Cross-Cultural Adaptation of The Indonesian Version Functional Assessment of Denture Instrument as a Measuring Tool for Complete Denture Functional Quality.

OBJECTIVE: Making good quality dentures is necessary to avoid patients' discomfort when adapting to new dentures. Several studies regarding the assessment of the quality of dentures have been carried out in many other countries, such as using the Functional Assessment of Dentures (FAD) by Anastassiadou. However, studies have yet to be conducted in Indonesia. This study aims to obtain a valid and reliable instrument to measure the quality of complete dentures (CDs). This study also aims to find out whether the functional quality of a CD measured with the Indonesian version of the FAD Instrument (PFGT) can affect patient satisfaction in receiving CD treatment (measured with Indonesian version of Patient's Denture Assessment [PDA-Id]) and to find contributing factors to the functional quality of a CD. MATERIALS AND METHODS: The study was conducted in two stages. The first stage was a qualitative study using cross-cultural adaptation methods and focus group discussions with experts. The second stage was a quantitative test with a total of 40 subjects for statistical analysis in the form of a kappa test, test-retest, Kuder-Richardson (KR) 20, and a correlation test between PDA-Id and PFG. Multivariate analysis was done to analyze contributing factors to the functional quality of CD. RESULTS: The final instrument was obtained from the qualitative test, which was tested for content and face validation. The interrater kappa test result of 0.828 shows an almost perfect agreement. The results of the intrarater test-retest (0.564; p > 0.05; intraclass correlation coefficient 0.889) showed excellent instrument stability. The results of the internal consistency test with Kuder-Richardson 20 (1.08; KR > 1) showed good internal consistency. The correlation test results between PFGT and PDA-Id (0.044; p < 0.05) showed a positive correlation. Multivariate analysis showed a relationship between the quality of the CD, the length of time the CD was used, and the patient's satisfaction with CD treatment. CONCLUSION: The PFGT instrument is considered a valid and reliable tool to measure the functional quality of a denture that can distinguish between good and bad quality.

The Red and Orange Complex Subgingival Microbiome of Cognitive Impairment and Cognitively Normal Elderly with Periodontitis.

Increasing evidence has shown an association between periodontitis and cognitive impairment. Subgingival microbiota play a great role in periodontitis pathogenesis. However, the correlation between the subgingival microbiome and cognitive impairment remains unclear. This study aimed to evaluate the red and orange complex subgingival microbiome of cognitively impaired and cognitively normal elderly Indonesian subjects with periodontitis. Twenty-eight elderly subjects diagnosed with periodontitis underwent two cognitive examinations using the Hopkins Verbal Learning Test and the Mini-Mental State Examination. Gingival crevicular fluid taken from the periodontal pocket, at a depth between 5 and 7 mm, using a paper point was used as the subgingival samples. The subgingival microbiome in the cognitive impairment group (n = 14) and cognitively normal group (n = 14) was compared using the 16S rRNA Metagenomic iSeq™ 100 Sequencing System. There was ß-diversity in the subgingival microbiota between the cognitively impaired and cognitively normal subjects. The metagenomic analysis showed a higher abundance of Porphyromonas and Treponema bacteria in the cognitive impairment group than in the normal cognitive group (p < 0.05). The abundance of Porphyromonas gingivalis and Treponema denticola was higher in the cognitively impaired elderly subjects. The role of P. gingivalis and T. denticola in the pathogenesis of cognitive impairment needs further investigation.

Interferon-Gamma (IFNg) +874A/T Polymorphism Does Not Significantly Affect the Severity of Periodontitis.

OBJECTIVES: Interferon-gamma (IFNg) is an immune-regulatory cytokine with a role in host responses to periodontitis. Genetic factors have been reported to modify the corresponding protein expression. The objective of this study was to evaluate the association and role of IFNg polymorphisms, such as IFNg +874 A/T, and the susceptibility to periodontitis. MATERIALS AND METHODS: A total of 100 unrelated subjects were included in the present study. Genomic deoxyribonucleic acid (DNA) was obtained from peripheral blood of 43 patients with mild periodontitis and 57 patients with severe periodontitis. The determined clinical parameters of periodontitis included probing depth, clinical attachment loss, and papilla bleeding index. The oral hygiene indicators were also assessed. The level of IFNg was determined from the gingival crevicular fluid by enzyme-linked immunosorbent assay technique. The IFNg +874 A/T polymorphisms were analyzed from peripheral blood by the method of restriction fragment length polymorphism-polymerase chain reaction. STATISTICAL ANALYSIS: Statistical analysis of the results was conducted using chi-squared testing for categorical data. Independent t-tests and Mann-Whitney U tests were used for numeric data. Kruskal-Wallis testing was used to compare genotypes concerning for IFNg +874 A/T polymorphism. A p-value < 0.05 was assumed for statistical significance. RESULTS: Analysis of the IFNg +874 A/T polymorphism showed no significant differences with the level of IFNg. No significant differences were observed either in IFNg +874 A/T polymorphism between the subjects with mild periodontitis and those with severe periodontitis (p > 0.05). The subjects with severe periodontitis showed marginally but not significantly higher levels of IFNg compared with subjects with mild periodontitis (p > 0.05). CONCLUSION: The polymorphism of IFNg +874 A/T was not associated with the level of IFNg nor with the risk of periodontitis in this study.

