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Abstrak :
Latar Belakang: Virus dengan gejala pneumonia berat teridentifikasi di Wuhan, Cina sebagai virus COVID-19. Sulitnya pemutusan rantai infeksi COVID-19 mengancam seluruh dunia dan dinyatakan sebagai pandemi pada 11 Maret 2020. Akhirnya, berbagai layanan esensial negara seperti pengobatan gigi dan mulut terpaksa dibatasi aktivitasnya sebagai upaya pengendalian infeksi. Namun, rasa sakit yang tidak dapat tertahankan seperti kegawatdaruratan endodontik tidak bisa dihindari dan membutuhkan pertolongan segera. Selama pandemi, RSKGM FKG UI sebagai pusat rujukan pelayanan kedokteran gigi tetap beroperasi dengan memperketat rangkaian pencegahan dan pengendalian infeksi. Maka, identifikasi dan evaluasi kasus kegawatdaruratan endodontik sebelum dengan selama pandemi di RSKGM FKG UI dilakukan. Tujuan: Mengetahui distribusi dan frekuensi kegawatdaruratan endodontik di Rumah Sakit Khusus Gigi dan Mulut Fakultas Kedokteran Gigi Universitas Indonesia sebelum dan selama pandemi COVID-19. Metode: Penelitian merupakan penelitian deskriptif retrospektif dan analitik komparatif kategorik menggunakan data sekunder rekam medik. Hasil: Terdapat 315 kasus kegawatdaruratan endodontik dengan 111 kasus ditemukan sebelum pandemi dan 204 kasus ditemukan selama pandemi. Terdapat dominasi pada kelompok usia produktif, jenis kelampin perempuan, dan tindakan PSA sebelum dan selama pandemi yang diiringi dengan perbedaan dominasi diagnosis kasus, yaitu acute apical abscess sebelum pandemi dan symptomatic irreversible pulpitis selama pandemi. Terdapat perbedaan bermakna antara diagnosis acute apical abscess dengan symptomatic irreversible pulpitis (p-value <0,05) dan perbedaan tidak bermakna antara tindakan perawatan kegawatdaruratan endodontik sebelum dengan selama pandemi. Kesimpulan: Terjadi peningkatan kasus kegawatdaruratan endodontik selama pandemi COVID-19 yang diiringi dengan penurunan arus kunjungan departemen konservasi. ......Background: Virus with symptoms of severe pneumonia was identified in Wuhan, China as COVID-19 virus. The difficulties in controlling the COVID-19 transmission have led to a pandemic which was declared on March 11, 2020. Various essential sectors of the country been restricted at last to control virus transmission. However, intolerable pain such as endodontic emergency is unavoidable and requires immediate help. During the pandemic, RSKGM FKG UI continues to operate as referral centre for dental services by tightening the health protocol. Therefore, it is necessary to identify and evaluate endodontic emergency cases before and during pandemic era at RSKGM FKG UI. Objective: This study aims to determine the distribution and frequency of endodontic emergency cases in RSKGM FKG UI before and during pandemic era of COVID-19. Methods: Retrospective descriptive and comparative analytical study is done using secondary data found in patient’s medical record. Results: There were 315 cases of endodontic emergency with 111 cases found before the pandemic and 204 cases found during the pandemic. Case was dominated by productive age, female, and root canal treatment group before and during pandemic followed by acute apical abscess domination before pandemic and symptomatic irreversible pulpitis domination during pandemic. There was significant difference between acute apical abscess group and symptomatic irreversible pulpitis group (p-value <0,05) accompanied by no significant difference between treatment group before and during pandemic. Conclusion: Collected data showed an increased cases of endodontic emergencies accompanied by decreased flow of regular visitors at conservative department.

