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Chondrogenic Differentiation Capacity of Human Umbilical Cord Mesenchymal Stem Cells with Platelet Rich Fibrin Scaffold in Cartilage Regeneration (In Vitro Study) Sumarta, Ni Putu Mira; D, Coen Pramono; Hendrianto, Eryk; Susilowati, Helen; Karsari, Deya; Rantam, Fedik A.
BALI MEDICAL JOURNAL Vol 5 No 3 (2016)
Publisher : BALI MEDICAL JOURNAL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (541.428 KB)

Background: Human umbilical cord mesenchymal stem cell is a promising source of allogenous MSC with great chondrogenic differentiation capacity. Meanwhile, platelet rich fibrin (PRF) is a natural fibrin matrix, rich in growth factors, forming a smooth and flexible fibrin network, supporting cytokines and cell migration, thus can be used as a scaffold that facilitate the differentiation of MSC. However, the differential capability of MSC cultured in PRF was still poorly understood. Method: We studied in vitro differentiation potential of MSC cultured in PRF by evaluating several markers such as FGF 18, Sox 9, type II collagen, aggrecan in 3 different culture medium. Result: The result showed that there was positive expression of FGF 18, Sox 9, type II collagen, aggrecan in all medium of in vitro culture. Conclusion: MSC cultured from human umbilical cord had the capacity of chondrogenic differentiation and able to produce cartilage extracellular matrix in vitro which means that hUCMSC is a potential allogeneic MSC for cartilage regeneration.

Identification of Single Nucleotide Polymorphism on Bone Morphogenetic Protein 2 Gene in Non-Syndromic Cleft Lip/ Palate Patient Mala Kurniati; RM Coen Pramono D; Agung Sosiawan; David Sontani Perdanakusuma; Hari Basuki Notobroto; Andra Rizqiawan
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 4 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i4.16954

Cleft lip/palate (CL/P) is one of the most common birth defects in humans. Haploinsufficiency in genesBone Morphogenetic Protein (BMP) 2 is thought to play an important role in the incidence of CL/P. Thisstudy aimed to identify changes in the nucleotide (Single Nucleotide Polymorphism/SNP) BMP 2 rs235768A>T gene in CL/P patient in Indonesia. Seventy samples of DNA that were successfully amplified andrestricted consisted of patient and control samples with the three of which were used for sequencing. Basedon the analysis using restriction enzymes and Finch TV and Bioedit software programs, this study identifieda change from nucleotide A to nucleotide T which is a mutation missense (Serine-Arginine/TCA-TCT).Based on the results of the Fisher’s exact test, there was difference in genotype frequency between the CL/Pgroup and the control. Meanwhile, there was no difference in allele frequencies between the two groups. Theallele frequency T has a higher value than the frequency of the allele A.

The Genetic Aspect of Non-Syndromic Cleft Lip and Palate towards Candidate Genes in the Etiology : A literature Review Mala Kurniati; RM Coen Pramono D; Agung Sosiawan; Ni Wayan Tirtaningsih
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 2 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i2.14935

Cleft lip and cleft palate (CL/P) is a cleft lip deformity indicated by an opening or an uncommon cleft inthe lip or roof of the mouth (palate). The differences in ethnicity, gender, and the correlation with geneticfactors influence the prevalence of Non-syndromic CL/P. This study was conducted through a literaturereview on genes that were allegedly associated with Non-syndromic CL/P. Genetics play a role, to a greateror lesser extent, in all diseases. Besides, palatogenesis involves many diverse genes in a complex process.In this case, oral cleft phenotypes develop when this process is disrupted in some manner because of genedysfunction. Various genetic approaches, including genome-wide and candidate gene association studiesas well as linkage analysis, have been undertaken to identify etiologic factors, but results have often beeninconclusive or contradictory. Therefore, it concludes that the genetic basis of CL/P is still controversialbecause of the genetic complexity of clefting

The Genetic Aspect of Non-Syndromic Cleft Lip and Palate towards Candidate Genes in the Etiology : A literature Review Mala Kurniati; RM Coen Pramono D; Agung Sosiawan; Ni Wayan Tirtaningsih
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 3 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i3.15859

