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"Pendahuluan: Saat penutupan primer tidak dapat dilakukan, defek diafragma hernia diafragma kongenital (HDK) memerlukan penutup prosthesis. Mesh organik-absorbable memungkinkan tumbuhnya jaringan host seiring proses degradasi mesh. Bahan sintetik non-absorbable tidak terdegradasi namun cenderung menyusut sehingga seiring perkembangan anak dapat terjadi rekurensi dan deformitas muskuloskeletal. Peneliti menyusun mesh komposit tiga lapis dari polypropylene-human amniotic membrane (HAM)-oxygenated regenerated cellulose (ORC) sebagai anti-adhesi. Efektifitas mesh ini sebagai alternatif penutup defek diafragma dan bagaimana reaksi histologis host terhadap mesh ini akan dinilai.Metode: dibuat defek hemi-diafragma kiri pada 20 tikus Sprague Dawley (SD) yang dibagi menjadi tiga kelompok perlakuan (KP). Defek diafragma KP-1 ditutup dengan polypropylene mesh, KP-2 dengan tiga lapis HAM, dan KP-3 dengan polypropylene-HAM-ORC. Pada hari ke-7 dan 30, dinilai ada-tidaknya rekurensi, asimetri hemithorax, dilanjutkan pemeriksaan histologis derajat jumlah polymorphonuclear cells (PMN), fibroblas, foreign body giant cells (FBGC), angiogenesis, muskularisasi, dan adhesi. Hasil: Tidak terjadi rekurensi defek diafragma dan asimetri hemithorax pada ketiga KP. Gambaran histologis ketiga KP tidak berbeda bermakna kecuali dalam hal angiogenesis pada kelompok yang menggunakan HAM. Kelompok yang menggunakan bahan anti-adhesi (KP-3) mengalami derajat adhesi teringan. Kesimpulan: mesh komposit tiga lapis dapat digunakan sebagai alternatif penutup defek diafragma SD. Mesh ini tidak menimbulkan reaksi inflamasi dan reaksi benda asing secara berlebihan.

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Introduction: When primary closure is not possible, autologous flap or mesh repair is indicated for congenital diaphragmatic hernia (CDH) repair. Absorbable-organic meshes allow ingrowth of host tissue as they are degraded, creating natural and durable neodiaphragm. Non-absorbable synthetic patches act as strengthening replacement for diaphragm but have propensity to shrink and there is concern as the infant grows, musculoskeletal deformity and recurrence may occur. We investigated a composite mesh consist of polypropylene-human amniotic membrane (HAM)-oxygenated regenerated cellulose (ORC) as adhesion barrier. The aim of the study was to evaluate the effectiviness and host reaction to the implantated mesh.

Methods: a defect on left hemi-diaphragm of 20 Sprague Dawley were made. The first group received polypropylene mesh, second group triple layer of HAM, and the third group received HAM-polypropylene-ORC. After 7 and 30 days, reccurence, hemithorax asymmetry, and histological features of neodiaphragm were evaluated.

Results: There were no patch disruption and asymmetries of hemithorax occurred in all groups. There were no significant differences in polymorphonuclear cells (PMN), foreign body giant cell (FBGC), fibroblast, and muscularization degree. However angiogenesis were better in groups who used HAM material. Adhesions in mildest degree were found at group who used ORC.

Conclusion: Triple layer composite mesh can be used as an alternative for diaphragmatic defect repair. There was no exaggerated inflammation or foreign body reaction"

"Latar Belakang: Dalam penanganan hernia ventralis, penggunaan mesh menjadi standar untuk menutup defek dinding abdomen anterior. Mesh komposit yang sesuai untuk penutupan defek dinding abdomen anterior saat ini harganya mahal dan sulit didapatkan di daerah-daerah terpencil di Indonesia. Penelitian ini mengembangkan mesh komposit triple layer dari amniotic membrane coated polypropylene mesh with adhesion barrier sebagai alternatif penutup defek dinding abdomen anterior pada hernia ventralis.Metode: Penelitian eksperimental ini dilakukan terhadap tikus Sprague-Dawley pasca dilakukan pembentukan hernia ventralis mekanik buatan, lalu dibagi menjadi empat kelompok yang masing-masing mendapatkan sham surgery¸mesh polypropylene, mesh komposit amniotic membrane coated polypropilene mesh (AMPM), dan mesh komposit Amniotic membrane coated polypropylene mesh with adhesion barrier (mesh komposit triple layer). Pada hari ke-7 dan hari ke-30 pasca perlakuan, dilakukan penilaian rekurensi defek dinding abdomen anterior baru; gambaran histologis derajat jumlah sel polimorfonuklear (PMN), foreign body giant cells (FBGC), fibroblas dan neovaskularisasi, dan adhesi mesh dengan jaringan sekitar pada masing-masing kelompok.Hasil: Terdapat 20 tikus Sprague-Dawley dengan usia 4-5 minggu yang diikutsertakan dalam studi. Seluruh tikus tidak mengalami rekurensi defek dinding abdomen anterior baru pada hari ke-7 maupun 30 pasca perlakuan. Tidak ditemukan perbedaan derajat histologis jumlah sel PMN, FBGC, dan fibroblast antar kelompok perlakuan, namun terdapat perbedaan signifikan antara kelompok mesh polypropylene dengan mesh AMPM dan dengan mesh komposit triple layer untuk derajat histologis neovaskularisasi (p=0.025) dan adhesi (p=0.025 dan p=0.034 secara berurutan). Perbandingan gambaran histologis setiap kelompok perlakuan pada hari ke-7 dan 30 tidak menunjukkan adanya perbedaan yang signifikan. Kesimpulan: Mesh komposit triple layer dapat digunakan sebagai alternatif penutup defek dinding abdomen anterior.Tidak ada perbedaan dalam rekurensi pada dinding abdomen di semua kelompok perlakuan. Kelompok mesh komposit triple layer dan AMPM menunjukkan derajat neovaskularisasi yang signifikan lebih tinggi serta derajat adhesiyang siginifikan lebih rendah dibandingkan kelompok polypropylene mesh.

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ntroduction: In the management of ventral hernia, the use of mesh for anterior abdominal wall defect closure has become a standard. Currently, a suitable composite mesh for anterior abdominal wall defect closure is expensive and not always available in every hospital. This study aimed to develop triple-layer composite mesh made from amniotic membrane coated polypropylene mesh with adhesion barrier as an alternative for anterior abdominal wall defect closure.

