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Management of Completely Edentulous Resorbed Mandibular Ridge with Flabby Tissue Using Suction Method Impression Technique and Lingualized Posterior Occlusal Scheme: A Case Report Sari, Nila; Rostiny, Rostiny; Dahlan, Agus
Indonesian Journal of Prosthodontic Special Issue 2021
Publisher : Indonesia Prosthodontic Association

Background: Oral health problems often leads to edentulism. Post-extraction alveolar ridge will undergo bone resorption and can be aggravated by ill-fitting denture. There are some treatment options for completely edentulous patients. However, conventional complete denture is still one of the most popular treatment options as it is predictable, cost effective, and non-invasive. There are some principles that should be followed to ensure a more comfortable and functional complete denture. Objective: The purpose of this article is to describe how a case of fully edentulous patient, with flabby tissue and flat mandibular ridge, is managed using suction method impression technique and a lingualized posterior occlusal scheme. Case Report: A female patient aged 68 years old came to the Universitas Airlangga Dental Hospital to get a new denture since her previous denture is ill-fitting and unfunctional. The mandibular alveolar ridge is flat and there is flabby tissue in the anterior region of the maxilla and mandible. Case Management: First, a preliminary impression was taken using the reversible hydrocolloid alginate impression material. Then, a bite rim was fabricated from the preliminary model. Next, the horizontal and vertical position of the mandible was determined using the bite rim. The lower bite rim was cut into 4 pillars so that a suction method impression technique could be done. A neutral zone registration was also done for guiding the lower denture teeth arrangement. The posterior occlusal scheme was arranged to be lingualized occlusion. The denture needed some minor adjustment during control. Conclusion: Suction method impression technique combined with lingualized posterior occlusal scheme will make a more retentive and stable complete denture.

The importance of neutral zone in fully edentulous case with highly resorbed ridge Salim, Irvan; Dahlan, Agus
Indonesian Journal of Prosthodontic Vol 1, No 2 (2020): December 2020
Publisher : Indonesia Prosthodontic Association

Full edentulous is one of the most challenging cases for prosthodontist. One of the difficulties in treating that cases is the limitations in support and retention, especially in cases with highly resorbed ridge where the denture bearing area avalaible is minimum.One of the techniques to achieve the retention is by using the neutral zone tech-nique. Neutral zone is the area where the displacing forces of the lips, cheeks, and tongue are in balance. It is in this zone that the natural dentitions lie and this is where the artificial teeth should be positioned. This area of mi-nimal conflict may be located by using the neutral zone technique. The artificial teeth can then be set up in the correct positions. By using this concept it will be able to achieve retention, stability and support. This case report will share the usage of the neutral zone technique in treating fully edentulous ridge with highly resorbed ridge.

The importance of masticatory functional analysis in the diagnostic finding and treatment planning for prosthodontic rehabilitation Harry Laksono; Agus Dahlan; Sonya Harwasih
Dental Journal (Majalah Kedokteran Gigi) Vol. 45 No. 2 (2012): June 2012
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Background: The masticatory system as a biologic system is subjected to harmful influences of varying severity. Almost half of routine patients requesting prosthodontic treatment indicated at least one sign or symptom of temporomandibular disorders. Analysis of the masticatory system often neglected by dentist. Untreated temporomandibular disorders may significantly implicated in the perpetuation of the disorder and may interfere with routine prosthodontic clinical procedures. It would be resulted unsuccessful long term goal of prosthodontic rehabilitation because of the uncompleted diagnoses and treatment plan. Purpose: The purpose of this case report was to give the information of the importance of masticatory functional analysis in the diagnostic finding for treatment planning in the prosthodontic rehabilitation. Case: A 45 year - old male patient, partial dentate with reduced chewing efficiency, mild pain in right preauricular region in function, left click in opening mouth, severe attrition on all anterior lower teeth with vertical dimension of occlusion decreased due to loss of posterior support. He wanted to make a new denture. Case management: Record and analyze of active and passive mandibular movement, opening pathway, muscle and temporomandibular joints palpation, load testing, and vertical dimension of occlusion with manual functional analysis (MFA), occlusal condition and radiographic examination. Treatment plan was formulated into 3 phases: stabilization of the masticatory system, definitive treatment and periodical control. The result of this treatment excellent for 1 year evaluation after permanent cementation. Conclusion: Masticatory functional analysis is very important and must be done in the diagnosis finding for treatment planning in every case of prosthodontic rehabilitation.Latar belakang: Sistem pengunyahan sebagai sistem biologis sewaktu-waktu dapat terjadi gangguan dengan berbagai derajat keparahan. Hampir setengah dari jumlah pasien yang memerlukan perawatan prostodontik minimal menunjukkan satu tanda atau keluhan dari gangguan temporomandibular. Analisis fungsional sistem pengunyahan masih sering dilupakan oleh dokter gigi. Gangguan temporomandibular yang tidak dirawat akan terus ada dan mungkin dapat mengganggu prosedur klinis perawatan prostodonsia. Hal tersebut akan menyebabkan keberhasilan klinis jangka panjang perawatan prostodonsia tidak dapat tercapai karena diagnosis dan rencana perawatan yang kurang lengkap. Tujuan: Tujuan dari laporan kasus ini adalah untuk memberikan informasi tentang pentingnya analisis fungsional sistem pengunyahan untuk menegakkan diagnosis dan rencana perawatan pada perawatan prostodonsia. Kasus: Pasien laki-laki usia 45 tahun, bergigi sebagian merasa sulit untuk mengunyah makanan, nyeri ringan di daerah depan telinga kanan saat fungsi, keletuk sendi kiri saat membuka mulut, atrisi pada seluruh gigi depan rahang bawah disertai penurunan dimensi vertikal oklusi akibat kehilangan dukungan gigi belakang. Dia ingin membuat gigi tiruan yang baru. Tatalaksana kasus: Mencatat dan menganalisis pergerakan aktif dan pasif rahang bawah, arah pergerakan rahang bawah saat membuka mulut, palpasi otot-otot pengunyahan dan sendi temporomandibula, uji beban, dimensi vertikal oklusi dengan metode analisis fungsional secara manual, keadaan oklusal dan radiologis. Rencana perawatan dibagi menjadi 3 tahap berupa stabilisasi sistem pengunyahan, perawatan tetap dan kontrol secara periodik. Hasil perawatan menunjukkan keberhasilan klinis yang baik setelah dilakukan evaluasi selama 1 tahun setelah penyemenan tetap. Kesimpulan: Analisis fungsional sistem pengunyahan sangat penting dan harus dilakukan untuk menegakkan diagnosis dan rencana perawatan pada setiap perawatan prostodonsia.

