RELATIONSHIP OF SALIVARY PEROXIDASE ACTIVITY TO CD4+ LEVEL IN HIV/AIDS PATIENTS: HUBUNGAN AKTIVITAS PEROKSIDASE SALIVA TERHADAP TINGKAT CD4 PASIEN HIV/AIDS

Human whole saliva contains peroxidases (human peroxidase and myeloperoxidase) which are part of the innate host defence mechanism in oral cavity. The primary function is to catalyse the oxidation of thyocyanate, in the presence of hydrogen peroxidase, that resulting in the end product of wide antimicrobial activity. Patient with HIV/AIDS is often decreased in salivary flow rate, and this condition may also change the salivary composisition. These changes are contributed in oral lesions of HIV/AIDS patients. The aim of this study was to evaluate the salivary peroxidase activities of HIV/AIDS patients. The study involved 98 patients with HIV/AIDS of whom 55 were men and 43 were women. Unstimulated whole saliva was collected and all the patients received a complete oral examination. The saliva samples were analysed with Bradford assay (with Bradford reagent) and salivary peroxidase measurement with microplate reader and read at 450 nm wave length. The results showed that the mean concentration of total salivary protein and peroxidase in this study population was 1169µg/ml (SD±186.1) and 6.101unit/mg Protein (SD±1.26) respectively. It showed a tendency that the lower the CD4 level, the higher the total protein concentration as well as salivary peroxidase activity, however the difference was not statistically significant (p>0.05). Patients’ data on age, sex, salivary flow rate and pH did not significantly influencing the total salivary protein concentration as well as the peroxidase activity (p>0.05). This study showed that salivary peroxidase activity have a correlation with the total salivary protein concentration. There was a tendency of higher total protein concentration and salivary peroxidase activity found in patients with lower CD4 counts but in those with more acidic saliva. In conclusion, salivary peroxidase activity have a correlation with the total salivary protein concentration in HIV/AIDS patients

SALIVARY PROFILE AND IDENTIFICATION OF EXISTING CANDIDA sp OF AN INSTITUTIONALIZED ELDERLY POPULATION IN JAKARTA: PROFIL SALIVA DAN IDENTIFIKASI KEBERADAAN CANDIDA sp PADA LANSIA DI PANTI JOMPO DI JAKARTA

Saliva plays an important role to protect oral and dental health, in maintenance oral microflora balance. In elderly, disease, and medications usually influence the saliva. The purpose of this preliminary study was to investigate salivary profile, oral symptoms of dryness, and existing of Candida sp of an institutionalized elderly in Jakarta, Twenty seven (27) elderly (17 men and 10 women) were examined in a cross sectional study. Unstimulated whole saliva was collected for 5 minutes, according to published protocol, and then salivary flow rate and pH were measured. Candida sp were cultured in CHROM agar. The yeasts were counted and identified. Oral symptom or complaints of oral dryness, and burning or itching were recorded with an interview. Data of systemic conditions and medication the used were obtained from the medical record. Eighteen (66.7%) CHROM agar plates were Candida sp positive cultured, and about 61.1% subjects’ salivary pH were below normal range. Twenty one (77.8%) subjects had oral symptom and complain about oral dryness, even thought the salivary flow rate were in normal range. In this study, C.albicans is not the most frequently found colonized. About 72% were identified not C.albicans. This study suggests that, in elderly which salivary pH was below normal range have greater opportunistic infected by Candida sp. It can be concluded that, the result did not confirm a significant difference between subjects’ data and salivary profile concentration. The mycological finding Candida albicans is not the most frequently found colonized in this elderly population. Further study which lagger elderly population and might give deeper insights of salivary profile in this population

Oral Health and Salivary Profiles of Geriatric Outpatients in Cipto Mangunkusumo General Hosp ital

