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"ABSTRAKAbstrak. Inovasi terbaru untuk mendapatkan regenerasi jaringan periodontal adalah dengan bahan platelet rich fibrin (PRF) dan cangkok tulang. Penelitian ini merupakan penelitian eksperimental klinis. Tujuan: Mengevaluasi perbedaan tinggi tulang alveolar pada terapi bedah flep poket infraboni menggunakan Platelet rich fibrin dan kombinasi dengan cangkok tulang. Metode penelitian: Evaluasi radiografis periapikal sebelum dan sesudah perawatan menggunakan PRF dan kombinasi dengan cangkok tulang Hasil: secara statistik, terdapat perbedaan tinggi tulang yang bermakna pada terapi bedah poket infraboni dengan PRF dan kombinasi dengan cangkok tulang. Kesimpulan: Platelet rich fibrin dan kombinasi dengan cangkok tulang memiliki hasil yang sama pada evaluasi radiografis ketinggian tulang secara statistik

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ABSTRACTAbstract. The new innovation to enhance periodontal tissue regeneration are using PRF and bone graft material. The study was clinical experimental. Purpose:To evaluate the difference of alveolar bone heigh on periodontitis therapy using PRF and combination with bone graft.Research methods: periapical radiograph evaluation before and after periodontitis therapy using PRF compare to combination with bone graft. by assessing alveolar bone height. Results: Statistically, there were no significant difference between alveolar bone height on periodontitis therapy PRF compare to combination with bone graft. Conclusion: PRF and combination with bone graft has the same result statictically in radiographic evaluation of alveolar bone height."

"ABSTRAKImplan lemak dalam bidang plastik rekonstruksi sudah lama digunakan oleh para ahli bedah, namun dengan seiringnya waktu lemak dapat mengalami absorpsi 30-50 , terutama pada lemak yang disentrifugasi. Untuk itu diperlukan suatu bahan autologous untuk mempertahankan viabilitas lemak. Tujuan penelitian ini adalah membandingkan antara lemak mikrolobular, lemak yang disentrifugasi, lemak mikrolobular dengan penambahan PRF dan lemak yang disentrifugasi dengan penambahan PRF. Tiga puluh enam kelompok dilakukan implan lemak di daerah dorsal telinga kelinci sebanyak 0,5cc, dievaluasi selama 4 minggu. Penilaian dilakukan secara makroskopik dengan menilai hiperemis, nekrosis dan menghitung diameter pada minggu pertama, kedua, ketiga dan keempat. Pada penelitian ini didapatkan bahwa pada minggu pertama hingga minggu keempat terjadi penurunan jumlah kelompok yang mengalami hiperemis, semua jaringan tidak terdapat nekrosis sejak minggu pertama dan diameter lemak yang mengalami penyusutan hanya terdapat pada perlakuan lemak yang disentrifugasi sebanyak dua kelompok, namun secara statistik tidak didapat perbedaan bermakna p>0,05 . Evaluasi mikroskopik didapatkan bahwa jumlah adiposit median= 547,74 , fibroblas median= 600,52 , pada perlakuan lemak mikrolobular dengan penambahan PRF lebih banyak dibandingkan kelompok perlakuan lainnya, namun secara statistik tidak bermakna p>0,05 , sedangkan parameter neovaskularisasi lebih banyak ditemukan pada kelompok lemak mikrolobular mean= 12,67 , tetapi secara statistik tidak bermakna p=0,268 Namun analisis regresi membuktikan bahwa peningkatan neovaskularisasi sejalan dengan pertambahan jumlah adiposit, hal ini membuktikan bahwa viabiltas adiposit bergantung pada neovaskularisasi.

