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Tooth extraction often cause tissue damage and wound. After tooth extraction, the wound healing process becomes a major concern because of many complications and makes patients feel the pain suffered. Lande et al. (2015) showed the prevalence of tooth extraction complications, including crown fracture (31.82%), root fracture (13.6%), dry socket (4%), swelling (2.27%), and bleeding (1.6%). Macrophages are a common inflammatory cell in wounds, and the local macrophage population shifts from pro-inflammatory (M1-like phenotypes) to anti-inflammatory (M2-like phenotypes), indicating to the start of the next healing phase. Various alternative materials can help the healing process of wounds, one of which is mahogany seeds. Flavonoids found in Mahagony seeds can influence cell function by boosting the synthesis of PDGF, VEGF, pro-inflammatory cytokines, activating monocytes, and raising the number of macrophages involved in the wound healing. Proving mahogany seed extract (Swietenia mahagoni) affects the number of macrophages in the wound healing process after extracting Wistar rat (Rattus norvegicus) teeth. 20 Wistar rats were divided into four groups there were one control group (K) performed tooth extraction without any treatment, and three treatment groups (P1, P2, P3) performed tooth extraction and topically induced with three different doses of mahogany seeds extract (50 mg/200g rbw, 100mg/200g rbw, 200mg/200g rbw) in the post-extraction socket. Wistar rats were sacrificed on the 3rd day. Observations were made by reading histologic preparations using Hematoksilin Eosin (HE) 400x light microscope magnification. The quantity of macrophages in each group differed significantly between 4 groups (p = 0.003), namely between K1 and P1 (p = 0.008), P1 and P3 (p = 0.001), P2 and P3 (p = 0.006). Mahogany seeds extract affects the wound healing process, with 50mg/200g rbw as the optimal dose

Aggregatibacter actinomycetemcomitans caused oral infection in recent years. It requires advancements in health technology, such as infection and sickness detection kits. This study purposed to provide data to aid in the detection kits. Aggregatibacter actinomycetemcomitans was prepared to be biofilm cultured sample. Then the samples were induced by glucose, lactose, soy protein, and iron. Scanning Electron Microscopy Energy Dispersive X-Ray, Confocal Laser Scanning Microscopy, and Olympus FluoView ver 4.2a were used to analyze the ultrastructural dimension of biofilms. The surface structure of biofilm induced by iron differed from that of biofilms induced by other inducers. O(78.65±10.32) and Cl(1.28±0.21) were the most abundant chemical compounds induced by glucose; S(14.67±4.56) and Fe(37.46±59.62) were induced by lactose; C(25.41±16.36) and N(13.49±9.37) were induced by soy protein; and P(58.53±17.80) was induced by iron. Iron induced the highest amount of polysaccharides (605.641±71.66). Lactose (857.877±70.86) induced the greatest number of bacterium cells. Iron (11.000±1000)nm caused the thickest layer. The biofilm of Aggregatibacter actinomycetemcomitans induced by glucose, lactose, soy protein, and iron are all different.

Background: Physical exercise has been proven to accelerate wound healing. Physical training itself consists of aerobic (continuous training) and anaerobic (interval training) exercise. The effectiveness of continuous physical exercise on post-tooth extraction wound healing is the focus of this study. Purpose: This study aims to investigate the differences in post-tooth extraction wound healing in Wistar rats (Rattus norvegicus) after aerobic and anaerobic exercise based on the number of fibroblasts and neovascularisation. Methods: Wistar rats were divided into three groups: the control group (K1); K2 undertook continuous aerobic exercise, swimming at 50% maximum swimming capacity (MSC) with an additional 3% bodyweight load; K3 undertook anaerobic continuous exercise, swimming at 65% MSC with a 6% load. The rats swam three times per week for six weeks. The number of fibroblasts and neovascularisation were examined three days after tooth extraction. Data was analysed using the one-way analysis of variance (ANOVA) and Least Significant Difference (LSD) tests (p

Objectives To analyze CD35/CD89 expression ratio on the surface of neutrophils as an early detection marker for S-ECC. Materials and Methods Saliva was collected from 4- to 6-year-old kindergarten students. Salivary neutrophils were obtained by instructing the subjects to rinse their mouth with 1 mL of sterile 1.5% NaCl for 30 seconds before expectorating it into a sterile glass. The expression of CFSE+CD35+ and CFSE+CD89+was measured and analyzed using flow cytometry. Results The expression of CFSE+CD89+ in the caries-free group (2.46 ± 0.39) was significantly lower than that in the S-ECC group (3.41 ± 1.11), with a p-value of 0.0001, while the expression of CFSE+CD35+ in the caries-free group was (2.35 ± 0.56) compared with (1.54 ± 0.35) (p = 0.0001) in the S-ECC group. Conclusions The expression ratio of CFSE+CD89+ and CFSE+CD35+constitutes a marker for S-ECC.

