THE LEVELS OF TNF-Α IN GINGIVAL CREVICULAR FLUID (GCF) OF OSING TRIBE WOMEN WITH OCCLUSAL DISHARMONY

Abstract

The Osing tribal region is demographically adjacent
to the island of Java, Madura and Bali. The proximity
of this demographic regions affects multiple systems
of their organization, culture, and arts. The Osing’s
familial and societal patterns are similar to the other
Javanese tribes, including housing, food, lifestyle and
health. Osing tribe is frequently compared to
Balinese culture, such as traditional clothing,
wedding dresses, and others [1]. One of the cultures
associated with the teeth is Pangur or asa i.e.
reducing/flattening the occlusal surfaces of the teeth
especially for Osing bride women. In addition, there
is also a tradition of Osing women called Nginang or
betel chewing [2]. This situation may lead to an
imbalance of dental occlusion and disruption of the
normal flora in the oral cavity alleging effect on oral
health
Dental and oral health can be achieved if there is a
relationship of harmony and balance between the
organs and tissues in the oral cavity. This is because
the oral cavity is an integral stomatognatic complex
system.
Stomatognatic system is unitary organ that has
mutual-related functions. These organs include jaw
bones, temporo mandibular joint (TMJ), teeth, and
other supporting structures e.g. mastication
muscles, facial muscles, head and neck. This
stomatognatic system plays an active role in the
process of mastication. In normal conditions, it
occurs a harmonious relationship of all components
of the masticatory system i.e. teeth, muscles, TMJ,
lips, cheeks, palate, tongue and salivary secretion
[3]. The conditions of normal tooth anatomy and
well-structured on curved teeth will put both
condyle joints at the center of the articular disc. This
situation will create an effective mastication process
[4].
Abnormal condition of tooth structure will cause
malocclusion [3]. Occlusion is an interocclusal
relation (intercups) between the teeth of each jaw in
accordance with the position and movement of the
mandible [5]. Occlusion pathological state is known
as occlusal disharmony. Occlusal disharmony can be
caused by several factors such as the loss of teeth,
caries, attrition, tooth anomalies, bruxism, and the
habit of chewing on one side [6].
Occlusal disharmony is suspected to cause
inflammation in periodontal tissues. Periodontal
tissue disease is one of the dental and oral disease
that most commonly occurs. Periodontal diseases
can be caused by bacteria or mechanical the
overloads. The overloads can be caused by the
occlusal disharmony. Thus, occlusal disharmony is
suspected to cause inflammation in the periodontal
tissues. Abnormal oocclusion condition in this
occlusion disharmony leads into occlusal trauma
which will increase the load received by the
periodontal tissue [7]. If this condition is persistent,
it will cause periodontal tissue inflammation.
Inflammation undergoing locally to the periodontal
tissues will induce the immune system to increase
the activity of the inflammatory cytokine secretion,
one of which is TNF-α (tumor necrosis factor-alpha).
TNF-α will play a role in activating osteoclasts, which
can result in the destruction of the alveolar bone [8].
This inflammatory cytokines can be found in gingival
crevicular fluid (GCF), which are inflammatory
exudates collected in the gingival sulcus [9].
TNF-α is a cytokine that plays a role in the
occurrence of periodontal disease through its
activities, which triggers proliferation, differentiation
and activity of osteoclasts resulting in bone
resorption, and inducing production of proteinase in
the cells of the mesenchyme that is responsible in
bond tissue destruction. In patients with
periodontitis it occurs increased levels of TNF-α,
which will be decreased after periodontal treatment.
Based on the description above, it is necessary to
know the levels of TNF-α in GCF Osing women as an
indicator of periodontal tissue inflammation due to
occlusion disharmony. It is important for prevention
and treatment of abnormalities of occlusion
disharmony that will improve oral health and quality
of life, especially in the Osing community in Kemiren
village, Glagah District, Banyuwangi Regency.