Pendahuluan: Disfungsi ovarium merupakan kondisi yang menimbulkan defisiensi hormon estrogen dan progesteron. Penurunan hormonal ini menyebabkan peningkatan produksi tumor necrosis factor (TNF) yang dapat memicu peningkatan produksi matriks metalloproteinase-8 (MMP-8). Periodontitis yang disebabkan oleh bakteri gram negatif akan memicu makrofag melepaskan TNF-α yang berkontribusi dalam pembentukan MMP-8. MMP-8 ini berperan dalam degradasi kolagen jaringan ikat gingiva. Meningkatnya MMP-8 dapat menyebabkan terjadinya periodontitis. Gejala periodontitis karena disfungsi ovarium dan induksi bakteri ini dapat diperlambat dengan bahan alam, yaitu daun singkong. Tujuan penelitian ini adalah untuk menganalisis potensi ekstrak daun singkong (Manihot esculenta Crantz) terhadap ekspresi MMP-8 fibroblas pada model tikus disfungsi ovarium dan periodontitis. Metode: Penelitian ini merupakan penelitian eksperimental laboratoris dengan post-test only control group design. Sampel yang digunakan adalah tikus Sprague-Dawley betina yang dibagi dalam 5 kelompok yaitu (1) kelompok kontrol (K), (2) Kelompok yang diinduksi bakteri Porphyromonas gingivalis dan diberi aquades, (3) Kelompok yang diinduksi bakteri Porphyromonas gingivalis dan diberi ekstrak daun singkong, (4) Kelompok yang diberi perlakuan ovariektomi dan diberi aquades, (5) Kelompok yang dilakukan ovariektomi dan diberi ekstrak daun singkong. Pengambilan jaringan gingiva setelah tahap euthanasia dilakukan untuk pembuatan preparat histopatologi dengan pewarnaan imunohistokimia. Pengamatan dan penghitungan ekspresi MMP-8 dilakukan dengan menggunakan software ImageJ dan Immunoratio. Hasil: Hasil analisis data one-way ANOVA, ekspresi MMP-8 fibroblas gingiva menunjukkan perbedaan yang signifikan (p=0,000). Hal ini menunjukkan bahwa ekstrak daun singkong dapat menurunkan ekspresi MMP-8 fibroblas gingiva tikus yang mengalami disfungsi ovarium dan periodontitis diinduksi P. gingivalis. Simpulan: Ekstrak daun singkong (Manihot esculenta Crantz) dapat menurunkan ekspresi MMP-8 sel fibroblas gingiva pada model tikus disfungsi ovarium dan periodontitis.Kata kunci: Disfungsi ovarium, periodontitis, ekspresi MMP-8, ekstrak daun singkong. ABSTRACTIntroduction: Ovarian dysfunction is a condition that causes estrogen and progesterone deficiency. This hormonal decrease causes an increase in the production of Tumour Necrosis Factor (TNF), which can trigger an increase in the production of matrix metalloproteinase-8 (MMP-8). Periodontitis caused by gram-negative bacteria will trigger macrophages to release TNF-α, which contributes to the formation of MMP-8. MMP-8 plays a role in collagen degradation of the gingival connective tissue. An increase in MMP-8 can cause periodontitis. Periodontitis symptoms due to ovarian dysfunction and bacterial induction can be slowed down by natural ingredients, such as cassava leaf. The purpose of this study was to analyse the potential of cassava leaf extract (Manihot esculenta Crantz) on MMP-8 expression of gingival fibroblast in rats model with ovarian dysfunction and periodontitis. Methods: This study was an experimental laboratory with post-test only control group design. The samples were female Sprague-Dawley rats divided into five groups: (1) control group (K); (2) Porphyromonas gingivalis induced group and given aquadest; (3) Porphyromonas gingivalis induced and given cassava leaf extract; (4) Group with ovariectomy treatment and given aquadest; (5) Group with ovariectomy treatment and given cassava leaf extract. Gingival tissue retrieval after the euthanasia was carried out for the histopathology preparations by immunohistochemical staining. Observation and calculation of MMP-8 expressions were performed using ImageJ and Immunoratio software. Results: The results of the one-way ANOVA analysis of MMP-8 expression of gingival fibroblasts showed a significant difference (p = 0.000); thus cassava leaf extract reduce the MMP-8 expression of gingival fibroblasts of rats with ovarian dysfunction and P. gingivalis induced periodontitis. Conclusion: Cassava (Manihot esculenta Crantz) leaf extract can reduce the MMP-8 expression of gingival fibroblast cells in rats’ model with ovarian dysfunction and periodontitis.Keywords: Ovarian dysfunction, periodontitis, MMP-8 expression, cassava leaf extract.

