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"ABSTRAKLatar Belakang: Ameloblastoma merupakan tumor odontogenik yang sering dijumpai.Tatalaksana dari Ameloblastoma dapat berupa terapi konservatif seperti enukleasi atau radikal kuretase maupun dengan terapi bedah radikal seperti reseksi mandibula.Defek yang ditimbulkan pasca reseksi akan berpengaruh pada sistem mastikasi dan penampilan pasien. Standar emas rekonstruksi defek dapat menggunakan vascularised bone graft serta rehabilitasi dental implat untuk mengembalikan fungsi mastikasi dan estetik.Tujuan: Untuk mengetahui bagaimana keberhasilan rehabilitasi menggunakan dental implantpada rekonstruksi vascularisedbone graft sebagai tatalaksana ameloblastomaMetode: Penelitian yang digunakan berjenis systematic review, sesuai dengan PRISMA-P, Penelitian ini dilakukan dengan menggunakan desain PICO.Pencarian elektronik dilakukan tanpa batasan tanggal pada Bulan September 2019 melalui basis data online Cochrane, EBSCOhost, Pubmed, Scopus, Wiley Online Library, dan SpringerLink dengan kata kunci utama mandibular resection, ameloblastoma, vascularised bone graft, dental implant, Studi dengan desain penelitian berupa controlled trials, retrospektif,prospektif, case report dan case series. Artikel Studi dieksklusi dengan desain penelitianopinion articles, dan review articles, Studi pada selain pasien Ameloblastoma, Studi mengenai implan selain dental implant, Studi yang dilakukan pada hewan atau laboratoris.Hasil: Sebanyak 5.996 artikel publikasi ilmiah ditemukan. Kemudian 82 artikel ilmiah dieksklusi setelah dilakukan skrining duplikasi. Sisa 5.914 artikel publikasi ilmiah kemudian dilakukan skrining elektronik berdasarkan criteria didapatkan 28 artikel yang tersisa. Kemudian dilakukan pencarian artikel dalam bentuk full text. Setelah semua artikel full text berhasil dikumpulkan, dilakukan eksklusi kembali dengan alasan tidak menampilkan record data pasien ameloblstoma yang jelas. Hasil eksklusi tersebut didapatkan sebanyak 13 artikel. Survival dental implant pada vascularised bonegraft mencapai 238/241 (99%) dengan metode delay placement lebih banyak digunakan. Jenis rekonstruksi pada tatalaksana pasien ameloblastoma dengan reseksi mandibula terbanyak menggunakan vascularised free fibula flap dengan tekhnik double barel fibula, yaitu sebanyak 24 (30,76%) pasien.Kesimpulan: Delay dental implant placement pada vascularised bone graftdoubel barel fibulalebih banyak dilakukan karena dengan teknik rekonstruksi ini dapat memberikan dimensi vertikal yang baik dan dapat memberikan dukungan yang baik untuk rehabilitasi dental implant serta dapat memberikan kesempatan untuk memperoleh evaluasi kondisi yang baik tentang vaskularisasi flap, mengevaluasi kebutuhan prostetik dan motivasi pasien serta mengevaluasi kemungkinan titik penempatan regio dental implant .