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ABSTRACTFat graft in plastic reconstructive surgery has been used for a long time by surgeons. However, problem lies with fat being absorbed up to 30 50 , especially centrifuged fats. Therefore, an autologous material is needed to maintain fat viability. This research aims to compare the viability of microlobular fat, centrifuged fat, microlobular fat with PRF, and centrifuged fat with PRF. As much as 0.5 mL of these fat were grafted to thirty six groups of rabbits at the dorsal area of rabbits rsquo ear, which were then evaluated for 4 weeks. Macroscopic evaluation was performed on the first, second, third, and fourth week while microscopic evaluation was performed only on fourth week. Macroscopic evaluation performed since the first to the fourth week on hyperemia parameter showed reduction of redness hyperemia in all treatment groups and necrosis parameter was not found since the first week in all treatment groups. Although the diameter parameter was seen in two centrifuged fat groups on fourth week, it showed no statistically significant difference p 0,05 . Upon microscopic evaluation, the amount of adipocytes in microlobular fat with PRF group showed a greater number median 547.74 and also fibroblast median 600,52 compared to other treatment groups, but it was also not statistically significant p 0,05 . Neovascularization parameter was greater on microlobular fat group mean 12,67 , but it was not statistically significant p 0,268 . Result of regression analysis proved that increase in neovascularization was in line with the increase amount of adipocytes. Therefore, it is proved that the viability of adipocytes depends on neovascularization"

"Luka kaki diabetes (LKD) adalah salah satu komplikasi diabetes melitus (DM). Terapi LKD adalah perawatan luka dan growth factor (GF) seperti advanced-platelet rich fibrin (A-PRF). Penyandang DM memiliki GF rendah, untuk mengoptimalkan GF yang dilepaskan oleh PRF, ditambahkan asam hialuronat (AH). Penelitian ini bertujuan menganalisis pengaruh A-PRF + AH terhadap penyembuhan LKD dengan mengkaji VEGF, PDGF, IL-6, dan indeks granulasi. Desain penelitian randomized control trial, dilaksanakan pada bulan Juli 2019 −Maret 2020 di RSPAD Gatot Soebroto dan RSUD Koja, Jakarta. Subjek penyandang LKD yang mengalami luka kronik, kriteria Wagner II, luas luka < 40 cm2. Subjek diambil berdasarkan rule of thumb dan dibagi tiga secara acak yaitu kelompok terapi topikal A-PRF + AH (n = 10), A-PRF (n = 10) dan kontrol NaCl 0,9% (n = 10). Pada kelompok A-PRF + AH dan A-PRF dilakukan pemeriksaan VEGF, PDGF, IL-6 dari usap LKD dan fibrin gel sedangkan kontrol hanya diperiksa usap LKD. Biomarker dan Indeks Granulasi (IG) diperiksa hari ke-0, ke-3, ke-7. Khusus IG pengukuran ditambah hari ke-14. Data dianalisis menggunakan SPSS versi 20 dengan uji Anova atau Kruskal Wallis. Pada kelompok A-PRF + AH, kadar VEGF usap LKD hari ke-0 adalah 232,8 meningkat menjadi 544,5 pg/mg protein pada hari ke-7. Pada kelompok A-PRF tejadi peningkatan dari 185,7 menjadi 272,8 pg/mg protein, namun kelompok kontrol terjadi penurunan dari 183,7 menjadi 167,4 pg/mg protein. Kadar PDGF usap LKD kelompok A-PRF + AH hari ke-0 adalah 1,9 pg/mg protein, meningkat menjadi 8,1 pg/mg protein hari ke-7, kelompok A-PRF dari 1,7 meningkat menjadi 5,4 pg/mg protein dan kontrol dari 1,9 meningkat menjadi 6,4 pg/mg protein. Kadar IL-6 usap LKD kelompok A-PRF + AH hari ke-0 adalah 106,4 menjadi 88,7 pg/mg protein hari ke-7, pada A-PRF dari 91,9 menjadi 48,8 pg/mg protein dan kontrol dari 125,3 menjadi 167,9 pg/mg protein. IG kelompok A-PRF + AH hari ke-0 adalah 42,1% menjadi 78,9% dan 97,7% hari ke-7 dan ke-14, pada kelompok A-PRF dari 34,8% menjadi 64,6% dan 91,6%. Kelompok kontrol dari 35,9% menjadi 66,0% dan 78,7% hari ke-7 dan ke-14. Pada kelompok A-PRF + AH dibandingkan A-PRF dan NaCl didapatkan peningkatan bermakna kadar VEGF pada hari ke-3 (p = 0,011) dan hari ke-7 (p < 0,001). Kadar IL-6 menurun bermakna (p = 0,041) pada hari ke-7 saja. Namun persentase IG meningkat bermakna pada hari ke-3 (p = 0,048), ke-7 (p = 0,012) dan hari ke-14 (p < 0,001). Disimpulkan penambahan AH pada A-PRF meningkatkan VEGF (marker angiogenesis) dan IG (tanda klinis penyembuhan luka), serta menurunkan IL-6 (marker inflamasi) secara bermakna sehingga mempercepat penyembuhan LKD.

