Dwi Ariawan

Background: Rapid hemostasis is essential in oral surgery to minimize blood loss, prevent postoperative complications, and promote early wound healing. This study developed freeze-dried fish-derived gelatin–chitosan composite sponges with different polymer compositions (G100, GC75, GC50, and GC25) and regularly investigated the relationships among scaffold microstructure, physicochemical properties, biological performance, and hemostatic efficacy. Methods: The sponges were characterized using Fourier transform infrared spectroscopy, scanning electron microscopy, mechanical testing, swelling, and degradation analyses. Biological performance was evaluated through cytocompatibility and antibacterial assays, while hemostatic function was assessed using BCI, BCT, fibrin generation, PT, and PTT. Results: Among the formulations, the gelatin-rich composite GC75 exhibits an interconnected porous structure, high fluid-absorption capacity, and a distinct degradation profile while maintaining acceptable cytocompatibility. Compared with the other formulations and a commercial gelatin sponge, GC75 demonstrated significantly enhanced hemostatic performance, as evidenced by lower BCI values, shorter BCT, and accelerated fibrin generation (all p < 0.001), while maintaining physiological PT and aPTT values. In a rat tooth extraction model, GC75 significantly reduced bleeding time and achieved hemostatic efficacy comparable to or better than the commercial control. Conclusions: These findings demonstrate the potential of gelatin-rich fish-derived gelatin–chitosan composite sponges as biodegradable hemostatic biomaterials for oral surgical applications.

Background: Late-stage presentation of oral cancer remains a major challenge in low- and middle-income countries and contributes substantially to poor clinical outcomes. Data describing oral cancer presentation patterns in Indonesia remain limited. This study aimed to characterize the clinicopathological profile, stage distribution, treatment patterns, and exposure-related characteristics of oral cancer patients treated at a national referral center in Indonesia. Methods: A retrospective study was conducted using medical records of 404 patients with histopathologically confirmed oral malignancies treated between 2021 and 2025. Descriptive analyses were performed to summarize demographic, clinicopathological, staging, treatment-related, and exposure-related characteristics. Results: The mean age at diagnosis was 49.17 ± 14.11 years, with a relatively balanced sex distribution. The tongue was the most common primary tumor site (76.0%), and oral squamous cell carcinoma (OSCC) represented the predominant histopathological diagnosis (81.9%). Late-stage presentation (stage III–IV) was observed in 64.1% of all cases and increased to 70.7% among patients with available staging information, while 29.2% of patients had incomplete or undefined staging data. Surgical treatment, either alone or combined with adjuvant therapies, was the most frequently employed treatment modality. Notably, 21.5% of patients had no documented definitive oncologic treatment during the recorded treatment period. Smoking was reported by 35.4% of patients, alcohol consumption by 4.0%, and a family history of cancer by 24.8%. Conclusions: Advanced-stage oral cancer was highly prevalent in this referral-based cohort. The substantial burden of late-stage disease, together with incomplete staging information and the proportion of patients without documented definitive treatment, highlights challenges related to staging completeness, treatment documentation, and cancer care monitoring. These findings support efforts to strengthen early detection, referral coordination, and cancer care monitoring within the Indonesian healthcare system.

Background/Objectives: Accurate quantification of alveolar cleft defects for bone grafting remains difficult due to inconsistent anatomical boundaries. This study established an expert consensus on boundary landmarks for alveolar bone graft (ABG) planning and validated the accuracy and reliability of digital volumetric measurement methods. Methods: Three cleft specialists performed repeated simulated graft procedures in seven patient-specific 3D-printed models, first according to the operator’s clinical judgment, and subsequently according to panel-derived consensus boundaries. Two radiologists independently conducted digital volumetric assessments in 3D X-ray imaging using four measurement approaches (axial tracing, interpolated axial tracing, landmark-based mirroring, and mesh-based mirroring), generating 56 independent digital segmentations to be evaluated against the consensus-based physical reference standard. Volumes of the defects were recorded, intra- and inter-rater reliabilities were calculated using the intraclass correlation coefficient (ICC), and differences among methods were analyzed. Results: Operator-defined plans showed significant inter-operator differences (p < 0.001) with poor-to-excellent reliability (intra-rater ICC 0.060–0.967; inter-rater ICC 0.300–0.635). Consensus established standardized boundaries: tilted plane from base of anterior nasal spine to hard palate, cemento-enamel junctions, incisive canal, and alveolar contour. Consensus-based filling showed non-significant inter-rater differences (p = 0.139) and substantially improved reliability (intra-rater ICC 0.904–0.988; inter-rater ICC 0.622–0.861). Among the four digital methods evaluated, axial tracing demonstrated excellent reliability (intra-rater ICC 0.971–0.99; inter-rater ICC 0.965) and high accuracy (mean difference 0.001–0.026 cm³), with no significant difference (p = 0.999) from the physical reference standard. Conclusions: These proposed consensus-based boundary definitions and validated volumetric measurement methods improved the accuracy and reproducibility of personalized alveolar bone graft planning.

