Oral Disorders Research Articles

Oral Pathogenic Bacteria and the Oral-Gut-Liver Axis: A New Understanding of Chronic Liver Diseases.

Liver diseases have long been a prevalent cause of morbidity and mortality, and their development and progression involve multiple vital organs throughout the body. Recent studies on the oral-gut-liver axis have revealed that the oral microbiota is associated with the pathophysiology of chronic liver diseases. Since interventions aimed at regulating oral biological disorders may delay the progress of liver disease, it is crucial to better comprehend this process. Oral bacteria with potential pathogenicity have been extensively studied and are closely related to several types of chronic liver diseases. Therefore, this review will systemically describe the emerging role of oral pathogenic bacteria in common liver diseases, including alcoholic liver disease (ALD), non-alcoholic steatohepatitis (NASH), non-alcoholic fatty liver disease (NAFLD), cirrhosis, autoimmune liver diseases (AILD), and liver cancer, and bring in new perspectives for future research.

The Effect of Drug Users on Periodontal Health : Literature Review

Background: Drug trafficking in the world affects the country and spread to all levels of Indonesian society. Methamphetamine, marijuana, and heroin are the most commonly abused drugs. Drugs cause a lot of bad effects, including the oral cavity. Results of Health Research on the Impact of Drug Abuse in 2019, as many as 64.1% of them experienced dental problems and 60.1% of oral cavity disorders. The risk of periodontal disease in drug users is higher than non-users. Objective: To determine the effect of the use of methamphetamine, marijuana, and heroin and the most influential drug users on the health of periodontal tissues. Methods: Using secondary data obtained through several e-databases, that are Pubmed Central (PMC), SpringerLink, and ResearchGate based on keywords and a predetermined time span. Discussion: Periodontal disease in drug users is related to xerostomia, oral hygiene, and immunosuppression. The high accumulation of calculus and plaque in drug users due to their low awareness of maintaining oral health and impaired motor function that makes it difficult for a person to clean his oral cavity. Comparison of Bleeding on Probing (BOP) and Clinical Attachment Loss (CAL) values were used as the main variables to show the parameters of periodontal tissue inflammation in each type of drug (methamphetamine, marijuana, and heroin). Conclusion: There was an effect of methamphetamine, marijuana, and heroin on the health of periodontal tissues including gingivitis and periodontitis. The heroin used by intravenous injection had the most effect on periodontal tissue health compared to methamphetamine and marijuana.

Management Of Oral Candidiasis Children And Infant With Hiv/Aids Infection : Report Of Two Cases

Background: HIV infection is characterized by progressive immunosuppression due to low absolute CD4 counts. The most common HIV-related oral disorder is oral candidiasis.
 Case(s): First case, A 10-month-old baby girl complained of white plaque on her hard palate since 3 months ago.She had experienced the same before and was treated with Nystatin then the lesion resolved. She was HIV positive and took Abacavir twice a day. The latest CD4 test was 3 months ago and the result was 1000 cells/µL. The second case is an 8-year-old male patient who complained white lesion all over his mouth one week ago and treated by Nystatin for 7 days but the lesion has not resolved. He had confirmed HIV at 2.5 y.o and takes ARV regularly. The CD4 count three weeks ago was 8 cells/mm3. Both of them were diagnosed with acute pseudomembranous candidiasis
 Management: The first patient was given Nystatin oral suspension 4 times a day and the lesion resolved in 1 week. The caregiver instructed to clean the child's mouth with gauze regularly. The second patient was given fluconazole 150 mg tablets 3-6 mg/kg once a day for 14 days. Both of the lesions responded well to antifungal.
 Conclusion: Oral candidiasis in children with HIV often occurs in conditions of low CD4 and often appears as acute pseudomembranous candidiasis. Treatment of is adjusted to the PNPK HIV Kemenkes RI 2019 according to the level of disease

Systemic Type 2 Inflammation-Associated Atopic Dermatitis Exacerbates Periodontitis