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Diabetic foot ulcer (DFU) is one of complications of diabetes mellitus (DM). Advance wound treatment in DFU such as growth factors (GF) including Advanced-Platelet Rich Fibrin (A-PRF) topical has been developed . People with DM have low GF, so to optimize GF hyaluronic acid (AH) is added. This study analyzed the combination of A-PRF + AH combination in DFU recovery by examining VEGF, PDGF, IL-6, and granulation index (IG). The study used a randomized control design, done from July 2019−March 2020 at the Gatot Soebroto Army Hospital and Koja District Hospital, Jakarta. Subjects were DFU patients who had chronic wounds, area < 40 cm2 and Wagner II criteria. Subjects were recruited according to the rule of thumb and were randomly divided into three groups namely topical A-PRF + AH (n = 10), A-PRF (n = 10) and control NaCl 0.9% groups (n = 10). The A-PRF + AH and A-PRF groups underwent VEGF, PDGF, and IL-6 examinations of the DFS swabs and fibrin gel while the controls could only underwent the DFU swabs. Biomarkers and Granulation Index (GI) were measured on day 0, 3rd, 7th. Special GI measurements were added on day 14. Data were analyzed using SPSS version 20 with the Anova and Kruskal Wallis test. In the A-PRF + AH group the VEGF level from swab DFU day 0 was 232,8 pg/mg protein increase to 544,5 pg/mg protein on day 7. In the A-PRF group VEGF increase from 185,7 to 272,8 pg/mg protein and control decrease from 183.7 to 167.4 pg/mg protein. Increasing of PDGF levels in group A-PRF + AH day 0 was from 1,9 pg/mg protein to 8,1 pg/mg day 7, group A-PRF from 1,7 increased to 5,4 pg/mg protein and control from 1,9 to 6,4 pg/mg protein. Decreasing of IL-6 level of DFU swab in group A-PRF + AH day 0 was 106,4 pg/mg protein to 88,7 pg/mg protein day 7, in group A-PRF from 91,9 to 48,8 pg/mg protein and control from 125,3 to 167,9 pg/mg protein. The granulation index of DFU group A-PRF + AH on day 0 was 42,1% increased to 78,9% and 97,7% days 7 and 14. In the A-PRF group increased from 34,8% to 64,6 % and 91,6%. and controls from 35,9% to 66,0% and 78,7% on days 7 and 14. On the 7th day the VEGF level of the A-PRF + AH group increased significantly (p < 0.001), while IL-6 decreased and the granulation index increased significantly with p level of p = 0.041 and p = 0.012 respectively, compare with other group. It was concluded that on day 7 the AH to A-PRF increases VEGF (a marker of angiogenesis) and GI (a clinical sign of wound recovery), as well as a decrease in IL-6 (a marker of inflammation) which fully increase in DFU. "

