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EFEK KOMBINASI SPIRULINA KITOSAN UNTUK PRESERVASI SOKET TERHADAP OSTEOBLAS, OSTEOKLAS DAN KEPADATAN KOLAGEN: EFFECT SPIRULINA CHITOSAN COMBINATION AS A SOCKET PRESERVATION TOOSTEBLAST, OSTEOCLAST, AND COLLAGEN DENSITY Sherman Salim; Mefina Kuntjoro
Dentika: Dental Journal Vol. 18 No. 3 (2015): Dentika Dental Journal
Publisher : TALENTA

Soket preservasi merupakan tindakan penting dilakukan sehubungan dengan perawatan di bidang prostodonsia yangmemerlukan bentukan tulang yang prominen sebagai retensi dan stabilitas untuk pemakaian gigi tiruan. Bahan yang dapatmencegah inflamasi berlebihan dan meningkatkan remodeling tulang perlu diaplikasikan pada soket pasca pencabutan.Biomaterial spirulina memiliki sifat antiinflamasi dan antioksidan serta kitosan yang memiliki sifat mucoadhesive akandikombinasikan karena memiliki efek sinergis apabila digabungkan. Tujuan penelitian ini adalah untukmendapatkanbiomaterial yang memberikan efek untuk preservasi soket. Sebanyak 28 ekor Cavia cobaya (marmot) dibagi menjadi 4kelompok perlakuan. Setelah dilakukan pencabutan, pada soket kelompok kontrol diinduksi gel CMC Na 3%, kelompokI diinduksi gel spirulina 12%, kelompok II diinduksi gel kitosan 20%, kelompok III diinudksi gel kombinasi spirulina12% kitosan 20%. Pada hari ke 14, hewan coba dieksekusi dan diambil mandibulanya. Kemudian dilakukan pemeriksaanhistopatologi jumlah osteoblas, osteoklas dan kolagen pada daerah 1/3 soket. Data hasil pemeriksaan dianalisismenggunakan Kruskal Wallis test. Pada pemeriksaan hari ke 14 terdapat perbedaan signifikan antara kelompok kontroldan kelompok perlakuan. Jumlah osteoblas dan kolagen paling tinggi pada kelompok III dan jumlah osteoklas palingrendah pada kelompok III. Sebagai kesimpulan, kombinasi spirulina 12% dan kitosan 20% meningkatkan jumlahosteoblas dan kolagen dan menurunkan jumlah osteoklas pada hari ke 14.

Stem Cells Approach for Implant Therapy in Diabetes Model Kuntjoro, Mefina; Hendrijantini, Nike; Agustono, Bambang; Salim, Sherman
Indonesian Journal of Prosthodontic Special Issue 2021
Publisher : Indonesia Prosthodontic Association

Objective of Investigation: Dental implant osseointegration in patients with hyperglycemic conditions was reported to be delayed so the restoration procedure must be postponed. Mesenchymal Stem Cells (MSCs) is a tissue engineering material that has the potential to treat various systemic diseases. Human Umbilical Cord Mesenchymal Stem Cells (hUCMSCs) is proven to improve bone microenvironment and have osteogenic potential. Their excellent capability can be a new approach for osseointegration acceleration. The purpose of this study was to determine the capability of hUCMSCs to accelerate dentalimplant osseointegration in hyperglycemic condition through angiogenesis and osteoblastogenesis. Experimental methods used: 28 Wistar rats were injected intraperitoneally with Streptozotocin 20mg/kg body weight for 5 days in a row to make the diabetic model. The treatment was carried out after fasting blood sugar levels 300 mg/dl and waited 5 days for the glycation period. The source of stem cell is human umbilical cord which has been isolated and cultured until passage 6. The experimental animals were divided into 4 groups, namely the 2-week implant group (K1), the 4-week implant group (K2), the 2-week implant + hUCMSCs group (P1) and the 4-week implant + hUCMSCs group (P2). The variables examined were BIC (Bone Implant Contact), VEGF and Runx2 expression. Data were analyzed using Analysis of Variance (ANOVA). Result : BIC, VEGF and Runx2 expresssion was higher in treatment groups compared with control groups. The highest expression of VEGF and Runx2 occurred in the P1 and decreased in the P2 group. While for BIC in groups P1 and P2 remained high to maintain osseointegration. Conclusion : With the limitation of this study, stem cells was proven to accelerate the osseointegration of dental implants through osteoblastogenesis and angiogenesis in diabetes model.

