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.

Background. Population aged 60 years old and above are growing in number; a fact that will have an impact on general and oral health in the future. Oral health is often overlooked in the management of geriatric patients but it is vital to have a knowledged-based practice in order to increase the quality of life of elderly patients. Objective. The purpose of this study is to determine the number and types of oral mucosal lesions in geriatric patients who come to the Universitas Airlangga Dental Hospital. Methods. This is an observational descriptive study with cross-sectional design. Intraoral soft tissue examination was performed on geriatric patients coming to the hospital between March and December 2018. Results. One hundred twenty-four (124) new geriatric patients came to the hospital. A total of 152 oral lesions from 63 geriatric patients (50.81%) were identified. Overall, coated tongue (55.56%) was the most frequently detected lesion, followed by linea alba buccalis (31.74%) and lingual varicosities (26.98%). Conclusion. Coated tongue or white tongue is the most frequently detected oral mucosal lesion, often caused by poor oral hygiene. The dentist should be able to recognize and differentiate them from the worrisome lesions and decide on the appropriate treatment in geriatric patients.

Background: Aplastic anaemia is a disease that occurs when the body fails to produce enough blood cells. Oral lesions, such as canker sores, are often used as an early marker of this disease condition. In the COVID-19 pandemic era, a teledentistry method is expected to assist in the management of patients with various diseases including aplastic anaemia. Purpose: This case report discusses the management of patients with aphthous-like ulcers related to aplastic anaemia in a 34-year-old woman, based on history, clinical examination, and blood tests through teledentistry. Case: The patient complained of a bleeding wound on the inner left cheek and corner of the left lip that appeared one month ago. There was an ulcer lesion that was bleeding easily in the buccal mucosa sinistra and the angular sinistra, as well as macules lesion on her hand and foot. The complete blood count test exhibits a low platelet level. Case management: The diagnosis was an aphthous-like ulcer related to aplastic anaemia. Patient was treated with topical antiseptic and anti-inflammatory mouthwashes for the oral lesions, as well as collaboration with the medical team. The lesions improved after the patient received a blood transfusion and drug therapy from the internist while she was hospitalized, but the lesions reappeared in other locations in the oral cavity when the platelet level dropped. Conclusion: Management of oral manifestations in patients with aphthous-like ulcers related to aplastic anaemia in the COVID-19 pandemic era can be done through teledentistry. However, this requires sensitivity from the dentist, patient compliance in following instructions, and the involvement of a multidisciplinary approach, such as collaboration with internists to achieve recovery. Delay in detecting and treating aplastic anaemia will lead to death, as in this case.

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Background: Several studies have shown anti-inflammatory, anti-microbial, antifungal, and antioxidant effects from Citrus limon-peel essential oil (Cl-PEO). Cl-PEO can be developed as topical drugs for oral ulceration because of its potential active components. There have been no studies on the topical application of Cl-PEO inducing type IV hypersensitivity reaction. Purpose: To investigate the potential of Cl-PEO from Batu City to induce type IV hypersensitivity reactions based on clinical changes, lymphocytes, macrophages, IFNγ, andIL10 expression. Methods: This study was adapted from a guinea pig maximization-test method in Indonesia and the guidance of ISO 10,993-10:2010, and conducted on 20 guinea pigs (Cavia cobaya) divided into a control group and a treatment group. The treatment group was given Cl-PEO and the control group CMC-Na. Clinical changes were observed, then tissue specimens taken for hematoxylin-eosin and immunohistochemistry staining. Results: There were no clinical changes after exposure. Lymphocyte and macrophage numbers and IFNγ and IL10 expression increased in the treatment group compared to the control group (p=0). Conclusion: Cl-PEO can induce type IV hypersensitivity reactions in guinea pigs based on cellular and molecular cytokines, but there are no clinical changes after topical application.