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"Host modulation, includes inhibition of matrix metalloproteinases, blocking production of proinflammatory cytokines and inhibition of osteoclastic activity, has therapeutic value as adjunctive therapy in treating chronic periodontitis. This case series presented three patients with chief complaint of teeth mobility where endo perio involvement was diagnosed. The endo perio combined lesions generally shows the communication between pulp and periodontal tissues with the same origin of dental infection. Diagnosis in such cases is difficult and generally raising problem in the management. All of the cases were managed by non surgical endodontic therapy combined with host modulation. All local factors causing the lesion were removed. Clinical outcome after six and nine months were quite satisfactory. Combined endo perio cases are challenging to the dentists and involve multidisciplinary involvement. To manage such cases, dentists have to rely on the unconventional techniques."

"The correlation between endodontic-periodontal lesion has been documented well by researches. Endodontic lesion originates from pulp, while periodontal lesion originates from periodontal tissues. Anatomically they are connected by apical foramen, lateral canal and accesories, as well as dentin tubules. The correlation appeared as the endodontic defect can be from periodontal lesion, or a periodontal defect is from a pulp tissue. Together they can emerge and form a combination lesion. Endodontic infections have been highly correlated with deeper periodontal pockets and furcation involvement in mandibular, the causal relationship between the two pathoses has not yet been established. This consensus supports the influence of degenerated or inflamed pulp that can happen on the periodintium; but not all researchers agree about the effect of periodontal disease on the pulp. Conclusion: The mechanism of endo-perio lesion need to taken care in order to have appropriate diagnostic so that the right therapy would be able to keep the teeth in the oral cavity."

"By means of a double-chamber model, different root canal filling materials and procedures were compared. Briefly, the root canals of single-rooted human teeth, extracted for periodontal reasons, were instrumented and obturated by gutta-percha/Pulp Canal Sealer EWT (PCS) or by Resilon, in association with different sealers (Real Seal, RelyX Unicem or Meta). Obturation was achieved by traditional continuous wave of condensation technique (TCWCT), a modified version of it (MCWCT), or single cone technique (SCT). The obturated roots, inserted in a double-chamber model, were sterilized by gamma irradiation. Next, Enterococcus faecalis was added to the upper chamber and the specimens were incubated at 37°C for up to 120 days: the development of turbidity in the lower chambers' broths indicated bacterial leakage through the obturated root canals. The kinetics of leakage were analyzed in different groups by means of Kaplan-Meier statistics and compared by log-rank test. The results showed that root canals obturated with either gutta-percha/PCS using the MCWCT, Resilon/Real Seal SCT or Resilon/RelyX Unicem using the TCWCT displayed significantly better performance than the remaining groups (p < 0.01). Histological evaluation, performed to investigate microbial localization inside specimens, confirmed that this parameter varied according to the obturation procedures and materials employed. This ex vivo study indicates that gutta-percha/PCS, if used with the MCWCT, is as effective as Resilon when coupled to Real Seal with the SCT or, interestingly, to RelyX Unicem with the TCWCT. These data suggest that further improvement of the currently employed root canal filling procedures is achievable, depending on booth the filling materials and the technique employed, thus encouraging clinical studies in this direction."

"Endodontic glide path is the creation of a smooth patency from canal orifice to apex, which can be performed manually or with small tapered NiTi rotary instruments. The use of stainless steel (SS) hand K-files inserted in a reciprocating handpiece can be a possible alternative to create a mechanical glide path. The aim of this study was to compare the cyclic fatigue resistance between SS K-files used in a reciprocating motion and NiTi rotary instruments in artificial curved canals. Ten SS size 15 K-files used with the M4 handpiece (SybronEndo, Glendora, CA, USA) and ten PathFiles (Maillefer-Dentsply, Ballaigues, CH, Switzerland) NiTi rotary instruments size 16, 0.02 taper were tested for resistance to cyclic fatigue. The time to fracture inside an artificial curved canal was recorded for each instrument. Data were analyzed by one-way ANOVA and Tukey HSD test. Mean time (and SD) to failure was 464 s (±40.4) for the Group PF (NiTi rotary PathFile), and 1049 s (±24.8) for the Group M4 (SS K-files reciprocating) with a statistically significant difference between the two groups (p = 0.033). The SS 15 K-files used with the M4 handpiece showed a significant greater resistance to cyclic fatigue when compared to the NiTi rotary PathFiles. Therefore, the use of small size SS files in a reciprocating motion might be a rational choice for the creation of a mechanical endodontic glide path in curved root canals."

