Tita Ratya Utari
Faculty of Medical and Health Sciences, Muhammadiyah Yogyakarta University, Yogyakarta 55813

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Bisphosphonate: Brief Review of Its Development for Usage in Dentistry Utari, Tita Ratya
Journal of Dentistry Indonesia Vol 18, No 1 (2011): April
Publisher : Faculty of Dentistry, University of Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (620.79 KB) | DOI: 10.14693/jdi.v18i1.154

Abstract

Bisphosphonate (BP) is a class of drug that prevent the loss of bone mass. It inhibits the resorption of bone by encouraging osteoclast to undergo apoptosis. Considering that oral diseases and dental procedures may lead to teeth instability whereas alveolar bone is the main tooth supporting tissue, forceful indication of this drug is for preventing and minimizing bone resorption following oral surgery and relapse movement in orthodontic treatment. Clinical use of BP in dentistry is limited by risk of osteonecrosis of the jaw (ONJ) and of its systemic effects such as an increase of the bone mineral density in another bone area. Topical application with local effect would seem the choice of administration route for usage in dentistry. Until recently, no clinical usage of topical BP has been studied, however some experimental laboratory studies proved that this drug would be beneficial in a wide scope of dental treatments.DOI: 10.14693/jdi.v18i1.154
Alkaline phosphatase expression during relapse after orthodontic tooth movement Pudyani, Pinandi Sri; Asmara, Widya; Ana, Ika Dewi; Utari, Tita Ratya
Dental Journal (Majalah Kedokteran Gigi) Vol 47, No 1 (2014): (March 2014)
Publisher : Faculty of Dental Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (396.449 KB) | DOI: 10.20473/j.djmkg.v47.i1.p25-30

Abstract

Background: The increasing of osteoblast activities during bone formation will be accompanied with the increasing expression of alkaline phosphatase enzyme (ALP). ALP can be obtained from clear fluid excreted by gingival crevicular fluid (GCF). Bone turnover, especially bone formation process, can be monitored through the expression of ALP secreted by GCF during orthodontic treatment. Thus, retention period is an important period that can be monitored through the level of bone metabolism around teeth. Purpose: This research were aimed to determine the relation of distance change caused by tooth relapse and ALP activities in gingival crevicular fluid after orthodontic; and to determine ALP as a potential biomarker of bone formation during retention period. Methods: Lower incisors of 25 guinea pigs were moved 3 mm to the distally by using open coil spring. Those relapse distance were measured and the gingival crevicular fluid was taken by using paper points to evaluate ALP levels on days 0, 3, 7, 14 and 21 respectivelly by using a spectrophotometer (405 nm). t-test and ANOVA test were conducted to determine the difference of ALP activities among the time intervals. The correlation regression analysis was conducted to determine the relation of distance change caused by the relapse tooth movement and ALP activities. Results: The greatest relapse movement was occurred on day 3 after open coil spring was removed. There was significant difference of the average of distance decrease among groups A1-A5 (p<0.05). It was also known that ALP level was increased on day 3, but there was no significant difference of the average level of ALP among groups A1-A5 (p>0.05). Finally, based on the results of correlation analysis between the ALP level decreasing and the relapse distance on both right and left of mesial and distal sides, it is known that there was no relation between those two variables (p>0.05). Conclusion: It can be concluded that relapse after orthodontic tooth movement occurs rapidly as the teeth are free from orthodontic force. ALP level can be detected through gingival crevicular fluid during relapse by using a spectrophotometer.Latar belakang: Peningkatan aktivitas osteoblas selama pembentukan tulang akan disertai peningkatan ekspresi enzim alkalin fosfatase (Alkaline Phosphatase/ALP). Sumber ALP dapat diperoleh dari cairan bening yang diekskresi celah gingiva gigi yang dikenal sebagai cairan krevikuler gingiva (gingival crevicular fluid/GCF). Bone turnover terutama proses pembentukan tulang dapat dimonitor melalui ekspresi ALP cairan krevikuler gingiva selama perawatan ortodonti. Periode retensi merupakan periode yang penting. Kesulitan memecahkan masalah retensi akan dapat ditangani dengan memonitor tingkat metabolisme tulang disekitar gigi. Tujuan: Penelitian ini bertujuan untuk meneliti perubahan jarak relapse gigi dan aktivitas ALP pada cairan krevikuler gingiva setelah digerakkan secara ortodonti dan potensi ALP sebagai biomarker pembentukan tulang pada periode retensi. Metode: Gigi insisivus bawah 25 ekor marmot digerakkan ke distal menggunakan opencoil spring sampai mencapai jarak ± 3 mm, diukur gerakan relapse gigi dan pengambilan cairan krevikuler gingiva menggunakan paper point untuk dievaluasi kadar ALP pada hari ke 0, 3, 7, 14 dan 21 menggunakan spektrofotometer (405 nm). Analisis t-test dan anova untuk mengetahui perbedaan aktivitas ALP antar interval waktu dan analisis regresi korelasi untuk mengetahui hubungan besarnya jarak relapse dengan aktivitas ALP. Hasil: Pergerakan relapse yang paling besar terjadi pada hari ke 3 setelah opencoil spring dilepas. Terdapat perbedaan rata-rata penurunan jarak antar kelompok A1-A5 yang signifikan (p<0,05). Kadar ALP mengalami peningkatan pada hari ke 3, namun tidak terdapat perbedaan rata-rata yang signifikan kadar ALP antar kelompok A1-A5 (p>0,05). Hasil uji korelasi antara penurunan jarak dengan kadar ALP pada mesial distal gigi baik kanan maupun kiri tidak menunjukkan adanya hubungan kedua variabel (p>0,05). Simpulan: Relapse pada perawatan ortodonti terjadi secara cepat ketika gigi terbebas dari gaya ortodonti. Kadar ALP dapat terdeteksi dari cairan krevikuler gingiva pada pergerakan relapse gigi menggunakan spektrofotometer.
Perawatan maloklusi Angle kelas II divisi 2 pasien dewasa dengan pencabutan dua premolar atas Utari, Tita Ratya
Majalah Kedokteran Gigi Indonesia Vol 3, No 1 (2017): April
Publisher : Faculty of Dentistry, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (12.633 KB) | DOI: 10.22146/majkedgiind.17249

