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"[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. ]"

"Fraktur mandibula merupakan fraktur kraniomaksilofasial yang paling umum dan seringkali menyebabkan gangguan mengunyah. Tata laksana definitif fraktur mandibula adalah reduksi terbuka dan fiksasi interna menggunakan plat dan sekrup sistem 2.0, seperti plat tiga dimensi (3D). Namun, desain plat 3D konvensional memiliki keterbatasan karena bentuknya yang tidak dapat diubah, sehingga sulit menghindari garis fraktur atau struktur anatomi penting seperti akar gigi dan saraf saat melakukan pemasangan sekrup. Untuk mengatasi masalah ini, diperlukan desain plat 3D yang dapat diubah konfigurasinya. Oleh karena itu, dikembangkanlah desain plat 3D interlocking. Berbeda dengan plat 3D yang sudah ada selama ini, plat 3D interlocking memiliki kebaruan yaitu plat ini dapat dirangkai dari beberapa jenis plat dengan menumpuk 2 buah plat menjadi 1 kesatuan plat. Sambungan kedua buah plat ini tidak menambah ketebalan plat dan dapat diubah konfigurasinya dengan menyesuaikan sudut antara plat horizontal dan plat vertikal. Finite Element Analysis (FEA) dilakukan untuk menentukan kelayakan desain plat 3D interlocking. Setelah FEA memastikan kelayakan desain, purwarupa yang diproduksi dilakukan pengujian biomekanik menggunakan sepuluh mandibula kambing untuk menilai kekuatan mekanik dan stabilitas plat 3D interlocking. Biokompatibilitas dan penyembuhan tulang dievaluasi dalam uji hewan coba yang melibatkan 28 kambing. Biokompatibilitas dinilai dengan mengevaluasi respons inflamasi dari uji radiologik dan histopatologik (pewarnaan Hematoxylin-Eosin). Penyembuhan tulang dinilai melalui berbagai metode, termasuk uji radiologik yang mengukur kepadatan tulang, uji histopatologik menggunakan pewarnaan Mason Trichome, dan analisis penanda tulang melalui imunohistokimia dan ELISA. Selain itu, uji kemudahan penggunaan dilakukan dengan sembilan Spesialis Bedah Plastik Rekonstruksi dan Estetik untuk menilai tingkat kenyamanan dan durasi yang diperlukan untuk mengaplikasikan plat pada model mandibula sintetik. Uji biomekanik juga dilakukan pada uji kemudahan penggunaan sebagai komponen evaluasi objektif. Dalam uji biomekanik, plat 3D interlocking menunjukkan kemampuan yang lebih baik dalam mempertahankan stabilitas fraktur yang memungkinkan gerakan mikro yang terkendali. Selanjutnya, uji biokompatibilitas menunjukkan bahwa kelompok plat 3D interlocking menghasilkan reaksi jaringan dan respons inflamasi yang lebih rendah dibandingkan plat tolok ukur pada uji hewan coba. Selain itu, plat 3D interlocking juga mempercepat proses penyembuhan tulang, terbukti dari peningkatan bermakna dalam pembentukan dan kepadatan tulang pada uji hewan coba. Hasil uji kemudahan penggunaan menunjukkan bahwa plat 3D interlocking dapat digunakan dengan mudah seperti halnya plat tolok ukur. Secara keseluruhan, plat 3D interlocking menunjukkan potensi sebagai alternatif yang layak untuk tata laksana fraktur mandibula.

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Mandibular fractures are the most common craniomaxillofacial fractures, often resulting in mastication disturbances. Mandibular fracture management typically involves the use of 2.0 system plates and screws, such as three-dimensional (3D) plates. However, the conventional 3D plate designs for mandibular fracture management have limitations. Their fixed shape makes it challenging to avoid fracture lines or vital anatomical structures, such as dental roots and nerves when placing screws. A 3D plate design that allows for configuration changes is needed to address this issue. Therefore the interlocking 3D plate was developed. This novel design features components that can be adjusted to avoid critical anatomical structures and fracture lines while still offering the stability of a 3D plate, enhancing its utility in mandibular fracture management. Finite element analysis was performed to establish the feasibility of the interlocking 3D plate design. Once that was established, biomechanical evaluation was conducted using ten goat mandibles to assess the mechanical strength and stability of the interlocking 3D plate. Biocompatibility and bone healing properties were evaluated in an animal study involving 28 goats. Biocompatibility was assessed by evaluating inflammatory responses from radiological and histopathological (Hematoxylin-Eosin staining) study. Bone healing properties were assessed through various methods, including radiological study measuring bone density, histopathological study using Mason Trichome staining, and analyzing bone markers through immunohistochemistry and ELISA. Additionally, usability study were conducted with nine plastic surgeons to assess the level of comfort and the duration required to apply the plate on a synthetic mandibular model. These findings were correlated with biomechanical test results. The biomechanical evaluation revealed that the interlocking 3D plate design better-maintained fracture stability while allowing controlled micro-movement. Regarding biocompatibility, the interlocking 3D plate exhibited better results than the standard plate, as indicated by lower tissue reaction and inflammatory response in animal study. The interlocking 3D plate also facilitated faster bone healing, with significant bone formation and bone density improvements in animal study. Usability study demonstrated that the interlocking 3D plate was as easy to use as the standard plate, with no significant differences in application time. Overall, the interlocking 3D plate demonstrates significant potential as a viable alternative for managing mandibular fractures."