Innovation of Stichopus hermanii and HBOT in Increasing the Number of Fibroblasts on Periodontal Ligament

Authors

  • Robbi Akbar Dirmadana Sarjana Kedokteran Gigi Fakultas Kedokteran Gigi, Universitas Hang Tuah
  • Ghina Sucilia Mediani Sarjana Kedokteran Gigi Fakultas Kedokteran Gigi, Universitas Hang Tuah
  • I Ketut Ika Sandana Sarjana Kedokteran Gigi Fakultas Kedokteran Gigi, Universitas Hang Tuah
  • Febryan Alief Sarjana Kedokteran Gigi Fakultas Kedokteran Gigi, Universitas Hang Tuah
  • Jessica Jenuary Yasin Sarjana Kedokteran Gigi Fakultas Kedokteran Gigi, Universitas Hang Tuah
  • Arya brahmanta Ortodonsia Fakultas Kedokteran Gigi Universitas Hang Tuah

Keywords:

Orthodontic tooth movement, Stichopus hermanii, HBOT, fibroblast, periodontal ligament.

Abstract

Background: The prevalence of malloclussion in Indonesia reached 80% in 2013, accordingly, orthodontic treatment needs also increased. Orthodontic treatment is a treatment to improve the arrangement of teeth. Orthodontic treatment causes movement of the teeth, but this treatment takes quite long time around 15-24 months and it needs an additional therapy to accelerate it.. Fibroblast is a main cell in periodontal ligaments that has an important role on orthodontic tooth movement. Stichopus hermanii (golden sea cucumber) and Hyperbaric Oxygen Therapy (HBOT) can induce fibroblast proliferation. Purpose: To investigate how the innovation of Stichopus hermanii and HBOT can increase the number of Fibroblast in periodontal ligament during orthodontic tooth movement. Materials and Methods: This research used Randomized Post Test Only Control Group Design. The sample involve 30 male adult guinea pigs was randomly divided into 5 groups: negative groups (K-), positive groups (K+), Stichopus hermanii treatment group (P1), HBOT group (P2), and combination group(P3). In K+ and treatment groups, maxillary incisors of guinea pig was placed a helical spring in order to move the teeth to distal. To analyze the number of fibroblast on histology, used Hematoxylin Eosin (HE). Data analysis uses One Way ANOVA, Post Hoc LSD, and Paired T Test. Result: Research data shows an increased average of fibroblast number in the pressure area, K(-): 10,8±0,83; K(+): 9±1,14; P1: 10±1,58; P2: 10,6±1,51; P3: 11±1,41 and in the tension area also experienced an increased average of fibroblast number, K(-): 11,6±1,11; K(+): 12,6±2,88; P1: 14,6±1,14; P2: 16,6±1,14; P3: 18,2±1,92. Conclusion: Innovation of Stichopus hermanii and HBOT increased the number of fibroblast in periodontal ligament during orthodontic tooth movement.

Downloads

Download data is not yet available.

References

Laguhi VA, Anindita PS, Gunawan PN. Gambaran Maloklusi dengan Menggunakan HMAR pada Pasien di Rumah Sakit Gigi dan Mulut Universitas Sam Ratulangi Manado. Jurnal e-Gigi (eG). 2014:2(2);7-1.

Rahardjo P. Ortodonti Dasar. 2nd ed. Surabaya: Airlangga University Press; 2012. p. 142-153.

Oley AB, Anindita PS, Leman MA. Kebutuhan perawatan ortodonti Berdasarkan Index of Orthodontic Treatment Need pada Usia Remaja 15-17 Tahun. Jurnal e-Gigi (eG). 2015;3(2): 297-292.

Maulani C. Seluk Beluk Kawat Gigi. Jakarta: Alex Media Komputindo; 2009. p. 1.

Ardhana W. Ortodonsia III Perawatan Ortodontik. Materi Kuliah: Fakultas Kedokteran Gigi Universitas Gadjah Mada; 2008. p. 6.

Kusumadewy W. Perbandingan Kadar Interleukin-1β (IL-1 β) dalam Cairan Krevikular Gingiva Anterior Mandibula Pasien pada Tahap Awal Perawatan Ortodonti Menggunakan Braket Self-Ligating Pasif dengan Braket Konvensional Pre-Adjusted MBT [Tesis]. Jakarta: Universitas Indonesia; 2012. p. 1-3.

Isaacson KG, Muir JD, Reed RT. Removable Orthodontic Appliances. India : Elsevier; 2006. p. 8.

