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"Anterior traumatic injury could be caused by many functional disturbances, such as mastication, speech, and esthetic. This condition can be repaired by paying attention to the aspects. Reposition can be done with any appliance but if the reposition must focus on the esthetic aspect, it will require special attention. In this case, it shows that fixed and removable appliance with prosthetic function can be used as alternative treatment for children who suffer traumatic injury."

"Latar Belakang: Cedera Otak Traumatik (COT) mempengaruhi jutaan orang di seluruh dunia setiap tahunnya. Penelitian ini bertujuan untuk mengetahui hubungan temuan radiologi TBI dengan angka kecacatan dan kematian di RSUPN dr. Cipto Mangunkusumo. Metode: Penelitian ini merupakan penelitian deskriptif analitis, dilakukan secara retrospektif dengan menggunakan data sekunder yang diambil dari rekam medis dan arsip pasien yang disediakan oleh Departemen Neurologi FKUI-RSCM yang telah didiagnosis menderita COT sedang dan berat di RSUPN dr. Cipto Mangunkusumo dari Januari hingga Desember 2021. Hasil CT diklasifikasikan menggunakan skor CT Rotterdam. GOSE digunakan sebagai outcome prediktor dimana penilaian dilakukan pada hari ke 14, 30, dan 90. Analisis bivariat akan dilakukan dengan menggunakan uji Chi-square dan uji Mann-Whitney. Hasil: TBI sedang menjadi dominan (88,5%) dan SAH menjadi kelainan CT paling umum di RSCM (57,6%). Usia ditemukan menjadi faktor signifikan dalam perkembangan hasil yang lebih buruk pada hari ke-14 pasca-trauma (p= 0,026). Keparahan juga ditemukan sebagai faktor yang signifikan terlepas dari kapan skor GOSE diambil (hari ke-14 p= 0,004, hari ke-30 p= <0,001, hari ke-90 p=<0,001). SAH merupakan prediktor hasil yang signifikan pada hari ke-14 (p=0,030), hari ke-30 (p=0,010), dan hari ke-90 (p = 0,009). DAI (p= 0,048) dan edema serebral (p=0,009) memainkan peran penting terhadap hasil pada hari ke-90. Skor CT Rotterdam memiliki hubungan yang signifikan terhadap prediksi hasil pada hari ke-14 (p=0,009), hari ke-30 (p <0,001), dan hari ke- 90 (p <0,001). Kesimpulan: Tingkat keparahan COT, SAH, DAI, dan edema serebral mempunyai peran penting dalam prediksi hasil akhir penelitian.

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Introduction: TBI affects millions of individuals around the world. This research aims to explore the relationship between radiological findings of TBI and the disability and mortality rate in Cipto Mangunkusumo Hospital Methods: This is a descriptive analytical research, done in a retrospective way by the usage of secondary data extracted from medical records of patients that had been diagnosed with TBI in Cipto Mangunkusumo hospital in 2021. GOSE was used as an outcome predictor in which assessment was done at the 14th, 30th, and 90th day. Analysis was done using Chi-square test and Mann-Whitney test Results: Moderate TBI to be predominant (88.5%) and SAH to be the most prevalent CT abnormality in Cipto Mangunkusumo hospital (57.6%). Age was found to be a significant factor in the development of worse outcomes in the 14th day post-trauma (p= 0.026). Severity was found to be a significant factor also regardless of when the GOSE score was taken (14th day p= 0.004, 30th day p= <0.001, 90th day p=<0.001). SAH was a significant predictor of outcome at the 14th day (p=0.030), 30th day (p=0.010), and 90th day (p = 0.009). DAI (p= 0.048) and cerebral edema (p=0.009) played a significant role on the outcome at the 90th day. Rotterdam CT score had a significant association in outcome prediction at the 14th day (p=0.009), 30th day (p < 0.001), and 90th day (p < 0.001). Conclusion: Severity, Rotterdam CT score, SAH, DAI, and cerebral edema had a significant role in prediction of outcome at the end of the study."