Treatment of temporomandibular disorder using occlusal splint Agus Dahlan
Dental Journal (Majalah Kedokteran Gigi) Vol. 42 No. 1 (2009): March 2009
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Background: Patient suffering from occlusal abnormality is usually detected months or even years when the acute patient visits a dentist, and generally the patient does not receive direct treatment upon his complaints since minimum information is available on this type of treatment. In general, the dentist provides medication only or conducts incorrect selective grinding where in fact, the patient does not feel better from the previous conditions. Purpose: The objective of this study is to discuss the treatment on the dysfunctional temporomandibular joint followed by orofacial pain caused by occlusal disorder using occlusal splint. Case: In this case, a forty three years old male having trouble with the joint on the left jaw followed by orofacial pain caused by occlusal disorder. Case Management: Initial treatment with occlusal splint makes the patient comfortable and recovers from his complaints since the patient could restructure the chewing muscles. This treatment will be more successful if the dentist has the knowledge to use and choose occlusal splint method properly. Occlusal Splint could be used as a supporting therapy and consideration as one of the therapies to avoid the unwanted side effects. The use of occlusal splint is meant as an alternative of the main therapy in overcoming the problem of occlusal splint. Conclusion: Finally, therapy with occlusal splint is very effective as an alternative treatment to handle the dysfunction of temporomandibular joint caused by occlusion.

RANKL expressions in preservation of surgical tooh extraction treated with Moringa (Moringa oleifera) leaf extract and demineralized freeze-dried bovine bone xenograft S. Soekobagiono; Adrian Alfiandy; Agus Dahlan
Dental Journal (Majalah Kedokteran Gigi) Vol. 50 No. 3 (2017): September 2017
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Background: Preservation of sockets is a procedure aimed to reduce bone resorption after tooth extraction. One of the most commonly used xenograft materials is demineralized freeze-dried bone bovine xenograft (DFDBBX). Meanwhile, one of the key regulations in osteoclast genesis process is RANKL bond. A decrease in the number of RANKL expressions can suppress the osteoclast genesis process so that bone resorption can be prevented. The combination of Moringa leaf extract and DFDBBX, as a result, is expected to decrease the number of RANKL. Purpose: This study aimed to measure RANKL expressions in tooth extraction socket treated with Moringa leaf extract combined with DFDBBX. Methods: Fifty six Cavia cobaya rats were divided into eight groups. The first group was a control group with PEG administration onto their extraction sockets. The second group was a treatment group with DFDBBX administration. The third group was a treatment group with Moringa leaf extract administration. The fourth group was a treatment group induced with a combination of DFDBBX and Moringa leaf extract. Examination then was performed on days 7 and 30. After 7 and 30 days, those Cavia cobaya rats were executed and tested with immunohistochemical techniques. Further research data collected then were tested with one-way ANOVA. Results: There were significant differences between the control group and the groups induced with the combination of Moringa leaf extract and DFDBBX. On days 7 and 30, the groups induced with the combination of Moringa leaf extract and DFDBBX had the lowest number of RANKL expressions. Conclusion: The combination of Moringa leaf extract and DFDBBX can decrease the number of RANKL expressions in Cavia cobaya rats on the day 7 and day 30 after tooth extraction.

