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Treatment of a Class I Malocclusion with Severe Crowding using Passive Self-Ligating Brackets Pramustika, Agita; Widayati, Retno
Journal of Dentistry Indonesia Vol. 27, No. 2
Publisher : UI Scholars Hub

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Presently, dental crowding is the most common problem among orthodontic patients. The prevalence of crowding in the dental arch is significantly increased in modern dentitions, and it is the most common reason why patients pursue orthodontic treatment. Objective: To report an advanced bracket systems, namely self-ligating brackets, to increase the efficacy of orthodontic treatment especially in patients with severe crowding. Case Report: A 22-year-old female patient presented with severe crowding of the maxillary and mandibular arches. In the upper arch, both second premolars were palatally positioned; in the lower arch, the lower right canine was lingually positioned and the lower left second premolar was extracted. The patient had a balanced facial profile with a straight profile and skeletal Class I relationship. Treatment was initiated using passive self-ligating brackets followed by extraction of the upper second premolars and the lower right first premolar. Conclusion: The use of passive selfligating brackets proved to be effective and resulted in a significant improvement in the patient’s dental and smile esthetics. The active treatment time was 11 months; this resulted in successfully alleviating the crowding of the maxillary and mandibular arches and significant improvement in the occlusal relationship.

Penetration effect of prostaglandin E2 gel on oral mucosa of rats Rafinus Arifin; Retno Widayati; Erni H Purwaningsih; Dewi Fatma S
Dental Journal (Majalah Kedokteran Gigi) Vol. 45 No. 3 (2012): September 2012
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Background: Several researches reported that Prostaglandin E2 (PGE2) injection on buccal mucosa combined with orthodontic pressure can faster tooth movement but has disadvantages such as high alveolar bone and root resorption furthermore pain from injection needle. PGE2 gel was made to better replace the lacks of injectable PGE2. Purpose: This research was aimed to prove that PGE 2 gel can penetrate rat’s oral mucosa effecting the appearance of PMN cells. Methods: This research was an in vivo laboratory experiment using 36 Sprague Dawley rats which were divided into 3 groups: normal group, topical PGE2 gel group after 1, 2, 4, 8 hours (4 subgroups), and topical gel without PGE2 group after 1, 2, 4, 8 hours (4 subgroups). Each group consists of 4 rats, therefore the total sample for all research groups were 36 rats. Gel with 25 µg/mL of PGE2 and gel without PGE2 were applied on oral mucosa for 2 minutes. Then, the rats were sacrificed after 1 hour, 2 hours, 4 hours, and 8 hours application. After that, the samples were prepared for histological examination with Hematoxyllin and Eosin. The picture were taken with OptiLab View and PMN cells amount were counted with light microscope, set 400 times of magnification. Results: Penetration effect of PGE2 gel on rat’s oral mucosa result in PMN inflammation cells distribution. One-way ANOVA showed no significant difference on PMN cells count in rats’ lower jaws between groups of normal and gel without PGE2. There was significant difference between groups of PGE2 gel and gel without PGE2 (p=0,001). PGE2 gel application showed PGE2 as inflammatory media, even though administered topically. Conclusion: PGE2 gel can penetrate rat’s oral mucosa, effecting PMN cells 1, 2, 4 and 8 hours after application of PGE2 gel.Latar belakang: Beberapa penelitian melaporkan bahwa injeksi (Prostaglandin E2) PGE2pada mukosa bukal yang dikombinasikan dengan tekanan ortodonti dapat mempercepat pergerakan gigi, tapi mempunyai kekurangan berupa resorpsi yang besar pada tulang alveolar dan akar gigi, serta adanya rasa sakit akibat penggunaan jarum suntik. Gel PGE2 dibuat untuk mengatasi kekurangan pemberian PGE2 secara injeksi. Tujuan: Untuk membuktikan bahwa gel PGE2 dapat berpenetrasi pada mukosa mulut tikus dengan efek munculnya sel PMN. Metode: Jenis penelitian adalah eksperimental laboratorik in vivo, menggunakan 36 tikus Sprague Dawley yang dibagi menjadi 3 kelompok, yaitu kelompok normal; kelompok pengolesan gel PGE2 setelah 1 jam, 2 jam, 4 jam, 8 jam (4 sub kelompok); kelompok pengolesan gel tanpa PGE2 setelah 1 jam, 2 jam, 4 jam, 8 jam (4 sub kelompok). Masing-masing kelompok terdiri 4 sampel, sehingga total sampel seluruh kelompok penelitian 36 tikus. Gel PGE2 dosis 25 µg/mL dan gel tanpa PGE2 dioleskan pada mukosa mulut rahang bawah selama 2 menit. Tikus di sacrifice setelah 1 jam, 2 jam, 4 jam dan 8 jam pengolesan. Kemudian dibuat sediaan histologi dengan pewarnaan Hematoxylin dan Eosin. Foto preparat diambil menggunakan OptiLab View. Hitung jumlah sel-sel PMN menggunakan mikroskop cahaya dengan pembesaran 400x. Hasil: Efek penetrasi gel PGE2 pada mukosa mulut terlihat distribusi sel-sel inflamasi PMN. Uji one-way ANOVA menunjukkan tidak ada perbedaan jumlah sel PMN yang bermakna pada mukosa rahang bawah tikus antara kelompok gel tanpa PGE2 dan normal. Ada perbedaan bermakna antara jumlah sel PMN kelompok pengolesan gel PGE2 dengan gel tanpa PGE2. (p = 0,001). Hasil aplikasi gel PGE2 menunjukkan gel PGE2 sebagai media inflamasi, meskipun zat aktif diberikan secara topikal. Kesimpulan: PGE2 gel dapat berpenetrasi ke mukosa mulut tikus, dengan efek adanya sel-sel PMN pada 1 jam, 2 jam, 4 jam dan 8 jam setelah pengolesan gel PGE2.

