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"Osteoporosis is a silent disease, i.e. the disease will progress without symptoms or pain until bones start to break. Densitometry examinations to diagnose osteoporosis is relatively expensive for most people in Indonesia. Kusdhany et al have produced a mandibular density index specific for Deutero-Malay postmenopausal women (POSTUR-P). This index can be used to predict osteoporosis risk in mandibular and other bones. The objective of this research was to try out POSTUR-P before using it in the community. The study was a diagnostic test, on 31 Teratai clinic postmenopausal patients of Ciptomangunkusumo Hospital between 50-75 years of age from June to October 2014 and fulfilling inclusion criteria. Densitometry on lumbal and femur bones was used as a gold standard. The result of this study showed that POSTUR-P has high sensitivity and moderate specificity, and appears to be a good screening tool to indicate osteoporosis cases."

"Today jawbone radiographic studies have shifted to 'bone quality'. The jawbone quality indicator which is often used is trabeculation density. To obtain accurate interpretation, analysis of jawbone quality needs modern radiographic imaging modalities that still very limited in Indonesia. In prosthetic dentistry analysis of tarabecular bone density in postmenopause women is very important to anticipate the possibility of osteoporotic cases. Because of inadequacy of human eye sight, information obtained from plain conventional radiographic is very limited. With digitized conventional radiogram, dentist could obtain more accurate information to analyze radiographic trabeculation density in Indonesia. The aim of this study is to get more quantitative radiographic data from digitized conventional radiogram comparing those obtained from conventional radiogram. 112 conventional radiograms were evaluated using grading of trabeculation density. The same radiograms then digitized to obtain the quantitative numeric data of trabeculation density. The result showed that each grade from conventional radiogram has a range of numeric value in the digitized radiogram. This result could provide higher accuracy of trabeculation density analysis than the value obtained by using human eyes that will be beneficial for the dentist, especially prosthodontist in Indonesia."

"Deteksi dini osteoporosis perlu dilakukan untuk mencegah kegagalan perawatan gigi tiruan. Quantitative Ultrasound (QUS) selama ini dipakai secara luas untuk skrining osteoporosis. Kuesioner Postur-P juga digunakan untuk skrining osteoporosis. Penelitian ini bertujuan untuk menganalisis sensitivitas dan spesifisitas kuesioner Postur-P terhadap QUS dalam penilaian densitas tulang perempuan pascamenopause. Penelitian ini merupakan uji diagnostik. Pengambilan data dilakukan lewat wawancara menggunakan kuesioner Postur-P dan pengukuran densitas tulang menggunakan alat QUS. Hasil penelitian menunjukkan sensitivitas dan spesifisitas kuesioner Postur-P terhadap QUS cukup baik dengan persentase masing-masing sebesar 77,23% dan 75% sehingga kuesioner Postur-P dapat dijadikan sebagai pengganti QUS dalam melakukan skrining osteoporosis.

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Early detection of osteoporosis needs to be done to prevent the failure of denture treatment. Quantitative Ultrasound (QUS) is widely used for osteoporosis screening. So is Postur-P questionnaire. This research was done to analyze the sensitivity and specificity of the Postur-P questionnaire towards QUS in assessing postmenopausal women bone density. This study was a diagnostic test. Data were collected through interviews using Postur-P questionnaire and bone density was measured with QUS. The results of this study show that the sensitivity and specificity of the Postur-P questionnaire towards QUS are quite good with the value of 77.23% and 75% therefore questionnaire Postur-P can be considered to replace QUS in osteoporosis screening."

"Latar belakang dan tujuan: Prevalensi osteoporosis di Indonesia cukup tinggi disertai peningkatan risiko patah tulang terutama pada wanita. Pemeriksaan kepadatan massa tulang dengan DXA merupakan baku emas dalam mendiagnosis osteopenia maupun osteoporosis dan memperkirakan risiko patah tulang berdasarkan nilai T-score, namun ketersediaan perangkat DXA sangat terbatas di wilayah Indonesia. Indeks ketebalan korteks merupakan salah satu parameter sederhana, objektif, dan mudah diterapkan pada radiografi konventional dalam memperkirakan kepadatan massa tulang, namun perlu dibuktikan korelasinya dengan nilai T-score. Metode: Uji korelatif dengan pendekatan potong lintang pada nilai indeks ketebalan korteks femur proksimal menggunakan radiografi konvensional dan T-score kolum femur menggunakan DXA berdasarkan database populasi Indonesia, terhadap 31 subjek penelitian, menggunakan data sekunder dalam kurun waktu Juli 2012 sampai Juni 2016. Hasil: Dengan uji korelasi Pearson, didapatkan nilai p<0,000 dan r=0,76 antara nilai indeks ketebalan korteks femur proksimal menggunakan radiografi konvensional dan T-score kolum femur menggunakan DXA. Kesimpulan: Terdapat korelasi positif yang kuat antara nilai indeks ketebalan korteks femur proksimal menggunakan radiografi konvensional dan T-score kolum femur menggunakan DXA.