Introduction: Atopic dermatitis (AD) is a prevalent and chronic inflammatory skin disease characterized by Th2 cell-mediated type 2 inflammation. Emerging evidence indicated that AD patients exhibit an increased incidence of oral disorders. In the present study, we sought mechanistic insights into how AD affects periodontitis. Methods: Onset of AD was induced by 2,4-dinitrochlorobenzene (DNCB). Furthermore, we induced periodontitis (P) in AD mice. The effect of AD in promoting inflammation and bone resorption in gingiva was evaluated. Hematoxylin and eosin staining, tartrate-resistant acid phosphatase staining, immunofluorescence assay, and flow cytometry were used to investigate histomorphology and cytology analysis, respectively. RNA sequencing of oral mucosa is used tissues to further understand the dynamic transcriptome changes. 16S rRNA microbial analysis is used to profile oral microbial composition. Results: Compared to control group, mice in AD group showed inflammatory signatures and infiltration of a proallergic Th2 (Th2A)-like subset in oral mucosa but not periodontitis, as identified by not substantial changes in mucosa swelling, alveolar bone loss, and TRAP+ osteoclasts infiltration. Similarly, more Th2A-like cell infiltration and interleukin-4 levels were significantly elevated in the oral mucosa of DNCB-P mice compared to P mice. More importantly, AD exacerbates periodontitis when periodontitis has occurred and the severity of periodontitis increased with aggravation of dermatitis. Transcriptional analysis revealed that aggravated periodontitis was positively correlated with more macrophage infiltration and abundant CCL3 secreted. AD also altered oral microbiota, indicating the re-organization of extracellular matrix. Conclusions: These data provide solid evidence about exacerbation of periodontitis caused by type 2 dermatitis, advancing our understanding in cellular and microbial changes during AD-periodontitis progression.

Polymorphisms associated with oral clefts as potential markers for oral pre and malignant disorders.

To investigate whether genes in the Wnt pathway, which have been previously associated with both oral clefts and oral squamous cell carcinoma, are also associated with oral potentially malignant disorders (leukoplakia, erythroplakia and lichen planus). Case-control study: Dataset consisted of clinical information linked to DNA samples from affected subjects diagnosed with oral potential malignant disorders and oral cancer and their matched controls. Individual samples, clinical history, and potential risk factors were obtained through the Dental Registry and DNA Repository project of the School of Dental Medicine, University of Pittsburgh. The rs1533767 (WNT11), rs9879992 (GSK3B), and rs3923087 (AXIN2) were tested. After genomic DNA had been extracted, genotyping was performed blindly to clinical diagnosis status. Representation of genotypes and alleles in affected subjects in comparison to the unaffected individuals was determined using PLINK. Additional analysis was performed to investigate associations between environmental (socioeconomic/lifestyle) risk factors and the oral pathologies studied using STATA. Two of the SNPs tested (rs9879992 in GSK3B and rs3923087 in AXIN2) were statistically, significantly associated with the pathologies studied (p = 0.039 and 0.038, respectively). Single-nucleotide polymorphisms in genes in the Wnt pathway were associated with oral potentially malignant disorders.

Human Papillomavirus-Associated Oral Epithelial Dysplasia: Report of 5 Illustrative Cases from Latin America.

