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"Osteoporosis has become a worldwide problem and has been known as a silence disease. Nowadays, there are a lot of diagnostic tools for detecting osteoporosis. Eighty eight postmenopausal were included and underwent digital panoramic, digital periapical, and conventional radiography. Ultrasound bone densitometry of os calcis used as gold standard. Correlation between stiffness index (SI) with a digital dental, digital panoramic and conventional dental radiography are 0.170 (p = 0.11), -0382 (p = 0.001) and 0.246 (p = 0.021) respectively. Significant relationship was found between the SI only with digital panoramic and conventional dental. The highest correlation was found between SI values with mandibular Inferior Cortex on digital panoramic (-0.382, Pearson Correlation Tests). Correlation between digital panoramic radiographs and the SI values was the highest of the three radiographic modalities in this study. This indicates that evaluation of cortical bone is more accurate than cancellous bone. Bone quality evaluation in patients at high risk for osteoporosis using panoramic and dental conventional radiograph by dentist, contributes in preventing further occurrence of osteoporosis which in turn could reduce mortality and morbidity of osteoporosis in Indonesia."

"Latar Belakang: Osteoporosis merupakan penyakit tulang sistemik yang ditandai dengan penurunan massa tulang/densitas radiografik tulang dan kerusakan mikroarsi-tektur jaringan tulang. Berbagai indeks radiomorfometrik telah banyak digunakan untuk mengevaluasi tulang pada kasus osteoporosis radiograf panoramik dua dimensi. Analisis Fraktal Dimensi (FD) juga telah digunakan untuk mengidentifikasi struktur pada radio-graf dental dua dimensi. Penelitian ini dilakukan untuk mengevaluasi hubungan peruba-han densitas radiografik tulang rahang terkait BMD dengan menggunakan modalitas pen-citraan tiga dimensi CBCT, yang diwakili pemeriksaan indeks radiomorfometrik (CTCI, CTMI, CTI-S, CTI-I) dan FD value dengan memperhitungkan faktor-faktor risiko yang berpengaruh pada densitas radiografik tulang rahang di antaranya usia, jenis kelamin, jumlah gigi yang tersisa dan ketinggian tulang mandibula. Tujuan: Mengembangkan me-tode deteksi perubahan densitas radiografik tulang rahang pada kasus-kasus kedokteran gigi dengan pemeriksaan CBCT pada individu yang berisiko untuk mendeteksi osteopo-rosis. Metode: Penelitian ini menggunakan data sekunder berupa 87 data set file DICOM CBCT dari pasien lansia dengan rentang usia 50-79 tahun di Klinik Radiologi Kedokteran Gigi RSKGM FKG UI dan Rumah Sakit Pondok Indah Jakarta. Penilaian indeks radio-morfometrik CTCI, jumlah gigi yang tersisa, ketinggian tulang mandibula dilakukan me-lalui panoramik rekonstruksi CBCT dengan slice thickness 30 mm. Pengukuran indeks radiomorfometrik CTMI, CTI-S, CTI-I dan FD value dilakukan pada potongan koronal mandibula di regio foramen mentale terlihat paling jelas dan jarak mesiodistal terlebar. Penilaian FD dilakukan pada dua Region of Interest (ROI) berbentuk persegi berukuran 3x3 mm pada tulang trabekular dan kortikal. Hasil: Indeks radiomorfometrik CTCI, CTMI, CTI-S, CTI-I menunjukkan hubungan yang bermakna secara statistik (p=0.000) dengan FD value ROI tulang kortikal, sementara ROI tulang trabekular tidak menunjuk-kan hubungan yang bermakna. CTCI menunjukkan perbedaan bermakna dengan faktor risiko ketinggian tulang mandibula (p=0.004). CTMI menunjukkan perbedaan bermakna dengan jumlah gigi yang tersisa (p= 0.027) dan ketinggian tulang mandibula (p=0.010). Sementara FD value pada kedua ROI dan faktor risiko usia, jenis kelamin, jumlah gigi yang tersisa serta ketinggian tulang mandibula tidak menunjukkan hubungan yang ber-makna secara statistik. Kesimpulan: Penelitian ini merupakan penelitian pertama meng-gunakan modalitas CBCT yang membandingkan indeks radiomorfometrik melalui pano-ramik rekonstruksi dan analisis FD pada ROI trabekular dan kortikal. Hasil penelitian menunjukkan bahwa pengukuran FD value pada tulang kortikal lebih dapat diandalkan dibandingkan tulang trabekular untuk mendeteksi perubahan densitas radiografik tulang rahang terkait osteoporosis.