Rahardjo C, Prameswari N, Rahardjo P. Pengaruh Gel Teripang Emas Terhadap Jumlah Fibroblas Di Daerah Tarikan pada Relaps Gigi Setelah Perawatan Ortodonti. Denta Jurnal Kedokteran Gigi. 2014; 8(1): 33-26.

Shita ADP. Pengaruh Gaya Ortodonsi Terhadap Ekspresi Tumor Necrosis Factor-α Tulang Alveolar Pada Model Tikus Diabetes yang Diinduksi Streptozotocin (Kajian in vivo pada tikus Wistar). Laporan Hasil Penelitian Hibah Khusus Bagi Peneliti Muda atau Pemula. Jember: Universitas Jember; 2015. p. 3.

D’Apuzzo F, Cappabianca S, Ciavarella D, Monsurro A, Silvestrini-Biavati A, Perillo L. Biomarkers of Periodontal Tissue Remodelling During Orthodontic Tooth Movement in Mice and Men : Overview and Clinical Relevance. The Scientific World Journal. 2013; 105873: 4.

Arundina I, Suardita K, Setiabudi H, Ariani MD. Golden Sea Cucumber (Stihopus hermanii) as Growth Factor of Stem Cell. Journal of International Dental and Medical Research. 2016;9(3):247-243.

Parisihni K, Revianti S. Antifungal Effect of Stichopus Hermanii and Holothuria atra extract and Its cytotoxicity on Gingiva-Derived Mesenchymal Stem Cell. Dental Journal Majalah Kedokteran Gigi. 2013;46(4):223-218.

Gokce S, Bengib AO, Akinc E, Karacayd S, Sagdicc D, Kurkcue M, Gokce HS. Effect of Hyperbaric Oxygen during Experimental Tooth Movement. The Angle Orthodontist. 2008;78(2):308-304.

Ananda SJ. Perbedaan Jumlah Fibroblas antara Daerah Tekanan dan Tarikan pada Proses Pergerakan Gigi akibat Pemberian Terapi Oksigen Hiperbarik (HBOT) [Skripsi]. Surabaya: Universitas Hang Tuah; 2016. p. 55.

Sutomo S, Rahardjo P, Sjafei A. Efek Pemberian Oksigen Hiperbarik Terhadap Peningkatan Osteoblas Pada Proses Remodeling Selama Pergerakan Gigi pada Marmut Jantan. Orthodontic Dent J. 2012:(3):32-22.

Niklas A, Proff P, Gosau M, RÖmer P. The Role of Hypoxia in Orthodontic Tooth Movement. International Journal of Dentistry. 2013:7-1.

Jan A. Effects of Hyperbaric Oxygen on Healing of Bone, Bone Grafts and Bone Graft Substitutes in Calvarial Defects. Disertasi. Finland: University of Tampere; 2012. p. 103-110.

Amin MN, Permatasari N. Aspek Biologis Pergerakan Gigi secara Ortodonti. Stomatognatic (J.K.G Unej). 2016;13(1):27-22.

Susilowati A. Efek Pemberian Seduhan Kopi terhadap Jumlah Sel Fibroblas pada Ligamen Periodontal Gigi Tikus yang Diinduksi Gaya Ortodonti [Skripsi]. Jember: Fakultas Kedokteran Gigi Universitas Jember; 2016. p. 1-3.

Newman MG, Takei HH, Klokkevold PR, Carranza FA. Carranza’s Clinical Periodontology. 10th ed. St. Louis, Missouri: Saunders Elsevier; 2006. p. 68-71.

Rizal MB. Komposisi Senyawa Organik dan Anorganik Ekstrak Teripang Pasir dan Teripang Emas yang Biokompatibel terhadap Pulpa. Skripsi. Surabaya: Fakultas Kedokteran Gigi, Universitas Hang Tuah; 2012. p. 36-35.

Khrisnan V, Davidovitch Z. American Journal Orthodontics Dentofacial Orthopedics. 2006;129:32-1.

Rizal MB. Komposisi Senyawa Organik dan Anorganik Ekstrak Teripang Pasir dan Teripang Emas yang Biokompatibel terhadap Pulpa [Skripsi]. Surabaya: Fakultas Kedokteran Gigi Universitas Hang Tuah; 2012. p. 35-36.

Mehta V, De A Balachandran C. Hyperbaric Oxygen Therapy. J Pakistan Assoc. Of Dermatologiss. 2009;(9):167-164.