Introduction: This study aimed to evaluate nasolabial appearance following lip repair using the Cronin technique in patients with complete unilateral cleft lip by utilizing the unilateral cleft lip surgical outcomes evaluation (UCL SOE) scale. Methods: Nine evaluators of different backgrounds, including three oral and maxillofacial surgeons, three oral and maxillofacial surgery residents, and three dental nurses, conducted the evaluations. Twenty-four pairs of photographs of patients with unilateral cleft lip who underwent lip repair using the Cronin technique were evaluated. Intra- and inter-evaluator reliability tests were conducted using the intraclass correlation coefficient. Results: The intraclass correlation coefficients for each component and the total score revealed that oral and maxillofacial surgeons had very high intraclass correlation coefficients and scored 1.00 on nearly all components, indicating an almost perfect correlation. Conclusion: In this study, intra-evaluator and inter-evaluator intraclass correlation coefficient (ICC) showed consistent and reliable results for evaluating the esthetic outcomes of unilateral cleft lip repair using the Cronin lip repair technique; however, differences exist in the assessments between the different groups of evaluators. The evaluation of nasolabial appearance with the UCL SOE scale showed good reliability and consistency regardless of the evaluator's background. In addition, the technique used in this study, the Cronin method, can be recommended for unilateral cleft lip repair.

Background: Cleft lip and palate are the most common congenital orofacial anomalies. Dental students must have a basic knowledge, understanding, and awareness of comprehensive cleft management. The Faculty of Dentistry Universitas Indonesia undergraduate program uses the problem-based learning (PBL) method to teach dental students about cleft management. Purpose: This study aims to determine the level of knowledge and exposure to learning with the PBL method regarding comprehensive cleft management. Methods: A cross-sectional design was used, and data were collected from 253 dental students using an online questionnaire via Google Forms. Results: Ten preclinical students (8.5%) had a low level of knowledge, 56 (47.5%) had a sufficient level of knowledge, and 52 (44.1%) had a high level of knowledge of comprehensive cleft management. Among the clinical students, 6 (4.4%), 65 (48.1%), and 64 (47.4%) demonstrated low, sufficient, and high levels of knowledge, respectively. Furthermore, most students were content with the lectures on comprehensive cleft management (46.24% satisfied and 20.55% very satisfied) and the supervision received during the lectures (43.48% agreed and 23.71% strongly agreed). Most students believed the lectures on cleft management could be applied when they graduate as dentists. The Chi-square test showed no significant relationship between learning exposure and the student’s knowledge level. Conclusion: Most Faculty of Dentistry Universitas Indonesia students who had learned about cleft lip and palate using the PBL method had sufficient knowledge about comprehensive cleft management. However, no significant relationship was observed between learning exposure and knowledge level.

Probiotics, known for their anti-inflammatory properties and ability to balance the oral microbiome, show promise in enhancing wound healing, particularly through topical application, in oral healthcare. The main objective of the present study was to investigate the topical application of probiotics to accelerate oral wound healing, focusing on key indicators, like collagen density, angiogenesis, the reepithelization rate, the wound area, and the wound length. Palatal wounds were induced in 60 male Sprague-Dawley® rats, which were divided into 4 groups. Probiotics, including Streptococcus salivarius K12 (BLIS K12®) and Lactobacillus reuteri (Interlac® Pro-D and Interlac®), were topically administered. The rates were sacrificed on days 3, 7 and 14 to evaluate the early, middle and late proliferation phases. Histopathological examinations assessed collagen density, angiogenesis, the re-epithelialization rate, the wound area, and the wound length. Probiotics showed beneficial effects on the oral wound healing indicators examined in this study. This study demonstrates the significant benefits of applying probiotics in enhancing wound healing throughout various proliferation stages. Our findings consistently highlight their positive impact across key indicators. With 3 different probiotic types, we observed improvement in all aspects of wound healing, from early to late stages. The study underscores the potential of probiotics as effective agents in promoting wound repair and regeneration, offering promising avenues for enhanced clinical outcomes.