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Background and Objective: The prevalence of osteoporosis in Indonesia is high with increased risk of fractures, especially in women. Examination of bone density by DXA is the gold standard in the diagnosis of osteopenia or osteoporosis and predicts fracture risk based on the T-score, but the availability of DXA devices in Indonesia is very limited. The cortical thickness index is a simple, objective parameter, and easily applied to conventional radiography in estimating bone density, but needs to be proven its correlation with the T-score.

Methods: A cross sectional correlation study between the cortical thickness index of proximal femur by conventional radiography and T-score of femoral neck by DXA based on population database in Indonesia, conducted in 31 subjects in the period of July 2012 to June 2016.

Results : With the Pearson correlation test, there is a significant correlation (p < 0.001 and r = 0.76) between the cortical thickness index of proximal femur by conventional radiography and T-score of femoral neck by DXA.

Conclutions: There is a strong positive correlation between the cortical thickness index of proximal femur by conventional radiography and T-score of femoral neck by DXA."

"The need for women to use a dental prosthesis increases with age. Low estrogen level is characteristic in post menopausal women. In this case, it often related with reduction of density and mandibular alveolar bone height. This study aimed to investigate the differences in density and mandibular alveolar bone height in post-menopausal women wearing complete dentures with tissue conditioner. The clinical observations were conducted on seven persons who had received a new set of complete denture in the Prosthodontic Department of the Dental Hospital of the Dental Faculty in Jember University. Balanced occlusion was used in all dentures, fabricated according to the principles used in the department. Panoramic radiographs had been made for all subjects as the baseline, and two, four, and six months later using dentures with tissue conditioner. The data was analyzed by using one-way analysis of variance at the 0.05 level. The conclusion was that there is no significant difference in density and mandibular alveolar bone height of complete denture wearers with tissue conditioner in post-menopausal women."

"Indonesian Journal of Dentistry 2006: Edisi Khusus KPPIKG XIV: 148-154Removable Partial Denture Management on Post-Menopause Osteoporotic FemaleOsteoporosis a condition of generalized skeletal fragility caused by diminishing bone amount and disturbance in bone microarchitecture with implication that the bone ability to withstand forces is decreased.This condition leads to more bone resorption. Some researches show that this condition also affects jaw bone. Therefore we must take this condition into consideration during prosthodontic treatment. Dental prostheses are made to restore stomatognatic function as well to preserve what was left including residual alveolar bone. The ability ofdental prostheses to preserve residual alveolar bone differs according to type of prostheses. The case presented here proposing the treatment of an osteoporotic old female in Prosthodontic Clinic FKG Ul with removable partial denture. Considerations inselecting the type and design of dental prostheses and attempts to modif, factors that might play a role in bone resorption in connection with patient's physical and psychological status will be discussed. Thorough examination, careful planning and good communication with patient can provide optimum result."

