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Abstrak :
Background: Infeksi Endodontik dapat menjadi faktor prediktor penyakit jantung koroner (PJK) aterosklerosis. Penyakit ini terjadi karena merespon proses inflamatori akibat infeksi bakteri Porphyromonas endodontalis. Beberapa literatur mengatakan bahwa etiologi penyakit kardiovaskular disebabkan infeksi kronik. Diduga bakteri Porphyromonas endodontalis yang ada dalam Infeksi Endodontik (IE) dapat juga menjadi faktor prediktor PJK aterosklerosis. Objective: Mengetahui peran dan potensi IE sebagai faktor predikdi PJK aterosklerosis dan juga peran sitokin inflamatori, IL-1 , IL-6, hsCRP, TNF- dalam kaitannya akan hubungan IE dan PJK aterosklerosis. Method: Dilakukan riset rancangan kasus kontrol dengan mengamati ada terpaparnya IE pada penderita PJK aterosklerosis. Dibagi menjadi kelompok subjek PJK aterosklerosis dengan IE sebagai kasus dan kelompok subjek bukan PJK aterosklerosis dan tanpa IE sebagai kontrol. Subjek dilihat intra oralnya terutama jaringan periapikal dan jaringan periodontal, dicatat faktor-faktor tradisional penyebab PJK serta diukur kadar IL-1 , IL-6, hsCRP, TNF- di dalam darah sirkulasi. Dicatat juga adanya gastritis, psoriosis, dan periodontitis. Results: Dianalisis dengan regresi logistik terlhat ada peran yang potensial (p < 0,041) Infeksi Endodontik sebagai penyebab penyakit jantung koroner aterosklerosis. IL-1, IL-6, dan CRP di dalam darah sirkulasi tidak berbeda bermakna setelah dianalisis denam tes Mann- Whitney, walaupun median setiap kelompok variabel lebih tinggi pada kelompok kasus daripada kontrol. Hanya TNF- yang berbeda bermakna (p < 0,019) setelah danalisis dengan uji-t. Conclusion: Infeksi Endodontik mempunyai peran yang potensial menjadi faktor prediktor penyakit jantung koroner aterosklerosis dan mungkin hanya TNF- yang terlibat dalam mekanisme terjadinya PJK karena IE. ......Endodontic infection can be a predictive factor of atherosclerosis coronary heart disease (CHD). This disease occurs because it responds to the inflammatory process caused by infection of Porphyromonas endodontalisbacteria. Several literature state that the etiology of cardiovascular disease is caused by chronic infection. Porphyromonas endodontalis bacteria inside Endodontic Infection (EI) is also assumed to be a predictive factor of atherosclerosis CHD. The purpose of this research is to determine the role and potential of EI as a predictive factor of atherosclerosis CHD as well as the role of inflammatory cytokines, IL-1 , IL-6, hsCRP, TNF- in relation to the relationship of EI and atherosclerosis CHD. This research used a case control design research method by observing EI exposure in atherosclerosis CHD patients. Subjects were divided into atherosclerosis CHD subjects with IE as case and non-atherosclerosis CHD subjects without IE as the control. On the subjects, their intraoral was observed, specifically the periapical tissue and periodontal tissue, the traditional factors causing CHD were recorded and the level of IL-1 , IL-6, hsCRP, TNF- in circulating blood was measured. The presence of gastritis, psoriasis, and periodontitis was also recorded. The results of data analysis in this research with logistic regression showed that there was a potential role (p <0.041) of endodontic infection as a cause of atherosclerosis CHD. IL-1, IL-6, and CRP in circulating blood do not differ significantly after being analyzed by Mann- Whitney test even though the median of each group was higher in the case than the control group. It was only TNF- that was significantly different (p <0.019) after being analyzed by t-test. Therefore, the researcher concludes that endodontic infection has a potential role as a predictive factor of atherosclerosis CHD and probably it is only TNF- that is involved in the mechanism of CHD incidence due to IE.