Alghamdi MYM. The Effect of Hyperbaic Oxygen Therapy on Bone Distant From Sites of Surgery [Tesis]. University Of Toronto; 2011. p. 1-28.

Kang TS, Gorti GK, Quan SY, Ho M, Koch J. Effect of Hyperbaric Oxygen on the Growth Factor Profile of Fibroblast. American Medical Association. 2004; (6):34-31.

Thom SR. Oxidative Stress Is Fundamental To Hyperbaric Oxygen Therapy. J Appl Physiol. 2009;106:995-988.

Ornitz DM. FGFs, Heparan Sulfat, and FGFRs: Complex Interactions Essential for Development . BioEssays 2000. (22):108-112.

Anindyajati TP, Harsini, Widjijono. Pengaruh Konsentrasi Ekstrak Kulit Batang Jambu Mete dalam Bahan Kumur terhadap Proliferasi Sel Fibroblas pada Penyembuhan Luka (In Vivo). The International Symposium an Oral and Dentist Science. 2013;3(2):42-36.

Necas J. Bartosikova L. Brauner P. Kolar J. Hyaluronic Acid (Hyaluronan): a review. Vetenerian Medicina. 2008; 53:411-397.

Kusumawardhani AD, Kalsum U, Rini IS. Pengaruh Sediaan Salep Ekstrak Daun Sirih (Piper betle Linn.) terhadap Jumlah Fibroblas Luka Bakar Derajat IIA pada Tikus Putih (Ratus novergicus) Galur Wistar. Majalah Kesehatan FKUB. 2015; 2(1):28-16.

Liu C, Ou Y, Zhang Y, Fu X. Total Saponins of Panax Notoginseng Enhance VEGF and Relative Receptors Signals and Promote Angiogenesis Derived from Rat Bone Marrow Mesenchymal Stem Cells. J. Ethopharmacol. 2013; 143(3):602-595.

Huda N. Pengaruh Hiperbarik Oksigen (HBO) Terhadap Perfusi Perifer Luka Gangren pada Penderita DM di RSAL Dr. Ramelan Surabaya [Tesis]. Jakarta: Universitas Indonesia; 2010. p. 61-66.

Frisca Sardjono, CT. Sandra F. Angiogenesis: Patofisiologi dan Aplikasi Klinis. JKM. 2009;8(2):178.

Downloads

Published

2021-08-26

How to Cite

Robbi Akbar Dirmadana, Ghina Sucilia Mediani, I Ketut Ika Sandana, Febryan Alief, Jessica Jenuary Yasin, & Arya brahmanta. (2021). Innovation of Stichopus hermanii and HBOT in Increasing the Number of Fibroblasts on Periodontal Ligament. DENTA JURNAL KEDOKTERAN GIGI, 11(1), 15–24. Retrieved from https://journal-denta.hangtuah.ac.id/index.php/jurnal/article/view/107

Issue

Vol. 11 No. 1 (2017): Februari

Section

Articles

License

Copyright (c) 2017 Universitas Hang Tuah

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Dengan menggunakan Hak Lisensi (sebagaimana didefinisikan di bawah), Anda menerima dan setuju untuk terikat oleh syarat dan ketentuan Lisensi Publik Internasional Creative Commons Atribusi-BerbagiSerupa 4.0 ini ("Lisensi Publik"). Sejauh Lisensi Publik ini dapat diartikan sebagai suatu kontrak, Anda diberikan Hak Lisensi dengan mempertimbangkan penerimaan Anda terhadap syarat dan ketentuan ini, dan Pemberi Lisensi memberikan Anda hak tersebut dengan mempertimbangkan manfaat yang diterima Pemberi Lisensi dari penyediaan Materi Berlisensi berdasarkan syarat dan ketentuan ini.

Bagian 1 – Definisi.

