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"Class III malocclusion which caused by disharmonious growth of maxilla and mandible are considered as a complex and difficult case to be treated. Although there are many debates concerning the result and stability of the treatment, class III malocclusion is still a challenge to be handled. Many orthodontists agreed that treatment should be done since early ages to prevent malocclusion becoming worst which at the end will need a surgical treatment. This paper will describe the treatment of class III malocclusion on growing patients with variable of difficulties cases. Facemask as orthopedics appliance is chosen to stimulate the growth of maxilla and to modify the growth direction of mandible."

"Thos case report described the skeletal and dental changes contributing to class II skeletal with mandibula retrognatism correction with Twin Blocks appliance. Cephalometric evaluation were compare between pre-treatment and after eight month treatment wearing Twin Blocks appliance at an 8 year, 1 month old girl patient. This short-term cephalometric study indicates that after eight month treatment with Twin Blocks appliance, the overjet reduces 3 mm correction of the first molar permanent from class II Angle (cusp to fossa) to class II Angle (cusp to cusp) and lengthening the mandible."

"Persistensi dan kehilangan prematur gigi sulung merupakan beberapa contoh dari gangguan tumbuh kembang gigi yang dapat mempengaruhi susunan gigi geligi pada rahang. Adapun akibat yang ditimbulkannya dapat berupa pergeseran posisi erupsi dan mempengaruhi waktu erupsi gigi permanen. Adanya pergeseran gigi yang tidak pada tempatnya tersebut menyebabkan deviasi signifikan dari oklusi normal seseorang yang disebut maloklusi. Penelitian ini dilakukan untuk melihat apakah terdapat hubungan antara persistensi gigi sulung dan kehilangan prematur gigi sulung dengan status maloklusi dental kelas I pada siswa SDN Cisauk usia 9-12 tahun serta menilai seberapa kuat hubungan tersebut dengan cara memeriksa 153 anak di SDN Cisauk, Tangerang. Analisis data yang digunakan adalah Analisis Kendall dan menghasilkan kesimpulan tidak terdapat hubungan yang bermakna antara gangguan tumbuh kembang gigi dengan status maloklusi kelas I.

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Persistency and premature loss of primary teeth were being two cases of growth and development disturbances which can influence the eruption of the teeth in arch. The effects of these disturbances can affect not only the eruption position but also eruption time of permanent teeth. Movement of the teeth from its proper place can make significant deviation from its normal occlusion, called malocclusion. The aim of this research is to find out the relationship between growth and development disturbances of the teeth with class I dental malocclusion status. This was conducted to a number of elementary school student in Cisauk age 9-12 years. This was a cross-sectional survey which was carried out to 153 subjects. Kendall?s analysis is being used and the conclusion is there was no significant relationship between growth and developmental disturbances of the teeth with class I dental malocclusion status."

"Objective: To investigate the correlations between head posture and mandible growth in Deuteromalayid OURT (obstruction of the upper respiratory tract) patients with mouth breathing habit. Material & Methods: The study used cross sectional design for 64 subjects including 32 OURT patients with mouth breathing habit and 32 normal subjects, all 12 to 15 years old. Lateral cephalometry radiograph was taken for head posture measurements and mandibular growth (ramus height, mandibular length, and mandibular rotation) measurements. Results: The fraction of subjects with kifosis head posture in OURT withmouth breathing habit (34.4%) was larger than that in normal subjects (28.1%). There is no correlation between head posture and OURT with mouth breathing habit, but there is a correlation between OURT with mouth breathing habit and mandibular rotation. Conclusion: Patients with OURT and mouth breathing habit show more vertical growth of mandible than normal subjects."

"In orthodontics, functional appliance can be used as a preliminary appliance in treating class II malocclusion with retruded mandible. This type of removable appliance needs patient's full cooperation. However, there is one type of a fixed functional appliance, known as : Herbst Appliance, which was introduced by Herbst in 1909 and was redeveloped by Pancherz in 1979. By using this appliance, the treatment period is much shorter compared to that of other removable functional appliances and the results is more effective. This telescopic mechanism principle produces posterior forces to maxillary dentoalveolar complex and anterior forces to mandibular dentoalveolar complex. The expected effect of the treatment is longer mandible, distal movement of upper molars, mesial movement of lower molars, higher vertical dimension and a decrease of profile convexity. Based on those facts, in treating class II malocclusion-division I or II - a Herbst appliance might be taken into consideration."

"The treatment of class II division 1 malocclusion with retruded mandible in the mixed dentition period is suggested to use functional appliance. Bionator is one of the removable myofunctional appliance which is less bulky and simpler design compare to the activator, so that bionator can be worn all the time. An 8 year, 9 month old girl patient who has class II division 1 malocclusion with retruded mandible, overjet 11 mm, overbite 7 mm, and convex facial profile with lip trap and lip incompetence. Bionator has been used for about 8 month. The results were satisfied, normal overjet, overbite, and a pleasant appearance. The successfull treatment of this case, beside patient in the growing period, patient should had a good cooperation."

"Pencabutan gigi untuk keperluan perawatan ortodonti telah menjadi perdebatan selama bertahun-tahun. Berkaitan dengan hal tersebut, maka telah dilakukan studi pendahuluan untuk melihat "Kecenderungan perawatan ortodonti dengan pencabutan gigi ditinjau dari faktor usia, jenis kelamin dan maloklusi " pada pasien ortodonti di Jakarta periode tahun 1993 - 1995. Hasil penelitian menunjukkan bahwa perawatan ortodonti dengan pencabutan cenderung meningkat pada periode tersebut, meskipun prosentasenya masih dalam rentangan 25 % - 85 % . Pasien perempuan jumlahnya lebih banyak daripada laki-laki. Pada penelitian ini terlihat bahwa kelompok umur 13-17 tahun adalah yang terbanyak mendapat perawatan ortodonti dan maloklusi yang terbanyak dijumpai adalah maloklusi klas I. Angka prevalensi dan data-data yang diperoleh memperlihatkan bahwa pencabutan cukup sering menjadi pilihan dalam melakukan perawatan ortodonti, meskipun pasien masih berusia muda dan maloklusi bersifat dental."

