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Abstract Background The effects of smoking on the accumulation of dental plaque have not been studied in depth. We compared dental plaque quantitation obtained with a novel light induced fluorescence technology among current, former, and never smokers and verified measurements’ repeatability. Methods Dental plaque quantitation was objectively assessed by quantitative light induced fluorescence (QLF) technology on three separate study visits in current, former, and never smokers: baseline (day 0), day 7, day 30. Increase in the fluorescence intensity of at least 30% (ΔR30) and 120% (ΔR120) together with the simple oral hygiene (SOH) scoring were considered for analysis. Results The QLF parameters were highly repeatable in each study group (p

BackgroundAlthough the detrimental effects of conventional combustible cigarettes on oral health and dental esthetics are well known, there is limited information about the long-term impact of combustion-free nicotine alternatives (C-F NA) such as e-cigarettes or heated tobacco products. ObjectiveThis multicenter, prospective, 3-parallel-arm randomized controlled trial will investigate whether switching from combustible cigarettes to C-F NA will lead to measurable improvements in oral health parameters and dental esthetics over 18 months in adult smokers with limited gum disease. MethodsRegular smokers not intending to quit and without clinical signs of periodontitis will be randomly assigned (1:4 ratio) to either standard of care with brief cessation advice (control group; arm A) or C-F NA use (intervention group; arm B). The study will also include a reference group of never smokers (reference group; arm C). The primary end point is the change in the Modified Gingival Index (MGI) score from baseline between the control arm (arm A) and the intervention arm (arm B) at the 18-month follow-up. In addition, the study will analyze the within- and between-group (arms A, B, and C) changes in MGI assessment, plaque imaging, dental shade quantitation, tooth stain scores, and oral health–related quality of life questionnaires measured at each study time point. All participants will attend a total of 7 clinic visits: screening, enrollment, and randomization (visit 0); baseline visit—day 14 (visit 1); day 90 (visit 2); day 180 (visit 3); day 360 (visit 4); and day 540 (visit 5). This multicenter study will be conducted in 4 dental clinics in 4 countries. The statistical analysis will involve descriptive statistics for continuous and categorical data. Primary end points will undergo tests for normality and, based on distribution, either a 2-sided t test or Mann-Whitney U test. Linear mixed model with random factors center and study arms by center will also be applied. Secondary end points, including MGI assessment and quality of life, will be subjected to similar tests and comparisons. Only if one value of the parameter MGI is missing after day 1, the last available observation will be carried forward. The analysis will be performed on the substituted data. Secondary parameters will not have missing value replacement. ResultsParticipant recruitment began in October 2021, and enrollment was completed in June 2023. Results will be reported in 2025. ConclusionsThis will be the first study to provide key insights into oral health benefits or risks associated with using C-F NA in smokers who are seeking alternatives to cigarette smoking. Trial RegistrationClinicalTrials.gov NCT04649645; https://clinicaltrials.gov/ct2/show/NCT04649645 International Registered Report Identifier (IRRID)DERR1-10.2196/53222

Objectives: Abstaining from tobacco smoking may not only improve general health, but also reduce teeth staining and restore teeth whiteness. Compared with conventional cigarettes, E-cigarettes (ECs) and heated tobacco products (HTPs) may offer substantial reduction in exposure to pigmented tar-like compounds of cigarette smoke. It is possible that improvements in dental color indices may be observed in those who have stopped smoking combustible cigarettes by switching to tar-free nicotine delivery products. Methods: This cross-sectional study evaluated and compared dental color parameters by digital spectrophotometry among five different groups: individuals who currently smoke ; individuals who used to smoke but have quit ; individuals who have never smoked ; exclusive users of electronic cigarettes (former smokers) ; and exclusive users of heated tobacco products (former smokers) . Results: Dental whiteness in current cigarette smokers was notably worse compared with never and former smokers, (13.38 Whiteness Index for Dentistry (WID) units vs. 19.96 and 16.79 WID units). Remarkably high WID values (i.e., whiter teeth) were also observed in ECs (16.72 WID units) and HTPs users (17.82 WID units). Compared to current smokers, difference in dental whiteness for ECs and HTPs users was visually noticeable (ΔWID difference being on average > 2.90 units). The colour differences measured as delta E*(ΔE*) were all visually detectable except for the comparison between ex-smokers and ECs users for which no perceptible color difference was observed (0.415). Conclusion: Exclusive use of ECs and HTPs is associated with better dental color measurements than current smoking, suggesting that tar-free nicotine delivery technologies are unlikely to have negative effects on dental appearance. Clinical significance: Use of alternative nicotine delivery systems may be associated with cosmetic benefits with important implications for those smokers perceiving dental aesthetics as a significant problem. For these an oral-based narrative may be a much more significant reason to refrain from smoking than the fear of developing smoking-related diseases in future.