Abstrak :
Latar Belakang: Saat ini perawatan pulpa vital mengacu pada konsep minimal intervensi, yaitu dengan meninggalkan lapisan affected dentin saat ekskavasi karena masih terdapat ikatan silang kolagen sehingga dapat dilakukan upaya remineralisasi. Remineralisasi melalui aplikasi material bioaktif Mineral Trioxide Aggregate (MTA) belum dapat menghasilkan karakteristik dentin menyerupai dentin normal karena pembentukan mineral hanya terjadi pada ruang ekstrafibrillar. Penggunaan material analog protein non kolagen dibutuhkan untuk menstabilkan nano Amorphous Calcium Phosphate (ACP) agar dapat memasuki ruang intrafibrillar, salah satunya menggunakan Carboxymethyl Chitosan (CMC). Tujuan: mengevaluasi remineralisasi dentin pada permukaan dentin terdemineralisasi setelah aplikasi material MTA dan material modifikasi MTA-CMC dengan melihat morfologi permukaan dan komposisi ion pada dentin. Metode: remineralisasi dilakukan melalui aplikasi material MTA, MTA-CMC 5% dan 10% selama 14 hari pada permukaan sampel dentin yang terdemineralisasi. Pengamatan morfologi dilakukan dengan Scanning Electron Microscope (SEM) dan konfirmasi komposisi ion dengan Energy Dispersive X-ray Spectroscopy (EDX). Hasil: terdapat perbedaan morfologi pada permukaan dentin setelah dilakukan remineralisasi melalui aplikasi MTA, MTA-CMC 5%, dan MTA-CMC 10% selama 14 hari yang dievaluasi menggunakan SEM. Hasil analisis EDX mengonfirmasi adanya peningkatan kandungan kalsium dan fosfor pada permukaan dentin yang diremineralisasi dengan material MTA-CMC. Kesimpulan: remineralisasi melalui aplikasi material modifikasi MTA-CMC dapat memengaruhi morfologi permukaan dan komposisi ion pada permukaan dentin yang terdemineralisasi. ......Background: Vital pulp treatment refers to the concept of minimal intervention by preserving the affected dentin layer in the excavation process because there are still collagen cross-linked to induce remineralization. Remineralization through the application of bioactive material Mineral Trioxide Aggregate (MTA) produce different dentin characteristics to normal dentin because mineral formation only occurs in the extrafibrillar space. The use of non-collagen protein analog materials is needed to stabilize the nano Amorphous Calcium Phosphate (ACP) to get into the intrafibrillar space, one of which is Carboxymethyl Chitosan (CMC). Objective: To evaluate dentin remineralization on the surface of demineralized dentin after the application of MTA and MTA-CMC modified material by looking at the surface morphology and ionic composition of the dentin. Methods: The remineralization was carried out through the application of MTA,MTA-CMC 5%, MTA-CMC 10% materials for 14 days on the surface of demineralized dentin samples. Morphological observations were carried out by Scanning Electron Microscope (SEM) and confirmation of ion composition by Energy Dispersive X-ray Spectroscopy (EDX). Results: there were morphological differences on the dentin surface after remineralization through the application of MTA, MTA-CMC 5%, and MTA-CMC 10% for 14 days which were evaluated using SEM. The results of the EDX analysis confirmed an increase in the content of calcium and phosphorus on the dentin surface remineralized with MTA-CMC material. Conclusion: remineralization through the application of MTA-CMC modified material can affect the surface morphology and ion composition on the demineralized dentin surface.

Abstrak :
Latar Belakang: Perawatan pulpa vital adalah perawatan konservatif yang bertujuan menjaga pulpa tetap sehat pada gigi yang mengalami trauma, karies, prosedur restorasi dan kelainan anatomi. Mineral Trioxide Aggregate (MTA) merupakan bahan bioaktif yang sering digunakan perawatan pulpa vital. Pengembangan MTA dilakukan untuk meningkatkan karakter fisik dan biokompatibilitasnya. Tujuan: Mengetahui pengaruh aplikasi material MTA dan MTA modifikasi carboxymethyl chitosan (CMC) terhadap viabilitas sel fibroblas. Metode: Sel fibroblas yang telah mengalami serum starvation selama 24 jam, diaplikasikan media kultur berupa material bioaktif yang berbeda yaitu MTA, MTA modifikasi CMC 5% dan 10 % serta DMEM sebagai kontrol. Pengaruh viabilitas sel fibroblas 24 dan 72 jam dinilai dan dihitung menggunakan MTT Assay. Analisis data menggunakan uji statistik One-Way ANOVA, dilanjutkan Post Hoc Bonferonni. Hasil: Terdapat perbedaan bermakna viablitas sel fibroblas pada kelompok MTA, MTA-CMC 5% dan 10% pada periode waktu pengamatan 24 dan 72 jam. Nilai viabilitas terendah terdapat pada kelompok MTA 72 jam sedangkan nilai viabilitas tertinggi terdapat pada kelompok MTA-CMC 5% 24 jam. Kesimpulan: MTA, MTA modifikasi CMC 5% dan 10% memengaruhi viabilitas sel fibroblas pada periode pengamatan 24 dan 72 jam. MTA modifikasi CMC 5% pengamatan 24 jam menghasilkan nilai viabilitas tertinggi dan termasuk kategori material yang tidak toksik. ......Background: Vital pulp treatment is a conservative treatment designed to keep the pulp healthy in teeth that have experienced trauma, caries, restoration procedures and anatomical abnormalities. Mineral Trioxide Aggregate (MTA) is one of the bioactive materials that is often used for vital pulp treatment. The development of MTA was carried out to improve its physical characteristics and biocompatibility.Objective: To determine the effect of the application of MTA modified carboxymethyl chitosan (CMC) and MTA materials on the viability of fibroblast cells.Methods: Fibroblast cells that had undergone 24 hours serum starvation were cultured in the different media in in every group MTA and MTA modified CMC concentrations of 5% and 10% and DMEM as a control. The effect of fibroblast cell viability at 24 hours and 72 hours was assessed based on the percentage of live cells calculated using the MTT Assay. Then the results obtained were analyzed using the SPSS statistical test. The distribution of the data was normal so that the One-Way ANOVA parametric test was carried out, followed by Post Hoc Bonferonni.Results: MTT Assay test, it was found that there was a significant difference in the viability of fibroblast cells in the MTA, MTA-CMC groups of 5% and 10% in the 24 and 72 hours observation periods. The lowest viability value was found in the MTA group with 72 hours of observation, while the highest viability value was found in the 5% MTA-CMC group with 24-hour observation. Conclusion: MTA, MTA modified CMC 5% and 10% affected the viability of fibroblast cells in the 24-hour and 72-hour observation periods. MTA modified CMC 5% at 24-hour observation resulted in the highest viability value and included in the category of non-toxic material.