Association between Epstein-Barr virus and periodontitis: A meta-analysis.

PURPOSE: Previous studies have found that Epstein-Barr virus (EBV) is associated with periodontitis, though some controversy remains. This meta-analysis aimed to clarify and update the relationship between EBV and periodontitis as well as clinical parameters. METHODS: A comprehensive search was conducted in the PubMed and Scopus databases in December 2020. Original data were extracted according to defined inclusion and exclusion criteria. Outcomes were analyzed, including overall odds ratios (ORs) and 95% confidence intervals (CIs). A random-effects model was used, and publication bias was assessed by Egger's and Begg's tests. Sensitivity analysis was used to evaluate the stability of the outcome. RESULTS: Twenty-six studies were included in the present meta-analysis, involving 1354 periodontitis patients and 819 healthy controls. The included studies mostly showed high quality. The overall quantitative synthesis for the association between EBV and periodontitis was an increased odds ratio when subgingival EBV was detected OR = 7.069, 95% CI = 4.197-11.905, P<0.001). The results of subgroup analysis suggested that the association of EBV with periodontitis was significant in Asian, European, and American populations (P<0.001; P = 0.04; P = 0.003, respectively) but not in African populations (P = 0.29). Subgroup analysis by sample type showed that subgingival plaque (SgP), tissue and gingival crevicular fluid GCF were useful for EBV detection (P<0.001). EBV detection amplification methods included nested PCR, multiplex PCR and PCR (P<0.001; P = 0.05, P<0.001, respectively), but EBV detection by real-time PCR and loop-mediated isothermal amplification presented no significant result (P = 0.06; P = 0.3, respectively). For the clinical parameters of periodontitis, pocket depth (PD) and bleeding of probing (BOP) percentages were higher in the EBV-positive sites than in the EBV-negative sites (MD 0.47 [0.08, 0.85], P = 0.02; MD 19.45 [4.47, 34.43], P = 0.01). CONCLUSIONS: A high frequency of EBV detection is associated with an increased risk of periodontitis. The EBV association was particularly significant in all populations except in African populations. Subgigival plaque (SgP), tissue and GCF were not significantly different useful material for detecting EBV in periodontitis. Nested PCR and multiplex PCR are reliable methods for this purpose. In the presence of EBV, PD and BOP are reliable clinical parameters for gingival inflammation. However, some caution in such interpretation is justified due to heterogeneity among studies. A suggested extension could assess the parallel influence of other human herpesviruses.

Association of subgingival Epstein-Barr virus and periodontitis.

Background: The Epstein-Barr virus (EBV) is gaining interest as a possible agent in the etiology of periodontitis. Previous studies have shown controversy on whether EBV DNA in the subgingival periodontal pockets is associated with periodontitis. The aim of the present study was to seek the potential relationship between EBV and periodontitis. Methods: Data on socio-demographics, oral health, and periodontal health were recorded, and samples were collected from gingival crevicular fluid, using sterile paper point. This case-control study of 118 participants included 59 subjects with severe periodontitis and 59 control subjects with mild periodontitis. The EBV load was determined by quantitative real-time PCR. Results: EBV DNA was detected in 37.3% of the case samples and in 18.6% of the control samples. There was no significant difference in the load of EBV DNA between severe and mild periodontitis (p>0.05). The observed load of EBV DNA was up to 4.55x10 5 copies/mL. The detected EBV DNA was significantly associated with the plaque index and the oral hygiene index (all p<0.05). Conclusions: A significant association was not found, but EBV might contribute to periodontitis. Gingival crevicular fluid is useful for monitoring the EBV load by the real-time PCR technique.

Obesity correlated to a higher risk of acquiring periodontitis: a cross-sectional study.

