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Abstrak :
Latar Belakang: Epigenetik lingkungan merupakan faktor yang masih dapat dikontrol dalam kejadian celah bibir dan lelangit. Masyarakat diharapkan dapat mengetahui apa saja epigenetik lingkungan yang berpengaruh terhadap kejadian celah bibir dan lelangit sehingga masyarakat sadar akan pentingnya tata laksana yang baik pada penderita celah bibir dan lelangit. Tujuan: Mengetahui gambaran epigenetik lingkungan pada penderita celah bibir dan lelangit. Metode: Penelitian deskriptif dengan desain potong lintang dengan sampel 184 rekam medis pasien celah bibir dan lelangit di RSAB Harapan Kita. Data menunjukkan gambaran epigenetik lingkungan pada anak dengan celah bibir dan lelangit yang sudah selesai menjalani perawatan bedah primer di RSAB Harapan Kita. Hasil: Nilai rerata usia ibu saat hamil adalah 30,5 tahun. Terdapat riwayat konsumsi obat pada 77,7 persen subjek. Tidak diketahui adanya kebiasaan merokok pada ibu. Tingkat pendidikan ibu sedang (SMP, SMA, Diploma 1–3) dan tingkat pendidikan ayah tinggi (Sarjana 1–2) memiliki persentase terbesar. Mayoritas ibu pasien berdomisili di Jabodetabek. Nilai rerata berat badan lahir, lingkar kepala lahir, dan panjang badan lahir sebagai parameter dari nutrisi ibu termasuk dalam kategori normal. Sebanyak 79,9% subjek menjalani recall pasca perawatan primer. Kesimpulan: Epigenetik lingkungan menunjukkan gambaran yang normal pada pasien celah bibir dan lelangit di RSAB Harapan Kita. ......Background: Environmental epigenetics are controllable elements in the occurrence of cleft lip and palate. The community is expected to understand the environmental epigenetics that influence the incidence of cleft lip and palate, raising awareness of the importance of proper management in cleft lip and palate. Objective: This study aims to understand the overview of environmental in epigenetics individuals with cleft lip and palate. Methods: Descriptive research with a cross-sectional design involving a sample of 184 medical records of cleft lip and palate patients at RSAB Harapan Kita. The data illustrates the overview of environmental epigenetics in children with cleft lip and palate who have completed primary surgical treatment at RSAB Harapan Kita. Results: The average maternal age during pregnancy is 30,5 years. About 77,7% of subjects have a history of drug consumption, and smoking habits are unknown. Mothers typically have a moderate education level, while fathers have a higher education level. Most mothers reside in Jabodetabek. Birth weight, head circumference, and birth length fall within normal ranges. A recall after primary care was conducted for 79,9% of the subjects. Conclusion: The environmental epigenetics indicate a normal overview in patients with cleft lip and palate at RSAB Harapan Kita.

Abstrak :
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. ......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.

Abstrak :
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 ......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.