Spirulina chitosan gel induction on healing process of Cavia cobaya post extraction socket Rostiny Rostiny; Mefina Kuntjoro; Ratri Maya Sitalaksmi; Sherman Salim
Dental Journal (Majalah Kedokteran Gigi) Vol. 47 No. 1 (2014): March 2014
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Background: Prominent residual ridge is necessary to gain retention and stabilility for succesful prosthodontic treatment such as removable, fixed or implant. Spirulina is a natural substance that can help tissue healing and chitosan also a natural substance that reported to have the ability to help bone remodelling. The combination gel of spirulina and chitosan could be considered as an alternative material to maintain residual ridge height after tooth extraction. Purpose: The aim of study was to examine the effect of combination gel of Spirulina and chitosan on healing process of Cavia cobaya post tooth extraction socket by counting the amount of osteoclast, osteoblast and colagen as an indicator. Methods: Twenty eight cavia cobaya were divided into 4 groups. Insisive mandible extraction was done and the sockets were filled with 3% CMCNa for control groups, 3% spirulina chitosan 200 mg for group 1, 6% spirulina chitosan 200 mg for group 2, 12% spirulina chitosan 200 mg for group 3. After 30 days, histopathology examination was done by using microscope to count the amount of osteoclast, osteoblast and collagen. Results: Data was analyzed by using Anova and Tukey HSD. For osteoclast, there was no significant different between every groups, while for osteoblast and collagen there was significant different between groups. The results showed that induction of combination gel spirulina chitosan was able to accumulate collagen fiber and resulting faster wound healing. Conclusion: Combination 12% gel spirulina chitosan 200 mg could be used as an alternative material for better bone remodeling after tooth extraction.Latar belakang: Residual ridge yang prominen sangat dibutuhkan untuk mendapatkan retensi dan stabilitas untuk menunjang keberhasilan perawatan di bidang prostodonsia seperti pada kasus removable, fixed atau implant. Tindakan pencabutan gigi dapat merusak jaringan periodontal, sementum dan tulang alveolar yang mengakibatkan resorbsi ridge yang besar. Spirulina telah terbukti mempunyai kemampuan untuk membantu penyembuhan tulang sedangkan kitosan mempunyai kemampuan untuk membantu proses pembentukan tulang. Kombinasi kedua bahan ini diharapkan dapat menjadi bahan alternatif untuk mempercepat proses penyembuhan luka dan pembentukan tulang. Tujuan: Penelitian ini bertujuan meneliti efek induksi kombinasi gel dari Spirulina dan kitosan terhadap proses penyembuhan soket pasca ekstraksi gigi Cavia cobaya dengan indikator jumlah osteoklas, osteoblas dan kolagen. Metode: Penelitian ini menggunakan 28 marmot yang dibagi menjadi 4 kelompok penelitian. Pencabutan dilakukan pada incisive rahang bawah kemudian soket pencabutan diisi dengan CMCNa 3% pada kelompok control; spirulina 3% chitosan 200 mg pada kelompok perlakuan 1; spirulina 6 % chitosan 200 mg pada kelompok perlakuan 2, dan spirulina 12% citosan 200 mg pada kelompok perlakuan 3. Pada hari ke 30 dilakukan pemeriksaan histopatologi menggunakan mikroskop untuk menghitung jumlah osteoblas, osteoklas dan kolagen. Hasil: Data dianalisis dengan Anova dan Tukey HSD. Jumlah osteoklas tidak berbeda secara signifikan antara setiap kelompok, sedangkan jumlah osteoblas dan kolagen terdapat perbedaan yang signifikan antara kelompok. Hasil penelitian menunjukkan bahwa induksi kombinasi gel spirulina chitosan mampu mengakumulasi serat kolagen dan menghasilkan penyembuhan luka lebih cepat. Simpulan: Kombinasi gel spirulina 12% chitosan 200 mg dapat digunakan sebagai bahan alternatif untuk remodeling tulang yang lebih baik setelah pencabutan gigi.