Abstract

Treatment of maloclussion angle class II division 2 in adult patient with two maxillary premolar extractions. Angle Malocclusion class II division 2 had a characteristic of central incisor retroclination, lateral incisor proclination, added by severe deep overbite that caused aesthetic disturbance to the patient. In adult patient this type of case usually is treated with rst premolar extraction. This case report aimed to describe orthodontic treatment in maloclussion Angle class II division 2 to correct anterior crowding deep overbite which nally improve the aesthetics. A 19-year old female patient with overjet 0.5 mm, step bite (overbite 7.8mm) and ANB 10° (SNA 92°, SNB 82°). An 18 year old male patient with overjet 0.5 mm step bite (overbite 9mm) and ANB 10,5° (SNA 87,5°, SNB 77°). Both patients were diagnosed with malocclusion Angle class II division 2 with the palatoversi of central incisor, labioversi of lateral incisor and anterior crowding with trapezoid shape of the jaw. Patient was given orthodontic treatment using xed appliance with straight wire system and extraction of upper rst premolar. The treatments began by correcting the inclination of central incisor that allowed braces installation in lower anterior teeth. Canine was distalized then anterior retraction, it followed by intrusion of anterior maxilla using U loop. Treatment for malocclusion Angle Class II division 2 with the extraction of upper rst premolar feasible for correcting its anterior relation. Deep overbite and anterior crowding in both patients were corrected for better face aesthetics. ABSTRAKMaloklusi Angle kelas II divisi 2 dengan karakteristik retroklinasi insisivus sentral, proklinasi insisivus lateral disertai deep overbite yang parah menyebabkan gangguan estetik bagi pasien. pencabutan gigi premolar atas umumnya dilakukan untuk memperbaiki maloklusi pada pasien dewasa. Laporan kasus ini bertujuan memaparkan perawatan ortodontik dengan diagnosis maloklusi Angle Klas II Divisi 2 dengan tujuan memperbaiki crowding dan deep over bite sehingga diperoleh estetika yang baik. Kasus 1, pasien perempuan berusia 19 tahun dengan overjet 0,5 mm, deepbite (overbite 7,8 mm), dan ANB 10° (SNA 92°, SNB 82°). Kasus 2, pasien laki laki berusia 18 tahun dengan overjet 0,5 mm, deepbite (overbite 9 mm), dan ANB 10,5° (SNA 87,5°, SNB 77°). Diagnosis kedua kasus tersebut maloklusi Angle kelas II divisi 2 dengan insisivus sentralis rahang atas palatoversi, insisivus lateralis labio versi disertai crowding gigi anterior dan bentuk lengkung trapezoid. Pasien dilakukan perawatan ortodontik menggunakan alat cekat Straight Wire System dengan pencabutan premolar pertama kanan dan kiri rahang atas. Perawatan diawali dengan melakukan koreksi inklinasi gigi insisivus sentral atas sehingga memungkinkan pemasangan braket pada rahang bawah. Dilanjutkan distalisasi gigi kaninus, kemudian retraksi sekaligus intrusi gigi anterior rahang atas menggunakan wire dengan U-loop. Perawatan klas II divisi 2 dengan pencabutan premolar pertama rahang atas kanan dan kiri dapat memperbaiki relasi gigi anterior. Deep overbite dan crowding gigi anterior pada kedua pasien tersebut dapat dikoreksi sehingga diperoleh estetika wajah yang jauh lebih baik.