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Beta defensin polipeptida antimikroba dalam hubungannya dengan periodontitis kronis dan agresif Sugiharto Wijaya; Sri Lelyati C Masulili
MKGK (Majalah Kedokteran Gigi Klinik) (Clinical Dental Journal) UGM Vol 2, No 2 (2016)
Publisher : Fakultas Kedokteran Gigi, Universitas Gadjah Mada

Periodontitis merupakan penyakit inflamasi yang menyerang periodonsium dan faktor utama penyebab kehilangan gigi di dunia. Di Indonesia, penyakit periodontal menduduki urutan kedua setelah karies dan masih merupakan masalah di masyarakat. Defensin merupakan elemen kunci dari sistem kekebalan bawaan dan sebagai pertahanan pertama untuk jaringan mulut serta organ lainnya. HBDs telah terdeteksi dalam epitel gingiva, kelenjar ludah, air liur, dan gingival crevicular fluid (GCF). Tujuan telaah pustaka adalah untuk mengetahui tentang adanya peptida antimikroba Human Beta Defensin khususnya Human Beta Defensin-1 dan pengaruhnya terhadap perkembangan terjadinya periodontitis baik kronis maupun agresif. Terdapat peptida antimikroba yang dikenal dengan nama Human Beta Defensin yang merupakan mekanisme pertahanan tubuh awal terhadap infeksi, dimana fungsi dan pengaruhnya masih banyak diperdebatkan oleh para peneliti.ABSTRACT: Antimicrobial polypeptides beta defensin in conjunction with chronic and aggressive periodontitis. Periodontitis is an inflammatory disease that attacks the periodontium and the main factors causing the loss of teeth in the world. In Indonesia, periodontal disease ranks second after caries and still is a problem in the community. Defensins are key elements of the innate immune system and as a first defense for oral tissues and other organs. HBDs has been detected in the gingival epithelium, salivary glands and saliva and gingival crevicular fluid (GCF). Objective to know about the existence of the Human beta defensin antimicrobial peptides, especially Human beta defensin-1 and its influence on the development of chronic and aggressive periodontitis either. There is an antimicrobial peptide, known as Human beta defensin which is the body's defense mechanism against infection early, in which the function and influence is still much debated by researchers

Perkembangan Terkini Membran Guided Tissue Regeneration/Guided Bone Regeneration sebagai Terapi Regenerasi Jaringan Periodontal Cindy Cahaya; Sri Lelyati C Masulili
Majalah Kedokteran Gigi Indonesia Vol 1, No 1 (2015): August
Publisher : Faculty of Dentistry, Universitas Gadjah Mada

Latest Development of Guided Tissue Regeneration and Guided Bone Regeneration Membrane as Regenerative Therapy on Periodontal Tissue. Periodontitis is a patological state which influences the integrity of periodontal system that could lead to the destruction of the periodontal tissue and end up with tooth loss. Currently, there are so many researches and efforts to regenerate periodontal tissue, not only to stop the process of the disease but also to reconstruct the periodontal tissue. Periodontal regenerative therapy aims at directing the growth of new bone, cementum and periodontal ligament on the affected teeth. Regenerative procedures consist of soft tissue graft, bone graft, roots biomodification, guided tissue regeneration and combination of the procedures, including restorative surgical procedure that is connected with oral rehabilitation with implant placement. At cellular phase, periodontal regeneration is a complex process with well-organized proliferation, distinction, and development of various type of cell to form attachment of periodontal tissue. Rationalization of the use of guided tissue regeneration as barrier membrane is to prohibit the penetration of epithelial and connective tissue migration into the defect, to maintain space, and to stabilize the clot. This research discusses: 1. Healing process on periodontal therapy including regeneration, repair or formation of new attachment. 2. Periodontal specific tissue engineering. 3. Various commercially available membrane/guided tissue regeneration in the market with its advantages and disadvantages and their characteristics. 4. Recent advancement of membrane as regenerative therapy on periodontal disease. In addition, this review is presented to give an outlook for promising regenerative therapy as a part of developing knowledge and skills to treat periodontal disease.

