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The Pentahelix Approach to Oral-Systemic Health Integration: A Policy Framework for Academic-Primary Care Partnerships in Transitional Health Systems Zelka Dapala; Rachmat Hidayat; Muhammad Ashraf
Community Medicine and Education Journal Vol. 6 No. 2 (2025): Community Medicine and Education Journal
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/cmej.v6i2.877

Abstract

The historical bifurcation of dental and medical care pathways imposes a severe epidemiological burden, particularly within transitional health systems confronting a high prevalence of both non-communicable diseases and chronic periodontitis. Bridging this gap requires robust policy frameworks that extend beyond clinical interventions to involve cross-sectoral collaboration. To evaluate the structural efficacy, clinical outcomes, and policy implications of integrating oral-systemic healthcare using a Pentahelix collaborative model between primary healthcare centers and academic dentistry institutions in South Sumatra, Indonesia. A mixed-methods implementation study was conducted over eighteen months across twelve primary care centers in South Sumatra. The intervention utilized the Pentahelix model, integrating government authorities, academic dentistry faculties, health technology industries, community leaders, and local media. Quantitative data included inter-departmental referral completion rates, changes in patient glycemic control (HbA1c), and systemic inflammatory markers (C-Reactive Protein). Qualitative data assessed stakeholder engagement and interprofessional competencies. Implementation of the Pentahelix framework significantly improved medical-dental cross-referral completion rates from a baseline of twelve percent to seventy-six percent. Clinically, patients with comorbid type 2 diabetes and severe periodontitis receiving integrated care demonstrated a mean HbA1c reduction of 0.9% and a significant decrease in serum C-Reactive Protein levels following combined medical and non-surgical periodontal therapy. Furthermore, interprofessional competency scores among participating academic students and primary care staff increased significantly. In conclusion, the Pentahelix model provides a viable, highly effective policy framework for dismantling clinical silos in transitional health systems. By anchoring interprofessional clinical practice within a multi-stakeholder governance structure, health systems can achieve measurable improvements in both population health metrics and health workforce readiness.
Personalized Periodontal Regeneration: Integrating 3D Bioprinting with Autologous Activated Growth Factor (AGF) for Enhanced Alveolar Bone Defect Healing Zelka Dapala; Rachmat Hidayat; Muhammad Ashraf
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i12.1605

Abstract

Background: The complete structural restoration of alveolar bone defects remains a critical challenge in reconstructive periodontology. Conventional grafting methods often fail to replicate the complex microarchitecture of periodontal tissues. This study integrated three-dimensional bioprinting technology with Autologous Activated Growth Factor to construct personalized scaffolds for treating severe infrabony periodontal defects. Methods: A randomized controlled clinical study was conducted at a private hospital in Palembang, South Sumatera, involving patients with Stage III periodontitis exhibiting vertical alveolar bone defects. Cone-beam computed tomography data guided the precise three-dimensional bioprinting of polycaprolactone and beta-tricalcium phosphate scaffolds. These constructs were functionalized operatively with Autologous Activated Growth Factor prepared from peripheral blood. The control group received conventional deproteinized bovine bone mineral with a collagen membrane. Clinical attachment level, probing depth, and radiographic bone fill were evaluated over six months. Results: The three-dimensional bioprinted scaffolds functionalized with Autologous Activated Growth Factor demonstrated superior clinical outcomes. At six months, the experimental group showed a mean probing depth reduction of 4.82 mm and a clinical attachment level gain of 4.15 mm. Radiographic analysis revealed a mean bone fill of 82.4% in the experimental group compared to 64.1% in the control. Inflammatory biomarkers were significantly modulated, indicating a highly favorable regenerative microenvironment. Conclusion: The synergistic integration of personalized three-dimensional bioprinted scaffolds with the potent osteoinductive and angiogenic properties of Autologous Activated Growth Factor significantly enhanced alveolar bone defect healing, providing a highly predictable alternative for complex periodontal regeneration.
Personalized Periodontal Regeneration: Integrating 3D Bioprinting with Autologous Activated Growth Factor (AGF) for Enhanced Alveolar Bone Defect Healing Zelka Dapala; Rachmat Hidayat; Muhammad Ashraf
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i12.1605

Abstract

Background: The complete structural restoration of alveolar bone defects remains a critical challenge in reconstructive periodontology. Conventional grafting methods often fail to replicate the complex microarchitecture of periodontal tissues. This study integrated three-dimensional bioprinting technology with Autologous Activated Growth Factor to construct personalized scaffolds for treating severe infrabony periodontal defects. Methods: A randomized controlled clinical study was conducted at a private hospital in Palembang, South Sumatera, involving patients with Stage III periodontitis exhibiting vertical alveolar bone defects. Cone-beam computed tomography data guided the precise three-dimensional bioprinting of polycaprolactone and beta-tricalcium phosphate scaffolds. These constructs were functionalized operatively with Autologous Activated Growth Factor prepared from peripheral blood. The control group received conventional deproteinized bovine bone mineral with a collagen membrane. Clinical attachment level, probing depth, and radiographic bone fill were evaluated over six months. Results: The three-dimensional bioprinted scaffolds functionalized with Autologous Activated Growth Factor demonstrated superior clinical outcomes. At six months, the experimental group showed a mean probing depth reduction of 4.82 mm and a clinical attachment level gain of 4.15 mm. Radiographic analysis revealed a mean bone fill of 82.4% in the experimental group compared to 64.1% in the control. Inflammatory biomarkers were significantly modulated, indicating a highly favorable regenerative microenvironment. Conclusion: The synergistic integration of personalized three-dimensional bioprinted scaffolds with the potent osteoinductive and angiogenic properties of Autologous Activated Growth Factor significantly enhanced alveolar bone defect healing, providing a highly predictable alternative for complex periodontal regeneration.