Perdarahan Gingiva Sebagai Indikator Penyakit SistemikKasus pada Individu yang Sebelumnya Tak Terdeteksi Menderita Demam Berdarah Dengue

Latar belakang: Perdarahan gingiva dapat disebabkan oleh trombopati. Kondisi medikokompromais seperti DBDmerupakan salah satu faktor predisposisinya. Demam Berdarah Dengue (DBD) adalah penyakit sistemik yang seringterlambat terdiagnosis dan berisiko kematian, banyak dijumpai pada daerah tropis seperti Indonesia. Insidensi DBDdi Jawa Timur sebesar 29,25/100.000 dengan risiko kematian sebesar 0,88%. Tujuan: Penulisan laporan kasusini bertujuan untuk melaporkan perdarahan gingiva pada pasien yang sebelumnya tidak terdeteksi DBD. Kasus:Seorang laki-laki 26 tahun dirujuk untuk melanjutkan pembersihan karang gigi dengan diagnosis gingivitis akut.Pada awalnya, pasien mengeluhkan perdarahan gingiva selama seminggu terakhir saat menyikat gigi dan bau mulut.Pasien merasakan badan lelah dan lemah sejak 1 bulan yang lalu. Tiga minggu sebelum datang, pasien terdiagnosis fludengan gejala demam dan pusing. Ekstra-oral tampak konjungtiva dan kuku pucat serta petechiae pada lengan kanansaat pemeriksaan tekanan darah. Intra-oral terlihat perdarahan gingiva spontan dan ekimosis pada mukosa labial dangingiva. Penanganan: Pemeriksaan darah dilakukan pada hari yang sama dan diketahui adanya trombositopenia yangparah. Hasil anamnesis mengacu pada dugaan adanya penyakit sistemik. Pasien dirujuk ke spesialis penyakit dalamdan terdiagnosis DBD. Kesimpulan: Temuan klinis perdarahan gingiva dapat digunakan sebagai indikator penyakitsistemik, pada kasus ini adalah DBD tanpa gejala demam. Identifikasi dini lesi mulut terkait penyakit sistemik dapatmembantu penderita untuk memperoleh perawatan lebih awal dan mengurangi angka kematian akibat keterlambatanpenanganan

Stomatitis aftosa yang diperparah oleh iritasi kimiawi obat tradisional

Stomatitis aftosa adalah suatu kondisi inflamasi dengan etiologi yang belum diketahui, ditandai dengan ulserasi sangat nyeri di mukosa rongga mulut selama 7 hingga 14 hari. Berbagai faktor berpengaruh dalam pembentukannya, salah satunya adalah trauma lokal. Perawatan diberikan untuk meredakan nyeri, mengeliminasi sumber trauma, dan penyembuhan ulserasi. Tujuan laporan kasus ini adalah untuk melaporkan stomatitis aftosa yang diperparah oleh iritasi kimiawi obat tradisional. Seorang laki-laki berusia 64 tahun mengeluh sariawan pada gusi kiri bawah terasa nyeri sejak kurang lebih 1 minggu yang lalu. Pasien mengoleskan suatu obat cair tradisional untuk meredakan rasa nyeri tapi kemudian rasa nyeri timbul kembali dan belum mereda. Tanda vital normal kecuali skor VAS (visual analog scale) nyeri mulut 6/10. Pemeriksaan ekstra oral normal, pemeriksaan intra oral didapatkan ulkus soliter berukuran 1x1,5 cm pada lipatan bukal regio 34, 35 dengan peninggian tanpa indurasi dan nyeri. Tata laksana meliputi anamnesis untuk mengetahui faktor yang memperparah, pemeriksaan klinis, debridement lesi untuk menghilangkan jaringan nekrotik dan aplikasi obat topikal gel mengandung klorin dioksida. Pasien diinstruksikan untuk berhenti mengoleskan obat tradisionalnya dan menggunakan obat yang diresepkan. Lesi sembuh dalam waktu 13 hari. Stomatitis aftosa dapat diperparah oleh iritasi kimiawi. Anamnesis, pemeriksaan klinis, debridement lesi dan pemberian obat yang tepat dapat membantu tata laksana dan penyembuhan yang efektif

Effects of citrus limon essential oil (Citrus limon L.) on cytomorphometric changes of Candida albicans