Method: This experimental study was conducted using Sprague-Dawley mice, inflicted with mechanical ventral hernia, and then divided into four groups given different treatments after: sham surgery, mesh polypropylene, amniotic membrane coated polypropylene mesh (AMPM) composite, and amniotic membrane coated polypropylene mesh with adhesion barrier (triple-layer composite mesh). After 7 and 30 days of procedure, we estimated the recurrence of new anterior abdominal wall defect, histological profile of polymorphonuclear (PMN) cells, foreign body giant cells (FBGC), fibroblast cells, neovascularization, and adhesion of mesh with surrounding tissue in each group.

Result: Twenty Sprague-Dawley mice aged 4-5 weeks were included in our study. We recorded no recurrence of anterior abdominal wall defect in all groups, both in 7- and 30-days post-procedure. This study found no significant difference in histological profiles of PMN, FBGC, and fibroblast cells from each group, but we found statistically significant difference in the histological profile of neovascularization (p=0.025) and adhesion rate (p-0.025 and p=0.034 respectively) of polypropylene mesh group with AMPM mesh group and triple-layer composite group. Histological profile comparison of each group in 7- and 30-days post-procedure showed no significant difference.

Conclusion: Triple layer composite mesh can be used as an alternative to cover anterior abdominal wall defects. There was no difference in abdominal wall recurrence in all treatment groups. Triple-layer composite mesh group and AMPM mesh group significantly showed higher rate of neovascularization and lower rate of adhesion compared to polypropylene mesh group."

"ABSTRAK Pendahuluan. Kesulitan dalam tatalaksana defek tulang yang luas merupakan salah satu tantangan dewasa ini. Selain tatalaksananya yang kompleks juga dapat memberikan dampak jangka panjang negatif yang berat. Penggunaan BMP-2 dalam tatalaksana fraktur dengan defek tulang yang luas memegang peranan penting. BMP-2 berperan pada proses osteogenesis dan chondrogenesis dan menghambat osteoclastogenesis melalui RANKL signaling. Penelitian ini bertujuan untuk mengetahui efek dari perbedaan dosis BMP-2 terhadap penyembuhan fraktur dengan defek tulang yang luas. Metode. Penelitian dilakukan di Laboratorium Animal Gizi di FKUI dan Laboratorium Patologi Anatomi FKUI-RSCM, pada bulan Juli hingga September 2015. Desain penelitian adalah randomized post test control group. Sejumlah 25 ekor tikus putih Sprague Dawley dengan usia 3-4 bulan dan berat badan antara 250 ? 350 gram, dibagi secara acak menjadi kelompok kontrol hidroksiapatit (HA) saja dan kelompok kombinasi HA + BMP-2 1 μg/ml, HA + BMP-2 5 μg/ml, HA + BMP-2 10 μg/ml, HA + BMP-2 20 µg/ml. Tiap kelompok dilakukan tindakan berupa frakturisasi dengan defek tulang 10mm pada femur kanan dan dilakukan fiksasi interna dengan menggunakan intramedullary k-wire ukuran 1,4 mm secara retrograd. Setelah 6 minggu dilakukan penilaian secara histomorfometri, radiologis dan Scanning Electron Microscope (SEM). Hasil. Berdasarkan hasil penelitian secara histomorfometri ditemukan terdapat perbedaan rerata total area kalus yang bermakna diantara kelompok penelitian (p<0,001),terdapat perbedaan bermakna rerata area penulangan antara kelompok kontrol dengan kelompok 1 μg/ml, 5 μg/ml, 10 μg/ml, 20 μg/ml (masing-masing p=0,009, p=0,016, p=0,009 dan p=0,016), terdapat perbedaan bermakna rerata area kartilago antara kelompok kontrol dengan kelompok 1 μg/ml, 5 μg/ml, 10 μg/ml, 20 μg/ml (masing-masing p=0,009, p=0,009, p=0,009 dan p=0,028), terdapat perbedaan bermakna rerata area fibrosis antara kelompok kontrol dengan kelompok 1 μg/ml dengan kelompok kontrol dan 10 μg/ml(masing-masing p=0,047 dan p=0,009).Secara radiologis dengan RUST score didapatkan perbedaan bermakna antara kelompok kontrol dengan kelompok 1 μg/ml, 5 μg/ml, 10 μg/ml, 20 μg/ml (masing-masing p=0,005, p=0,006, p=0,005 dan p=0,006). Dengan SEM didapatkan gambaran kalus yang lebih homogen dan padat pada kelompok 10μg/ml dibandingkan dengan 5 μg/ml dan 20 μg/ml. Kesimpulan: Pemberian BMP-2 dapat menstimulasi proses penyembuhan fraktur pada defek tulang luas (critical bone defect) yang bermakna secara statistik, histomorfometri, radiologis maupun secara kualitatif dengan SEM. Terdapat dosis optimal dalam pemberian BMP-2.ABSTRACT Introduction: Difficulties in the management of extensive bone defects is one of today's challenges. It is not only complex treatment but also can provide long-term negative severe effects. The use of BMP-2 in the treatment of fractures with extensive bone defect plays an important role. BMP-2 plays a role in the process of osteogenesis and chondrogenesis and inhibits osteoclastogenesis via the RANKL signaling. This study aims to determine the effect of differences in doses of BMP-2 on the healing of the fracture with extensive bone defects. Methods: The study was conducted at the Laboratory of Animal Nutrition at the Faculty of Medicine University of Indonesia (FMUI) in July until September 2015. The study design was randomized posttest control group. A number of 25 Sprague Dawley rats aged 3-4 months and bodyweight between 250-350 grams, were randomly divided into a control group of hydroxyapatite (HA) alone and HA+BMP-2 1 µg / ml, HA+BMP -2 5 ug / ml, HA + BMP-2 10 µg / ml, HA + BMP-2 20 ug / ml. Each group carried out fracturization with 10mm bone defect in right femur and internal fixation by using intramedullary K-wire size of 1.4 mm retrograde. After 6 weeks we did histomorfometri assessment, radiological and Scanning Electron Microscope (SEM). Results: Based on the research results histomorfometrcally found there are differences in the mean total area of ​​callus significantly between the study group (p <0.001), there were significant differences in the mean area of ​​woven bone between the control group with group 1 ug / ml, 5 µg / ml, 10 µg / ml, 20 ug / ml (respectively p = 0.009, p = 0.016, p = 0.009 and p = 0.016), there were significant differences in the average area of ​​the cartilage between the control group with group 1 ug / ml, 5 µg / ml, 10 µg / ml, 20 ug / ml (respectively p = 0.009, p = 0.009, p = 0.009 and p = 0.028), there were significant differences in the average area of ​​fibrosis between the control group with group 1 ug / ml in the control group and 10 mg / ml (respectively -masing p = 0.047 and p = 0.009) .In radiologist assessment with RUST scores obtained significant differences between the control group and group 1 ug / ml, 5 µg / ml, 10 µg / ml, 20 µg / ml (respectively p = 0.005 , p = 0.006, p = 0.005 and p = 0.006). SEM features with callus more homogeneous and dense in the group of 10μg / mL compared with 5 ug / ml and 20 µg / ml. Conclusion: Administration of BMP-2 could stimulate the process of fracture healing in large bone defects (critical bone defect) which was statistically significant with histomorfometri assestment, radiological and qualitatively with the SEM. There is an optimal dose in the administration of BMP-2.;Introduction: Difficulties in the management of extensive bone defects is one of today's challenges. It is not only complex treatment but also can provide long-term negative severe effects. The use of BMP-2 in the treatment of fractures with extensive bone defect plays an important role. BMP-2 plays a role in the process of osteogenesis and chondrogenesis and inhibits osteoclastogenesis via the RANKL signaling. This study aims to determine the effect of differences in doses of BMP-2 on the healing of the fracture with extensive bone defects. Methods: The study was conducted at the Laboratory of Animal Nutrition at the Faculty of Medicine University of Indonesia (FMUI) in July until September 2015. The study design was randomized posttest control group. A number of 25 Sprague Dawley rats aged 3-4 months and bodyweight between 250-350 grams, were randomly divided into a control group of hydroxyapatite (HA) alone and HA+BMP-2 1 µg / ml, HA+BMP -2 5 ug / ml, HA + BMP-2 10 µg / ml, HA + BMP-2 20 ug / ml. Each group carried out fracturization with 10mm bone defect in right femur and internal fixation by using intramedullary K-wire size of 1.4 mm retrograde. After 6 weeks we did histomorfometri assessment, radiological and Scanning Electron Microscope (SEM). Results: Based on the research results histomorfometrcally found there are differences in the mean total area of ​​callus significantly between the study group (p <0.001), there were significant differences in the mean area of ​​woven bone between the control group with group 1 ug / ml, 5 µg / ml, 10 µg / ml, 20 ug / ml (respectively p = 0.009, p = 0.016, p = 0.009 and p = 0.016), there were significant differences in the average area of ​​the cartilage between the control group with group 1 ug / ml, 5 µg / ml, 10 µg / ml, 20 ug / ml (respectively p = 0.009, p = 0.009, p = 0.009 and p = 0.028), there were significant differences in the average area of ​​fibrosis between the control group with group 1 ug / ml in the control group and 10 mg / ml (respectively -masing p = 0.047 and p = 0.009) .In radiologist assessment with RUST scores obtained significant differences between the control group and group 1 ug / ml, 5 µg / ml, 10 µg / ml, 20 µg / ml (respectively p = 0.005 , p = 0.006, p = 0.005 and p = 0.006). SEM features with callus more homogeneous and dense in the group of 10μg / mL compared with 5 ug / ml and 20 µg / ml. Conclusion: Administration of BMP-2 could stimulate the process of fracture healing in large bone defects (critical bone defect) which was statistically significant with histomorfometri assestment, radiological and qualitatively with the SEM. There is an optimal dose in the administration of BMP-2."