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ABSTRACTBackground: Ameloblastoma is an odontogenic tumor that is often found. The management of Ameloblastoma can be in the form of conservative therapy such as enucleation or radical curettage or with radical surgical therapy such as mandible resection. Defects caused after resection will affect the system of mastication and the appearance of the patient. The gold standard for reconstructive defects can use vascularised bone graft and dental implant rehabilitation to restore mastication and aesthetic function.Objective: To find out how the success of rehabilitation using dental implants in vascularised bone graft reconstruction as an ameloblastoma treatmentMethods: The study used is a systematic review type, according to PRISMA-P, this research was conducted using the PICO design. Electronic searches were carried out indefinitely in September 2019 through online databases of Cochrane, EBSCOhost, Pubmed, Scopus, Wiley Online Library, and SpringerLink with the main keywords mandibular resection, ameloblastoma, vascularised bone graft, dental implants, studies with controlled research designs in the form of controlled trials, retrospectives, prospectives, case reports and case series. Study articles were excluded by opinion opinion research designs, and review articles, studies in addition to Ameloblastoma patients, studies of implants other than dental implants, studies conducted in animals or laboratories.Results: A total of 5,996 scientific publication articles were found. Then 82 scientific articles were excluded after duplication screening. The remaining 5,914 scientific publications articles were then screened electronically based on the criteria for the remaining 28 articles. Then search for articles in full text. After all the full text articles have been collected, exclusion is done again with the reason that it does not display a clear ameloblstoma patient data record. The exclusion results obtained as many as 13 articles. Dental implant survival in vascularised bonegraft reached 238/241 (99%) with more delay placement methods used. Types of reconstruction in the management of ameloblastoma patients with the most mandibular resection using vascularised free fibula flap with double barrel fibula technique, which is as many as 24 (30.76%) patients.Conclusion: Delay of dental implant placement in vascularised bone graft doubel barrel fibula is mostly done because with this reconstruction technique can provide good vertical dimensions and can provide good support for dental implant rehabilitation and can provide an opportunity to obtain a good evaluation of the condition of flap vascularization, evaluating prosthetic needs and patient motivation and evaluating possible placement points for the dental implant region."

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ABSTRAK

 

Nama : Fredy Budhi Dharmawan

Program Studi : Ilmu Bedah Mulut dan Maksilofasial

Judul :

 

SYSTEMATIC REVIEW REHABILITASI DENTAL IMPLANT PADA VASCULARISED BONE GRAFT SEBAGAI TATALAKSANA AMELOBLASTOMA

Latar Belakang:Ameloblastoma merupakan tumor odontogenik  yang sering dijumpai.Tatalaksana dari Ameloblastoma dapat berupa terapi konservatif seperti enukleasi atau radikal kuretase maupun dengan terapi bedah radikal seperti reseksi mandibula.Defek yang ditimbulkan pasca reseksi akan berpengaruh pada sistem mastikasi dan penampilan pasien. Standar emas rekonstruksi defek dapat menggunakan vascularised bone graft serta rehabilitasi dental implat untuk mengembalikan fungsi mastikasi dan estetik.

Tujuan: Untuk mengetahui  bagaimana keberhasilan rehabilitasi menggunakan dental implantpada rekonstruksi vascularisedbone graft  sebagai tatalaksana ameloblastoma

Metode: Penelitian yang digunakan berjenis systematic review, sesuai dengan PRISMA –P, Penelitian ini dilakukan dengan menggunakan desain PICO.Pencarian elektronik dilakukan tanpa batasan tanggal pada Bulan September 2019  melalui basis data online Cochrane, EBSCOhost, Pubmed, Scopus, Wiley Online Library, dan SpringerLink dengan kata kunci utama mandibular resection, ameloblastoma, vascularised bone graft, dental implant, Studi dengan desain penelitian berupa controlled trials, retrospektif,prospektif, case report dan case series. Artikel Studi dieksklusi dengan desain penelitianopinion articles, dan review articles, Studi pada selain pasien Ameloblastoma, Studi mengenai implan selain dental implant, Studi yang dilakukan pada hewan atau laboratoris.

Hasil: Sebanyak 5.996 artikelpublikasiilmiahditemukan.Kemudian 82 artikelilmiahdieksklusi setelahdilakukanskriningduplikasi.Sisa 5.914 artikelpublikasiilmiahkemudiandilakukanskrining elektronik berdasarkan criteria didapatkan 28 artikel yang tersisa.Kemudiandilakukanpencarianartikeldalambentukfull text.Setelahsemuaartikelfull text berhasildikumpulkan, dilakukaneksklusikembalidenganalasan tidak menampilkan record data pasien ameloblstoma yang jelas .Hasileksklusitersebutdidapatkansebanyak 13 artikel.Survival dental implant pada vascularised bonegraft mencapai 238/241 (99%) dengan metode delay placement lebih banyak digunakan. Jenis rekonstruksi pada tatalaksana pasien ameloblastoma dengan reseksi mandibula terbanyak menggunakan vascularised free fibula flap dengan tekhnik double barel fibula, yaitu sebanyak 24 (30,76%) pasien.