Framework of Convention for Tobacco Control is the international regime and norm that provides regulation for cigarette and tobacco industries in global level. Indonesia has its narrative in declining FCTC ratification proposal. This study attempts to describe Indonesian interest and sovereignty as part of third world country over FCTC as international regime. The method uses analytical descriptive with qualitative approach using sovereignty, international regime compliance, and national interest concept in the framework of international regime. In addition, dependency theory is also used to emphasize the relationship between Indonesia and FCTC. The main reason of Indonesian narrative against FCTC agenda is historical roots with national heritage and the tobacco industry contribution to Indonesia economy. In other words, iobacco products in Indonesia is no longer concern of health issues, but also the economy and culture. Beside that, Indonesia position is in line with sovereignty principle that apply also for US and Switzerland as the country which do not ratify FCTC in its national regulation on tobacco. The elaboration of this research is divided into two parts. The research found that the FCTC are not that harmful to the business of international cigarette company such as Phillip Morris International, it even creates a new business opportunity for them. The FCTC also believed to form a dependency relationship, where the industry of developing country such as Indonesia is dependent on the global interest which is mostly sponsored by developed country to be able to grow.

Background: Oral condition is one of substantial factors in general health. Good oral health will determine dental fitness or readiness in military troops. Oral diseases affecting soldiers may have negative impacts in readiness on deployment or fight and contributes to lowering morale among personnel. At the recruitment stage, the prevalence of periodontal disease is low and controlled before the commencement of the training. As a matter of fact, periodontal health was not considered to be maintained and found to be worsening through the course of time. In the end, many of soldiers were found to suffer from periodontal diseases. Method : This review article aims to discuss several factors in military way of life related to oral condition. Result : Lack of oral hygiene practices, stress, deficiency of nutritious food, and smoking among military personnel may contribute to the prevalence of periodontal disease. Several attempts should be incorporated in military life to reduce the negative impacts of these factors on oral health. Conclusion: Periodontal therapy should be provided early in the military careers and repeated at intervals specific to the needs of each personnel. Several risk factors contributing to the development and severity of periodontal disease should be assessed and overcome to arrest the progression of the disease.

Smoking is one of the sources of many health problems in the world. Smoking adversely affects systemic diseases as well as oral health. The effects of smoking on oral health are mainly periodontal tissue damage. Periodontal inflammation limited to the gingival tissue is gingivitis, most often caused by bacteria. According to the results of several studies, it is stated that there were differences in gingivitis in smokers and non-smokers based on clinical parameters. We aimed to map the kinds of literature comparing gingivitis in smokers and non-smokers based on clinical parameters. The research was carried out using the scoping review method by PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews) based on predetermined inclusion and exclusion criteria. Articles were retrieved from four databases, including PubMed, Google Scholar, ScienceDirect, and Scopus. After screening according to inclusion and exclusion criteria, 12 articles were included in the analysis. Nine parameters used to compare gingivitis in smokers and non-smokers were Plaque Index (PI), Gingival Bleeding Index (GBI), Bleeding on Probing (BOP), Gingival Index (GI), gingival redness, vascular reaction, gingival exudate, Calculus Index (CI), and OHI-S. The review results showed that the PI in smokers and non-smokers was similar. GBI, BOP, GI, gingival redness, vascular reactions, and gingival exudate were higher in non-smokers compared to smokers. CI showed higher results in smokers and OHI-S it showed worse results in smokers. Gingivitis in smokers showed minimal signs of inflammation compared to non-smokers. This is characterized by the Gingival Bleeding Index (GBI), Bleeding on Probing (BOP), Gingival Index (GI), gingival redness, vascular reaction, and gingival exudate that were lower in smokers compared to non-smokers. [ABSTRACT FROM AUTHOR]