Human papillomavirus-associated oral epithelial dysplasia (HPV-OED) is a distinct oral epithelial disorder characterized by viral cytopathic changes caused by transcriptionally active high-risk HPV. The aim of the present study was to report 5 additional cases from Latin America. Clinical data from five patients with HPV-OED were obtained from the archives of three oral pathology services from Brazil and Chile. All cases were submitted to morphological, p16 expression and in situ hybridization (ISH) for HPV analyses. Four patients were male and one patient was female, with a mean age of 55.4 years. Four patients were HIV seropositive and two were smokers. Three cases affected the buccal mucosa and commissure, one of which had an additional plaque in the soft palate, and one case each occurred on the floor of mouth and lower labial mucosa. Most cases presented as well-demarcated white plaques with a verrucous surface. One case presented multiple lesions ranging from normal to white-colored slightly elevated plaques with a cobblestone surface. Peripheral mucosal pigmentation was observed in two cases. All five cases presented with the characteristic microscopic features of HPV-OED, including severe dysplasia with numerous karyorrhectic and apoptotic cells, full-thickness "block positivity" for p16 and high Ki-67 index (> 90%) sharply demarcated from the adjacent non-dysplastic epithelium. Wide-spectrum DNA ISH-HPV was positive in 4 cases. All patients were treated with conservative surgical excision with no signs of recurrence after a mean of 39-month follow-up. This represents the first series of HPV-OED from Latin America; most cases presented as well-demarcated papillary white plaques affecting the buccal mucosa and commissure of HIV-positive middle-aged men, two of them exhibiting peripheral pigmentation caused by reactive melanocytes. The typical microscopic findings of HPV-OED were observed in all cases, which also showed strong p16 positivity in a continuous band through the full thickness of the epithelium and high Ki67.

U-shaped fusion convolutional transformer based workflow for fast optical coherence tomography angiography generation in lips.

Oral disorders, including oral cancer, pose substantial diagnostic challenges due to late-stage diagnosis, invasive biopsy procedures, and the limitations of existing non-invasive imaging techniques. Optical coherence tomography angiography (OCTA) shows potential in delivering non-invasive, real-time, high-resolution vasculature images. However, the quality of OCTA images are often compromised due to motion artifacts and noise, necessitating more robust and reliable image reconstruction approaches. To address these issues, we propose a novel model, a U-shaped fusion convolutional transformer (UFCT), for the reconstruction of high-quality, low-noise OCTA images from two-repeated OCT scans. UFCT integrates the strengths of convolutional neural networks (CNNs) and transformers, proficiently capturing both local and global image features. According to the qualitative and quantitative analysis in normal and pathological conditions, the performance of the proposed pipeline outperforms that of the traditional OCTA generation methods when only two repeated B-scans are performed. We further provide a comparative study with various CNN and transformer models and conduct ablation studies to validate the effectiveness of our proposed strategies. Based on the results, the UFCT model holds the potential to significantly enhance clinical workflow in oral medicine by facilitating early detection, reducing the need for invasive procedures, and improving overall patient outcomes.

Oral and systemic health in Singapore: Revisiting the past to define the future.

This study aimed to identify studies exploring oral and systemic conditions using Singapore data. Studies were searched using the databases PubMed, Embase and Web of Science, with no publication date or language restrictions. Studies analysing Singaporean data were included in this review. Six domains were identified: pregnancy and gingivitis; tooth eruption, dental caries and early-life factors; Crohn's disease and oral microbiome; diabetes and periodontal diseases; number of teeth, chewing ability and cognitive status; and oral health and pneumonia. Using data from Singapore, oral-systemic studies have prompted reflections on the aetiopathogenesis of oral disorders, such as common causes connecting oral and systemic chronic conditions. Moreover, it is speculated whether oral conditions could be used as a marker to predict future systemic diseases or whether early-life factors could affect the development of oral and systemic immune responses. While Singapore provides opportunities to explore challenges connected to healthy ageing, it also explores health development in many stages of life. Singapore has been prioritizing investigations on a healthier life, and new initiatives are paving the way for oral health research across the lifespan.

Oral Health Status of Health Care Workers in Tertiary Care Hospitals of Rawalpindi, Islamabad Pakistan

Studies from all around the world have shown that healthcare professionals may encounter a number of obstacles to receiving dental care, which raises the prevalence of oral disorders in this population. In recent years, Pakistan has not done a national oral health assessment on the state of oral health among healthcare workers. Objective: To determine the oral health status of health care workers in tertiary care hospitals using Decayed, Missed, Filled tooth Index. Methods: Descriptive cross-sectional study was conducted utilizing a simple random selection and 385 healthcare workers between the ages of 20-50 years. Healthcare workers were assessed in tertiary care hospitals, and information on caries and gingival health was gathered. For the oral examination, the standards and procedures of the WHO were applied. Results: Only 9.8% of the respondents were healthy and mean DMFT score came out to be 3.28 ± 1.12. Conclusions: Healthcare workers in tertiary have unsatisfactory dental practices, poor attitude related to oral health and general lack of awareness about oral health.

