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Neutral Zone: Concept and Technique Application for Managing Severely Resorbed Mandibular Ridges â€“ A Case Report Nuriyanto, Ainy F.; Rostiny, Rostiny; Agustono, Bambang
e-GiGi Vol 10, No 1 (2022): e-GiGi
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/eg.v10i1.36615

Abstract: Full dental prosthesis rehabilitation on flat mandibular ridge has been a difficult case for clinicians for a long time. A huge resorption of mandibular ridge results in inadequate retention, and tounge muscle pressure, as well as lip and cheek muscles, causing a decrease in dentureâ€™s stability and retention. Neutral zone is a potential area or position where lips and cheek on one side, and tounge on the other side have balance pressure. We reported a 60-year-old male patient with chief complaints of difficulty in mastication, and loose upper and lower dentures. He also complained of denture moving during swallowing and speaking. In case management, the aim was to acquire optimum stability of the denture and arrangement of the mandibular teeth in full dental prosthesis guided by using the neutral zone. Preliminary impression was done by using alginate, then, horizontal and vertical jaw relation was recorded by using bite rim. Suction method impression technique was used to acquire functional impression. Lower denture teeth arrangement adapted the result of neutral zone impression. Acrylic denture was being contoured to adjust the natural anatomy of the oral cavity. In conclusion, the patient got a new full denture with maximum retention and stability while speaking as well as masticating. This article discussed about making of full dental prosthesis with pressure point on neutral zone impression technique on flat mandibular ridge caused by huge resorption.Keywords: flat mandibular ridge; denture stability; neutral zone; impression technique

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.

Neutral Zone: A Concept and Technique Application for Managing Severely Resorbed Fitri, Ainy; Agustono, Bambang
Indonesian Journal of Prosthodontic Special Issue 2021
Publisher : Indonesia Prosthodontic Association

Background: Full dental prosthesis rehabilitation on flat mandibular ridge has been a difficult case for clinician for a long time. A huge resorption of mandibular ridge resulted in not enough retention, tounge muscle force as well as lips and cheek muscle causing a decrease in dentureâ€™s stability and retention. Neutral zone is a potential area or position where lips and cheek on one side, and tounge on the other side have balance pressure. Purpose: To acquire optimum stability of the denture, arrangement of the mandibular teeth in full dental prosthesis must follow the neutral zone. Case Report: A 60-year-old male patient with a chief complaint of difficulty in mastication, loosening of upper and lower dentures, he also complained of denture moving during swallowing and speaking. Case Management: Preliminary impression was done using alginate. Then, horizontal and vertical jaw relation was recorded using bite rim. Suction method impression technique was used to acquire functional impression. Lower denture teeth arrangement followed the result of neutral zone impression. Acrylic denture was being contoured to follow natural anatomy of the oral cavity. Conclusion: The result of the treatment is patient get full denture with maximum retention and stability while speaking as well as masticating. This article explains about the making of full dental prosthesis with pressure point on neutral zone impression technique on flat mandibular ridge caused by huge resorption.

Shortening Dental Arch and Splint Crown in Mini Dental Implant Azhar, Imam Safari; Agustono, Bambang; Ari, Muhammad Dimas Aditya; Laksono, Harry
Indonesian Journal of Prosthodontic Special Issue 2021
Publisher : Indonesia Prosthodontic Association

A male patient, 40-years-old, came to Dental Hospital Universitas Airlangga with a complaint to replace the lower right and left teeth that had been extracted 1 year ago with a denture that could not be removed. The patient wants to make dentures to make them more comfortable when chewing. The tooth extraction was performed Â± 1 year ago in the lower left posterior tooth region caused caries. Treatment plan: Implant supported splint crown Based on the existing clinical conditions in patient, we examined the thickness of the existing bone. Then we performed to insert an implant fixture 3.0x10 mm type TS III SA in region 34 and 3.5x10 mm type ET III SA Osstem in region 35. This treatment using one stage surgery with splint crown restoration. Clinical significance of therapy/summary: In this case, patient refused invasive surgical procedure as bone augmentation. Shortening dental arch was chosen due to the loss of the antagonist teeth. Implant supported splint crown can be another solution because itâ€™s able to maintain the long term of mini dental implant especially in the posterior region.

The effect of a combination of propolis extract and bovine bone graft on the quantity of fibroblasts, osteoblasts and osteoclasts in tooth extraction sockets Louisa Christy Lunardhi; Utari Kresnoadi; Bambang Agustono
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.p126-132

Background: Tooth extraction is a procedure frequently performed in the field of dentistry that can cause alveolar bone resorption during the healing process. Therefore, preservation of sockets is necessary to maintain alveolar bone which represents one of the important factors in the successful manufacture of dentures. A combination of propolis extract and bovine bone graft (BBG) can accelerate bone regeneration. Purpose: The purpose of this study was to determine the effects of a combination of propolis extract and BBG on the quantity of fibroblasts, osteoblasts, and osteoclasts in the tooth extraction socket. Methods: 56 Cavia cobaya were divided into eight groups. The lower left incisor of each subject was extracted and induced with polyethylene glycol (PEG), propolis extract + PEG, BBG + PEG, combination of propolis extract + BBG + PEG at a concentration of 2% active substance. Experimental subjects were sacrificed on days 3 and 7. Histopathological examination with a microscope at 400x magnification was conducted to calculate the quantity of fibroblasts, osteoblasts, and osteoclasts. Statistical analysis was performed by one-way ANOVA and Tukey HSD tests. Results: The highest average quantity of fibroblasts and osteoblasts and the lowest average quantity of osteoclasts occurred in the group to which a combination of propolis extract and BBG had been administered on both days 3 and 7. According to the statistical analysis results, all the treatment groups recorded a significant difference in the quantity of fibroblasts, osteoblasts, and osteoclasts with a p value: 0.000 (p<0.05). Conclusion: A combination of propolis extract and BBG can increase the quantity of fibroblast and osteoblast cells, while reducing the number of osteoclast cells in tooth extraction sockets treated with 2% concentration of the active substance.