Objectives: Chitosan (poly-1,4-D-glucosamine) become popular as bone graft material. It has a high biocompatibility and biodegradability, non-toxic, bacteriostatic, and has good adsorption properties. It also enhances the proliferation and differentiation of the osteoblast cell cultures. However, chitosan also has a weakness for cell adhesion and the lack of sufficient bone formation capabilities. To improve it, we tried to develop a chitosan scaffolds that combine with carbonate apatite (CA), which has excellent biocompatibility properties of the tissues of the human body. Purpose: to make the carbonate apatite-chitosan scaffolds (CA-ChSs) and evaluate CA-ChSs from the standpoint of cell proliferation using mesenchymal stem cells (MSCs). Materials and Methods: Porous chitosan matrix was made by using the lyophilization technique. ChSs containing chitosan powder was made by the following procedure. 100, 150, 200, and 400 mg of chitosan powder was dissolved in 5 ml of 2% acetic acid at room temperature. To make CA-ChSs, ChSs containing 200 mg of chitosan powder was chosen. Ultraviolet radiation was then performed for 2 hours. CA-ChSs structure was observed by a scanning electron microscope (SEM). Proliferation of MSCs in CA-ChSs evaluated at days 1, 3, 5 and 7.Results:This study demonstrated that CA-ChSs containing 200 mg of chitosan powder and 50 mg CA has a three-dimensional structure that is porous and attachment powder CA in the pores and absorbance values were increased from the examination day 1 until day 7. Conclusion:Based on these results, it is expected CA-ChSs may be candidates for bone graft material in tissue engineering techniques.

Background: Severe early childhood caries (S-ECC) is a form of dental caries which is very destructive in early childhood since involving several teeth, include the maxillary anterior teeth. Streptococcus mutans (S. mutans) play an etiological integral role of ECC so that S. mutans are considered as the predictor of dental caries. The neutrophil is a key component of the rst line of defense against microbial invasion. The essential function of neutrophil is to kill pathogenic microbes through a phagocytosis process which is mediated by Complement Receptor 1 (CR1)/ (CD35+). Aims and Objectives: To analyze the phagocytosis process of the salivary neutrophil which is mediated by innate immunity component, i.e., Complement Receptor 1/CR1 (CD35) on S-ECC. Materials and Methods: his study was an observational analysis with cross-sectional approach using t-test analysis. This study employed the isolation steps of neutrophils saliva of caries-free children and the S-ECC and then conducted phagocytosis of salivary neutrophils test on S. mutans mediated by CD35 using ow cytometry. Results: Phagocytosis of salivary neutrophils on S. mutans mediated by CD35 on caries-free (2.35 ± 0.56) is higher than that on the S-ECC (1.54 ± 0.35). Conclusions: It is concluded that there is a decrease of phagocytic on S. mutans mediated by Complement Receptor 1/CR1 (CD35+) on S-ECC.

Introduction: With ongoing development of technology, and especially amid the current COVID-19 pandemic, there is rapidly increasing need for remote communications, including in the field of medical education. This study aimed to evaluate our telemedicine activities between Japan and Indonesia. Methods: We retrospectively analysed the data acquired for the period 2010–2019 inclusive, looking at number of programmes, content, participating sites, and videoconferencing systems. We also digitally sent questionnaires to attendees to request their evaluation of image quality and programmes. Results: There were a total 135 programmes, with 29 participating institutions in Indonesia. The number of programmes increased rapidly in 2017, following a rapid increase of participating sites in 2016. Programmes included endoscopy (50 programmes, 37%), neurology (25, 19%), and dentistry (12, 9%). Between 5 and 10 sites connected with 81 programmes (60% of all), and more than 10 sites with 33 (24%). The most commonly used videoconferencing system was Vidyo (108, 80%), followed by Zoom (15, 11%). Participating institutions were located among 19 cities on the five major islands. Image quality received a favourable evaluation from 98% (504/516) of questionnaire respondents, with 100% (400/400) holding a favourable view of the programmes. Conclusion: Remote medical education expanded in Indonesia in the 10 years under review. This expansion is expected to continue to foster more specialists and it is anticipated to improve medical care nationwide.