Abstrak :

Tujuan: Menganalisis pengaruh paparan larutan Sodium hipoklorit (NaOCl) dengan konsentrasi 2,5% dan 5,25% pada profil MMP-9 dan struktur kolagen di dentin terhadap kekuatan ikat geser resin komposit-dentin. Metode: Seratus empat puluh empat spesimen dentin dirandom untuk analisis profil MMP-9 dengan pemeriksaan imunohistokimia (n=18) dan ELISA (n=30); analisis struktur kolagen dengan SEM di permukaan oklusal (n=18) dan proksimal (n=18) dan pewarnaan Massons trichrome; serta analisis kekuatan ikat geser resin komposit permukaan oklusal (n=30) dan proksimal (n=30). Spesimen dibagi menjadi 3 kelompok dalam tiap analisis, yaitu: kelompok kontrol, kelompok paparan NaOCl 2,5% dan 5,25%. Hasil: Pemeriksan profil MMP-9 menunjukkan bahwa peningkatan konsentrasi NaOCl dapat menekan profil MMP-9 (p<0,05). Pemeriksaan struktur kolagen menunjukkan bahwa peningkatan konsentrasi NaOCl mampu mendegradasi kolagen dentin (p<0,05). Sodium hipoklorit 5,25% paling efektif menekan jumlah profil MMP-9 (9,9+3,63 ng/mL) dan mendegradasi kolagen serta memiliki nilai kekuatan ikat geser yang paling tinggi (15,85+0,43 MPa) dari pada NaOCl 2,5% (14,51+3,66 ng/mL) dan kelompok kontrol (24,09+8,88 ng/mL; 14,41+0,96 Mpa). Kelompok NaOCl 2,5% memiliki nilai kekuatan ikat geser yang paling rendah (9,2+0,65 MPa). Kesimpulan: Larutan NaOCl 5,25% dapat menekan profil MMP-9 dan mendegradasi kolagen fibril untuk meningkatkan nilai kekuatan ikat geser resin komposit-dentin dan menciptakan suatu ikatan mikro mekanis antara resin dan permukaan anorganik dentin tanpa hybrid layer. 
 
Kata kunci: Sodium hipoklorit, profil MMP-9, collagen, dentin, kekuatan ikat geser.

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Objective: To analyze the effect of Sodium hypochlorite (NaOCl) 2.5% and 5.25% exposure on MMP-9 profile and dentin collagen structure toward resin composite-dentin shear bond strength. Method: One hundred and forty four dentin specimens were randomized  for MMP-9 profile analysis using immunohistochemistry staining (n=6) and ELISA (n=10); collagen structure analysis with SEM and Massons trichrome staining (n=6); and resin composite shear bond strength analysis (n=10). Then, specimens were divided into three groups: control, NaOCl 2.5% and 5.25% groups. Results: MMP-9 profile analysis showed that NaOCl concentration increase can suppress MMP-9 profile (p<0.05). Collagen structure analysis showed that NaOCl concentration increase can degrade dentin collagen (p<0.05). NaOCl 5.25% is the most effective in suppressing MMP-9 profile amount (9.9+3.63 ng/mL) and degrading collagen, it also has the highest shear bond strength (15.85 +0.43 MPa) compared to NaOCl 2.5% (14.51+3.66 ng/mL) and control group (24.09+8.88 ng/mL; 14.41+0.96 MPa). NaOCl 2.5% group has the lowest shear bond strength (9.2+0.65MPa). Conclusion: NaOCl 5.25% can suppress MMP-9 profile and degrade fibril collagen to increase the shear bond strengths value and create a micro mechanical bonding between resin and anorganic part of dentin without hybrid layer.