"PendahuluanSalah satu tantangan dalam tatalaksana fraktur saat ini adalah rekonstruksi fraktur dengan defek tulang yang luas, di mana dibutuhkannya restorasi alignment dan fiksasi yang stabil untuk keberhasilan rekonstruksi. Pada kasus fraktur dengan defek tulang tidak ada lagi komponen osteoinduksi dan osteokonduktif sehingga diperlukan penggunaan graft tulang ataupun tindakan transport tulang. Walaupun perkembangan teknologi dan kemajuan dalam pembedahan orthopaedi telah berkembang saat ini, hasil akhir dari penyembuhan tulang paska pembedahan pada beberapa kasus fraktur akan mengalami penyembuhan tulang yang kurang baik yang akhirnya akan menyebabkan defek ataupun non-union dari fraktur tersebut.MetodeDesain penelitian adalah studi post test control group design. Sampel yang digunakan adalah dua puluh delapan tikus putih Sprague Dawley yang telah mengalami maturasi skeletal (8-12 minggu), dibagi menjadi empat kelompok, tiap tikus akan dilakukan tindakan fraktur dengan defek tulang pada tulang femur selebar 4mm, kemudian tikus dibagi berdasarkan implantasi yang diberikan, yaitu kelompok kontrol, kelompok implantasi amnion liofilisasi steril, kelompok implantasi xenograft morcalized bovine, dan kelompok implantasi kombinasi amnion dengan xenograft. Hewan coba akan dikorbankan setelah 8 minggu, kemudian dilakukan pemeriksaan radiologis dan histopatologis dari fraktur. Evaluasi radiologis menggunakan skor menurut Lane dan Sandhu, evaluasi histopatologis menggunakan skor menurut Salkeld.HasilBerdasarkan uji statistik non parametrik Kruskal-Wallis terhadap skor radiologis tulang pada minggu ke-8 paska pembedahan didapat nilai p 0,25. Secara statistik dapat diambil kesimpulan bahwa tidak terdapat perbedaan bermakna perbandingan skor radiologis antara empat kelompok tersebut. uji statistik non parametrik Kruskal-Wallis pada skor histopatologis menurut Salkeld minggu ke-8 paska pembedahan didapat nilai p 0,001 secara statistik, dapat diambil kesimpulan bahwa terdapat perbedaan bermakna perbandingan skor histopatologis antara empat kelompok tersebut.KesimpulanSkor radiologis pada implantasi amnion liofilisasi steril dibanding dengan kelompok kontrol pada fraktur dengan defek tulang tidak memberikan perbedaan bermakna, sementara skor histologis memberikan perbedaan percepatan penyembuhan bermakna pada implantasi amnion liofilisasi steril dibanding dengan kelompok kontrol. Skor radiologis dan histologis pada implantasi xenograft morcalized bovine dibanding kelompok kontrol tidak memberikan perbedaan percepatan penyembuhan bermakna. Skor radiologis pada implantasi kombinasi amnion liofilisasi steril dan xenograft morcalized bovine dibanding dengan kelompok kontrol tidak memberikan perbedaan bermakna, sementara skor histologis memberikan perbedaan percepatan penyembuhan bermakna dibanding dengan kelompok kontrol.