A RARE CLINICAL SYPHILIS ORAL MANIFESTATION DUE TO SEXUALLY TRANSMITTED DISEASE AMONG HOMOSEXUAL: CASE REPORT

Background: Syphilis is a sexually transmitted disease caused by Treponema pallidum, often found in Human Immunodeficiency Virus (HIV) patients and homosexuals. The oral manifestations are chancres, mucous patches, focal epithelial hyperplasia (FEH) and papilloma/condyloma. FEH is a rare oral mucosa disorder that occurs in immunocompromised patient. Objective: To present a rare oral manifestation in syphilis patient due to sexually transmitted infections. Case: A 25-year-old homosexual male came to Oral Medicine Department complaining of sores on the palate for 3 weeks and 2 weeks later a painless lump appeared. He was an HIV patient and had been taking ARVs since 6 months ago. Pain when opening the mouth, itching on his face and genital area. Intraoral revealed a soft, pedunculated, non-bleeding, mobile mass at the palate with a diameter about 2 cm, had the same color as the surrounding tissue. There was a reddish band-like area on the maxillary anterior gingival margin, suspected as Linear Gingival Erythema (LGE). Case management: 0.2% Chlorhexidine gluconate mouthwash was administered to prevent secondary infection and he was referred to Dermatovenereology and Periodontology Department. HBsAg Immunochromatography (negative), VDRL titer (reactive), TPHA titer (reactive) therefore diagnosis of syphilis was made and he was treated with a single dose Benzathine penicillin G 2.4 million units intramuscular. The oral lesions healed after 1 month therapy. Conclusion: FEH is a rare oral mucosa disorder in syphilis patients. Knowledge of the signs and symptoms of the disease is needed to make a diagnosis and a multidisciplinary approach to achieve successful treatment. Keywords: Oral manifestation, Sexual transmission, Syphilis, Treponemal infection

CD44-SNA1 integrated cytopathology for delineation of high grade dysplastic and neoplastic oral lesions.

The high prevalence of oral potentially-malignant disorders exhibits diverse severity and risk of malignant transformation, which mandates a Point-of-Care diagnostic tool. Low patient compliance for biopsies underscores the need for minimally-invasive diagnosis. Oral cytology, an apt method, is not clinically applicable due to a lack of definitive diagnostic criteria and subjective interpretation. The primary objective of this study was to identify and evaluate the efficacy of biomarkers for cytology-based delineation of high-risk oral lesions. A comprehensive systematic review and meta-analysis of biomarkers recognized a panel of markers (n: 10) delineating dysplastic oral lesions. In this observational cross sectional study, immunohistochemical validation (n: 131) identified a four-marker panel, CD44, Cyclin D1, SNA-1, and MAA, with the best sensitivity (>75%; AUC>0.75) in delineating benign, hyperplasia, and mild-dysplasia (Low Risk Lesions; LRL) from moderate-severe dysplasia (High Grade Dysplasia: HGD) along with cancer. Independent validation by cytology (n: 133) showed that expression of SNA-1 and CD44 significantly delineate HGD and cancer with high sensitivity (>83%). Multiplex validation in another cohort (n: 138), integrated with a machine learning model incorporating clinical parameters, further improved the sensitivity and specificity (>88%). Additionally, image automation with SNA-1 profiled data set also provided a high sensitivity (sensitivity: 86%). In the present study, cytology with a two-marker panel, detecting aberrant glycosylation and a glycoprotein, provided efficient risk stratification of oral lesions. Our study indicated that use of a two-biomarker panel (CD44/SNA-1) integrated with clinical parameters or SNA-1 with automated image analysis (Sensitivity >85%) or multiplexed two-marker panel analysis (Sensitivity: >90%) provided efficient risk stratification of oral lesions, indicating the significance of biomarker-integrated cytopathology in the development of a Point-of-care assay.