During the last decades, a huge body of evidence has been accumulated suggesting that citrus fruits and their constituents might have a role in preventing many diseases including oral disease. We aimed to map the existing evidence of the potential of Citrus aurantifolia essential oil as an antiplaque agent. Electronic databases (PUBMED, Google Scholar, and Scopus) were searched using the broad MeSH terms and keywords. Search terms included Citrus aurantifolia, lime peel, essential oil, and antiplaque. The last search was performed on October 15th, 2023. Only original articles evaluating the potential of lime peel essential oil in plaque-forming inhibition were included. Study selection and systematic review were carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Review (PRISMA- ScR) statement. Before the beginning of the review, the Authors defined a checklist for inclusion criteria, thus including articles that meet the following: (i) published on peer- reviewed scientific journals; (ii) Citrus aurantifolia; (iii) essential oil derived from Citrus aurantifolia peel; (iv) preclinical and clinical studies. Reviews, meta-analyses, conference abstracts, and book chapters were excluded. Four reviewers performed the extraction of articles. Out of 6430 records, 1980 were screened for titles and abstracts after the removal of duplicates, only 59 were considered to be potentially eligible for inclusion. Finally, only 4 articles were included. The result showed that Citrus aurantifolia peel essential oil indirectly prevents the formation of dental plaque by inhibiting the oral growth of bacteria initiating the formation of biofilms. [ABSTRACT FROM AUTHOR]

Periodontitis is a multifactorial disease that occurs due to the accumulation of plaque formed from the colonization of bacteria on the tooth surface, caused by Gram-negative bacteria, one of which is Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans). Periodontitis treatment can be conducted using beneficial herbal materials. One such herbal material is the pepper elder leaf (Peperomia pellucida (L.) Kunth), which has been traditionally used for the treatment of various diseases, including dental and oral diseases. This study aims to determine the effectiveness of pepper elder leaf extract against the growth of A. actinomycetemcomitans bacteria. This is an experimental laboratory study using a Post-Test Control Group Design with a disk diffusion method across six treatment groups. Data analysis was performed using one-way ANOVA (P < 0.05). The study showed that the pepper elder leaf extract at all concentrations was effective against the growth of A. actinomycetemcomitans bacteria, as the pepper elder leaf contains a significant amount of alkaloids, flavonoids, and tannins, which are known to have antibacterial and anti- inflammatory effects. The study concluded that pepper elder leaf extract has effectiveness in inhibiting the growth of A. actinomycetemcomitans bacteria. [ABSTRACT FROM AUTHOR]

Smoking has detrimental effects on periodontal health, including poor gingival response toward bacterial plaque accumulation and delayed wound healing after periodontal therapy. Recently, an alternative product called Combustion-Free Nicotine Delivery System (C-FNDS) has been widely recognized among cigarette smokers as an aid to reducing or quitting smoking, and it has been marketed as a healthier, cost-effective, and more socially acceptable alternative to traditional cigarettes. However, the impact of using the product on gingival response is still unclear. We aimed to systematically review the impact of combustion-free nicotine delivery systems on gingival response. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA guidelines). Studies were evaluated using the PICO strategy. The search was conducted with Pubmed, Scopus, Science Direct, EBSCOHost, Google Scholar, and manual search up to March 2024. The quality of the methodology of each study was evaluated using The Joanna Briggs Institute (JBI) tool. The initial search resulted in 345 articles, after being screened for duplication and criteria, 10 articles were included. The term CF-NDS in searches predominantly brought up Electronic Nicotine Delivery Systems, e-cigarettes, or vaping. In terms of bleeding on probing and gingival conditions, the gingival response was suppressed in cigarette smokers compared with individuals using e-cigs and never-smokers. At the same time, the outcome of periodontal therapy was slightly compromised in e-cigarette users but more favorable compared to the results in smokers. Under the limitation of the study, the present review suggests that CF-NDS users demonstrated different gingival responses compared to smokers, and it merits further study to explore how switching from traditional cigarettes or combustible products to CF-NDS may affect the periodontal condition. [ABSTRACT FROM AUTHOR]