Gigi Tiruan Sebagian Kerangka Logam sebagai Penunjang Kesehatan Jaringan Periodontal Putri Lenggogeny; Sri Lelyati C Masulili
Majalah Kedokteran Gigi Indonesia Vol 1, No 2 (2015): December
Publisher : Faculty of Dentistry, Universitas Gadjah Mada

Frame Partial Denture as a Supportive Therapy for Periodontal Health. Partial denture is very important in maintaining periodontal health and maintaining the stability of the remaining teeth. The fabrication of denture is an important phase in comprehensive periodontal health therapy, so as to maintain the periodontal health. Removable partial dentures should be designed to reduce the accumulation of food residue and plaque on the teeth and gingival edge of the abutment. The selection of metallic materials as denture in case of periodontal compromise can help in preventing tooth movement and maintain the position of the teeth after periodontal treatment because the nature of metal is more rigid when compared with other materials, so that the success of the treatment can be achieved. Making good metal framework denture and good cooperation between all members of the medical team in handling the case will result in a successful treatment. The aim of the study is to enrich the knowledge for periodontists and prosthodontists in using metal removable prothesis in compromised periodontal patients. Providing information and educating patients in maintaining the cleanliness of denture and mouth are also an important factor that determines the success of the manufacture of dentures.

Keberhasilan Restorasi Komposit untuk Perbaikan Titik Kontak pada Terapi Periodontal Cindy Ariyani Hokardi; Sri Lelyati C Masulili
Majalah Kedokteran Gigi Indonesia Vol 19, No 1 (2012): August
Publisher : Faculty of Dentistry, Universitas Gadjah Mada

Latar Belakang: Pada kondisi fisiologis, gigi geligi berada pada posisi stabil dalam lengkung rahang, mempunyai kontak oklusal dengan gigi lawan, dan kontak proksimal dengan gigi disebelahnya. Adanya sedikit pembukaan kontak proksimal akan menyebabbkan terjadinya impaksi makanan, yang merupakan etiologi kelainan periodontal. Pembuatan restorasi permanen dengan menggunakan bahan komposit yang memperhatikan kontak proksimal, kontur permukaan oklusal, kontur fasial dan lingual dapat melindungi jaringan periodontal. Tujuan: menunjukkan bahwa restorasi komposit untuk perbaikan titik kontak dapat menunjang kesehatan jaringan periodontal. Laporan kusus: pada kasusu pertama ditemukan gigi 2.4 dan 3.5 terdapat karies di sisi distal, dan pada kasus kedua gigi 2.8 terdapat karies di sisi mesial sehingga kehilangan titik kontak yang mengakibatkan terjadi poket periodontal. Penanganan: terapi awal yang dilakukan berupa skeling dan penghalusan akar, serta kuretase. Pembuatan restorasi komposit untuk memperbaiki titi kontak dengan menggunakan matriks dan baji di area proksimal. Maladaptasi pita matriks atau baji menyebabkan kegagalan klinis seperti batas restorasi mengemper, kontur didnding proksimal serta titik kontak yang tidak baik. Pemilihan baji yang benar, harus mempertimbangkan : sudut konvergensi dasar, lebar mesiodistal dasar baji, ketinggian gingivooklusa dari arah transversal, dan kecembungan dinding baji. Kesimpulan: secara klinis terjadi penurunan kedalaman poket setelah perbaikan restorasi, namun gambaran radiografis belum memperlihatkan hasil signifikan dalam waktu tiga bulan. Blackground: under physiological conditions, teeth are stabilized in the dental arch by making occlusal contacts with opposing teeth and proximal contacts with adjacent teeth. A weak or slightly open proximal tooth contact would permit food impaction, one of the etiology of periodontal disease. The common therapy is to make a permanent restoration using composite restoratioan having regard to proximal contacts, occlusal contour, and facial and lingual contaour to protect periodontal tissues. Objective: to show that it is important to restore contacts points in maintaining periodontal tissues using composite restoration. Case: on the first case, we found caries on the distal site of 2.4 and 3.5 and mesial site of 2.8 on the second case, and open contacts, resulting a periodontal pocket. Therapy: the initial treatment are scaling and root planning and curretage. Composite restoration to restore proximal contact points using matrix band and wedge. Maladaptation of either the matrix band or the wedge result in clinical failure such as overhanging margins, faulty contouring of the proximal wall and inadequate contact points. To select a correct wedge, four variables should lie considered the convergence angle of the base, the mesiodistal width of the base, the gingivo-occlusal height of the transverse section and the concavity of the side walls. Conclusion: Clinically, there are reduction in pocket depth after the restoration, but radiograpgically, there are no significant result in three months.