Abstrak :
LatarBelakang: Struktur dentokraniofasial pada anak dengan celah bibir dan langit-langit yang ditangani dengan prosedur bedah, akan mempengaruhi pertumbuhan maksila, namun tidak mempengaruhi struktur dan posisi mandibula. Disproporsional atau kelainan dentofasial dapat terjadi apabila pertumbuhan maksila tidak sejalan dengan pertumbuhan mandibula sehingga untuk mencapai keberhasilan perawatan perlu memperhatikan keadaan pertumbuhan dan perkembangan anak terutama pada kasus yang diindikasikan perawatan orthodonti disertai bedah orthognatik, dimana waktu dilakukan bedah pada saat pertumbuhan telah selesai. Dalam mengidentifikasi tahap pertumbuhan dapat digunakan beberapa indikator seperti usia kronologis, tinggi dan berat badan, perkembangan gigi geligi dan karakteristik maturasi seksual yaitu menstruasi pada wanita dan perubahan suara pada pria. Indikator lainnya adalah perkembangan skeletal yang umumnya dilakukan melalui pemeriksaan foto radiografik. Penentuan maturasi skeletal dengan mengevaluasi marurasi tulang karpal, sangat membantu untuk menetapkan diagnosis dan merencanakan perawatan yang tepat. Tujuan: Untuk menilai tahap maturasi tulang karpal penderita celah bibir dan/atau langitlangit usia 15 - 20 tahun. Bahan dan Cara : Dilakukan pengambilan rontgen foto karpal tangan kiri pada 25 sampel, hasil radiografi dilakukan analisa dengan maturasi skeletal indeks. Dari data yang didapat dilakukan uji statistik chi-squere. Hasil: Hasil penelitian menunjukkan tahap maturasi tulang karpal pada penderita celah bibir dan langit-langit pada kelompok umur 15-17 tahun, sangat bervariasi. Pada kelompok umur 18-20 tahun, baik lakilaki dan perempuan tahap maturasi skeletal telah selesai. Hasil uji statistik memperlihatkan perbedaan maturasi skeletal yang bermakna antara laki-laki dan perempuan. Kesimpulan :.Dari penelitian ini dapat disimpulkan bahwa terdapat perbedaan yang bermakna antara maturasi skeletal kelompok laki-laki dibandingkan kelompok perempuan pada penderita celah bibir dan/atau langit-langit. ......Background : Dentocraniofacial structure in children with cleft lip and palate treated with surgical procedures, will affect the growth of the maxilla, but does not affect the structure and position of the mandible. Disproportionate or dentofacial abnormalities can occur when the growth of the maxilla is not in line with the growth of the mandible so as to achieve treatment success should pay attention to the state of growth and development of children, especially in the case of the indicated treatment with surgical orthodontic orthognatic, where surgery is the time when growth has been completed. In the growth stage can be used to identify some indicators such as chronological age, height and weight, the development of teeth and characteristics of sexual maturation that menstruation in women and in men the sound changes. Another indicator is the skeletal development which is generally done through radiographic examination. Determination of skeletal maturation by evaluating marurasi carpal bones, is helpful to establish the diagnosis and appropriate treatment plan. Objectives : To assess patients with carpal bone maturation stage cleft lip and/or palate aged 15-20 years. Material and Method : Hand wrist x-ray image of the left hand on 25 sample, result of radiograph performed analysis with Skeletal Maturation Index (SMI). The data was performed statistical analysis chi-squere test. Results : The results showed carpal bone maturation stage in patients with cleft lip and palate in the age group 15-17 years, are very varied. In the age group 18-20 years, both male and female skeletal maturation stage has been completed. The test result showed statistically differences in skeletal maturation between male and female with cleft lip and palate on Skeletal Maturation Index (SMI). Conclusion: From this study it can be conclude that there significant differences male skeletal maturation compared to female of children with cleft lip and palate.

Abstrak :
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 the age 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-Web online 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 a red flag indicator. Conclusion: In this study, we found 6.7% of the school-age children population with CL/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-term psychosocial conditions of the CL/P children post-operatively and be a baseline for further studies and care in Indonesian cleft center ......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.

