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Crown: Journal of Dentistry and Health Research
Published by Phlox Institute: Indonesian Medical Research Organization
ISSN : 30261473     EISSN : 30261473     DOI : https://doi.org/10.59345/crown
Core Subject : Health, Science,
Dentistry Health Professions Medicine & Pharmacology Neuroscience Public Health
Focus Crown: Journal of Dentistry and Health Research (Crown) focused on the development of dentistry sciences and health research for human well-being. Scope Crown: Journal of Dentistry and Health Research (Crown) publishes articles which encompass all aspects of dentistry and health research , especially all type of original articles, case reports, review articles, narrative review, meta-analysis, systematic review, mini-reviews and book review.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 30 Documents
 1   2   3 
In Vitro and In Vivo Efficacy of a Novel Strontium-Doped Bioactive Glass Hydrogel for Dentin-Pulp Complex Regeneration Rinna Azrida; Bryan Helsey; Bernadette Wilson; Mohammad Yoshandi
Crown: Journal of Dentistry and Health Research Vol. 3 No. 1 (2025): Crown: Journal of Dentistry and Health Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/crown.v3i1.236

Abstract

Introduction: The regeneration of the dentin-pulp complex is a major challenge in vital pulp therapy. This study aimed to develop and evaluate a novel injectable hydrogel composed of strontium-doped bioactive glass (Sr-BG) in a methacrylated gelatin (GelMA) matrix to promote dentin-pulp complex regeneration. Strontium was added for its dual therapeutic effects of enhancing odontogenic differentiation and inhibiting bacterial activity. Methods: We synthesized Sr-BG nanoparticles using a sol-gel method and characterized them with X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), and scanning electron microscopy (SEM). The nanoparticles were then incorporated into a GelMA hydrogel. We assessed the material's physical properties, including its swelling ratio, degradation rate, and ion release profiles (Si, Ca, P, Sr). We also evaluated its in vitro biocompatibility and odontogenic potential using human dental pulp stem cells (hDPSCs), assessing cell viability (MTT assay), alkaline phosphatase (ALP) activity, and the expression of odontogenic markers (DSPP, DMP-1, RUNX2) via RT-qPCR. We tested its antibacterial properties against Streptococcus mutans. For the in vivo evaluation, the hydrogel was used as a pulp capping agent in the mechanically exposed molars of Wistar rats. After 4 and 8 weeks, we assessed tissue regeneration using histological analysis (H&E and Masson's trichrome staining) and micro-computed tomography (micro-CT). Results: The synthesized Sr-BG nanoparticles were amorphous with a particle size of about 80-120 nm. The Sr-BG/GelMA hydrogel exhibited controlled swelling and degradation, along with a sustained release of therapeutic ions. In vitro, the hydrogel demonstrated excellent biocompatibility and significantly upregulated ALP activity and the expression of DSPP, DMP-1, and RUNX2 in hDPSCs compared to the control group (p < 0.05). The material also showed significant antibacterial activity against S. mutans. In vivo, histological analysis revealed the formation of a thick, continuous, and well-organized tertiary dentin bridge with minimal inflammation in the Sr-BG/GelMA group at 8 weeks. Micro-CT analysis confirmed a significantly greater volume and density of newly formed mineralized tissue compared to control groups treated with calcium hydroxide. Conclusion: The novel strontium-doped bioactive glass hydrogel showed significant potential for dentin-pulp complex regeneration. Its combined osteoinductive, angiogenic, and antibacterial properties make it a promising biomaterial for advanced vital pulp therapy, offering a superior alternative to traditional pulp capping agents.
Metatranscriptomic Profiling of the Subgingival Microbiome in Peri-implantitis versus Healthy Implants: Identifying Key Dysbiotic Pathways Rheina Weisch Fedre; Ramakhrisnand Ramakhrisnand; Firman Hadi; Mahmood Abbas
Crown: Journal of Dentistry and Health Research Vol. 3 No. 1 (2025): Crown: Journal of Dentistry and Health Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/crown.v3i1.237