Mouth and oral disease classification using InceptionResNetV2 method

Digital tools have greatly improved the detection and diagnosis of oral and dental disorders like cancer and gum disease. Lip or oral cavity cancer is more likely to develop in those with potentially malignant oral disorders. A potentially malignant disorder (PMD) and debilitating condition of the oral mucosa, oral submucous fibrosis (OSMF), can have devastating effects on one’s quality of life. Incorporating deep learning into diagnosing conditions affecting the mouth and oral cavity is challenging. Mouth and Oral Diseases Classification using InceptionResNetV2 Method was established in the current study to identify diseases such as gangivostomatitis (Gum), canker sores (CaS), cold sores (CoS), oral lichen planus (OLP), oral thrush (OT), mouth cancer (MC), and oral cancer (OC). The new collection, termed "Mouth and Oral Diseases" (MOD), comprises seven distinct categories of data. Compared to state-of-the-art approaches, the proposed InceptionResNetV2 model’s 99.51% accuracy is significantly higher.

Opiorphin as a biomarker of orofacial conditions: a meta-analysis

The aim of this meta-analysis was to answer the following question: “Are there any differences in opiorphin biomarker concentrations between different orofacial conditions and controls?”. Two reviewers searched for observational studies that evaluated the levels of opiorphin in orofacial conditions, annotated in seven main databases and three that compile gray literature. Of the 443 articles obtained initially, 8 met the inclusion criteria for quantitative analyses. Relative percentages showed a mean 24.1% higher opiorphin concentration in chronic conditions (Burning Mouth Syndrome, Oral Potentially Malignant Diseases and Temporomandibular Disorder) compared to controls; 33.2% higher opiorphin in sustained pain (Symptomatic Irreversible Pulpitis, Symptomatic Apical Periodontitis, Painful Oral Soft-tissue conditions); and 21.7% higher opiorphin after stimuli (Corneal Foreign Body, Capsaicin). Meta-analysis revealed a standardized mean difference of 0.62 [0.02, 1.22] in the absolute concentration of opiorphin in saliva for the chronic group compared to the control. The analogous values for the sustained group and the stimulated group were 2.24 [0.34, 4.14] and 0.43 [0.00, 0.85], respectively. No differences in opiorphin levels were found for ‘after Local Anesthesia before Tooth Extraction’ or for apicoectomy. Based on the available evidence, in general, a statistically higher level of opiorphin is found in orofacial conditions. Salivary opiorphin levels are elevated in chronic, persisted and acute pain conditions, presumably reflecting a physiological homeostatic adaptative response to different conditions such as stress or pain. Salivary opiorphin might therefore be used as a valuable biomarker in several oral disorders.

Oral Disorders in Sjögren’s Syndrome

Abstract Sjögren’s syndrome (SS) is a complex, chronic, systemic, autoimmune disease that mainly affects the exocrine glands, especially the salivary and lacrimal glands, leading to the dryness of the mouth and eyes, along with fatigue, joint and muscle pain. The prevalence of SS is estimated to be between 0.05% and 1% in European population. Diagnosis of SS is based on the revised criteria of the American-European consensus group (AECG). Sjögren’s syndrome can be subclassified into primary disease (primary Sjögren syndrome, pSS) and a secondary disease (secondary Sjögren syndrome, sSS) when present with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and systemic sclerosis. The decrease in salivary flow and qualitative alterations in saliva could explain many of the oral manifestations frequently present in patients with SS. Low salivary flow may affect chewing, swallowing, speech and sleeping in pSS patients. Oral manifestations include dental erosion, dental caries, mucosal infection, ulcers and oral candidiasis. Recent studies reveal that pSS patients experience impaired olfactory and gustatory functions and have higher occurrence of oral complications such as dysgeusia, burning sensation in the tongue (BST) and halitosis. The exocrine manifestations and systemic involvement in SS significantly impact the patient’s perception of oral healthrelated quality of life (OHRQoL).

