Digital Commons Network^™

Cost Analysis Of Rheumatoid Arthritis In Insured Patients And Its Determinant Factors: Data From A National Referral Hospital In Indonesia, Rudy Hidayat, Fara Fauzia, Mochammad Alfansyah Dhifanra, Aries Maulana

Kesmas

Rheumatoid arthritis (RA) leads to progressive functional impairment and considerable economic burden. This study estimated the annual (12-month) cost per patient among patients with RA and its determinant factors. A descriptive cross-sectional economic study of RA patients who had been treated for at least one year at the outpatient clinic of a national referral hospital in Jakarta, Indonesia, and met the 2010 ACR–EULAR criteria. Data collected from January 2023 to December 2024 were obtained from medical and billing records for demographic characteristics, direct medical costs, and DAS28-based disease activity, whereas non-medical and indirect costs were collected through structured patient interviews. …

Determinants Of Multimorbidity Among Stroke Patients For Epidemiological Management In Indonesia's Agro-Coastal Communities, Krish Naufal Anugrah Robby, Isa Ma'rufi, Farida Wahyu Ningtyias, Latifatul Izzah, Nurjazuli Nurjazuli, Suhartono Suhartono, Muchlis Achsan Udji Sofro, Ida Srisurani Wiji Astuti, Olivia Listiowati Prawoto, Dedek Sutinbuk, Taufik Kurrohman, Elhoussin Ouassou

Kesmas

Multimorbidity remains a major public health challenge among stroke patients, particularly in agro-coastal communities characterized by socioeconomic vulnerability, limited healthcare access, and lifestyle changes. This study aimed to analyze the determinants of multimorbidity among stroke patients in agro-coastal communities. A quantitative observational analytical design was employed, involving 45 stroke patients selected through total sampling in Jember District, Indonesia. Data were collected through structured interviews, anthropometric measurements, and secondary health records. The model included biological, socioeconomic, healthcare access, and lifestyle as exogenous variables, with multimorbidity as the endogenous variable. Data were analyzed using PLS-SEM, including evaluation of measurement and structural models …

Comparison Between The Tooth Coronal Index And Kvaal’S Method In Age Estimation In The Indonesian Population, Astika Swastirani, Nabilah Shafiyyah Rahmayati, Sari Kurniawati, Ferdy Jonathan Walelang

Journal of Dentistry Indonesia

Background: Age estimation in adults is important in forensic odontology, and radiographic approaches such as the Tooth Coronal Index (TCI) and Kvaal's method are commonly applied to panoramic radiographs. This study aimed to compare the agreement of TCI and Kvaal age estimates with chronological age in adults.

Methods: This cross-sectional analytic study evaluated 100 panoramic radiographs (50 males, 50 females) of adults aged 23–45 years. Measurements were performed on mandibular first premolars using ImageJ. Accuracy was operationalized as the closeness of the estimated age to the chronological age and assessed using mean differences and Wilcoxon signed-rank tests.

Results …

Clinical Outcomes Of Adjunctive Use Of Oxygen-Releasing Formula In Non-Surgical Treatment Of Periodontal Abscess Associated With Type 2 Diabetes Mellitus, Anil Kumar Kanakamedala, Laxmi Kavya Gangireddy, Gautami S Penmetsa, Sruthima Gottumukkala, Mohan Kumar Pasupuleti, Konathala Santhosh Venkata Ramesh

Journal of Dentistry Indonesia

Background: This study aimed to evaluate the effectiveness of oxygen-releasing formula (ORF) as an adjunct in the non-surgical management of periodontal abscess in patients with type 2 diabetes mellitus.

Methods: This split-mouth clinical trial was conducted on 14 patients with periodontal abscess with type 2 diabetes mellitus (T2DM), who were divided into a control group, nonsurgical periodontal therapy (NSPT) alone, and a test group (NSPT+ORF). Parameters such as Landry's healing index (HI) were evaluated at 1 week, 2 weeks, and 1 month. Probing pocket depth (PPD), clinical attachment level (CAL), and bleeding on probing presence or absence (BOP) …

Diode Laser And Conventional Ferric Sulfate Pulpotomy In Deciduous Molars: Comparative Outcomes In Myanmar Children, Moe Myat Noe Phyu Dr, Ei Ei Myo, Soe Naing

Journal of Dentistry Indonesia

Background: Pulpotomy is a widely accepted treatment for carious exposure of vital primary molars, using various medicaments. Currently, lasers have emerged as a non-pharmacologic pulpotomy technique. However, comparative clinical studies in Myanmar remain limited. This study aimed to compare the effectiveness of diode laser and conventional ferric sulfate pulpotomy in deciduous molars among children in Myanmar.