Abstract

Introduction: Peri-implantitis is a primary cause of dental implant failure, characterized by inflammatory destruction of supporting tissues. While microbial dysbiosis is implicated, the functional activities of the subgingival microbiome that drive disease pathogenesis remain poorly understood. This study aimed to elucidate the key functional and metabolic shifts in the subgingival microbiome associated with peri-implantitis using metatranscriptomic analysis. Methods: This cross-sectional study involved twenty patients, ten with healthy implants (HI) and ten diagnosed with peri-implantitis (PI). Subgingival biofilm samples were collected from the deepest peri-implant sulcus of each subject. Total RNA was extracted, followed by library preparation and sequencing on an Illumina NovaSeq platform. Bioinformatic analysis included quality control, taxonomic profiling using Kraken2, and functional annotation against the KEGG and Gene Ontology databases. Differential gene expression analysis was performed using DESeq2 to identify microbial transcriptional signatures distinguishing the PI and HI groups. Results: The metatranscriptome of the PI group exhibited significantly higher microbial diversity and a distinct taxonomic composition, with a notable enrichment of transcripts from species such as Porphyrononas gingivalis, Tannerella forsythia, and Fusobacterium nucleatum. In contrast, the HI group was dominated by transcripts from commensal streptococci. Functional analysis revealed a significant upregulation of pathways related to bacterial virulence, including lipopolysaccharide (LPS) biosynthesis, bacterial secretion systems (Type IV), and iron acquisition in the PI group. Furthermore, pathways associated with amino acid metabolism, particularly arginine and tryptophan degradation, were highly active, suggesting a proteolytic environment. Conversely, the HI metatranscriptome showed enrichment in carbohydrate metabolism and fermentation pathways. Conclusions: The subgingival microbiome in peri-implantitis is not only taxonomically distinct but also functionally primed for pathogenicity. The active transcription of genes related to virulence, inflammation induction, and proteolytic metabolism highlights the key dysbiotic pathways that likely contribute to tissue destruction. These findings provide a deeper understanding of the functional gene expression profile in peri-implantitis and suggest potential targets for future diagnostic and therapeutic strategies aimed at modulating microbial activity rather than merely eliminating specific taxa.
Three-Year Clinical Performance of Silver Diamine Fluoride (SDF) versus Glass Ionomer Cement in Arresting Carious Lesions in Primary Molars: A Community-Based Cohort Study Winata Putri; Sophia Lucille Rodriguez; Sarah Armalia; Alexander Mulya
Crown: Journal of Dentistry and Health Research Vol. 3 No. 1 (2025): Crown: Journal of Dentistry and Health Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/crown.v3i1.238

