Yunia Dwi Rakhmatia

Objective: To evaluate the feasibility of a modified presurgical naso-alveolar molding (PNAM) technique using segmental bowl cutting with contralateral soft-liner augmentation for correcting severely rotated premaxillae in infants with bilateral cleft lip and palate (BCLP). Design: Prospective case series. Setting: Clinical case series conducted over a 2-year period (July 2022–July 2024) at a single center. Participants: Three infants diagnosed with BCLP presenting with extreme premaxillary rotation (2 rightward, 1 leftward). Results: All 3 premaxillae achieved the predefined midline criterion within 4 to 5 weeks (28-35 days) at an average correction rate of approximately 2 mm per week. No major complications were observed; mild transient mucosal blanching was noted in 2 infants, which resolved with appliance relief. Conclusions: Segmental cutting of the PNAM bowl with contralateral soft-liner augmentation appears to be a feasible and clinically useful adjunct for correcting severely rotated premaxillae prior to labioplasty. These preliminary findings require validation in larger, controlled studies before superiority over conventional PNAM can be established.

Introduction: In patients with facial tissue loss, facial prostheses restore aesthetics and function. Nevertheless, Room-Temperature-Vulcanized (RTV) silicones exhibit poor clinical performance, including low tear strength and color stability. Clean/industrial-grade RTV silicone is a cheaper substitute for medical-grade silicone. This study evaluated the effects of nanosilica fillers and inherent pigmentation on the tear strength and color stability of RTV silicone. Materials and Methods: Fifty P25 silicone samples were used that contained nanosilica (0%, 1%, 2%, 3%, 6%) and TiO ₂ -impregnated Beauty by Lizzie Parra (BLP) foundation pigment. Tear strength was determined using a universal testing machine. Color stability was assessed under accelerated aging using the CIE Laboratory. Post hoc t-tests and one-way ANOVA were used ( p < 0.05). Results: The tear strength was low, ranging from 18.984 kN/m (0%) to 6.446 kN/m (6%). The 2% nanosilica group was better than the 3% and 6% groups, as it remained clinically viable. The use of intrinsic pigments improved the color stability of the pigment/filler compared to controls. TiO2 and nanosilica were used to prevent UV and sebum discoloration. Discussion: The study highlighted trade-offs between mechanical integrity and esthetics, corroborated by the previous studies on silica-elastomer interactions. Limitations included small sample sizes and processing variables. Conclusion: Mechanical durability of RTV silicone was enhanced by moderate 2 wt% nanosilica, whereas esthetics were maintained by intrinsic pigmentation. Optimization is suggested by filler surface modification and long-term clinical trials.

Objective: The aim of this study is to examine the potential of drug delivery systems (DDS) in advancing bone regeneration therapies by evaluating their efficacy, materials, and therapeutic agents, with the goal of guiding future clinical applications and improving treatment outcomes.Methods: A scoping review was conducted using PRISMA-ScR guidelines, covering studies published between 2014 and 2025 across databases including PubMed, Cochrane, Scopus, Science Direct, Springer, and DOAJ.Results: Forty-five eligible studies were identified, comprising in vitro, in vivo, and clinical investigations. Therapeutic agents evaluated included bone morphogenetic proteins (BMPs), natural compounds, and antibiotics, delivered through carriers such as hydrogels, collagen composites, calcium phosphates, nanomaterials, and 3D-printed scaffolds. Multifunctional DDS showed promising outcomes, with combinations like BMP-2 and vascular endothelial growth factor (VEGF) or statins and platelet-rich fibrin demonstrating enhanced regenerative capacity. DDS integrating infection control with bone healing further underscored their clinical potential. Overall, DDS represent an innovative approach to bone repair, though wider clinical adoption requires resolving safety, methodological, and scalability challenges to optimize patient-centered applications.Keywords: Drug delivery system, bone regeneration, scaffold, drug clinical, nanoparticle