Methods: A total of 40 deciduous mandibular molars requiring pulpotomy treatment were selected from children between 4 and 8 years of age. The subjects were randomly assigned to the diode laser group (Group A) or the ferric sulfate group (Group B) using …

Psychosocial And Functional Impact Of Temporomandibular Disorder Subtypes Among Adults: A Cross-Sectional Study In Indonesia, Ni Luh Dewi, Wita Anggraini, Maria Valiente-Lopez, Carolina Marpaung

Journal of Dentistry Indonesia

Background: Temporomandibular disorders (TMDs) affect psychological, functional, and pain-related aspects of oral health-related quality of life (OHRQoL). However, the differential impact of pain-related and non-pain-related TMDs remains limited. This study aimed to evaluate the impact of different TMD subtypes on psychological distress, jaw function, and OHRQoL in young adults and to determine whether pain-related TMDs exert a greater effect than non-pain-related TMDs.

Methods: In this cross-sectional study, 278 university students (aged 18–24 years) were categorized into no TMD (NT), pain-related TMD (PT), intra-articular TMD (IT), and combined TMD (CT). Diagnoses were made using the 5Ts Questionnaire screening tool …

Adverse Drug Reaction Reporting In Dental Practice And The Importance Of Pharmacovigilance In Dental Education, Radhakrishna Lagishetty, Lakshmi Ramya T, Kvr Barath Raju, Mohan Kumar Pasupuleti

Journal of Dentistry Indonesia

Background: Adverse drug reactions (ADRs) are a critical component of patient safety; however, ADR monitoring remains underutilized in dentistry. This study aimed to assess knowledge, attitudes, and practices regarding ADR reporting among undergraduate and postgraduate students and practicing dentists.

Methods: A cross-sectional observational study was conducted using a structured, validated 19-item questionnaire covering socio-demographics, knowledge (6 items), attitude (4 items), and practice (5 items), which was distributed both in person and online. A total of 258 complete responses were analyzed out of 300 individuals contacted (response rate: 86%). Descriptive statistics and Chi-square tests were applied, with p < 0.05 considered statistically significant.

Results …

Investigation Of Patients' Use Of Non-Pharmacological Substances In Dental Pain Management, Neslihan Yılmaz Çırakoğlu, Özgenur Kaya

Journal of Dentistry Indonesia

Background: Dental pain is a complex condition influenced by biological, biochemical, environmental, and psychological factors. Before seeking professional care, many patients attempt to relieve dental pain using self-administered, non-medical agents. This study aimed to investigate patients’ use of non-pharmacological substances in dental pain management and to identify factors influencing these practices.

Methods: The questionnaire consisted of four sections addressing demographic characteristics, oral hygiene habits, pain characteristics, and pain-relief agents. Categorical variables were analyzed using Pearson’s chi-square test. Categorical data are presented as frequencies and percentages, while continuous data are expressed as mean ± standard deviation and median values. …

Flaxseed Ethanolic Extract Modulates Β-Catenin And Dkk1 Expressions During Osteoblast Differentiation Of Dental Pulp-Derived Stem Cells, Nur Sazwi Nordin, Khairani Idah Mokhtar, Omar Abdul Jabbar Abdul Qader, Basma Ezzat Mustafa, Widya Lestari, Deny Susanti Darnis, Thirumulu Ponnuraj Kannan, Azlina Ahmad, Solachuddin Jauhari Arief Ichwan

Journal of Dentistry Indonesia

Background: WNT signaling regulates osteogenic differentiation of mesenchymal stem cells (MSC) through the canonical WNT pathway. β-catenin; an important molecule of WNT pathway, and DKK1; a WNT antagonist, play important roles in regulating bone formation. Although flaxseed (Linum usitatissimum) has various health benefits, including promoting bone health, our previous study showed that flaxseed ethanolic extract (FEE) reduced the osteoblast differentiation potential of stem cells from human exfoliated deciduous teeth (SHED). This study aimed to determine the effects of FEE on WNT pathway-related molecules, β-catenin and DKK1, during osteoblast differentiation of SHED.

Methods: RNA at Day 7, 14, …

Orthodontic Camouflage Treatment Of A Severe Class Iii Skeletal Pattern With Anterior Open Bite: A Case Report, Dikeledi Maureen Letsholo, Mandla Dominic Nyakale, Mosimane Peter Silas Sethusa

Journal of Dentistry Indonesia

Background: Class III malocclusion combined with anterior open bite (AOB) is one of the most challenging occlusal problems to treat. The objective of this article was to report a case of an adult female patient diagnosed with Class III malocclusion combined with an anterior open bite and a hyperdivergent facial pattern.