Abstract

Introduction: Early Childhood Caries (ECC) is a significant global health problem. Minimally invasive treatments like Silver Diamine Fluoride (SDF) and Glass Ionomer Cement (GIC) are crucial, but long-term comparative effectiveness data from real-world community settings are scarce. This study aimed to compare the three-year clinical performance of 38% SDF versus high-viscosity GIC in arresting active carious lesions in the primary molars of preschool children. Methods: This study was designed as a three-year, prospective, non-randomized, community-based cohort study in an underserved urban population in South Sumatra, Indonesia. A total of 450 children aged 3-5 years with at least one active cavitated carious lesion (ICDAS 5/6) in a primary molar were enrolled. Following parental consent and choice, lesions were treated with either a single application of 38% SDF or a high-viscosity GIC restoration using the Atraumatic Restorative Treatment (ART) technique. Calibrated examiners assessed the lesions for caries arrest at 6, 12, 24, and 36 months using standardized visual-tactile criteria. The primary outcome was the proportion of arrested lesions. Survival analysis was performed using Kaplan-Meier curves and a Cox proportional hazards model. Results: A total of 620 lesions (309 SDF, 311 GIC) were treated and followed. At the 36-month follow-up, the caries arrest rate in the SDF group was 81.2%, which was significantly higher than the 64.8% arrest rate observed in the GIC group (χ² = 24.5, p < 0.001). The Kaplan-Meier survival analysis demonstrated a significantly higher probability of lesions remaining in an arrested state in the SDF group over the three-year period (log-rank test, p < 0.001). The Cox regression model identified the treatment modality as the primary predictor of failure, with GIC having a hazard ratio of 2.15 (95% CI: 1.55-2.98) compared to SDF. Conclusion: Within the parameters of this community-based cohort study, a single application of 38% SDF was significantly more effective in arresting active carious lesions in primary molars over a three-year period than high-viscosity GIC applied via the ART technique. These findings support the prioritization of SDF in public health programs for managing ECC.
Biological Pathways of Oral Health Inequality: A Longitudinal Analysis of Stunting, Enamel Defects, and Salivary Immunity on Caries Trajectories in Indonesian Children Firman Hadi; Moon Kaeun; Fatimah Mursyid; Venny Melinda
Crown: Journal of Dentistry and Health Research Vol. 2 No. 2 (2024): Crown: Journal of Dentistry and Health Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/crown.v2i2.239

Abstract

Introduction: The syndemic of stunting and Early Childhood Caries (ECC) constitutes a major public health crisis in developing nations. While an association is established, the specific biological mechanisms remain poorly quantified. This study aimed to longitudinally determine the direct and indirect effects of early childhood stunting on caries increment, testing the mediating roles of enamel hypoplasia and salivary immunity after controlling for key confounders. Methods: We conducted a 3-year prospective cohort study of 542 two-year-old children in West Java, Indonesia. Stunting at baseline was defined as a height-for-age Z-score (HAZ) < -2 SD. The primary outcome was the 3-year increment in decayed, missing, and filled primary tooth surfaces (Δdmfs). Putative mediators—enamel hypoplasia and salivary secretory immunoglobulin A (s-IgA) and lactoferrin—were assessed. Longitudinal mixed-effects models and structural equation modeling (SEM) were used to analyze the pathways, adjusting for socio-demographic factors and fluoride exposure. Results: At baseline, 31.4% of children were stunted. After adjusting for confounders including fluoride exposure, stunting remained a powerful predictor of accelerated caries increment (an additional 1.95 surfaces/year; p<0.001). SEM analysis revealed the total effect of stunting on Δdmfs was substantial (Standardized β=0.45, p<0.001). This effect was significantly mediated by enamel hypoplasia (indirect effect β=0.17, accounting for 37.8% of total effect) and suppressed salivary s-IgA levels (indirect effect β=0.10, accounting for 22.2% of total effect). The direct effect of stunting, independent of these mediators, remained significant (β=0.18, p<0.001). Conclusion: Stunting in early life is a critical determinant of a high future caries burden, an effect that persists even after accounting for fluoride exposure. This relationship is substantially driven by two major biological pathways: compromised tooth structure (enamel hypoplasia) and impaired oral mucosal immunity (suppressed s-IgA). Public health strategies must integrate nutritional support within the first 1,000 days of life with oral health promotion to disrupt these pathways and combat the dual burden of stunting and ECC.
The Epidemiology of Oral Carcinogenesis in the Indonesian Archipelago: A Cross-Sectional, Population-Based Analysis of Oral Cancer and Potentially Malignant Disorders Driven by Kretek Smoking and Betel Quid Chewing Mariana Alifah; Sudarto Sudarto; Khalil Jibran; Theresia Putri Sinaga; Lisye Tiur Simanjuntak; Priscilla Kapoor
Crown: Journal of Dentistry and Health Research Vol. 2 No. 2 (2024): Crown: Journal of Dentistry and Health Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/crown.v2i2.240