Background: The most common fungal infection found in oral cavity is oral candidiasis, largely caused by Candida species, particularly Candida albicans (C. albicans). Candida infection can get worse since it is difficult to be treated and resistant with antifungal drugs. Therefore, new drugs and compounds as well as alternative therapies involving natural sources that have antifungal activities have continually been developed. Limonene, β-pinene, and ɣ-terpinene contained in Citrus limon essential oil have been known to have quite good antifungal activities against C. albicans. Purpose: This research aimed to examine and analyze the effects of Citrus limon essential oil on cytomorphometric changes of C. albicans. Method: The research used post test only control group design. Based on the results of the pre-elementary research on antifungal activities of Citrus limon essential oil against C. albicans, Citrus limon essential oil used in this research was on concentrations of 1.56%, 1.37%, 1.17%, 0.98%, and 0.78%. Citrus limon essential oil by C. albicans inoculum and incubated for 24 hours and 48 hours. After the incubation, those C. albicans cells were fixed, dried, and then observed using a scanning electron microscopy. Result: The most effective concentrations of Citrus limon essential oil triggering cytomorphometric changes of Candida albicans were at 1.37% and 1.56% with the incubation period of 48 hours. Conclusion: C. albicans can undergo necrosis process through cytomorphometric changes after the administration of Citrus limon essential oil at concentrations of 1.56% and 1.37% with the incubation period of 48 hours

TATALAKSANA STOMATITIS ALERGICA PADA PENDERITA YANG MENGALAMI STRESS (Management of Allergic Stomatitisin Patient with Stress)

Introduction: Allergic stomatitisis ahypersensitivity reaction caused by allergens, such as drugs, food, and dental materials. Manifestation allergic reaction to food in oral cavity can be recurrent ulcer. Purpose: This case report pupose to report management allergic stomatitis in Stress condition.Case: female was a 44-year-old with complaintmany stomatitis in oral cavity. Patients say often since ± 6 years ago without knowing the cause. Stomatitis often moving location but also in the same site. On intra oral examination found ulcer multiple, variant size, irregular shape, paintfull.Management: the patient performed examination of total IgE with a result of 642.98 (normal<150), skin prick test in patients results positive on dust house, dog hair, cotton, beef, cow's milk, chicken egg yolk, shrimp, milkfish, pindang, chocolate, and peanuts.Patients given aloe vera extract oral rinse at the first visit, then after skin prick test was given methylprednisolone, hepaprotector caplet, multivitamin B-Complex plus Zinc. Patients are also given education and instruction to avoid a food become allergic. Conclusion: Allergic Stomatitis diagnosis requires a complete history and supportive examination. In this case, the treatment requires good cooperation between the patient and the dentist so that treatment can be done thoroughly

Herpes-associated erythema multiforme in a postmenopausal woman

Herpes-associated erythema multiforme (HAEM) is an acute inflammatory mucocutaneous disease which is characterized by ulcerative lesion on oral mucous membrane with or without skin involvements. The etiology of erythema multiforme (EM) is probably hypersensitivity reaction to human herpes simplex virus tipe 1 (HSV-1). Lesions on lips with HAEM can be treated by corticosteroid and acyclovir topically and/or orally. The objective of this study wasto report the case of HAEM with painful ulcers accompanying with crust on lips. A 55 years old woman complained painful ulcers with crust on lips since the last five months. She had visited a primary health care service and received several medications such as antibiotic (ciprofloxacin), anti-inflammatory drug (corticosteroid), analgesic (mefenamic acid) but her complaint was never healed completely because it was always recurring. The lesion on her lips got worse when she ate hot and spicy food and after she went out for outdor activities. She had a history of herpes virus infection seven months before but it was completely healed after treated by acyclovir topically and amoxicilin orally. An extra oral examination found black brown crust on her upper lip vermillion, well-demarcated, irregular margin, rough surface, erythematous surrounding area, accompanied with pain. An intra oral examination identified ulcers, yellowish, 4-5 mm in size, well-demarcated, irregular margin, redness in surronding area, accompanied with pain. Acomplete blood count examination, serology test for HSV-1 (IgM and IgG) were taken and the result showed that only IgG was reactive. The therapies given to the patient were topical medications with a combination of corticosteroid, chloramphenicol and moisturizer, followed by methyl prednisolone and acyclovir orally. After 6-week treatment, the lesions were completely healed.Herpes-associated erythema multiforme (HAEM) caused by hypersensitivity reactionto herpes simplex virus type 1 (HSV-1) may have a characteristic of painful ulcers accompanied with crust on the lips. The combination of both anti-inflammatory and antiviral drugs can be a choice for the therapy