"Pendahuluan : Pasien maloklusi kelas III skeletal hiperdivergen memiliki tulang alveolar simfisis mandibula yang tipis. Perawatan ortodonti pada kasus maloklusi kelas III skeletal memiliki pergerakan gigi anterior yang terbatas. Retraksi anterior insisif bawah yang terbatas merupakan perawatan kamuflase untuk mengatasi maloklusi kelas III skeletal. Tujuan : Menganalisis perubahan ketinggian dan ketebalan tulang alveolar simfisis mandibula sebelum dan sesudah perawatan ortodonti cekat maloklusi kelas III hiperdivergen. Metode : Desain penelitian ini berupa observasional analitik dengan desain potong lintang. Sampel pasien ini terdiri dari 34 sefalometri lateral pasien maloklusi kelas III skeletal hiperdivergen yang telah selesai dirawat ortodonti cekat di Kinik Ortodonti RSKGM FKG UI. Pengukuran ketinggian dan ketebalan tulang alveolar simfisis mandibula menggunakan perangkat lunak Winceph versi 11 English Edition, Rise Coorporation 3-8-15 Sendai, Japan. Hasil : Ketinggian tulang alveolar simfisis mandibula sebelum dan sesudah perawatan ortodonti menunjukkan tidak ada perbedaan yang berbeda bermakna. Ketebalan tulang alveolar sebelum dan sesudah perawatan ortodonti menunjukkan perbedaan bermakna berupa penurunan pada 1/3 servikal tualng alveolar sisi labial dan 1/3 apikal tulang alveolar sisi lingual (p<0.05). Kesimpulan : Ketebalan tulang alveolar regio simfisis bagian labial dan lingual sebelum dan sesudah perawatan ortodonti cekat mengalami penurunan namun tidak menimbulkan efek samping yang tidak diinginkan yaitu dehisensi maupun fenestrasi.

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Introduction : Patient with Class III Skeletal Hiverdivergent have a thin alveolar bone thickness in symphisis region. Anterior teeth movement in orthodontic treatment in this Class III malocllusion case is limited. Retraction of lower incisors in orthodontic camouflage treatment in class III skeletal malocclusion become limited. Aim : Analyze alveolar bone height and thickness in symphisis region before and after fixed orthodontic treatment in Class III skeletal malocclusion Hyperdivergent. Methods : This research is analitic observasional study with cross sectional design. Sample are 34 cephalomatric lateral radiographs before and after fixed orthdootnics treatment in classs III hyperdivergent patients in RSGKM FKG UI. Alveolar bone height and thickness were measured using Winceph 11 English Edition Esoftware by Rise Coorp Rise Coorporation 3-8-15 Sendai, Japan. Results : There was no difference in alveolar bone height before and after orthodontic treatment. Significant decreased was found in the alveolar bone thickness in 1/3 servical on labial side and 1/3 apical on lingual side (p<0.05). Conclusion : Alveolar bone thickness was decreased before and after orthodontic treatment, however there was no undesireable effects, such as dehiscence or fenestration found."

"Pendahuluan: Bimaxillary protrusion merupakan kondisi gigi insisif atas dan bawah sangat maju sehingga perawatan umumnya memerlukan pencabutan diikuti dengan retraksi gigi anterior. Retraksi pada maloklusi hiperdivergen perlu memperhatikan kondisi simfisis mandibula yang memiliki tulang alveolar tipis untuk mencegah dehisensi atau fenestrasi. Tujuan: Menganalisis perbedaan ketinggian dan ketebalan tulang alveolar regio simfisis mandibula sebelum dan setelah perawatan ortodonti cekat dengan ekstraksi premolar pada maloklusi kelas I bimaxillary protrusion dan hiperdivergen. Metode Penelitian: Penelitian menggunakan data sekunder berupa 34 sefalogram lateral pasien kelas I bimaxillary protrusion dan hiperdivergen sebelum dan setelah perawatan di klinik Ortodonti RSKGM FKG UI. Desain penelitian berupa observasional analitik dengan desain potong lintang. Pengukuran ketinggian dan ketebalan tulang alveolar dilakukan menggunakan perangkat lunak Winceph versi 11 English edition, Rise Corporation 3-9-15 Sendai, Jepang. Hasil: Terjadi penurunan ketinggian tulang alveolar sisi lingual sebesar 0.498 mm (p=0.003), dan penurunan ketebalan tulang alveolar sisi labial 1/3 servikal sebesar 0.226 mm (p=0.038). Secara keseluruhan terjadi perbedaan pada ketinggian dan ketebalan tulang alveolar sisi labial dan lingual, dengan perbedaan bermakna ditemukan pada perbedaan ketinggian sisi lingual, dan perbedaan ketebalan sisi labial 1/3 servikal. Kesimpulan: Terdapat perbedaan ketinggian dan ketebalan tulang alveolar regio simfisis mandibula sebelum dan setelah perawatan ortodonti cekat dan tidak menunjukkan adanya dehisensi ataupun fenestrasi.