Abstract

Introduction: Indonesia faces a severe but poorly quantified epidemic of oral cancer (OC) and oral potentially malignant disorders (OPMDs), driven by culturally endemic habits of kretek (clove cigarette) smoking and betel quid chewing. The absence of robust, large-scale epidemiological data has critically hampered the development of targeted public health interventions. This study aimed to determine the prevalence of OC and OPMDs and to quantify their association with these specific cultural practices in a large, geographically diverse Indonesian population. Methods: A multi-center, cross-sectional study was conducted across the Indonesian archipelago, enrolling 17,850 adults aged ≥30 years through a stratified, multi-stage cluster sampling design at community primary health centers (Puskesmas). Participants completed a structured questionnaire and underwent a standardized oral examination by calibrated dental professionals. All statistical analyses, including bivariate tests and multivariable logistic regression, were performed using survey-specific methods to account for the complex sampling design (stratification, clustering, and weighting) to produce nationally representative estimates. Results: The overall, nationally-weighted prevalence of the combined OC/OPMD outcome was 5.7% (95% CI: 5.2% - 6.2%). The prevalence was 4.9% for OPMDs and 0.8% for OC. After adjusting for confounders in a survey-weighted multivariable logistic regression model, current kretek smoking (Adjusted Odds Ratio [AOR]: 6.15; 95% CI: 4.98 - 7.59) and current betel quid chewing (AOR: 9.22; 95% CI: 7.31 - 11.63) were the most powerful factors associated with the presence of OC/OPMDs. A significant, non-linear dose-response relationship was observed for both habits. Conclusion: The burden of oral cancer and its precursors in Indonesia is substantial and is overwhelmingly associated with the culturally embedded habits of kretek smoking and betel quid chewing. These findings provide definitive, population-level evidence underscoring the urgent necessity for culturally-tailored public health strategies focused on cessation, regulation, and systematic early detection to mitigate this preventable cancer epidemic.
Oral Candidiasis and Dry Mouth with SGLT2 Inhibitors in FAERS, 2013 Q1–2025 Q2: A Disproportionality Analysis Rachmat Hidayat; Firman Hadi
Crown: Journal of Dentistry and Health Research Vol. 3 No. 2 (2025): Crown: Journal of Dentistry and Health Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/crown.v3i2.327

Abstract

Background: Oral adverse-event reporting with sodium-glucose cotransporter 2 (SGLT2) inhibitors remains poorly characterized. Objective: To evaluate disproportionate reporting of oral candidiasis, dry mouth, and periodontal disease with pure SGLT2 inhibitors in FAERS from 2013 Q1 through 2025 Q2. Methods: A retrospective case–non-case analysis used source-reported aggregates from 54 quarterly FAERS extracts. Latest-version handling, deletion-file exclusion, curated drug mapping, exact MedDRA Preferred Terms, reporting odds ratios (RORs) with 95% confidence intervals (CIs), and Benjamini–Hochberg-adjusted q values were applied. A signal required at least three co-reports, a lower CI bound greater than 1, and q < 0.05; role-scope and diabetes-indication comparator analyses assessed directional consistency. Results: Among 17,415,743 retained reports, 174,627 contained a mapped pure SGLT2 inhibitor. Primary-suspect analysis identified oral candidiasis (103 co-reports; ROR 1.71, 95% CI 1.41–2.07; q = 8.89 × 10−8) and dry mouth (578 co-reports; ROR 1.54, 95% CI 1.42–1.67; q = 1.99 × 10−24). Both estimates remained above 1 across broader role-scope and active-comparator analyses; periodontal disease was non-conclusive. Conclusion: Oral candidiasis and dry mouth showed hypothesis-generating disproportional reporting. The findings support targeted case review and external validation but do not estimate incidence, comparative risk, or causality.
Cross-Cohort Discovery and Independent Validation of Transcriptomic Programs and Candidate Genes in Oral Squamous Cell Carcinoma Abhimanyu Putra; Hasrita Soleiman
Crown: Journal of Dentistry and Health Research Vol. 3 No. 2 (2025): Crown: Journal of Dentistry and Health Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/crown.v3i2.328

