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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.

The Role of Ultrasonography in The Diagnosis of Oral and Maxillofacial Disease Ni Putu Mira Sumarta1 , David Buntoro Kamdjaja2 , Roberto Manahan Yantie Simandjuntak3
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 1 (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.v15i1.13680

Objective: Ultrasonography, as a diagnostic tool, constitutes a non-invasive, cost-effective, readily-availableand repeatable imaging technique. Ultrasonography has been used as a means of diagnosing various medicalconditions for many years. However, in the field of maxillofacial surgery it represents a relatively new aidin the diagnosis of various diseases affecting the oral and maxillofacial regions. These include: infection,soft-tissue related diseases and vascular anomalies which can be detected using Doppler ultrasonography.This article presents four cases, in which ultrasonography was employed to confirm diagnoses and act as aguide to treatment. Methods: Four cases of soft tissue swelling and enlargement were diagnosed with theaid of ultrasonography, namely: a submasseteric abscess, a nasolabial cyst, a dermoid cyst and a left buccalspace abscess caused by a foreign body (i.e. a fish bone). Result: In the case of a submasseteric abscess,ultrasonography was used in confirming the diagnosis and therapy, while determining the maximal point ofthe abscess. In the cases of both cysts, ultrasonography highlighted well-defined cystic lesions with internalecho showing fluid accumulation, while in the buccal space abscess, an ultrasonogram confirmed the exactlocation of the fish bone. Conclusion: Ultrasonography is a quick, widely-available, relatively inexpensive,painless procedure which can be repeated as often as necessary without risk to the patient. Thus, ultrasonographyis a valuable diagnostic aid to the oral and maxillofacial surgeon in achieving early and accurate diagnosis.

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.

Management of idiopathic alveolar bone necrosis associated with oroantral fistula after upper left first molar extraction Ni Putu Mira Sumarta
Dental Journal (Majalah Kedokteran Gigi) Vol. 43 No. 3 (2010): September 2010
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Background: Complications such as alveolar osteonecrosis and oroantral fistula can occure in maxillary molar extraction. The management of such complication is done by treating to treat any persisting maxillary sinusitis if present, prevent further antral contamination, wound bed preparation, and oroantral fistula closure with appropriate method. Purpose: This case report presents a treatment stage of an idiopathic upper alveolar bone necrosis and oroantral fistula that occurred 4 months after left upper first molar extraction. Case: A case of an idiopathic upper alveolar bone necrosis associated with oroantral fistula that occurred 4 months after left upper first molar extraction is presented. Patient suffered from pain and swelling at left upper jaw since 2 month before admission. There was a history of complicated tooth extraction 4 months earlier. Patient also complained pus and blood discharge from post extraction socket. Patient occasionally choked when drinking and fluids escaped through the nostril. There was a diffuse swelling in the left maxillary region; there was no hyperemia, with soft consistency and no pain on palpation. In the 26, 27 region there was a

Fibrous epulis associated with impacted lower right third molar Ni Putu Mira Sumarta; David B Kamadjaja
Dental Journal (Majalah Kedokteran Gigi) Vol. 42 No. 4 (2009): December 2009
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Background: Epulis or epulides are lesions associated with gingival tissues. Fibrous epulis is a type of hyperplastic fibrous tissue mass located at the gingival which is slow growing, painless, having same color as the oral mucosa and firm on palpation. Anterior regions of the oral cavity are the frequently affected sites as these areas are more prone to be affected by calculus deposition and poor plaque control due to frequent teeth malposition. Removal of any irritating factors and excision of the lesion are the usual treatments. Purpose: This case report presents a rare case of fibrous epulis which occurred in the posterior region of the oral cavity and associated with impacted lower third molar. Case: A case of fibrous epulis at the lower right third molar area of three months duration is presented. The mass was slow growing, painless and on examination it was a pedunculated mass overlying the unerupted lower right third molar, having same color with the oral mucosa and firm on palpation. Clinically, the lesion was diagnosed as fibrous epulis associated with impacted lower right third molar. Case management: The treatment were surgical excision of the epulis and removal of the lower right third molar. The histopathology result showed tissue with squamous epithelial lining, achanthotic fibrous connective tissue, mononuclear inflammatory cells and few capillaries without signs of malignancy. This is consistent with the diagnosis of fibrous epulis. Conclusion: Fibrous epulis, although frequently occurred at the anterior region of the oral cavity, may rarely grow at the area of lower third molar. This phenomenon supports the theory that epulis can grow on any surface of oral mucous membrane as long as local irritants are present.