Orthodontic camouflage treatment using a passive self-ligating system in skeletal Class III malocclusion Fransiska Monika; Retno Widayati
Dental Journal (Majalah Kedokteran Gigi) Vol. 53 No. 4 (2020): December 2020
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.v53.i4.p191-195

Background: The treatment options for adults with skeletal Class III malocclusion can be dentoalveolar compensation, also known as orthodontic camouflage, or orthognathic surgery. Camouflage treatment can be carried out with teeth extractions, distalisation of the mandibular dentition, and use of Class III intermaxillary elastics. However, intermaxillary elastics as anchorage has its own risk–benefit. Purpose: To explain that camouflage treatment with teeth extractions can be performed in a mild to moderate skeletal Class III malocclusion using intermaxillary anchorage with elastics, while minimising the deleterious effects and achieving a satisfactory treatment outcome. Case: Our patient was a 25-year-old female who had a skeletal Class III pattern, with normal maxilla and a protruded mandible. She had a straight facial profile with a Class III canine and molar relationship on her right and left sides. Anterior crossbite was also present with crowding on both the maxilla and the mandible. Case Management: The treatment plan was carried out with dentoalveolar compensation by extracting teeth. Extraction of the lower first premolars was conducted to eliminate the crowding and correct the anterior crossbite. The mandibular incisors were retroclined and the maxillary incisors were proclined with dentoalveolar compensation. Passive self-ligating system was used with standard torque prescription, intermaxillary anchorage, and no additional appliances for anchorage control. Class I canine and incisor relationship were both achieved at the end of the treatment, while maintaining the Class III molar relationship. Conclusion: Orthodontic camouflage treatment in an adult patient using a passive self-ligating system and intermaxillary anchorage can improve facial profile and improve dental occlusion.

Second molar scissor bite correction in class ii malocclusion using miniscrew and cross-elastic Citra L. Yuwono; Retno Widayati
Journal of Dentomaxillofacial Science Vol. 7 No. 1 (2022): (Available online: 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/jdmfs.v7i1.1407

Objective: Scissor bite is one of the atypical findings that could be found in daily practice, especially in Class II malocclusion. The aim was to report second molar scissor bite correction using miniscrew and cross-elastic. Methods: A 20 years-old, female, had second molar scissor bite with Class II malocclusion. Extrusion and buccoversion of the upper left second molar were noted with lingual tipping of bilateral lower second molar. Deep bite and mild crowding were found with missing upper first premolar and lower anterior tooth gemination. A miniscrew was placed to intrude the extruded second molar, while additional cross-elastic was used to correct both upper and lower teeth position. Results: Combination of miniscrew and cross-elastic successfully correct second molar scissor bite in seven months through intrusion and palatal tipping of upper molar and uprighting of the lower molar. With a total treatment of twenty-three months, a good intercuspation was achieved with Class I canine, Class II molar relationship, and normal overjet and overbite Conclusion: The use of miniscrew with cross-elastic successfully correct second molar scissors bite in Class II malocclusion.

Class III Malocclusion Camouflage Treatment Using a Conventional Orthodontic Appliance in a Non-Growing Patient Monika, Fransiska; Widayati, Retno
Journal of Dentistry Indonesia Vol. 30, No. 1
Publisher : UI Scholars Hub

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The treatment of skeletal and dental Class III malocclusions is a challenge for orthodontists, and one of the treatment alternatives for a non-growing patient is orthodontic camouflage treatment. Different approaches may result in different outcomes; therefore, a proper diagnosis and treatment plan are needed to avoid undesirable effects. In this case, a 21-year-old female patient presented with a skeletal Class III malocclusion, with a normal maxilla, prognathic mandible, moderate crowding, and an acceptable facial profile. The treatment modality for orthodontic camouflage treatment was a conventional orthodontic appliance with the extraction of mandibular first premolars to resolve crowding. At the end of the treatment, a Class I canine and incisor relationship was achieved while maintaining a Class III molar relationship. After 25 months of treatment, the patient had a more pleasant smile with improved functional occlusion.

