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Mother-to-child transmission (MTCT) of human immunodeficiency virus type 1 (HIV-1) and human cytomegalovirus (HCMV) may occur during pregnancy, labor, or breastfeeding. These viruses from amniotic fluid, cervicovaginal secretions, and breast milk may simultaneously interact with oropharyngeal and tonsil epithelia; however, the molecular mechanism of HIV-1 and HCMV cotransmission through the oral mucosa and its role in MTCT are poorly understood. To study the molecular mechanism of HIV-1 and HCMV MTCT via oral epithelium, we established polarized infant tonsil epithelial cells and polarized-oriented ex vivo tonsil tissue explants. Using these models, we showed that cell-free HIV-1 and its proteins gp120 and tat induce the disruption of tonsil epithelial tight junctions and increase paracellular permeability, which facilitates HCMV spread within the tonsil mucosa. Inhibition of HIV-1 gp120-induced upregulation of mitogen-activated protein kinase (MAPK) and NF-κB signaling in tonsil epithelial cells, reduces HCMV infection, indicating that HIV-1-activated MAPK and NF-κB signaling may play a critical role in HCMV infection of tonsil epithelium. HCMV infection of tonsil epithelial cells also leads to the disruption of tight junctions and increases paracellular permeability, facilitating HIV-1 paracellular spread into tonsil mucosa. HCMV-promoted paracellular spread of HIV-1 increases its accessibility to tonsil CD4 T lymphocytes, macrophages, and dendritic cells. HIV-1-enhanced HCMV paracellular spread and infection of epithelial cells subsequently leads to the spread of HCMV to tonsil macrophages and dendritic cells. Our findings revealed that HIV-1- and HCMV-induced disruption of infant tonsil epithelial tight junctions promotes MTCT of these viruses through tonsil mucosal epithelium, and therapeutic intervention for both HIV-1 and HCMV infection may substantially reduce their MTCT. IMPORTANCE Most HIV-1 and HCMV MTCT occurs in infancy, and the cotransmission of these viruses may occur via infant oropharyngeal and tonsil epithelia, which are the first biological barriers for viral pathogens. We have shown that HIV-1 and HCMV disrupt epithelial junctions, reducing the barrier functions of epithelia and thus allowing paracellular penetration of both viruses via mucosal epithelia. Subsequently, HCMV infects epithelial cells, macrophages, and dendritic cells, and HIV-1 infects CD4+ lymphocytes, macrophages, and dendritic cells. Infection of these cells in HCMV- and HIV-1-coinfected tonsil tissues is much higher than that by HCMV or HIV-1 infection alone, promoting their MTCT at its initial stages via infant oropharyngeal and tonsil epithelia.

Introduction: The Behçet's Disease Current Activity Form (BDCAF) is crucial for monitoring the progression and treatment efficacy of Behçet's Disease (BD), an autoimmune disorder that can be triggered or exacerbated by viral infections. Herpes simplex virus type 1 (HSV-1) has long been recognized as a potential trigger for BD, as it can induce systemic inflammation and exacerbate symptoms. In contrast, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has recently emerged and may also initiate or worsen BD symptoms. This report examines three BD cases with oral manifestations specifically triggered by HSV-1 and SARS-CoV-2, comparing their clinical activity and treatment responses. Case: Three female patients, aged 29, 24, and 41 years, presented to the Oral Medicine Department with complaints of canker sores, along with genital and skin lesions and red eyes. Intraoral examination showed ulcerative, erosive, and white plaque lesions throughout the oral mucosa. The first patient was confirmed to have COVID-19 by the SARS-CoV-2 RNA test. The second and third patients had a two-year history of recurrent oral ulcerations with reactive IgG anti-HSV-1 tests. All patients were diagnosed with BD according to the International Criteria for Behcet's Disease. The BDCAF measurements were conducted, showing a BD activity index score of 4 for the COVID-19-positive patient, while scores of 6 and 7 were recorded for the other two patients with seropositive HSV-1. Case Management: Medications provided include corticosteroid, antimetabolite, analgesic, antiviral, antifungal, antiseptic mouthwash, and multivitamin. All patients showed good clinical improvement after treatment. Conclusion: The BD activity index scores of a BD patient with COVID-19 were lower than those with HSV-1 infection. This difference may be due to the recent SARS-CoV-2 infection in the patient, whereas reactivation of chronic latent HSV-1 in the other patients likely contributed to a longer history of clinical manifestations, resulting in increased disease activity. [ABSTRACT FROM AUTHOR]