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ntroduction: Bimaxillary protrusion is characterized by protrusive incisors requiring first premolar extractions and retraction of anterior teeth as treatment plan. Precautions are needed when retracting aenterior teeth of hyperdivergent patients with thin alveolar bones in order to prevent dehiscence and fenestration. Aim: To Analyze the difference of alveolar bone thickness and alveolar bone height before and after orthodontic treatment in Class I hyperdivergent and bimaxillary protrusion with extraction. Methods: This research is an analytical observational cross-sectional study using 34 before and after lateral cephalograms of Class I hyperdivergent with bimaxillary protrusion cases treated in the Orthodontic Clinic at RSKGM FKG UI. Changes of alveolar bone height and thickness were measured with Winceph software 11th version English edition, Rise Corporation 3-9-15 Sendai, Japan. Results: Reduce of 0.498 mm was found in alveolar bone height on the lingual side (p=0.003), and reduce of 0.226 mm was found in alveolar bone thickness on the 1/3rd coronal part of the labial side (p=0.038). Overall changes occur in alveolar bone height and alveolar bone thickness at both labial and lingual sides, but significant changes were only found at the alveolar bone height on the lingual side, and at the alveolar bone thickness on the coronal part of labial side. Conclusion: Changes were found at the alveolar bone height and alveolar bone thickness after fixed orthodontic treatment and showed no sign of dehiscene or fenestration."

"Background: Platelet-Rich Plasma is believed to repair cartilage degeneration by stimulating tissue regeneration, however the clinical evidence is still insufficient. The aim of this research is to compare the efficacy of intra-articular hyaluronic acid injection (HA) and combined hyaluronic acid and platelet-rich plasma (HA-PRP) on osteoarthritis of the knee, and the association on gender, age, body mass index and osteoarthritis degree towards the efficacy. Methods: This is a cross-setional study using 58 patients’ medical records. 27 patients received HA injections, and 31 patients received HA-PRP injections. Patients were evaluated weekly using IKDC and WOMAC score until 2 months after the injections. Results: On the 2nd month of follow up, AH-PRP shows greater increase in IKDC (p=0,146) and WOMAC (Pain p=0,004; Stiffness p=0,008; Knee function p=0,007) score compared to HA injection. There’s no association on gender, age, and body mass index towards the IKDC and WOMAC score increase on either HA or combined HA-PRP injection. There’s no significant difference on osteoarthritis degree towards IKDC and WOMAC score increase on HA injection. However, there’s a significant difference between osteoarthritis degree 2 and 4 towards IKDC (p=0,002) and WOMAC score (Pain p=0,042; Stiffness p=0,018; Knee function p=0,042) and between osteoarthritis degree 2 and 3 towards WOMAC Pain (p=0,008) and WOMAC Knee function (p=0,018). Conclusions: HA-PRP injection shows better results to reduce osteoarthritis symptoms compared to HA injections. Better results were observed in patients with less severe osteoarthritis degree."

"Pendahuluan: Kejadian ruptur tendon Achilles meningkat dalam beberapa dekade terakhir dengan insiden tertinggi didapatkan pada kelompok usia 30-39 tahun. Penanganan terkini untuk ruptur tendon Achilles adalah pembedahan dengan penjahitan primer, serta dapat juga secara konservatif pada kondisi-kondisi tertentu. Karena komplikasi adhesi dan gliding tendon sering terjadi pasca tindakan pembedahan, para peneliti berusaha menemukan bahan yang secara efektif mampu memperbaiki proses penyembuhan tendon. Platelet-rich plasma (PRP) dan membran amnion merupakan bahan yang dinyatakan memiliki potensi dalam memperbaiki proses penyembuhan tendon, mencegah adhesi dan gliding tendon. Namun, penelitian mengenai efek kombinasi keduanya masih belum pernah dilakukan.Metode: Model ruptur tendon Achilles dilakukan pada 24 ekor kelinci putih New Zealand yang terbagi dalam 4 kelompok perlakuan, yaitu kelompok kontrol, kelompok dengan pemberian membran amnion, kelompok dengan pemberian PRP dan kelompok dengan pemberian kombinasi membran amnion dan PRP. Evaluasi dilakukan pada 6 minggu setelah tindakan pembedahan berdasarkan penilaian terhadap pemeriksaan gliding tendon dengan USG, Tang score gambaran makroskopis adhesi tendon, grading adhesi secara makroskopis, Tang score gambaran histopatologis adhesi, grading adhesi secara histopatologis, serta Tensile strength tendon dengan uji tarik. Data yang didapatkan diuji secara statistik dengan jenis data dan jumlah kelompoknya.Hasil: Kelompok perlakuan membran amnion serta kelompok kombinasi membran amnion dan PRP memiliki perbedaan bermakna terhadap dalam hal gliding tendon secara USG, Tang score makroskopis dan histopatologis serta grading adhesi makroskopis dan histopatologis. Kelompok perlakuan PRP dan kombinasi membran amnion dan PRP menunjukkan perbedaan bermakna terhadap kelompok kontrol dalam hal nilai tensile strength test.