BACKGROUND: The present study aimed to investigate the correlation between obesity and periodontitis, among other risk factors for periodontitis.   Methods:  In total, 262 Indonesian male and female subjects were analysed for body mass index (BMI), oral hygiene, plaque index, and clinically evaluated periodontitis. Statistical analysis was performed using Spearman tests and Pearson chi-square tests to estimate the correlation between BMI and periodontitis. Multivariate binary logistic analysis was conducted between covariate and periodontitis. P<0.05 was considered as statistically significant.   Results: The prevalence of obesity was 48.47%. There were positive correlations between BMI and periodontal status for healthy-mild periodontitis, moderate, and severe periodontitis respectively. BMI and periodontitis crude odds ratio (OR) = 2.31 (95% CI 1.41-3.78); p < 0.05, adjusted OR of BMI among other variables, was 1.88 (95%CI 1.05-3.37); p < 0.05. Exploration of the ROC curve found a BMI cut off point of 24.785 kg/m2.  Conclusion: Obesity by BMI measurement of ≥ 25kg/m2 correlated to a higher risk of acquiring periodontitis compared to normal-weight individuals.

Genotyping analysis of the Pax9 Gene in patients with maxillary canine impaction.

Background: Paired-box gene 9 ( PAX9) mutation is potentially associated with impaction in some patient populations. Here, we analyzed the relationship between PAX9 polymorphism and the occurrence of maxillary canine impaction. Methods: Patients with and without maxillary canine impaction were selected based on specific inclusion criteria, and samples of genomic DNA were obtained from a buccal mucosa swab. DNA was amplified by polymerase chain reaction and sequenced for further bioinformatics analysis to identify single nucleotide polymorphism (SNP) genotypes. Genotype and allele counting was performed in both case and control groups prior to conducting statistical analysis. Results: Four SNPs were identified in patients with maxillary canine impaction, with relative confidence determined based on chromatogram-peak assessment. All SNPs were located in exon 3 of PAX9 and in the region sequenced by the primer pair -197Fex3 and +28Rex3. Three of the SNPs (rs375436662, rs12881240, and rs4904210) were reported previously and are annotated in NCBI (dbSNP version 150), whereas another SNP mapped to chromosome 14 has not been reported. Patients with a CC genotype at SNP 3 [odds ratio (OR): 2.61 vs. TT; 1.28 vs. CT] and a CC genotype at SNP 4 [OR: 0.71 vs. GG; 0.79 vs. CG] were more likely to have maxillary canine impaction. Conclusions: These results demonstrated that the presence of SNPs 3 and 4 is associated with increased likelihood of suffering from maxillary canine impaction.

Relationship of Age, Body Mass Index, Bone Density, and Menopause Duration with Alveolar Bone Resorption in Postmenopausal Women

Objective: To analyze the relationship between age, body mass index (BMI), bone mineral density (BMD), and alveolar bone resorption with menopause duration in postmenopausal women. Material and Methods: A cross-sectional study was developed involving 59 subjects, aged 45 to 80 years and categorized the duration of menopause as ≤5 years and >5 years. Body mass index measurement and menopause duration were collected. Bone loss seen on radiography was measured by drawing a vertical line from the cementoenamel in the distal part of the 36 teeth and the mesial portion of 46 teeth to the base of the bone marked by the lamina dura intact. Categorical determinations of age, BMI, BMD, and alveolar bone resorption were based on receiver operating characteristic (ROC) curves. Were used Pearson correlation and Spearman correlation tests with the significance level set at 5%. Results: The majority of subjects (54.2%) with menopause duration >5 years were aged >54.5 years, most had BMI >24.2 kg/m2 (39%), had bone resorption >2.95 mm (52.5%), and had bone density ≤73.89 (49.2%). Pearson and Spearman correlation tests showed no significant correlation between age, BMI, bone density, and alveolar bone resorption (p>0.05). Conclusion: The longer the duration of menopause showed a tendency for lower bone density and higher age, BMI, and bone resorption.

