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"Latar belakang: Skeling dan penghalusan akar (SPA) dapat mengubah komposisi bakteri patogen. Tujuan: Mengetahui efek klinis dan mikrobiologis (P. gingivalis, T. forsythia) setelah SPA pada periodontitis kronis poket 4-6 mm. Metode: Empat puluh tiga subjek diperiksa kedalaman poket, indeks pendarahan gingiva, sampel plak subgingiva, serta dilakukan SPA pada kunjungan awal, bulan kedua, ketiga, keenam. Hasil: Kedalaman poket, pendarahan gingiva, populasi P. gingivalis, T. forsythia menurun (p<0,05). Penurunan kedalaman poket tidak berhubungan dengan penurunan populasi P.g (p>0,05). Kesimpulan: SPA meningkatkan kondisi klinis dan mikrobiologis poket 4-6 mm. Perbaikan kondisi klinis berhubungan dengan penurunan kedua bakteri kecuali kedalaman poket dengan populasi P.gingivalis.

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Background: Scaling and root planing (SRP) can change the composition of bacterial pathogens.

Objective: To know the clinical and microbiological effects (P.gingivalis and T. forsythia) of SRP at 4-6 mm pocket depth of chronic periodontitis.

Method: Forty-three subject were performed with SRP on the initial visit, two, three, six month. Pocket depth, gingival bleeding index (PBI) and subgingival plaque samples were examined.

Result: (There is a) decrease in pocket depth, gingival bleeding index, populations of P. gingivalis and T. forsythia (p <0.05). The decrease in pocket depth was not associated with a decrease in the population of P.g (p >0.05).

Conclusion: SRP can improve clinical and microbiological condition in the treatment of chronic periodontitis with 4-6 mm pocket depth. The improvement of clinical condition is associated with the decreasing of bacteria population, except pocket depth is not associated with the P. gingivalis population."

"Aplikasi Subgingiva antimikroba setelah Skeling dan Penghalusan Akar SPA mampu membunuh bakteri anaerob yang tersisa Penelitian ini bertujuan menganalisis efek klinis aplikasi subgingiva H2O2 3 setelah SPA pada periodontitis kronis poket le 6 mm 45 subjek periodontitis kronis poket le 6 mm diskor plak skor perdarahan kedalaman poket kehilangan perlekatan Satu sisi rahang diaplikasi subgingiva H2O2 3 dan kontrol pada kontralateral dievaluasi 4 minggu setelahnya Aplikasi subgingiva H2O2 3 secara statistik terbukti menurunkan skor perdarahan kedalaman poket kehilangan perlekatan pre dan post perawatan serta antar kedua kelompok periodontitis kronis poket le 6 mm Kata kunci Skor Perdarahan Poket Periodontal Kehilangan Perlekatan SPA Aplikasi subgingiva

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Subgingival application with 3 H2O2 after scaling and root planing SRP is assumed to be kill the bacteria left behind after mechanical debridement The aim of this study was to analyze the clinical effects of subgingival application 3 H2O2 after SRP in the treatment of chronic periodontitis pocket depth le 6 mm Forty five patients chronic periodontitis pocket depth le 6 mm were scaled and root planed prior to baseline measurement BOP PPD CAL and evaluated on weeks 4 Subgingival application with 3 H2O2 produced a significant reduction in BOP PPD and CAL compared to the control Key words Gingival bleeding on probing probing pocket depth clinical attachment loss scaling and root planing subgingival application 3 H2O2 "

"Latar Belakang: Periodontitis kronis mempunyai prevalensi yang sangat tinggi. Baru-baru ini, ada tipe baru fototerapi non bedah untuk mengeliminasi bakteri dinamakan terapi fotodinamik. Tujuan: Menganalisis efek terapi fotodinamik setelah SPA pada periodontitis kronis. Metode: Desain split-mouth menerima SPA dengan atau tanpa terapi fotodinamik. BOP, kedalaman poket, dan kehilangan perlekatan diperiksa pada awal dan 1 bulan. Hasil: Terjadi penurunan kedalaman poket dan peningkatan perlekatan, yang lebih besar dibandingkan sisi kontrol (p<0,05). Pada BOP terjadi penurunan hampir sama dengan sisi kontrol. Kesimpulan: Tindakan SPA + terapi fotodinamik dibandingkan SPA saja terbukti menyebabkan perubahan efek klinis yang lebih baik pada penurunan kedalaman poket periodontal dan meningkatkan perlekatan gingiva.

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Background: Chronic periodontitis has a very high prevalency. Recently, there is a new type of non-surgical phototherapy to eliminate bacteria called photodynamic therapy.