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Introduction

One of the current chalenge on fracture treatment is reconstruction of fracture with critical size bone defect, where the restoration of the alignment dan stable fixation for succesfull result is necessary. bone graft or bone transport is usually needed for bone defect reconstruction because there isnt any osteoinductive and osteoconductive component on fracture with bone defect. Although new technologies and advances in orthopaedic surgery have enhanced fracture healing and surgical outcomes, there are fracture that continue to be deficient in bone repair or become non-union.

Methode

The research design is post test control group using twenty eight skeletally matured Sprague Dawley rats, divided into four groups, 4mm sized femoral defects were surgically created in the right femur of 28 rats. 7 rats were ran­domly assigned to each treatment group, in which the femoral defect was filled with sterile lyophilized amnion, morcalized bovine xenograft and combination. In the empty defect group (control group) defects were left empty. Animals were sacrificed at 8 weeks postoperatively. Then the radiologic and histopathologic examination were completed. Radiologic evaluation using Lane and Sandhu score, histologic evaluation using Salkeld score.

Result

Non parametric Kruskal-Wallis statistic analysis for the radiologic score 8 weeks postoperatively reveal p value 0,25 which mean there is no significance difference between four groups. However for the histopathologic score statistic analysis examination reveal the p value 0,001 which mean there are significance differences between four groups. The statistic analysis for histopathologic is then continued with Man Whitney analysis.

Conclusion

Regarding the radiologic score, amniotic membrane has similar radiological score to control, however the histopathologic score is better. Xenograft have similar radiological and histopathological score to the control. Combination of amniotic membrane with xenograft has better histopathological score to control. Although the radiologic score is similar.

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"[ABSTRAKLatar Belakang: Kebutuhan bahan pengganti tulang pada bidang bedah mulut dan maksilofasial semakin meningkat. Metode guided bone regeneration (GBR) yaitu suatu metode penambahan volume tulang dengan memungkinkan terjadinya pertumbuhan jaringan tulang yang selektif dalam suatu ruang, dimana pertumbuhan sel-sel tulang tersebut dijaga oleh suatu bahan (membran). Berkembangnya bahan biokomposit yang diketahui secara fakta bahwa pada penggunaan satu bahan saja tidak dapat digunakan untuk memenuhi seluruh kebutuhan pada penggunaan bahan implan pada biomedikal. Pada penelitian ini dibuat suatu komposit membran yang terdiri dari perpaduan bahan polivinilalkohol (PVA) + kolagen + hidroksiapatit. Kompositmembran (PVA-Kolagen-HA) diaplikasikan pada defek mandibular tikus Sprague-Dawley. Tujuan: Mengkaji penggunaan komposit membran (PVA-Kolagen- Hidroksiapatit) dalam regenerasi defek tulang mandibula pada hewan coba tikus perlakuan dibandingkan dengan hewan coba tikus kontrol dengan menilai sel osteoblas, sel radang dan angiogenesis.Metode Penelitian: 40 ekor tikus jantan jenis Sprague-Dawley usia 8-10 minggu dengan berat badan rata-rata 225 ± 25 gram. Tikus dibagi atas kelompok kontrol dan kelompok perlakuan dengan masing-masing berjumlah 20 ekor tikus. Dilakukan pembuatan defek pada angulus mandibular kiri tikus. Pada tikus kontrol tidak diaplikasi dengan komposit membran sedangkan pada kelompok perlakuan diaplikasi dengan komposit membran (PVA-Kolagen-HA). Kelompok kontrol dan kelompok perlakuan dengan komposit membran diamati sel osteoblas, sel radang dan angiogenesis melalui preparat histopatologi pada interval waktu hari ke-3, hari ke-7, hari ke-10, hari ke-14 dan hari ke-21. Hasil: Terdapat perbedaan bermakna (p<0,01) terhadap jumlah sel osteoblas, jumlah sel radang dan angiogenesis antara kelompok kontrol dan kelompok perlakuan dengan komposit membran (PVA-Kolagen-Hidroksiapatit). Terdapat perbedaan bermakna (p<0,01) antara jumlah sel osteoblas, jumlah sel radang dan angiogenesis terhadap interval waktu (3 hari, 7 hari, 10 hari, 14 hari dan 21 hari). Kesimpulan: Penggunaan komposit membran (PVA-Kolagen-Hidroksiapatit) mempercepat regenerasi tulang mandibular pada hewan coba tikus Sprague?Dawley.