Abstrak :
Latar Belakang: Rekayasa jaringan tulang memerlukan tiga komponen utama, yaitu sel punca, scaffold, dan faktor pertumbuhan. IGF-1 merupakan salah satu faktor pertumbuhan yang berperan dalam proliferasi dan diferensiasi sel osteoblast. IGF-1 akan berikatan dengan reseptornya, yaitu IGF-1R untuk mengaktivasi jalur hilir. Dalam sirkulasi tubuh manusia, IGF berikatan dengan IGFBP-3 yang dapat memperpanjang waktu paruh serta menghambat IGF-1 berikatan dengan IGF-1R. Pada penelitian sebelumnya, tercatat bahwa tidak ada perbedaan kemampuan proliferasi dan diferensiasi antara DPSC subjek normal dan subjek CLP, namun ada perbedaan signifikan dalam jumlah ekspresi IGF-1. OCT-4, SOX-2 dan NANOG merupakan faktor transkripsi utama pluripotensi yang telah diteliti dapat mengatur pluripotensi, pembaruan diri, proliferasi, serta diferensiasi DPSC. Penelitian terbaru mencatat peningkatan ekspresi ketiga gen tersebut pasca dilakukan penghambatan jalur GSK-3 dan m-TOR yang merupakan jalur hilir dari aksi IGF-1 pada sel DPSC. Namun, belum diketahui secara pasti ekspresi ketiga gen tersebut pada DPSC subjek normal dan CLP setelah dilakukannya penghambatan IGF-1 menggunakan anti IGF-1R dan IGFBP-3. Tujuan: Menganalisis pengaruh anti IGF-1 dan IGFBP-3 terhadap ekspresi gen OCT4, SOX2, dan NANOG pada DPSC subjek normal dan CLP. Metode: Sampel RNA DPSC subjek normal (n=4) dan DPSC subjek CLP (n=3), sebelum dan setelah diberikan perlakuan anti IGF-1R atau IGFBP-3, diperoleh dari bahan biologis tersimpan di Laboratorium Oral Biologi Fakultas Kedokteran Gigi Universitas Indonesia. Selanjutnya, ekspresi gen OCT4, SOX2, NANOG, dan housekeeping gene GAPDH diuji dengan two step Real-Time PCR (RT-PCR). Hasil: Tidak terdapat perbedaan ekspresi gen OCT4, SOX2, dan NANOG, baik antara DPSC subjek normal dan CLP sebelum dan setelah diberikan perlakuan anti IGF-1R dan IGFBP-3 (p³0,05). Kesimpulan: Perlakuan anti IGF-1R dan IGFBP-3 tidak memengaruhi tingkat ekspresi gen OCT4, SOX2, dan NANOG sel punca pulpa gigi permanen subjek normal dan subjek celah bibir dan palatum ......Background: Bone tissue engineering requires three main components, namely stem cells, scaffold, and growth factors. IGF-1 is a growth factor that plays role in osteoblast proliferation and differentiation. IGF-1 will bind to its receptor, namely IGF-1R, to activate the downstream pathway. In the human body circulation, IGF binds to IGFBP-3 which can inhibit IGF-1 from binding to IGF-1R. Previous studies noted that there were no differences in the ability to proliferate and differentiate between DPSC from normal subjects and CLP subjects, yet there were significant differences in the level of IGF-1 expression. OCT-4, SOX-2 and NANOG are core pluripotency factors which regulate pluripotency, self-renewal, proliferation and differentiation of DPSC. Recent study has noted an increase in the expression of these three genes after inhibition of GSK-3 and m-TOR pathways, which are the downstream pathways of IGF-1 on DPSC cells. However, the expression of these three genes in DPSC from normal and CLP subjects after inhibition of IGF-1 using anti IGF-1R and IGFBP-3 is still unknown. Objective: To analyze the effect of anti IGF-1 and IGFBP-3 on OCT4, SOX2, and NANOG gene expression in DPSC of normal and CLP subjects. Methods: RNA samples of DPSC from normal and CLP subjects, before and after being treated with anti-IGF-1R or IGFBP-3, were obtained from Laboratory of Oral Biology, Faculty of Dentistry, Universitas Indonesia. Furthermore, the expression of OCT4, SOX2, NANOG, and housekeeping gene GAPDH were tested using two step Real-Time PCR (RT-PCR). Results: There was no difference between the expression of the OCT4, SOX2, and NANOG in DPSC from normal and CLP subjects before and after anti IGF-1R and IGFBP-3 treatment (p≥0.05). Conclusion: Anti-IGF-1R and IGFBP-3 did not affect the expression level of OCT4, SOX2, and NANOG in dental pulp stem cells of normal subjects and cleft lip and palate subjects.

Abstrak :
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. ......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