Alveolar ridge rehabilitation to increase full denture retention and stability Mefina Kuntjoro; Rostiny Rostiny; Wahjuni Widajati
Dental Journal (Majalah Kedokteran Gigi) Vol. 43 No. 4 (2010): December 2010
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Background: Atrophic mandibular alveolar ridge generally complicates prostetic restoration expecially full denture. Low residual alveolar ridge and basal seat can cause unstable denture, permanent ulcer, pain, neuralgia, and mastication difficulty. Pre-proshetic surgery is needed to improve denture retention and stability. Augmentation is a major surgery to increase vertical height of the atrophic mandible while vestibuloplasty is aimed to increase the denture bearing area. Purpose: The augmentation and vestibuloplasty was aimed to provide stability and retentive denture atrophic mandibular alveolar ridge. Case: A 65 years old woman patient complained about uncomfortable denture. Clinical evaluate showed flat ridge in the anterior mandible, flabby tissue and candidiasis, while residual ridge height was classified into class IV. Case management: Augmentation using autograph was conducted as the mandible vertical height is less than 15 mm. Autograph was used to achieve better bone quantity and quality. Separated alveolar ridge was conducted from left to right canine region and was elevated 0.5 mm from the previous position to get new ridge in the anterior region. The separated alveolar ridge was fixated by using T-plate and ligature wire. Three months after augmentation fixation appliances was removed vestibuloplasty was performed to increase denture bearing area that can make a stable and retentive denture. Conclusion: Augmentation and vestibuloplasty can improve flat ridge to become prominent.Latar belakang: Ridge mandibula yang atrofi pada umumnya mempersulit pembuatan restorasi prostetik terutama gigi tiruan lengkap (GTL). Residual alveolar ridge dan basal seat yang rendah menyebabkan gigi tiruan menjadi tidak stabil, menimbulkan ulser permanen, nyeri, neuralgia, dan kesulitan mengunyah. Tujuan: Augmentasi dan vestibuloplasti pada ridge mandibula yang atrofi dilakukan untuk menciptakan gigi tiruan yang stabil dan retentive. Kasus: Pasien wanita usia 65 tahun datang dengan keluhan gigi tiruan yang tidak nyaman. Pemeriksaan klinis menunjukkan ridge flat pada anterior mandibula, jaringan flabby dan kandidiasis, sedangkan residual ridge digolongkan menjadi kelas IV. Tatalaksana kasus: Augmentasi dilakukan karena ketinggian vertikal mandibula kurang dari 15 mm. Autograf digunakan untuk mendapatkan kuantitas dan kualitas tulang yang lebih baik. Alveolar ridge diambil dari sisi kiri dan kanan region kaninus dan digunakan 0,5 mm dari posisi awalnya untuk mendapatkan ridge baru pada region anterior. Alveolar ridge telah diseparasi difiksasi menggunakan T-plate dan ligature kawat. Tiga bulan setelah fiksasi dilepas, dilakukan vestibuloplasti untuk meningkatkan denture bearing area sehingga gigi tiruan lebih stabil dan retentive. Kesimpulan: Augmentasi dan vestibuloplasti dapat memperbaiki ridge atrofi sehingga menjadi tinggi kembali.

