education. The entire lesion resolved within 2 months therapy. Candidal infection treatment on denture patient needs not only medication or denture replacement, but also patient compliance to achieve maximal result."

"Latar Belakang: Osteoporosis adalah penyakit yang ditandai oleh BMD yang rendah dan mikroarsitektur jaringan tulang yang memburuk akibat kerapuhan tulang yang meningkat dan kerentanan terhadap patah tulang. Beberapa faktor lingkungan dan genetik dianggap dapat berkontribusi terhadap terjadinya penyakit osteoporosis. Salah satu gen yang dapat mempengaruhi proses resorpsi tulang adalah gen LRP5 Gen LRP5 telah terbukti memainkan peran penting dalam biologi tulang. LRP5 adalah protein transmembran dan berfungsi sebagai co-receptor untuk protein Wnt. LRP5 diekspresikan dalam osteoblast dan mempengaruhi pembentukan tulang dengan mengubah Wnt signaling.Tujuan: Penelitian ini bertujuan untuk melihat ada atau tidaknya polimorfisme dan perbedaan polimorfisme gen LRP5 Q89R pada wanita pascamenopause dengan osteoporosis.Metode: 100 bahan biologis tersimpan (50 sampel wanita pascamenopause dengan osteoporosis dan 50 sampel individu sehat) dianalisa menggunakan teknik PCR-RFLP dengan enzim retriksi AvaII, selanjutnya data diuji secara statistik menggunakan uji Chi-square.Hasil: Ditemukan banyak genotip QQ baik pada kelompok osteoporosis dan non-osteoporosis. Pada kelompok osteoporosis terdapat 93% genotip QQ dan 3% genotip QR dan tidak ditemukan genotip RR. Pada kelompok non-osteoporosis, terdapat 100% genotip QQ dan tidak ditemukan genotip QR dan RR.Kesimpulan: Tidak terdapat perbedaan bermakna pada distribusi polimorfisme gen LRP5 Q89R antara penderita osteoporosis dengan kelompok non-osteoporosis (p = 0.105).

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Background: Osteoporosis is a disease characterized by low bone mineral density (BMD) and deteriorating bone tissue microarchitecture due to increased bone fragility and susceptibility to fractures. Some environmental and genetic factors are considered to contribute to the occurrence of osteoporosis. One of the genes that can affect the bone resorption process is the LRP5 gene. The LRP5 gene has been shown to play an important role in bone biology. LRP5 is a transmembran protein and functions as a co-receptor for Wnt protein. LRP5 is expressed in osteoblasts and affects bone formation by changing Wnt signaling.Objective: This research aims to look for genetic polymorphism and differentiate the distribution LRP5 Q89R gene polymorphism in postmenopausal woman with osteoporosis.Methods: 100 stored biological samples (50 samples of postmenopausal woman with osteoporosis and 50 healthy control samples) were analyzed with PCR-RFLP technique using AvaII restriction enzyme, and subsequently assessed with statistical analysis using Chi-square test.Result: QQ genotype was found with the highest amount in both samples. The postmenopausal group has 94% of GG genotype, 6% of QR genotype, and no RR genotype was found. The healthy control group has 100% of GG genotype and no QR and RR genotype was found. Based on Fisher-Extract test, there is no significant association between LRP5 Q89R and postmenopausal osteoporosis (p value = 0.105).Conclusion: The genetic polymorphism of LRP5 Q89R in postmenopausal woman was found, but the polymorphism didnt have any association with osteoporosis in Indonesia populations."

"Latar Belakang : Peningkatan populasi lansia berjalan seiring denganpeningkatan masalah kesehatan mulut terutama kehilangan gigi. Untuk memperbaiki kualitas hidup dan faktor resiko lain, perawatan prostodonsia dilakukan dengan tujuan merehabilitasi fungsi di dalam rongga mulut. Tujuan : Tujuan penelitian ini untuk menganalisis hubungan antara permintaan (demand) gigi tiruan dan kualitas hidup pada lansia. Metode : Subyek penelitian berjumlah 100 orang lansia.Dilakukan wawancara dengan kuesioner Permintaan (demand) Gigi Tiruan dan kuesioner Dampak Kesehatan Gigidan Mulut terhadap Kualitas Hidup, kemudian dilakukan pemeriksaan rongga mulut untuk melihat kehilangan gigi dan penggunaan gigi tiruan.Desain penelitian adalah potong lintang, dianalisis dengan uji Chi Squre dan uji Regresi Logistik. Hasil : Terdapat hubungan antara permintaan (demand) gigi tiruan dan kualitas hidup lansia (p< 0,05), tetapi permintaan (demand) bukan merupakan faktor yang paling berpengaruhterhadap kualitas hidup (OR=0,355). Jumlah kehilangan gigi merupakan faktor yang paling mempengaruhi kualitas hidup (OR=4,218). Kesimpulan :Tingkat kualitas hidup lansia tidak dipengaruhi oleh permintaan (demand) gigitiruan.

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Background : Increased in elderly population was in conjunction with the increased of health problems particulary tooth loss. With the intention of improving quality of life and another risk factors, prosthodontics treatment was done to rehabilitate oral function.

Purpose : To analyze the relation between demand of the dentures and quality of life in elderly.

Method : 100 subject were questioned with 'Demand of the dentures' and 'Oral Health Impact Profile and Quality of Life' questionnaire. Intra oral examination was done to observed tooth loss and denture worn. The design of this study was crosssectional, the data was analyzed using Chi Square and Logistic Regression.

Result : Relationship was found between demand of the denture and quality of life (p<0,05), but demand was not the most influential factor (OR=0,355). The amount of tooth loss has the greatest effect in quality of life (OR=4,218).

Conclusion :The level of quality of life was not affected by demand of the denture."