Aim: Analyzing the effects of photodynamic therapy after SPA in chronic periodontitis.

Methods: split-mouth design receives SPA with or without photodynamic therapy. BOP, pocket depth, and attachment loss examined at baseline and 1 month.

Results: There was a decrease in pocket depth and increasing clinical attachment, which is greater than the controls (p <0.05). In BOP decreased nearly equal to the control side.

Conclusions: Measures SPA + photodynamic therapy have better clinical effect on periodontal reduction pocket depth and increased gingival attachment."

"Chronic adult periodontitis (CAP) is the most common type of periodontal disease. Treatment of moderate CAP has primarily been directed at the physical removal of bacterial plaque, calculus and contaminated cementum by scaling and root planing (SRP) with or without surgical access. Irrigation solutions reach the apical portion of the pocket has flushing action properties and easy to apply. Tetracyline HCI (TTC HCI) solutions demonstrated its antimicrobial activity against subgingival microflora, shown to be substantive to dentin surface and subsequently released in active form, also has anti-collagenase properties. This study evaluates the clinical outcomes of treatment with locally TTC HCI 10% irrigation as an adjunct to SRP in subset of moderate CAP patients. The data examined were obtained from 24 patients. All patient were scaled and root planed prior to baseline measurement. The patients were monitored by parameters : bleeding on probing (BOP), probing pocket depth (PPD), and attachment loss (LA). 56 contralateral surface exhibiting residual pocket depths 4-6 mm were randomly assigned as test or control sites. After baseline measurement, each subgingival root surface was irrigated with approximately 10ml for 1 minute either with TTC HCI 10% solution (test), or Aquabides solution (control). The clinical parameters were assessed at baseline and weeks 3. The two sites resulted in significant statistical and clinical improvement in all parameters. BOP was not significantly reduced in test site compared to control site. PPD and I.A was significantly reduced at test site compared to control site. The result indicate that subgingival irrigation with TTC HCI 10% solution 10 ml for 1 minute may have a role in the management of moderate CAP. This treatment reduces surgical needs."

"Latar Belakang: Periodontitis kronis adalah penyakit multifaktorial yang dipengaruhi oleh plak bakteri dan respon inflamasi tubuh dengan matriks metalloproteinase sebagai salah satu molekul inflamasi yang ditemukan meningkat pada penyakit periodontal. Skeling dan penghalusan akar (SPA) telah umum digunakan sebagai pengobatan konvensional atau non-bedah dalam terapi periodontal. Tujuan: Untuk mengevaluasi ekspresi m-RNA matriks metalloproteinase-9 (MMP-9), jumlah Tannerella forsythia (T. forsythia), dan parameter klinis periodontal satu bulan setelah SPA. Metode: Lima puluh gigi dengan poket 4-6 mm dari enam pasien periodontitis kronis dan satu subjek periodontal sehat disertakan dalam penelitian ini. Data penelitian cairan sulkus gingiva diambil dari poket terdalam setiap gigi dengan poket periodontal 4-6 mm untuk mengukur tingkat ekspresi m-RNA MMP-9 dan T.forsythia menggunakan quantitative real time-PCR (qPCR). Kedalaman poket, indeks perdarahan gingiva, dan kehilangan perlekatan klinis diukur pada hari pertama sebagai baseline dan pada hari ke 30. SPA dilakukan pada hari ke-1. Data dianalisis menggunakan program perangkat lunak SPSS 22.0. Hasil: Dibandingkan dengan kontrol, parameter klinis periodontal dan T.forsythia secara signifikan berkurang sementara pengurangan ekspresi m-RNA ­MMP-9 ditemukan tidak signifikan pada hari ke-30 setelah SPA. Kesimpulan: Satu bulan setelah SPA pada periodontitis kronis dengan poket 4-6 mm didapatkan penurunan jumlah T.forsythia dan parameter klinis periodontal secara signifikan dengan ekspresi m-RNA MMP-9 menurun tidak signifikan. Penelitian lebih lanjut dengan periode pengamatan lebih lama diperlukan untuk mengkonfirmasi atau menolak temuan di atas.