Abstract

Background: Cross-cohort validation can distinguish reproducible oral squamous cell carcinoma (OSCC) expression signals from cohort- and platform-specific findings. Objective: This study aimed to identify genes and pathways that replicate across independent OSCC microarray cohorts. Methods: GSE30784 (discovery) and GSE25099 and paired GSE37991 (validation) comprised 264 OSCC and 107 non-malignant samples. Cohorts were normalized, annotated, and modeled separately using robust empirical-Bayes linear models, with 12,708 shared genes eligible for testing. Discovery required FDR < 0.05 and |log₂ fold change| ≥ 1.0. Replication required concordant direction, validation FDR < 0.05, and |log₂ fold change| ≥ 0.5 in both validation cohorts. Direction-specific GO and KEGG enrichment used the common gene universe; QC-flagged arrays were excluded in sensitivity analyses. Results: GSE30784 yielded 1,167 DEGs (583 upregulated; 584 downregulated), of which 504 replicated in both validation cohorts (273 upregulated; 231 downregulated). CRISP3, MMP10, MMP13, MMP1, FAM3B, KRT4, TMPRSS11B, TYRP1, MMP12, and SERPINE1 had the largest minimum cross-cohort effects. Replicated upregulated genes were enriched in cytokine, ECM-receptor, integrin, IL-17, focal-adhesion, and PI3K-Akt pathways; downregulated genes were enriched in cornified-envelope and metabolic pathways. Sensitivity analysis retained 488 of 504 primary calls, including all top 20 candidates. Conclusion: Independent validation identified reproducible OSCC transcriptional programs centered on matrix remodeling, adhesion, inflammation, and reduced epithelial-metabolic functions. These expression-based candidates require orthogonal and functional validation.
Conserved Immune Activation and Compartment-Specific Dysregulation in Temporomandibular Joint Osteoarthritis Cartilage: A Cross-Species Transcriptomic Analysis Dedi Sucipto; Cindy Susanti; Vidhya Sathyakirti
Crown: Journal of Dentistry and Health Research Vol. 3 No. 2 (2025): Crown: Journal of Dentistry and Health Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/crown.v3i2.329

Abstract

Background: Temporomandibular joint osteoarthritis (TMJ-OA) is molecularly heterogeneous, and differences in tissue, species, and disease model complicate transcriptomic integration. Objective: This study aimed to identify conserved and compartment-specific transcriptional programs across complementary rabbit and rat TMJ-OA cartilage datasets. Methods: A targeted GEO screen identified rabbit post-traumatic TMJ-OA (GSE232867; paired condylar cartilage and superficial zone; three animals per condition) as the primary dataset and rat unilateral anterior crossbite TMJ-OA (GSE207461; three samples per condition) for pathway-level validation. Counts were filtered with edgeR, TMM-normalized, transformed with voom, and modeled with limma; rabbit analyses were blocked by animal. Differentially expressed features required BH-FDR < 0.05 and absolute log2 fold change >= 1. Ordered g:Profiler enrichment tested directional pathway concordance. Results: Rabbit condylar cartilage yielded 421 differentially expressed features (346 upregulated and 75 downregulated), the superficial zone yielded 180 (69 upregulated and 111 downregulated), and 135 showed a condition-by-compartment interaction. Immune-associated genes were prominent in condylar cartilage, whereas superficial-zone downregulation centered on mitotic programs. Only Morf4l2 met the strict rat threshold, but 13 upregulated pathways were concordant across species; leukocyte activation was strongest (conservative adjusted P = 2.16 x 10^-6). Conclusion: Pathway-level immune activation was the most reproducible signal across these animal TMJ-OA cartilage datasets, accompanied by compartment-specific proliferative dysregulation. Small preclinical bulk datasets preclude cell-specific or human inference.
Natural Bioactive Compounds against Periodontal Matrix Metalloproteinases: A ChEMBL-LOTUS Chemoinformatics Study Alexander Mulya; Pham Uyen; Sarah Armalia; Isadora Selestine
Crown: Journal of Dentistry and Health Research Vol. 3 No. 2 (2025): Crown: Journal of Dentistry and Health Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/crown.v3i2.330