"Tatalaksana nutrisi pada pasien cedera kepala sedang dan berat mencakup pemberian makronutrien mikronutrien nutrien spesifik pengelolaan cairan dan elektrolit serta pemantauan dan evaluasi Dukungan nutrisi yang adekuat perlu diberikan pada pasien cedera kepala agar meningkatkan perbaikan kondisi optimal pasien Sebagian besar pasien cedera kepala memiliki status gizi yang baik sebelum terjadinya trauma Pemenuhan nutrisi yang optimal dapat turut menunjang perbaikan inflamasi metabolisme dan menjaga tidak terjadi penurunan status gizi Pasien pada serial kasus ini seluruh pasien laki laki mempunyai rentang usia 19 sampai 49 tahun Adanya penyakit penyerta mempengaruhi luaran akhir pasien cedera kepala Terapi nutrisi diberikan sesuai dengan kebutuhan setiap pasien Kebutuhan energi total dihitung berdasarkan perkiraan kebutuhan energi basal menggunakan persamaan Harris Benedict dikalikan faktor stres 1 4 1 6 dan pemberiannya disesuaikan dengan kondisi klinis pasien Kebutuhan protein 1 5 2 g kg BB hari dan lemak 20 30 Pemantauan mencakup tanda klinis toleransi asupan makanan kapasitas fungsional keseimbangan cairan parameter laboratorium dan antropometri Pemberian nutrisi pada pasien cedera kepala berat dengan sakit kritis bersifat individual dan mencakup semua aspek Tatalaksana nutrisi yang baik dan dilanjutkan dengan edukasi pada pasien dan keluarga diharapkan dapat meningkatkan kualitas hidup pasien cedera kepala dengan meminimalkan komplikasi yang dapat terjadi

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Nutrition therapy in patients with moderate and severe traumatic brain injury includes the provision of macronutrient micronutrient specific nutrition fluid and electrolyte management with monitoring and evaluation Adequate nutrition support should be given in traumatic brain injury to optmalyze outcome patient Three from four this case series have a normoweight before trauma Nutritional support can improve metabolism decrease inflammation and manage nutritional status Patients in this case series all male have an age range from 19 to 49 kg years Their comorbid condition influence outcome of traumatic brain injury patient Nutritional support is given according to each patient rsquo s requirement which is calculated with basal energy requirement using Harris Benedict equation with stress factor 1 4 1 6 and the administration starts with individual condition which gradually increased to reach the total energy expenditure Protein requirement 1 5 2 g kg day and lipid requirement is calculated 20 30 total energy requirement Patient rsquo s monitoring include clinical signs food intake tolerance functional capacity fluid balance laboratory and anthropometric parameter were taken With the management of good nutrition expected quality of life of patients with moderate and severe traumatic brain injury various comorbidities would be better "

"Prevalensi kejadian maloklusi cukup tinggi. Seorang ortodontis dituntut bekerja efektif dan efisien waktu. Braket self-ligating di klaim memfasilitasi pergerakan gigi lebih baik, friksi lebih kecil sehingga lebih efektif dan efisien waktu. Tesis ini bertujuan untuk mengetahui perbandingan kecepatan penutupan ruang pencabutan gigi premolar pertama rahang bawah antara sistem ligasi konvensional dan sistem self-ligating pasif menggunakan closed-coil spring serta melihat kehilangan penjangkaran antara kedua sistem.Desain penelitian ini prospective randomized controlled clinical trial dengan teknik split-mouth. Dua puluh dua regio rahang bawah sampel siap untuk dilakukan retraksi enmassedipasangkan braket MBT Agile 3M slot.022" pada keseluruhan satu regio, regio dan braket Damon Q standar torque Ormco pada regio sebelahnya, aktivasi closed-coil spring. Pengukuran kecepatan penutupan ruang dan kehilangan penjangkaran dihitung dari model cetakan gigi pada 4 dan 8 minggu.Hasil menunjukkan perbedaan bermakna kecepatan penutupan ruang serta kehilangan penjangkaran antara kedua kelompok dimanaself-ligating pasif lebih cepat menutup ruang dengan rata-rata penarikan 4 minggu 0,58mm dan 8 minggu 0,74mm, serta lebih tahan terhadap kehilangan penjangkaran. Dapat disimpulkan braket self-ligating pasif cukup efisian dan efektif pada tahap penutupan ruang. Teknik split-mouth efektif melihat perbandingan kecepatan penutupan ruang serta kehilangan penjangkaran dengan meminimalkan variasi antar individu.

