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"Latar belakang: Celah bibir dan palatum adalah kelainan bawaan yang mempengaruhi regio orofacial. Perawatan yang menjadi baku emas untuk pasien celah bibir dan palatum adalah autologous bone graft. Namun, perawatan ini masih invasif dan ada beberapa kekurangannya sehingga perlu teknik rekayasa jaringan dengan sel stromal. Sel stromal mesenkim yang terdapat dalam rongga mulut adalah sel stromal pulpa gigi sulung (SHED) dan sel stromal pulpa gigi permanen (DPSC). Kemampuan diferensiasi osteogenik SHED dan DPSC pada subjek normal sudah diketahui. Namun, kemampuan diferensiasi osteogenik dengan ekspresi gen RUNX-2 pada DPSC dan SHED pasien celah bibir dan palatum belum diketahui secara pasti. Tujuan: Membandingkan kemampuan diferensiasi osteogenik sel stromal pulpa gigi permanen pasien celah bibir dan palatum dengan sel stromal pulpa gigi sulung pasien celah bibir dan palatum melalui ekspresi gen RUNX-2. Metode: DPSC celah bibir dan palatum dan SHED celah bibir dan palatum dikultur dengan medium osteogenik dan tanpa medium osteogenik selama 21 hari. Sampel RNA diperoleh kultur sel stromal pulpa gigi permanen (DPSC) dan sel stromal pulpa gigi sulung (SHED) pasien celah bibir dan palatum. Selanjutnya diuji ekspresi gen RUNX-2, dan housekeeping gene 18S dengan Real-Time Polymerase Chain Reaction (RT-PCR). Hasil: Tidak ada perbedaan kemampuan diferensiasi sel stromal pulpa gigi permanen pasien celah bibir dan palatum dengan sel stromal pulpa gigi sulung pasien celah bibir dan palatum melalui ekspresi gen RUNX-2. Kesimpulan: Kemampuan diferensiasi osteogenik sel stromal pulpa gigi sulung pasien celah bibir dan palatum ekuivalen dengan sel stromal pulpa gigi permanen pasien celah bibir dan palatum.

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Background: Cleft lip and palate are congenital anomalies that affect the orofacial region including lips, alveolar ridge, hard palate, and soft palate. Patients with cleft lip and palate have impaired esthetic and stomatognathic functions. The gold standard treatment for cleft lip and palate patients is an autologous bone graft. However, this treatment is still invasive and has some limitations therefore requires tissue engineering techniques by using stromal cells. Mesenchymal stromal cells that are found in the mouth are stromal cells from human exfoliated deciduous teeth (SHED) and dental pulp stromal cells (DPSC). The osteogenic differentiation of SHED and DPSC normal subjects are well known. Nevertheless, the osteogenic differentiation capacity by RUNX-2 mRNA expression in DPSC and SHED cleft lip and palate patients is still need to be elucidated. Objective: To compare the osteogenic differentiation capacity of stromal cells from human exfoliated deciduous teeth and dental pulp stromal cells in cleft lip and palate patients through RUNX-2 gene expression. Methods: DPSC and SHED cleft lip and palate patients were cultured with and without osteogenic medium for 21 days. RNA sample were collected from cell culture followed by the examination of RUNX-2 and 18S gene expression were tested by Real-Time Polymerase Chain Reaction (RT-PCR). Result: There was no difference in osteogenic differentiation capacity between DPSC and SHED cleft lip and palate patients through RUNX-2 gene expression. Conclusion: The osteogenic differentiation capacity of SHED was equivalent to DPSC of cleft lip and palate patients."