Histomorphometric analysis of angiogenesis in oral submucous fibrosis and oral squamous cell carcinoma associated with oral submucous fibrosis

Background: Oral submucous fibrosis (OSMF), now worldwide acknowledged as the disease of “Southeast Asia and Indian subcontinent”, has the utmost malignant transformation prevalence amongst oral precancerous disorders. Increased vascularity that is neoangiogenesis has been observed in the superficial connective tissue region of pre-cancerous lesions showing dysplasia. This could be an initial occurrence of the carcinogenesis process. The aim of this study will be to analyse neoangiogenesis by examining immunoexpression of CD105 in OSMF, and OSCC with OSMF cases. Methods: The project will comprise 30 normal oral mucosa samples (group I), 30 clinicopathologically diagnosed cases of OSMF (group II), and on the basis of association of OSMF, 30 surgically operated and histopathologically diagnosed cases of OSCC associated with OSMF (group III). Hematoxylin and eosin stains will be used for routine staining procedures and immunohistochemistry for the expression of CD105. Oral epithelial dysplasia (OED) cases of OSMF will be categorized into two groups, low-risk epithelial dysplasia (LRED) and high-risk epithelial dysplasia (HRED). The micro vessel density (MVD), total microvessel area (TVA), and mean microvessel area (MVA) are within and surrounding the tumor tissue sections immunostained with the CD105 antibody will be determined. ANOVA will be applied for evaluation of the mean scores of MVD, TVA, and MVA of groups II and III. The obtained score will be compared with different parameters of OSCC (TNM stage, lymph node metastasis, and histopathological grades). Conclusions: We postulate the progressively increased vascularity with the disease progression from LRED to HRED and further its transformation to invasive oral squamous cell carcinoma This increased vascularity will be evident by enhanced MVD, TVA and mean MVA, which is expressed by CD105 immunoexpression. This observation will emphasize the significance of neoangiogenesis in cases of OSMF with epithelial dysplasia and its further progression to OSCC.

Effectiveness and safety of mesenchymal stem/stromal cell for radiation-induced hyposalivation and xerostomia in previous head and neck cancer patients (MESRIX-III): a study protocol for a single-centre, double-blinded, randomised, placebo-controlled, phase II study

BackgroundA predominant side effect of radiotherapy for head and neck cancer is salivary gland hypofunction and xerostomia leading to debilitating oral disorders and impaired quality of life (QoL). Intraglandular mesenchymal stem cell therapy has shown promising results as a treatment for xerostomia.MethodsThis is a randomised, double-blinded, placebo-controlled, parallel-group, prospective, single-centre trial investigating the safety, tolerability, and effectiveness of allogeneic stem cells as a treatment for radiation-induced hyposalivation and xerostomia for previous head and neck cancer patients.We will include a total of 120 patients who previously have been treated with radiotherapy for a head and neck cancer in Denmark. Participants will be randomly assigned using block randomisation to one of two parallel groups in a 1:1 ratio to receive ultrasound-guided injection of allogeneic adipose-derived mesenchymal stem cell (ASC) (n = 60) or placebo (n = 60) into the submandibular glands. Placebo will consist of CryoStor10 (BiolifeSolutions), the freeze media for ASCs containing 10% dimethyl sulfoxide (DMSO). The primary endpoint is change in unstimulated whole saliva flow rate. The secondary endpoints are change in stimulated whole saliva flow rate, QoL, and composition of saliva. Further secondary endpoints are safety and immune response (human leukocyte antigen (HLA) response) to the stem cells will be assessed. Patients are evaluated at baseline (before treatment), after 4 months, and after 12 months. All study personnel, except study personnel thawing and preparing the treatment for injection, and participants will be blinded to group assignment. Unblinded study personnel will not participate in the outcome assessment.DiscussionThe trials will investigate the efficacy and safety of ASC injection to the submandibular gland as a potential new treatment for post-radiation xerostomia. We hope the results will pave the way for a clinically relevant treatment to ameliorate patients with xerostomia, a severely hampering condition.Trial registrationThe study is approved by the Danish Data Protection Agency (protocol number P-2020-1164), the National Ethics Committee protocol number: (Protocol number: 1802872), and the Danish Medical Agency (2018-000348-24). The protocol was registered at the ClinicalTrials.gov database (NCT04776538).