E-cigarettes or vaping has gained more popularity in Indonesia, a country with the third highest smoking prevalence in the world. This survey aimed to obtain data on the characteristics, perceived side effects and benefits, and tobacco use profile of e-cigarette users (vapers) in Indonesia. An online survey was performed in 29 provinces using a convenience sampling approach. Inclusion criteria were being a current e-cigarette user/vaper and aged 18 years or more. A total of 1,408 subjects (97.64% male, 2.3% female, 0.06% undefined, mean age 29.3 years) participated in this study. The majority (90.6 %) were first exposed to nicotine via tobacco smoking. Most subjects (81.7%) believed that vaping was less harmful than smoking. The vast majority of smokers (96.3%) reported smoking cessation (78.3%) or reduction in consumption (18%) with the help of vaping. Participants reported minimal side effects and some health benefits after vape use initiation. [ABSTRACT FROM AUTHOR]

Osteoradionecrosis is a condition in which the nonvital irradiated bone, fails to heal to over for three to six months, causing the bone to open and disrupt the mucosa or overlying skin without cancer recurrence. Osteoradionecrosis most often occurs at mandibular sites, one of the treatments is hyperbaric oxygen therapy (HBOT) but it's still a contradiction whether HBOT has a good effect or not. This study aims to determine the effectiveness of HBOT in osteoradionecrosis of the mandible. This scoping review was on studies reporting the use of HBOT in osteoradionecrosis of the mandible. Search for articles refers to Preferred Reporting Items for Systematic Review and Metaanalysis (PRISMA) through PubMed and Google Scholar that meet the criteria according to the PICO (Population, Intervention, Comparison, Outcome) framework. The filterings were the year published, indexed by Scopus, the title and abstract, and the contents of the entire article. There were 7 articles related to the administration of HBOT in the treatment of mandibular osteoradionecrosis with the majority as multimodality therapy. HBOT has a positive role in the healing process of mandibular osteoradionecrosis, especially as a multimodality therapy. [ABSTRACT FROM AUTHOR]

Cigarette smoke contains a large number of oxidants and plays an important role in disturbing the oxidative balance due to the content of free radicals in it, which is responsible for many adverse effects in the oral cavity. Chronic inflammation accompanied by increased TNF-a can lead to increased production of free radicals in the body. A high total antioxidant capacity can help neutralize free radicals and reduce oxidative stress, which in reducing TNF-a production. This study aimed to evaluate the effect of switching from tobacco smoking to using non-combustion products on gingival health in terms of TNF-a levels in saliva, and total antioxidant capacity in saliva in smokers with gingivitis. This study was a randomized controlled trial. A total of 34 subjects (17 smokers and 17 switching to non-combustion products) were involved in the study according to the inclusion criteria. Saliva samples were taken at month 0 and month 3 to examine TNF-a levels and total antioxidant capacity (TAOC). TAOC in the switch group increased after 3 months (p=0.006) compared to the smoker group. TNF-a in the switch group decreased after 3 months compared to the smoker group, but there was no significant difference (p=0.473). Switching smoking behavior from conventional cigarettes to non-combustion products has the potential to increase TAOC levels and decrease TNF-a after 3 months. [ABSTRACT FROM AUTHOR]