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Latar Belakang: Gen Homeobox adalah gen pengatur perkembangan antara lain morfogenesis sel dengan menyandikan faktor transkripsi pada tahap awal embriogenesis dan diferensiasi sel. Gen EN1 adalah gen Homeobox yang berperan dalam proses pembentukan tulang. Penelitian terbaru menunjukkan bahwa gen EN1 mengalami overexpression signifikan pada sel stromal pulpa gigi permanen pasien celah bibir dan palatum. Namun, pengaruh gen EN1 pada karakteristik sel stromal pulpa gigi sulung dan permanen subjek normal dan pasien celah bibir dan palatum belum diketahui secara pasti. Tujuan: Melakukan verifikasi karakteristik sel stromal gigi permanen pasien celah bibir dan palatum dan subjek normal serta sel stromal gigi sulung pasien celah bibir dan palatum melalui ekspresi gen EN1. Metode: Sampel RNA DPSC subjek normal (n=2), DPSC CLP (n=2), SHED CLP (n=2) diperoleh dari bahan biologis tersimpan Laboratorum Oral Biologi Fakultas Kedokteran Gigi Universitas Indonesia. Kemudian, dilakukan sintesis cDNA dan standarisasi konsentrasi sampel hasil sintesis cDNA. Selanjutnya, ekspresi gen EN1 dan gen referensi GAPDH diuji dengan quantitative reverse-transcription PCR (RT-qPCR). Hasil: Tidak terdapat perbedaan bermakna ekspresi gen EN1, antara DPSC subjek normal dengan DPSC CLP (p≥0,05) sedangkan terdapat perbedaan bermakna ekspresi gen EN1 antara sel DPSC CLP dengan sel SHED CLP (p≤,05). Kesimpulan: Tidak terdapat perbedaan karakteristik sel stromal pulpa gigi permanen antara subjek normal dan pasien celah bibir dan palatum, sedangkan terdapat perbedaan antara sel stromal pulpa gigi sulung dan sel stromal pulpa gigi permanen pada pasien celah bibir dan palatum. ......Background: Homeobox gene is a group of master regulatory developmental genes which are responsible for encode transcription factor in the early phase of embryogenesis and for cell differentiation. EN1 gene is a Homeobox gene that has a role in bone formation. The latest research discovered that EN1 gene was significantly overexpressed in Permanent Teeth’s Stromal Cell of Cleft Lip and Palate Subjects. However, the effect of EN1 gene on the characteristics of Permanent and Deciduous Teeth’s Stromal Cell of Normal Subjects and Cleft Lip and Palate Subjects still remain unknown. Objective: To Verify on the characteristic of the Permanent Teeth’s Stromal Cell between Cleft Lip and Palate Patients and Normal Subjects as well as the characteristic between the Permanent Teeth’s Stromal Cell of Cleft Lip and Palate Patients and Deciduous Teeth’s Stromal Cell of Cleft Lip and palate Patients. Methods: DPSC of normal subjects’ RNA sample (n=2), DPSC of CLP Patient’s RNA sample (n=2), SHED of CLP Patients’ RNA sample (n=2) obtained from Archived Biological Materials in Laboratorium. Subsequently, synthesis the RNA sample into cDNA sample and standardize the cDNA concentration sample. Afterwards, perform RT-PCR assay to validate EN1 and GAPDH reference gene expression. Results: No statistically significant difference of the EN1 gene expression between the Permanent Teeth’s Stromal Cell between Cleft Lip and Palate Patients and Normal Subjects (p≥0,05) and there is statistically significant difference of the EN1 gene expression between the Permanent Teeth’s Stromal Cell of Cleft Lip and Palate Patients and Deciduous Teeth’s Stromal Cell of Cleft Lip and palate Patients. (p ≤05) Conclusion: There is no characteristic difference between the Permanent Teeth’s Pulp Stromal Cell between Cleft Lip and Palate Patients and Normal Subjects, Meanwhile There is characteristic difference between the Deciduous Teeth’s Pulp Stromal Cell of Cleft Lip and Palate Patients and the Permanent Teeth’s Pulp Stromal Cell of Cleft Lip and Palate Patients.