Introduction: Population of geriatric patients would increase in line with that of elderly population. Health problems related to this group of people would have impact on general and oral health maintenance aiming for good quality of life. Objectives: This study aimed to determine the profile of oral health, saliva, and oral mucosa on geriatric patients at Geriatric Policlinic in Cipto Mangunkusumo Hospital. Materials and Methods: This research was a descriptive crosssectional study, which data was taken using questionnaire containing basic demographical information and oral clinical examination using standard form used by Faculty of Dentistry Universitas Indonesia. Results: The study included 75 geriatric patients, ranging from 60 to 86 of age. The mean of DMF-T score of 69 geriatric patients was 4.68 ±2.893, OHI-S 2.790 ±1.102, PBI 0.779±0.585. The mean of unstimulated salivary pH score was 6.618 ± 0.54 and stimulated buffer capacity of saliva was 7.46±2.827. Mean of salivary flow rate is 0.24mL/min and 39 people had hiposalivation. 93 normal variations and 117 pathological oral lesion was found. Conclusion: This study showed that poor oral health status and pathological oral lesion found in this study elderly population could be caused from poor salivary flow, pH saliva, and buffer capacity of saliva. Systematic oral examination of the elderly is of considerable importance and ought be carried out regularly by a dentist in collaboration with the physician; making holistic management of the elderly properly performed.DOI: 10.14693/jdi.v17i2.4

Oral Probiotik: Pendekatan Baru Terapi Halitosis

Halitosis is a general term denoting unpleasant breath arising from mouth, where odorous breath components could be originated from intraoral and/or extraoral. Classification includes genuine halitosis, pseudo-halitosis and halitophobia. Local and systemic factor play role in the process of halitosis. Diagnosis of halitosis can be made by analysing the degree and type of the presence of volatile compounds, as well as the identification of microbial components. Currently available treatments of halitosis includes local (mechanic and chemical) and systemic (probiotic) approaches. Probiotic is a new therapeutic approach for halitosis. Development of available probiotic-based halitosis treatments is significantly progressing and is overviewed herein.DOI: 10.14693/jdi.v16i1.1

Oral Hairy Leukoplakia: Clinical Indicator of an Immunusuppressive Condition and Challenges in Patient Management

Oral hairy leukoplakia is defined as an asymptomatic white patch with vertical corrugation pattern on the lateral borders of the tongue, that is associated with Epstein-Barr Virus (EBV) infection. Generally, it is related to immunosuppressive condition found in HIV-positive patients and patients undergoing immunosuppressive therapy. Sometimes, its clinical appearances could mimic other white lesions. Although most OHL cases are found in HIV seropositive individuals, finding in the immunocompetent individuals has also been reported. Appropriate clinical evaluations and laboratory investigations are important for patient’s comprehensive management. Objective: To report a finding of oral hairy leukoplakia as a clinical indicator of an immunosuppressive condition in otherwise a clinically healthy-looking individual and to discuss the challenges on patient management. Case Report: A 40 year-old man presented with asymptomatic, bilateral and homogenous white hyperkeratotic plaques with a hairy appearance located on the dorsal of the tongue, extended to the lateral tongue mucosa. The patient failed to remember the lesion’s first appearance, until three weeks before a visit. Working diagnosis of oral hairy leukoplakia was made with differential diagnoses including white sponge nevus, leukoplakia and oral lichen planus. Histopathological assessment was consistent with oral hairy leukoplakia, without the presence of epithelial dysplastic changes. Challenges on patient management include identifying possible risk factors and assuring patient for HIV testing.  Conclusion: This case reported findings of OHL as the first clinical indicator of immunosuppressive condition that might be related to HIV-infection. The differential diagnoses and challenges in patient’s management were also discussed.Keywords: oral hairy leukoplakia, clinical indicator, challenges on managemen

Profile of Human TERT and P73 in Oral Squamous Cell Carcinoma Cell Lines Compared to Normal Human Oral Mucosa: a Preliminary Study

Genetic alteration on p53 allows cellular immortalization and predisposes cells to neoplastic transformation. This immortalization is related to telomere length maintenance by telomerase. Human TERT is a key compo-nent of telomerase, which activity is suppressed by p53. The p73, the homolog of p53, has a similar ability in tumor suppression. The P73 is expressed at a different level in various cancer cells and normal tissues. Profile of human TERT and P73 in mutant p53 OSCC cell line and normal human oral mucosa have not been known. Objective: To observe human TERT and P73 profile in mutant p53 OSCC cell lines and normal human oral mucosa. Methods: The extracted protein of HSC-3 and HSC-4 cell lines and normal mucosal tissues were ana-lyzed with SDS PAGE to detect human TERT and p73 expression based on the molecular weight. Results: The HSC-3 cell line showed thicker band density of P73 compared to its density of HSC-4. Only 50% of normal oral mucosa tissue showed thick P73 band density. The human TERT band was clearly shown in HSC-3 and HSC-4 cell lines but not in normal oral mucosa. Conclusion: Different profile of human TERT and P73 in OSCC cell lines and normal oral mucosa might be cell-type specific and influenced by the status of p53. Analy-sis of the role of p73 in these cancers might need further research to determine possible p73 substitution for p53 function.DOI: 10.14693/jdi.v18i1.5