Salivary metabolomics for oral leukoplakia with and without dysplasia

PurposeOral leukoplakia (OL) is a common potentially malignant oral disorder. Therefore, there is a need for simple screening methods for OL before its transformation into oral cancer. Furthermore, because invasive open biopsy is the sole method to determine if an OL lesion is dysplastic, there is also a clinical need for non-invasive methods to differentiate dysplastic OL from non-dysplastic OL. This study aimed to identify salivary metabolites that can help differentiate patients with OL from healthy controls (HC) and also dysplastic OL from non-dysplastic OL. Material & methodsWhole unstimulated saliva samples were collected from patients with OL (n = 30) and HCs (n = 29). The OL group included nine patients with dysplastic OL and 20 with non-dysplastic OL. Hydrophilic metabolites in the saliva samples were comprehensively analyzed through capillary electrophoresis mass spectrometry. To evaluate the discrimination ability of a combination of multiple markers, a multiple logistic regression (MLR) model was developed to differentiate patients with OL from HCs and dysplastic OL from non-dysplastic OL. ResultsTwenty-eight metabolites were evidently different between patients with OL and HCs. Finally, three metabolites (guanine, carnitine, and N-acetylputrescine) were selected to develop the MLR model, which resulted in a high area under curve (AUC) of the receiver operating characteristic (ROC) to differentiate patients with OL from HCs (AUC = 0.946, p < 0.001, 95% confidential interval [CI] = 0.889– 1.000). Similarly, two metabolites were evidently different between patients with dysplastic and non-dysplastic OL. Finally, only one metabolite (7-methylguanine) was selected in the MLR model, which revealed a moderate discrimination ability for dysplastic and non-dysplastic OL (AUC = 0761, p = 0.027, 95% CI = 0.551–0.972). ConclusionOur candidate salivary metabolites showed potential not only to discriminate OL from HC, but also to discriminate dysplastic OL from non-dysplastic OL.

The Relevant Oral Burden of Patients with Hidradenitis Suppurativa.

Interleukin-17 plays a pivotal role in both hidradenitis suppurativa (HS) and in maintaining oral homeostasis, but their potential link remains unknown. Thus, we aimed to evaluate and quantify the oral burden of patients with HS. In this real-life, multicenter, cross-sectional study, patients with HS were clinically evaluated by two board-certified dermatologists and two board-certified dentists. Oral comorbidities were carefully collected with medical history and therapeutic information. A total of 102 patients (44.0 ± 0.9years, body mass index 27.0 ± 2.2kg/m2) were enrolled. Remarkably, 48% and 43% did not undergo at least an oral hygiene or a dental visit each year, respectively. Oral disorders were found in 55.9% of patients with HS, in particular 39.2% had caries and 46.7% reported at least one missing tooth. The main oral manifestations in patients with HS were recurrent aphthous stomatitis (N = 19, 19.2%), amalgam tattoo (N = 14, 14.1%), leukoplakia (N = 11, 11.1%), nicotinic stomatitis (N = 9, 9.1%), papilloma (N = 8, 8.1%), and geographic tongue (N = 8, 8.1%). Whilst the main predictor of oral pathological conditions was Hurley staging (P = 0.0276), multivariate regression analysis indicated that gender and International Hidradenitis Suppurativa Severity Score System (IHS4) were the main predictors for the presence of caries and number of missing teeth. As a result of the relevant oral burden in patients with HS, dentists should be part of the multidisciplinary team and oral education should be promoted among patients with HS.