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Background: Chronic periodontitis is a multifactorial disease influenced by both bacterial plaque and host inflammatory response with matrix metalloproteinase as one of inflammatory molecules found elevated in periodontal disease. Scaling and root planning (SRP) has been commonly used as conventional or non-surgery treatment in periodontal therapy. Aim: To evaluate m-RNA expression of matrix metalloproteinase-9 (MMP-9), Tannerella forsythia (T. forsythia), and clinical periodontal parameter one month after SRP. Methods: Fifty tooth with pocket 4-6 mm from six CP patients and one periodontally healthy subject was recuited in this study. Gingival crevicular fluid (GCF) were collected from deepest pocket of every tooth with pocket 4-6 mm, the expression level of MMP-9 m-RNA and T.forsythia was measured using quantitative real time-PCR(qPCR). Pocket depth (PD), papilla bleeding index (PBI), and clinical attachment loss (CAL) were measured on day 1 as baseline and on the 30th day. SRP were performed on day 1. Data were analyzed using SPSS 22.0 software program. Results: By comparing to control, the periodontal clinical parameters and T.forsythia were significantly reduced after SRP while the reduction of MMP-9 m-RNA expression was found no significantly after 30th day. Conclusion: Our study show that SRP was clinically effective for CP with 4-6 mm pocket although the expression of MMP-9 m-RNA was not significantly reduced following SRP for one month period. Further studies with longer observation period are needed to confirm or reject the above finding."

"Latar Belakang: Eliminasi Porphyromonas gingivalis (Pg) dan Treponema denticola (Td), dengan skeling dan penghalusan akar (SPA) meningkatkan densitas tulang alveolar. Tujuan: Analisis densitas tulang alveolar serta jumlah bakteri Pg dan Td sebelum dan sesudah SPA pada kasus periodontitis kronis. Metode: Empat puluh subjek menyetujui informed consent, dilakukan pemeriksaan klinis, radiografis densitas tulang alveolar, penghitungan jumlah Pg dan Td dengan RT-PCR. Hasil: Perbedaan bermakna jumlah bakteri Pg, Td, serta densitas tulang antara sebelum dan sesudah SPA (p<0,05); Hubungan bermakna antara jumlah bakteri Pg dan Td dengan densitas radiografis (p<0,05). Kesimpulan: SPA menurunkan jumlah bakteri Pg, Td, dan meningkatkandensitas radiografis tulang alveolar.

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Background: Elimination of Porphyromonas gingivalis (Pg) and Treponema denticola (Td) with scaling and root planing (SRP) can increase the radiographic alveolar bone density.

Objective: To analyze radiographic bone density, amount of Pg and Td before and after SRP.

Methods: Fourty subjects fill the informed consent, clinical examination, radiographic examination for bone density, count of Pg and Td using RT-PCR.

Result: Significant differences between radiographic bone density, amount of Pg and Td before and after SRP. Significant association between amount of Pg and Td and bone radiographic density.

Conclusion: Scaling and root planing decrease the amount of Pg and Td and increase radiographic bone density."

"Osteonectin adalah glikoprotein matricellular yang terlibat dalam berbagai proses biologis seperti remodeling jaringan, perbaikan luka, angiogenesis serta diferensiasi seluler, adhesi, proliferasi sel endotel dan fibroblas serta migrasi. Tujuan: mengevaluasi ekspresi mRNA osteonectin sebagai indikator potensial penyembuhan setelah skeling dan penghalusan akar pada pasien periodontitis. Pemeriksaan kedalaman poket dan indeks perdarahan gingiva dilakukan sebelum dan empat minggu setelah skeling dan penghalusan akar. Sampel cairan krevikuler gingiva dikumpulkan dari lima pasien sehat (kontrol) dan 14 pasien periodontitis dengan kedalaman poket absolut 4-6 mm (subjek penelitian) pada sebelum, satu minggu, dua minggu dan empat minggu setelah skeling dan penghalusan akar. Ekspresi mRNA osteonectin dianalisis menggunakan quantitative real-time polymerase chain reaction (qPCR). Uji Friedman ekspresi mRNA osteonectin antara sebelum dan sesudah skeling dan penghalusan akar menunjukkan terdapat perbedaan ekspresi mRNA osteonectin antara sebelum dan satu minggu setelah skeling dan penghalusan akar (p<0,05); penurunan kedalaman poket dan indeks perdarahan gingiva terjadi secara bermakna (p<0,05) antara sebelum dan empat minggu setelah skeling dan penghalusan akar. Uji Spearman menunjukkan tidak ada hubungan antara ekspresi mRNA osteonectin dengan kedalaman poket (p>0,05, r=0,036) maupun indeks perdarahan gingiva (p>0,05, r=0,421). Ekspresi mRNA osteonectin sebelum dan setelah skeling dan penghalusan akar tidak berhubungan terhadap kedalaman poket maupun indek perdarahan gingiva.