"ABSTRAKLatihan naik turun bangku LNTB dan latihan jalan kaki LJK adalah aktivitas bersifat weight bearing yang dapat meningkatkan massa tulang. Kedua latihan fisik tersebut memiliki karakter biomekanik yang berbeda yang akan memengaruhi proses formasi dan resorbsi tulang. Densitas massa tulang rendah berhubungan dengan polimorfisme gen TNFSF11 dan TNFRSF11B.Penelitian ini bertujuan untuk menganalisis pengaruh perbedaan peningkatan kadar osteokalsin sebagai petanda formasi dan penurunan CTX-1 sebagai petanda resorbsi setelah LNTB dan LJK dan pengaruh polimorfisme gen TNFSF11 SNPs-290C>T, -643C>T, -693G>C dan gen TNFRSF11B SNPs 163A>G, 950T>C, 1181G>C terhadap perbedaan peningkatan kedua petanda. Disain penelitian adalah studi eksperimental. Subjek penelitian adalah perempuan osteopenia sebanyak 59 orang yang diberi LNTB 30 subjek dan LJK 29 subjek dan ditentukan secara acak. Kadar osteokalsin dan serum diukur pra dan pascalatihan setelah 12 sesi selama 3 bulan latihan. Identifikasi polimorfisme gen TNFSF11 dan gen TNFRSF11B dianalisis dengan metode PCR dilanjutkan RFLP. Perbedaan peningkatan kadar osteokalsin dan CTX-1 diuji dengan uji T-tidak berpasangan. Hubungan polimorfisme dengan perubahan kadar osteokalsin dan CTX-1 dianalisis dengan odds ratio. Analisis haplotype dan uji Kruskall Wallis dilakukan untuk melihat hubungan pasangan haplotype dengan kadar osteokalsin dan CTX-1. Kadar osteokalsin dan CTX-1 setelah latihan pada kedua kelompok latihan meningkat p < 0,05 . Peningkatan CTX-1 setelah LNTB lebih kecil dibanding LJK p < 0,05 . Tidak ditemukan hubungan antara polimorfisme gen TNFSF11 dan gen TNFRSF11B dengan perubahan kadar osteokalsin dan CTX-1 p>0,05 Meskipun tidak bermakna, terdapat kecenderungan alel heterozigot/resesif berhubungan dengan peningkatan kadar osteokalsin, alel homozigot dominan berhubungan penurunan kadar CTX-1, serta haplotype gen TNFRSF11B dan haplotype gen TNFSF11 dengan perubahan osteokalsin dan CTX-1. Kedua latihan fisik terbukti dapat meningkatkan formasi tulang. LNTB mencegah resorbsi tulang lebih baik dibanding LJK. Polimorfisme mungkin memengaruhi formasi dan resorbsi tulang akibat latihan fisik. LNTB dan LJK meningkatkan osteokalsin. Peningkatan CTX-1 setelah LNTB lebih rendah dari LJK. Perubahan osteokalsin tidak berhubungan dengan polimorfisme gen TNFSF11 dan TNFRSF11B sedangkan perubahan CTX-1 tidak dipengaruhi polimorfisme gen TNFSF11 tetapi terdapat hubungan antara haplotype ATG dengan ACG dan GCC gen TNFRSF11B dengan perubahan CTX-1. Kata Kunci: gen TNFRSF11B, gen TNFSF11, karakter biomekanik, latihan naik turun bangku, polimorfisme, remodeling tulang

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Bench step exercise BSE and walking exercise WE have a different biomechanical characteristics that can affect bone formation and resorbtion. Low bone mass density was associated with TNFSF11 SNPs 290C T, 643C T, 693G C and TNFRSF11B 163A G, 950T C, 1181G C genes polymorphism.The purpose of the studi is to analyze the difference effect of BSE and WE on changes in bone formation osteocalcin and bone resorbtion CTX 1 markers and the association of TNFSF11 and TNFRSF11B genes polymorphism. This is an experimetal study involving 59 postmenopausal women with osteopenia. Participants were grouped randomly according to the type of exercise bench step exercise 30 subjects and walking exercise 29 subjects . Subjects performed exercise for 12 sessions in 3 months. Osteocalcin and CTX 1 serum was measured pre and post exercise. The TNFSF11 gene and TNFRSF11B gene polymorphism was identified by PCR and RLFP methods. The difference in changes on osteocalcin and CTX 1 between groups were analysed by independent T test. Association between changes in osteocalcin and CTX 1 polymorphism and haplotype were analysed using odss ratio and Kruskall Wallis, respectively. Osteocalcin and CTX 1 increased significantly after BSE and WE P 0.05 , with no difference between group. BSE increased CTX 1 lower than WE P 0.05 . There is no association between polymorphism and the changes on osteocalcin and CTX 1 levels after BSE and WE P 0.05 . However, some tendencies were observed. Heterozygous recessive alleles had association with increased osteocalcin, homozygous dominant alleles had association with decreased CTX 1, haplotype TNFRSF11B gene had associaton with changes in osteocalcin and CTX 1 levels, whereas haplotype TNFSF11 gene with changes in CTX 1 level only. This results indicate that both BSE and WE increased bone formation. TNFSF11 gene polymorphism did not affect changes in formation and resorbtion after BSE and WE. Both exercises increased osteocalcin but was not different even though level of CTX 1 in BSE is lesser compared to WE. TNFSF11 gene polymorphism did not associate to the changes in osteocalcin and TNFRSF11B gene polymorphism did not associate to the changes in osteocalcin despite haplotype ATG had association with ACG and GCC in TNFSF11B gene for the changes in CTX 1 level after BSE and WE. Keywords Bench step exercise, biomechanical character, bone remodelling, gene TNFRSF11B, gene TNFSF11, polymorphism"

