Agung Sosiawan

Background: Tooth extraction is the process of removing teeth from the alveolus. It will leave a mark on the socket and surrounding soft tissue. One of the cells that plays an important role in the wound healing process after tooth extraction is fibroblasts. When an injury occurs, some blood vessels are damaged; therefore, new blood vessels need to form. Purple leaves extract could be an alternative treatment for wound healing after tooth extraction as it contains flavonoids, saponins, alkaloids, steroids, and tannins. Purpose: The study aimed to analyze the role of purple leaves extract on the increase in fibroblasts and blood vessels in the socket after tooth extraction in Wistar rats. Methods: The method used was a laboratory experiment with a post-test-only control group design. The samples used were 24 rats divided into two groups: the control group, which was given aquadest, and the treatment group, which was given 1.5 mL of purple leaves extract with 10% concentration by sondage. Tissue preparations were used to count fibroblasts, and blood vessels were counted and observed on the 3rd, 5th, and 7th days. Results: Statistical tests showed a significant difference in the number of fibroblasts and blood vessels between the control and treatment groups on days 3, 5, and 7. Conclusion: Purple leaves extract could increase the number of fibroblasts and blood vessels in the tooth socket after tooth extraction of Wistar rats.

Background: Informed consent is an agreement between the doctor/the provider of medical services and the patient/the recipient of medical services. This relationship between these parties has changed from a paternalistic to a contractual relationship due to technological shifts. Doctors are obliged to notify the patient of all the risks and benefits of a procedure while respecting their autonomy by not intervening the decision-making process. This article will look at three government and academic hospitals in Surabaya, as informed consent has to be practiced in all medical settings. Purpose: This study aims to review the role of informed consent according to Law Number 29, 2004. Review: This study aims to discuss the characteristics of informed consent under Law Number 29, 2004, because there are too few articles addressing this issue. It also explains the roles of the patient and the doctor/dentist in informed consent according to this piece of legislation. Conclusion: According to Article 184, informed consent provides vital evidence that can be used to hold doctors and dentists legally accountable because it contains information about standard operating procedures (SOPs) that medical professionals are legally required to follow. Guidelines for informed consent are given in Law Number 29, 2004, Article 45, paragraph 2.

Celah bibir dengan atau tanpa palatum (CB/P) adalah suatu kondisi deformitas orofasial yaitu terbentuknya pembukaan atau celah yang tidak wajar pada bibir atau palatum. Sekitar 70% CB/P yang terjadi di populasi adalah non sindromik (NS). Tujuan penelitian ini yaitu mengetahui pola kombinasi genotip gen BMP2 rs235768 A>T pada keluarga pasien CB/P. Sampel DNA yang berhasil diamplifikasi dan direstriksi sebanyak 5 sampel keluarga yang terdiri dari ayah, ibu dan anak dengan kelainan CB/P. Berdasarkan analisis dengan menggunakan enzim restriksi dan software program Finch TV dan Bioedit, penelitian ini mengidentifikasi adanya perubahan basa A men­jadi basa T yang merupakan missense mutasi (Serin – Arginin/TCA-TCT). Dari hasil pemetaan pada gen BMP2 rs235768 A>T menunjukkan kelima keluarga memiliki kombinasi yang berbeda-beda. Hal yang menarik pada keluarga ke - 3, kombinasi ayah bergenotip AA (Homozigot/common) dan ibu bergenotip TT (Homozigot/uncommon), memiliki anak ke -3 bergenotip AA (Homozigot/common) dengan kelainan CP (Palatoschizis incomplete). Kombinasi genotip yang mungkin dapat terjadi pada anak dari keluarga 4 yaitu 50 % bergenotip AT (Heterozigot), 50% bergenotip TT (Homozigot/uncommon). Kejadian CB/P tidak hanya melibatkan satu faktor keturunan yang berasal dari satu atau kedua orang tua, tetapi suatu kondisi yang bersamaan. Kelainan CB/P yang terjadi pada anak perempuan, diprediksi risiko kekambuhan pada anak berikutnya jauh lebih tinggi.