A study of cytotoxicity and proliferation of Cosmos caudatus Kunth leaf extract in human gingival fibroblast culture Zhafira Nur Shabrina; Ni Putu Mira Sumarta; Coen Pramono
Dental Journal (Majalah Kedokteran Gigi) Vol. 51 No. 4 (2018): December 2018
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Background: Post-extraction dental sockets clinically resolve within a period of 3-4 weeks. However, complete healing and bundling of gingival fibers may require several months. Medication is therefore required to accelerate the healing process. Cosmos caudatus (C. caudatus), a local plant with antioxidant properties and high calcium content, has the potential to promote wound healing while also reportedly capable of strengthening bone. Previous studies have demonstrated the effectiveness of C. caudatus as an alternative treatment for post-menopausal osteoporosis by investigating the dynamic and cellular parameters of bone histomorphometry. Purpose: The study aimed to examine the citotoxicity and proliferation of human gingival fibroblast cells culture after the application of C. caudatus extract. Methods: Cultures of human gingival fibroblast cells with 5x104 cell density were divided into two groups and placed in a 30-well culture dish. The control group contained human gingival fibroblast cell culture without extract, while the experimental group consisted of human gingival fibroblast cells culture with extract. The concentrations of extract were 1200 μg/ml, 600 μg/ml, 300 μg/ml, 150 μg/ml, and 75 μg/ml. A toxicity test was conducted and the optimum concentration evaluated using an MTT assay, while fibroblast numbers on were calculated days 1 and 2 by means of a hemocytometer. Research data was analyzed using a one-way ANOVA test. Results: No toxicity was found. The optimum concentration was 600 μg/ml and fibroblast proliferation was significantly higher in the experimental group compared to the control group, p=0.002 (P<0.05). Conclusion: C. caudatus leaf extract is non-toxic and increases the proliferation of human gingival fibroblast culture at an optimum concentration of 600 μg/ml.

Musculoskeletal disorder risk level evaluation of posterior maxillary tooth extraction procedures Anggy Prayudha; Roberto M. Simandjuntak; Ni Putu Mira Sumarta
Dental Journal (Majalah Kedokteran Gigi) Vol. 52 No. 1 (2019): March 2019
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Background: The professional activity of dentists involves a relatively small treatment area, namely; the oral cavity. Dental treatment requires a high level of precision with the result that dentists frequently perform their duties in a physically uncomfortable position over a relatively extended period of time. Tooth extraction is the most common form of treatment performed in a standing position, with extraction of the posterior maxillary tooth being the most challenging. 80 per cent of students and dentists working in the Faculty of Dentistry at the University of Indonesia present musculoskeletal disorders (MSD). Purpose: To evaluate the level of MSD risk of Oral and Maxillofacial Surgery Clinic students at the Universitas Airlangga Dental Hospital following posterior maxillary tooth extraction. Methods: The evaluation of MSD risk level was performed over a period of three months on 73 subjects who had experienced posterior maxillary tooth extraction, categorized as extraction under anaesthesia, extraction involving the use of an elevator and extraction using forceps. Evaluation was conducted by two observers by means of CCTV video footage using a Rapid Entire Body Assessment (REBA) worksheet. Results: Under anaesthetic sedation, 67.12% experienced medium risk, 31.51% high risk, and 1.37% low risk. During extraction using an elevator, 58.90% experienced high risk, 35.62% medium risk and 5.48% extremely high risk. During extraction using forceps, 57.53% ran medium risk, 39.73% high risk, and 2.74% extremely high risk. Conclusion: Students who performed posterior maxillary tooth extraction could be categorized as running a high risk of MSD during extraction using an elevator, but medium risk when administering anaesthesia and performing extraction with forceps.