Abstrak :

Tujuan: Menganalisis pengaruh paparan larutan Sodium hipoklorit (NaOCl) dengan konsentrasi 2,5% dan 5,25% pada profil MMP-9 dan struktur kolagen di dentin terhadap kekuatan ikat geser resin komposit-dentin. Metode: Seratus empat puluh empat spesimen dentin dirandom untuk analisis profil MMP-9 dengan pemeriksaan imunohistokimia (n=18) dan ELISA (n=30); analisis struktur kolagen dengan SEM di permukaan oklusal (n=18) dan proksimal (n=18) dan pewarnaan Massons trichrome; serta analisis kekuatan ikat geser resin komposit permukaan oklusal (n=30) dan proksimal (n=30). Spesimen dibagi menjadi 3 kelompok dalam tiap analisis, yaitu: kelompok kontrol, kelompok paparan NaOCl 2,5% dan 5,25%. Hasil: Pemeriksan profil MMP-9 menunjukkan bahwa peningkatan konsentrasi NaOCl dapat menekan profil MMP-9 (p<0,05). Pemeriksaan struktur kolagen menunjukkan bahwa peningkatan konsentrasi NaOCl mampu mendegradasi kolagen dentin (p<0,05). Sodium hipoklorit 5,25% paling efektif menekan jumlah profil MMP-9 (9,9+3,63 ng/mL) dan mendegradasi kolagen serta memiliki nilai kekuatan ikat geser yang paling tinggi (15,85+0,43 MPa) dari pada NaOCl 2,5% (14,51+3,66 ng/mL) dan kelompok kontrol (24,09+8,88 ng/mL; 14,41+0,96 Mpa). Kelompok NaOCl 2,5% memiliki nilai kekuatan ikat geser yang paling rendah (9,2+0,65 MPa). Kesimpulan: Larutan NaOCl 5,25% dapat menekan profil MMP-9 dan mendegradasi kolagen fibril untuk meningkatkan nilai kekuatan ikat geser resin komposit-dentin dan menciptakan suatu ikatan mikro mekanis antara resin dan permukaan anorganik dentin tanpa hybrid layer. 
 
Kata kunci: Sodium hipoklorit, profil MMP-9, collagen, dentin, kekuatan ikat geser.

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Objective: To analyze the effect of Sodium hypochlorite (NaOCl) 2.5% and 5.25% exposure on MMP-9 profile and dentin collagen structure toward resin composite-dentin shear bond strength. Method: One hundred and forty four dentin specimens were randomized  for MMP-9 profile analysis using immunohistochemistry staining (n=6) and ELISA (n=10); collagen structure analysis with SEM and Massons trichrome staining (n=6); and resin composite shear bond strength analysis (n=10). Then, specimens were divided into three groups: control, NaOCl 2.5% and 5.25% groups. Results: MMP-9 profile analysis showed that NaOCl concentration increase can suppress MMP-9 profile (p<0.05). Collagen structure analysis showed that NaOCl concentration increase can degrade dentin collagen (p<0.05). NaOCl 5.25% is the most effective in suppressing MMP-9 profile amount (9.9+3.63 ng/mL) and degrading collagen, it also has the highest shear bond strength (15.85 +0.43 MPa) compared to NaOCl 2.5% (14.51+3.66 ng/mL) and control group (24.09+8.88 ng/mL; 14.41+0.96 MPa). NaOCl 2.5% group has the lowest shear bond strength (9.2+0.65MPa). Conclusion: NaOCl 5.25% can suppress MMP-9 profile and degrade fibril collagen to increase the shear bond strengths value and create a micro mechanical bonding between resin and anorganic part of dentin without hybrid layer.
 