Cleft lip and cleft palate (CL/P) is a cleft lip deformity indicated by an opening or an uncommon cleft in the lip or roof of the mouth (palate). The differences in ethnicity, gender, and the correlation with genetic factors influence the prevalence of Non-syndromic CL/P. This study was conducted through a literature review on genes that were allegedly associated with Non-syndromic CL/P. Genetics play a role, to a greater or lesser extent, in all diseases. Besides, palatogenesis involves many diverse genes in a complex process. In this case, oral cleft phenotypes develop when this process is disrupted in some manner because of gene dysfunction. Various genetic approaches, including genome-wide and candidate gene association studies as well as linkage analysis, have been undertaken to identify etiologic factors, but results have often been inconclusive or contradictory. Therefore, it concludes that the genetic basis of CL/P is still controversial because of the genetic complexity of clefting.

Degrees of chitosan deacetylation from white shrimp shell waste as dental biomaterials Sularsih Sularsih; Anita Yuliati; Coen Pramono D
Dental Journal (Majalah Kedokteran Gigi) Vol. 45 No. 1 (2012): March 2012
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Background: Chitosan is biomaterial improved for various dentistry applications because it is biocompatible, degradable, nontoxic, and not carcinogenic. The main parameter affecting the characteristics of chitosan is deacetylation degree. Purpose: This study is aimed to determine the degree of deacetylated of chitosan derived from white shrimp shell waste used as dental biomaterial. Methods: White shrimp shells were crushed into powder. Next, deproteination process was conducted with 3.5% NaOH solution, demineralized with 1N HCl solution, and then depigmented with 90% acetone solution into chitin powder. Deacetylation process was then conducted by soaking the chitin powder in 50% NaOH solution for 6 h at 65° C to produce white powder of chitosan. Afterwards, deacetylation degree test was conducted by using Fourier Transform Infrared Spectrophotometer (FTIR) to calculate the ratio of the absorption bands between the absorbance peak of amide group about 1655 cm–1 and the absorbance peak of hydroxyl group about 3450 cm–1. Results: The result of the deacetylation degree test on the chitosan powder derived from white shrimp shell waste was high, about 85.165%, and had the eligible form, solubility, and pH. Conclusion: It can be concluded that the deacetylation degree of chitosan from white shrimp shells could reach 85.165%.Latar belakang: Kitosan merupakan biomaterial yang dikembangkan untuk berbagai aplikasi kedokteran gigi karena biokompatibel, dapat didegradasi, tidak toksik dan tidak karsinogenik. Parameter utama yang mempengaruhi karakteristik kitosan adalah derajat deasetilasi. Tujuan: Tujuan dari penelitian ini adalah mengetahui derajat deasetilasi kitosan dari limbah kulit udang putih sebagai biomaterial kedokteran gigi. Metode: Kulit udang putih dihaluskan menjadi serbuk. Setelah itu dilakukan proses deproteinasi dengan larutan NaOH 3,5%, demineralisasi dengan larutan HCl 1N, depigmentasi dengan larutan aseton 90% sehingga menjadi serbuk kitin. Proses deasetilasi dilakukan dengan merendam serbuk kitin dalam larutan NaOH 50% selama 6 jam pada suhu 65° C sehingga dihasilkan serbuk putih kitosan. Uji derajat deasetilisasi menggunakan metode spektrofotometer Fourier Transform Inframerah (FTIR) dengan menghitung nilai perbandingan pita serapan antara puncak absorbansi gugus amida sekitar 1655 cm–1, dan puncak absorbansi gugus hidroksil sekitar 3450 cm–1. Hasil: Hasil uji derajat deasetilasi serbuk kitosan dari limbah kulit udang putih adalah tinggi yaitu sebesar 85.165% dan memiliki bentuk, kelarutan dan pH yang memenuhi syarat. Kesimpulan: Dapat disimpulkan derajat deasitilasi kitosan dari kulit udang putih adalah 85,165%.