"Kasus implan sederhana dalam bidang kedokteran gigi umum. Implan kedokteran gigi telah menjadi bidang yang berkembang cepat dan dinamis dalam praktek sehari-hari. Hal ini diakui sebagai modalitas perawatan yang dapat diprediksi dengan tingkat keberhasilan klinis yang tinggi. Gigi tiruan cekat konvensional tidak lagi dianggap sebagai pilihan perawatan utama untuk menggantikan gigi yang hilang. Meskipun jumlah pasien yang meminta perawatan implan meningkat, namun dokter gigi yang menawarkan perawatan implan dalam praktek sehari-hari masih terbatas. International Team for Implantology (ITI) atau tim implantologi internasional mendeskripsikan kasus straightforward segai kasus sederhana. Dinyatakan bahwa penempatan implan dilakukan pada jaringan lunak dan keras yang memadai, dan restorasi gigi tunggal di zona non-estetika. Tinjauan pustaka saat ini banyak membahas tentang penerapan implan kedokteran gigi di perguruan tinggi seluruh dunia dan dimasukkan ke dalam kurikulum mereka untuk program sarjana maupun pascasarjana dalam bidang kedokteran gigi umum. Konsensus Eropa tentang pendidikan implan kedokteran gigi menyimpulkan bahwa sebaiknya pendidikan teknik bedah untuk penempatan implan kasus straightforward disertakan ke dalam kurikulum. Berbagai tingkat dan keterbatasan implan kedokteran gigi dan keterampilan terkait harus diajarkan dan ditentukan oleh para staf pengajar. Malah ini bertujuan untuk meningkatkan kesadaran para praktisi kedokteran gigi dan lembaga terkait di Indonesia terhadap pergeseran paradigma perawatan dalam penatalaksanaan kehilangan gigi. Dengan demikian para praktisi akan dapat menyertakan implan kedokteran gigi dalam perencanaan dan perawatan pasien.

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Dental implant has become a fast developing and dynamic field in dental practice. It is acknowledged as a predictible treatment modality with high clinical success rates. Conventional fixed prostheses are no longer considered to be the first choice treatment for replacing a missing tooth. Despite the increasing number of patients requesting dental implant treatments, there are only some clinicians who are offering implant therapy in their daily practice. The international Team for implantology described a straightforward case as a simple case such as implant placements in adequate soft and hard tissue conditions and single-tooth restoration in a non-aesthetic zone. A review of the current literature discussed the implementation of implant dentistry in universities worldwide into their curriculum for both undergraduate and postgraduate programs in general dentistry. The European consensus in implant dentistry education concluded that it is desirable to include the surgical technique for implant placement for straightforward cases into the dental curriculum. The levels and limitations to which the various aspects of implant dentistry and related skills are to be taught are determined by the academic community. This review aimed at promoting awareness amongst dental practitioners and institutions in Indonesia of the shifting treatment paradigm in the management of a missing tooth. Hence clinicians with able to include implant dentistry in the treatment planning of their patients and also undertake a significant part in the execution of such treatments."

"Endo-perio lesion cound occur due to the close relationship between the pulp and the periodontium. Therefore, pulpal lesion could cause a periodontium lesion. To decide on an appropriate diagnosis, a thorough and careful examination needs to be done in order to determine the right treatment. Most of the endo-perio cases should be approached with a root canal treatment because the source of the lesion is in the canal and there is a possibility of healing of the periapical and periodontal ligament without surgical intervention. A report of a healing of an endo-perio case without surgical approach will be discussed."