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.

Tumor necrosis factor-α and osterix expression after the transplantation of a hydroxyapatite scaffold from crab shell (Portunus pelagicus) in the post-extraction socket of Cavia cobaya Irvan Salim; Michael Josef Kridanto Kamadjaja; Agus Dahlan
Dental Journal (Majalah Kedokteran Gigi) Vol. 55 No. 1 (2022): March 2022
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.v55.i1.p26-32

Background: Socket preservation using bone graft is one way to minimise resorption and maximise the bone formation process. Tumor necrosis factor-α (TNF-α) is an inflammatory cytokine that affects bone regenerating osteoblast activity, while osterix (Osx) is an osteoblast-specific transcription factor that activates gene receptors during pre-osteoblast differentiation. The hydroxyapatite (HA) scaffold from crab shells (Portunus pelagicus) has osteoconduction properties. Purpose: To analyse the decrease of TNF-α expression and the increase of Osx expression and the correlation between these two in the post-extraction socket after the transplantation of a crab shell HA scaffold. Methods: The lower left incisors of Cavia cobaya (n = 24) were extracted and divided into four groups: the first and second groups were control groups on Day 7 and Day 14 (K7 and K14), the third and fourth groups were treatment groups (P7 and P14). The statistical analysis used was a multivariate analysis of variance (MANOVA) with a significance level of 0.05. Results: A MANOVA test showed that the use of crab shell HA scaffolds led to a significant difference (p < 0.05) in TNF-α expression (p = 0.01) and Osx expression (p = 0.01). A Pearson correlation test result showed a strong inverse correlation between TNF-α and Osx expressions (p = 0.00 and r = -0.78). Conclusion: The transplantation of HA scaffolds from crab shells can decrease TNF-α expression but increase Osx expression in the post-extraction socket of C. cobayas. Furthermore, an inverse correlation was found between TNF-α and Osx.

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.

Complete Denture Treatment With a Flat Ridge Using Semi-adjustable Articulator Herdianti, Nur Cecilia; Soekobagiono, Soekobagiono; Dahlan, Agus
Indonesian Journal of Dental Medicine Vol. 1 No. 1 (2018): Indonesian Journal of Dental Medicine
Publisher : Faculty of Dental Medicine Universitas Airlangga

Background: Complete denture is a removable denture replacing all the missing teeth and tissue in the upper jaw and lower jaw. The purpose of making complete denture is to improve the function of chewing, aesthetic functions and maintaining patient's oral health. Complete edentulous ridge will causes resorption, until it become flat. A flat ridge is associated with difficulties in providing successful dentures. Purpose: This case report aims to reported the treatment of complete edentulous maxillary and mandibular with a flat ridge using semi-adjustable articulator. Case(s): A 63-year-old male patient visited the Prosthodontic Clinic of Dentistry Faculty, Airlangga University with complete edentulous maxillary and mandibular, also flat ridge in his mandibular. Case Management: This case is using semi-adjustable articulator (Stratos 300). Some accessories in Stratos 300 were used in this case, such as centric tray to help determine the height of bite, gnathometer M to help the process of functional impression and bite block, also tooth arrangement with 2D templates. Conclusion: The use of semi-adjustable articulator (Stratos 300) could restore stomatognathic function in accordance with patient's condition.

Mandibular Magnet Retained Complete Overdenture Chumaidi, Glady; Dahlan, Agus; Laksono, Harry
Indonesian Journal of Dental Medicine Vol. 1 No. 1 (2018): Indonesian Journal of Dental Medicine
Publisher : Faculty of Dental Medicine Universitas Airlangga

Background: Complete denture in the lower jaw often has problems. The entire loss of the mandibular teeth often has a large resorption, so it is difficult to obtain retention and stability. Purpose: To report mandibular magnet retained complete overdenture is can increase retention and stability in the lower jaw. Case: A 60-year-old man came to the Prosthodontics Clinic of RSGM Airlangga University with complaints of the old complete denture that made by previous dentist, is often unstable while talking and chewing, so the patient feel uncomfortable. The denture has been used for approximately four years. Therefore the patient wants to make a new complete denture. Case Management: PFM crown removed and 31,32,33,41,43 are treated with root canal treatment. Magnet keepers are fabricated on teeth 33,43, and metal copings are fabricated on teeth 31,32,41. The complete lower denture is attached to the magnet. Acrylic material denture are chosen. Discussion: Overdenture is a complete or partial denture that is placed above the tooth structure or the root of the original tooth which is the support of the denture. Overdenture treatment can maintain ridge height, reduced load of supporting elements, and avoid mucosal irritation. It's necessary to add retention in the form of magnets to the teeth 33 and 43 to get good retention and stability. Conclusion: Mandibular magnet retained complete overdenture is can increase retention and stability in the lower jaw so that the patient feels satisfied and comfortable because the dentures are more retentive and stable.

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