CORRELATION OF Ki67 EXPRESSION TO DEGREE OF DYSPLASIA IN LINGUAL EPITHELIAL DYSPLASIA IN Rattus norvegicus EXPOSURED BY CIGARETTE SMOKE (Hubungan Ekspresi Ki67 Terhadap Derajat Displasia Pada Epitel Mukosa Lidah Rattus norvegicus yang Dipapar Asap Rokok)

Background: Dysplasia is malignant transformation of stratified squamous epithelium characterized by cellular atypia and loss of stratification and maturation. It can caused by cigarette smoke. Measuring the activity of cell proliferation as the beginning of dysplasia is very useful to know the development of malignancy. One of proliferation marker is Ki67 that expressed in all cell cycle phase except G0.Methods: 30 male wistar rats divided into: control grup (n=10), exposed to cigarette smoke for 4 weeks (n=10), 8 weeks (n=10) as much as 20 cigarettes/group/day/exposure used smoking pump. Specimen were stained HE to see dysplasia and Ki67 expression seen immunohistochemically. Statistical analyzed by Spearman correlation.Result: There was an increase in mean of Ki67 expression and significant differences between groups (p=0,000) and also significant difference of degree of dysplasia between groups (p=0,000). There was a strong correlation between Ki67 score to degree of dysplasia (p=0.001).Conclusion: Increased of Ki67 expression proportional to the Increase in degrees of dysplasi

Number of macrophages and transforming growth factor β expression in Citrus limon L. Tlekung peel oil-treated traumatic ulcers in diabetic rats

Purpose: To analyse the potential use of Citrus limon L. Tlekung peel oil in the treatment of traumatic ulcers in diabetic rats based on number of macrophages and transforming growth factor β (TGF-β) expression. Method: Standard steam distillation was performed to produce Citrus limon L. peel oil with its components subsequently analysed by gas chromatography-mass spectrometry (GC-MS). Diabetes was induced with streptozotocin (STZ) via administration of a single 50 mg/kg dose. A traumatic ulcer was subsequently induced with a 5 mm burnisher heated for 30 s and applied without pressure for 1 s to the lower labial mucosa of the animals. Citrus limon L. oil gel containing 3% carboxyl methyl cellulose sodium was then topically administered to the traumatic ulcer for a period of three or five days. TGF-β expression was analysed through immunohistochemical staining and the macrophage number calculated with haematoxylin-eosin stain. Results: The major identified compounds in Citrus limon L. peel oil include fumaric (31.78 %), dlimonene (17.38 %), z-citral (13.55 %), L-linalool (8.51 %), geraniol nerol (3.56 %), geraniol (2.94 %,), αterpineol (1.25 %) and γ-terpinene (1.03 %) together with other minor constituents. Treatment of traumatic ulcers with Citrus limon L peel oil produced higher number of macrophages and TGF-β expression (p = 0.000). Treatment over a period of five days also indicated higher expression of TGF-β and number of macrophages compared to that lasting three days with Citrus limon L peel oil (p = 0.000). Conclusion: Citrus limon L peel oil stimulates TGF-β expression and an increase of macrophage numbers in diabetic subjects during traumatic ulcer healing after three and seven days. Clinical application of Citrus limon L peel oil constitutes a potential therapy in the treatment of traumatic ulcers in diabetic subjects

Hyperplasia of Wistar rat tongue mucosa due to exposure to cigarette side-stream smoke