Kesimpulan:Delay dental implant placement pada vascularised bone graftdoubel barel fibulalebih banyak dilakukan karena dengan teknik rekonstruksi ini dapat memberikan dimensi vertikal yang baik dan dapat memberikan dukungan yang baik untuk rehabilitasi dental implant serta dapat memberikan kesempatan untuk memperoleh evaluasi kondisi yang baik tentang vaskularisasi flap, mengevaluasi kebutuhan prostetik dan motivasi pasien serta mengevaluasi kemungkinan titik penempatan regio dental implant .

 

Kata kunci:ameloblastoma, mandibular resection, dental implant, vascularised bone graft.

 

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ABSTRACT

 

Name                        : Fredy Budhi Dharmawan

Study Programme    : Oral and Maxillofacial Surgery

Title                          :

 

DENTAL IMPLANT REHABILITATION  ON VASCULARISED BONE GRAFT IN AMELOBLASTOMA TREATMENT; A SYSTEMATIC REVIEW

 

Background:Ameloblastoma is an odontogenic tumor that is often found. The management of Ameloblastoma can be in the form of conservative therapy such as enucleation or radical curettage or with radical surgical therapy such as mandible resection. Defects caused after resection will affect the system of mastication and the appearance of the patient. The gold standard for reconstructive defects can use vascularised bone graft and dental implant rehabilitation to restore mastication and aesthetic function.

Objective: To find out how the success of rehabilitation using dental implants in vascularised bone graft reconstruction as an ameloblastoma treatment

Methods: The study used is a systematic review type, according to PRISMA-P, this research was conducted using the PICO design. Electronic searches were carried out indefinitely in September 2019 through online databases of Cochrane, EBSCOhost, Pubmed, Scopus, Wiley Online Library, and SpringerLink with the main keywords mandibular resection, ameloblastoma, vascularised bone graft, dental implants, studies with controlled research designs in the form of controlled trials, retrospectives, prospectives, case reports and case series. Study articles were excluded by opinion opinion research designs, and review articles, studies in addition to Ameloblastoma patients, studies of implants other than dental implants, studies conducted in animals or laboratories.

Results: A total of 5,996 scientific publication articles were found. Then 82 scientific articles were excluded after duplication screening. The remaining 5,914 scientific publications articles were then screened electronically based on the criteria for the remaining 28 articles. Then search for articles in full text. After all the full text articles have been collected, exclusion is done again with the reason that it does not display a clear ameloblstoma patient data record. The exclusion results obtained as many as 13 articles. Dental implant survival in vascularised bonegraft reached 238/241 (99%) with more delay placement methods used. Types of reconstruction in the management of ameloblastoma patients with the most mandibular resection using vascularised free fibula flap with double barrel fibula technique, which is as many as 24 (30.76%) patients.

Conclusion: Delay of dental implant placement in vascularised bone graft doubel barrel fibula is mostly done because with this reconstruction technique can provide good vertical dimensions and can provide good support for dental implant rehabilitation and can provide an opportunity to obtain a good evaluation of the condition of flap vascularization , evaluating prosthetic needs and patient motivation and evaluating possible placement points for the dental implant region.

Keywords: ameloblastoma, mandibular resection, dental implant, vascularised bone graft.