A correlation between malocclusion complexity with periodontal status Nugroho, Mahardhika Setya; Krisnawati, Krisnawati; Widayati, Retno; Lesang, Robert
Majalah Kedokteran Gigi Indonesia Vol 10, No 2 (2024): August
Publisher : Faculty of Dentistry, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/majkedgiind.92375

Malocclusion is the third most common dental problem after caries and periodontal diseases, with prevalence reaching 56% in the world and 89% in Indonesia (2006), respectively. Index of Complexity, Outcome, and Need (ICON) is an assessment tool to measure the necessity, complexity, and success of orthodontic treatment. Although several studies have reported a causal relationship between malocclusion and periodontal disease, the association is still under debate. The aim of this study was to analyze the correlation between malocclusion complexity based on ICON and the periodontal status of patients who underwent orthodontic treatment at the Orthodontic Clinic, Dental Hospital, Faculty of Dentistry, Universitas Indonesia. Material and Method: This was an analytical study with a cross-sectional design. Fifty-four new patients (aged 25-44 years) were included. Patients who had systemic disease, used fixed orthodontic appliance or prosthesis, and had some local factors were excluded. Periodontal status, ICON complexity, study model, and radiographic results were examined and analyzed. An interclass correlation test was carried out to obtain data reliability. Result: the majority of malocclusion complexities based on ICON were mild (46.3%). Periodontal status consisted of Plaque Index (good, 81.5%; moderate, 18.5%), Papillary Bleeding Index (no bleeding, 90.7%; severe bleeding, 1.9%), Clinical Attachment Loss (moderate, 40.7%; severe, 22.2%), gingival recession (mild, 83.3%; severe, 7.4%), periodontal probing depth (moderate, 77.8%; severe, 3.7%), and alveolar bone height (middle third, 53.7%; cervical third, 46.3%). Conclusion: No significant correlation was found between malocclusion complexity based on ICON and periodontal status.

Perbedaan interpretasi asimetri dentokraniofasial antara orthopantomogram dan sefalometri posteroanterior menggunakan analisis linear vertikal dan angular: studi cross-sectional Jazaldi, Fadli; Widayati, Retno; Putri, Gema Paramesti
Jurnal Kedokteran Gigi Universitas Padjadjaran Vol 37, No 1 (2025): April 2025
Publisher : Fakultas Kedokteran Gigi Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jkg.v37i1.58720