Pendahuluan: Diabetes mellitus adalah penyakit disregulasi metabolisme yang disebabkan oleh defisiensi fungsional aksi insulin dan bermanifestasi pada berbagai organ tubuh termasuk rongga mulut. Diabetes mellitus merupakan modifying factor penyakit periodontal karena dapat memperburuk respon jaringan periodontal terhadap iritasi plak bakteri. Akumulasi plak dapat diukur dari tingkat kebersihan mulut seseorang. Penelitian ini bertujuan untuk mengevaluasi tingkat kebersihan mulut penderita diabetes mellitus tipe 1 di RSUP Dr. Hasan Sadikin, RSUD Ujung Berung dan RS Al Islam Bandung. Metode: Sebanyak 16 penderita diabetes mellitus tipe 1 berusia 16-48 tahun diperiksa kebersihan mulutnya menggunakan Oral Hygiene Index-Simplified (OHI-S) dari Greene dan Vermillion (1964). Hasil: Rata-rata skor OHI-S sebesar 1,905, berdasarkan OHI-S, skor tersebut berada dalam kriteria sedang. Simpulan: Kebersihan mulut penderita diabetes mellitus di RSUP Hasan Sadikin, RSUD Ujung Berung dan RS Al Islam tergolong dalam kategori sedang. Kata kunci: Diabetes mellitus tipe I, kebersihan mulut, Oral Hygiene Index-Simplified ABSTRACT Introduction: Diabetes mellitus is a metabolic dysregulation disease caused by a functional deficiency of insulin action and manifests in various organs including the oral cavity. Diabetes mellitus is a modifying factor for periodontal disease because it can worsen the response of periodontal tissues to bacterial plaque irritation. Plaque accumulation can be measured from the level of one’s oral hygiene. This study aims to evaluate the level of oral hygiene of type 1 diabetes mellitus patients at Dr. Hasan Sadikin Hospital, Ujung Berung Hospital, and Al Islam Hospital Bandung. Methods: 16 patients with type 1 diabetes mellitus aged 16-48 years were examined for oral hygiene using the Oral Hygiene Index-Simplified (OHI-S) from Greene and Vermillion (1964). Result: The average OHI-S score is 1.905, based on OHI-S, the score is in the medium criteria. Conclusion: Oral hygiene of diabetes mellitus patients at Hasan Sadikin General Hospital, Ujung Berung Regional Hospital, and Al Islam Hospital is classified as moderate. Keywords: Diabetes mellitus type 1, oral hygiene, Oral Hygiene Index-Simplified

Smokers display less gingival inflammation and gingival bleeding than non-smokers due to the altered inflammatory response. Vape or e-cigarette has been said to be less harmful than combustible cigarette, but no information regarding the gingival inflammation in vapers. This pilot study aimed to evaluate gingival response in vapers, smokers and non-smokers. We recruited fifteen participants consisted of non-smokers (n=5), smokers (n=5), and vapers (n=5). Participants were instructed not to clean teeth in lower jaw throughout the duration of the experimental gingivitis phase (21 day). The primary outcome measures of gingival inflammation were Gingival Index (GI) and Angulated Bleeding Index (AngBI) during experimental gingivitis period. Plaque Index (PlI) and salivary cotinine levels were also determined. Despite the similar amount of bacterial plaque accumulation in 3 study groups, smokers showed reduced inflammation and bleeding while in vapers with nicotine vapour and non-smokers there were obvious increases of clinical features of inflammation as gingival response to bacterial challenge, suggesting that the use of e-cigarettes with nicotine vapour did not mask the clinical features of inflammation. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate expression of TNF-a, IL-1ß, and macrophages in intermittent hypobaric hypoxia exposure in post tooth extraction socket healing process in rats. Forty-five healthy adult male Sprague Dawley rats were used in this study. Tooth extraction was performed on the maxillary left first molar, then randomly divided into 9 groups, namely the intermittent hypobaric hypoxia (IHH) group which was given exposure to hypobaric hypoxia (HH) for 30 minutes every day in the Hypobaric Chamber at an altitude of 18. 000 feet for 1 time HH, 3 times HH, 5 times HH, and 7 times HH, and the normoxia group that was not exposed to HH, and the control group were terminated on days 0, 1, 3, 5 and 7. Molecular changes in mRNA expression were measured by RT-PCR extracted from socket tissue after rat tooth extraction to evaluate the expression of TNF-a mRNA and IL-1ß mRNA, as well as histological changes by Hematoxylin and Eosin (H&E) staining to evaluate macrophages. Molecular and histological parameters were calculated at the end of each experiment on days 0,1,3,5, and 7 after tooth extraction as repair phase of the socket healing process. In this study, it was found that the expression of TNF-a mRNA, IL-1ß mRNA and the number of macrophages, began to increase significantly after 1 time exposure to HH on day 1, and reached the highest peak after 3 times exposures to HH on day 3, this increase was higher than the control group and the normoxia group, then after 5 times exposures to HH on day 5 there was a decrease, and further decreased after 7 times exposures to HH on day 7, this decrease also occurred faster approaching the control group than the normoxia group. Repeated or intermittent exposure to hypobaric hypoxic conditions induces a protective response, can make cells adapt to hypoxia. Several inflammatory cytokines and inflammatory processes, such as inflammatory cell migration and monocyte differentiation into macrophages, are modulated under hypoxic conditions. TNF-a and IL-1ß are proinflammatory cytokines produced by macrophages in early wounds, and play an important role in inflammation and immune responses in wound healing. The results showed that changes in TNF-a and IL-1ß mRNA expression were in line with changes in the number of macrophages in the socket after tooth extraction under hypobaric hypoxic conditions, and there was a gradual mechanism of cell adaptation under intermittent hypobaric hypoxic conditions which could affect the wound healing process after tooth extraction. [ABSTRACT FROM AUTHOR]

