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"Metronidazole gel 25% as an adjunct to scaling and root planing showed clinical effect better than scaling and root-planing alone. In Indonesia metronidazole gel is not popular, since probably it is expensive and not easy to obtain, so there is an idea to make metronidazole gel 25% mixture with relatively cheaper. The purpose of the study was to evaluate clinical effect of metronidazole gel 25%. Thirty Chronic Adult Periodontitis patients possessing at least 3 teeth >6mm pocket dept, >4 mm attachment loss, and bleeding on probing were selected and grouped into metronidazole 25%, PVP-I 10%, and as controle respective. After SRP of all quadrant, 3 teeth were randomly selected as respectively metronidazole gel 25% and PVP-I 10% were applied on day 0 and day 7, BOP, PPD, and clinical attachment gain were recorded at baseline and 1 month post therapy. Bleeding on probing was analyzed using Kruskal-Wallis test, pocket depth and attachment gain were analyzed using Anova test. The result showed a significant difference in each group before and after the application. However, metronidazol group was the best compared to the other two groups."

"In deep periodontal lesions, scaling and root planning (SRP) failed to complete elimination of periodontal bacteria, so chemical antimicrobial agents are used topically to destroy microorganism. Povidon-iodin 10% is one of antimicrobial agents that can be applied topically anddirectly in the pocket. The aim of the research were evaluated the efficacy of povidon-iodin l0% as chemical antimicrobial agents locally applied into periodontal pocket. The data are obtained from patients with chronic adult periodontitis baseline periodontal pocket depth (PPD) are 5-7 mm. The teeth are scaled and root planed after clinical examinations ( plaque index, papilla bleeding index and periodontal pocket depth ) and test sites or control sites are assisned randomly. Topically application of povidon-iodin 10% at test sites and aquabides at control sites is applied at day 1st and day 7th. The clinical parameters are assessed at day 14th. The results of the research showed that application of povidon-iodin l0% afer SRP provide statistically significant more favorable papilla bleeding index reduction than SRP + aquabides after 14 days. The pocket depth reduction at testsites are greater than control sites ( baseline PPD=6 and 7 mm). The conclusions of the research showed that application subgingival povidon-iodin 10% as adjunctive to SRP significantly reducePBI and PPD ( 6 & 7 mm ) than without application povidon-iodin 10%."

"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."

"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: 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."

"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 "

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Latar Belakang: Menurut data Riset Kesehatan Dasar (Riskesdas) 2018, prevalensi penyakit periodontitis menduduki peringkat kedua terbanyak setelah karies gigi, yaitu sebesar 74,1% di Indonesia. Periodontitis merupakan penyakit inflamasi yang dihubungkan dengan kerusakan jaringan periodontal. Dalam perjalanan periodontitis, TLR-4 berperan penting dalam respon imun dan patogenesis inflamasi periodontitis karena dapat mengenali bakteri gram negatif lipopolisakarida (LPS). Propolis merupakan salah satu zat alami berupa produk resin yang memiliki banyak aktivitas biologis, salah satunya antiinflamasi. Tujuan: Mengetahui interaksi molekuler senyawa propolis yang berpotensi sebagai antiinflamasi terhadap TLR-4 pada terapi periodontitis melalui studi penambatan molekuler. Metode: Studi eksperimental komputasional secara in silico menggunakan perangkat Autodock Tools 1.5.6 dan BIOVIA Discovery Studio Visualizer 2021 untuk menguji interaksi dan afinitas ikatan dari ligan propolis terhadap reseptor target TLR-4. Hasil interaksi akan dianalisis untuk menilai konformasi terbaik dari suatu molekul dan afinitas pengikatannya. Penambatan molekuler dilakukan dengan menambatkan 7 senyawa propolis yang berpotensi sebagai antiinflamasi terhadap TLR-4 sebagai reseptor yang berperan dalam proses inflamasi. Hasil: Terdapat interaksi molekuler ikatan antara ligan propolis dengan reseptor TLR-4. Dari ketujuh ligan propolis yang diuji, senyawa Adhyperforin memiliki afinitas terbaik dibandingkan ligan propolis lainnya. Kesimpulan: Senyawa bioaktif pada propolis dapat berinteraksi terhadap reseptor TLR-4 melalui uji penambatan molekuler dan dapat berpotensi menjadi agen antiinflamasi terhadap TLR-4 yang dapat digunakan sebagai kandidat obat untuk terapi periodontitis. Namun, perlu dilakukan penelitian lebih lanjut untuk membuktikan sifat senyawa bioaktif pada propolis yang dapat bertindak sebagai agen antiinflamasi yang baik untuk terapi periodontitis.