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ABSTRACTBackground: The need of alternative bone substance in oral and maxillofacial surgery has increased. Guided bone regeneration method (GBR) is one of bone adding volume method by making the bone tissue regeneration to occur selectively in a room where the growth of bone cells are protected by a particular substance (membrane). It has been known that the developing biocomposite substance is cannot be achieved from only a single substance to recover all the requirements needed in the use of biomedic implant. In this study, a composite membrane consist of combination of polivinilalcohol material (PVA) + collagen + hydroxyapatite was made. Composite membrane applied on the mandibular defect of Sprague-Dawley rats.Objective: To evaluate the use of compocite membrane (PVA-Collagen-Hydroxyapatite) for regeneration of mandibular defect in animal testing (rats) comparing with group control of animal testing by observing the osteoblas, membrane (PVA-Collagen-HA) applied only in rats of testing group. The appearance of osteoblasts, inflammation cells, and angiogenesis were evaluated histopathologically on interval of 3rd, 7th, 10th, 14th and 21st day after application of composite membrane. Result: There are significant differences (p<0,01) in the number of osteoblast cells, inflammation cells and angiogenesis between the control group and the group applied with composite membrane (PVA-Collagen-Hydroxyapatite) on interval of determined days (day 3, day 7, day 10, day 14 and day 21st). Conclusion: Use of composite membrane (PVA-Collagen-Hydroxy) accelerates the mandibular bone regeneration of animal testing Sprague-Dawley rats.;Background: The need of alternative bone substance in oral and maxillofacial surgery has increased. There are many ways can be done to add bone volume.Guided bone regeneration method (GBR) is one of bone adding volume method bymaking the bone tissue regeneration to occur selectively in a room where thegrowth of bone cells are protected by a particular substance (membrane). It hasbeen known that the developing biocomposite substance is cannot be achieved fromonly a single substance to recover all the requirements needed in the use ofbiomedic implant. In this study, a composite membrane consist of combination ofpolivinilalcohol material (PVA) + collagen + hydroxyapatite was made. Compositemembrane applied on the mandibular defect of Sprague-Dawley rats.Objective: To evaluate the use of compocite membrane (PVA-CollagenHydroxyapatite)for regeneration of mandibular defect in animal testing (rats)comparing with group control of animal testing by observing the osteoblas,inflammation cells and angiogenesis.Method: 40 male Sprague-Dawley rats aged 8-10 months with weight ofapproximately 225 ± 25 grams were divided into two groups. First twenty rats weretreated as control group and another twenty rats for testing group. Defecation onleft angulus mandibula was done for all groups and composite membrane (PVACollagen-HA)appliedonlyinratsoftestinggroup.Theappearanceofosteoblasts,inflammationcells,andangiogenesiswereevaluatedhistopathologicallyonintervalof3rd,7th,10th,14thand21stdayafterapplicationofcompositemembrane.Thisstudywasdoneundercertificationfromtheresearchethicalcommittee.Result:Therearesignificantdifferences(p<0,01)inthenumberofosteoblastcells,inflammationcells and angiogenesis between the control group and the groupapplied with composite membrane (PVA-Collagen-Hydroxyapatite) on interval ofdetermined days (day 3, day 7, day 10, day 14 and day 21st).Conclusion: Use of composite membrane (PVA-Collagen-Hydroxy) accelerates the mandibular bone regeneration of animal testing Sprague-Dawley rats. ;Background: The need of alternative bone substance in oral and maxillofacial surgery has increased. There are many ways can be done to add bone volume.Guided bone regeneration method (GBR) is one of bone adding volume method bymaking the bone tissue regeneration to occur selectively in a room where thegrowth of bone cells are protected by a particular substance (membrane). It hasbeen known that the developing biocomposite substance is cannot be achieved fromonly a single substance to recover all the requirements needed in the use ofbiomedic implant. In this study, a composite membrane consist of combination ofpolivinilalcohol material (PVA) + collagen + hydroxyapatite was made. Compositemembrane applied on the mandibular defect of Sprague-Dawley rats.Objective: To evaluate the use of compocite membrane (PVA-CollagenHydroxyapatite)for regeneration of mandibular defect in animal testing (rats)comparing with group control of animal testing by observing the osteoblas,inflammation cells and angiogenesis.Method: 40 male Sprague-Dawley rats aged 8-10 months with weight ofapproximately 225 ± 25 grams were divided into two groups. First twenty rats weretreated as control group and another twenty rats for testing group. Defecation onleft angulus mandibula was done for all groups and composite membrane (PVACollagen-HA)appliedonlyinratsoftestinggroup.Theappearanceofosteoblasts,inflammationcells,andangiogenesiswereevaluatedhistopathologicallyonintervalof3rd,7th,10th,14thand21stdayafterapplicationofcompositemembrane.Thisstudywasdoneundercertificationfromtheresearchethicalcommittee.Result:Therearesignificantdifferences(p<0,01)inthenumberofosteoblastcells,inflammationcells and angiogenesis between the control group and the groupapplied with composite membrane (PVA-Collagen-Hydroxyapatite) on interval ofdetermined days (day 3, day 7, day 10, day 14 and day 21st).Conclusion: Use of composite membrane (PVA-Collagen-Hydroxy) accelerates the mandibular bone regeneration of animal testing Sprague-Dawley rats. , Background: The need of alternative bone substance in oral and maxillofacial surgery has increased. There are many ways can be done to add bone volume.Guided bone regeneration method (GBR) is one of bone adding volume method bymaking the bone tissue regeneration to occur selectively in a room where thegrowth of bone cells are protected by a particular substance (membrane). It hasbeen known that the developing biocomposite substance is cannot be achieved fromonly a single substance to recover all the requirements needed in the use ofbiomedic implant. In this study, a composite membrane consist of combination ofpolivinilalcohol material (PVA) + collagen + hydroxyapatite was made. Compositemembrane applied on the mandibular defect of Sprague-Dawley rats.Objective: To evaluate the use of compocite membrane (PVA-CollagenHydroxyapatite)for regeneration of mandibular defect in animal testing (rats)comparing with group control of animal testing by observing the osteoblas,inflammation cells and angiogenesis.Method: 40 male Sprague-Dawley rats aged 8-10 months with weight ofapproximately 225 ± 25 grams were divided into two groups. First twenty rats weretreated as control group and another twenty rats for testing group. Defecation onleft angulus mandibula was done for all groups and composite membrane (PVACollagen-HA)appliedonlyinratsoftestinggroup.Theappearanceofosteoblasts,inflammationcells,andangiogenesiswereevaluatedhistopathologicallyonintervalof3rd,7th,10th,14thand21stdayafterapplicationofcompositemembrane.Thisstudywasdoneundercertificationfromtheresearchethicalcommittee.Result:Therearesignificantdifferences(p<0,01)inthenumberofosteoblastcells,inflammationcells and angiogenesis between the control group and the groupapplied with composite membrane (PVA-Collagen-Hydroxyapatite) on interval ofdetermined days (day 3, day 7, day 10, day 14 and day 21st).Conclusion: Use of composite membrane (PVA-Collagen-Hydroxy) accelerates the mandibular bone regeneration of animal testing Sprague-Dawley rats. ]"

"Pendahuluan: Magnesium (Mg) memiliki karakter biomekanik menyerupai tulang dengan mechanical strength melebihi keramik namun mempunyai tingkat korosi yang tinggi. Salah satu cara untuk mengurangi tingkat korosi Mg adalah dengan mencampurnya dengan material lain atau melapisinya. Karbonat apatit (CA) dipilih untuk menjadi campuran komposit Mg karena osteokonduktivitasnya yang baik. Penelitian ini bertujuan untuk mengevaluasi biodegradabilitas implan komposit MgxCA yang dibuat dengan teknik ekstrusi pada tikus Sprague Dawley.Metode: Penelitian ini merupakan uji post-test only in vivo experimental pada tikus Sprague Dawley (SD) pada bulan Juli hingga Desember 2021. Sebanyak 33 tikus SD dibagi menjadi 6 kelompok perlakuan yaitu kelompok dengan plat Mg0CA, Mg5CA, Mg10CA, Mg15CA, titanium, serta prosedur sham. Pemeriksaan meliputi diameter paha, pembentukan gas pasca operasi (krepitasi), kondisi luka, kadar laboratorium, dan analisis histopatologis pada hari ke 15 dan 30.Hasil: Tidak ditemukan perbedaan yang signifikan pada diameter paha, krepitasi, dan kondisi luka antar kelompok perlakuan selama 5 hari pasca-operasi (p>0.05). Didapatkan perbedaan yang signifikan pada pembentukan gas pada hari ke 15 dimana implantitanium menunjukan pembentukan gas yang lebih rendah (p=0.002) namun kembali menjadi tidak signifikan pada hari ke 30 (p>0.05). Pemeriksaan laboratorium dan histopatologis tidak menunjukan perbedaan yang bermakna baik secara lokal ataupun sistemik (p>0.05).Kesimpulan: Kombinasi magnesium dengan karbonat apatit dari teknis fabrikasi ekstrusi merupakan implan yang biodegradable dengan biokompatibilitas yang tidak toksik baik secara lokal ataupun sistemik.