Effect of soybean extract after tooth extraction on osteoblast numbers Rosa Sharon Suhono; Coen Pramono; Djodi Asmara
Dental Journal (Majalah Kedokteran Gigi) Vol. 44 No. 2 (2011): June 2011
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Background: Many researches were done to find natural materials that may increase and promote bone healing processes after trauma and surgery. One of natural material that had been studied was soybean extract which contains phytoestrogen, a non-steroidal compounds found in plants that may binds to estrogen receptors and have estrogen-like activity. Purpose: The aim of this study was to investigate the effect of soybean extract feeding on the number of osteoblast cells in alveolar bone socket after mandibular tooth extraction. Methods: This study was studied on male Rattus norvegicus strain Wistar. Seventeen rats divided into three groups were used in this study. Group 1 fed with carboxy methyl cellulose (CMC) solution 0,2% for seven days, and the left mandibular central incisivus was extracted; group 2 fed with soybean extract for seven days and the left mandibular central incisives was extracted; group 3 received the left mandibular central incisives extraction followed by soybean extract feeding for seven days after the extraction. All groups were sacrificed on the seventh day post-extraction, and the alveolar bone sockets were taken for histopathological observation. The tissues were processed and stained using hematoxylin and eosin to identify the amount of osteoblast cells. The number of osteoblast cells was counted using an Image Tool program. The data was analyzed statistically using the One-Way ANOVA test. Results: Significant differences were found on the number of osteoblast cells in alveolar bone after tooth extraction between groups. Group 2 (fed with soybean extract) is higher than group 1 (fed with CMC) and group 3 (fed with soybean extract after extraction). Conclusion: Soybean extract feeding that given for seven days pre-tooth extraction can increase the number of osteoblast cells compared with the group that were not given soybean extract feeding and also with the group that were given soybean extract feeding for seven days post-tooth extraction.Latar belakang: Pada masa sekarang, banyak dilakukan penelitian-penelitian untuk menemukan bahan-bahan alami yang dapat mendukung dan meningkatkan proses remodeling tulang untuk mengembangkan perawatan penyakit osteoporosis dan juga untuk mengembangkan penyembuhan tulang pasca trauma dan pasca pembedahan. Salah satu bahan alami yang banyak diteliti adalah ekstrak kedelai yang mengandung fitoestrogen, suatu senyawa non-steroid yang terdapat dalam tumbuhan, yang dapat berikatan dengan reseptor estrogen dan memiliki bioaktivitas yang sejenis dengan hormon estrogen. Tujuan: Tujuan dari penelitian ini adalah untuk meneliti pengaruh ekstrak kedelai yang mengandung fitoestrogen terhadap jumlah sel osteoblas pada tulang alveolar pasca pencabutan gigi. Metode: Penelitian ini dilakukan pada tikus wistar jantan. Tujuh belas ekor tikus dibagi menjadi tiga kelompok sampel dalam penelitian ini. Kelompok sampel tersebut mendapatkan perlakuan yang berbeda-beda. Kelompok 1 dilakukan feeding larutan CMC 0,2% selama tujuh hari, kemudian dilakukan pencabutan satu gigi insisivus sentral kiri rahang bawah, kelompok 2 dilakukan feeding ekstrak kedelai selama tujuh hari, kemudian dilakukan pencabutan satu gigi insisivus sentral kiri rahang bawah, kelompok 3 kelompok yang dilakukan pencabutan satu gigi insisivus sentral kiri rahang bawah, kemudian diberikan feeding ekstrak kedelai selama tujuh hari pasca pencabutan gigi. Semua kelompok dikorbankan pada hari ketujuh pasca pencabutan gigi, dan soket bekas pencabutan gigi tersebut diambil untuk dibuat sediaan histopatologis. Jaringan tersebut diproses dan dilakukan pengecatan dengan hematoxylin and eosin untuk melihat sel osteoblas. Setiap preparat diperiksa di bawah mikroskop cahaya dan sel osteoblas dihitung dengan menggunakan program Image Tool. Data hasil penelitian kemudian dianalisa dengan uji statistik One-Way ANOVA. Hasil: Terdapat perbedaan yang signifikan pada jumlah sel osteoblas pada tulang alveolar pasca pencabutan gigi, antara kelompok sampel yang mendapatkan feeding ekstrak kedelai sebelum pencabutan gigi (Kelompok 2) dibandingkan dengan (Kelompok 1) dan (Kelompok 3). Kesimpulan: Pemberian ekstrak kedelai selama tujuh hari sebelum pencabutan gigi dapat meningkatkan jumlah osteoblas.

