Sialorrhea with Neurological Diseases in Oral Medicine Fields: A Narrative Review

Background: Sialorrhea also known as drooling, literally means excessive saliva flow. In patients with neurological conditions such as Parkinson’s disease, cerebral palsy, and stroke. drooling or sialorrhea conditions can be a problem in their lives. In patients with neurological disorders, they experience impaired coordination of facial and mouth muscle movement. Purpose: To describe a review comprehensive management of sialorrhea in neurological, then quality of life can be improved. Reviews: literature search was done thorough literature search between 2008-2020 was done using Science direct, Pubmed and Google Scholar. Conclusion: Treatment for sialorrhea includes non-medical therapy, medical therapy, botulinum toxin, radiotherapy and surgical treatment. Oral medicine specialist dentists have a role in the care of sialorrhea patients with neurological disorders in terms of oral care related as a result of sialorrhea such as perioral dermatitis

Scaffold combination of chitosan and collagen synthesized from chicken feet induces osteoblast and osteoprotegerin expression in bone healing process of mice

Background: Over 500.000 of the 2,3 million surgical treatments requiring bone grafting procedures that are performed annually are likely to be necessitated by or will result in bone defects that will not regenerate. Treatment to regenerate new tissues is needed, especially for hard tissue repair, which not only relies on a natural osseointegration process, but also requires a physical support to guide the differentiation and proliferation of cells into the targeted functional tissue. Chitosan and collagen extracted from chicken feet combinations are expected to enhance the bioactive surface and provide mechanical strength as a bone graft scaffold. Purpose: The aim of this study was to investigate the role of chitosan and collagen scaffold synthesized from chicken feet applications to increase the expression of Osteoprotegerin (OPG) and osteoblast cells on the fourteenth day of bone healing. Methods: Eighteen three-month old, adult, male, Rattus novergicu strain rodents with a body weight ranging from 200-350 g were kept under controlled environmental conditions. The mice were randomly divided into three groups consisting of three subjects, each treated with collagen, chitosan, chitosancollagen combination (50:50) scaffolds. On the 14th post-treatment day, three members of each group were sacrificed. Examination of Osteoprotegerin (OPG) expression was conducted by means of immunohistochemistry staining with anti-OPG polyclonal antibodies. Meanwhile, osteoblast cell examination was performed by means of hematoxilin-eosin (HE) staining. Results: The mice treated with collagen and a chitosan-collagen combination scaffold presented an increase in the expression of Osteoprotegerin (OPG) and the number of osteoblast cells respectively. Conclusion: A combination of chitosan-collagen (50:50) scaffold extracted from chicken feet increased the expression of OPG and the number of osteoblasts in the bone healing process. The combination scaffolds demonstrated the highest OPG expression and number of osteoblasts compared to the other groups

Neuropathy complication of antiretroviral therapy in HIV/AIDS patients

Objectives: Significant pain from HIV-associated sensory neuropathy (HIV-SN) affects 40% of HIV-infected individuals treated with antiretroviral therapy (ART). The most salient symptom of the neuropathy is pain, which frequently is moderate-tosevere intensity, associated with reduced activities and physical function, sleep disruption, increased severity of depression, and anxiety. Yet, evidence for managing painful HIV-SN is poor. The purpose of this study was to verify by scientific evidence the neuropathy complication in HIV/AIDS patients to develop effective pain management strategies. Methods: Design: Systematic review. Data sources: PubMed (MEDLINE), Cochrane, www.controlled-trials.com. Selection criteria: the filter “English” was used, timeframed searched was 2009–2019, randomized controlled trials (RCT). Keywords were verified in MeSH “Peripheral Nervous System Disease” and “Antiretroviral Agents” or “Antiretroviral therapy.” Review method: the PRISMA flowchart was used. Result: A systematic search following PRISMA guidelines was carried out, and 12 specific articles/studies on the subject were selected. The results revealed that HIV therapy, aging, body mass index, height, and systemic conditions influence neuropathy conditions in HIV/AIDS patients. The multistudies focused on pain management approaches such as administration of pain medication, drug combination to prevent side effects, or ART with minimal side effects. Conclusion: Sensory neuropathy is a frequent complication of HIV infection and ART. An understanding of the mechanism and pathophysiology of neuropathy in HIV is urgently required to develop alternative treatment modalities and to evaluate preventive strategies

Expression of fibroblast growth factor-β and transforming growth factor-β in mauli banana stem (Musa Acuminate) extract gel - treated traumatic ulcer