The Effect of a combination of 12% spirulina and 20% chitosan on macrophage, PMN, and lymphocyte cell expressions in post extraction wound Nike Hendrijantini; Rostiny Rostiny; Mefina Kuntjoro; Kevin Young; Bunga Shafira; Yunita Pratiwi
Dental Journal (Majalah Kedokteran Gigi) Vol. 50 No. 2 (2017): June 2017
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Background: Tooth extraction is the ultimate treatment option for defective teeth followed by the need for dentures. Inflammation is one phase of the healing process that should be minimized in order to preserve alveolar bone for denture support. Macrophage, PMN and lymphocyte cells are indicators of acute inflammation. Spirulina and chitosan are natural compounds with the potential to be anti-inflammatory agents. Purpose: This research aimed to determine macrophage, PMN and lymphocyte cells of animal models treated with a combination of 12% spirulina and 20% chitosan on the 1st, 2nd and 3rd post-extraction day. Methods: Animal models were randomly divided into control (K) and treatment (P) groups. Each group was further divided into three subgroups (KI, KII, KIII and PI, PII, PIII). The post-extraction sockets of the control group animals were then filled with CMC Na 3%. Meanwhile, the post-extraction sockets of the treatment group members were filled with a combination of 12% spirulina and 20% chitosan. Subsequently, the number of PMN, macrophage and lymphocyte cells was analyzed by means of HE analysis on the 1st., 2nd. and 3rd. days. Statistical analysis was then performed using a T-test. Results: There was a decrease in PMN cells and an increase in macrophage and lymphocyte cells on Days 1, 2, and 3. Conclusion: It can be concluded that a combination of 12% spirulina and 20% chitosan can not only decrease PMN cells, but can also increase macrophage and lymphocyte cells on Days 1, 2 and 3 after tooth extraction.

An Overview of Type 2 Diabetes Mellitus (T2DM): Dental Implant Survival Rates Mefina Kuntjoro; Nike Hendrijantini; Agus Dahlan; Husniya Juwita Farha; Mayang Aziza Hanif Ardianto
Indonesian Journal of Prosthodontic Vol 3 No 2 (2022): December 2022
Publisher : Indonesia Prosthodontic Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46934/ijp.v3i2.124

Background: Dental implants are an alternative treatment to replace missing teeth, as it is one of the oral health problems in the elderly. The success of dental implants is affected by a process known as osseointegration. Systemic conditions such as T2DM can interfere with the osseointegration process which can lead to implant failure. As the patient's blood glucose level increases, it will increase the accumulation of AGEs. These AGEs will interfere with the stages of bone-implant contact and also bone growth around the implant Objectives: To review dental implant survival rates in T2DM patients based on HbA1c, ISQ and CBCT examinations. Conclusion: Dental implants in T2DM patients after being evaluated for 2 years showed a good result. This result is obtained with the condition that HbA1c control is below 8%. Another solution to support the success of dental implants placement in T2DM patients is the use of delayed insertion technique and modification of the implant surface with HA or SLA is also recommended. Evaluation of implant success can also be done with pre-operative planning, such as evaluation of the bone condition with ISQ and CBCT examinations.

The importance of good health and well-being in Sekarkare Village, Probolinggo, East Java Village, Probolinggo, East Java Kuntjoro, Mefina; Hendrijantini, Nike; Safari Azhar, Imam; Ayu Nararya, Sheila; Danang Subeqi, mochamad
Indonesian Journal of Dental Medicine Vol. 7 No. 1 (2024): Indonesian Journal of Dental Medicine
Publisher : Faculty of Dental Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijdm.v7i1.2024.17-19

Background: Oral health is essential to total health and a satisfactory quality of life. One of the most contributingfactors is how a human being has an understanding of how to maintain oral health to improve the quality and well-being of life. Purpose: to provide and describe the community knowledge about the importance of replacing missing teeth using dentures and maintaining oral health to improve the quality of life. Methods: The event was carried out with an interactive educational concept by giving pre- and post-tests at the beginning and end of the event. There were at least 80 education participants, consisting of the people of Sekarkare village of various ages, from late adolescents to the elderly, along with village officials and guests from the Sekarkare Health Center. The activity was carried out at the village hallof Sekarkare Village, Dringu District, Probolinggo Regency, East Java. Results: The majority of people understand and are enthusiastic about participating in a series of counseling events. There is an increase in scores in the pre-test (59,06%) and post-test (65,58%) results. Conclusion: The existence of counseling events with interactive educational concepts can increase public enthusiasm for participating in events, making it easier for people to gain new knowledge.