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Background: The incidence of Achilles tendon rupture has increased in the last few decades with the highest incidence found in the 30-39 years of age group. The current treatment for Achilles tendon rupture is surgery with primary suturing, and can also be conservative under certain conditions. Because adhesion complications and gliding tendons often occur after surgery, the researchers tried to find a material that is able to effectively improve the tendon healing process. Platelet-rich plasma (PRP) and amniotic membrane are substances that have the potential to improve tendon healing processes, prevent adhesion and gliding tendons. However, research on the effects of the combination of both has never been done.

Methods: The Achilles tendon rupture model was carried out in 24 New Zealand white rabbits, which were divided into 4 treatment groups, namely the control group, the group with the administration of amniotic membrane, the group with the administration of PRP and the group with the combination of amniotic membrane and PRP. The evaluation was carried out at 6 weeks after surgery based on an assessment of gliding tendon examination with ultrasound, Tang score macroscopic image of tendon adhesion, macroscopic adhesion grading, Tang score histopathological adhesion, histopathological adhesion grading, and Tensile strength tendon with the tensile test. The data obtained were tested statistically with the type of data and the number of groups.

Results: Amniotic membrane treatment group and combined amniotic membrane and PRP treatment group had significant differences in terms of gliding tendon by ultrasound, macroscopic and histopathological Tang scores and macroscopic and histopathological adhesion grading. The PRP treatment group and combined amniotic membrane and PRP treatment group showed significant differences compared to the control group in terms of tensile strength test values.

Conclusion: The administration of amniotic membrane can reduce the formed paratenon adhesion, however, it does not have statistical significance in influencing tendon strength. Giving Platelet-rich Plasma (PRP) does not affect the formation of paratenon adhesion statistically, but it affects the increase in tendon strength. The combination of amniotic membrane and PRP has a significant effect in reducing paratenon adhesion and increasing tendon strength."