Background: Hyperplasia, a condition whereby an increasing number of cells are produced due to their uncontrolled division, represents a common symptom of carcinogenesis. Cancer is a physical manifestation of cell malignancy resulting from abnormal proliferation. Globally, oral cancer currently constitutes the sixth largest lethal form of the condition. The most common etiology of oral cancer is tobacco of which cigarettes are the most popular related product. The health risks associated with cigarette smoke not only affect active smokers but also individuals who ingest it passively. Sidestream smoke comes from the lighted end of a burning tobacco product such as a cigarette, pipe or cigar and contains nicotine and many harmful cancer-causing chemicals. Inhaling sidestream smoke increases the risk of lung and other types of cancer. Purpose: The purpose of this study was to understand how sidestream cigarette smoke initiates precancerous changes, in this case hyperplasia, in the oral mucosa epithelium of Wistar rats. Methods: The subjects were divided into three groups, a 4-week treatment group (P1), an 8-week treatment group (P2), and a control group (K), each consisting of ten subjects. The subjects were exposed to a daily two-cigarette dose of smoke. The experiment used a post-test only control group design. All samples were sacrificed during the fourth and eighth weeks. Haematoxylin-eosin staining was performed on the tongues of the Wistar rats to establish the presence of hyperplasia. Data was analyzed using a one-way ANOVA test. Results: After the Wistar rats had been exposed to cigarette smoke, an increased degree of epithelial cell proliferation (hyperplasia) showed a significant difference with a p-value <0.05 during the eighth week. Conclusion: Exposure to cigarette sidestream smoke induces increased epithelial cell proliferation (hyperplasia) in Wistar rats

Number of macrophages and transforming growth factor β expression in Citrus limon L. Tlekung peel oil-treated traumatic ulcers in diabetic rats

Purpose: To analyse the potential use of Citrus limon L Tlekung peel oil in the treatment of traumatic ulcers in diabetic rats based on number of macrophages and transforming growth factor β (TGF-β) expression. Method: Standard steam distillation was performed to produce Citrus limon L peel oil with its components subsequently analysed by gas chromatography-mass spectrometry (GC-MS). Diabetes was induced with streptozotocin (STZ) via administration of a single 50 mg/kg dose. A traumatic ulcer was subsequently induced with a 5 mm burnisher heated for 30 s and applied without pressure for 1 s to the lower labial mucosa of the animals. Citrus limon L oil gel containing 3% carboxyl methyl cellulose sodium was then topically administered to the traumatic ulcer for a period of three or five days. TGF-β expression was analysed through immunohistochemical staining and the macrophage number calculated with haematoxylin-eosin stain. Results: The major identified compounds in Citrus limon L peel oil include fumaric (31.78 %), dlimonene (17.38 %), z-citral (13.55 %), L-linalool (8.51 %), geraniol nerol (3.56 %), geraniol (2.94 %,), α- terpineol (1.25 %) and γ-terpinene (1.03 %) together with other minor constituents. Treatment of traumatic ulcers with Citrus limon L peel oil produced higher number of macrophages and TGF-β expression (p = 0.000). Treatment over a period of five days also indicated higher expression of TGF-β and number of macrophages compared to that lasting three days with Citrus limon L peel oil (p = 0.000). Conclusion: Citrus limon L peel oil stimulates TGF-β expression and an increase of macrophage numbers in diabetic subjects during traumatic ulcer healing after three and seven days. Clinical application of Citrus limon L peel oil constitutes a potential therapy in the treatment of traumatic ulcers in diabetic subjects

The Response of the Tongue Epithelial on Cigarette Smoke Exposure as a Risk Factor for Oral Cancer Development

Objective The aim of this study is to analyze the tongue epithelial response to cigarette smoke exposure on a number of macrophages, lymphocytes, plasma cells, and matrix metalloproteinase 9 (MMP-9) expression to determine the risk factor of oral cancer development. Materials and Methods Thirty Rattus norvegicus will be exposed to two kinds of cigarette smoke by a smoking pump for 4 and 8 weeks. The tongues were collected to analyze the number of macrophages, lymphocytes, and plasma cells with hematoxylin-eosin. The MMP-9 expression was similarly analyzed with immunohistochemical staining and then compared with the control group. Results The number of macrophages, lymphocytes, and MMP-9 expression was higher in the 8-week cigarette smoke exposure compared to the 4-week cigarette smoke exposure and the control group (p < 0.000). The number of plasma cell did not differ in the 8-week cigarette smoke exposure from that of the control group (p > 0.05). The number of plasma cells in the tongue tissue during the 4-week cigarette smoke exposure was not determined. Conclusion Cigarette smoke exposure induces the risk of oral cancer development as a result of an increase in the number of macrophages, lymphocytes, and MMP-9 expression in the tongue epithelial