Background: Alveolar osteitis is a well-known complication that occurs following a tooth extraction when the clot within the socket breaks down too early, causing increased localised inflammation and extreme pain. Alveolar osteitis delays the wound healing process of the socket. The polyphenols in the cocoa bean (Theobroma cacao L.) can stimulate the wound healing process. Purpose: The aim of this study was to analyse the effect of an 8% cocoa bean extract gel on the healing of alveolar osteitis following a tooth extraction. Methods: This study is an in vivo experiment with a posttest-only control group design. Thirty-six male Wistar rats were divided into three groups: a negative control, positive control and an 8% cocoa bean extract gel. A tooth extraction was performed on the mandibular incisor, and alveolar osteitis was induced by the application of adrenaline using a paper point on the socket. On the 3rd, 7th and 14th days, the clinical wound size of the extraction socket was measured, and the rats were sacrificed to observe the number of macrophages, fibroblasts and osteoblasts microscopically. A two-way analysis of variance test and post hoc least significant difference test were used to analyse the data (p < 0.05). Results: The data analysis showed a significant difference in the clinical wound size of the extraction socket and the number of macrophages, fibroblasts and osteoblasts between the 8% cocoa bean extract gel and the control groups (p = 0.000). Conclusion: An 8% cocoa bean extract gel stimulates the healing of alveolar osteitis following tooth extraction in Wistar rats.

Background: Cleft lip and palate as a frequent congenital defect is caused by genetic and environmental factors. Micronutrient folic acid as an environmental factor has shown a role as a cleft lip and palate protective factor in several previous studies. Purpose: The purpose of this study was to determine the distribution of adequacy of folic acid supplementation and the association between folic acid supplementation during the first trimester of pregnancy with the incidence of cleft lip and palate at Mitra Sejati Hospital, Medan, North Sumatra, Indonesia. Methods: This study used analytical research with a case-control design and questionnaire. A Chi-square test was used to observe the association between the folic acid supplement intake during the first trimester with the incidence of cleft. The p-value ≤ 0.05 was deemed to be significant. Results: The study found that 47 mothers (51.09%) had insufficient, while 45 mothers (48.91%) had adequate folic acid supplementation. This study did not show a significant association between supplement use and all cleft incidence (p>0.05), but a significant result was found between inadequate supplementation (<400µ/day) and cleft lip with or without cleft palate occurrence (p=0.043; OR 2.4[1.022-5.625]). Conclusion: The present study showed that most pregnant women did not have sufficient folic acid supplement in the first trimester. Furthermore, inadequate maternal folic acid supplementation (<400µ/day) during the first trimester of pregnancy increased the tendency for cleft lip and cleft palate (with or without cleft lip) to occur significantly.