Cytotoxicity difference of 316L stainless steel and titanium reconstruction plate Ni Putu Mira Sumarta; Coen Pramono Danudiningrat; Ester Arijani Rachmat; Pratiwi Soesilawati
Dental Journal (Majalah Kedokteran Gigi) Vol. 44 No. 1 (2011): March 2011
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Background: Pure titanium is the most biocompatible material today and used as a gold standard for metallic implants. However, stainless steel is still being used as implants because of its strength, ductility, lower price, corrosion resistant and biocompatibility. Purpose: This study was done to revealed the cytotoxicity difference between reconstruction plate made of 316L stainless steel and of commercially pure (CP) titanium in baby hamster kidney-21 (BHK-21) fibroblast culture through MTT assay. Methods: Eight samples were prepared from reconstruction plates made of stainless steel type 316L grade 2 (Coen’s reconstruction plate®) that had been cut into cylindrical form of 2 mm in diameter and 3 mm long. The other one were made of CP titanium (STEMA Gmbh®)) of 2 mm in diameter and 2,2 mm long; and had been cleaned with silica paper and ultrasonic cleaner, and sterilized in autoclave at 121° C for 20 minutes.9 Both samples were bathed into microplate well containing 50 μl of fibroblast cells with 2 x 105 density in Rosewell Park Memorial Institute-1640 (RPMI-1640) media, spinned at 30 rpm for 5 minutes. Microplate well was incubated for 24 and 48 hours in 37° C. After 24 hours, each well that will be read at 24 hour were added with 50 μl solution containing 5mg/ml MTT reagent in phosphate buffer saline (PBS) solutions, then reincubated for 4 hours in CO2 10% and 37° C. Colorometric assay with MTT was used to evaluate viability of the cells population after 24 hours. Then, each well were added with 50 μl dimethyl sulfoxide (DMSO) and reincubated for 5 minutes in 37° C. the wells were read using Elisa reader in 620 nm wave length. Same steps were done for the wells that will be read in 48 hours. Each data were tabulated and analyzed using independent T-test with significance of 5%. Results: This study showed that the percentage of living fibroblast after exposure to 316L stainless steel reconstruction plate was 61.58% after 24 hours and 62.33% after 48 hours. And after exposure to titanium reconstruction plate, the percentage of living fibroblast was 98.69% after 24 hours and 82.24% after 48 hours. Based on cytotoxicity parameter (CD50%), both reconstruction plate made of 316L stainless steel or titanium showed as a non-toxic materials to fibroblast. Conclusion: Both reconstruction plate made of stainless steel and CP titanium were non-toxic to fibroblast, although the stainless steel plate showed lower cytotoxicity level compared to titanium. Therefore a reconstruction plate made from stainless steel type 316L can be used as a safe material for mandibular reconstruction. Latar belakang: Titanium murni adalah bahan yang paling biokompatibel saat ini dan digunakan sebagai standar emas implan logam. Saat ini stainless steel masih digunakan karena kekuatan, ductility, harganya yang murah, tahan terhadap korosi dan cukup biokompatibel. Tujuan: Penelitian ini dilakukan untuk mengetahui perbedaan sitotoksisitas antara plat rekonstruksi yang terbuat dari titanium murni komersial dan plat rekonstruksi yang terbuat dari stainless steel pada kultur sel fibroblas baby hamster kidney-21 (BHK-21) menggunakan MTT assay. Metode: Delapan sampel yang masing-masing tipe 316L terbuat dari stainless steel 316L grade 2 (Coen’s reconstruction plate®) yang dipotong berbentuk silinder diameter 2 mm dan panjang 3 mm, serta yang terbuat dari titanium murni komersial (STEMA Gmbh®) diameter 2 mm dan panjang 2,2 mm; dan dibersihkan dengan kertas silika dan pembersih ultrasonik serta disterilkan dengan autoclave pada suhu 121° C selama 20 menit. Kedua sampel dimasukkan ke dalam sumur mikroplat yang mengandung 50 μl sel fibroblas dengan kepadatan 2 × 105 dalam media Rosewell Park Memorial Institute-1640 (RPMI-1640), diputar dengan kecepatan 30 rpm selama 5 menit. Sumur mikroplat diinkubasi selama 24 dan 48 jam pada suhu 37° C. Setelah 24 "> jam, pada tiap sumur yang akan dibaca pada jam ke 24 ditambahkan 50 μl cairan yang mengandung 5mg/ml MTT dalam phosphat buffer saline (PBS), kemudian diinkubasi kembali selama 4 jam dalam CO2 10% pada suhu 37° C. Assay kolorimetri dengan MTT digunakan untuk mengetahui viabilitas populasi sel setelah 24 jam. Setiap sumur ditambahkan pelarut dimetil sulfoksida (DMSO) dan diinkubasi kembali selama 5 menit pada suhu 37° C. sumur-sumur tersebut kemudian dibaca dengan Elisa reader dengan panjang gelombang 620 nm. Langkah yang sama dilakukan pada sumur-sumur yang akan dibaca pada jam ke 48. Data kemudian ditabulasi dan dianalisis dengan menggunakan independent T-test dengan signifikansi 5%. Hasil: Penelitian ini menunjukkan presentase fibroblas hidup setelah terpapar plat rekonstruksi yang terbuat dari stainless steel adalah 61,58% setelah 24 jam dan 62,33% setelah 48 jam. Dan setelah paparan dengan plat rekonstruksi yang terbuat dari titanium murni adalah 98,69% setelah 24 jam dan 82,24% setelah 48 jam. Berdasarkan pada parameter sitotoksisitas (CD50%) kedua plat rekonstruksi baik yang terbuat dari titanium murni maupun yang terbuat dari stainless steel tipe 316L merupakan bahan yang tidak bersifat toksik terhadap fibroblas. Kesimpulan: Kedua plat rekonstruksi baik yang terbuat dari stainless steel maupun CP titanium tidak bersifat toksik terhadap fibroblas, walaupun plat stainless steel menunjukkan level sitotoksisitas yang lebih rendah daripada titanium murni. Dengan demikian plat rekonstruksi yang terbuat dari stainless steel 316 L aman digunakan sebagai bahan untuk rekonstruksi mandibula.