Background: Ameloblastoma is a benign odontogenic tumor that predominantly occurs in the mandible and is frequently associated with the BRAFV600E mutation, which activates the mitogen-activated protein kinase (MAPK) signaling pathway. These mutations indicate potential targets for molecular therapies. This systematic review evaluated the effectiveness of molecular-targeted therapies, particularly BRAF inhibitors such as dabrafenib and vemurafenib, in the treatment of ameloblastoma and their effects on clinical outcomes and quality of life.Methods: In accordance with PRISMA guidelines (PROSPERO: CRD42024627944), a comprehensive search of databases including PubMed/MEDLINE and Scopus identified 4,620 studies, of which eight case reports met the inclusion criteria for analysis.Results: The selected case reports involved patients aged 13 to 85, most of whom had experienced prior surgical recurrences. Treatment with BRAF/MEK (mitogen-activated protein kinase kinase) inhibitors resulted in significant tumor regression and improved quality of life, although some manageable side effects were observed.Conclusion: BRAF inhibitors demonstrate promising efficacy in the management of ameloblastoma, especially in patients harboring BRAFV600E mutations. These therapies may reduce the necessity for extensive surgical procedures and enhance patient outcomes. Further research is needed to establish standardized treatment protocols and to assess long-term effects on recurrence and quality of life.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants exhibit different phenotypes and clinical manifestations in comparison to non-mutated viruses. Spike gene target failure (SGTF) is a characteristic feature of the gene in a novel variant that is recognized as highly transmissible. Several studies have demonstrated the virucidal effects of mouthwashes on SARS-CoV-2. Moreover, mouthwashes have proven beneficial for patients undergoing oral and maxillofacial surgery. The present study aimed to analyze the effects of 2 different types of mouthwash (0.2% chlorhexidine gluconate and 1% povidone-iodine) on the cycle threshold (CT) values in coronavirus disease 2019 (COVID-19) patients with and without SGTF. This single-blind, non-randomized controlled clinical trial comprised 45 patients who were divided into 3 groups based on the intervention method: 0.2% chlorhexidine gluconate mouthwash; 1% povidone-iodine mouthwash; and mineral water (control group). The patients were instructed to gargle with the assigned solution 3 times a day for 5 days. Reverse transcription polymerase chain reaction (RT-PCR) tests were conducted at the time of initial diagnosis and on days 3 and 5. A normality test (Shapiro-Wilk test) was performed. Consequently, the non-parametric Friedman test was used. The analysis revealed that the subjects who utilized mouthwashes exhibited higher CT values in comparison to the control group. Furthermore, 73% of patients who used 0.2% chlorhexidine gluconate presented with increased CT values, as indicated by a negative RT-PCR test on the 3rd day. Gargling with 0.2% chlorhexidine gluconate or 1% povidone-iodine for 30 s for at least 3 days has been demonstrated to increase CT values in both SGTF and non-SGTF COVID-19 patients. Hence, using the mouthwash may be considered for preoperative use in patients undergoing oral and maxillofacial surgery.

Background: Oral and maxillofacial surgeons often deal with skin wounds, where the healing process involves phases such as inflammation and remodelling. Excessive inflammation can disrupt healing, leading to complications such as abnormal scarring and impaired tissue regeneration. Probiotics, especially strains such as Streptococcus salivarius K12, show promise in modulating inflammation and enhancing wound healing. Recent studies have aimed to explore how these probiotics affect inflammatory markers during wound healing, potentially offering new therapeutic benefits. Methods: This quasi-experimental study, conducted in June–July 2023 at IPB (Institut Pertanian Bogor) University’s Veterinary Teaching Hospital, included 24 healthy Sprague-Dawley rats. The rats were randomly assigned to two groups: one was treated with Streptococcus salivarius K12, and the other was the control group. The treated group’s palatal wounds received Streptococcus salivarius K12, covered with a daily-changed mucosal patch, whereas the control group received only the patch. Four rats per group were sacrificed on days 3, 7, and 14. Wound areas were examined histopathologically, and neutrophil, macrophage, and lymphocyte counts were quantified using ImageJ software. Statistical analysis was conducted using MANOVA and the Tukey HSD test. Results: All inflammatory indicators (neutrophils, macrophages, and lymphocytes) showed significant differences between the control and treated groups, as well as across different necropsy days. Conclusions: The inflammation modulation by the probiotic Streptococcus salivarius K12 contributes to enhanced wound healing. In the treated group, there were higher counts of neutrophils, macrophages, and lymphocytes compared with the control group, with notable variations observed over time.