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All Journal Sriwijaya Journal of Internal Medicine Crown: Journal of Dentistry and Health Research
Alexander Mulya
Department of Oral Health and Dentistry, Emerald Medical Center, Jakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Glycated Hemoglobin (HbA1c) as a Predictor of Periodontal Disease Progression in Patients with Type 2 Diabetes: A Longitudinal Study in Surabaya, Indonesia Alexander Mulya; Muhammad Ashraf; Muhammad Yoshandi; Ayesh Mahmood; Daphne Marshall
Sriwijaya Journal of Internal Medicine Vol. 3 No. 1 (2025): Sriwijaya Journal of Internal Medicine
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjim.v2i2.178

Abstract

Introduction: Periodontal disease is a prevalent complication of type 2 diabetes mellitus (T2DM), and poor glycemic control is a known risk factor. This longitudinal study aimed to investigate the predictive value of glycated hemoglobin (HbA1c) for periodontal disease progression in a cohort of T2DM patients in Surabaya, Indonesia. Methods: A prospective cohort study was conducted at private hospital, Surabaya, Indonesia, from January 2021 to January 2023. 180 patients with T2DM and pre-existing chronic periodontitis were enrolled. Periodontal parameters, including probing pocket depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), and plaque index (PI), were assessed at baseline, 12 months, and 24 months. HbA1c was measured at each visit. Multivariate linear regression and mixed-effects models were used to analyze the association between HbA1c and changes in periodontal parameters over time, adjusting for potential confounders. Results: The mean age of participants was 58.5 ± 8.2 years, and 55% were female. Baseline mean HbA1c was 8.2 ± 1.5%. After adjusting for age, gender, smoking status, diabetes duration, and baseline periodontal parameters, higher baseline HbA1c was significantly associated with greater increases in PPD (β = 0.15 mm per 1% HbA1c increase, 95% CI: 0.08-0.22, p < 0.001) and CAL (β = 0.18 mm per 1% HbA1c increase, 95% CI: 0.10-0.26, p < 0.001) over 24 months. Furthermore, sustained elevation of HbA1c (average HbA1c over 24 months) was a stronger predictor of periodontal disease progression than baseline HbA1c alone. A significant interaction between HbA1c and time was observed (p < 0.001), indicating that the effect of HbA1c on periodontal parameters increased over time. Conclusion: HbA1c is a significant independent predictor of periodontal disease progression in patients with T2DM. Sustained glycemic control is crucial for preventing and managing periodontal complications in this population. These findings highlight the importance of interdisciplinary collaboration between internists and dentists in the comprehensive care of T2DM patients.
Three-Year Clinical Performance of Silver Diamine Fluoride (SDF) versus Glass Ionomer Cement in Arresting Carious Lesions in Primary Molars: A Community-Based Cohort Study Winata Putri; Sophia Lucille Rodriguez; Sarah Armalia; Alexander Mulya
Crown: Journal of Dentistry and Health Research Vol. 3 No. 1 (2025): Crown: Journal of Dentistry and Health Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/crown.v3i1.238

Abstract

Introduction: Early Childhood Caries (ECC) is a significant global health problem. Minimally invasive treatments like Silver Diamine Fluoride (SDF) and Glass Ionomer Cement (GIC) are crucial, but long-term comparative effectiveness data from real-world community settings are scarce. This study aimed to compare the three-year clinical performance of 38% SDF versus high-viscosity GIC in arresting active carious lesions in the primary molars of preschool children. Methods: This study was designed as a three-year, prospective, non-randomized, community-based cohort study in an underserved urban population in South Sumatra, Indonesia. A total of 450 children aged 3-5 years with at least one active cavitated carious lesion (ICDAS 5/6) in a primary molar were enrolled. Following parental consent and choice, lesions were treated with either a single application of 38% SDF or a high-viscosity GIC restoration using the Atraumatic Restorative Treatment (ART) technique. Calibrated examiners assessed the lesions for caries arrest at 6, 12, 24, and 36 months using standardized visual-tactile criteria. The primary outcome was the proportion of arrested lesions. Survival analysis was performed using Kaplan-Meier curves and a Cox proportional hazards model. Results: A total of 620 lesions (309 SDF, 311 GIC) were treated and followed. At the 36-month follow-up, the caries arrest rate in the SDF group was 81.2%, which was significantly higher than the 64.8% arrest rate observed in the GIC group (χ² = 24.5, p < 0.001). The Kaplan-Meier survival analysis demonstrated a significantly higher probability of lesions remaining in an arrested state in the SDF group over the three-year period (log-rank test, p < 0.001). The Cox regression model identified the treatment modality as the primary predictor of failure, with GIC having a hazard ratio of 2.15 (95% CI: 1.55-2.98) compared to SDF. Conclusion: Within the parameters of this community-based cohort study, a single application of 38% SDF was significantly more effective in arresting active carious lesions in primary molars over a three-year period than high-viscosity GIC applied via the ART technique. These findings support the prioritization of SDF in public health programs for managing ECC.
Natural Bioactive Compounds against Periodontal Matrix Metalloproteinases: A ChEMBL-LOTUS Chemoinformatics Study Alexander Mulya; Pham Uyen; Sarah Armalia; Isadora Selestine
Crown: Journal of Dentistry and Health Research Vol. 3 No. 2 (2025): Crown: Journal of Dentistry and Health Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/crown.v3i2.330

Abstract

Background: Matrix metalloproteinases (MMPs), particularly MMP-8, MMP-9, and MMP-13, contribute to extracellular matrix degradation in periodontitis, but natural-product bioactivity evidence is dispersed across heterogeneous assays. Objective: This study aimed to map IC50 and Ki evidence for natural-product-associated compounds against human MMP-1, MMP-2, MMP-3, MMP-8, MMP-9, and MMP-13 and to identify structurally traceable candidates for orthogonal experimental validation. Methods: Records were extracted from ChEMBL 37 on 5 August 2026 and filtered for positive values with pChEMBL, exact relations, nM units, acceptable validity metadata, no potential-duplicate flag, and direct single-protein assay assignment (confidence score 9). Measurements were summarized by compound-target-endpoint using median pChEMBL. ChEMBL natural-product-flagged candidates were exact-matched by full InChIKey in LOTUS; a study-defined high-support occurrence tier required at least 10 taxa and two reference records. Results: Of 28,002 raw records, 7,451 met the strict criteria. The 153 flagged candidates yielded 42 LOTUS matches and 35 high-support compounds, forming 81 compound-target-endpoint pairs. Isoliquiritigenin showed IC50 values of 10.0 nM for MMP-9 and 14.13 nM for MMP-13, each from one measurement. Caffeic acid showed a median MMP-9 IC50 of 14.62 nM from two assays in one document. No high-support MMP-8 IC50 record was identified; available Ki values were 4.47 micromolar for pyrogallol and 8.71 micromolar for piceatannol. Conclusion: These signals prioritize compounds for orthogonal validation but do not establish periodontal selectivity, safety, or efficacy.
Co-Authors Ayesh Mahmood Daphne Marshall Isadora Selestine Muhammad Ashraf Muhammad Yoshandi Pham Uyen Sarah Armalia Sophia Lucille Rodriguez Winata Putri