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"Over the last decade, access to dental care has increasingly become a service requested by the population, especially in the case of dental implants. However, the major cause of implant failure is an inflammatory disease: peri-implantitis. Currently, the adhesion strength of antibacterial coatings at implant surfaces remains a problem to solve. In order to propose a functionalized implant with a resistant antibacterial coating, a novel method of chitosan immobilization at implant surface has been investigated. Functionalization of the pre-active titanium (Ti) surface was performed using triethoxysilylpropyl succinic anhydride (TESPSA) as a coupling agent which forms a stable double peptide bond with chitosan. The chitosan presence and the chemical resistibility of the coating under acid pH solutions (pH 5 and pH 3) were confirmed by FTIR-ATR and XPS analyses. Furthermore, peel test results showed high adhesive resistance of the TESPSA/chitosan coating at the substrate. Cytocompatibility was evaluated by cell morphology with confocal imaging. Images showed healthy morphology of human gingival fibroblasts (HGF-1). Finally, the reported method for chitosan immobilization on Ti surface via peptide bindings allows for the improvement of its adhesive capacities and resistibility while maintaining its cytocompatibility. Surface functionalization using the TESPSA/chitosan coupling method is noncytotoxic and stable even in drastic environments as found in oral cavity, thus making it a valuable candidate for clinical implantology applications."

"Kasus implan sederhana dalam bidang kedokteran gigi umum. Implan kedokteran gigi telah menjadi bidang yang berkembang cepat dan dinamis dalam praktek sehari-hari. Hal ini diakui sebagai modalitas perawatan yang dapat diprediksi dengan tingkat keberhasilan klinis yang tinggi. Gigi tiruan cekat konvensional tidak lagi dianggap sebagai pilihan perawatan utama untuk menggantikan gigi yang hilang. Meskipun jumlah pasien yang meminta perawatan implan meningkat, namun dokter gigi yang menawarkan perawatan implan dalam praktek sehari-hari masih terbatas. International Team for Implantology (ITI) atau tim implantologi internasional mendeskripsikan kasus straightforward segai kasus sederhana. Dinyatakan bahwa penempatan implan dilakukan pada jaringan lunak dan keras yang memadai, dan restorasi gigi tunggal di zona non-estetika. Tinjauan pustaka saat ini banyak membahas tentang penerapan implan kedokteran gigi di perguruan tinggi seluruh dunia dan dimasukkan ke dalam kurikulum mereka untuk program sarjana maupun pascasarjana dalam bidang kedokteran gigi umum. Konsensus Eropa tentang pendidikan implan kedokteran gigi menyimpulkan bahwa sebaiknya pendidikan teknik bedah untuk penempatan implan kasus straightforward disertakan ke dalam kurikulum. Berbagai tingkat dan keterbatasan implan kedokteran gigi dan keterampilan terkait harus diajarkan dan ditentukan oleh para staf pengajar. Malah ini bertujuan untuk meningkatkan kesadaran para praktisi kedokteran gigi dan lembaga terkait di Indonesia terhadap pergeseran paradigma perawatan dalam penatalaksanaan kehilangan gigi. Dengan demikian para praktisi akan dapat menyertakan implan kedokteran gigi dalam perencanaan dan perawatan pasien.

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Dental implant has become a fast developing and dynamic field in dental practice. It is acknowledged as a predictible treatment modality with high clinical success rates. Conventional fixed prostheses are no longer considered to be the first choice treatment for replacing a missing tooth. Despite the increasing number of patients requesting dental implant treatments, there are only some clinicians who are offering implant therapy in their daily practice. The international Team for implantology described a straightforward case as a simple case such as implant placements in adequate soft and hard tissue conditions and single-tooth restoration in a non-aesthetic zone. A review of the current literature discussed the implementation of implant dentistry in universities worldwide into their curriculum for both undergraduate and postgraduate programs in general dentistry. The European consensus in implant dentistry education concluded that it is desirable to include the surgical technique for implant placement for straightforward cases into the dental curriculum. The levels and limitations to which the various aspects of implant dentistry and related skills are to be taught are determined by the academic community. This review aimed at promoting awareness amongst dental practitioners and institutions in Indonesia of the shifting treatment paradigm in the management of a missing tooth. Hence clinicians with able to include implant dentistry in the treatment planning of their patients and also undertake a significant part in the execution of such treatments."