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Introduction : Magnesium (Mg) has a biomechanical character resembling bone with mechanical strength exceeding ceramics but has a high corrosion rate. One way to reduce the corrosion level of Mg is to mix it with other materials or coatingit. Carbonate apatite (CA) was chosen to be a Mg composite mixture because of its good osteoconductivity. This study aimed to evaluate the biodegradability of MgxCA composite implants made by extrusion technique in Sprague Dawley.

Method: This study is a post-test only in vivo experimental on Sprague Dawley (SD) mice from July to December 2021. A total of 33 SD rats were divided into 6 treatment groups, namely groups with plates Mg0CA, Mg5CA, Mg10CA, Mg15CA, titanium, and sham procedures. The examination includes thigh diameter, postoperative gas formation (crepitation), wound condition, l levelof the aboratorium, and histopathological analysis on days 15 and 30.

Result:No significant differences were found in thigh diameter, crepitation, and wound condition between treatment groups during 5 days post-operative (p>0.05). There was a significant difference in gas formation on day 15 where titanium implants showed lower gas formation (p = 0.002) but again became insignificant on day 30 (p > 0.05). Laboratory and histopathological tests showed no significant differences either locally or systemically (p>0.05).

Conclusion: The combination of magnesium with apatite carbonate from extruded fabrication techniques is a biodegradable implant with biocompatibility with non-toxic properties either locally or systemically. "

"[ABSTRAKLatar Belakang: Penggunaan biomaterial berupa bahan tandur tulang dan membran untuk prosedur Guided Bone Regeneration (GBR) sangat diperlukan di bidang bedah maksilofasial dan, untuk mengatasi defek tulang yang dapat terjadi oleh berbagai sebab. Penelitian ini bertujuan untuk mengetahui efek pemakaian bahan tandur tulang DFDBX dengan membran perikardium (MPK) bovine pada defek tulang kalvaria tikus.Bahan dan Metode: Studi eksperimental ini menggunakan 45 ekor tikus Sprague Dawley sebagai hewan coba dibagi dalam 3 kelompok secara acak. Ciritical size defect sebesar diameter 5 mm dibuat pada tulang kalvaria seluruh hewan coba. Kelompok I merupakan kelompok kontrol, tidak diberikan perlakuan dan defek dibiarkan sembuh dengan sendirinya, kelompok II yang diberi DFDBX, dan pada kelompok III defek diisi dengan DFDBX dan ditutup dengan MPK (DFDBX+MPK). Setelah 1,4 dan 8 minggu dilakukan dilakukan pengorbanan pada kelompok hewan coba, dilanjutkan dengan evaluasi secara radiologik, histopatologik untuk reaksi radang, pertumbuhan tulang dan pemeriksaan imunohistokimia dengan osteokalsin. Data dianalisis secara statistik dengan menggunakan uji ANOVA.Hasil: Penilaian radiografik diperoleh perbedaan bermakna pada rerata densitas area defek minggu ke 8 antara kelompok kontrol dengan DFDBX+MPK (p<0,001) dan antara kelompok DFDBX dengan DFDBX+MPK (p=0,03).Pertumbuhan tulang baru pada minggu ke 8 tertinggi adalah pada kelompok DFDBX+MPK dengan perbedaan bermakna dengan kelompok kontrol (p=0,016) dan dengan kelompok DFDBX nilai p=0,048. Ekspresi osteokalsin minggu ke-8 menunjukkan perbedaan bermakna antara kelompok kontrol dengan kelompok DFDBX (p<0,001) maupun dengan kelompok DFDBX+MPK (p=0,0013), namun tidak terdapat perbedaan bermakna antara kelompok DFDBX dengan kelompok MPK (p=1,000).Kesimpulan: Penggunaan DFDBX dengan kombinasi MPK terbukti secara radiologik, histopatologik dan imunohistokimia dapat meningkatkan regenerasi tulang pada defek tulang kalvaria.