 

Abstrak :
Latar belakang: Di Indonesia, prevalensi karies gigi berkisar antara 85% - 99% dan 67.4% pria umur 15 tahun atau lebih merokok. Tujuan: Tujuan penelitian ini mengkaji hubungan keparahan karies gigi dan intensitas merokok pada pria Indonesia umur 45 – 54 tahun (n = 34.534), responden Riskesdas 2007. Metode: Pengalaman karies gigi (DMFT) dicatat oleh enumerator yang sudah dilatih. Enumerator juga mencatat karakteristik sosiodemografik (umur, pekerjaan, status sosial ekonomi, pendidikan) perilaku kesehatan gigi (gosok gigi) dan merokok responden. 31.4 % responden DMFT-nya ≥ 8, cut off point karies gigi parah dalam penelitian ini. Uji Chi-square digunakan untuk mendeteksi kemaknaan perbedaan prevalensi karies gigi parah pada perokok berat (BI ≥ 400) dan pada yang tidak pernah merokok (BI = 0). Regresi logistik digunakan untuk meng-estimasi besarnya peran merokok berat pada keparahan karies gigi. Hasil: Prevalensi karies gigi parah pada yang tidak pernah merokok, perokok ringan (BI 1-399) dan perokok berat berturut turut adalah, 24,9 %; 32,5 % dan 38,7% (P <0,005). Dibanding yang tidak pernah merokok, adjusted OR karies gigi parah pada perokok ringan dan perokok berat adalah 1,45 (95% CI 1,37-1,53) dan 1,70 (95% CI: 1,59 – 1,81). Kesimpulan: Merokok merupakan salah satu faktor risiko karies gigi parah pada pria Indonesia dan semakin berat intensitas merokoknya, semakin besar pula risikonya. Saran: Para dokter gigi Indonesia, baik secara perorangan, maupun secara kolektif, perlu ambil bagian secara lebih sungguh sungguh dalam pengendalian tembakau di Indonesia ......Background: In Indonesia, dental caries the prevalence between 85% - 99% and 67.4% of males aged 15 years or older currently used tobacco. Objective: The aim of this study is to examine the association between dental caries severity and smoking intensity in 45 – 54 years old Indonesian males (n = 34.534), respondents of Basic Health Research 2007. 31.4 % of respondents have DMFT value ≥ 8, the cut off point of severe dental caries in this study. Methods: The dental caries experience (DMFT) were recorded by well trained enumerators. In addition, the enumerators recorded sociodemographic characteristics (age, socio-economic status, education, job), tooth brushing and smoking behavior of respondents. Chisquare test was used to detect significant difference on prevalence of severe dental caries between heavy smokers (BI ≥ 400) and never smokers (BI = 0). Logistic regression was used to estimate contribution of heavy smoking on dental caries severity. Result: The prevalence of severe dental caries on never smokers, light smokers (BI 1-399) and heavy smokers were 24,9 %; 32,5 % and 38,7% respectively (P <0,005). Compared to never smokers, the adjusted OR of light smokers and heavy smokers were 1,45 (95% CI 1,37-1,53) and 1,69 (95% CI: 1,59 – 1,80). Conclusion: Smoking is a risk factor of severe dental caries in Indonesian men and the higher the smoking intensity, the higher the risk. Recommendation: Indonesian dentists, individually and collectively have to take part more seriously in smoking prevention and control in Indonesia.