"Latar Belakang: Pengembangan teknologi rekayasa jaringan sebagai terapi CLP berpotensi untuk menggantikan terapi autologous bone graft. Rekayasa jaringan terdiri dari tiga komponen yang dikenal sebagai triad rekayasa jaringan, yaitu sumber sel punca, biodegradable scaffold, dan faktor pertumbuhan. DPSC merupakan salah satu sumber sel punca yang diketahui efektif dalam memperbaiki defek CLP dengan metode isolasi sel yang relatif lebih mudah, tidak invasif, dan efek samping minimal. Pada penelitian sebelumnya DPSC yang diisolasi dari pasien CLP menunjukkan ekspresi gen IGF-1 yang berlebih. Faktor pertumbuhan tersebut diketahui berperan dalam proliferasi dan diferensiasi sel, namun ekspresi berlebih IGF-1 pada DPSC pasien CLP tidak diikuti oleh peningkatan kemampuan proliferasi dan diferensiasinya. Dalam sistem sirkulasi, IGF-1 berikatan dengan IGFBP-3 yang dapat memperpanjang waktu paruhnya. IGFBP-3 memiliki afinitas yang lebih tinggi terhadap IGF-1 dibanding dengan IGF-1R, sehingga dapat meregulasi dan menghambat peran IGF-1. Fungsi IGF-1 dijalankan dengan berikatan dengan IGF-1R untuk mengaktifkan jalur pensinyalan hilir, salah satunya adalah jalur MAPK/ERK1/2. ERK1 dan ERK2 diketahui meregulasi fungsi proliferasi dan diferensiasi sel, namun belum diketahui secara pasti bagaimana ekspresi gen ERK1 dan ERK2 pada DPSC subjek normal dan CLP. Tujuan: Menganalisis pengaruh anti IGF-1R dan IGFBP-3 terhadap ekspresi gen ERK1 dan ERK2 pada DPSC subjek normal dan CLP.Metode: Sampel RNA DPSC pasien normal (n=4) dan CLP (n=3) sebelum dan sesudah perlakuan anti IGF-1R atau IGFBP-3 diperoleh dari bahan biologis tersimpan di Laboratorium Biologi Oral Fakultas Kedokteran Gigi Universitas Indonesia. Dilakukan analisis ekspresi relatif gen ERK1, ERK2, dan GAPDH sebagai housekeeping gene dengan two-step Real-Time PCR (RT-PCR)Hasil: Tidak terdapat perbedaan ekspresi gen ERK1 dan ERK2 pada DPSC pasien CLP dibanding pasien normal, baik pada perlakuan anti IGF-1R maupun IGFBP-3. Kesimpulan: Inhibisi IGF-1 dengan anti IGF-1R dan IGFBP-3 tidak memengaruhi ekspresi gen ERK1 dan ERK2.

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Background: The development of tissue engineering as a therapy for CLP have potential to replace the current autologous bone graft that is considered not ideal in repairing the bone defect in CLP patients. Tissue engineering consists of three parts known as the tissue engineering triad: stem cell source, biodegradable scaffold, and growth factors. DPSC is one such stem cell source that is known to effectively repair CLP defects with a relatively easy cell isolation, less invasive, and minimal patient compromise. Recent studies have found that DPSC isolated from CLP patients display a higher expression of IGF-1 gene expression. IGF-1 is known for its role in cell proliferation and differentiation, however the overexpression of IGF-1 gene in CLP patient’s DPSC is not followed by the increase of proliferation and differentiation capability. In the circulation system, IGF-1 binds to IGFBP-3 to extend its half time in the system. IGFBP-3 displays a higher affinity towards IGF-1 than IGF-1R, thus acting as a regulator and inhibitor to IGF-1 activity. IGF-1 functions by binding with IGF-1R and activating the downstream signalling pathway. One such pathway is the MAPK/ERK1/2 signalling pathway. ERK1 and ERK2 are both known for its role in regulating the proliferation and differentiation function in cells, but the exact gene expression characteristics in both normal and CLP subject’s DPSC are not known. Objective: To analyze the effect of anti IGF-1R and IGFBP-3 to ERK1 and ERK2’s gene expression in normal and CLP subject’s DPSC. Methods: RNA samples of DPSC of normal (n=4) and CLP subjects (n=3) before and after treated with anti IGF-1R and IGFBP-3 were obtained from the Oral Biology Laboratory of Faculty of Dentistry Universitas Indonesia. Relative gene expression of ERK1, ERK2, and GAPDH as the housekeeping gene were analyzed using two-step Real-Time PCR (RT-PCR) Results: There was no difference in both ERK1 and ERK2 gene expression between normal and CLP subject following anti IGF-1R or IGFBP-3 treatment. Conclusion: anti IGF-1R and IGFBP-3 treatment did not influence ERK1 and ERK2 gene expression"

