Insisiva Dental Journal: Majalah Kedokteran Gigi Insisiva

Management of Angioedema and Mucositis as Oral Manifestations of Juvenile Systemic Lupus Erythematosus

Manuel Dwiyanto Hardjo lugito — 2025-05-30

Angioedema and mucositis are rare in juvenile systemic lupus erythematosus (jSLE) and increase morbidity and mortality in an individual under 18 years. This case report aims to describe the management of an 11-year-old female patient with a history of jSLE, presenting with swelling of her lip, difficulty in speaking, oral pain since a month ago, and self-medicating, which led to the swelling becoming worse. Full blood count, immunology, and antigen laboratory examination indicated anemia normocytic normochromic, leukopenia, hypoalbuminemia, vitamin D deficiency, proteinuria, neonatal lupus erythematosus, and Sjogren’s syndrome. Methylprednisolone, mycophenolate mofetil, and hydroxychloroquine sulfate were given by the pediatrician. Medications consisted of topical application of 0.1%triamcinolone acetonide in orabase for angioedema and mucositis, benzydamine hydrochloride oral rinse before meals, chlorhexidine gluconate and 0.025% hyaluronic acid mouthwash after meals and before bed. Oral complaints and lesions have improved within 10 days. High caution, specific examinations to determine the type of angioedema, collaboration with pediatric rheumatologists, and systemic treatment of SLE must be supported by topical therapy to treat AE and mucositis, which are oral manifestations of SLE.

Successful Camouflage Orthodontic Treatment of Class II Malocclusion with Maxillary Severe Crowding: A Case Report

Leni Paramita Nurmalini — 2025-05-30

There are some limitations of conventional orthodontic treatment in class II skeletal malocclusion. Ideally, skeletal malocclusion needs surgical orthodontic treatment, but mild to moderate class II skeletal malocclusion can be treated with camouflage orthodontic treatment. This report aims to present that the goal of camouflage treatment of skeletal class II is to disguise the unacceptable skeletal relationship by orthodontically moving teeth, such as extraction of upper premolars followed by anterior retraction. Confidence issues brought a 19-year-old female to RSGM Universitas Padjadjaran. She exhibits skeletal malocclusion symptoms such as a convex facial profile, SNA: 84°, SNB: 78° with ANB: 6°, moderate crowding in the mandibular arch, palatoversion and rotation of the second premolars, a deep overbite (5 mm), a large overjet (5,5 mm), and a shifted midline in the maxillary and mandibular, measuring 2 mm and 1.5 mm, respectively. The first course of therapy was removing the lower left second premolar and the upper two-second premolars—a prescription for braces with MBT 0.022 inch pre-adjustments. Anchorage was strengthened by placing TPA in the maxillary arch. Treatment was finished in 22 months. This case report presents the successful management of camouflage orthodontic treatment of class II skeletal malocclusion by extracting maxillary premolars and unilateral extraction of mandibular premolars to create space and relieve crowding teeth. This treatment was able to change the overbite, overjet, and convexity of the patient's profile to normal. The patient was delighted with the treatment results because she had more confidence when smiling.

Effectiveness of Reagent-Grade and Food-Grade Citric Acid as Denture Cleanser in Reducing Candida albicans Colonies

Zulharistya Prima Sahda — 2025-05-30

Candida albicans is an opportunistic pathogenic fungus commonly found in the oral cavity, with increased prevalence among denture wearers. Citric acid is known for its antimicrobial properties. Reagent-grade citric acid has been previously studied, while food-grade citric acid has not been investigated as a denture cleanser. This study, thus, aims to evaluate the effectiveness of reagent-grade and food-grade citric acid as denture cleansers in reducing Candida albicans colonies. The samples were heat-cured acrylic resin plates (n=28) contaminated with Candida albicans ATCC 10231 suspension, then soaked for 30 minutes in different solutions: reagent-grade and food-grade citric acid at concentration of 4%, 5%, 7%, and distilled water as negative control. Candida colonies on the plates were cultured, incubated, and counted using the Total Plate Count (TPC) method. Data were analyzed using Welch’s ANOVA followed by post-hoc T-test. As a result, the average number of Candida albicans colonies in the reagent-grade citric acid groups (4%, 5%, 7%) were (2.15, 1.75, 0.29) ×10⁴ CFU/ml. In the food-grade citric acid groups (4%, 5%, 7%), the averages were (6.55, 4.27, and 3.17) × 10⁴ CFU/ml. The distilled water group had the highest number of colonies (13×10⁴ CFU/ml). The lowest reduction in colony count was in the 4% food-grade citric acid group (49.6%), while the highest reduction was in the 7% reagent-grade citric acid group (97.7%). Welch’s ANOVA indicated a significant difference (p<0.05) among all treatment groups. Reagent-grade and food-grade citric acid as acrylic denture cleansers are effective in reducing Candida albicans colonies.