Minor modification of Millard's surgical technique for correction of complete unilateral cleft lip Coen Pramono D
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: A surgical technique for correction of complete unilateral cleft lip was done using a minor modification of Millard’s surgical technique. The purpose of this modification is to achieve a good anatomical form of columelia, nostril cill and the position of nasal tip. Purpose: This article presents the correction of the complete cleft lip which was done initially by correction of the slanted columella followed by correction of the nostril sill which was done before the sequence of closing the lip crevice. Case: Correction of a case with complete unilateral cleft lip on a fifteen year old girl using modification of Millard’s surgical technique is presented. Case Management: Rotation incision in the philtrum region was made as introduced by Millard to make a triangular flap. The triangular flap was contralaterally rotated and pulled into the direction of cleft to achieve a normal position of the columella and nasal tip. The lateral side of the ala was incised in circular form down to the alar base and straight through to the direction of cleft formed an alar flap which consisted of ala, clefted and slanted nasal base tissue. The tip of the triangular flap was trimmed and approximated to the alar flap to form a new the nostril sill. Adjustment of the size of the nostrill sill size was achieved during the approximation of those two flaps. The nasal base was built during approximation of the lateral and the medial segment flap or philtrum region and the base of new nostril sill. Surgical correction of the complete unilateral cleft lip including correction of the nostrill sill using approximation of triangular flap and the alar flap was achieved. Conclusion: This surgical technique with minor modification of Millard’s surgical technique can be used for correction of the complete unilateral cleft lip with extremely slanted columella and nasal tip to form thenostril sill.Latar belakang: Koreksi celah bibir komplit satu sisi telah dilakukan menggunakan metode operasi Millard yang dimodifikasi. Modifikasi dimaksudkan untuk memperoleh bentuk anatomis yang baik dari columella, nostril dan letak ujung hidung yang baik. Tujuan: Melaporkan koreksi suatu celah bibir komplit satu sisi menggunakan metode operasi Millard yang dimodifikasi yang dimulai dengan melakukan perbaikan pada columella yang miring pada bentuk nostril sebelum tahapan penutupan celah bibir dilakukan. Kasus: Dilaporkan satu kasus koreksi celah bibir komplit satu sisi pada pasien wanita usia 15 tahun menggunakan metode operasi Millard yang dimodifikasi. Tatalaksana kasus: Dilakukan insisi berbentuk rotasi di regio seperti pada metode Millard untuk membuat flap berbentuk trianguler. Flap trianguler dirotasikan ke arah kontra lateral dan ditarik menuju arah celah bibir untuk memperoleh posisi columella yang normal, bentuk nostril yang simetris dan letak ujung hidung yang baik. Dilakukan insisi sirkuler ke bawah ke arah dasar ala pada regio lateral ala menuju ke bagian celah bibir, selanjutnya akan diperoleh bentuk flap yang disebut alar flap yang terdiri atas bagian ala nasi, bagian dari jaringan yang berada pada sisi celah dan bagian dari dasar hidung di sisi celah bibir. Bagian ujung dari trianguler flap dipotong dan selanjutnya ditautkan pada flap alar untuk membentuk bentukan nostril baru. Penyesuaian ukuran nostril dilakukan pada tahap penautan kedua flap tersebut. Bagian dari dasar hidung dibentuk pada saat tahapan penautan antara flap segmen lateral dan medial atau bagian dari philtrum dan bagian dasar dari nostril atau cuping hidung. Koreksi bedah suatu celah bibir komplit satu sisi termasuk koreksi pada bentuk nostril diperoleh dengan menautkan antara flap trianguler dan flap alar. Kesimpulan: Teknik bedah Millard dengan modifikasi kecil dapat dipakai untuk melakukan koreksi pada kasus celah bibir komplit satu sisi yang disertai kemiringan columella dan ujung hidung yang ekstrim.