"Latar belakang: Inkontinensia urin tekanan (IUT) atau Stress Urinary Incontinence (SUI) didefinisikan sebagai kebocoran urin yang tidak disengaja saat aktivitas fisik atau saat bersin atau batuk. Jenis inkontinensia urin ini merupakan yang paling umum terjadi, dengan prevalensi sebesar 23–35% pada kelompok wanita dewasa. Biaya perawatan IUT diperkirakan lebih dari 16 milliar US dollar per tahunnya. Saat ini, terdapat beberapa pilihan terapi IUT, baik bedah hingga non–bedah. Jenis prosedur yang ditanggung oleh sistem Jaminan Kesehatan Nasional (JKN) di Indonesia adalah teknik Plikasi Kelly dengan efektifitas yang rendah dan rekurensi yang tinggi. Kemampuan regenerasi dari PRP (Platelet–Rich Plasma) menjadi salah satu pertimbangan yang dapat diberikan bagi pasien–pasien IUT yang dilakukan pembedahan Plikasi Kelly. Kemampuan PRP sebagai perekat, diharapkan mampu mengembalikan struktur dan fungsi Ligamentum Pubouretralis melalui aktivasi fibroblas untuk memacu pembentukan kolagen baru dengan biaya yang cukup murah menjadi pertimbangan untuk meningkatkan efektivitas tindakan Plikasi Kelly di Indonesia. Objektif: Penelitian ini bertujuan untuk mengetahui perbedaan–perbedaan perbaikan gejala klinis berupa perbaikan kualitas hidup (dinilai menggunakan kuisioner IIQ–7), penurunan berat Tes Pembalut serta kenaikan kadar serum IGF–1 pada pasien IUT yang diberikan penambahan PRP pada saat prosedur pembedahan Plikasi Kelly. Metode: Uji klinis acak tersamar tunggal yang berlangsung di 2 center penelitian, yaitu di RSUPN Dr. Cipto Mangunkusumo Jakarta dan RSUP Dr. Kariadi Semarang. Penelitian berlangsung dari bulan Maret 2021 hingga Desember 2021. Sampel penelitian adalah wanita dengan IUT yang menjalani prosedur pembedahan Plikasi Kelly.Hasil: Tidak terdapat perbedaan kualitas hidup (berdasarkan skor kuisioner IIQ–7) antara kelompok studi yang menerima adjuvan PRP dengan kelompok kontrol (4,8 vs 14,3; p=0,104). Rerata perubahan delta Tes Pembalut pada kelompok studi didapatkan lebih tinggi bermakna dibanding kelompok kontrol (49,8 vs 10,8; p=0,03), namun perbedaan hasil ini dipengaruhi oleh derajat keparahan IUT. Rerata kenaikan kadar serum IGF–1 pada kelompok studi ditemukan lebih tinggi bermakna dibanding kelompok kontrol pasca 3 bulan tindakan operatif (33,5 vs 13; p = 0,000). Kesimpulan: Pemberian PRP sebagai terapi adjuvan pada pasien IUT yang menjalani tindakan Plikasi Kelly memberikan manfaat perbaikan Ligamentum Pubouretralis yang dinilai berdasarkan perbaikan klinis (penurunan berat Tes Pembalut), kenaikan kadar IGF–1, dan peningkatan kualitas hidup (kuisioner IIQ–7). Prosedur injeksi PRP dinilai relatif aman dan efektif dalam meningkatkan efektifitas tindakan Plikasi Kelly. Hasil ini diharapkan dapat memberi bukti klinis untuk rejimen baru terapi IUT yang dapat dilakukan di Indonesia.

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Background: Stress urinary incontinence (SUI) is defined as involuntary urine leakage that occurs during physical activity, sneezing, or coughing. It is the most common type of urinary incontinence, with a prevalence of 23–35% in adult women. The treatment cost for SUI was approximately more than 16 billion US dollars each year. There are plenty of choices for SUI management, from surgical to non–surgical therapies. The procedure covered by Indonesia’s National Health Insurance is Kelly Plication surgery with a low rate of effectiveness and a high chance of recurrent. The Platelet–Rich Plasma (PRP), with its regenerative ability, is considered to be given for patients with SUI that underwent Kelly Plication surgery. The PRP injection, with its ability to act as an adhesive agent, is expected to help restore the Pubourethal Ligament’s structure and function through fibroblast activation to help trigger new collagen formation. Due to it’s low cost required, the PRP injection could be considered to help improve the effectiveness of Kelly Plication Surgery in Indonesia.

Objective: The aim of this study was to find the differences in clinical improvements, including the quality of life (measured with IIQ–7 questionnaire), decreased in weight of Pad test results, and increase in IGF–1 serum level in patients with SUI that were given the PRP injection as an adjuvant during Kelly Plication surgery.

Methods: Experimental single–blind randomized control trial study in a group of women with SUI that underwent the Kelly Plication Surgery. The study was conducted at 2 study centers in Dr. Cipto Mangunkusumo Central General Hospital, Jakarta, and Dr. Kariadi Central General Hospital, Semarang, from March 2021 to December 2021.

Result: There was no significant difference in the quality of life (measured with IIQ–7 questionnaire scores), between the study group which received the PRP adjuvant with the control group (4,8 vs 14,3; p = 0,104). The mean difference score for the weight of Pad test results in the study group was significantly higher than the control group (49,8 vs 10,8; p = 0,03). But this result was influenced by the severity of IUT. The mean increased score for the IGF–1 serum level in the study group was significantly higher than the control group, 3 months after the surgery (33,5 vs 13; p = 0,000).

