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Abstrak :
Karies gigi merupakan salah satu penyakit infeksi jaringan keras gigi yang sangat banyak menyerang penduduk Indonesia, dengan tingkat prevalensi lebih dari 90%. Karies terjadi sebagai akibat ketidakseimbangan proses demineralisasi dan remineralisasi yang terjadi pada permukaan gigi, yaitu pada saat tingkat demineralisasi terjadi lebih tinggi daripada remineralisasi. Untuk menanggulangi masalah karies, diperlukan usaha preventif yang terjangkau oleh masyarakat. Salah satu agen yang dipercaya dapat mencegah terjadinya karies adalah xylitol. Penelitian-penelitian terdahulu telah menyatakan bahwa xylitol dapat meningkatkan remineralisasi. Pada penelitian ini, diteliti pengaruh penambahan xylitol pada larutan remineralisasi pada permukaan email yang didemineralisasi ditinjau dari struktur permukaan email gigi. Penelitian ini dilakukan dengan menggunakan 22 potong spesimen gigi yang dikelompokkan menjadi kelompok kontrol positif, kontrol negatif, dan perlakuan. Seluruh spesimen gigi, kecuali kelompok kontrol positif, direndam ke dalam larutan asam asetat dengan pH 4 selama 2x24 jam pada suhu 500C. Setelah itu, kelompok perlakuan dibagi ke dalam dua kelompok dan direndam kembali ke dalam larutan reminerlisasi, yang mengandung 20% dan 50% xylitol pada suhu 370C selama 2x7 hari. Seluruh sampel difoto dengan menggunakan SEM (Scaning Electron Micrograf) pada laboratorium CMPFA FTUI dan dilakukan analisis secara kualitatif. Berdasarkan hasil yang diperoleh, dapat disimpulkan bahwa xylitol dapat memicu terjadinya proses remineralisasi pada permukaan gigi yang telah mengalami demineralisasi.

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Dental caries is one of the infection diseases on the tooth. Its prevalence in Indonesia is more than 90%. Caries happened when there is unbalance condition between demineralization and remineralization process, which is higher in demineralization. To prevent the dental caries, there should be preventive programs that can be reached by all people. One agent believed to control and reduced dental caries is xylitol. This research observed the enamel surface?s structure related remineralization effects of xylitol on artificially demineralized enamel. The samples were demineralized in an acid solution with 4.0 pH level for two days. After that, they`re immersed in a remineralized solution containing 20% or 50% xylitol at 37oC for two weeks. Samples were analyzed using SEM to see the quality difference between the control samples and the other one on the enamel?s surface. SEM analyzing indicated that remineralization happened in enamel?s surfaces. The enamel?s surfaces remineralized with solution containing 50% xylitol had a better change after remineralization than the 20% did. These results mean that xylitol can avoid caries by inducing remineralization and inhibit demineralization.

Abstrak :
Tujuan penelitian ini adalah mempelajari pengaruh pemaparan xylitol pada email yang telah terdemineralisasi terhadap remineralisasi ditinjau dari kekerasan email. Demineralisasi dilakukan dengan larutan asam asetat 0.01 Μ (pH 4.0) pada suhu 50°C selama 2 hari. Untuk remineralisasi, sampel kemudian direndam dalam larutan remineralisasi dengan konsentrasi xylitol 20% atau 50% pada suhu 37°C selama 2 minggu. Kekerasan email dari sampel dengan dan tanpa xylitol diuji menggunakan alat uji kekerasan Vickers. Hasil menunjukkan adanya perbedaan kekerasan email antara kelompok yang diberi aplikasi larutan remineralisasi berxylitol dengan kelompok kontrolnya (p<0.05). Kelompok yang direndam dalam larutan remineralisasi ber-xylitol menunjukkan nilai kekerasan yang lebih besar daripada kelompok kontrolnya. Kekerasan email berkisar antara 423 ± 45 VHN pada kelompok larutan remineralisasi ber-xylitol 20%, sedangkan kelompok kontrolnya menunjukkan nilai 302 ± 60 VHN. Kelompok yang direndam dalam larutan remineralisasi ber-xylitol 50% menunjukkan nilai kekerasan 367 ± 70 VHN, sedangkan kelompok kontrolnya menunjukkan nilai 252 ± 100 VHN. Ini dikarenakan kemampuan xylitol untuk membentuk kompleks dengan ion-ion kalsium, hal ini membantu remineralisasi, sehingga lebih lanjut meningkatkan kekerasan dari email yang terdemineralisasi. Fungsi utama kalsium adalah untuk kekerasan tulang dan gigi.

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This study aimed to determine the effects of xylitol exposure of demineralized enamel on remineralization in terms of enamel microhardness. The demineralizing treatment was done with a 0.01 Μ acetate buffer solution (pH 4.0) at 50°C for 2 days. For remineralization, the enamel samples were then immersed in a solution with 20% or 50% xylitol at 37°C for 2 weeks. Hardness of the enamel samples with and without xylitol treatment was measured as Vickers microhardness. Results showed differences of enamel microhardness between the group that is immersed in remineralizing solutions with xylitol and the control group (p < 0.05). Groups that is immersed in remineralizing solutions with xylitol showed higher microhardness values than its control groups. The enamel microhardness ranged between 423 ± 45 VHN on samples that are immersed in remineralizing solution with 20% xylitol, while its control group showed 302 ± 60 VHN in microhardness test. Samples that were immersed in remineralizing solution with 50% xylitol showed 367 ± 70 VHN in microhardness test, while its control group result in 252 ± 100 VHN. This is caused by the xylitol?s capability to form complexes with calcium ions, which helps the remineralization process and further increase the microhardness of the demineralized enamel. The major function of calcium is to provide rigidity and strength to bones and teeth.