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ABSTRACTBackground: Reconstruction of cranial and maxillofacial defects is a challenging task. The standard method has included bone grafting and using membrane in guided bone regeneration procedure. Using biomaterial such as bone grafting and membrane for Guided Bone Regeneration (GBR) procedures is an essential issue in maxillofacial and dental reconstruction surgery to overcome bone defects caused by various etiologies. Our study was aimed to identify the effect of using Demineralized Freeze-Dried Bone Xenograft (DFDBX) with (or without) bovine pericardium membrane (PCM) on the treatment of rats calvarial bone defects.Materials and Method: The experimental study used 45 Sprague-Dawley rats as the experimental animals, which were categorized randomly into three groups, i.e. the control group, DFDBX group, and DFDBX+PCM group. The 5-mm-critical-sized calvarial defects were created in all experimental animals. The first group was a control group, which did not receive any treatment with self-limiting defects; while subjects in the second group received DFDBX (DFDBX group) and in the third group, the defects were filled with DFDBX and PCM (DFDBX + PCM group). Animals were sacrified at the 1st, 4th, and 8th weeks following the surgery. Subsequently, an evaluation was carried out using radiological analysis, histopathological assay to observe inflammatory reaction and bone growth, as well as immunohistochemical analysis of osteocalcin. Data were analyzed statistically using ANOVA test. The specimens were embedded ini paraffin, serially cut, and stained with hematoxylin and eosin for analysis under light microscope. The inflammation reaction, new bone formation, and the rest of DFDBX and PCM were histomorphometrically evaluated. Immunohistochemical analysis of osteocalcin expression was performed.Results: Radiological analysis demonstrated a significant difference of mean bone density in the defect area at the 8th week between subjects in the control group and those in DFDBX+PCM group (p < 0.001), as well as between subjects in the DFDBX group and those in DFDBX+PCM group (p = 0.03). The highest rate of bone healing at the 8th week was found in DFDBX+PCM group, which showed significant difference compared to the control group (p=0.016) and to DFDBX group (p=0.048). There was a significant difference of osteocalcin expression between the control group and DFDBX group (p < 0.001), as well as between the control group and DFDBX + PCM group (p=0,0013). However, there was no significant difference between the DFDBX group and the DFDBX+PCM group (p = 1.000). Conclusion: Our radiological, histopahtological and immunohistochemical evaluation has demonstrated that DFDBX combined with PCM increases bone regeneration in the treatment of bone calvarial defect. ;Background :Reconstruction of cranial and maxillofacial defects is a challenging task. The standard method has been bone grafting and using membrane in guided boneregeneration procedure.The aim of this study was to analyze the effect of Demineralized Freeze Dried BoneXenograft (DFDBX) with (or without)bovine pericardium membrane (PCM) on boneregeneration, in surgically created critical-size defects in rat calvaria, radiographically,histopathologically and immunohistochemically.Material and Methods :Surgical critical-size bone defects were created in 45 animalsthat randomly divided into three groups : control group, DFDBX group, andDFDBX+PCM group. Animals were sacrified at 1, 4 and 8 weeks post surgery.Radiological analysis was done. The specimens were embedded ini paraffin, serially cut,and stained with hematoxylin and eosin for analysis under light microscope. Theinflammation reaction, new bone formation, and the rest of DFDBX and PCM werehistomorphometrically evaluated. Immunohistochemical analysis of osteocalcinexpression was performed. Result : DFDBX and DFDBX+PCM groups demonstrated superior bone healingcompared with control group. Group DFDBX+PCM showmore advanced healing at 8weeks post surgery and show the highest density radiographically as compared with theother group DFDBX and control.Immunohistochemistry revealed the presence ofosteocalcin in osteoblast and matrix extracellular and show significant differences werenoted between DFDBX and DFDBX+PCM to control groups.Conclusion : Application of DFDBX combined with bovine PCM gave the best result in bone regeneration of critical size defects in rat calvaria. , Background :Reconstruction of cranial and maxillofacial defects is a challenging task. The standard method has been bone grafting and using membrane in guided boneregeneration procedure.The aim of this study was to analyze the effect of Demineralized Freeze Dried BoneXenograft (DFDBX) with (or without)bovine pericardium membrane (PCM) on boneregeneration, in surgically created critical-size defects in rat calvaria, radiographically,histopathologically and immunohistochemically.Material and Methods :Surgical critical-size bone defects were created in 45 animalsthat randomly divided into three groups : control group, DFDBX group, andDFDBX+PCM group. Animals were sacrified at 1, 4 and 8 weeks post surgery.Radiological analysis was done. The specimens were embedded ini paraffin, serially cut,and stained with hematoxylin and eosin for analysis under light microscope. Theinflammation reaction, new bone formation, and the rest of DFDBX and PCM werehistomorphometrically evaluated. Immunohistochemical analysis of osteocalcinexpression was performed. Result : DFDBX and DFDBX+PCM groups demonstrated superior bone healingcompared with control group. Group DFDBX+PCM showmore advanced healing at 8weeks post surgery and show the highest density radiographically as compared with theother group DFDBX and control.Immunohistochemistry revealed the presence ofosteocalcin in osteoblast and matrix extracellular and show significant differences werenoted between DFDBX and DFDBX+PCM to control groups.Conclusion : Application of DFDBX combined with bovine PCM gave the best result in bone regeneration of critical size defects in rat calvaria. ]"

"Pendahuluan: Penelitian in vitro menggambarkan inferioritas osteogenesis SPM adiposa dibandingkan dengan SPM sumsum tulang. Sebaliknya, penelitian in vivo menunjukkan kemiripan potensi osteogenik keduanya. penelitian ini mencoba mengetahui perbedaan kapasitas osteogenik antara keduanya dengan mengukur ekspresi Bone Morphogenetic Protein (BMP)-2 dan BMP Reseptor II, juga proses penyembuhan tulang dengan pengukuran histomorfometri.Metode: Delapan belas tikus Sprague dawley (SD) dilakukan defek tulang femur 5mm. Tikus dibagi tiga kelompok yang terdiri dari kontrol, implantasi SPM sumsum tulang + Hydroxypatite, dan implantasi SPM adiposa + Hydroxypatite. Tikus dikorbankan pada minggu kedua kemudian penilaian histomorfometri kuantitatif dilakukan dengan Image-J. Paramater yang diukur adalah luas total kalus, % area penulangan, % area kartilago, dan % area fibrosis. Dilakukan penilaian imunohistokimia menggunakan intensitas pewarnaan dan skor Imunoreaktivitas (IRS).Hasil: Kelompok SPM sumsum tulang menunjukkan ekspresi BMPR II lebih tinggi dibandingkan kelompok lainnya. Ekspresi BMPR II dianalisis dan didapatkan hasil yang signifikan (p= 0,04) dengan median 4.00 ± 2.75. Kelompok SPM sumsum tulang dan adiposa juga menunjukkan proses penyembuhan tulang yang lebih baik dibandingkan kelompok kontrol (p = 0,001). Tidak ada perbedaan yang signifikan antara SPM sumsum tulang dan SPM adiposa yang diukur pada % total area kalus (p = 1.000),% area penulangan (p = 1.000),% kartilago (p = 0,493) dan % fibrosis (p = 0,128).Diskusi: SPM adiposa memiliki kemampuan penyembuhan tulang yang serupa dengan SPM sumsum tulang. Growth factor dan reseptornya penting namun bukan satu-satunya faktor penyembuhan tulang.