Antibacterial Test of Ruku-Ruku Leaf Extract (Ocimum tenuiflorum L.) Against the Growth of A. actinomycetemcomitans

Hanifah Ramadhanty — 2025-05-30

A. actinomycetemcomitans bacteria is the main pathogenic microorganism identified as the cause of aggressive periodontitis, with a prevalence of 90%. Periodontitis treatment is generally done mechanically by scaling root planning (SRP) and chemically by administering antibiotics as antibacterial agents. Specifically, ruku-ruku leaves contain several natural compounds with potential as antibacterials. This study, thus, aims to determine the potency of ruku-ruku leaf extract in inhibiting the growth of A. actinomycetemcomitans bacteria. This study employed a true experimental method in the form of a post-test-only control group design. Ruku-ruku leaf extract was prepared by a maceration method using 96% ethanol solvent and diluted with DMSO (Dimethyl Sulfoxide) to obtain concentrations of 10%, 20%, 40%, and 70%. The inhibition test was conducted using the Kirby-Bauer method, which utilized paper discs on Mueller Hinton Agar media. The zone of inhibition formed around the discs was measured. Data analysis was then performed using the One-Way ANOVA test, and the Post Hoc LSD (Least Significant Difference) test was continued. The results of this study revealed significant differences in inhibition from each treatment group. The concentration of 70% ruku-ruku leaf extract is more effective in inhibiting the growth of A. actinomycetemcomitans with an inhibition zone of 7.49 mm. Post Hoc LSD results uncovered p values of 0.001 and 0.003 (p<0.01). In conclusion, ruku-ruku leaf extract has potential antibacterial properties against the organization of A. actinomycetemcomitans.

Formulation and Physical Characteristics Evaluation of Sargassum sp. Lip Gel for the Exfoliative Cheilitis Treatment

Carmaylia Athallah Ferawati — 2025-05-30

Exfoliative cheilitis is a disease that often occurs, especially in Indonesia, exacerbated by hot weather and vehicle exhaust pollution, which can cause dry and cracked lips. The components found in Sargassum sp. are beneficial in enhancing the effectiveness of vitamin C, aiding skin regeneration, and potentially acting as antioxidants to combat free radicals. To develop a lip care formulation from Sargassum sp. seaweed to overcome the problem of exfoliative cheilitis. Sargassum sp. was crushed and extracted to produce three kinds of formulations that tested for homogeneity using methylene blue, which was dripped on each replication on a watch cup and stirred until a homogeneous mixture between the oil and water content. Viscosity was tested using a Brookfield viscometer, the organoleptic assessment was done visually, the pH test was performed using a pH meter, occlusivity was tested using filter paper, the stability test was evaluated using a centrifuge, and the adhesion test was conducted using an adhesion test tool. The study results revealed in the organoleptic test that the form of the three formulations was the gel form, with transparent yellowish to yellowish brown color. At the same time, the aroma was slightly pungent, which is typical of Sargassum sp. (F1-2). In the viscosity test, there were significant differences between preparations F1(48.740±408.412), F2(9.420±274.955), and F3(2200±91.652). In the pH test, there were significant differences between F1(5.657±0.019), F2(6.838±0.058), and F3(8.960±0.112). All formulations were homogeneous and stable after centrifugation for 30 minutes in the homogeneity and stability tests. In the occlusivity test, there was no significant difference in preparations F1-3, and only significant differences were found in the occlusivity test at 24 and 48 hours in the F3 formulation. In the adhesion test, there were significant differences between F1(2.4367±0.168), F2(2.1467±0.127), and F3(1.3467±0.145). Formulations 1 and 2 met the gel preparation test criteria, while formulation 3 did not meet the gel preparation test criteria.