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Osteonectin is a matricellular glycoprotein that is involved in various biological processes involves tissue remodeling, wound repair, angiogenesis, cellular differentiation, adhesion, endothelial cell proliferation and migration. Objective: to evaluate the expression of osteonection mRNA as potential indicator of periodontal healing response after scaling and root planing (SRP) in periodontitis patients. Gingival crevicular fluid (GCF) samples were collected from five periodontally healthy subjects and fourteen periodontitis patients with probing pocket depth (PPDs) of 4-6 mm at baseline and one, two, and four weeks respectively after SRP. The expression levels of osteonectin mRNA were measured using quantitative real-time polymerase chain reaction (qPCR). The Friedman test results of osteonectin mRNA expression between before and after SRP showed there were differences in osteonectin mRNA expression between before and one week after SRP (p< 0.05). A decrease in PPDs and Papillar bleeding index (PBI) occured significantly (p<0.05) between before and four weeks after SRP. The Spearman test showed no association between osteonectin mRNA expression and pocket depth (p>0.05; r=0.036), also with gingival index (p>0.05; r=0.421). The expression of osteonectin mRNA before and after SRP is no related to PPD and PBI."

"Latar Belakang: Minosiklin merupakan antibiotik dengan sifat bakteriostatik yang potensial mengeliminasi bakteri patogen periodontal. Kesembuhan perawatan periodontitis kronis umumnya ditunjukkan secara klinis dan mikrobiologis. Tujuan: Menganalisis parameter klinis (penurunan kedalaman poket dan indeks perdarahan gingiva, peningkatan perlekatan klinis) dan jumlah T. forsythia sebelum dan sesudah aplikasi gel Minosiklin HCl 2%. Metode: Empat puluh dua subjek menerima aplikasi gel Minosiklin HCl 2% sebanyak empat kali, kemudian dievaluasi parameter klinis dan T. forsythia dengan Real-Time Polymerase Chain Reaction (RT-PCR). Hasil: Terdapat perbedaan bermakna dari parameter klinis dan T. forsythia antara pemeriksaan awal dan kontrol bulan ke-6 (p<0,05). Terdapat perbedaan bermakna antara hubungan penurunan indeks perdarahan gingiva dengan jumlah T. forsythia (p<0,05). Kesimpulan: Aplikasi gel Minosiklin HCl 2% secara klinis dan mikrobiologis efektif dalam perawatan periodontitis kronis.

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Background: Minocycline is known as one of the antibiotics with great bacteriostatic effect to eliminate periodontal pathogen. Healthier periodontal environment is usually shown with better clinical and microbiological response.

Objective: To clinically and microbiologically (T. forsythia) analyze the effect of Minocycline HCl 2% for treatment of chronic periodontitis within six months.

Methods: Forty-two subjects applied with Minocyline HCl 2% for four times. Clinical and microbiological examinations were evaluated on baseline, month-2, month-3, and month-6. T. forsythia was examined with Real-Time Polymerase Chain Reaction (RT-PCR) techniques.

Result: There were significant differences between Probing Pocket Depth, Papilla Bleeding Index, Clinical Attachment Level, and amount of T. forsythia in baseline compare to six months period (p<0.05). There was an association between the amount of T. forsythia and Papilla Bleeding Index (p<0.05).

Conclusion: Minocycline HCl 2% was effective clinically and microbiologically in chronic periodontitis therapy."

"Latar Belakang: Poket periodontal merupakan karakteristik periodontitis. Scaling dan root planing merupakan standar emas untuk perawatan periodontitis. Antimikroba lokal tambahan direkomendasikan pada pasien dengan kedalaman probing ≥5 mm. Tujuan: Untuk mengetahui efektivitas klorheksidin dibandingkan dengan antimikroba lokal lainnya pada periodontitis. Metode: Pencarian dilakukan dengan menggunakan panduan Preferred Reporting Items for Systematic Review and Meta Analysis (PRISMA). Meta-analisis dilakukan pada studi yang memenuhi kriteria inklusi setelah penilaian risiko bias. Hasil: Meta-analisis antara chip klorheksidin dan antimikroba lain menunjukkan perbedaan rata-rata kedalaman probing setelah satu bulan sebesar 0,58 mm (p<0,00001) sedangkan setelah tiga bulan perbedaan rata-rata kedalaman probing adalah 0,50 mm (p=0,001), indeks plak 0,01 (p=0,94) dan indeks gingiva -0,11 mm (p=0,02). Antara gel chlorhexidine dan antimikroba lainnya menunjukkan perbedaan rata-rata kedalaman probing 0,40 mm (p=0,30), indeks plak 0,20 mm (p=0,0008) dan indeks gingiva -0,04 mm (p=0,83) setelah satu bulan. Kesimpulan: Chip klorheksidin lebih efektif pada indeks gingiva dibandingkan antimikroba lainnya setelah tiga bulan. Antimikroba lainnya lebih efektif daripada chip klorheksidin pada kedalaman probing setelah satu dan tiga bulan, dan dari gel klorheksidin pada indeks plak setelah satu bulan.