Terapi Bedah Flep dan Cangkok Tulang pada Periodontitis Agresif di Regio Gigi Anterior Mandibula Levina Mulya; Sri Lelyati C Masulili
Majalah Kedokteran Gigi Indonesia Vol 19, No 1 (2012): August
Publisher : Faculty of Dentistry, Universitas Gadjah Mada

Background: Aggressive periodentitis is a multifactorial disease that usuallyOccurs at a young age with the disease spreading fast and found the bacteria. Commonly aggressive periodontitis associated with hereditary factors and lack of immune system so as to reveal any family history with the same disease, and found savere alveolar bone destruction that may ultimately lead to tooth loss. Aggressive periodontitis and generalized aggressive periodontitis. The development of aggressive periodontitis is difficult to predict, so the mechanical therapy is not sufficient, and required antibiotic therapy or surgical therapy. Aim: the purpose of this case report is to explain the procedures and result of surgical treatment of the flap surgery with bone graft in anterior teeth of the patients with generalized aggressive periodontitis. Case report: Cases one and two with complaints of anterior teeth mobility. On clinical examination teeth mobility two and three degree, absolute pocket depth 4-6 mm. Radiograpic examination bone loss reached one third apical in all region. The diagnosis of both cases in generalized aggressive periodontitis. Treatment: After initial theraphy heve been evaluated, flap surgery with bone graft done in booth cases. Control evaluation after 6 month from surgery, in clinically reduced pocket depth 1-2m and tooth mobility, in radiographically increased bone height and bone fill. Conclusion: Flap surgery with bone graft in generalized aggressive periodontitis can assist periodontal regeneration.

Perawatan Periodontal pada Pasien Lupus Eritematosus Sistemik Nur Rahma Prihantini; Sri Lelyati C Masulili
Majalah Kedokteran Gigi Indonesia Vol 19, No 1 (2012): August
Publisher : Faculty of Dentistry, Universitas Gadjah Mada

Background: Systematic disease is a risk factor in periodontal disease. In contrast, severe generalize periodontal disease may also contribute to the development of certain systemic diseases and has and adverse affect in controlling the systemic disease. The majority of systemic diseases manifest in the oral cavity, one of which is systemic Lupus Erythematosus (SLE)., anautoimmune chronic systemic diseases. To date, the etiology of Lupus Erythematosus is still not clear, but the prognosis can become good if the adequate theraphy is given. SLE have a fairly high incidence, but the dangers of this disease is still not widely understood by the public. Purpose: To demonstrate how to manage the oral manifestations of SLE, as it must be done carefully so that patients ca get appropriate treatment to be successful, and the patients with oral manifestations similar to SLE can have a more thorough axamination. Cases: Two patients with SLE and symptoms of easy bleeding gums, frequent stomatitis, dry mouth, and mobile teeth. In both cases, there is gingival hyperemia, edema, pockets of 3-6 mm (case 1) and 3-4 mm (case 2). Prior to dental treatment, both patients are consulted to an internist. Treatment: Periodontal initial treatment such as DHE, scaling, and tooth restorations. Gradual scaling done in multiple visits, followed by gingival curettage. Conclusion: A good periodontal treatment can reduce gingival inflammation, and relatively improve oral hygiene, so it can be expected to increase body immunity.