Background: Severe early childhood caries (S-ECC) is a form of dental caries which is very destructive in early childhood since involving several teeth, include the maxillary anterior teeth. Streptococcus mutans (S. mutans) play an etiological integral role of ECC so that S. mutans are considered as the predictor of dental caries. The neutrophil is a key component of the rst line of defense against microbial invasion. The essential function of neutrophil is to kill pathogenic microbes through a phagocytosis process which is mediated by Complement Receptor 1 (CR1)/ (CD35+). Aims and Objectives: To analyze the phagocytosis process of the salivary neutrophil which is mediated by innate immunity component, i.e., Complement Receptor 1/CR1 (CD35) on S-ECC. Materials and Methods: his study was an observational analysis with cross-sectional approach using t-test analysis. This study employed the isolation steps of neutrophils saliva of caries-free children and the S-ECC and then conducted phagocytosis of salivary neutrophils test on S. mutans mediated by CD35 using ow cytometry. Results: Phagocytosis of salivary neutrophils on S. mutans mediated by CD35 on caries-free (2.35 ± 0.56) is higher than that on the S-ECC (1.54 ± 0.35). Conclusions: It is concluded that there is a decrease of phagocytic on S. mutans mediated by Complement Receptor 1/CR1 (CD35+) on S-ECC.

Background. Traumatic ulcer is a lesion formed by a local tissue damage due to trauma on epithelial layer. Vascular Endothelial Growth Factor (VEGF) plays an important role in wound healing, especially in angiogenesis. Golden sea cucumber (Stichopus hermanni) is believed to accelerate the wound healing process. Objective. To prove that golden sea cucumber extract can increase VEGF expression in oral mucous membrane traumatic ulcer in rat.Method. S. hermanni extract was prepared by freeze-dry method, then an extract was made using PEG 400 or PEG 4000 at 40% and 80% concentrations, respectively, and applied to the animal’s oral wounds. The animals were divided into three groups: control; 40% S. hermanni extract gel; and 80% S. hermanni extract gel. The ulcers that formed on day 3 were rubbed gently with S. hermanni extract gel. After being sacrificed on day 4, sample tissues from the lower lips were prepared for histopathology to count the number of VEGF expression. The results were analyzed using the One-Way ANOVA statistical test. Results. A significant increase in the VEGF expression of 80% concentration S. hermanni extract gel was found compared with those in the control group (p=0.00). Conclusion. Golden sea cucumber extract (Stichopus hermanni) gel increased the VEGF expression in oral mucous traumatic ulcer.

Introduction. The healing process of tooth extraction is desired to take place faster to restore the normal tissue. Physical exercise is proven to accelerate wound healing through various physiological mechanisms. Aerobic exercise increases oxygen perfusion which leads to wound healing process. On the other hand, anaerobic exercise stimulates reactive oxygen species and may interfere with the wound healing process. Objective. To observe if there are differences in the effectiveness of wound healing after tooth extraction based on the number of fibroblast and neovascularization in Wistar rats (Rattus norvegicus) that performed interval aerobic or anaerobic exercise. Methods. Rats were divided into 3 groups, a control group and two treatment groups which performed the aerobic physical exercise or the anaerobic physical exercise. Fibroblast and neovascularization were calculated 7 days after the tooth extraction. Data were analyzed using Krusskal-Wallis statistical tests. Results. The aerobic exercise group showed the higher number of fibroblasts and neovascularization compared to anaerobic exercise group, while the control group showed the lowest number of fibroblast and neovascularization. Conclusion. This study demonstrated that aerobic physical exercise accelerates wound healing in the proliferation phase better than anaerobic exercise and no exercise.

Early childhood caries (ECC) is still one of the many diseases found in children throughout the world. Cariogenic bacteria are a significant risk factor for ECC associated with early colonization and high levels of cariogenic microbes (Streptococcus mutans, S. mutans). Lymphocyte T (CD4+) cells known as helper T cells, are effector cells for mediated host immunity. Naive T cells (CD4+) must be activated to initiate effector function. This activation occurs through interaction with professional antigen- presenting cells (pro-APC), especially dendritic cells that lead to intracellular pathways that regulate T cell receptor (TCR) more specifically against antigen in T cells. Lymphocyte cells from samples were collected from severe early childhood caries (S-ECC) and Free caries aged 5 to 6 years. The subjects were instructed to gargle 10 mL of sterile NaCl 1.5% solution for 30 seconds, and expectorate it into a sterile glass then analyzing T lymphocyte cell (CD4+) expression using flow cytometry. Lymphocyte T (CD4+) cell expression at SECC (6.2525 ± 64482) while in free caries (8.4138 ± 1.10397) with P-value (P = 0. 000). Conclusion of lymphocyte T (CD4+) cells expression at S-ECC is lower than that occurring in free caries.