  1. Materi Adaptasi  berarti materi yang tunduk pada Hak Cipta dan Hak Serupa yang berasal dari atau berdasarkan Materi Berlisensi dan di mana Materi Berlisensi tersebut diterjemahkan, diubah, disusun, ditransformasi, atau dimodifikasi dengan cara lain yang memerlukan izin berdasarkan Hak Cipta dan Hak Serupa yang dimiliki oleh Pemberi Lisensi. Untuk tujuan Lisensi Publik ini, jika Materi Berlisensi berupa karya musik, pertunjukan, atau rekaman suara, Materi Adaptasi selalu diproduksi di mana Materi Berlisensi tersebut disinkronkan dalam hubungan waktu dengan gambar bergerak.
  2. Lisensi Adaptor  berarti lisensi yang Anda terapkan pada Hak Cipta dan Hak Serupa dalam kontribusi Anda pada Materi Adaptasi sesuai dengan syarat dan ketentuan Lisensi Publik ini.
  3. Lisensi Kompatibel BY-SA  berarti lisensi yang tercantum di  creativecommons.org/compatiblelicenses , yang disetujui oleh Creative Commons sebagai padanan hakiki dari Lisensi Publik ini.
  4. Hak Cipta dan Hak Serupa  berarti hak cipta dan/atau hak serupa yang berkaitan erat dengan hak cipta, termasuk, namun tidak terbatas pada, hak pertunjukan, hak siaran, hak rekaman suara, dan Hak Basis Data Sui Generis, tanpa memperhatikan bagaimana hak tersebut diberi label atau dikategorikan. Untuk tujuan Lisensi Publik ini, hak-hak yang disebutkan dalam Pasal  2(b)(1)-(2)  bukan merupakan Hak Cipta dan Hak Serupa.
  5. Langkah-Langkah Teknologi yang Efektif  berarti langkah-langkah yang, jika tidak ada kewenangan yang tepat, tidak dapat dielakkan berdasarkan hukum yang memenuhi kewajiban berdasarkan Pasal 11 Perjanjian Hak Cipta WIPO yang diadopsi pada tanggal 20 Desember 1996, dan/atau perjanjian internasional serupa.
  6. Pengecualian dan Batasan  berarti penggunaan wajar, perlakuan wajar, dan/atau pengecualian atau batasan lain terhadap Hak Cipta dan Hak Serupa yang berlaku untuk penggunaan Anda atas Materi Berlisensi.
  7. Elemen Lisensi  berarti atribut lisensi yang tercantum dalam nama Lisensi Publik Creative Commons. Elemen Lisensi dari Lisensi Publik ini adalah Atribusi dan Berbagi Serupa.
  8. Materi Berlisensi  berarti karya seni atau sastra, basis data, atau materi lain yang kepadanya Pemberi Lisensi menerapkan Lisensi Publik ini.
  9. Hak Berlisensi  berarti hak yang diberikan kepada Anda sesuai dengan syarat dan ketentuan Lisensi Publik ini, yang terbatas pada semua Hak Cipta dan Hak Serupa yang berlaku untuk penggunaan Anda atas Materi Berlisensi dan yang Pemberi Lisensi berwenang untuk melisensikannya.
  10. Pemberi lisensi  berarti individu atau badan yang memberikan hak berdasarkan Lisensi Publik ini.
  11. Berbagi  berarti menyediakan materi kepada publik melalui cara atau proses apa pun yang memerlukan izin berdasarkan Hak Lisensi, seperti reproduksi, tampilan publik, pertunjukan publik, distribusi, penyebaran, komunikasi, atau impor, dan menyediakan materi kepada publik termasuk dengan cara yang memungkinkan anggota publik mengakses materi tersebut dari suatu tempat dan pada waktu yang mereka pilih sendiri.
  12. Hak Basis Data Sui Generis  berarti hak-hak selain hak cipta yang timbul dari Direktif 96/9/EC Parlemen Eropa dan Dewan tanggal 11 Maret 1996 tentang perlindungan hukum basis data, sebagaimana telah diubah dan/atau digantikan, serta hak-hak lain yang pada hakikatnya setara di mana pun di dunia.
  13. Anda  berarti individu atau entitas yang menjalankan Hak Lisensi berdasarkan Lisensi Publik ini.  "Anda"  memiliki arti yang sesuai.

Bagian 2 – Ruang Lingkup.

  1. Pemberian lisensi .
    1. Tunduk pada syarat dan ketentuan Lisensi Publik ini, Pemberi Lisensi dengan ini memberikan Anda lisensi yang berlaku di seluruh dunia, bebas royalti, tidak dapat disublisensikan, tidak eksklusif, dan tidak dapat dibatalkan untuk melaksanakan Hak Lisensi dalam Materi Berlisensi untuk:
      1. memperbanyak dan Membagikan Materi Berlisensi, secara keseluruhan atau sebagian; dan
      2. memproduksi, memperbanyak, dan Berbagi Materi yang Diadaptasi.
    2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.
    3. Term. The term of this Public License is specified in Section 6(a).
    4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a)(4) never produces Adapted Material.
    5. Downstream recipients.
      1. Offer from the Licensor – Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.
      2. Additional offer from the Licensor – Adapted Material. Every recipient of Adapted Material from You automatically receives an offer from the Licensor to exercise the Licensed Rights in the Adapted Material under the conditions of the Adapter’s License You apply.
      3. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.
    6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

  2. Other rights.

    1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.
    2. Patent and trademark rights are not licensed under this Public License.
    3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties.