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Malocclusion prevalence is high, an orthodontist needs to be efective and efficient in treating malocclusion. Self-ligating brackets are claimed more effective and efficient, which have less friction in ortodontic movement than conventional brackets. The objective of this study is to compare the rate of mandibular en-masse space closure retraction and loss of anchorage between pasif self-ligating brackets and conventional brackets using closed-coil spring.The design of this study was prospective randomized controlled clinical trialwith splitmouth technique. Twenty two mandibular quadrant that ready for en-masse space closure retraction was placed with conventional bracketsMBT Agile 3M slot.022" in a whole quadrant, while the contra lateral was placed with pasif self-ligating brackets Damon Q standar torque Ormco. The en-masse space closure retraction rate and loss of anchorage measurement was made in study model in 4 and 8 weeks.The results were there was significant difference between pasif self-ligating and conventional brackets regarding the en-masse space closure retraction rate and loss of anchorage rate. Self-ligating brackets were faster in en-masse space closure with mean rate 0,58mm in 4 weeks and 0,74mm in 8 weeks and more resistant in loss of anchorage. Split-mouth technique was effective to compare the rate of mandibular en-masse retraction and loss of anchorage between self-ligating bracket and conventional bracket using closed-coil spring, where individual variability was minimized."

"ABSTRAKCedera kepala traumatik merupakan penyebab kematian tersering pada kecelakaan. Trauma tumpul pada kepala dapat menimbulkan contusio cerebri berupa lesi coup dan contrecoup. Namun, mekanisme dari terjadinya lesi coup dan contrecoup belum diketahui dengan jelas. Penelitian ini dilakukan untuk mengetahui hubungan antara letak trauma tumpul pada kepala dengan terjadinya lesi coup dan contrecoup.Metode: Sampel penelitian diambil dari rekam medis jenazah dengan trauma tumpul pada kepala yang diotopsi di Departemen Forensik dan Medikolegal RSCM pada tahun 2012-2016. Peneliti kemudian mencari tahu mengenai letak trauma tumpul dan temuan contusio cerebri pada rekam medis jenazah.Hasil: Dari 97 sampel dengan trauma tumpul pada kepala, didapatkan proporsi lesi coup sebesar 5,2 , 11,3 , dan 2,1 , dan proporsi lesi contrecoup sebesar 1,0 , 15,5 , dan 2,1 pada trauma tumpul yang terjadi di depan, samping, dan belakang kepala secara berturut-turut. Hasil uji chi square menunjukkan hubungan yang bermakna antara trauma tumpul pada sisi depan p=0,005 dan samping p=0,002 kepala dengan lesi contrecoup.Pembahasan: Terjadinya lesi coup tidak selalu diikuti oleh terjadinya lesi contrecoup, dan berlaku juga sebaliknya. Hubungan bermakna antara trauma tumpul pada sisi samping kepala dengan lesi contrecoup secara teori dapat dikaitkan dengan teori sistem suspensori otak.Kesimpulan: Dari penelitian ini, dapat disimpulkan bahwa terdapat hubungan antara trauma tumpul pada sisi depan dan samping kepala dengan lesi contrecoup.