"Latar Belakang: Berkurangnya kepadatan tulang dapat dipengaruhi oleh beberapa faktor seperti usia dan jenis kelamin dan memiliki pengaruh terhadap perawatan kedokteran gigi. Radiograf panoramik digital dapat menjadi salah satu cara untuk memperkirakan penurunan densitas radiografik tulang. Tujuan: Memperoleh nilai rerata densitas radiografik tulang kortikal tepi bawah mandibula pada individu pria dan wanita yang berusia 20 – 60 tahun di RSKGM FKG UI dari radiograf panoramik digital. Metode: Menggunakan studi potong lintang dengan 300 sampel radiograf panoramik digital yang terbagi menjadi 150 sampel wanita dan 150 sampel pria dan dikategorikan berdasarkan kelompok usia berjumlah 75 sampel untuk setiap kelompok usia. Rerata densitas radiografik diperoleh di region of interest tulang kortikal tepi bawah mandibula menggunakan software I-Dixel Morita. Hasil: Hasil analisis statistik menunjukkan nilai rerata densitas radiografik tulang pada kelompok wanita sebesar 92,80 sedangkan pada kelompok pria sebesar 97,46. Berdasarkan kelompok usia, kelompok usia 31- 40 memiliki rerata densitas radiografik paling besar yaitu 101,99 sedangkan nilai terendah pada kelompok usia 51-60 sebesar 86,43. Kesimpulan: Rerata densitas radiografik tulang kortikal tepi bawah mandibula pada pria lebih tinggi dibandingkan wanita serta terus mengalami peningkatan dari usia 20 tahun dan mulai mengalami penurunan di usia lebih dari 40 tahun.

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Background: Reduced bone density can be influenced by several factors such as age and gender and has an influence on dental treatment. Digital panoramic radiographs can be used to estimate decreased bone density.

Objective: To obtain the radiographic mean density of cortical bone at the inferior border of the mandible in male and female aged 20-60 years at RSKGM FKG UI using digital panoramic radiographs.

Methods: A cross-sectional study with 300 digital panoramic radiograph samples divided into 150 female and 150 male samples and categorized by age group into 75 samples for each age group. The mean radiographic density was obtained in the region of interest of the cortical bone at the inferior border of the mandible using the I-Dixel Morita software.

Results: the results of statistical analysis showed that the mean radiographic bone density in the female group is 92.80 while in the male group it is 97.46. Based on the age group, the 31-40 age group had the highest mean radiographic density which is 101.99, while the lowest value was in the 51-60 age group which is 86.43.

Conclusion: The mean radiographic density of cortical bone at the inferior border of the mandible in men is higher than in women and continues to increase from the age of 20 and begins to decrease at the age of more than 40 years."

"Densitas tulang adalah jumlah kandungan mineral per cm2 tulang, dibedakan menjadi 3 yaitu normal, osteopenia, dan osteoporosis. Penelitian ini dilakukan untuk mengetahui risiko kegoyangan gigi melalui analisis densitas tulang. Diasumsikan bahwa densitas tulang rendah yang berhubungan dengan osteopenia/osteoporosis dapat berpengaruh secara langsung pada mikroarsitektur tulang alveolar, dan menyebabkan kegoyangan gigi. Subjek terdiri dari 22 pria dan 56 wanita berusia ≥ 50 tahun. Pengukuran densitas tulang mandibula dilakukan dengan radiograf panoramik dan periapikal DDIR (direct digital intraoral radiograph). Pengukuran densitas tulang skeletal dilakukan dengan QUS (Quantitative Ultrasound). Hasilnya menunjukkan adanya hubungan antara kebersihan mulut dan densitas tulang skeletal dengan kegoyangan gigi (p= 0,000, p=0,035, berturut-turut) serta diperoleh indeks perkiraan kegoyangan ≥50% dari seluruh gigi di mandibula.

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Bone mineral density is the amount of bone mineral content in cm2. It can be classified into normal, osteopenia, and osteoporosis. This study was conducted to determine the risk assessment of tooth mobility through bone density analysis. Low bone density, which is associated with osteopenia / osteoporosis can affect directly the alveolar bone microarchitecture, and cause tooth mobility. The subjects consisting of 22 men and 56 women aged ≥ 50 years. Mandibular bone density measurements done by panoramic radiographs and periapical DDIR (direct digital intraoral radiograph). Bone mineral density measurement was performed with QUS (Quantitative Ultrasound). The result showed that there is a relationship between oral hygiene and bone mineral density with tooth mobility (p = 0.000, p = 0.035, respectively) and an index was formulated to estimate mobility of ≥ 50% out of teeth in mandible."

"ABSTRAKIn prosthodontics, mandibular bone density plays an important role in the success of treatment. Generally, the aging process will be accompanied by decreasing mandibular bone density. This is more obvious in post menopausal women with low or absent estrogen production. Relationship between mandibular bone density and bone density in other parts of the body is still debatable. The aim of this study was to evaluate this relationship. Periapical radiographs and bone densitographs of 114 post menopausal women were evaluated in a cross sectional study. The results showed a relationship between age and amount of teeth present with decreasing mandibular bone density, and a significant correlation between mandibular bone density and lumbal or femur bone density."