Evaluation of osteogenic properties after application of hydroxyapatite-based shells of Portunus pelagicus Michael Josef Kridanto Kamadjaja; Alya Nisrina Sajidah Gatia; Agtadilla Novitananda; Lintang Maudina; Harry Laksono; Agus Dahlan; Bambang Agustono Satmoko Tumali; Muhammad Dimas Aditya Ari
Dental Journal (Majalah Kedokteran Gigi) Vol. 54 No. 3 (2021): September 2021
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.v54.i3.p119-123

Background: After tooth extraction, the socket leaves a defect on the alveolar bone. The administration of shell crab-derived hydroxyapatite maintains bone dimensions that are important for achieving successful prosthodontic treatment. Purpose: The aim of the study was to determine the osteogenic properties, such as the number of osteoclasts, osteoblasts and osteocytes, after the application of hydroxyapatite-based shell crab in the post-extraction sockets of Wistar rats. Methods: There were two groups: the control group (K) and the treatment group (T). Wistar rats were randomly divided into control and treatment groups. After tooth extraction, hydroxyapatite gel derived from Portunus pelagicus shells was applied to the tooth sockets of Wistar rats. Observations and calculations of osteoclasts, osteoblasts and osteocytes were carried out on the 14th and 28th days under a light microscope with 400 times magnification. Statistical analysis was performed using one-way ANOVA. Results: There was a significant difference (p<0.05) between the K14 and P14 groups, K28 and P28 groups, K14 and K28 groups, and P14 and P28 groups. The results indicated that there were significant differences between groups of variables. Conclusion: The application of shell crab-derived hydroxyapatite (Portunus pelagicus) was able to decrease the number of osteoclasts and increase the number of osteoblasts and osteocytes.

Oral rehabilitation using immediate implant placement in mandibular lateral incisors – a case report Nila Sari; Abil Kurdi; Bambang Agustono Satmoko Tumali; Muhammad Dimas Aditya Ari
Dental Journal (Majalah Kedokteran Gigi) Vol. 54 No. 3 (2021): September 2021
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.v54.i3.p160-164

Background: Dental problems often lead to missing teeth. After tooth extraction, the alveolar bone will undergo a healing phase, and this will cause some vertical and horizontal resorption. Immediate implant placement can shorten treatment time and preserve the rest of the alveolar bone. Purpose: The purpose of this study is to present a case of oral function, equilibrium and aesthetic rehabilitation using immediate implant placement. Case: A male patient aged 31 came to Dental Hospital Universitas Airlangga with a fractured anterior tooth. The tooth had fractured two weeks before he came to the hospital, and he wanted to improve his appearance. Case management: The mandibular incisor was fractured, and its residual root remained. The treatment plan was to undertake an immediate implant placement. The type of implant chosen was a bone level tapered implant SC roxolid® SLA Ø 2.9 mm and 10 mm long. Surgery was performed in two stages. The first stage was to extract the residual root, position the implant and apply the bone graft. The second stage was to position the healing abutment. A crown impression was made using the closed tray technique. The crown was cemented to the abutment. Conclusion: Immediate implant placement is an aesthetic means of rehabilitating a missing tooth, such as an anterior mandibular tooth.

Increasing Denture Retention using Compound Denture Technique – A Case Report Wirayudha, Agam; Kamadjaja, Michael Josef Kridanto; Agustono, Bambang
Indonesian Journal of Dental Medicine Vol. 1 No. 2 (2018): Indonesian Journal of Dental Medicine
Publisher : Faculty of Dental Medicine Universitas Airlangga

Background: Treating missing tooth with denture, in some cases, still leave the patient unfulfilled. Good mastication and retention are the main considerations especially for those who require more retentions. In some cases, combination of partial and fixed denture the best approach to achieve better functional and retention results. Purpose: To report compound denture procedures with good mastication and retention as the main considerations. Case: A 43-year-old male patient reported a complaint of chewing difficulty due to missing right upper front teeth caused by work accident and extracted posterior. Patient wanted to wear partial denture to regain good mastication. Case management: Compound denture was chosen to optimize the remaining teeth for better functional and aesthetic. Zirconia all ceramic fixed dentures were fabricated on 13, 14, 15 with an occlusal rest on 13 and 15. Pontic on the 14 used ridge lap design. Discussion: Compound denture is a combination of removable and fixed denture where a minor connector of a removable denture should involve a fixed denture. Fixed denture shall be fabricated first and then removable denture. Conclusion: The definitive restoration of this case was compound denture, which is a combination of partial denture metal frame and fixed denture to restore the good mastication and retention.

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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