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ABSTRACTTraumatic brain injury remains the most common cause of mortality in accidents. Blunt trauma in the head may cause cerebral contusion, which includes coup and contrecoup contusion. However, the mechanism of coup and contrecoup contusion formation remains unknown. This research aims to know the relationship between the position of head blunt trauma with coup and contrecoup contusion.Methods Research samples were taken from corpse medical records with head blunt trauma who had undergone autopsy in Forensics and Medicolegal Department of Cipto Mangunkusumo Hospital from 2012 2016. The position of head blunt trauma and findings of cerebral contusions were recorded.Results Out of 97 samples with head blunt trauma, the proportions for coup contusion were 5,2 , 11,3 , and 2,1 , while the proportions for contrecoup contusion were 1,0 , 15,5 , and 2,1 in blunt trauma happening at the front, side, and back part of the head respectively. Chi square tests showed significant relationships between blunt trauma of front p 0,005 and side p 0,002 part of the head with contrecoup contusion.Discussion Coup contusion is not always followed by contrecoup contusion, and vice versa. The significant relationship between blunt trauma of the side part of the head and contrecoup contusion can be explained by the theory of brain suspensory system.Conclusion This research concludes that blunt trauma of the front and side part of the head is related to contrecoup contusion."

"Indonesian Journal of Dentistry 2006; Edisi Khusus KPPIKG XIV: 189-192Dental trauma in childhood and adorescence is a common accidents, with the most accident-prone time is between 9 and 10 years old. Boys affected are almost twice than girls and the maxillary central incisors are the most affected. This report describes an Ellis class II fracture in maxillary central incisors caused by trauma on a 9 years old boys. The case was treated by pulp capping and restored by composite material."

"Offers complete coverage of maxillofacial trauma highlighted by an unparalleled collection of outstanding, full-color photographs, and highly detailed line drawings that clarify surgical procedures. Addresses secondary surgery in a dedicated section, covering such topics as facial scar management; secondary osteotomies and bone grafting to correct deformities; bone distraction, used commonly with congenital malformations; secondary rhinoplasty for traumatic nasal deformities, which are associated with a variety of cosmetic and functional issues; secondary orbital surgery; facial nerve injuries; and psychological support for patient with facial trauma. Features an outstanding, full-color art program, with more than 750 color photos that cover all aspects of injury and treatment, and 250 color line drawings that walk you step by step through surgical procedures. Includes contributions from a "who's who" list of international experts in oral and maxillofacial surgery, psychology, ophthalmology, neurosurgery, plastic surgery, and craniofacial surgery. Relates brain injury to the overall management of the face for both function and esthetics. Contains updated guidelines on facial fractures, expanded information on psychological problems following facial trauma, and a new chapter on pediatric trauma."

"Latar belakang dan tujuan: Sejalan dengan meningkatnya kesadaran masyarakat akan pentingnya penampilan yang baik, semakin banyak orang yang membutuhkan jasa dokter gigi untuk memperbaiki kondisi estetika gigi geliginya yang menunjang estetika penampilan secara umum. Terdapat beberapa konsep dalam estetika kedokteran gigi seperti golden proportion & golden percentage. Konsep golden proportion merupakan panduan yang pertama dikenal dalam estetika kedokteran gigi khususnya penentuan proporsi lebar gigi geligi anterior atas tampilan frontal. Namun golden proportion memiliki beberapa kelemahan, sehingga dikembangkan konsep alternatif, salah satunya adalah konsep golden percentage yang menyatakan bahwa proporsi lebar gigi geligi anterior atas yang estetis adalah 10%, 15%, 25%, 25%, 15%, 10%. Konsep golden percentage dianggap lebih mudah diterapkan di masyarakat. Belum diketahui apakah proporsi lebar gigi geligi anterior atas kelompok Deutro Melayu di Indonesia sesuai dengan konsep golden percentage. Penelitian ini dilakukan untuk mengetahui proporsi lebar gigi geligi anterior mahasiswa FKG UI ras Deutro Melayu sekaligus untuk mengetahui apakah terdapat kesesuaian konsep golden percentage dengan proporsi lebar gigi geligi anterior yang diperoleh. Bahan dan metode: Penelitian ini adalah penelitian deskriptif yang melibatkan 100 mahasiswa (10 pria, 90 wanita) FKG UI ras Deutro Melayu. Subjek mengisi lembar Orofacial Esthetic Scale dan dilakukan pencetakan rahang atas. Lebar mesiodistal gigi geligi anterior atas tampilan frontal pada model studi diproyeksikan pada kertas milimeter dan hasil proyeksinya diukur. Analisis data menggunakan piranti lunak SPSS 18. Hasil: Proporsi lebar gigi geligi anterior yang diperoleh adalah 12%, 16%, 22%, 22%, 16%, 12%. Berdasarkan data persepsi estetika menggunakan Orofacial Esthetic Scale, proporsi lebar gigi geligi anterior dianggap memuaskan oleh 99% subjek. Kesimpulan: Proporsi lebar gigi geligi anterior mahasiswa FKG UI ras Deutro Melayu memiliki nilai tertentu yang tidak sesuai dengan konsep golden percentage. Walaupun demikian, secara umum proporsi lebar gigi geligi anterior subjek dianggap memuaskan.