Case Report: Camouflage orthodontic treatment with the extraction of maxillary and mandibular first premolars was used to treat the patient. Anterior teeth were retracted maximally against the Nance holding arch and fixed lingual arch appliances, and box elastics were used to close AOB. At the end of …

The Correlation Between Medication Adherence, Blood Glucose Levels, And Quality Of Life In Patients With Type 2 Diabetes Mellitus At Ciamis Regional Hospital, Amyla Putri Nurul Nazmi, Nur Rahayuningsih, Lusi N

Pharmacology and Clinical Pharmacy Research

Type 2 diabetes mellitus is a chronic condition requiring continuous treatment, including patient adherence to prescribed medication. This study aimed to explore the relationship between medication adherence, blood glucose levels, and quality of life in patients with type 2 diabetes mellitus at Ciamis Regional Hospital, conducted from January to March 2025, the research employed a quantitative, prospective cross-sectional design involving 49 hospitalized patients. Data included blood glucose levels (RPG, FPG, 2hPG), medication adherence measured using the Medication Adherence Report Scale (MARS-5), and quality of life assessed via the Diabetes Quality of Life-Brief Clinical Inventory (DQOL-BCI). The chi-square test was used …

The Phytochemical Content And Antibacterial Activity Of Purified Extract Of Mangifera Indica L. Against Gram Positive Pathogen, Dewi Andini Kunti Mulangsri, Masduki Faqih, Sugar Arifin, Mutiara Trie Sieya Agustin

Pharmacology and Clinical Pharmacy Research

The purified extract of arum manis mango leaves contained flavonoid compounds by TLC methods and antibacterial activity against Gram-positive and negative pathogens. This research aimed to identify and determine the phytochemical content (mangiferin and flavonoids content) and antibacterial activity against other Gram-positive pathogens. Purification of ethanol extract of arum manis mango leaves by liquid-liquid fraction method. Determination of total flavonoid content and identification of mangiferin used respectively by aluminum chloride and Thin Layer Chromatography method. The disk diffusion method was used to assay antibacterial activity against S. epidermidis, and B. subtilis bacteria with the concentration of the sample such …

Development Of Ultrafast Protein Digestion And Standards Free Quantitation Methods For Mass Spectrometric Analysis, Praneeth Ivan Joel Fnu

Dissertations

A wide variety of biologically important molecules, such as enzymes, antibodies, hormones, transporters and receptors are proteins by composition and they play key roles in biological functions such as cellular regulation, communication, metabolism and physiological function. Protein dysfunctions and abnormalities are associated with numerous diseases, making proteins critical targets for understanding disease mechanisms and developing therapeutic interventions. Protein-based therapeutics such as monoclonal antibodies, hormones and vaccines gained popularity due to their high specificity, efficacy, and ability to treat complex diseases that are often difficult to address with small-molecule drugs.

Given the important role of proteins in a variety of biological …

Effect Of Partial Ablation Of Skeletal Dynamin Related Protein 1 On Mitochondrial Health, Inflammation, And Fibrosis In A Mouse Model Of Duchenne Muscular Dystrophy, Tessa L. Duzz

Graduate Masters Theses

Duchenne muscular dystrophy (DMD) is a progressive neuromuscular disorder characterized by muscle weakness, degeneration, fibrosis, and impaired muscle regeneration. Mitochondrial dysfunction is an early pathological feature of DMD and has been linked to excessive mitochondrial fission. Dynamin-related protein 1 (Drp1) is a central regulator of mitochondrial fission, a key process in regulating mitochondrial quality and function. Inhibition of Drp1-mediated mitochondrial fission has shown promise as a potential therapeutic target for alleviating pathology and dysfunction in dystrophic muscle. The objective of this study was to determine whether partial skeletal muscle-specific ablation of Drp1 could improve muscle pathology and mitochondrial health in …

Cultural Responsiveness: Examining Assessments Of Therapists For Ethical And Clinical Outcomes (Create Clout), Tsotso T. Ablorh

