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All Journal Narra J Narra X
Endang W. Bachtiar
Department of Oral Biology, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430 / Implantology Research Center, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430

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Oral microbiome: A paradigm shift in dental diagnosis Megantoro, Aryo; Alphianti, Likky T.; Gunawan, Paulina N.; Bachtiar, Endang W.; Bachtiar, Boy M.
Narra X Vol. 3 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v3i1.197

Abstract

For decades, the diagnosis of oral diseases primarily relied on clinical symptoms presented by patients. This traditional approach, which included visual inspection, palpation, and assessment of discomfort, provided limited insights into the underlying microbiological factors contributing to oral diseases. Recent studies have identified specific microorganisms believed to play pivotal roles in oral disease development, particularly in conditions such as dental caries, periodontal disease, and pulpitis. The challenge lies in the dynamic nature of the oral microenvironment, where the microbial community can shift rapidly due to changes in diet, hygiene practices, and overall health, complicating attempts to establish direct causative links between specific pathogens and oral diseases. The aim of this study was to explore the role of the oral microbiome in advancing dental diagnostics and to assess how integrating microbial analysis can improve early detection and personalized treatment of oral diseases. Research into the oral microbiome has brought about a paradigm shift in understanding dental diagnostics. Advances in molecular biology techniques, such as next-generation sequencing (NGS) and polymerase chain reaction (PCR), have enabled more detailed examination of microbial communities within the oral cavity. This shift from a purely symptom-based diagnostic approach to one that incorporates microbial analysis represents a significant advancement in dental care. For instance, identifying specific bacterial profiles associated with caries could facilitate the implementation of personalized preventive measures, such as tailored oral hygiene regimens or dietary recommendations. Moreover, integrating microbiological data into clinical practices could lead to improved diagnostics for conditions that are traditionally difficult to assess. By adopting a more comprehensive view that includes microbial assessments, clinicians can better understand the interplay between oral microbiota and systemic health, as oral diseases are often linked to broader health issues. Another challenge is that this approach requires interdisciplinary collaboration among dental practitioners, microbiologists, and public health experts. This collaboration is essential to translate abstract microbiological findings into practical diagnostic indicators that can be utilized in clinical settings. Furthermore, with the advent of new technologies, maintaining accurate interpretations of microbiome data presents another layer of complexity, as variations in sample collection, processing, and analysis can lead to differing results. In summary, the elevated role of the oral microbiome in dental diagnostics marks a significant transition from traditional, symptom-focused approaches to more holistic methodologies that consider the underlying microbial communities. By leveraging advanced technologies, dental practitioners can enhance their diagnostic capabilities, leading to improved outcomes for patients suffering from various oral diseases.
Biomolecules derived from salivary exosomes encapsulated in chitosan for bone regeneration in alveolar osteitis: A systematic review Sulistiani, Silvia; Bachtiar, Endang W.; Bachtiar, Boy M.
Narra J Vol. 5 No. 3 (2025): December 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i3.2877

Abstract

Alveolar osteitis (dry socket) is a common complication after tooth extraction that delays bone healing and causes significant pain. Conventional treatments are largely palliative and do not actively promote regeneration. Salivary exosomes, rich in bioactive molecules, and chitosan, a biocompatible and biodegradable polymer, might offer a promising combined approach for targeted bone regeneration. The aim of this systematic review was to systematically evaluate the regenerative potential of salivary exosomes encapsulated in chitosan for the treatment of alveolar osteitis. The systematic review was conducted following PRISMA guidelines and the PICO framework. Comprehensive searches were performed across PubMed, ScienceDirect, ProQuest, Cochrane Library, and Google Scholar for English-language articles published between 2021 and 2025. Eligible studies included in vitro, in vivo, and preclinical research assessing chitosan-encapsulated salivary exosomes for bone regeneration. Data were extracted on study design, interventions, outcome measures, and therapeutic effects. From 524 retrieved records, 10 full-text articles were assessed, and two met the eligibility criteria. Both studies demonstrated that chitosan encapsulation improved the stability and delivery efficiency of salivary exosomes. Outcomes included increased osteogenic gene expression (ALP, BMP-2, osteocalcin, RUNX2), enhanced angiogenesis, reduced inflammation, and histological evidence of accelerated bone regeneration compared with conventional treatment. In conclusion, current evidence suggests that salivary exosomes encapsulated in chitosan have strong therapeutic potential for alveolar osteitis by promoting osteogenesis, reducing inflammation, and enhancing bone healing. However, further preclinical validation and controlled human trials are required before clinical translation.