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ackground: Osteoporosis is a systemic bone disease characterized by decreased bone mass/radiographic bone density and changes in bone microarchitecture. Various radio-morphometric indices have been widely used to evaluate bone in osteoporosis cases on two-dimensional panoramic radiographs. Fractal Dimension (FD) analysis has also been used to identify structures on two-dimensional dental radiographs. This study was con-ducted to evaluate the relationship of radiographic density changes of the jawbones re-lated to BMD by using a three-dimensional imaging modality CBCT, represented by ra-diomorphometric indices (CTCI, CTMI, CTI-S, CTI-I) and FD value taking into account the risk factors that affect the radiographic density of the jawbone including age, gender, number of remaining teeth and mandibular bone height. Objective: To develop a method for detecting radiographic density changes of the jawbone in dental cases by CBCT ex-amination in individuals at risk for detecting osteoporosis. Methods: This study used sec-ondary data in the form of 87 DICOM CBCT file data sets from elderly patients with an age range of 50-79 years at the RSKGM FKG UI and Pondok Indah Hospital Jakarta. Assessment of the CTCI, number of remaining teeth, and mandibular bone height were performed through CBCT panoramic reconstruction with a slice thickness of 30 mm. The CTMI, CTI-S, CTI-I, and FD values were measured on the coronal section of the mandi-ble in the mental foramen region which was most clearly visible and the widest mesi-odistal distance. FD assessment was carried out in two Regions of Interest (ROI) with a rectangular shape measuring 3x3 mm in trabecular and cortical bone. Results: The radi-omorphometric indices CTCI, CTMI, CTI-S, and CTI-I showed a statistically significant correlation (p=0.000) with the FD value ROI of cortical bone, while the ROI of trabecular bone did not show a significant correlation. CTCI showed a significant difference with risk factors for mandibular bone height (p=0.004). CTMI showed a significant difference in the number of remaining teeth (p=0.027) and mandibular bone height (p=0.010). Mean-while, the FD value for both ROI and risk factors for age, sex, number of remaining teeth, and mandibular bone height did not show a statistically significant correlation. Conclu-sion: This study is the first study using the CBCT modality comparing radiomorphomet-ric indices through panoramic reconstruction and FD analysis on ROI of trabecular and cortical bone. The results showed that measuring the FD value of cortical bone is more reliable than trabecular bone for detecting radiographic density changes of the jawbone associated with osteoporosis"

"This book presents the design of a robust, portable and low-cost PoC sensing system for the early detection of bone loss. The device can measure the level of CTx-I-one of the most sensitive biochemical markers of bone resorption-in serum and transmit the measured value to an IoT-based cloud server. The selectivity of the sensing system to CTx-I has been achieved by coating the sensor with artificial antibodies, prepared by means of molecular imprinting technology. Explaining all aspects of the systems development in detail, the book will be of great interest to all engineers, researchers and scientists whose work involves the development of electrochemical sensors and PoC devices."