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Latar Belakang: Rekayasa jaringan merupakan perawatan alternatif autologous bone graft pada rekonstruksi tulang alveolar pasien celah bibir dan palatum (CLP). Potensi klonogenik dan proliferatif yang baik serta kemudahan aksesibilitas membuat sel stromal pulpa gigi permanen (DPSC) dan gigi sulung (SHED) menjadi sel yang ideal untuk rekonstruksi tulang alveolar. Gen HOXC9 merupakan gen homeobox di bawah famili Hox, yang mengatur pola perkembangan skeletal. Penelitian terbaru menyatakan gen Hox tetap terekspresikan saat dewasa dan ditemukan dalam regenerasi jaringan. Namun, karakteristik ekspresi gen HOXC9 pada DPSC dan SHED subjek normal dan pasien celah bibir dan palatum belum diketahui secara pasti. Tujuan: Mengevaluasi karakteristik DPSC dan SHED subjek normal dan pasien CLP melalui ekspresi gen HOXC9. Metode: Sampel RNA DPSC subjek normal (n=2), DPSC CLP (n=3), SHED CLP (n=2) diperoleh dari bahan biologis tersimpan Laboratorium Oral Biologi Fakultas Kedokteran Gigi Universitas Indonesia. Selanjutnya ekspresi gen HOXC9 dan housekeeping gene GAPDH diuji dengan two step Real-Time PCR (RT-PCR). Hasil: Tidak terdapat perbedaan ekspresi gen HOXC9, baik antara DPSC subjek normal dengan DPSC CLP (p>0,05) ataupun DPSC CLP dengan SHED CLP (p>0,05). Kesimpulan: Sel stromal pulpa gigi permanen dan gigi sulung subjek normal dan pasien celah bibir dan palatum memiliki karakteristik yang sama melalui ekspresi gen HOXC9. ......Background: Tissue engineering is an alternative treatment of autologous bone graft in alveolar bone reconstruction for cleft lip and palate (CLP) patients. The clonogenic and proliferative capacity as well as the ease of accessibility make DPSC and SHED ideal cells for alveolar bone reconstruction. HOXC9 is a homeobox gene under the Hox family, which regulates the development of skeletal patterns. Recent research suggests that the Hox gene remains expressed in adulthood and is found in tissue regeneration. However, the characteristics of HOXC9 gene expression in DPSC and SHED of normal subjects and cleft lip and palate patients are unknown. Objective: To evaluate the characteristics of DPSC and SHED in normal subjects and CLP patients through HOXC9 gene expression. Methods: RNA samples from DPSC of normal subjects (n=2), DPSC of CLP patients (n=3), SHED of CLP patients (n=2) were obtained from the Laboratory of Oral Biology, Faculty of Dentistry, Universitas Indonesia. HOXC9 gene expression and housekeeping gene GAPDH were tested by two-step Real-Time PCR (RT-PCR). Results: There was no difference in HOXC9 gene expression, either between DPSC of normal subjects and DPSC of CLP patients (p>0.05) or DPSC and SHED of CLP patients (p>0.05). Conclusion: DPSC and SHED of normal subjects and cleft lip and palate patients have the same characteristic through HOXC9 gene expression.

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ABSTRAK
Latar Belakang: Operasi orthognatik merupakan tahapan akhir dari perawatan fungsional dan rehabilitasi pada penderita celah bibir dan langit-langit, disebabkan karena tingginya prevalensi dari rahang atas yang mengalami hipoplasi, sehingga banyak penderita yang memerlukan osteotomi maksila. Tujuan: Mengetahui kebutuhan operasi orthognatik pada penderita celah bibir dan langit - langit usia pasca perawatan orthodontik konvensional usia 18–25 tahun pada RSAB Harapan Kita Unit Celah Bibir dan Langit-langit. Metode: Analisis antropometri dengan mengukur besar sudut nasolabial dan facial contour, analisis sefalometri dengan mengukur besar sudut ANB dan jarak Wits Appraisal, analisis model studi dengan mengukur jarak inter insisal dan inter molar. Hasil perbandingan antar kelompok dianalisa menggunakan uji T – Test tidak berpasangan .Hasil: Kebutuhan bedah orthognatik usia 18–25 tahun cukup tinggi dibandingkan yang dapat dirawat dengan perawatan orthodontik konvensional. Kesimpulan: Untuk meningkatkan pelayanan di unit CLP RSAB Harapan Kita pasien celah bibir dan langit-langit harus diedukasi ke arah bedah orthognatik untuk mendapat hasil akhir yang lebih baik.

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ABSTRACT
Background: Orthognathic surgery is the final stage of treatment and functional rehabilitation in patients with cleft lip and palate, due to the high prevalence of maxillary hipoplasia that require osteotomy. Purpose: Measure the need for orthognathic surgery in 18-25 years old patients with cleft lip and palate after orthodontic treatment at Harapan Kita Hospital. Method: Anthropometric analysis with a large measure the nasolabial angle and facial contour, cephalometric analysis with a large measure ANB angle and Wits appraisal distance, analytical study of the model by measuring the inter-incisal distance and inter molar. The results of comparisons between groups were analyzed using T test - Test. Result: Surgical needs orthognatik age 18-25 years is quite high compared to that can be treated with conventional orthodontic treatment. Conclusion: To improve services in the CLP unit RSAB Harapan Kita patients cleft lip and sky - the sky should be educated towards orthognatik surgery to get a better end result.