Low-Level Laser Therapy for Treatment of Oral Mucositis

Radiation and chemotherapy are the treatment options for head and neck cancer. Several side effects related to those treat-ment have been shown. Oral mucositis is a common side effect in patients undergoing those treatment. The presence of oral mucositis in these patients would influencing quality of life therefore compromising treatment outcome. The spec-trum of oral mucositis can be clinically seen as thinning of oral mucosa, oral discomfort to painful oral lesion causing mastication impairment with increasing risk of infection. The Multinational Association for Supportive Care in Cancer (MASCC)/International Society for Oral Oncology (ISOO) has recommended some means that have important role in the management oral mucositis. The low-level laser therapy (LLLT) is a relatively new way of reducing the severity of oral mucositis, although the true mechanism of action is still under study. This review aimed in exploring update about the usage of LLLT for oral mucositis treatment.DOI: 10.14693/jdi.v17i3.4

EFFICACY OF MOUTH RINSE FORMULATION BASED ON CETYLPYRIDINIUM CHLORIDE 0.1% IN THE CONTROL OF DENTAL CALCULUS BUILDUP

Objective: This study aimed at comparing the antiplaque, anticalculus, and antigingivitis potentials of a mouth rinse containing essential oil, alcohol,zinc, and fluoride with a mouth rinse containing cetylpyridinium chloride (CPC) 0.1% over 1-, 2-, and 3-month periods.Methods: This study was a double-blind, parallel randomized clinical trial with a 3-day run-in phase. Respondents were asked to gargle twice dailywith 15 ml of mouth rinse for 30 seconds after brushing teeth. Respondents were 80 females with a mean age of 21 years, and a single dental examinerwas employed throughout the study to decrease the variance. Prophylaxis was performed for all respondents before the intervention. Three mouthrinses were tested: Group 1 with the mouth rinse containing CPC 0.1%, Group 2 as the negative control, and Group 3 as the positive control with amouth rinse containing alcohol. Evaluations were conducted by plaque index, gingival index, calculus index, and CariScreen examinations.Results: The clinical trial showed that the mouth rinse with alcohol and the mouth rinse containing CPC 0.1% were effective in inhibiting bacterialbuildup (antiplaque) and have anticalculus properties, but with no statistically significant antigingivitis effect.Conclusion: It was found that the mouth rinse containing alcohol has similar effectiveness with CPC 0.1% mouth rinse, but side effects, such as aburning sensation, were reported in the alcohol-containing mouth rinse

Orofacial Disorders of Patients with End Stage Renal Disease Undergoing Haemodialysis

Several orofacial disorders in patients with end stage renal disease (ESRD) undergoing hemodialysis have been reported. However, up to the present, particularly in Indonesia, such data still limited. Objective: the purpose of this study was to assess the orofacial disorders in patients with ESDR undergoing hemodialysis at Cipto Mangunkusumo Hospital, Indonesia. Methods: The study was conducted through observation using a cross-sectional design. The subjects were selected by consecutive sampling. Ninety-three patients fulfilled the inclusion criteria and enrolled in this study. They participated in the structural interview-using questionnaire assessing subjective complaints; clinical examinations; and salivary measurements. Results: Xerostomia (82.8%) dysgeusia (66.7%), metal taste (57%), perioral anesthesia (24.7%) were the common symptoms. Clinical findings consisted of tongue coating (100%), calculus deposits (97.8%), pallor of oral mucous (94.6%), sialosis (75.3%), uremic odor (40,9%), haemorrhagic spot (39.8%), angular cheilitis (37.7%), gingival bleeding (15.1%), and oral candidiasis (3.2%) were also found. Salivary changes showed the increase of salivary viscosity (86%), pH (80.6%), buffer capacity (76.3%) whereas decrease of mucous hydration level (79.6%) and the flow rates of unstimulated (22.6%) and stimulated (31.2%) whole saliva were observed. Conclusion: The findings of orofacial disorders required attention and further comprehensive management to enhance the quality of life of patients with ESDR.DOI: 10.14693/jdi.v21i3.26