DETERMINANT FACTORS OF DENTAL AND ORAL SELF-CARE FOR ADOLESCENTS IN THE COASTAL AREA OF CILACAP CITY

Background: The prevalence of oral health problems in Indonesia is 25.9%. The incidence of oral and dental diseases in Central Java in 2019 was recorded at 126,225 cases and 39,759 of them occurred in Cilacap District. Based on data taken from the Kampung Laut Community Health Center, there were a total of 164 confirmed cases of oral health in 2022, dental and oral diseases that are often found in the community include caries and periodontal disease. Oral health care efforts are the main preventive measures to prevent oral disorders in order to avoid oral diseases, which can be carried out by each individual through self-care, such as brushing teeth, using dental floss, and using mouthwash. The purpose of this study was to determine the relationship between factors of knowledge, behavior, attitude, age, gender, parents' occupation, social history, and history of toothache with oral self-care in adolescents at Kampung Laut 1 Senior High School.Method: This type of observational analytic study uses a cross-sectional design. The sample in this study were 82 students. Data collection was carried out by providing questionnaires which were filled out independently by students.Result: The results of the analysis of the relationship between factors of knowledge (p = 0.037), behavior (p = 0.018), attitude (p = 0.046), age (p = 0.037), gender (p = 0.025), parents' occupation (p = 0.049), social history (p = 0.037) and history of toothache (p = 0.018) on dental and oral self-care in adolescents where the p value of each variable is &lt;0.05 which means it is significant.Conclusion: There is a relationship between knowledge, behavior, attitudes, age, gender, parents' occupation, social history and history of toothache on dental and oral self-care in adolescents.

Comparing the Effectiveness of Low-Level Laser Therapy and Topical Steroid Therapy Combination Regimen With Routine Topical Steroid Therapy in the Management of Oral Lichen Planus Symptomatic Patients.

For symptomatic oral lichen planus (OLP), a wide range of therapeutic approaches have been suggested. To minimize discomfort and symptoms among individuals with symptomatic OLP, extensive therapy is frequently needed. Therefore, finding a new therapeutic approach that may effectively manage OLP's symptoms and signs while having few adverse effects continues to be a difficult task. Recently, low-level laser therapy (LLLT) has become a popular alternative therapy option for OLP with no serious side effects. The present research was designed to compare the effectiveness of a combination regimen of LLLT in addition to topical steroids with routine topical steroid therapy separately in order to manage patients with bothersome OLP with an extended period of follow-up. In our trial, 60 patients were chosen and given sequential numbers as they signed up to take part. The participants were divided randomly into two categories: category A (LLLT plus topical steroids) and category B (only topical steroids). The data were entered into the aforementioned prepared case template after receiving informed consent. The aforementioned prepared case template included the following criteria for evaluating the result of the treatment: pain, recurrence, burning sensation, clinical remission, and size of the lesion. Applying the visual analog scale (VAS), pain, as well as burning sensations, were assessed in both categories. With the aid of the Electronic Digital Vernier Caliper (Mitutoyo, China), these individuals were assessed for the dimension of the lesion. The pain score on day 21 of intervention in category A was 2.5, while it was 4.63 in category B. The difference in findings was significant statistically at day 21 (p = 0.0032). The pain score on day 28 of intervention in category A was 1.3, while it was 3.0 in category B. The difference in findings was significant statistically at day 28 (p = 0.003). The pain score was greater in the control category as compared to the intervention category. The burning sensation score on day 21 of intervention in category A was 2.5, while it was 4.5 in category B. The difference in findings was significant statistically (p = 0.0024). The burning sensation score at the follow-up phase on day 45 of intervention in category A was 1.1, while it was 3.4 in category B. The difference in findings was significant statistically (p = 0.002). Newer therapeutic techniques are becoming accessible to oral specialists for controlling oral mucosal disorders as a result of evolving dental trends. The gold standard for treating people with symptomatic OLP continues to be topical corticosteroids. The therapeutic advantages of topical corticosteroids, however, are considerably outweighed by their complementary effect when paired with newer treatment methods like LLLT.