"BACKGROUND: MCH book is a tool for early detection for vulnerable gravida. Meanwhile, the utilization of MCH book was still low. The target achieved for early detected was 12% out of 20% from 2011 to 2012. Based on SDKI 2012 duka, the average material mortality rate reached 359 per 100.000 live births, increased significatly from the date of SDKI 2007 which reached 228 per 100.000 live births. METHODS: This study was observational with cross sectional design. Both quatitative and qualitative data were collected. Secondary data were collectied by the availability of MCH book, midwives training, supervisions, and complete fulfillment of MCH book. Populations in Puskesmas Kedudung and Puskesmas Geger Bangkalan district. The samples were midwives with more than oneyear working and graduated from DII (diploma). The complete fulfillment of MCH book was identifiedfrom family identity, delivery preparation, gravida medical record, antenatal medical record, postnatal medical record, KMS (Booklet to Infant Nutritional Status Detection), Neonatus medical record, infact medical record, vitamin A Supplementtary. RESULT: The Complete fulfillments were in Puskesmas Geger 0.66 (category: good 0.51-1.00) and Puskesmas Kedundung 0.35 (category: loww 0.00 -0.50). Midwives' Motivations were low (50.0%) and midwives workload were high (66.7 %) at Puskesmas Geger. Midwives were highly motivatied (66.7%) and their workloads are fair. RECOMENDATION: make group of work and allocate the job desscription properly to assist midwives workload. In addition, helth office of bangkalan should give reward to those who so the work excellently."

"Osteoporosis adalah kelainan umum dengan komponen genetik yang kuat. Osteoporosis dapat terjadi pada wanita pasca menopause dan lansia di atas 70 tahun. Osteoporosis disebabkan oleh penurunan BMD (Bone Mineral Density) pada individu. Penelitian ini bertujuan untuk mengetahui distribusi polimorfisme gen BGLAP pada pasien osteoporosis. BGLAP -298 C > T (rs 1800247), ddH2O, dan MyTaq dicampur pada template DNA (sampel osteoporosis dan non-osteoporosis), kemudian dianalisis menggunakan teknik PCR-RFLP menggunakan HindIII sebagai enzim restriksi dilanjutkan dengan elektroforesis. Kemudian dianalisis menggunakan uji Pearson Chi - Square dan Continuity Correction. Frekuensi alel untuk osteoporosis dan non-osteoporosis dalam penelitian ini adalah 110% untuk h dan 90% untuk H. Prevalensi masing-masing genotipe dalam populasi penelitian adalah 35% hh, 40% Hh, dan 25% HH. Subjek dengan genotipe hh memiliki BMD terbesar dan subjek dengan HH memiliki BMD terkecil. Hasil penelitian menunjukkan bahwa terdapat perbedaan yang signifikan dalam distribusi frekuensi polimorfisme genotipe BGLAP antara osteoporosis dan non-osteoporosis. Kesimpulannya, polimorfisme gen BGLAP dikaitkan dengan penurunan BMD dan merupakan faktor predisposisi osteoporosis.Osteoporosis is a common disorder with a strong genetic component. Osteoporosis can occur in postmenopausal women and the elderly over 70 years. Osteoporosis is caused by a decrease in BMD (Bone Mineral Density) in individuals. This study aims to determine the distribution of BGLAP gene polymorphisms in osteoporosis patients. BGLAP -298 C > T (rs 1800247), ddH2O, and MyTaq were mixed on DNA templates (osteoporosis and non-osteoporosis samples), then analyzed using PCR-RFLP technique using HindIII as a restriction enzyme followed by electrophoresis. Then analyzed using the Pearson Chi - Square test and Continuity Correction. The allele frequencies for osteoporosis and non-osteoporosis in this study were 110% for h and 90% for H. The prevalence of each genotype in the study population was 35% hh, 40% hh, and 25% hh. Subjects with the hh genotype had the largest BMD and subjects with HH had the smallest BMD. The results showed that there was a significant difference in the frequency distribution of BGLAP genotype polymorphisms between osteoporosis and non-osteoporosis. In conclusion, BGLAP gene polymorphism is associated with decreased BMD and is a predisposing factor for osteoporosis."