Immediate Complete Overdenture: optimizing patient’s quality of life with endodontic - prosthodontic approach Kuntjoro, Mefina; Agustono, Bambang; Laksono, Harry; Kamadjaja, Michael Josef Kridanto; Mundiratri, Karina; Kurdi, Abil; Fitriana, Astila; Faidah, Faidah; Prasetyo, Eric Priyo
Conservative Dentistry Journal Vol. 14 No. 2 (2024): July-December
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cdj.v14i2.2024.56-60

Background: Immediate complete overdentures are designed for placement denture immediately following the extraction or decapitation of natural teeth. This procedure overcome the challenges associated of esthetic problems, including functional difficulties and psychological issues. Purpose: The article aims to highlight the advantages of endodontic-prosthodontic approach through immediate overdenture, such as the preservation of alveolar bone and improvement in patient’s psychological well-being and quality of life. Case: A 60-years-old female came into Universitas Airlangga Dental Hospital with the chief complaint of missing multiple teeth with upper front teeth becoming loose and desire to replace them because of difficulty in chewing food. Case Management: Diagnostic impressions were taken using irreversible hydrocolloid material, then poured in the dental stone to create final impression. The treatment plan included endodontic treatment, scaling and root planning for 11. The vertical dimension of occlusion was established using a bite rim and mounted on an articulator. Then, the immediate overdenture was created by arranging artificial teeth. Before the denture insertion, 11 was decapitated and filled the orifice with glass ionomer cement. Extraction of 21, 22, 23 was carried out and after ensuring hemostasis, the immediate overdenture was inserted. To finalize the denture insertion, occlusion was assessed using articulating paper. Control was done after day 1,3 and 7 after denture insertion. Conclusion: This case report describes the effectiveness of immediate overdentures as a valuable treatment option through endodontic-prosthodontic approach. By providing a functional and aesthetic solution while minimizing the edentulous period, immediate dentures significantly enhance patient’s quality of life.

Bone formation and mineralization around the implant in osteoporotic animal models enhanced by mesenchymal stem cells Hendrijantini, Nike; Kuntjoro, Mefina; Agustono, Bambang; Ari, Muhammad Dimas Aditya; Kurdi, Abil; Mundiratri, Karina; Prasetyo, Eric Priyo; Hong, Guang
Dental Journal (Majalah Kedokteran Gigi) Vol. 57 No. 2 (2024): June
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/j.djmkg.v57.i2.p91-96

Background: Poor bone quality, sometimes caused by osteoporosis, can lead to dental implant failure. Human umbilical cord mesenchymal stem cells (hUCMSCs) can differentiate into osteoblasts and offer an alternative therapy for poor bone conditions. Purpose: This study aims to evaluate the effect of hUCMSCs induction on the extent of osseointegration by the new bone formation area of dental implants in osteoporotic animal models. Methods: The samples were divided into two groups, i.e., control and induced hUCMSCs groups at different times. An ovariectomy was performed to assess the osteoporosis condition. The control group was injected using gelatin, and the treatment group was administered hUCMSCs. Terminations were conducted at 2 and 4 weeks, respectively. The collected samples were then subjected to histological examination to analyze new bone formation and its proportion. In addition, alkaline phosphatase staining was also performed to evaluate the mineralization area. The data was analyzed using the one-way analysis of variance (ANOVA). Results: Both for new bone formation area as well as the proportion of new bone, it was observed that the best results were in the group with induction of hUCMSCs at 2 weeks. Alkaline phosphatase staining also confirmed that the highest mineralization was observed in the same group. Conclusion: hUCMSCs induced new bone formation in the implant placement in osteoporotic animal models.

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