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Background: Periodontal pockets are characteristic of periodontitis. Scaling and root planing is the gold standard for periodontitis treatment. Additional local antimicrobials are recommended in patients with a probing depth of ≥5 mm.

Objective: To determine the effectiveness of chlorhexidine compared to other local antimicrobials in periodontitis.

Method: Searches were conducted using the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines. Meta-analysis was performed on studies that met inclusion criteria after risk of bias assessment.

Results: Meta-analysis between chlorhexidine chips and other antimicrobials showed a mean difference in probing depth after one month of 0.58 mm (p<0.00001) whereas after three months the mean difference in probing depth was 0.50 mm (p=0.001), index plaque 0.01 (p=0.94) and gingival index -0.11 mm (p=0.02). Between chlorhexidine gel and other antimicrobials showed a mean difference in probing depth of 0.40 mm (p=0.30), plaque index of 0.20 mm (p=0.0008) and gingival index of -0.04 mm (p=0.83) after one month.

Conclusion: Chlorhexidine chips were more effective on the gingival index than other antimicrobials after three months. The other antimicrobials were more effective than chlorhexidine chips on probing depth after one and three months, and than chlorhexidine gels on plaque index after one month."

"Osteopontin merupakan salah satu sitokin yang banyak dihubungkan dengan proses resorpsi tulang, namun perannya di dalam proses penyembuhan periodontal masih didapatkan hasil yang berbeda-beda sedangkan Tumor Necrosis Factor-α (TNF-α)merupakan sitokin pro-inflamasi yang berperandalam inflamasi kronis dan proses resorpsi tulang. Penelitian ini bertujuan menganalisis perbedaan tingkat ekspresi Osteopontin dan TNF-αpada pasien periodontitis sebelum terapi dengan setelah terapi skeling dan penghalusan akar (diukur setelah 7 hari, 14 hari, dan 28 hari). Tingkat ekspresi Osteopontin dan TNF-αdalam cairan krevikuler gingiva (CKG)dari 28 subjek penderita periodontitis berusia ≥ 30 tahun dan dari 8 subjek sehat diukur dengan menggunakan qPCR. Dilakukan juga uji korelasi Spearmanantara tingkat ekspresi Osteopontin dan TNF-αdalam CKG dengan pemeriksaan klinis berupa modified gingival index (MGI).Uji Wilcoxontingkat ekspresi Osteopontin dan TNF-αdalam CKG pada pasien periodontitis sebelum dan setelah 28 hari terapi skeling dan penghalusan akar menunjukkan perbedaan bermakna (p < 0,05). Uji korelasi Spearmanmenunjukkan korelasi positif lemah antara tingkat ekspresi OPNdengan skor MGI(r=0,213;p<0,05) dan antara tingkatekspresi TNF-αdengan skor MGI(r=0,256;p<0,05). Penelitian ini menyimpulkan bahwa terdapat perbedaan tingkat ekspresi Osteopontin dan TNF-αpada subjekperiodontitis antara sebelum terapi dengan 28 hari setelahterapi skeling dan penghalusan akar gigi. Adakorelasi positif antara tingkat ekspresi OPNdengan MGIdan tingkat ekspresi TNF-αdengan MGI.

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Osteopontin is one of many cytokines that is often associated with bone resorption process, but the role in the periodontal healing is still not clear accordingto some studies presenting different results, while Tumor Necrosis Factor-α (TNF-α) is a well-known pro-inflammatory cytokine which stimulates bone resorption. The objective of this study was to analyze different Osteopontin and TNF-α expression level on patients with periodontitis before (baseline) and 7 days, 14 days, 28 days following scaling and root planing. Osteopontin and TNF-α level on gingival crevicular fluid (GCF) from 28 subjects with periodontitis aged ≥ 30years old and 8 healthy patients (control subjects)were measured by qPCR. Spearman correlation test between GCF Osteopontin and TNF-α level and modified gingival index (MGI) was also done. Wilcoxon test between Osteopontin and TNF-α level before scaling and root planing and 28 days after scaling and root planing showed a significant difference (p < 0.05). Spearman correlation test between TNF-α level on GCF and MGI showed a positive correlation (r=0.256; p<0.05). Conclusions of this study was a significant difference of OPN and TNF-αexpression level between baseline and 28 days after scaling and root planing in periodontitis subjects and a positive correlation between GCF OPN level and MGI and also between TNF-α expression level and MGI."