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Background and objectives: An increased need of beautiful smile and teeth which support appearance that will be more esthetically pleasing is found. Many concepts have been proposed as a guideline in esthetic dentistry, such as golden proportion and golden percentage. Golden proportion is the first concept accepted as a guideline in esthetic dentistry, especially in the proportion of the frontal widths of maxillary anterior teeth. But, golden proportion has weaknesses, therefore alternative concepts have been formulated, one of which is golden percentage. According to golden percentage, the proportion of the frontal widths of maxillary anterior tooth should be 10%, 15%, 25%, 25%, 15%, 10%. Golden percentage is more applicable to the population. It is not known whether the proportion of the widths of maxillary anterior teeth among Deutro Melayu population in Indonesia is the same as golden percentage. The aim of this study was to know the proportion of the widths of maxillary anterior teeth among FKG UI students of Deutro Melayu origin and to find out whether the proportion of the widths of maxillary anterior teeth of the subjects is the same as golden percentage.

Materials and methods: Descriptive study involving 100 FKG UI students (10 males, 90 females) of Deutro Melayu origin was made. Subjects filled questionnaire of Orofacial Esthetic Scale and study models from maxillary impression of the subjects were made. The frontal widths of maxillary anterior teeth were projected on milimeter block and measured. Data was tabulated and analized using SPSS 18.0.

Results: The proportion of the widths of the maxillary anterior teeth of the subjects were 12%, 16%, 22%, 22%, 16%, 12%. Based on Orofacial Esthetic Scale scores, this proportion was accepted esthetically by 99% of the subjects.

Conclusion: The widths of the maxillary anterior teeth among FKG UI students of Deutro Melayu origin showed a specific proportion which is not the same as golden percentage. However, this proportion was generally accepted esthetically by subjects."