Section 3 – License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

  1. Attribution.

    1. If You Share the Licensed Material (including in modified form), You must:

      1. retain the following if it is supplied by the Licensor with the Licensed Material:
        1. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);
        2. a copyright notice;
        3. a notice that refers to this Public License;
        4. a notice that refers to the disclaimer of warranties;
        5. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;
      2. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and
      3. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.
    2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.
    3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.
  2. ShareAlike.

    In addition to the conditions in Section 3(a), if You Share Adapted Material You produce, the following conditions also apply.

    1. The Adapter’s License You apply must be a Creative Commons license with the same License Elements, this version or later, or a BY-SA Compatible License.
    2. You must include the text of, or the URI or hyperlink to, the Adapter's License You apply. You may satisfy this condition in any reasonable manner based on the medium, means, and context in which You Share Adapted Material.
    3. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, Adapted Material that restrict exercise of the rights granted under the Adapter's License You apply.

Section 4 – Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

  1. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database;
  2. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material, including for purposes of Section 3(b); and
  3. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 – Disclaimer of Warranties and Limitation of Liability.

  1. Unless otherwise separately undertaken by the Licensor, to the extent possible, the Licensor offers the Licensed Material as-is and as-available, and makes no representations or warranties of any kind concerning the Licensed Material, whether express, implied, statutory, or other. This includes, without limitation, warranties of title, merchantability, fitness for a particular purpose, non-infringement, absence of latent or other defects, accuracy, or the presence or absence of errors, whether or not known or discoverable. Where disclaimers of warranties are not allowed in full or in part, this disclaimer may not apply to You.
  2. To the extent possible, in no event will the Licensor be liable to You on any legal theory (including, without limitation, negligence) or otherwise for any direct, special, indirect, incidental, consequential, punitive, exemplary, or other losses, costs, expenses, or damages arising out of this Public License or use of the Licensed Material, even if the Licensor has been advised of the possibility of such losses, costs, expenses, or damages. Where a limitation of liability is not allowed in full or in part, this limitation may not apply to You.
  1. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 – Term and Termination.

  1. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

  2. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

    1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or
    2. upon express reinstatement by the Licensor.
    For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.
  3. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.
  4. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Bagian 7 – Syarat dan Ketentuan Lainnya.

  1. Pemberi Lisensi tidak akan terikat oleh ketentuan atau persyaratan tambahan atau berbeda yang dikomunikasikan oleh Anda kecuali disetujui secara tegas.
  2. Segala pengaturan, kesepahaman, atau perjanjian mengenai Materi Berlisensi yang tidak dinyatakan di sini terpisah dari dan independen dari syarat dan ketentuan Lisensi Publik ini.

Bagian 8 – Interpretasi.

  1. Untuk menghindari keraguan, Lisensi Publik ini tidak, dan tidak akan ditafsirkan untuk, mengurangi, membatasi, mengekang, atau memaksakan ketentuan pada penggunaan Materi Berlisensi yang secara sah dapat dilakukan tanpa izin berdasarkan Lisensi Publik ini.
  2. Sedapat mungkin, jika ada ketentuan dalam Lisensi Publik ini yang dianggap tidak dapat diberlakukan, ketentuan tersebut akan secara otomatis direformasi hingga batas minimum yang diperlukan agar dapat diberlakukan. Jika ketentuan tersebut tidak dapat direformasi, ketentuan tersebut akan dihapus dari Lisensi Publik ini tanpa memengaruhi keberlakuan syarat dan ketentuan lainnya.
  3. Tidak ada syarat atau ketentuan Lisensi Publik ini yang akan diabaikan dan tidak ada kegagalan untuk mematuhi yang disetujui kecuali disetujui secara tegas oleh Pemberi Lisensi.
  4. Tidak ada satu pun dalam Lisensi Publik ini yang merupakan atau boleh ditafsirkan sebagai pembatasan atau pengesampingan hak istimewa dan kekebalan apa pun yang berlaku bagi Pemberi Lisensi atau Anda, termasuk dari proses hukum di yurisdiksi atau otoritas mana pun.