Graduate Doctoral Dissertations

The Multicultural Counseling Competencies (MCC) and Multicultural and Social Justice Counseling Competencies (MSJCC) are well-researched and supported counseling practices for decreasing microaggressions in therapy and consequent attrition, lack of satisfaction, and maltreatment (Ratts et al., 2016; Sue et al., 1982). However, scholars critique existing methods for measuring therapists’ cultural responsiveness for being disconnected from therapeutic process and outcomes (Hays, 2020; Wilcox et al., 2020). This study examined which MSJCC measures associated with variables clinically and ethically relevant to better treatment outcomes and lower microaggressive, neglectful, and stereotypical treatment for hypothetical Black, female clients by White therapists. 62 White psychologists in …

Understanding Factors Influencing Multiple Tobacco Product Use Among Adolescents In Thailand: A Structural Equation Modeling Approach, Chaowalit Srisoem

Graduate Doctoral Dissertations

Tobacco use among Thai adolescents is shaped by personal, environmental, and product-related factors. However, the pathways linking these influences to actual behavior remain unclear. This study examined how personal, environmental, and product-related factors, along with intentions to use, relate to tobacco use among Thai adolescents. A cross-sectional secondary analysis was conducted using data from the 2022 Thailand Global Youth Tobacco Survey of 6,235 students aged 13–15 years. Survey weights methods were applied to produce nationally representative estimates. Confirmatory factor analysis and structural equation modeling assessed latent constructs, and multinomial logistic regression examined predictors of single, dual, and multiple product use. …

Mitochondrial Trna-Derived Fragments As Candidate Metastasis-Modifying Rna, Katy L. Swancutt, R. Mckinnon Walsh, Sydney Quijano, Emily Schueddig, Devin C. Koestler, Adam D. Scheid, Tony Vanden Bush, Yi Jing, Isidore Rigoutsos, Danny R. Welch

Computational Medicine Center Faculty Papers

UNLABELLED: How mitochondrial DNA (mtDNA) polymorphisms influence complex phenotypes remains poorly understood. Using mitochondrial-nuclear exchange mice, we previously showed that mtDNA single-nucleotide polymorphisms (SNP) modify metastasis, cardiovascular disease, and epigenetic marks independently of metabolic differences. The only mtDNA SNP correlating with these phenotypes resides in the gene encoding mitochondrial transfer RNA (tRNA)-arginine [mt-tRNAArg (UCG), mt-TR], suggesting a role for non-protein-coding loci. In this study, we identify and preliminarily characterize previously undescribed tRNA-derived fragments (tRF) generated from mt-TRs. Northern blotting revealed distinct tRF that are differentially expressed among mtDNA SNPs, between lung and liver, and between sexes. Surprisingly, small RNA sequencing …

Staff Education To Strengthen Patient Counseling For Recurrent Uti Prevention In Middle-Aged And Older Women In A Low-Income Community Clinic, Linda Osamede Isidienu

Walden Dissertations and Doctoral Studies

This doctor of nursing practice (DNP) project was a practice-focused quality improvement (QI) staff education initiative designed to address recurrent urinary tract infections (UTIs) among middle-aged and older women receiving care in a low-income community clinic. Recurrent UTIs are associated with increased antibiotic use, antimicrobial resistance, and reduced quality of life. The purpose of this project was to evaluate whether a structured staff education program could improve provider knowledge related to patient counseling on UTI prevention. Twenty nurses and medical assistants participated in the intervention, which included education on evidence-based prevention strategies, counseling techniques for low health literacy populations, and …

Guided Tissue Regeneration Of Localized Deep Combined 2-To-3- Wall Angular Defects: A Clinical Case Report With 15-Month Follow-Up

Journal IDA

Periodontitis is a chronic inflammatory disease affecting nearly 50 percent of U.S. adults. It is characterized by the irreversible destruction of the alveolar bone, periodontal ligament, and gingival tissues supporting the teeth. Periodontal breakdown results from a dysbiotic relationship between the plaque bacteria and host-immune response. Initiated by the bacterial plaque biofilm, the once normal and homeostatic host defenses intended to contain the subgingival inflammation become dysregulated and hyperactive. A diagnosis of an infrabony defect, also known as intrabony, vertical, or angular defects, is made when the base of the pocket is apical to the alveolar crest. It has been …

Diagnostic Challenge: Oral Pathology

Journal IDA

The challenge: We present a case of a 27-year-old female patient who presented to the Fritts Screening Clinic at Indiana University School of Dentistry. She takes metformin for pre-diabetes and levothyroxine for hypothyroidism. Her extraoral exam reveals no pathologies. The intraoral clinical examination reveals a non-wipeable unifocal hyperkeratotic papillary lesion measuring 0.8 x 0.5 cm on the left lateral border of the tongue (Figure 1). The patient reports noticing it approximately a month before the screening appointment; however, she did not experience any pain or other symptoms in the area. An excisional biopsy is performed to obtain a definite diagnosis …