The Dental Students’ Compliance To The Covid-19 Health Protocols In Private Universities In Indonesia: Cross-Sectional Survey

Lisa prihastari — 2025-05-30

The COVID-19 pandemic has brought about extensive changes in human lifestyles as individuals adopt preventive measures through health protocols. Dental students, playing a pivotal role in society, are particularly instrumental in implementing these protocols within their families and communities. This study aims to evaluate the compliance of dental students with COVID-19 protocols at five private universities in Indonesia and explore associated factors. This study was carried out by distributing validated online questionnaires to college students enrolled in undergraduate and professional dental programs. The questionnaire encompassed five questions assessing the adherence to COVID-19 preventive measures gained from 706 participants and was analyzed using statistical methods, including chi-square and multivariate logistic regression. Descriptive analysis revealed that 51.1% of students adhered to COVID-19 protocols. Notably, female students exhibited significantly higher compliance, with an odds ratio of 2.361 (p < 0.001). On the contrary, variables such as student group, academic year, parental education levels, family size, and the presence of vulnerable family members showed no significant associations (p ≥ 0.05). Gender and students' comorbid disease history emerge as influential factors affecting their compliance with COVID-19 protocols.

Centering Ability and Canal Transportation of Three Reciprocal Files in Moderately Curved Canals

Indra Kanujaya — 2025-05-30

Assessing the complexity of the root canal’s curvature is one of the crucial factors for the root canal procedure to succeed. Iatrogenic complications can happen during the shaping procedure of the curved canal as it can deviate from the original anatomy, such as transportation and ledge. Therefore, maintaining the initial anatomy of the root canal’s curvature and its centering during instrumentation is essential during the shaping procedure. This ex vivo study aims to analyze the centering ability and canal transportation of three reciprocal file systems, with and without a glide path in moderately curved canals. Thirty-six root canals with moderate curvature from freshly extracted maxillary premolar with separated buccal and palatal root canals, first maxillary molar with separated mesiobuccal and distobuccal canals, and first mandibular molar with separated mesial canals were selected then distributed into six random groups (n=6) according to with and without glide path procedure (#15 K-file) before instrumentation with different reciprocal system (GP+WOG, GP+R, GP+RB, NGP+WOG, NGP+R, NGP+RB). The centering ability and transportation were evaluated by CBCT both before and after instrumentation. One-way Analysis of Variances was employed to analyze the data. (p<0.05). There were significant differences in centering ability at the middle third (p<0.05) and transportation at the apical third and middle third (p<0.05). All techniques showed certain transportation, and none of them had perfect centering ability. Reciproc Blue had better canal centering and transportation compared to Reciproc when glide paths were used prior to instrumentation. All systems can shape the curved canal without iatrogenic complications.

Combination of Channa striata Extract Gel and HBOT on Trabeculae Area during Orthodontic Treatment

Bunga Fauzia — 2025-05-30

Orthodontic pressure applied to the teeth causes stress and inflammation in the periodontal tissues. Channa striata extract gel and hyperbaric oxygen therapy (HBOT) accelerate the healing process of periodontal tissues under stress due to orthodontic pressure by stimulating osteoblasts to form bone trabeculae in tension areas on bone remodeling. To determine the effect of the combination of Channa striata extract gel and HBOT on the trabecular bone area during orthodontic tooth movement in the tension area. 30 male Cavia cobaya were randomly divided into 5 groups (n=6): negative control (K-) without orthodontic tooth movement (OTM), positive control (K+) with OTM, treatment (P1) with OTM and Channa striata extract gel, treatment (P2) with OTM and HBOT, and treatment (P3) with OTM and combination of Channa striata gel extract and HBOT. Rubber separators were attached to the maxillary central incisors. HBOT 2.4 ATA was administered for 7 days from day 17 to day 23, and Channa striata gel was administered for 14 days from day 10 to day 23. The trabecular bone area was examined using HE staining, and results were calculated using Image Raster. Data were evaluated using the One-Way ANOVA test and LSD (p<0.05). The mean trabecular bone area was the largest in the P3 group (1,126,649.83+90,817.17). Anova and LSD analysis showed that the most significant difference was found in group P2 (p<0.05). The combination of HBOT and Channa striata gel extract affects the trabecular bone area in the tension area during OTM, and the most effective therapy is HBOT