"Latar Belakang: Berkembangnya populasi lansia secara global termasuk di Indonesia tidak diikuti dengan kualitas hidup yang baik, yang salah satu penyebabnya adalah penyakit. Osteoporosis adalah salah satu penyakit dengan usia lanjut sebagai faktor risikonya. Deteksi awal osteoporosis antara lain dapat dilakukan melalui pengukuran tebal tulang kortikal mandibula pada radiograf panoramik.Tujuan: Mencari nilai rata-rata lebar/tebalnya tulang kortikal mandibula pada individu yang berisiko mengalami osteoporosis dengan rentang usia 40-80 tahun tanpa membedakan wanita dan pria.Metode: Sampel penelitian adalah radiograf panoramik yang berjumlah 89 dengan usia 40-80 tahun. Pengukuran tebal tulang kortikal mandibula dilakukan pada regio sekitar foramen mental kiri dan kanan.Hasil: Nilai rata-rata tebal tulang kortikal mandibula 4,80618 mm pada populasi kelompok usia 40-80 tahun dengan kecenderungan lebih tebal pada kelompok usia 40-59 tahun dibandingkan pada kelompok usia 60- 80 tahun.Kesimpulan: Nilai rata-rata tebal tulang kortikal mandibula pada kelompok usia 40-80 tahun pada penelitian ini masih tergolong normal.

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Background: The increasing number of elderly population in the world, which including Indonesia, is not followed by enhanced quality of life of the elderly that partly caused by with one of the reason is diseases. Osteoporosis is one of the diseases with age as its risk factor. Panoramic radiographs can be used as early detection of osteoporosis, which one of the methods is measuring mandibular cortical bone thickness.Objective: To obtain the average width / thickness of the mandibular cortical bone in individuals at risk of osteoporosis with age ranged 40- 80 years without differentiating women and men.Methods: The research sample is panoramic radiographs. The study subjects were 89 people aged 40-80 years. Measurements of cortical bone thickness done in the left and right foramen mental region.Results: Average width/thickness of the mandibular cortical bone in individuals at risk of osteoporosis with age range 40-80 years is 4,80618 mm. There is a tendency of thicker mandibular cortical bone in age ranged 40-59 years population than in age ranged 60-80 years population.Conclusion: In this study, the average thickness / width of the mandibular cortical bone in the age group 40- 80 years were within the normal range."

"Objectives: Osteoporosis is condition where the bone becoming brittled and easily cracked or broken because of calcium deficiency. Osteoporosis can be diagnosed by Bone Mineral Density (BMD) test to know the decrease of their bone density. The objective of this study is to determine the correlation between calcium blood level and osteoporosis at Rumah Sakit Ibu dan Anak Jakarta Islamic Hospital Al-Fauzan in period of January 2012 – December 2014. Materials and Method: This type of research was analytical descriptive study by using cross-sectional design. The population of this study were 68 patients who had osteoporosis at Rumah Sakit Ibu dan Anak Al-Fauzan in period of January 2012 – December 2014 and with the proportion of 20% of samples taken in 61 patients. Results: The highest frequency distribution: age 61-70 years at 62,2%, female at 96,7%, and underweight Body Mass Index 57,4%. Conclusion: This study was using Chi Square test showed there is no correlation between calcium blood level and osteoporosis (p = 0,054)"

"Penelitian ini dilakukan untuk mengetahui nilai rata-rata penurunan tinggi puncak tulang alveolar pada kelompok usia berisiko osteoporosis. Jarak tulang alveolar ke CEJ masing-masing gigi pada bagian mesial dan distal diukur pada gigi 36 atau 46 dari empat puluh lembar radiograf periapikal menggunakan penggaris (mm). Nilai rata-rata penurunan tinggi puncak tulang alveolar pada kelompok usia berisiko osteoporosis sebesar 3.50 ± 1.085 dengan nilai pada prelansia sebesar 3.15 ± 0.864 dan lansia sebesar 3.90 ± 1.156. Terdapat kecenderungan nilai rata- rata penurunan tinggi puncak tulang alveolar pada lansia lebih tinggi dibandingkan dengan prelansia.

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This study is held to provide database of decreased alveolar bone crest height in risk ages of osteoporosis. The distance from alveolar bone crest to the CEJ for each tooth on mesial and distal side measured on 36 or 46 from forty periapical radiographs using ruler (mm). The average value of decreased alveolar bone crest height in risk ages of osteoporosis is 3.50 ± 1.085 which is 3.15 ± 0.864 in people age of 45-59 year old and 3.90 ± 1.156 in people age of 60-75 year old. Average value of decreased alveolar bone crest height in people age of 60-75 year old is higher than people age of 45-59 year old."