Pendahuluan: Disfungsi ovarium merupakan keadaan ovarium yang mengalami kegagalan dalam sekresi hormon seks steroid. Penurunan sekresi hormon terutama estrogen dapat memicu peningkatan sitokin proinflamasi seperti IL-1, IL-6 dan TNF-α yang berperan dalam resorpsi tulang dan reaksi inflamasi periodontal. Salah satu drug of choice dari periodontitis adalah metronidazole. Penggunaan metronidazole secara sistemik dapat mengakibatkan efek samping, sehingga diperlukan bahan alternatif yang memiliki efek terapi antiinflamasi. Salah satu tanaman yang memiliki efek antiinflamasi adalah daun Singkong. Tujuan penelitian adalah menganalisis potensi ekstrak daun Singkong sebagai antiinflamasi terhadap profil leukosit darah tepi model tikus disfungsi ovarium dan periodontitis. Metode: Jenis penelitian eksperimental laboratoris dengan post-test only control group design. Sampel penelitian sebanyak 18 ekor tikus betina yang dibagi menjadi dua kelompok besar yakni kelompok disfungsi ovarium dan kelompok kecil periodontitis. Pembuatan model tikus disfungsi ovarium dan tikus periodontitis dilakukan selama 28 hari. Setelah masing-masing kelompok dibagi menjadi 3 kelompok yang diberikan perlakuan aquades, metronidazole dan ekstrak daun Singkong selama 7 hari. Setiap tikus diambil darahnya melalui plexus infraorbitalis pada hari ke-1, hari ke-3 dan hari ke-7. Darah yang diambil selanjutnya dilakukan perhitungan jumlah sel leukosit darah tepi menggunakan kamar hitung dan perhitungan jenis dengan cara visual. Hasil: Hasil uji LSD menunjukkan bahwa terdapat perbedaan bermakna jumlah leukosit darah tepi antar hari pada kelompok tikus yang mengalami disfungsi ovarium (p≤0,05). Simpulan: Ekstrak daun Singkong (Manihot esculenta Crantz) dapat menurunkan profil leukosit perifer model tikus disfungsi ovarium dan periodontitis.Kata kunci: Disfungsi ovarium, periodontitis, profil leukosit perifer, ekstrak daun singkong. ABSTRACTIntroduction: Ovarian dysfunction is when the ovaries fail in the secretion of steroid sex hormones. Decreased secretion of hormones, especially estrogen, can trigger an increase in pro-inflammatory cytokines such as IL-1, IL-6 and TNF-α, which play a role in bone resorption and periodontal inflammatory reactions. One drug of choice for periodontitis is metronidazole. Systemic use of metronidazole can cause side effects, so an alternative material with a therapeutic anti-inflammatory effect is needed. One of the plants that have an anti-inflammatory effect is cassava leaves. The research objective was to analyse the potential of cassava leaf extract as an anti-inflammatory against the peripheral blood leukocyte profile in a mouse model of ovarian dysfunction and periodontitis. Methods: This was an experimental laboratory study with a post-test only control group design. The research sample consisted of 18 female rats divided into two large groups: the ovarian dysfunction group and the small periodontitis group. The making of mouse models of ovarian dysfunction and periodontitis rats was carried out for 28 days. After each group was divided into three groups treated with distilled water, metronidazole and cassava leaf extract for seven days. Blood was drawn from each mouse through the infraorbital plexus on day 1, day three, and 7. The blood that was taken was then performed to calculate the number of peripheral blood leukocytes using the counting room and the calculation of the type by visual means. Results: The results of the LSD test showed that there was a significant difference in the number of peripheral blood leukocytes between days in the group of rats with ovarian dysfunction (p≤0.05). Conclusion: Cassava leaf extract (Manihot esculenta Crantz) can reduce the profile of peripheral leukocytes in a mouse model of ovarian dysfunction and periodontitis.Keywords: Ovarian dysfunction, periodontitis, peripheral leukocytes profile, cassava leaf extract.

Objective: Clicking, popping, and crepitation is the most common symptom of Temporomandibular Disorders (TMD). TMD can be caused by tooth loss, and tooth loss is widespread among the elderly. Material and Methods: This research is using a correlational analysis with a cross-sectional study approach. Tooth loss was divided into six regions (R1, R2, R3, R4, R5, R6) and joint sounds were divided into four categories (clicking, popping, crepitation, normal).Result: Multinomial logistic regression analysis test for overall tooth loss showed a p-value of 0.000 in clicking and crepitation, and for popping, it has a p-value of 0.248. The results of tests on six regions of tooth loss obtained a p-value of 0.017 at R1 for clicking sound and p-value of 0.014 at R2 for crepitation. This showed that clicking and crepitation had a significant correlation with the amount of tooth loss (p<0.05). Conclusion:The amount of tooth loss has a significant relationship with clicking and crepitation of Temporomandibular Joint (TMJ).

People often adjust their behavioral pattern to the physical conditions of local environment, especially for elderly dental and oral health. Elderly is a population which is very vulnerable to environmental changes and diseases. Elderly people who have good oral health are expected to have good general health. This study focuses on dental and oral health profiles of elderly in the different residential location. Geographically, the locations of elderly resident are divided into 4 areas, i.e. urban, agricultural, highland/mountain and coastal areas. This research was carried out using a cross sectional approach. The research population was elderly aged more than 45 years. Research subjects were determined using cluster random sampling based on the geographic residential areas (n=229). Measurements of dental and oral health profile were based on the Decay-Missing-Filling-Teeth (DMF-T) indicators and the Simplified Oral Hygiene Index (OHI-S). 229 research subjects were analyzed using Kruskall Wallis tests. The results show that most of the elderly have poor dental and oral health profile. However, the elderly who live in the coastal area have better dental and oral health profile. Meanwhile, the elderly who live in the highland area have the worst profile of oral and dental health compared to the elderly who live in other areas.

Neem gum is an exudate from hardened neem plant (Azadirachta indica). Neem gum contains many active compounds especially heteropolysaccharides. It composes monosaccharides namely L-arabinose, L-fucose, D-galactose, D-glucuronic acid, D-xylose, glucose, and mannose. In addition, there are other compounds of neem gum such as NaCl, KCl, salvadora, salvadorin, saponin, phenol, and tannin have the potential to reduce the viability of pathogens. Heteropolysaccharides are water soluble non-starch carbohydrates. Heteropolysaccharides are known unable to be degraded by digestive enzymes but have potential as substrates for commensal bacteria that can benefit the host. One of the requirements for functional food ingredient is also to reduce the viability of pathogenic bacteria such as Escherecia coli and Salmonella Typhimurium. The MTT test method was used to calculate bacterial viability. The viability of two bacteria exposed to neem gum solution decreased as the concentration increased, according to the results of this study.