Purpose: To investigate the effect of mauli banana (Musa acuminate) stem topical gel extract application on the expression of transforming growth factor - β (TGF - β) and fibroblast growth factor-β (FGF-β) during the healing process in traumatic oral ulcers. Methods: The work represented a true experimental study incorporating a post test - only control group design. Four groups of male Wistar rats (Rattus norvegivus) (n = 20) with traumatic oral ulcers were given mauli banana stem extract gel of varying concentrations the negative control group: 0 %; treatment group I: 25 %; treatment group II: 37.5 %; and treatment group III: 50 %. The animals were subsequently sacrificed prior to conducting biopsy on day 5. Immunohistochemical staining was performed in order to analyze the degree of FGF-β and TGF–β expressions. Results: TGF–β was strongly expressed in treatment group II (16.80 ± 1.30). TGF-β expression was significantly different, except between treatment groups II and III (Table 2). FGF-β was strongly expressed in treatment group II (15.60 ± 3.97). There was significant difference in FGF-β expression between all the groups with the exception of treatment groups I and III. Conclusion: Topical application of mauli banana stem extract gel (37.5 % concentration) stimulates FGF-β and TGF-β expression on day 5 of traumatic oral ulcer healing process. Thus, the extract gel has potentials for clinical application for the therapy of traumatic oral ulcer

RECURRENT APHTHOUS STOMATITIS RELATED TO PSYCHOLOGICAL STRESS, FOOD ALLERGY AND GERD

Background: Recurrent Aphthous Stomatitis (RAS) is inflammation in oral mucosa characterized by recurrent single or multiple ulcers that usually affected in non keratinized mucosa. Etiology RAS is unknown but psychological stress, allergy, and gastrointestinal disease can be predisposing factors Case Management: A 23rd years old complained recurrent oral ulcer with free ulcer period for 3-5 days. The patient had a history of food allergy, GERD and psychological stress. Intraoral examination showed recurrent multiple ulcers in variation site of the mouth. DASS 42 screening showed high stress and high anxiety. Skin Prick Test showed positive allergy to kapok, beef, chicken, cow milk, white egg, duck egg, shrimp, cob fish, milkfish, chocolate, and peanut. Ulcers treated with nonsteroid antiinflammation Aloe Vera gel and stress management by reading assignment method.Discussion: Psychological stress altered the immune system so oral mucosa prone to inflammation, and make the history of GERD getting worse. Stress causes cortisol secretion that changes the imbalance of proinflammatory and antiinflammatory cytokines. Oral mucosa becomes more susceptible to hypersensitivity. In addition, stress decreased oral and esophageal mucosa resistance to GERDConclusion: RAS triggered by psychological stress, allergy, and GERD. Treatment of RAS is by elimination predisposing factors to prevent recurrence

Mauli banana stem extract application increased expression of NF-κB in traumatic ulcer healing

Background: A traumatic ulcer represents one of the most prevalent disorders affecting the oral cavity. Ulceration of the oral cavity potentially results in secondary infection requiring topical medication which involves the use of antiseptics to accelerate wound healing. Previous research has shown that Mauli banana (Musa acuminata) stem extract (MBSE) contains bioactive material from terpenoid saponin present in Ambon bananas. The terpenoid saponin in Ambon banana stems will be captured by a G protein receptor in the macrophages, subsequently producing a protein kinase C that activates nuclear factor kappa beta (NF-κB). This increases both the activity and number of macrophages. Purpose: To analyze the expression of NF-κB (p50) in traumatic ulcers as an effect of MBSE. Methods: A true experimental design with a post-test only control group. It involved 40 male Rattus norvegicus strain rats as traumatic ulcer models divided into four groups: the negative control group administered gel, and the other treatment groups administered 25%, 37.5% and 50% ethanol extracts of MBSE gel respectively. A biopsy was performed on days 3 and 5. The preparation was produced to analyze the expression of NF-κB (p50) by means of immunohistochemistry examination. Results: There was a significant difference (p<0.05) in NF-κB (p50) expression (p=0.005) following MBSE gel administration of 37.5% concentration on day 3 compared to day 5. Conclusion: It can be concluded that MBSE gel topical application can increase expression of NF-κB (p50) in traumatic ulcer healing

Mauli banana stem extract application increased expression of NF-kB in traumatic ulcer healing

Background: A traumatic ulcer represents one of the most prevalent disorders affecting the oral cavity. Ulceration of the oral cavity potentially results in secondary infection requiring topical medication which involves the use of antiseptics to accelerate wound healing. Previous research has shown that Mauli banana (Musa acuminata) stem extract (MBSE) contains bioactive material from terpenoid saponin present in Ambon bananas. The terpenoid saponin in Ambon banana stems will be captured by a G protein receptor in the macrophages, subsequently producing a protein kinase C that activates nuclear factor kappa beta (NF-kB). This increases both the activity and number of macrophages. Purpose: To analyze the expression of NF-kB (p50) in traumatic ulcers as an effect of MBSE. Methods: A true experimental design with a post-test only control group. It involved 40 male Rattus norvegicus strain rats as traumatic ulcer models divided into four groups: the negative control group administered gel, and the other treatment groups administered 25%, 37.5% and 50% ethanol extracts of MBSE gel respectively. A biopsy was performed on days 3 and 5. The preparation was produced to analyze the expression of NF-kB (p50) by means of immunohistochemistry examination. Results: There was a significant difference (p<0.05) in NF-kB (p50) expression (p=0.005) following MBSE gel administration of 37.5% concentration on day 3 compared to day 5. Conclusion: It can be concluded that MBSE gel topical application can increase expression of NF-kB (p50) in traumatic ulcer healing

Inhibitory effects of siwak (Salvadora persica L.) extract on the growth of enterococcus faecalis planktonics and biofilms by in vitro.