A pre-implantation bone graft provides structural support when alveolar bone is insufficient. This study investigates nanocellulose and poly(lactic-co-glycolic acid) (PLGA) as grafting materials. PLGA enhances scaffold degradability through hydrolytic cleavage, with degradation kinetics determined by its lactic acid to glycolic acid (LA: GA) ratio. A 50:50 ratio degrades fastest (~8 w), while a 75:25 ratio slows degradation (~16 w). Nanocellulose, while being poorly degradable in vivo, improves mechanical strength and hydrophilicity. PLGA/CNF scaffolds showed 95% porosity with through-pores (20–100 µm), promoting cell infiltration. Mechanical strength improved with nanocellulose: compressive strength increased from 4.0 MPa (PLGA) to 6.4 MPa (PLGA/CMC), and elastic modulus reached 1,240±40 MPa in PVA/PLGA/CNC composites—a 42-fold increase. Good biocompatibility was found in all the composite samples examined, and osteogenesis was promoted. In vitro and in vivo studies confirmed that PLGA compensates for nanocellulose’s limited degradability, with complete scaffold resorption observed within 12 w for 50:50 PLGA and within three months for CPC/PLGA/CMC in PBS. These results highlight the synergistic potential of PLGA/nanocellulose composites for bone tissue engineering by combining tunable degradability, enhanced mechanics, and strong biocompatibility.

Poly(lactic-co-glycolic) acid membranes developed for guided bone regeneration (GBR) in dental care have the shortcoming of not being rigid enough to withstand soft tissue stress during healing, which may significantly affect the bone formation process. This study aims to overcome the lack of mechanical properties of poly(lactic-co-glycolic) acid (PLGA) membranes for GBR by using cellulose nanofibers to reinforce the membranes. The manufacture of cellulose nanofibers begins with the wood pulping process of oil palm empty fruit bunches (OPEFB) residue. The fibers were then oxidized using the 2,2,6,6-tetramethylpiperidine-1-oxyl (TEMPO) system at pH 10-11 and mechanically disintegrated using ultrasonication to produce nano-sized fibers (denoted as TEMPO-oxidized cellulose nanofibers – TOCNs). The resulting TOCNs were incorporated into PLGA at concentrations of 0.4%, 0.8%, and 1.0% (wt/wt). The incorporation of TOCNs modified PLGA membranes, increasing surface texture and crystallinity, as confirmed by SEM, XRD, and FTIR. Membranes thinned with TOCNs addition, with pore size/volume peaking at 0.4% loading (6.31 nm, 0.23 cm³/g), then reverting towards neat PLGA values at 1.0%. Optimal tensile strength was noted for 0.8% TOCNs. PLGA-TOCNs composites degraded slower than neat PLGA. The research results are expected to support the use of renewable natural fibers as reinforcement for PLGA membranes. The TOCNs can effectively modify PLGA membrane properties, offering potential for tailoring these materials for biomedical applications.

Background: Parenting stress is an unpleasant psychological reaction to the demands of being a parent. It affects parents who raise children with developmental disabilities and presents unique challenges, the impact of which is exacerbated by socio-economic status, age, income, and parental education level. Individuals with intellectual disabilities have poorer general health and oral hygiene compared to the general population. Parenting stress can influence parents’ knowledge and attitudes about maintaining oral health. This research aimed to determine whether there was a relationship between parenting stress and the level of education, knowledge, and attitudes of parents toward maintaining oral health in children with intellectual disabilities. Methods: This research used a cross-sectional analytical method. The total sample was 104 parents of children with intellectual disabilities in two special schools in Bandung Regency, Indonesia. Data was collected and then tested for correlation with Spearman’s Rank and Kendall Coefficient of Concordance. Results: The majority of parents described their level of parenting stress as moderate (51%), with the highest level of education being high school (36.5%), a sufficient level of knowledge (48.1%), and an adequate attitude towards maintaining dental and oral health (46.2%). Multivariate analysis showed a relationship between parenting stress and parents’ level of education, knowledge, and attitudes, with a p-value of 0.0008 and W=0.205. Conclusion: There is a relationship between parenting stress and the level of education, knowledge, and attitudes of parents regarding the maintenance of the oral health of children with intellectual disabilities (whether it is related between parenting stress and each variable or when parenting stress is related to all three).