"Penelitian ini bertujuan untuk mengetahui tingkat kepuasan pengguna pelayanan Program Pengelolaan Penyakit Kronis Prolanis BPJS Kesehatan yang diselenggarakan oleh Puskesmas dan klinik pratama. Jenis penelitian ini adalah kuantitatif dengan menggunakan desain studi cross sectional. Penelitian ini menggunakan data primer yang diperoleh dengan menyebar kuesioner ke responden. Hasil penelitian menunjukan kepuasan pengguna pelayanan Prolanis terhadap dimensi responsiveness sebesar 73,6 di Puskesmas, sedangkan di klinik pratama 58,3. Kepuasan terhadap dimensi reliability sebesar 76,4 di Puskesmas, sedangkan di klinik pratama 73,3. Kepuasan terhadap dimensi assurance sebesar 76,4 di Puskesmas, sedangkan di klinik pratama 75. Kepuasan terhadap dimensi empathy sebesar 83,3 di Puskesmas, sedangkan di klinik pratama 61,7. Kepuasan terhadap dimensi tangible sebesar 73,6 di Puskesmas, sedangkan di klinik pratama 65. Berdasarkan kelima dimensi didapatkan kepuasan total pada Puskesmas lebih tinggi dibandingkan pada klinik pratama.

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This study aims to determine the user satisfaction level of Chronic Disease Management Program Prolanis BPJS Kesehatan services which organized by Puskesmas and primary clinics. Type of this research is quantitative using cross sectional design. This study used primary data obtained by spreading questionnaires to respondents. The results show that user satisfaction level of Prolanis services for the responsiveness dimension was 73,6 in Puskesmas, while in primary clinics was 58,3. Satisfaction with reliability dimension was 76,4 in Puskesmas, while in primary clinics was 73,3. Satisfaction with assurance dimension was 76,4 in Puskesmas, while in primary clinics was 75. Satisfaction with empathy dimension was 83,3 in Puskesmas, while in primary clinics was 61,7. Satisfaction with tangible dimension was 73,6 in Puskesmas, while in primary clinics was 65. Based on those dimensions, total satisfaction at Puskesmas was higher than in primary clinics."

"Recurrent intraoral herpes infection (RIH) is one of the recurrent herpes simplex virus type-1 infections (HSV-1). It presents as single or clustered painful ulcers occur mainly on the keratinized mucosa, with the size of one to five millimeter. The Onset of RIH is considered to be associated with various endogenous and exogenous triggers. Therefore, it is important to recognize each individual triggers to prevent and to minimize and the infection for recurring. This report will describe three cases of RIH associated with emotional and physical stress. All patients have experienced continous recurrence of the disease for almost a year. Symptoms included painful multiple minute ulcers on oral mucosa initiated with fever. Serology investigation on antibody against HSV-1 confirmed a reactive elevation in these patients. Treatment consisted of acyclovir per oral 1000 mg daily per oral, counseling on stress condition and intake of nutritionalsupplementation. Nevertheless, stress conditions were difficult to overcome, therefore long-term medications were recommended to prevent recurrence episodes. One patient was taken a long-term acyclovir therapy and the other two patients were taken long-term acyclovir therapy with Phyllanthusniruri (Meniran) supplementation. Follow-ups on three cases showed the benefit of taking Phyllanthusniruri (Meniran) supplementation as reduction in RIH symptoms, shorten healing time and prolonged recurrence interval. "

"Indonesian Journal of Dentistry 2006; Edisi Khusus KPPIKG XIV: 74-78The failure of endodontic treatment is commonly caused by errors in preoperative, operative and postoperative endodontic treatment. Inadequate final restoration of post-endodontic treatment would impact the success of the treatment. Loose restoration is an example of restoration failure caused by inadequate retention which leads to penetration of saliva along the root canal.This could dissolve the luting cement and cause microleakage to constantly reach the periradicular areas. lf neglecled, this situation will result in a periradicular lesion. Endodontic retreatment was performed to resolve the failing restoration. The restoration failed due to inadequate retention. The treatment was needed to prevent more problems to occur sometime in the future."