Background: Enterococcus faecalis (E. faecalis) is one of the most persistent gram positive bacteria in root canal, resulting in secondary infection after endodontic treatment. E. faecalis pathogenicity is caused by overgrowth of E. faecalis planktonics and biofilms. E. faecalis planktonics produce lipoteichoid acid (LTA) as a virulence factor that can defend their permeability cell. On the other hand, E. faecalis biofilms produce protease, such as Esp (enterococcal surface protein), GelE (gelatinase), and SprE (serin protease), that have quorum-sensing mechanism as an adhesion factor to form extracellular polysaccharide substance (EPS) and increase the growth of the biofilms themselves. Siwak (Salvadora persica L.) has active components, namely benzylisothio-cyanate, trimethylamine, and salvadorine that can inhibit the growth of E. faecalis planktonics and biofilms. Purpose: This study aimed to measure inhibitory effects of siwak extract on the growth of E. faecalis planktonics and biofilms. Method: This research was an antimicrobial research on the culture of E.faecalis incubated in a TSB medium. Siwak extract was diluted into different concentrations, namely 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, and 100%. The extract then was placed into the E. faecalis’s colony and planted into Trypticase Soy Agar medium. After incubated for 24 hours at 37°C, the colony would be measured and compared with the control (+) and control (-). As an antibiofilm research, this research used biofilm microtitter assay method to form E. faecalis biofilms incubated in a well-plate medium containing TSB and 0.1 % glucose. Siwak extract then was diluted into the same range concentration as in first method, and placed into the colony of E. faecalis to form biofilms. The biofilms were measured and compared to the control (+) given siwak extract and the control (-) given 0.1% chlorhexidine. After the incubation, they were washed three times, and staining process was conducted using Chrystal violet. The optical density then was measured by ELISA Reader 595 nm. Result: Siwak extract could inhibit the growth of E. faecalis planktonics at the concentration of 35% as a minimum inhibitory concentration as well as the growth of E. faecalis biofilms at the concentration of 45% as a minimum biofilm inhibitory concentration. Conclusion: Siwak extract has an inhibitory effect, particularly at a concentration of 35% on the growth of E. faecalis planktonics and at the concentration of 45% on the growth of E. faecalis biofilms

Oral mucosal lesions and oral symptoms of the SARS-CoV-2 infection

INTRODUCTION: SARS-CoV-2 develops well in the oral mucosa because, it is the first contact area with the virus. The oral mucosa is highly expressed with angiotensin-converting enzyme 2 (ACE2) and makes the virus replicated in the epithelial cells and produce both oral lesions and oral symptoms. This review aimed to describe the oral mucosal symptoms and lesions related to SARS-CoV-2-infected patients that have been reported around the world. EVIDENCE ACQUISITION: A literature search was performed on PubMed, ScienceDirect and Google Scholar, from February to October 5, 2020, focusing on COVID-19 (SARS-CoV-2) oral lesions and oral symptoms. EVIDENCE SYNTHESIS: Eighteen studies were identified with a total of 25 cases describing the oral symptoms and oral mucosal lesions of the SARS-CoV-2 infection. The oral symptoms related to the SARS-CoV-2 infection included dysgeusia, ageusia, a burning mouth sensation, a dry mouth and severe halitosis. The oral mucosal lesions varied from ulceration and depapilation to pseudomembranous, maculae, nodules and plaque. The mucosal lesions related to the skin lesions were in the form of crusty lips, multiple ulcerations and rashes, targeted lesions, blisters and vesiculobullous lesions. CONCLUSIONS: The manifestations of the SARS-CoV-2 infection in the oral cavity are non-specific. The oral mucosal lesions that occur mimic the Herpes zoster virus infection, the Herpes simplex virus infection, Varicella and hand, foot and mouth disease, and the oral mucosal lesions with the skin manifestations (e.g. erythema multiforme)

The effect of musa acuminata stem in increasing macrophage and neovascular cells of healing process

Introduction: Musa acuminata stem has both of imunostimulatory and imunosuppressant effects that are influenced by their concentrations. The study aimed to analyze the effect of Mauli banana stem extract (EMBS) to increase the number of macrophage and neovascular cells in traumatic ulcer healing. Methods: Rattus norvegicus of male Wistar strain were used as model of traumatic ulcer. The left buccal mucous was biopsied, then used the histopathology method to find the number of macrophage and neovascular cells. Results: EMBS gel was effected when administered at a concentration of 37.5% because it significantly increased the number of macrophage and neovascular cells in traumatic ulcer healing on the 3rd day to 5th days. Conclusion: It can be concluded that EMBS within concentration of 37.5% can accelerate ulcer healing through the increasing number of macrophage and neovascular cells