Peran Hipertensi terhadap Mediator Peradangan dalam Perkembangan Penyakit Periodontal dan Jantung Koroner Rendy Sumali; Sri Lelyati C Masulili; Robert Lessang; Irene Sukardi
Majalah Kedokteran Gigi Indonesia Vol 17, No 1 (2010): August
Publisher : Faculty of Dentistry, Universitas Gadjah Mada

Badan kesehatan dunia (WHO) pada tahun 2002 melaporkan bahwa lebih dari 7 juta orang meninggal dunia akibat penyakit kardiovaskular. Prevalensi penyakit periodontal pun dapat mencapai sekitar 70% pada usia produktif. Mengingat besarnya prevalensi keduanya, ada baiknya kita mentelaah lebih dalam hubungan diantara keduanya. Penyakit periodontal merupakan penyakit peradangan yang berhubungan dengan sejumlah kecil bakteri anaeob negatif Gram yang terdapat pada plak supragingiva. Bakteri negatif Gram anaerob tersebut juga mempunyai peluang menjadi penyebab tiga penyakit sistemik, seperti diabetes melitus, penyakit kardiovaskular, dan masalah penggumpalan darah. Penyakit kardiovaskular yang paling banyak dijumpai adalah penyakit jantung koroner dan hipertensi. Penyebab utama penyakit jantung koroner adalah aterosklerosis koroner, jika ditelaah lebih dalam, periodontitis dan aterosklerosis keduanya mempunyai faktor risiko yang sama, seperti: merokok, umur, etnis, jenis kelamin laki-Iaki, hipertensi, hiperkolesterol dan stress. Hubungan antara hipertensi dan penyakit periodontal bahwa keduanya merupakan proses peradangan. Baik pada penderita hipertensi dan penyakit periodontal dijumpai adanya peningkatan kadar C-reactive protein (CRP), sitokin-sitokin peradangan seperti IL-6, IL-1~, dan Tumour Necrosis Factor Alpha (TNF-a). C-Reactive Protein (CRP) juga menstimulasi pelepasan monosit yang menghasilkan Intercellular Adhesion Molecule (ICAM) -1 dan Vascular Adhesion Molecule (VCAM) -1 yang berperan dalam proses aterosklerosis. Disfungsi endotel pembuluh darah akibat proses aterosklerosis ini dapat memicu pengeluaran hormon Angiotensin /I (Ang II) yang berperan dalam mengatur tekanan darah. Hipertensi dapat menyebabkan disfungsi mikrosirkulasi pada jaringan periodontal, sehingga dapat mengakibatkan terjadi kelainan periodontal dan secara tidak langsung juga sebagai faktor risiko terjadinya penyakit jantung koroner.

Cairan Sulkus Gingiva sebagai Indikator Keadaan Jaringan Periodontal Sara Ekaputri; Sri Lelyati C Masulili
Majalah Kedokteran Gigi Indonesia Vol 17, No 1 (2010): August
Publisher : Faculty of Dentistry, Universitas Gadjah Mada

Cairan sulkus gingiva (CSG) adalah suatu produk filtrasi fisiologis dari pembuluh darah yang termodifikasi, karena asalnya dari darah maka komposisi CSG hampir sama dengan darah. Cairan ini diketahui berperan dalam patogenesis terjadinya penyakit atau kelainan periodontal, sehingga pengukuran terhadap adanya mediator-mediator inflamasi di dalam CSG ini dapat digunakan untuk mengevaluasi adanya faktor-faktor risiko terhadap kehilangan perlekatan gingiva hingga kerusakan tulang alveolar. Tujuan dari pemeriksaan CSG adalah untuk menganalisis bagaimana kondisi inflamasi dari jaringan periodontal yang kemungkinan akan mengakibatkan resorbsi jaringan periodontal yang lebih lanjut. Pada umumnya, dari CSG dapat dideteksi adanya indikator-indikator inflamasi seperti imunoglobulin, komplemen, aktivasi komplell)en, komponen-komponen respon imun, serta indikator lain yang dapat berperan dalam resorbsi tulang alveolar. Dari pembahasan inidiharapkan operator dapat lebih awal mengidentifikasi pasien yang memiliki risiko menderita penyakit periotlontal, sehingga dapat dilakukan terapi lebih awal untuk mencegah perkembangan penyakit periodontallebih lanjut. Kesimpulan:Cairan sulkus gingiva dapat digunakan untuk mendeteksi indikator-indikator inflamasi yang berperan dalam terjadinya penyakit periodontal.