"Background: MiR-21 is known to play a role in osteoclast proliferation and differentiation, but the role of serum miR-21 expression in osteoporosis remains unclear. Previous research found that serum miR-21 expression was positively correlated with bone mineral density in postmenopausal osteoporosis patients, but other factors involved in postmenopausal osteoporosis still unknown. This study aimed to determine the role of serum miR-21 expression, concentration of RANKL, OPG, TGF-β1, sclerostin and serum calcium, RANKL/OPG ratio, and physical activity on bone mineral density of spine in hypoestrogenic postmenopausal women with osteoporosis (PMOP) compared with no osteoporosis (PMNOP), with point of interest on the expression of serum miR-21. Methods: this study was conducted by comparative cross-sectional design. The subjects were divided into 2 groups of PMOP and PMNOP. We used an absolute quantification real-time PCR method to determine serum miR-21 expressions level. Results: Median of serum miR-21 expression at the PMOP group was significantly higher compared to PMNOP group (p = 0,001). Serum miR-21 expression, RANKL, RANKL/OPG ratio, and physical activity were significantly correlated with BMD values in the PMOP group. Moderate physical activity was significantly negatively correlated with serum miR-21 expression. We also obtained a linear regression equation BMD = 1,373-0,085*Ln.miR-21-0,176*Log10.RANKL (R2 = 52,5%). Conclusion: serum miR-21 expression in PMOP was higher compared with PMNOP. Serum miR-21 expression proved to have a negative effect on spinal BMD values in hypoestrogenic postmenopausal women with osteoporosis of 8,5%. Obtained equation of BMD = 1,373-0,085*Ln.miR-21-0,176*Log10.RANKL can explain the value of spinal BMD by 52,5%.

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Latar belakang: MiR-21 telah diketahui memainkan peranan dalam proliferasi dan diferensiasi osteoklas, tetapi peran ekspresi miR-21 dalam serum terhadap osteoporosis masih belum jelas. Penelitian sebelumnya menemukan bahwa ekspresi miR-21 dalam serum berkorelasi positif dengan kepadatan mineral tulang pasien osteoporosis pascamenopasue, tetapi faktor-faktor lain yang terlibat dalam osteoporosis pascamenopause masih belum diketahui. Penelitian ini bertujuan menentukan peran ekspresi miR-21 dalam serum, kadar RANKL, OPG, TGF-β1, sklerostin dan kalsium dalam serum, rasio RANKL/OPG dan aktivitas fisik terhadap kepadatan mineral tulang di tulang belakang pada wanita pascamenopause hipoestrogenik dengan osteoporosis / postmenopausal women with osteoporosis (PMOP) dibandingkan tanpa osteoporosis (PMNOP) dengan titik berat pada ekspresi miR-21 dalam serum.

Metode: penelitian ini dilaksanakan dengan desain potong lintang komparatif. Subjek penelitian dibagi menjadi dua kelompok, yaitu PMOP dan PMNOP. Metode kuantifikasi absolut dengan real-time PCR digunakan untuk menentukan kadar ekspresi miR-21 dalam serum.

Hasil: nilai median ekspresi miR-21 dalam serum pada kelompok PMOP lebih tinggi secara bermakna dibandingkan dengan kelompok PMNOP (p=0,001). Ekspresi miR-21 dalam serum, RANKL, rasio RANKL/OPG dan aktivitas fisik secara bermakna berkorelasi dengan nilai kepadatan mineral tulang/bone mineral density (BMD) pada kelompok PMOP. Aktivitas fisik sedang berkorelasi negatif secara bermakna dengan ekspresi miR-21 dalam serum. Kami juga mendapatkan persamaan regresi linear BMD=1,373-0,085*Ln.miR-21-0,176*Log10.RANKL (R2=52,5%).

Kesimpulan: Ekspresi miR-21 dalam serum pada PMOP lebih tinggi dibandingkan dengan PMNOP. Ekspresi miR-21 dalam serum terbukti mempunyai efek negatif terhadap nilai kepadatan mineral tulang di tulang belakang (spinal BMD) pada wanita pascamenopause hipoestrogenik dengan tingkat osteoporosis sebesar 8,5%. Persamaan yang didapatkan, yaitu

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