Conclusion: The PRP injection as adjuvant therapy is considered to give more benefits for patients with SUI that underwent Kelly Plication surgery. The repair of the Pubouretral Ligament is measured by the improvement of the symptom (decreased of the Pad Test score), increased IGF–1 serum level, and quality of life improvement (increased of IIQ–7 Questionnaire). The procedure is considered safe and helps improve the effectiveness of the surgery. This result helps to provide clinical evidence for a new therapy regimen that could be applied in Indonesia."

"Saat ini terdapat berbagai metode penyembuhan dari cedera saraf perifer. Namun, berbagai metode tersebut mempunyai keterbatasan yaitu masih dalam kategori lambat. Pada PRP terdapat kandungan Growth Factor yang penting untuk meningkatkan proses regenerasi saraf. Penelitian ini bertujuan untuk melihat peran PRP terhadap regenerasi cedera nervus ischiadicus. Kelompok perlakuan dibagi menjadi hari ke 7 dan hari ke 42. PRP sebanyak 0.2 ml diberikan pada cedera nervus ischiadicus melalui absorbable gelatine sponge. Pengamatan analisis fungsional gaya berjalan dilakukan dengan menghitung nilai SFI, TOA, dan Q1-Q4. Pengamatan gambaran mikroskopis dilakukan untuk melihat diameter akson, densitas akson, diameter akson + mielin, dan ketebalan mielin. Hasil penelitian, nilai SFI kelompok PRP membaik pada hari ke 21 dan 35. Nilai Q1-Q4 pada kelompok PRP memiliki nilai perbaikan sudut mendekati normal yang lebih stabil pada hari ke 7 dibandingkan pada kelompok skiatika tanpa pemberian PRP yang baru mengalami perbaikan pada hari ke 21. Sedangkan pada pengamatan gambaran mikroskopis, kelompok skiatika dengan pemberian PRP memberikan pengaruh terhadap peningkatan diameter akson dengan hasil yang signifikan baik pada hari ke 7 maupun hari ke 42. Oleh karena itu, pemberian PRP pada tikus model skiatika mampu memaksimalkan percepatan fungsi berjalan pada proses regenerasi saraf pasca terjadinya cedera melalui regenerasi akson.

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Currently there are various methods of healing from peripheral nerve injuries. However, these various methods have limitations, namely they are still in the slow category. PRP contains Growth Factor which is important for enhancing the process of nerve regeneration. This study aims to see the role of PRP in the regeneration of injured sciatic nerves. The treatment group was divided into day 7 and day 42. 0.2 ml of PRP was administered to the injured sciatic nerve via an absorbable gelatine sponge. Observation of gait functional analysis was carried out by calculating SFI, TOA, and Q1-Q4 values. Microscopic observation was carried out to see axon diameter, axon density, axon + myelin diameter, and myelin thickness. The results of the study, the PRP group's SFI scores improved on days 21 and 35. The Q1-Q4 values in the PRP group had an angle improvement value close to normal which was more stable on day 7 than in the sciatica group without PRP which only improved on day 21 Whereas in the observation of microscopic images, the sciatica group with PRP administration had an effect on increasing axon diameter with significant results both on day 7 and day 42. Therefore, giving PRP to sciatica model rats was able to maximize the acceleration of walking function in the regeneration process post-injury nerves through axon regeneration."

"In cases of advanced alveolar bone loss frequently associated with periodontal pockets that may not be accessible by conservative therapy, corrective surgery is often indicated as osseous resective and complete debridement therapy. Transplantation of osseous fill material is often necessary, as a surgical intervention may create an alveolar bone defect. In this reported case of surgery, a cortico-cancellous bone graft taken from the mandibular symphysis was transplanted in a mixture with human mineralized bone from the Dr. Soetomo Hospital Surabaya Bone Bank, expecting for osseous regeneration to reduce the bony defect. Six months after surgery the morphology of the reconstructed alveolar process was satisfactory and showing new growth of bone"