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Background: According to 2018 Basic Health Survey (Riskesdas) data, periodontitis is the second most frequent condition after dental caries, which reached a prevalence of 74.1% in Indonesia. Periodontitis is an inflammatory condition associated with the destruction of periodontal tissue. TLR-4, which recognizes gram-negative bacterial lipopolysaccharides (LPS), plays a crucial role in the immune response and inflammatory pathogenesis of periodontitis. Propolis is a natural product in the form of resin that has many biological activities, one of which is anti-inflammatory. Purpose: To investigate the molecular interactions of propolis compounds that have anti-inflammatory potential against TLR-4 in periodontitis therapy through molecular docking studies. Methods: In silico computational experimental study using Autodock Tools 1.5.6 and BIOVIA Discovery Studio Visualizer 2021 to test the interaction and binding affinity of propolis ligands towards the TLR-4 target receptor. The interaction results will be analyzed to assess the best conformation of a molecule and its binding affinity. Molecular docking was performed by targeting 7 propolis compounds that have anti-inflammatory potential against TLR-4 as a receptor that plays a role in the inflammatory process. Results: There is a binding interaction between propolis ligands and TLR-4 receptor. Of the seven propolis ligands tested, the compound Adhyperforin had the best affinity compared to other propolis ligand. Conclusions: Bioactive compounds in propolis can interact with TLR-4 receptors through molecular docking tests and can potentially become anti-inflammatory agents against TLR-4 that can be used as drug candidates for periodontitis therapy. However, further research is needed to prove the nature of bioactive compounds in propolis that can act as good anti-inflammatory agents for periodontitis therapy.

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"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."

"Periodontitis merupakan salah satu bentuk penyakit periodontal, dan merupakan Kelanjutan dari keradangan gingival yang meluas kejaringan periodontal dibawahnya. Tidak semua keradangan gingiva akan berkembang menjadi Periodontitis. Penelitian terakhir menunjukkan bahwa adanya kuman spesifik di daerah sub gingiva dan defek pertahanan seluler berhubungan erat dengan bermacam-macan penyakit periodontal. Perawatan periodontitis dilakukan dengan tujuan untuk menghilangkan kuman penyebab penyakit. Perawatan periodontitis yang dilakukan adalah secara mekanis dam pengobatan dengan antibiotik, tetapi pengobatan ini tidak dapat menghilangkan seluruh kuman di dasar poket. Dengan adanya keterbatasan ini aka dipilih beberapa bahan alternatif seperti asam sitrat untuk menunjang kaberhasilan perawatan. Pemakaian antibiotik, secara systemik cukup efektif untuk menghilangkan kuman penyebab periodontitis, tetapi efek sampingnya besar, sehingga akhir-akhir ini dipakai Cara Aplikasi lokal seperti aplikasi metronidazole untuk mengurangi gejala klinik dan mengobati periodontitis, karena efek sampingnya lebih kecil dan efektifitas untuk membunuh kuman lebih besar. Juga pemakaian asam sitrat dapat memberikan efek demineralisasi, membersihkan permukaan akar gigi dari plak dan kalkulus, menghilangkan kuman serta endotoksin dari permukaan cementum serta menghambat migrasi perekatan epithel kearah apikal. Penelitian terdahulu dilakukan untuk melihat efek aplikasi lokal metronidazole dan asam sitrat terhadap perawatan penyakit periodontal, belum parnah ada penelitian pengobatan kombinasi aplikasi lokal asam sitrat dengan metronidazole untuk perawatan penyakit periodontal. Maka di dalam penelitian ini akan diteliti efek kesembuhan penyakit periodontal dengan aplikasi lokal kombinasi asam sitrat dengan metronidazole."

"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."