The effects of breadfruit leaf (Artocarpus Altilis) extract on fibroblast proliferation in the tooth extraction sockets of Wistar rat Darin Hulwani Rinaldi; David B. Kamadjaja; Ni Putu Mira Sumarta
Dental Journal (Majalah Kedokteran Gigi) Vol. 51 No. 3 (2018): September 2018
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Background: A prolonged tooth extraction socket healing process can affect the well-being of the patient and increase the risk of infection. Fibroblast proliferation in the proliferation phase is an important stage in the healing process. Fibroblast formed from extracellular matrix and collagen fibers support bone formation in the socket. Breadfruit leaves, extremely common in Indonesia, contain polyphenol, flavonoid, tannin and alkaloid substances which accelerate the wound healing process because of their anti-inflammatory, anti-bacterial and anti-oxidant properties. A previous study showed that 16% breadfruit leaf gel extract administered to Wistar rats produced an encouraging anti-inflammatory effect, but its capacity for increasing fibroblast proliferation remains to be fully understood. Purpose: The aim of this study was to observe the effect of applying breadfruit leaf extract on fibroblast proliferation on the healing process in tooth extraction sockets. A preliminary phytochemical study was undertaken. Methods: 24 Wistar rats were divided into four groups: two control groups and two experimental groups. 16% breadfruit leaf gel extract was applied to the experimental groups, while none was applied to the control groups. The number of fibroblasts was counted on both the third and fifth days post-extraction. Data was analyzed statistically using an independent T-test. Results: There were significant differences in the number of post-extraction fibroblasts in Wistar rat tooth sockets on day 3 (p=0.000; p < α=0.05) and day 5 (p=0.000; p < α=0.05). Conclusion: Breadfruit leaf gel extract application increases fibroblast proliferation during the healing process in the tooth extraction sockets of Wistar rats.

Peripheral ossifying fibroma of the anterior maxillary gingiva Ganendra Anugraha; Ni Putu Mira Sumarta
Dental Journal (Majalah Kedokteran Gigi) Vol. 52 No. 4 (2019): December 2019
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.v52.i4.p204-208

Background: Peripheral ossifying fibroma is a rejuvenation of the reactive gingiva, usually occurring in the anterior maxillary gingiva. The condition is often clinically ambiguous when diagnosed on the basis of gingival hyperplastic lesions such as focal fibrous hyperplasia, peripheral giant cell granuloma, peripheral fibroma and pyogenic granuloma because peripheral ossifying fibroma has a tendency to recur with a ratio of around 20%. The literature on the subject predominantly classifies peripheral osifying fibroma as an epulis type, but it has also been identified as a peripheral mesenchymal tumor presenting similar clinical symptoms to ossified fibrous epulis. Purpose: The purpose of this article is to explain the rare case of peripheral ossifying fibroma in the anterior maxillary gingiva which can be clinically misdiagnosed as reactive gingival hyperplastic lesions. Case: A case report of peripheral ossifying fibroma in the left lateral incisor and canine of the maxillary gingiva in a 26 year-old male. The patient chiefly complained of a painless, slow growing gingival enlargement on the upper left jaw during the previous five years. Clinical examination confirmed it to be a single, hard swelling in the 21-24 region, pale in color and with a rough surface. Case management: The procedure constituted a complete surgical excision of the lesion together with the underlying periosteum curettage intended to prevent recurrence. The histopathologic examination results indicated tissue with squamous epithelial lining, stroma consisting of fibroblasts, and immature trabecula with osteoblastic rimming between collagen tissue without signs of malignancy. Osteoblastic rimming has specific features in histopathologic examination of ossifying fibroma. Conclusion: Peripheral ossifying fibroma is a rare solitary enlargement in the oral cavity frequently misdiagnosed as ossified fibrous epulis. A definitive diagnosis is made by means of histopathologic examination. The condition has a low reccurance rate.

Closed reduction in the treatment of neglected mandibular fractures at the Department of Oral and Maxillofacial Surgery, Universitas Airlangga Olivia Jennifer Gunardi; Riska Diana; David Buntoro Kamadjaja; Ni Putu Mira Sumarta
Dental Journal (Majalah Kedokteran Gigi) Vol. 52 No. 3 (2019): September 2019
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.v52.i3.p147-153

Background: The mandible is one of the bones most affected by facial fractures commonly resulting from trauma to the face. The ultimate goal of treatment is to re-establish the pre-injury dental occlusion (bite), mandibular anatomy and jaw function of the patient. Treatment approaches range from conservative non-invasive management by ’closed’ reduction and immobilization using intermaxillary fixation (IMF) to the more invasive surgery-based ’open’ reduction incorporating an internal fixation approach. Purpose: The purpose of this case series was to describe the close reduction method as a form of treatment in cases of neglected mandibular fracture. Cases: Four cases of single or multiple mandibular fracture were presented. Case management: All of the cases were managed using a closed reduction method and IMF. Conclusion: A closed reduction method in this case series produced encouraging results and could be considered an alternative in the treatment of neglected mandibular fractures with displacement.

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