Abstrak :
Topical fluoridation recently has become the method of choice in caries prevention. Flouride plays an important role not only in the formation of fluoroapatite, but also promoting enamel remineralization. Enamel remineralization occur when the enamel environtment supersaturated with calcium and phospate ions. When the pH level decrease, the rise of H ions, the hydroxyl of the apatite will be drawn out from the enamel, and substitute by fluoride ion, this condition will causes apatite breakdown and both calcium and phosphate will be released to the enamel environment. The release of those minerals, will cause supersaturation and promoting enamel remineralization. In the nature fluoride can be found in the sea fishes, such like teri (anchovy, Stolephorus sp) fishes. Teri fish has about 17-38 ppm of fluoride content. The high fluoride content of teri fish, lead this research to know the influence of it's application to the enamel surface on remineralization process, measured with enamel surface roughness and hardness tests. Seven enamel discs, 5 x 10 mm (W and L) obtained from 4 impacted third molars, were used in the research. One disc used as initial control, and 6 discs divided into 2 groups, used as experiment groups. All of the experimental discs demineralized using 50% phosphoric acid, then 3 of them were applied with teri substrate, wether other 3 discs applied with non ionic aquadest. All experimental discs, then immersed in the remineralization solution containing calcium phosphate stabilized with caseinphosphoptide. The cycle above repeated for 26 times. Analize of the specimens, were done using surfcom for enamel roughness and Buehler microhardness tester for surface hardness. Surface roughness of the teri group is 1,78 um compare to the initial group (215 um), and enamel surface microhardness of the teri group is (376 VHN), significantly differ from the control group, 358 VHN. Conclusion: Based on this research result, it can be concluded that : Teri fish substrate application on enamel surface causes the enhancement of enamel remineralization, as evaluated by surface roughness and micro hardness.

Abstrak :
Penelitian ini membahas pengaruh kimia dari xylitol terhadap remineralisasi enamel yang sebelumnya mengalami demineralisasi. Sampel email yang berasal dari gigi yang telah diekstraksi untuk kepentingan perawatan orthodonti didemineralisasi terlebih dahulu dan selanjutnya direndam dalam larutan remineralisasi yang mengandung 20% dan 50% xylitol pada suhu 37⁰C selama dua minggu. Sampel lalu dianalisis menggunakan metode Energy Dispersive Xray (EDX) dan X-ray Diffraction (XRD). Hasil berdasarkan EDX mengindikasikan terdapat peningkatan jumlah kalsium dan fosfor pada sampel yang direndam dalam larutan remineralisasi dengan xylitol 50% dibandingkan dengan sampel yang mengalami demineralisasi tanpa direndam dalam larutan remineralisasi dengan xylitol 50% (p < 0.05). Tidak terdapat peningkatan bermakna dari kalsium dan fosfor pada sampel yang direndam dalam larutan remineralisasi dengan xylitol 20% dibandingkan dengan sampel yang mengalami demineralisasi tanpa direndam dalam larutan remineralisasi dengan xylitol 20% (p > 0.05). Identifikasi komposisi senyawa kristal dengan metode XRD menunjukkan berbagai macam kristal apatit pada sampel yang berbeda. Hidroksiapatit dan fluorapatit ditemukan ada sampel kontrol yang tidak didemineralisasi. Material amorphous ditemukan pada sampel yang didemineralisasi untuk kontrol perlakuan xylitol 50%. Fluorapatit ditemukan pada sampel yang didemineralisasi untuk kontrol perlakuan xylitol 20%. Fluorapatit juga ditemukan pada sampel yang direndam pada larutan remineralisasi dengan xylitol 20% dan 50%. Hasil ini mengindikasikan bahwa xylitol dapat meningkatkan jumlah kalsium dan fosfor dengan menghambat presipitasi kalsium dan fosfat serta bertindak sebagai calcium carrier. Sifat xylitol tersebut dapat mempengaruhi reaksi kimia dari kalsium dan fosfor pada plak, saliva, dan lesi karies. Oleh karena itu, substansi amor phous dari email dapat berubah menjadi kristal apatit seperti fluorapatite. Dengan demikian, xylitol menunjukkan kemampuan untuk mencegah karies dan merestorasi lesi dini karies.

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This study aimed to determine the effects of xylitol exposure on the remineralization of artificially demineralized enamel. Samples that were obtained from teeth extracted due to orthodontic treatment were demineralized and then immersed in a remineralizing solution with 20% or 50% xylitol at 37°C for 2 weeks. The samples were analyzed using Energy Dispersive X-Ray (EDX) and Xray Diffraction (XRD) methods. The EDX results indicated that calcium and phosphorus contents were significantly higher in samples that had been immersed in 50% xylitol solution, compared to demineralized samples without such immersion treatment (p < 0.05). There was no significant increase in calcium and phosphorus content for samples that had been immersed in 20% xylitol solution compared to demineralized samples without this immerson treatment (p > 0.05). Identification of crystal compounds by XRD showed the presence of hydroxyapatite and fluorapatite in untreated samples. Amorphous materials were found in demineralized control samples for 50% xylitol solution. Fluorapatite was identified in demineralized control samples for 20% xylitol solution. Fluorapatite was also identified in samples that had been immersed in 20% and 50% xylitol solution. The results indicate that exposure to xylitol c an increase calcium and phosphorus contents in enamel, probably by inhibiting Ca2+ and PO43- precipitation and acting as calcium carrier. Xylitol exposure may influence the chemical reactions of calcium and phosphorus in plaque, saliva and caries lesions. Through the influenced reactions, amorphous substance of enamel could change into apatite crystal such as fluorapatite. Thereby, xylitol demonstrate caries prevention and possible restoration of initial enamel caries lesions.