Serum C-reactive protein and C-reactive gene (-717C>T) polymorphism are not associated with periodontitis in Indonesian male patients Antonius Winoto Suhartono; Benso Sulijaya; Niniarty Zeiroeddin Djamal; Sri Lelyati Chaidar Masulili; Christopher Talbot; Elza Ibrahim Auerkari
Dental Journal (Majalah Kedokteran Gigi) Vol. 48 No. 3 (2015): September 2015
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Background: Periodontitis is an inflammatory disease caused by periodontal pathogens and influenced by multiple risk factors such as genetics, smoking habit, age and systemic diseases. The inflammatory cascade is characterized by the release of C-reactive protein (CRP). Periodontitis has been reported to have plausible links to increased level of CRP, which in turn has been associated to elevated risk of cardiovascular disease (CVD). Purpose: The purpose of this study was t o investigate the relationship amongst the severity of periodontitis, CRP level in blood and CRP (-717 C>T) gene polymorphism in male Indonesian smokers and non-smokers. Method: The severity of periodontitis was assessed for 97 consenting male Indonesian smokers and non-smokers. The CRP level of the subjects was determined by using immuno-turbidimetric assay performed in PARAHITA Diagnostic Center Laboratory ISO 9001: 2000 Cert No. 15225/2. The rate of CRP (-717C>T) gene polymorphism was determined by using PCR-RFLP in Oral Biology Laboratory, Faculty of Dentistry, Universitas Indonesia. Result: The results suggest that the CRP protein level is not significantly associated with the tested CRP gene polymorphism (p>0.05). Also, while the severity of periodontitis increased significantly with subject age, the CRP level in blood serum was not significantly related to the severity of periodontitis. The genotypes of the tested polymorphism did not show significant association with the severity of periodontitis either in smokers or in the combined population including smokers and non-smokers. The results naturally do not exclude such associations, but suggest that to discern the differences the sample size must be considerably increased. Conclusion: The CRP (-717C>T) gene polymorphism and CRP level in blood serum were not found to be associated with the severity of periodontitis in male smokers or in the combined population of smokers and non-smokers.

Gingival enlargement as oral manifestation in acute myeloid leukemia patient Sandra Olivia Kuswandani; Yuniarti Soeroso; Sri Lelyati C. Masulili
Dental Journal (Majalah Kedokteran Gigi) Vol. 50 No. 3 (2017): September 2017
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Background: Acute myeloid leukemia (AML) is a bone marrow cancer, a malignant disease that triggering the cells develops into different types of blood cells. It is widely recognized that the main manifestation of AML could be gingival hyperplasia and bleeding. Occasionally, an initial diagnosis of leukemia is made after a dental examination. In relation to systemic diseases, gingival enlargement could constitute the intensification of an existing inflammation initiated by dental plaque, or a manifestation of the systemic disease independent of the inflammatory condition of the gingiva. Gingival enlargement negatively affects the quality of life, especially nutritional intake. Purpose: This study aimed to report on gingival enlargement in AML patients, dental management of this condition and considerations when treating patients. Case: A 46 year-old woman diagnosed with AML who chiefly complained of gingival enlargement in all parts of the mouth which restricted her nutritional intake. Case management: The subject attended the clinic twice where nonsurgical treatment for the gingival enlargement, supragingival scaling and dental health education to maintain her oral hygiene was carried out. Unfortunately, she did not return for follow-up appointments due to having already passed away. Information about AML and its relation to gingival enlargement contained in the literature is also reviewed. Conclusion: In conclusion, gingival enlargement represents one oral manifestation of AML. This condition is related to and affects the nutritional intake of the patient.

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