"Background: As the second most common congenital structural anomaly, CL/P may functionally disable children with regard to eating, drinking, speaking, breathing, and hearing. Psychosocial health issue is important in school-age children because by theage of 7 years, children start to make judgments about physical attractiveness in their peers. This study aims to evaluate psychosocial problems in Indonesian cleft center school-age patients identified using CBCL/6-18 despite any surgical interventions. Methods: We conducted a cross-sectional study on patients’ parents from Bandung,Indonesia from 2011 to 2016, have undergone CL/P associated surgeries in Bandung Cleft Center using the Bahasa Indonesia version of CBCL/6-18 questionnaire (administered orally by phone). The data was entered to the official ASEBA-Webonline calculator. We depicted the findings using descriptive statistics. Results: There were 104 patents who can be contacted from the Bandung Cleft Center surgery database from 2011 to 2016. The median age was 8 years old, 56.7% of them were male, and 73.0% of them has cleft of lip, gum, and palate. We found that the speech and appearance problem were not perceived on 36 patients (34.6%) after undergoing surgery. We found that 78,8% of the patients had below normal score in Activities scale, while 93.3% of the patient had normal score in the Social scale and 92.3% of the patient had normal score School scale. Seven patients (6.7%) scored Borderline or Clinical Range in the Problem Items section. Sixteen patients (15.4%) were noted for some of the Critical Items put in among the Problem Items checklist as ared flag indicator. Conclusion: In this study, we found 6.7% of the school-age children population withCL/P had psychosocial problems. As the Indonesian population is very diverse, a wider sample from all regions of Indonesia are necessary to give more complete understanding. The result of this study hopefully can shed some light in the long-termpsychosocial conditions of the CL/P children post-operatively and be a baseline for further studies and care in Indonesian cleft center

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Latar Belakang: Sebagai kelainan kongenital struktural kedua paling umum, CL/P dapat menyebabkan gangguan fungsional dalam hal makan, minum, berbicara, bernapas, dan mendengar. Masalah psikososial menjadi penting pada anak usia sekolah

karena pada usia 7 tahun, anak mulai dapat melakukan penilaian daya tarik fisik pada teman sebayanya. Penelitian ini bertujuan untuk mengevaluasi masalah psikososial pada pasien usia sekolah di pusat sumbing Indonesia menggunakan CBCL / 6-18 setelah dilakukan intervensi bedah. Metode: Kami melakukan studi potong lintang pada orang tua pasien dari Bandung,

Indonesia dari tahun 2011 hingga 2016, telah menjalani operasi terkait CL/P di Bandung Cleft Center menggunakan kuesioner CBCL / 6-18 versi Bahasa Indonesia (diberikan secara lisan melalui telepon). Data dimasukkan ke kalkulator online resmi ASEBA-Web. Kami menguraikan temuan menggunakan statistik deskriptif. Hasil: Terdapat 104 pasien yang dapat dihubungi dari database operasi Bandung Cleft

Center dari tahun 2011 sampai 2016. Median umur adalah 8 tahun, 56,7% berjenis

kelamin laki-laki, dan 73,0% diantaranya mengalami celah bibir, gusi, dan lelangit.

Kami menemukan bahwa masalah bicara dan penampilan tidak dikeluhkan pada 36

pasien (34,6%) setelah menjalani operasi. Kami menemukan bahwa 78,8% pasien memiliki skor di bawah normal pada skala Aktivitas, sedangkan 93,3% pasien memiliki skor normal pada skala Sosial dan 92,3% pasien memiliki skor normal Skala Sekolah.