COVID-19 has different possible clinical symptoms, namely asymptomatic and symptomatic. The SARS-CoV-2 infection becomes detrimental when it occurs in someone who has comorbidities. Several comorbidities in COVID-19 are also closely related to periodontitis. This scoping review aimed to advance the existing studies on the relationship between periodontitis and comorbidities and the severity of COVID-19 infection. PRISMA-Scr is used as a guideline. Searches were performed with keywords ("periodontitis" AND "COVID-19") AND ("Comorbidity" or "systemic disease") in the PubMed/MEDLINE, DOAJ, and Science Direct databases and manually using Google Scholar. Selected articles to be discussed and analyzed in detail. Twelve articles that. Twelve articles that met the criteria were selected and analyzed. Specifically reviewed based on; the relationship between periodontitis and COVID-19, the relationship between COVID-19 and comorbid disease, and the relationship between comorbid disease and periodontitis. The papers collected in this study support a correlation between periodontitis and the severity of COVID-19 compared with systemic disease, although so far, there are no experimental studies specifically designed to confirm this association. [ABSTRACT FROM AUTHOR]

Tobacco smoking is one of the most important risk factors for periodontal disease as it alters the host response to bacterial plaque. Although the prevalence of tobacco smoking has declined in recent years, the use of novel nicotine products, particularly electronic cigarettes (vape) have become increasingly popular around the world. This systematic scoping review aimed to identify gingival inflammatory response in vapers compared to tobacco smokers. The term "(Gingivitis) AND (Gingival Inflammation) AND (Gingival Response) AND (Smoking) AND (Tobacco) AND (Cigarettes) AND (Vaping OR E-cigarettes) were run in PubMed, EBSCOHost, and Google Scholar from inception to May 2021. From the 71 studies retrieved, 6 studies were included for this review. After exclusion of articles not addressing the end point in question, 6 articles were included in this scoping review. Of the 6 articles, two were pilot studies, two were cross-sectional studies, one was case-control study, and one was observational study. There was difference in gingival inflammatory response of tobacco smokers compared to vapers as seen from the bleeding on probing and gingival crevicular fluid volume as well as inflammatory mediators. Switching from combustible tobacco cigarette to vape may lead to increasing gingival bleeding and gingival crevicular fluid volume in a similar direction to that which occurs when smokers quit. Tobacco smoking and vaping have different effects on the gingival inflammatory response. The inflammation in cigarette smokers may have been masked and vaping has the potential to replete the gingival response towards bacterial plaque, but this must be investigated further. [ABSTRACT FROM AUTHOR]