Differences in Periodontal Severity Between Perimenopausal and Postmenopausal Women with Chronic Periodontitis

Abstract Objective: To analyze the differences in periodontal severity between perimenopausal and postmenopausal women with chronic periodontitis. Material and Methods: A cross-sectional study with 63 subjects, comprising 27 perimenopausal and 36 postmenopausal women, aged 45-59 years, was conducted in East Jakarta. The women were interviewed regarding their perimenopausal and postmenopausal status; they underwent a periodontal examination for periodontal pockets, attachment loss, gingival recession, plaque index, debris index, calculus index, oral hygiene index, papilla bleeding index, and tooth mobility. Independent T-test and Mann-Whitney U test were used for bivariate analysis Results: There were significant differences (p<0.05) in age between perimenopausal and postmenopausal women (p=0.01); however, no significant differences (p>0.05) in gingival recession (p=0.33) or tooth mobility (p=0.84) were observed. Independent t-test revealed no significant differences in pocket depth (p=0.95), attachment loss (p=0.71), plaque index (p=0.89), debris index (p=0.52), calculus index (p=0.46), oral hygiene index (p=0.48), or papilla bleeding index (p=0.63) between perimenopausal and postmenopausal women Conclusion: There was no difference in periodontal severity between perimenopausal and postmenopausal women; however, the current study obtained valuable information regarding periodontal severity in perimenopausal and postmenopausal women.

Relationships Between Tooth Loss and Masticatory Performance, Nutrition Intake, and Nutritional Status in the Elderly

Abstract Objective: To analyze the associations between posterior tooth loss and masticatory performance, nutrition intake, and nutritional status in the elderly. Material and Methods: A total of 158 subjects aged 60 years and older from Depok, West Java, Indonesia were enrolled in this cross-sectional study. Posterior teeth contacts were assessed and the subjects were divided into two groups based on Eichner Index; group A2-B3 and group B4-C3. The masticatory performance test was conducted using color-changeable chewing gum. A semi-quantitative food-frequency questionnaire was used to measure nutritional intake in the form of total calories, and the Mini-Nutritional Assessment-Short Form was used to measure nutritional status. Mann Whitney U test was used to determine differences in masticatory performance, nutrition intake, and nutritional status between the two groups Results: Seventy-four percent of participants were female, and 26% were male. A significant difference in the mean masticatory performance score (p<0.001) was noted between Eichner group A2-B3 (5.66 ± 1.80) and B4-C3 (3.20 ± 1.25). However, no statistically significant difference in nutritional status and calorie intake were found between the two groups (p>0.05) Conclusion: Despite the adequacy of nutrition intake and nutrition status in this population, tooth replacement is necessary to improve masticatory performance in both groups.

The Evaluation of Root Fracture with Cone Beam Computed Tomography (CBCT): An Epidemiological Study.

BACKGROUND: The aim of this study was evaluation of the cone-beam computed tomography (CBCT) image of 50 patients at the ages of 8-15 suspecting root fracture and root fracture occurred, exposed to dental traumatic. In additionally, this study was showed effect of crown fracture on root fracture healing. MATERIAL AND METHODS: All of the individuals included in the study were obtained images with the cone-beam computed tomography range of 0,3 voxel and 8.9 seconds.(i-CAT®, Model 17-19, Imaging SciencesInternational, Hatfield, Pa USA).The information obtained from the history and CBCT images of patients were evaluated using chi-square test statistical method the mean and the distribution of the independent variables. RESULTS: 50 children, have been exposed to trauma, was detected root fracture injury in 97 teeth. Horizontal root fracture 63.9% of the 97 tooth, the oblique in 31.9%, both the horizontal and oblique in 1.03%, partial fracture in 2.06% ,and both horizontally and vertical in 1.03% was observed.The most affected teeth, respectively of, are the maxillary central incisor (41.23% left, right, 37.11%), maxillary left lateral incisor (9.27%), maxillary right lateral incisor (11.34%), and mandibular central incisor (1.03%). CONCLUSIONS: Crown fractures have negative effects on spontaneous healing of root fractures. CBCT are used selected as an alternative to with conventional radiography for diagnosis of root fractures. In particular, it's cross-sectional image is quite useful and has been provided more conveniences seeing the results of diagnosis and treatment for clinician. Key words:Root fracture, CBCT, Epidemiolog.

Gene promoter polymorphism of RUNX2 and risk of osteoporosis in postmenopausal Indonesian women.