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Introduction: In vitro studies describe inferior osteogenesis of Adiposes to Bone Marrow Mesenchymal Stem Cell (MSC). Contrary, in vivo studies showing the resemblance of osteogenic potential between both groups. This study tries to investigate the difference of osteogenic capacity between BMSCs and ASCs by quantifying the expression of Bone Morphogenetic Protein (BMP)-2 and BMP receptor (BMPR) II also the bone healing process by histomorphometry measurement.Methods: Eighteen Sprague dawley (SD) rats were induced with 5mm femoral bone defect, then divided into three groups that consist of Control, Implementation of BMSC+Hydroxypatite, and Implementation of ASC+Hydroxypatite. They were sacrificed after 2 weeks, then performed histomorphometry assessment with Image-J. The measured paramater were total area of callus, % of osseous area, % of cartilage area, and % of fibrotic area. The immunohistochemistry measurement performed by staining intensity and immunoreactivity score (IRS).Results: The BMSC group showed higher expression of BMPR II compare to others. The expression of BMPR II was analyzed statistically and showed significant result (p=0.04) with median 4.00 ± 2.75. Both BMSC and ASC group have significantly better bone healing process compared with control group (p=0,001). There are no significant differences between ASC and BMSC measured in %total callus area (p=1.000), %Osseous area (p=1.000), %Cartilage area (p=0.493) and % Fibrous area (p=0.180). Discussions: ASC bone healing ability are similar to BMSC. Growth factor and its receptor are important but not sole contributing factor for bone healing."

"Pendahuluan. Kebocoran anastomosis merupakan komplikasi yang berat berhubungan dengan peningkatan morbiditas, dan mempengaruhi lama rawat di rumah sakit. Banyak peneliti yang telah meneliti faktor resiko terjadinya kebocoran usus, diantaranya sepsis, malnutrisi, ketegangan garis anastomosis, gangguan perfusi jaringan, obstruksi distal, dll. Usus adalah organ yang rentan terhadap cedera, cedera pada usus dapat menyebabkan edema, ileus, dan kegagalan mekanisme pertahanan usus. Kondisi ini dapat ditemukan pada gastroshizis, invaginasi, strangulasi, penyakit radang usus dan sirosis. Pemberian cairan berlebih dapat menyebabkan edema, peningkatan tekanan intra abdomen, menurunkan aliran darah mesenterik, berpengaruh terhadap penyembuhan dan meningkatkan kebocoran anastomosis. Studi ini bertujuan untuk mengetahui pengaruh edema terhadap anastomosis usus. Metode. Studi eksperimental pada tikus Sprague–Dawley untuk mengetahui pengaruh edema dan pemberian cairan yang berlebihan terhadap anastomosis usus. Hasil. Tidak terdapat perbedaan antara edema usus dan pemberian cairan berlebihan dengan peningkatan kebocoran anastomosis (p=0,178)  Kesimpulan. Edema usus tidak ada hubungan dengan kebocoran anastomosis.

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Introduction. Anastomotic leak is a severe complication associated with increased morbidity, and affects hospital stay. Many researchers have examined risk factors for intestinal leakage, including sepsis, malnutrition, anastomotic line tension, impaired tissue perfusion, distal obstruction, etc. The intestine is an organ that is prone to injury, injury to the intestine can cause edema, ileus, and failure of the intestinal defense mechanism. This condition can be found in gastroshizis, invagination, strangulation, inflammatory bowel disease and cirrhosis. Excessive fluid can cause edema, increase intra-abdominal pressure, decrease mesenteric blood flow, affect healing and increase anastomotic leakage. This study is to investigate intestinal edema on anastomosis. Method. This is an experimental study using Sprague-Dawley to determine the effect of edema and excessive fluid administration on intestinal anastomosis Results. There was no difference between intestinal edema and excessive fluid administration with increased anastomotic leak (p = 0.178). Conclusion. Intestinal edema is not associated with anastomotic leakage."

"Latar Belakang: Ti-6Al-4V merupakan material implan yang sering digunakan untuk aplikasi biomedis, tetapi biaya produksi yang masih mahal. Sehingga diperlukan perlakuan panas untuk mengurangi biaya produksi dengan hasil produk yang optimal. Salah satu syarat diterimanya material implan yaitu harus kompatibel dengan jaringan sekitar. Tujuan: Mengamati efek implantasi material implan Ti-6Al-4V ELI dengan perlakuan panas 850°C pada regenerasi tulang femur tikus yang diamati melalui gambaran histologi. Metode: Penelitian ini menggunakan desain studi ekperimental pada 2 tikus betina Sprague Dawley di setiap kelompok. Terdapat 3 kelompok penelitian yang mencakup kelompok kontrol normal, kelompok kontrol defek, serta kelompok perlakuan yang diberi defek dan diimplantasi bahan uji material implan Ti-6Al-4V ELI dengan perlakuan panas 850°C. Tikus dikorbankan pada minggu ke-4 lalu dilakukan pengamatan histologis menggunakan skoring histologi Salkeld yang dimodifikasi. Hasil: Hasil skor histologi pada kedua sampel kelompok kontrol defek dan sampel-1 kelompok perlakuan yaitu 2 yang menandakan proses pembentukan tulang baru mencapai tahap pembentukan fibrokartilago. Pada sampel-2 kelompok perlakuan didapatkan hasil skor histologi 3 yang menandakan proses pembentukkan tulang sudah mencapai tahap terjadinya mineralisasi kartilago. Kesimpulan: Implantasi material implan Ti-6Al-4V ELI dengan perlakuan panas 850°C dapat diterima oleh jaringan tulang disekitarnya diamati dari proses regenerasi tulang yang ditunjukkan oleh adanya fibrosa, fibrokartilago, dan kartilago yang termineralisasi. 

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Background: Ti-6Al-4V is an implant material that is often used to biomedis application but the production costs are still expensive, so that heat treatment is needed to reduce production costs with optimal product results. One of the conditions for implant material is that it must be compatible with surrounding tissue.

Objective: To evaluate the effect of Ti-6Al-4V ELI implan material implantation with 850°C heat treatment on the regeneration of rat femoral bone observed through histology.

Method: This study used an experimental study design with two female Sprague Dawley Rattus novergicus rat on each group. There were three observation groups including normal control group, defect control group, and one treatment group that was given a defect and implanted by the implant material (Ti-6Al-4V ELI) with 850° C heat treatment. Rats were sacrificed in the fourth week and performed histological observation using modified Salkeld scoring.

Result: The results obtained from histological scoring of 2 samples of control group and sample-1 of treatment group are 2 which indicate that they reached the formation stage of fibrocartilago tissue. The histological results of sample-2 treatment groups is 3 which indicates the recovery process have reached mineral cartilage mineralization.

Conclusion: Implantation of Ti-6Al-4V ELI implant material with 850°C heat treatment is acceptable within the nearest bone tissue, observed from bone regeneration process which is indicated by the presence of fibrous, fibrocartilages, and mineralized cartilages."