Tujuh pasien (6,7%) mendapat skor borderline atau clinical range di bagian Problem Items. Enam belas pasien (15,4%) dicatat untuk beberapa Critical ITems yang dimasukkan dalam daftar periksa Problem Items sebagai indikator bendera merah. Kesimpulan: Dalam penelitian ini ditemukan 6,7% dari populasi anak usia sekolah dengan CL/P memiliki masalah psikososial. Mengingat jumlah penduduk Indonesia

yang sangat beragam maka diperlukan sampel yang lebih luas dari seluruh wilayah

Indonesia untuk memberikan pemahaman yang lebih lengkap. Hasil penelitian ini

diharapkan dapat menjelaskan kondisi psikososial jangka panjang pada anak CL / P

pasca operasi dan menjadi dasar untuk studi dan perawatan lebih lanjut di pusat

sumbing di Indonesia."

"Latar Belakang: Sumber sel stromal yang paling ideal digunakan dalam rekayasa jaringan adalah sel stromal pulpa gigi permanen (DPSC) dan sel stromal pulpa gigi sulung (SHED) dikarenakan sifat proliferasinya yang tinggi. Pada penelitian sebelumnya, dinyatakan bahwa terdapat peningkatan ekspresi gen homeobox salah satunya yaitu gen ALX4 sebagai pada pasien celah bibir dan palatum dengan subjek normal. Gen ALX4 adalah gen homeobox dibawah famili Alx dan memiliki peran langsung dalam perkembangan dan pembentukan kepala serta wajah serta mentranslasi protein yang meregulasi perkembangan dan proliferasi sel, pendewasaan dan diferensiasi sel, pergerakan sel, dan pertahanan sel. Namun, karakteristik DPSC dan SHED dilihat dari ekspresi gen ALX4 pada subjek normal dan pasien celah bibir dan palatum belum diketahui. Tujuan: Mengevaluasi karakteristik DPSC dan SHED subjek normal dan pasien CLP berdasarkan ekspresi gen ALX4. Metode: DPSC subjek normal, DPSC pasien celah bibir dan palatum, dan SHED pasien celah bibir dan palatum diperoleh dari bahan biologis tersimpan Laboratorium Oral Biologi Fakultas Kedokteran Gigi Universitas Indonesia. Selanjutnya ekspresi gen ALX4 dan housekeeping gene GAPDH diuji dengan two step quantitative RT-PCR (RT-PCR). Hasil: Tidak terdapat perbedaan ekspresi gen ALX4 baik diantara DPSC subjek normal dengan DPSC CLP (p=0,407) maupun DPSC CLP dengan SHED CLP (p=0,145). Kesimpulan: Tidak terdapat perbedaan karakteristik sel stromal pulpa gigi permanen dan sel stromal pulpa gigi sulung pada subjek normal dengan pasien celah bibir dan palatum berdasarkan ekspresi gen ALX4

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Background: The most ideal sources of stromal cells used in tissue engineering are dental pulp stem cells (DPSC) and stem cells from human exfoliated deciduous teeth (SHED) due to their high proliferative properties. In previous studies, it was stated that there was an increase in the expression of homeobox genes (differentially expressed genes (DEGs), one of which was the ALX4 gene as in cleft lip and palate patients with normal subjects. The ALX4 gene is a homeobox gene under the Alx family and has a direct role in the development and formation of the skull and human face, along with the ALX4 proteins that regulate cell development and proliferation, cell maturation and differentiation, cell movement, and cell defence. However, the characteristics of ALX4 gene expression in DPSC and SHED in normal and cleft lip and palate patients are not known. Objective: To evaluate and compare the characteristics of Dental Pulp Stromal Cells (DPSC) and Stromal Cells from Human Exfoliated deciduous teeth (SHED) in cleft lip and palate and normal subjects by the expression of the ALX4 homeobox gene. Methods: DPSC of normal subjects, DPSC of CLP patients, SHED of CLP patients were obtained from stored biological material in the Oral Biology Laboratory, Faculty of Dentistry, University of Indonesia. Then, the examination of ALX4 gene expression was tested by Real-Time Polymerase Chain Reaction (RT-PCR) Results: There was no difference in ALX4 gene expression between DPSC in normal subjects and DPSC in cleft lip and palate subjects (p=0,407) and between DPSC in cleft lip and palate subjects and SHED in cleft lip and palate subjects (p=0,145). Conclusion: There were no differences in the characteristics of the pulp stromal cells of permanent and primary teeth in normal subjects with cleft lip and palate subjects through the expression of the ALX4 gene."