Management of zygomatic-maxillary fracture (The principles of diagnosis and surgical treatment with a case illustration) David B. Kamadjaja; Coen Pramono D
Dental Journal (Majalah Kedokteran Gigi) Vol. 41 No. 2 (2008): June 2008
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Mechanical trauma to the face may cause complex fracture of the zygoma and the maxilla. The characteristic clinical signs of zygomatic bone fracture include flattening of the cheek, infraorbital nerve paraesthesia, diplopia, and trismus, whereas maxillary fracture may typically cause flattening of the midface and malocclusion. The diagnosis of zygomatic and maxillary fracture should be established with thorough clinical examination and careful radiologic evaluation so that a three-dimensional view of the fractured bones can be obtained. This is essential in order to plan a proper surgical treatment to reconstruct the face in terms of functions and aesthetic. A standard surgical protocol should also be followed in performing the surgical reconstruction of the zygoma and the maxilla. A case of delayed bilateral fracture of zygoma and maxilla is presented here to give illustration on how the principle of diagnosis and surgical treatment of complex zygomatico-maxillary fracture are applied.

Coen’s ascending ramus fixator use for repositioning the ascending ramus during mandible reconstruction Coen Pramono D
Dental Journal (Majalah Kedokteran Gigi) Vol. 41 No. 1 (2008): March 2008
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

The aim of mandible reconstruction using reconstruction plate after resection is to restore aesthetic and function for muscles attachment and allow mandible movement during normal function and free from joint problem. Temporomandibular joint (TMJ) is an area of concern during mandible reconstruction using reconstruction plate as misalignment on placing of the reconstruction plate may cause the joint place in distortion to the glenoid fossa. Loss large part of mandible bone structure may lead problems during mandible reconstruction procedure because the surgeon may lose in orientation during forming the reconstruction plate into a horseshoe-shaped form of the mandible as well as during plate placement. The plate can only be well adapted when the position of two distal ends of the resected mandible bone are in a stable position. Simple ascending ramus fixator (CARF) to fix the ascending ramus in its stable original position to allow easy mandible reconstruction was created. Those CARF were designed in two types which have one and two fixator stems used to stabilize one or both sites of the ascending rami and showed its effectiveness.

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