Aim: To determine that okra fruit extracts are effective in inhibiting growth and killing the Aggregatibacter actinomycetemcomitans (Aa) bacteria that cause aggressive periodontitis. Materials and Methods: Aa ATCC 4371 strain Y3 serotype b bacteria obtained from the Stock Research Center of the Faculty of Medicine, Airlangga University, Jawa Timur, Indonesia, were bred on the Mueller Hinton media with the inclusion criteria that identification of bacteria from the stock shows that the bacterium is Aa, and the growth of bacteria in the Mueller Hinton media is with a number of colonies between 30–300 colony forming units (CFU)/mL. Culture media containing Aa bacteria were incubated for 1 × 24 h at 37°C, after it was diluted according to McFarland standard 0.5 (1.5 × 108 CFU/ mL). Fresh okra fruit derived from Materia Medica was prepared for extract. Serial dilution or dilution methods of 1:2 (wt/vol) are used for the detection of minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC). Results: One‑way analysis of variance test showed a difference with significance (P = 0.000), whereas, Tukey honestly significant difference (HSD) test showed a significant difference between okra fruit extract group with positive control concentrations of 100%, 3.125%, and 1.565%. Conclusion: The okra fruit extract effectively kills the Aa bacteria that causes aggressive periodontitis, as indicated by MIC at a concentration of 3.125% and MBC at a concentration of 6.25%

Aim: To analyze the expression of interleukin-10 (IL-10) in children with severe early childhood caries (S-ECC) and caries-free children. Materials and Methods: This was an observational analytic pilot study performed on children with social factors-ECC (S-ECC), and caries-free children as the objects of research with a cross-sectional study design. Saliva of children aged 4–6 years from the group of caries children in severe and caries-free early childhood was taken. Samples were taken by rinsing with 1.5% sterile NaCl for 30s and then accommodated in a sterile tube, to get a 40 mL sample from the aforementioned procedure repeated four times. Flow-cytometry test was used to analyze the IL-10 expression. The results of the study were analyzed using the normality test using Shapiro–Wilk, then continued with t test using the Statistical Package for the Social Sciences (SPSS) software program, version 20.0 (IBM Corp., Armonk, NY, USA). The data were analyzed by independent t test to see the difference between caries-free children and S-ECC. Results: The expression of IL-10 in the saliva of children with severe ECC was 3.32 ± 0.79; meanwhile, in caries-free children it was 4.04 ± 0.65. Conclusion: The IL-10 expression in children with severe ECC was significantly lower than that of in caries-free children.

Background: Tooth extraction is extracting teeth from alveolar bone. In the world, tooth loss is a disease that affects the function and aesthetics oral cavity, it causes 7.5 million Disability-Adjusted Life Year (DALY). Tooth extraction rate in Indonesia is around 24% in 2013 and 19% in 2018. Sports is one of the activities that can help accelerate wound healing after tooth extraction, this study examine differences in collagen density after tooth extraction of Wistar rats given aerobic and anaerobic interval training. Objective: To prove differences in post-extraction collagen density of Wistar Rat (Rattus norvegicus) with aerobic and anaerobic interval training. Method: Wistar rats were divided into 3 groups, control group (K) rat were soaked in a bucket with tap water as high as the rat soles with a duration of 50% of maximum swimming ability (KRM), aerobic interval (P 1 ) 3% load swim test with duration of 3 sets 50 % KRM exercise and 25% KRM rest, anaerobic interval P 2 load 6% duration 80% KRM exercise and rest with 4 sets. All groups were observed on the 3rd and 7th day post extraction. Data were analyzed using Kruskal-Wallis and continued with Post-hoc test to test differences between groups. Results: There was only significant difference in collagen thickness between groups K (3) and K 7 , and another groups had not significant difference. Conclusion: there unsignificant differences in collagen density after tooth extraction in Wistar rats (Rattus norvegicus) with aerobic and anaerobic interval training.