The aim of this study was to investigate titanium membranes (TMs) layered between poly (lactic-co-glycolic acid) (PLGA) containing fluvastatin (FS) for use in guided bone regeneration. Membranes consisting of PLGA, FS-containing PLGA (PLGA–FS), TM layered between PLGA (TM–PLGA) and TM layered between FS-containing PLGA (TM–PLGA–FS) were prepared, and their mechanical and chemical properties were evaluated. The TM groups showed statistically significant differences, in terms of tensile strength and elastic modulus, when compared to the PLGA groups. The release of FS was demonstrated to be higher in the TM–PLGA–FS group than the PLGA–FS group after Day 14. The effect of membrane implantation on the calvaria of Wistar rats was measured using micro-computed tomography (micro-CT) and morphometrical analyses, as well as histological observations. At 4 weeks, the TM–PLGA–FS and TM–PLGA groups were found to have lower bone mineral density but higher bone formation, when compared to the control and PLGA groups. At 8 weeks, the use of TM–PLGA–FS membranes significantly enhanced bone formation in the calvaria model, compared to the other groups. These results suggest that a TM layered between PLGA containing FS potentially enhances bone formation, thus showing good potential as a GBR membrane.

Various materials, such as titanium, zirconia and platinum-gold (Pt-Au) alloy, have been utilized for dental implant trans-mucosal parts. However, biological understanding of soft tissue reaction toward these materials is limited. The aim of this study was to compare the response of cell lines and soft tissue to titanium, zirconia and Pt-Au substrata. The surface hydroxyl groups and protein adsorption capacities of the substrata were measured. Next, gingival epithelial-like cells (Sa3) and fibroblastic cells (NIH3T3) were cultured on the materials, and initial cell attachment was measured. Immuno-fluorescent staining of cell adhesion molecules and cytoskeletal proteins was also performed. In the rat model, experimental implants constructed from various materials were inserted into the maxillary tooth extraction socket and the soft tissue was examined histologically and immunohistochemically. No significant differences among the materials were observed regarding the amount of surface hydroxyl groups and protein adsorption capacity. Significantly fewer cells of Sa3 and NIH3T3 adhered to the Pt-Au alloy compared to the other materials. The expression of cell adhesion molecules and a well-developed cytoskeleton was observed, both Sa3 and NIH3T3 on each material. In an animal model, soft tissue with supracrestal tissue attachment was observed around each material. Laminin-5 immuno-reactivity was seen in epithelia on both titanium and zirconia, but only in the bottom of epithelia on Pt-Au alloy. In conclusion, both titanium and zirconia, but not Pt-Au alloy, displayed excellent cell adhesion properties.

The purpose of this study was to evaluate the effects of an injectable composite made up of calcium sulfate (CAS), fluvastatin (FS), and atelocollagen on bone augmentation in rats. Porous structures and compressive strength of composites were evaluated. The cumulative release kinetics of FS were determined in vitro by a spectrophotometer. To observe bone regeneration in vivo, five different materials (normal saline; atelocollagen gel only; composite of CAS and atelocollagen; composite containing 0.5% FS; and composite containing 1.0% FS) were injected in extraction sockets and in the crania of rats. Microcomputed tomography and histological evaluation were performed after 2, 4, and 8 weeks of healing time. The composites had high porosity (greater than 55%). FS kept a slow and stable release for >30 days. In vivo results demonstrated that more new bone was formed in the FS groups compared with the other groups, and both bone mass and bone density had prominent increase in maxillae and crania. Resorption of the composite was also observed for cranial tissues. In conclusion, this composite can be applied percutaneously, without any incision. It has excellent properties with replaceability into bone and anabolic effects for bone formation, as well as a drug delivery system for bone formation.

Osteocytes are thought to act as stress sensors, and are known to display a gap junction‐mediated stress‐transfer mechanism. To demonstrate the stress‐related function of osteocytes, cells of an osteocyte‐like cell line derived from murine long bone osteocyte Y4 (MLO‐Y4) were cultivated in a three‐dimensional culture and subjected to cyclic loading from a titanium plate. This application of physiological loading using a titanium plate significantly increased connexin 43 (Cx43) expression, the number of dead and apoptotic cells, and receptor activator of nuclear factor κB ligand expression. Furthermore, the conditioned medium from the loaded osteocytes induced alkaline phosphatase activity in bone marrow cell culture. In addition, we immunohistologically determined whether bone metabolism increased as a result of the occlusal force in the bone surrounding the titanium implants in a rat model. Increased Cx43 expression and apoptotic osteocytes were observed in the loading group as well as a significantly increased number of tartrate‐resistant acid phosphatase‐positive cells. These findings indicate that stress from the implant adversely affected the osteocytes, which may promote osteoclastic and osteoblastic cell formation around the implants. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 815–827, 2019.