Abstract

Background: Matrix metalloproteinases (MMPs), particularly MMP-8, MMP-9, and MMP-13, contribute to extracellular matrix degradation in periodontitis, but natural-product bioactivity evidence is dispersed across heterogeneous assays. Objective: This study aimed to map IC50 and Ki evidence for natural-product-associated compounds against human MMP-1, MMP-2, MMP-3, MMP-8, MMP-9, and MMP-13 and to identify structurally traceable candidates for orthogonal experimental validation. Methods: Records were extracted from ChEMBL 37 on 5 August 2026 and filtered for positive values with pChEMBL, exact relations, nM units, acceptable validity metadata, no potential-duplicate flag, and direct single-protein assay assignment (confidence score 9). Measurements were summarized by compound-target-endpoint using median pChEMBL. ChEMBL natural-product-flagged candidates were exact-matched by full InChIKey in LOTUS; a study-defined high-support occurrence tier required at least 10 taxa and two reference records. Results: Of 28,002 raw records, 7,451 met the strict criteria. The 153 flagged candidates yielded 42 LOTUS matches and 35 high-support compounds, forming 81 compound-target-endpoint pairs. Isoliquiritigenin showed IC50 values of 10.0 nM for MMP-9 and 14.13 nM for MMP-13, each from one measurement. Caffeic acid showed a median MMP-9 IC50 of 14.62 nM from two assays in one document. No high-support MMP-8 IC50 record was identified; available Ki values were 4.47 micromolar for pyrogallol and 8.71 micromolar for piceatannol. Conclusion: These signals prioritize compounds for orthogonal validation but do not establish periodontal selectivity, safety, or efficacy.
Intervention Effects on Post-Endodontic Pain in Trials Indexed Under Periodontitis: A ClinicalTrials.gov Aggregate-Data Analysis Annisa Annisa; Aprilia Sari; Kim Sohyuk
Crown: Journal of Dentistry and Health Research Vol. 3 No. 2 (2025): Crown: Journal of Dentistry and Health Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/crown.v3i2.331

Abstract

Background: Post-endodontic pain is a patient-important outcome, yet posted trial-registry results are difficult to compare because outcome scales, time points, and reporting structures vary. Objective: This study aimed to estimate the magnitude and precision of intervention effects on postoperative pain and to characterize their temporal and multiplicity-adjusted patterns in eligible randomized endodontic trials. Methods: ClinicalTrials.gov records from a frozen query for periodontitis studies with posted results were screened for randomized endodontic trials reporting arm-level pain means, dispersion, and denominators. Official API records were used to verify groups and outcomes. Raw mean differences and Hedges g with 95% confidence intervals were calculated without cross-trial pooling. Standard errors were converted to standard deviations where indicated, independent recruitment cohorts were combined within a trial, and multiplicity was controlled using Holm adjustment. Results: Among 64 records, 11 contained pain-related outcomes and 4 endodontic trials were eligible. The trials enrolled 257 participants; 249 contributed to pain denominators. Nine of 18 non-pooled confidence intervals excluded zero, while 7 comparisons from 2 trials remained significant after Holm adjustment. Photobiomodulation produced lower pain than sham at 0, 6, 12, 24, and 72 hours. Cryotherapy produced lower pain than saline at 24 and 48 hours after adjustment. Estimates for occlusal reduction, GentleWave versus EndoActivator, and ibuprofen/acetaminophen versus ibuprofen were not robustly different. Conclusion: Posted aggregate results revealed treatment- and time-specific signals rather than a common intervention effect. Verified extraction and multiplicity-aware non-pooled analysis improve interpretability, but clinical decisions require full publications and harmonized outcome definitions.

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