"Pengetahuan tentang gastroenterologi anak dalam berbagai aspeknya telah sangat berkembang, yang meliputi antara lain

1. Perkembangan prosedur biopsi mukosa usus melalui mulut yang memungkinkan kita mempelajari struktur dan aspek biokimiawi jaringan mukosa hidup;
2. Prosedur intubasi duodenum yang memungkinkan diperolehnya isi lumen usus dari berbagai tempat;
3. Teknik endoskopi disertai fotografi dan ultrasonografi yang menambah pengetahuan baru;
4. Perkembangan pengetahuan imunologi usus memungkinkan kita untuk selanjutnya mempelajari imunisasi oral;
5. Perkembangan pengetahuan enzimologi usus dan penyelidikan proses transportasi memungkinkan kita untuk selanjutnya mempelajari proses biokimiawi dan metabolik.

Fungsi Traktus GastrointestinalFisiologi traktus gastrointestinal terdiri dari rangkaian proses makan (ingesti), pengeluaran getah pencemaan (sekresi), pencemaan (digesti), dan penyerapan (absorpsi) makanan. Getah pencemaan membantu pencemaan (digesti) makanan, hasil pencemaan diserap (absorpsi) ke dalam tubuh berupa zat gizi. Proses sekresi, digesti, dan absorpsi terjadi secara berkesinambungan pada bagian traktus gastrointestinal mulai dari mulut sampai ke rektum.Selain fungsi tersebut masih terdapat fungsi lainnya, yaitu fungsi motilitas dan imunologis. Secara bertahap massa hasil campuran makanan dan getah pencemaan (bolus) yang telah dicemakan didorong / digerakkan ke arah anus. Fungsi traktus gastrointestinal yang berkaitan langsung dengan tumbuh kembang anak adalah digesti dan absorpsi.Digesti dan absorpsi karbohidratKarbohidrat yang terpenting dalam diet bayi adalah laktosa, sedang pada dewasa 60 % dari karbohidrat dalam diet adalah tepung dengan sukrosa dan sedikit sekali laktosa. Walaupun konsep digesti disakarida dalam lumen usus telah diterima bertahun-tahun lamanya, namun sekarang jelas bahwa hidrolisis oleh enzim disakaridase terjadi di sel mukosa usus halus.Pada absorpsi monosakarida, misalnya glukosa, kini terbukti diperlukannya zat yang membantu transportasi aktif glukosa tersebut, yaitu Na+. Glukosa polimer merupakan karbohidrat yang mudah dicerna, dengan osmolaritas rendah, yaitu 1/5 osmolaritas glukosa.Digesti dan absorpsi lemakLemak makanan terutama terdiri dan trigliserid rantai panjang (TRP), yaitu ester gliserol asam lemak dengan rantai sebanyak 16- 18 atom C. Trigliserid rantai sedang (TRS), asam lemak dengan 6- 12 atom C, hanya terdapat dalam jumlah sedikit dalam alam. Di samping itu terdapat lemak tidak jenuh (LTJ), yang terdapat banyak pada tanaman.Lemak TRP diabsorpsi melalui fase intralumen yang memerlukan lipase pankreas dan garam empedu, pasase dalam sel mukosa, re-esterifikasi menjadi trigliserid dalam sel mukosa, pembentukan kilomikron, dan masuknya kilomikron ke dalam sistem limfe.TRS diserap lebih cepat daripada TRP. Absorpsi TRS tidak dipengaruhi oleh defisiensi garam empedu dan hanya sedikit dipengaruhi oleh tidak adanya lipase pankreas. Namun, mungkin trigliserid yang tidak terhidrolisis akan dihidrolisis oleh lipase intrasel spesifik. TRS diangkut sebagai asam lemak bebas melalui vena porta.Absorpsi akan lebih baik bila TRS dikombinasi dengan TRP daripada sendiri. Absorpsi optimal terjadi pada campuran 4 bagian TRS dan 3 bagian TRP. Hal ini merupakan informasi yang berguna sebagai dasar perencanaan diet dengan TRS. Kombinasi TRS dengan lemak tidak jenuh atau LTJ, misalnya minyak jagung, paling balk bila perbandingan TRS : LTJ = 2 : 3."

"A 12 years old female presented with class II division I malocclusion with skeletal disorder (ANB 6°), deep bite, posterior crossbite 26, prostrusive of anterior maxillary constriction, retrognatic of mandible and mild crowding of upper and lower jaws. The treatment of choice was twin block appliance for modifying the jaw development, and then followed by fixed orthodontics. After eight months, the progression of treatment was a better facial profile."

"Class lll skeletal anomaly is one of the most difficult malocclusions to correct in orthodontics. Orthodontist usually involved chincup appliances to restrain mandibular growth, camouflage techniquesto advances maxillary insicors and retract mandibular incisors or waiting until growth ceased to pursue orthognathic surgery. Many studies found that most of Class lll malocclusions were characterized by maxillary retrognathism. ln the late 1960s, the Delaire mask was popularized to protract the maxilla. The development of maxillary protraction with facemask and palatal expansion have provided a predictable and effective approach lo managing treatment that was once considered difficult. Although no significant difference was found between early or late treatment group, the effect of improvement in facial aesthetics on psychosocial development resulted in a significant advantage for early treatmentnt. However, the effects of face mask therapy should be evaluated over the long term in order to determine the relaps tendency."