Role Of Microsurgery In The Evolution Of Periodontal Surgery

Journal IDA

Microscopes and microsurgery techniques have revolutionized the field of periodontology, offering enhanced visualization, precision, and improved clinical outcomes. This review explores the role of magnification in periodontal treatments, the benefits of microsurgical techniques, and their impact on patient recovery and procedural success. It examines how these advancements align with evolving surgical principles and addresses their implications for clinical practice and patient outcomes. By integrating microsurgery into periodontics, clinicians can achieve minimally invasive procedures with superior aesthetic and functional results. This paper also discusses the challenges and future directions of microsurgical applications in periodontics, emphasizing the importance of continual advancements and …

Recent Advances In Periodontology

Journal IDA

Periodontology is a dynamic discipline focused on the prevention, diagnosis, and treatment of diseases affecting the supporting structures of the teeth and dental implants. Given the complex and multifactorial pathogenesis of periodontal and peri-implant diseases, the field continually evolves to address diverse clinical needs through evidence-based innovations. Recent years have witnessed significant advances in biomaterials, biologics, diagnostic tools, and minimally invasive therapies that have transformed the clinical management of periodontal conditions. These developments aim not only to improve treatment efficacy and patient outcomes but also to expand the scope of regenerative and patient-centered care. The purpose of this paper is …

Journal Ida 2025 104 2

Journal IDA

In the Spring 2025 issue, the reader will find the following feature articles:

• Teaching the Next Generation: Challenging the Narrative and Shifting Perspectives
• Recent Advances in Periodontolgy
• Role of Microsurgery in the Evolution of Periodontal Surgery
• Diagnostic ChallengeL Oral Pathology
• Factor V Lieden Heterozygosity and Hypertriglyceridemia in 88 Patients with Chronic Jaw Pain and Alveolar Osteonecrosis
• Guided Tissue Regeneration of Localized Deep Combined 3-to-3 Wall Angular Defects: A Clinical Case Report with 15-Month Follow-up

This issue also includes regular columns from the editor, the executive director as well as membership news.

Journal Ida 2025 104 1

Journal IDA

The Journal IDA is a peer-reviewed, scientific periodical owned and published by the Indiana Dental Association, a constituent of the American Dental Association.

Journal IDA concentrates on the clinical aspects of dentistry, including case studies and research; practice management and business aspects of dentistry, from start up to transition; and also includes special and regular feature articles.

Journal Ida 2024 103 4

Journal IDA

The Journal IDA is a peer-reviewed, scientific periodical owned and published by the Indiana Dental Association, a constituent of the American Dental Association.

Journal IDA concentrates on the clinical aspects of dentistry, including case studies and research; practice management and business aspects of dentistry, from start up to transition; and also includes special and regular feature articles.

Journal Ida 2024 103 3

Journal IDA

The Journal IDA is a peer-reviewed, scientific periodical owned and published by the Indiana Dental Association, a constituent of the American Dental Association.

Journal IDA concentrates on the clinical aspects of dentistry, including case studies and research; practice management and business aspects of dentistry, from start up to transition; and also includes special and regular feature articles.

Journal Ida 2021 100 2

Journal IDA

The Journal IDA is a peer-reviewed, scientific periodical owned and published by the Indiana Dental Association, a constituent of the American Dental Association.

Journal IDA concentrates on the clinical aspects of dentistry, including case studies and research; practice management and business aspects of dentistry, from start up to transition; and also includes special and regular feature articles.

Journal Ida 2020 99 4

Journal IDA

The Journal IDA is a peer-reviewed, scientific periodical owned and published by the Indiana Dental Association, a constituent of the American Dental Association.

Journal IDA concentrates on the clinical aspects of dentistry, including case studies and research; practice management and business aspects of dentistry, from start up to transition; and also includes special and regular feature articles.

Journal Ida 2020 99 3

Journal IDA

The Journal IDA is a peer-reviewed, scientific periodical owned and published by the Indiana Dental Association, a constituent of the American Dental Association.

Journal IDA concentrates on the clinical aspects of dentistry, including case studies and research; practice management and business aspects of dentistry, from start up to transition; and also includes special and regular feature articles.

Journal Ida 2019 98 3

Journal IDA

The Journal IDA is a peer-reviewed, scientific periodical owned and published by the Indiana Dental Association, a constituent of the American Dental Association.

Journal IDA concentrates on the clinical aspects of dentistry, including case studies and research; practice management and business aspects of dentistry, from start up to transition; and also includes special and regular feature articles.