ABSTRAK Pendahuluan: Interpretasi asimetri dentokraniofasial sangat penting dalam penegakkan diagnosis dan pembuatan rencana perawatan ortodonti. Walaupun sefalometri posteroanterior (PA) merupakan standar prosedur asimetri dentokraniofasial, namun memberi tambahan paparan radiasi bagi pasien, serta memerlukan biaya tambahan. Apabila orthopantomogram (OPG) dapat digunakan sebagai interpretasi dentokraniofasial, maka akan lebih efektif serta efisien. Penelitian ini bertujuan untuk menganalisis perbedaan interpretasi asimetri dentokraniofasial antara OPG dan sefalometri PA dengan analisis linear vertikal dan angular. Metode: Interpretasi asimetri dentokraniofasial analisis linear vertikal dan angular menggunakan Winceph 11 dari 30 subjek penelitian didapatkan sesuai kriteria inklusi. Terdapat 5 parameter yang dianalisis, yaitu Orbitale, Condyle, Sigmoid Notch Point, Gonion, Menton. Uji McNemar digunakan untuk menguji perbedaan kedua metode. Bland-Altman plot dan Kappa digunakan untuk menguji reliabilitas antara kedua metode. Hasil: Interpretasi asimetri dentokraniofasial dengan parameter orbitale, condyle, dan sigmoid notch point tidak terdapat perbedaan bermakna pada pengukuran linear vertikal dan angular, namun pengukuran angular pada parameter gonion didapatkan p=0,006 dan menton didapatkan p=0,039, didapatkan berbeda bermakna (p<0,05)antara gambaran OPG dan Sefalometri PA. Nilai Kappa yang didapatkan sebagai hasil uji reliabilitas pada penelitian ini p=0,087 dengan interpretasi bahwa seluruh parameter menunjukkan kesepakatan hampir sempurna (almost perfect agreement) antara kedua metode (Kappa>0,81). Simpulan: Terdapat perbedaan interpretasi asimetri dentokraniofasial antara orthopantomogram dan sefalometri posteroanterior menggunakan analisis linear vertikal dan angular. OPG dapat digunakan sebagai alat bantu interpretasi awal asimetri dentokraniofasial, namun untuk penegakan interpretasi asimetri dentokraniofasial utamanya menggunakan sefalometri PA. Kata kunci Asimetri dentokraniofasial, orthopantomogram, sefalometri posteroanterior, interpretasi asimetri Differences in interpretation of dentocraniofacial asymmetry between orthopantomogram and posteroanterior cephalogram using vertical and angular linear analysis: cross sectional study ABSTRACT Introduction: Interpretation of dentocraniofacial asymmetry is crucial in establishing the orthodontic diagnosis and treatment plans. Although posteroanterior (PA) cephalometry is the standard procedure for dentocraniofacial asymmetry, it provides additional radiation exposure for patients and requires additional costs. If orthopantomogram (OPG) can be used as a dentocraniofacial interpretation, it will be more effective and efficient. Objective: This study aims to analyze the differences in dentocraniofacial asymmetry interpretation between OPG and PA cephalogram with vertical and angular linear analysis. Methods: Interpretation of dentocraniofacial asymmetry vertical and angular linear analysis using Winceph 11 of 30 subjects were obtained according to the inclusion criteria. The parameters are Orbitale, Condyle, Sigmoid Notch Point, Gonion, and Menton. McNemar test was used to evaluate and observe the differences between the two methods. Bland-Altman plot and Kappa were used to evaluate and observe the reliability between the two methods. Results: Interpretation of dentocraniofacial asymmetry with orbitale, condyle, and sigmoid notch point parameters presented no significant differences in vertical linear and angular measurements, but in gonion p=0,006 and menton p=0,039 parameters, there was a significant difference (p<0.05) between OPG and PA cephalometry in angular analysis. The Kappa value obtained as a result of the reliability test was p=0,087 with the interpretation that all parameters showed almost perfect between the two methods (Kappa> 0.81). Conclusion: There are differences in interpretation of dentocraniofacial asymmetry between orthopantomogram and posteroanterior cephalometry using vertical and angular analysis with a cross-sectional study. OPG can be used as an initial interpretation of dentocraniofacial asymmetry, but PA cephalogram is mainly used to enforce the interpretation of dentocraniofacial asymmetry. KeywordsDentocraniofacial asymmetry, orthopantomogram, posteroanterior cephalogram, asymmetry interpretation

Public Elementary School Bumi Agung Lampung Students' Perceptions About Maloclusions and The Need for Orthodontic Treatment Krisnawati, Krisnawati; Widayati, Retno; Adiwirya, Muhammad Sulaiman Kusumah; Soegiharto, Benny Mulyono; Kusumadewy, Widya; Pratiwi, Dwita
Journal of Indonesian Dental Association Vol 7 No 1 (2024)
Publisher : Indonesian Dental Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32793/jida.v7i1.1107

Introduction: Based on Indonesia Basic Health Research in 2018, it is known that 47% of Lampung people experience tooth decay and only 51% of them regularly go to the dentist. The need for orthodontic treatment is quite high among students. Epidemiological studies in Japan show that around 40% of teenagers aged 15-18 years need orthodontic treatment, 27%-36% in England aged 10-15 years, while in South Jakarta (2004) is 48.5%. Brook and Shaw introduced the Index of Orthodontic Treatment Need (IOTN), to assess the need for orthodontic treatment in England. IOTN has been applied by Agusni, T to measure the treatment needs of urban and rural children in Surabaya. Objective: Aims to determine the perceptions of elementary school students in Lampung regarding Malocclusion and the need for Orthodontic treatment. Method: A cross-sectional study was conducted in May 2023, carried out on students at public Elementary School Bumi Agung who met the inclusion criteria, namely aged 9-13 years, had never and were not currently undergoing orthodontic treatment, and were willing to take part in the research. 130 people were selected using a purposive sampling technique. Questionnaires were used to obtain sociodemographic data and general knowledge about Dental and Oral Health and Malocclusion. Assessment of the need for orthodontic treatment was carried out using the AC IOTN by the subject and operator. Results: 90% of students answered the questionnaire correctly, and 42% of students needed orthodontic treatment. A Pearson Chi-Square analysis test was carried out and found that there was a statistical difference in the perception of the need for orthodontic treatment by students and operators (p-value <0.05). Conclusion: Students at SDN Bumi Agung, Kalianda, Lampung, have very good general knowledge about Dental and Oral Health and Malocclusion. However, this is unsubstantiated by the perception of the need for orthodontic treatment.

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