Background: Peri-implantitis is one of many factors that can cause implant failure, with common cases ranging from 1%-47% and the highest incidence ranging from 10.7%- 47.2%. Mechanical debridement (MD) is currently the standard for peri-implantitis treatment. However, MD has limitations in the removal of infected tissue. Moreover, the rough texture of the implant’s surface and bacteria adhesion and colonization increases the difficulty in performing MD. To overcome these limitations, adjunct therapy is needed to increase peri-implantitis treatment effectiveness. One of those adjunct therapies, photodynamic therapy (PDT), is used to destroy bacterial cells and significantly reduce inflammatory cell infiltration around the implant. Purpose: To describe the effectiveness of PDT as an adjunct therapy to MD in periimplantitis treatment through narrative review. Review: PDT is effective in reducing the number of bacteria, plaque index (PI), bleeding on probing (BOP), probing depth (PD), crestal bone loss (CBL), and excessive proinflammatory cytokines (IL-6, IL-1β, TNF-α) in patients. However, the effectiveness of PDT can be influenced by several factors, including patients’ conditions, such as diabetes and smoking habits, types of photosensitizers used, and exposure time. Conclusion: PDT is an effective adjunctive therapy to MD in peri-implantitis treatment since it can improve clinical parameter values, significantly reduce P. gingivalis, and decrease proinflammatory cytokines.

Background: Down Syndrome (DS) is a genetic disorder that causes structural, functional anomalies, and intellectual disability. The common oral hygiene problems found in DS children are gingivitis, periodontal problems, pain, infection, and problems with the masticatory system. This study explored the relationship between parents' oral hygiene knowledge and oral hygiene of children with DS. Method: This was an observational analytical study. To assess parents' oral hygiene knowledge, a questionnaire consisting of 25 questions was distributed to 100 parents whose DS children in POTADS (Down Syndrome Parents Association) Surabaya. To assess the DS children's oral hygiene, dental exams were performed to calculate the individual Oral Hygiene Index-Simplified (OHI-S) scores by dividing the sum of the individual debris and calculus scores by six (the number of teeth examined). The data were analysed using regression analysis. Results: There was a significant and strong inverse relationship between parents’ oral hygiene knowledge and DS children’s oral hygiene. Parents’ oral hygiene knowledge affected DS children’s oral hygiene. The results of the regression analysis indicated that a 1% increase in parents' knowledge caused a reduction in the OHI-S score to 7.377. Conclusion: A significant inverse relationship between parents’ oral hygiene knowledge and DS children’s oral hygiene was observed in this study. Further studies could be conducted to determine other variables that my influence both parents’ oral hygiene knowledge and DS children’s oral hygiene.

Background: Down Syndrome (DS) is a genetic disorder responsible for mental and development retardation. DS occurs when a person has an extra chromosome (47 instead of 46), the third copy of the Trisomy 21 chromosome. This causes structural and functional anomalies in the human body and some degree of intellectual disability. Children with DS have poor oral hygiene as they are unable to understand and are unaware of its importance. Oral hygiene problems commonly found in children with DS are gingivitis, periodontal problems, pain, infection, and problems with the masticatory system. This study explored the relationship between parents' knowledge and maintenance of the oral hygiene of children with DS through the OHI-S (Oral Hygiene Index Simplified) Index Score. Method: This study was conducted by distributing 25 questions via Google Form to 100 subjects that belong to POTADS (Down Syndrome Parents Association. The participants were children diagnosed with Down Syndrome and their parents. Questionnaires were used to assess parents' knowledge about their child's oral hygiene. To assess the children’s oral hygiene, dental exams were performed with the OHI-S on six tooth surfaces. To calculate the OHI-S score for each individual, the debris and calculus scores from the 6 surfaces of the teeth were totalled and divided by six. Results: The relationship between parents' knowledge and the maintenance of oral hygiene of children with DS was found by conducting a linear regression analysis and hypothetical test. The equation of Y = 77.734 + (-7.377) X was achieved through linear regression analysis, and indicated that a 1% increase in parents' knowledge caused a reduction in OHI-S score to 7.377. The hypothetical test showed that parents' knowledge affected their children's OHI-S score significantly. Conclusion: There was a significant contradictive relationship between parents' knowledge and the maintenance of oral hygiene of children with DS.