OBJECTIVES: Osteoporosis is a metabolic bone disease of reduced bone mass density (BMD) and elevated risk of fracture due to an imbalance in bone formation and resorption. The risk and incidence of osteoporosis increase towards advanced age, particularly in postmenopausal women, and the risk is known to be affected by the variation in the expression of the associated regulatory genes. This work aimed to clarify the impact of variation in RUNX2 (runt domain transcription factor 2), which is an osteoblast-specific transcription factor that normally stimulates bone formation and osteoblast differentiation, regarding single-nucleotide polymorphism within RUNX2 promoter (P1) and risk of osteoporosis in postmenopausal Indonesian women. METHODS: Using DNA sampling from blood, the variation at the single-nucleotide polymorphism (-330, G→T, rs59983488) at the RUNX2 P1 promoter was investigated using polymerase chain reaction-restriction fragment length polymorphism for 180 consenting postmenopausal Indonesian women. The subjects were examined for bone mass density and classification to normal and those with osteopenia or osteoporosis by T-scoring with dual-energy X-ray absorptiometry. Chi-square testing and logistic regression were mainly used for statistical assessment. RESULTS: The results showed a general trend with increased risk of osteoporosis associated with the genotype TT (mutant type) and the corresponding T allele of the tested polymorphism of RUNX2 promoter P1. The trend was, however, not significant in multivariate testing adjusted for age and time after menopause. CONCLUSION: To confirm the potential risk with TT genotype would require testing of a much larger sample of subjects. As the tested single-nucleotide polymorphism only represents one of the relevant candidate locations of RUNX2, the results are taken nevertheless to suggest an impact by overall RUNX2 variation in the risk of osteoporosis in Indonesian postmenopausal women.

Current state of craniofacial prosthetic rehabilitation.

PURPOSE: This study aimed to review the current state of the techniques and materials used to rehabilitate maxillofacial defects. MATERIALS AND METHODS: The MEDLINE and EMBASE databases were searched for articles pertinent to maxillofacial prostheses published from January 1990 to July 2011. The main clinical stages were the subject of analysis. RESULTS: A multidisciplinary approach is preferred when rehabilitating maxillofacial defects. Surgical reconstruction can be used for smaller defects, but larger defects require a prosthesis to achieve an esthetic rehabilitation. Implant retained prostheses are preferred over adhesive prostheses. Silicone elastomer is currently the best material available for maxillofacial prostheses; however, longevity and discoloration, which are greatly influenced by ultraviolet radiation, microorganisms, and environmental factors, remain significant problems. In the near future, the widespread availability and cost effectiveness of digital systems may improve the workflow and outcomes of facial prostheses. Patients report high satisfaction with their prostheses despite some areas that still need improvement. CONCLUSIONS: Maxillofacial prostheses are a reliable treatment option to restore maxillofacial defects and improve quality of life. Significant progress has been made in the application of implants for retention and digital technology for designing surgical guides, suprastructures, and craniofacial prostheses. Further improvements are necessary to enhance longevity of prostheses.

Indonesian undergraduate dental students' perceptions toward implant treatment and education.

OBJECTIVE: Indonesia foresees high demand in providing dental implant therapy and need to prepare competent graduating dentists. No information about undergraduate dental implant education in Indonesia has been reported in the literature. The objective of this study was to investigate dental students' perceptions towards implant treatment and education in one Indonesian dental school. METHODS: A survey was distributed to 166 fourth- and fifth-year students of Faculty of Dentistry, University of Indonesia (FD-UI). The survey consisted of 14 questions on students' perceptions on implant treatment, current undergraduate implant curriculum, and their future plans. RESULTS: One hundred and forty-one students (85%) returned the survey. Dental implant was considered as a treatment of choice for restoring missing mandibular first molar and maxillary anterior tooth, but not edentulous mandible. The majority of students rated that the topic of implant dentistry was insufficiently covered during undergraduate education, were interested in learning more, and planned to include implant as part of their future practice. CONCLUSION: Dental students of FD-UI are aware of implant treatment as a restorative option in replacing a single missing tooth. There is a need for a nationwide discussion for introducing a comprehensive implant dentistry curriculum in undergraduate dental education in Indonesia.

Microbial biofilms on facial prostheses.

The composition of microbial biofilms on silicone rubber facial prostheses was investigated and compared with the microbial flora on healthy and prosthesis-covered skin. Scanning electron microscopy showed the presence of mixed bacterial and yeast biofilms on and deterioration of the surface of the prostheses. Microbial culturing confirmed the presence of yeasts and bacteria. Microbial colonization was significantly increased on prosthesis-covered skin compared to healthy skin. Candida spp. were exclusively isolated from prosthesis-covered skin and from prostheses. Biofilms from prostheses showed the least diverse band-profile in denaturing gradient gel electrophoresis (DGGE) whereas prosthesis-covered skin showed the most diverse band-profile. Bacterial diversity exceeded yeast diversity in all samples. It is concluded that occlusion of the skin by prostheses creates a favorable niche for opportunistic pathogens such as Candida spp. and Staphylococcus aureus. Biofilms on healthy skin, skin underneath the prosthesis and on the prosthesis had a comparable composition, but the numbers present differed according to the microorganism.