Abstrak :
Latar Belakang : Remineralisasi Guided Tissue Remineralization (GTR) dentin digunakan untuk meningkatkan pembentukan kristal nano ke daerah gap zone serta membangun struktur mineral apatit pada kolagen demineralized dentin dan Carboxymethyl Chitosan (CMC) berperan sebagai protein analog serta memicu remineralisasi dentin. Tujuan: Mendapatkan novel semen carboxymethyl chitosan/amporphous calcium phosphate sebagai agen GTR dentin. Metode: Modifikasi CMC menjadi bubuk CMC/ACP (CA) melalui proses Freeze Dry dan modifikasi bubuk CA melalui proses milling 30 menit menjadi bubuk CMC/ACP paska milling (CAM) dan masing-masing dievaluasi menggunakan FTIR menganalisis gugus fungsi CMC dan gugus fungsi awal CA yang terbentuk. Bubuk CA dan CAM kemudian dicampurkan dengan gipsum hemihydrate pada rasio 5% dan 10% didapatkan kelompok novel semen CAG 5%, CAG 10%, CAMG 5% dan CAMG 10%. Kelompok tersebut dievaluasi menggunakan FTIR, XRD, SEM, setting time, ketahanan kompresi dan MTT assay. Novel semen tersebut diaplikasikan pada dentin terdemineralisasi selama 14 hari dan dievaluasi menggunakan TEM. Hasil: Gugus fungsi CMC berupa -CH2COOH dan N-H terlihat pada bubuk CA dan setelah dilakukan milling menjadi bubuk CAM. Tambahan gugus fungsi fosfat (-PO4) terlihat juga pada bubuk CA dan CAM. Gugus fungsi awal bubuk CA tetap terlihat pada bubuk CAM. Gugus fungsi fosfat (-PO4) terlihat juga pada kelompok novel semen CAG dan CAMG baik 5% dan 10%. Kombinasi bubuk CA dan CAM menggunakan gipsum mempengaruhi fasa mineral material. Kesan topografi berbeda pada novel semen CAG (5% dan 10%) dan novel semen CAMG (5% dan 10%). Terdapat perbedaan bermakna antara kelompok novel semen (CAG 5%, CAG 10%, CAMG 5% dan CAMG 10%) dibandingkan dengan gipsum (kontrol) pada setting time dan ketahanan kompresi (p<0.05). Viabilitas sel dari uji MTT assay menunjukkan novel semen CAMG 10% tidak toksik terhadap hDPSC. Novel semen CAG (5% dan 10%) dan novel semen CAMG (5% dan 10%) menunjukkan kesan remineralisasi dentin ekstrafibrillar dan intrafibrillar pada dentin terdemineralisasi. Kesimpulan: Modifikasi carboxymethyl chitosan melalui proses freeze dry dan milling serta pencampuran rasio 5% dan 10% menggunakan gipsum memiliki kemampuan untuk menginisiasi guided tissue remineralisazation dentin baik secara ekstrafibrillar dan intrafibrillar pada dentin terdemineralisasi. ......Background: Guided Tissue Remineralization (GTR) dentin is used to increase the formation of nanocrystals in the gap zone area and build an apatite mineral structure in demineralized dentin collagen and Carboxymethyl Chitosan (CMC) which acts as a protein analog and triggers dentin remineralization. Objective: To obtain a novel carboxymethyl chitosan/amorphous calcium phosphate cement as a dentinal GTR agent.Purpose: Obtained novel cement carboxymethyl chitosan/amporphous calcium phosphate as an agent for GTR. Methods: Modification of CMC into CMC/ACP (CA) powder through the Freeze Dry process and modification of CA powder through a 30-minute milling process into CMC/ACP powder after milling (CAM) and evaluated using FTIR, respectively, analyzing the CMC functional group and the initial CA functional group formed. CA and CAM powder were then mixed with gypsum hemihydrate at a ratio of 5% and 10% to obtain novel cement groups of CAG 5%, CAG 10%, CAMG 5%, and CAMG 10%. The groups were evaluated using FTIR, XRD, SEM, setting time, compression resistance, and MTT assay. The novel cement was applied to demineralized dentin for 14 days and evaluated using TEM. Result: The CMC functional group (-CH2COOH and N-H) was seen in CA and CAM powder. Addition of phosphate (-PO4) functional grup were detected in CA and CAM powder. Phosphate (-PO4) functional group was seen in novel cement CAG (5% and 10%) and CAMG (5% and 10%). The combination of gipsum using CA and CAM powders produces different mineral phases. Topographical impressions differed between Novel cement groups of CAG (5% and 10%) and CAMG (5% and 10%). There was a significant difference between the novel cement groups (CAG 5%, CAG 10%, CAMG 5%, and CAMG 10%) compared to gypsum (control) in setting time and compression resistance (p<0.05). Viability cell confirmation using MTT assay showed that novel cemen group of CAMG 10% did not toxic to hDPSC. Novel cement groups of CAG (5% and 10%) and CAMG (5% and 10%) demonstrated the effects of extrafibrillar and intrafibrillar dentin remineralization on demineralized dentin. Conclusion: Modifying carboxymethyl chitosan through freeze dry and milling processes and modifying the mixing ratio of 5% and 10% using gypsum can initiate guided tissue remineralization of dentin both extrafibrillarly and intrafibrillarly in demineralized dentin.