The COVID-19 pandemic has a different impact on everyone. The impact is not only on mortality and morbidity in infected people but also on the mental health of uninfected people.1,2 Apart from the health side, other sectors that may also be affected include the industrial sector, tourism, and education.3 The COVID-19 pandemic poses enormous challenges to all stakeholders in the educational field such as lecturers, students, and leaders and staff of institutions.1 Learning that was previously delivered in-person in the classroom has shifted to an online platform. The trend for all elements in learning today is towards the digital arena. One solution in the world of education is the use of asynchronous learning, which allows learning to be carried out at different times. It gives lecturers the flexibility to prepare learning materials and allow students to adjust to the demands of home and study. This system creates flexibility in learning without compromising competency. In the field of dentistry, in addition to learning in the classroom to obtain cognitive abilities, learning to achieve psychomotor abilities is also important. This psychomotor ability in dental education can be done through a simulation laboratory and clinical skills training. These aspects are challenging. Several countries have implemented the use of virtual reality (VR) in simulation laboratories to get the sensation of practice on the simulation model. However, this has not yet been fully adapted to all dental education institutions because the facilities owned by the institution still do not fully support this technology.4-6 The high risk of transmission through aerosols is a major challenge in dental education based on clinical skills training.7 The use of tele-dentistry, an electronic-based dentistry medical consultation facility, is an alternative.8,9 This facility can shorten dental treatment visits that have a high risk of transmission. In addition, in emergency dental care and other dental treatments, the use of adequate personal protective equipment (PPE) can reduce the risk of infection transmission. Finally, dental education innovations in cognitive and psychomotor aspects are urgently needed today in the era of the COVID-19 pandemic to achieve optimal student competencies. Dr. Agung Sosiawan, drg., M.H., M.Kes. Dean Faculty of Dental Medicine Universitas Airlangga REFERENCES

Background: Cleft lip with or without cleft palate (CL/P) is a facial growth ‘disorder that occurs during gestation and has multifactorial causes owing to both genetic and environmental factors. Several factors can increase the likelihood of CL/P, and one of them is family history. Differences in results obtained from studies conducted across several countries concerning family history as a risk factor for CL/P suggest there is no consensus on how the condition is inherited. Purpose: This study aims to review the literature on the role of family history as a risk factor contributing to the incidence of non-syndromic CL/P (NSCL/P). Review: This review discusses the etiology of CL/P and the risk factors influencing the incidence of CL/P. The review also examines the criteria for inheriting multifactorial disorders to calculate the risks involved should there be a recurrence of the condition based on family history. Conclusion: CL/P is a type of multifactorial disorder with unclear etiology. Therefore, it is important to investigate the risk factors stemming from family history (which play an important role) related to the recurrence risk. Additionally, there should be focus on increasing genetic education and offering counselling to parents and pregnant women.

Aim: To analyze the allelic sharing and a set of preferable short tandem repeats (STRs) loci among the Madurese full siblings. Materials and Methods: This was an observational analytical study. The research subjects were determined from 20 Madurese families that originated from Madura Island, Indonesia consisting of father, mother, and two biological children. The blood samples were collected, and kinship relationship was examined by using the PCR-STR technique by 11 loci of genotyped STR alleles and a sex-typing amelogenin locus. Calculations of combined sibship indices (CSIs) for each pair were done to determine the likelihood ratios. Results: Based on 220 observations (20 pairs of full sibling x 11 loci) of the STR allele genotype, 4 STR loci were found: D8S1179, F13, CSF1PO, and FES. A high-shared allelic frequency was found in two alleles that were shared among 11 STR loci by 57 times (25.9%), one allele shared among eleven STR loci by 130 times (59.1%), and zero alleles by 33 times (15.0%). Conclusion: This study indicated the power of one allele in the sibship among a Madurese establishment through the 11 STR loci.

Background: The applicability of dental age estimation has been expanded to meet a variety of medico-legal needs, law enforcement, and disaster victim identification. The objective of this study is to examine the applicability of the Willems method for Indonesian children. Material and method: A total of 110 panoramic radiographs of the patients (6–14 years old) who met the inclusion criteria were obtained from the Department of Forensic Odontology and Department of Radiology, Universitas Airlangga, Indonesia. Estimated dental age (EDA) was assessed using the Willems method by two blinded examiners. The statistical analysis was carried out using IBM® SPSS® Statistics version 23.0 (IBM, Armonk, NY, USA). Results and discussion: The mean of the chronological age (CA) in this study is 11.30 ± 1.43 years (boys) and 11.65 ± 1.55 years (girls). The overall mean difference between CA and EDA for boys and girls is − 0.08 ± 0.76 and − 0.31 ± 0.97, respectively. This study showed that the mean age difference in girls was more significant than in boys. The growth spurt timing between boys and girls might cause a difference in dental maturation, whereas the onset of the pubertal growth spurt in girls is about 2 years earlier than in boys. In general, girls start and finish their dental development earlier than boys end. Conclusion: The present study suggests that the dental age estimation methods proposed by Willems can be considered as an applicable method for the children population in Surabaya, both boys and girls. However, a detailed study may be required while applying this approach to the 11–14-year-old girl population in Surabaya, as a substantial underestimation was observed in this community.