"Cedera otak pada perdarahan intraserebral spontan (PIS) terdiri dari cedera primer kerusakan struktural karena proses mekanis dan cedera sekunder akibat respons patofisiologis subklinis mencakup inflamasi, stress oksidatif dan sitotoksik terhadap komponen serta produk degradasi darah. Proses subklinis PIS yang sedang berlangsung tersebut masih belum terpantau secara lengkap, sehingga penelitian ini ditujukan untuk mengidentifikasi perjalanan proses subklinis cedera otak sekunder perdarahan intraserebral spontan dan pengaruhnya terhadap perubahan luaran respons klinis kasus (LRK) PIS pasca-intervensi bedah saraf. Penelitian ini menggunakan desain observasional prospektif, mulai Agustus 2016-April 2018 terhadap 20 subjek yang baru pertama kali mengalami perdarahan intraserebral spontan yang disertai perdarahan intraventricular dan menjalani intervensi bedah saraf external ventricular drainage (EVD). Data tercatat mencakup skor Full Outline of UnResponsiveness (SF), TIK, dan kadar hari ke-1 dan hari ke-7 Tumor Necrosis Factor alpha (TNFα), Superoxide Dismutase (SOD) dan zat besi dalam LSS. Analisis bivariat menggunakan uji Ttak berpasangan atau uji Mann-Whitney. Data skala kategorik diuji dengan Chisquare atau Fisher's exact test, dan untuk data kategorik berpasangan dengan uji McNemar.TIK pasca-intervensi semua subjek menurun secara gradual menjadi normal dan ada lima subjek yang tidak mengalami perbaikan LRK SF hari 1-7. Semua subjek kelompok 'tanpa perbaikan' mempunyai kadar TNFα LSS hari ke-1 tinggi, sebaliknya yang kadarnya normal mengalami perbaikan LRK (P=0,003). Selisih nilai peningkatan TNFα hari 1-7 juga lebih besar bermakna pada yang 'tanpa perbaikan' (P=0,005). Kadar SOD LSS hari ke-1 dan perubahannya tidak terbukti berbeda bermakna antara kedua kelompok. Pengamatan klinis memperlihatkan 80% subjek 'perbaikan', mempunyai kadar zat besi LSS hari ke-1 normal dalam status saturasi transferin < 50%. Semua subjek yang mempunyai kadar zat besi hari ke-1 tinggi dalam status saturasi transferin ≥ 50% mengalami LRK 'tanpa perbaikan'. Terdapat perbedaan bermakna dari selisih peningkatan status saturasi transferin antara kedua kelompok subjek. (P=0,05). Penelitian ini menyimpulkan bahwa subjek PIS dengan kadar TNFα LSS hari ke-1 tinggi dan/atau zat besi LSS tinggi dalam status saturasi transferin ≥ 50%, mempunyai LRK 'tanpa perbaikan'. Semakin besar peningkatan kadar TNFα LSS pada hari ke-7 dan/atau kadar zat besi yang disertai peningkatan saturasi transferrin, mempunyai LRK 'tanpa perbaikan'. Kadar SOD hari ke-1 dan perubahan kadar hari 1-7 belum dapat dimanfaatkan sebagai penanda prognosis dan proses subklinis PIS.

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Brain injury of spontaneous intracerebral hemorrhage caused by primary injury of structural damage due to mechanical processes and secondary injuries resulting from subclinical pathophysiological responses of inflammation, oxidative stress and cytotoxicity to components and blood degradation products including iron. The subclinical pathophysiology processes still cannot be monitored explicitly. This study is aimed at identifying the course of ICH subclinical secondary brain injury process and finding its relations with the days 1-7 trend of clinical response outcomes after neurosurgical intervention. This study is a prospective observational designed study done from August 2016 until April 2018. Twenty subjects were diagnosed as spontaneous intracerebral hemorrhage and underwent neurosurgical intervention external ventricular drainage (EVD). Recorded data consist of everyday Full Outline of UnResponsiveness (FOUR) score, intracranial pressure, and cerebro-spinal fluid (CSF) Tumor Necrosis Factor alpha (TNFα), Superoxide Dismutase (SOD), iron and transferrin saturation at day-1 and day-7. Bivariate analysis performed with unpaired T-test or Mann-Whitney test. Unpaired categorical scale data tested by Chi-square or Fisher's exact test, and McNemar test for paired categorical data.All 'unimproved' subjects had high levels of day-1 CSF TNFα, whereas all subjects with normal TNFα have clinical improvement response (P=0.003). Subsequently those subjects had significantly greater increasing levels (P=0.005). No significant difference of CSF SOD between of 'unimproved' and 'improved' group. Clinical observation clearly showed that 80% of 'improved' subjects have normal day-1 iron levels in controlled by transferrin saturation < 50%. There will be no improvement of those high iron levels with transferrin saturation ≥ 50%. A significant difference results were also noted of increasing transferrin saturation status (P=0,05). This study concluded that SICH with high level of day-1 CSF TNFα and/or high CSF iron with transferrin saturation ≥ 50%, would have an 'unimproved' trend of clinical response outcome. Greater increasing level of those biomarkers in days 1-7, tend to have an unimproved outcome. CSF SOD could not to be use as a significant clinical prognostic and process biomarker."