This study aimed to compare the serum levels of IL-10 between non-DM and DM patients with and without oral manifestations at Dr. Hasan Sadikin Hospital Bandung. Methodology: This observational study used a cross-sectional design. A total of 88 serum samples that met the inclusion criteria were selected, consisting of 37 (42%) samples from non-DM patients, 35 (39.8%) samples from DM patients with oral manifestations, and 16 (18.2%) samples from DM patients without oral manifestations. Serum levels of IL-10 were measured using an enzyme-linked immunosorbent assay (ELISA) kit. Results: Among the 35 DM patients with oral manifestations, xerostomia was the most common (80%). The mean serum IL-10 level was 0.93 pg/mL in non-DM patients, 0.80 pg/mL in DM patients with oral manifestations, and 1.08 pg/mL in DM patients without oral manifestations. Statistical analysis using the Kruskal–Wallis test showed a p-value of 0.008 (p ≤ 0.05), indicating a significant difference in serum levels of IL-10 between non-DM and DM patients with and without oral manifestations. Conclusion: DM patients with oral manifestations had lower IL-10 serum levels compared to non-DM patients and DM patients without oral manifestations. These findings suggest that monitoring IL-10 levels could help identify diabetic patients at higher risk for oral complications. [ABSTRACT FROM AUTHOR]

Introduction: Oral mucosal wounds present significant clinical challenges due to their susceptibility to infection, inflammation, and delayed healing. The limitation of standard anti-inflammatory drugs (both steroidal and non-steroidal) highlights the urgent need for plant-derived alternative therapies. Granola potato (Solanum tuberosum L.) from Pangalengan, West Java, Indonesia, has shown promise due to its bioactive compounds. However, its potential for wound healing and anti-inflammatory effects, specifically for oral mucosal wounds, remains largely unexplored. Purpose: To evaluate the wound healing and anti-inflammatory activity of Granola potato peel ethanol extract (GPPEE) on the oral mucosa of Wistar rats based on histopathological analysis. Materials and Methods: Forty-eight Wistar rats were wounded on the palatal mucosa using a 4 mm punch biopsy and subsequently divided into four groups: placebo gel, 0.1% triamcinolone acetonide ointment (TCA), 4% GPPEE gel, and 6% GPPEE gel. The rats were euthanized on days 0, 1, 3, 7, and 14. Histopathological parameters assessed included fibroblast proliferation, collagen deposition, angiogenesis, and the presence of inflammatory cells. Results: Phytochemical screening revealed the presence of phenolic compounds, flavonoids, tannins, and alkaloids in the Granola potato peel ethanol extract (GPPEE). Significant differences in the number of inflammatory cells were observed on days 1, 3, 7, and 14 (p< 0.05), with the groups treated with 4% and 6% GPPEE gel initially exhibiting pro-inflammatory effects on day 3, followed by significant anti-inflammatory effects on days 7 and 14. The 6% GPPEE gel treatment demonstrated a notable increase in fibroblasts on days 1, 7, and 14 (p< 0.05), as well as collagen deposition on days 7 and 14 (p< 0.05). However, no significant difference was observed in angiogenesis (p> 0.05). Conclusion: The application of 4% and 6% GPPEE gel demonstrated superior wound healing efficacy compared to 0.1% TCA and exhibited comparable anti-inflammatory activity to 0.1% TCA. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the clinicopathological characteristics of oral squamous cell carcinoma (OSCC) patients and analyze the relationship between the degree of differentiation and factors including age, sex, stage, and tumor location in West Java, Indonesia. Patients and Methods: A retrospective cross-sectional study was conducted at the Central Referral and Teaching Hospital in West Java, Indonesia. The data were collected by reviewing medical records with International Classification of Diseases (ICD) codes C00-C06 from 2016 to 2023. Descriptive statistics were employed to summarize the clinicopathological characteristics of OSCC patients. Chi-square, rank Spearman tests, and contingency correlation coefficients were used to analyze the relationship between the degree of differentiation and various factors, such as age, sex, stage, and tumor location of OSCC. Results: Out of the 627 oral cancer patients, 70.49% were diagnosed with OSCC with a gender distribution of 45.7% males and 54.3% females, predominantly within the age range of 30– 49 (37.2%). Most OSCC cases were stage IV (37.7%), with the tongue identified as the most common site (68.8%). A consistent trend of higher well-differentiated and moderately differentiated OSCC by age and gender was observed. Statistical analysis revealed no significant correlation between age, gender, tumor location, and the degree of OSCC differentiation (p> 0.05). However, a statistically significant correlation was identified between the degree of OSCC differentiation and stage (p< 0.001, r=0.460). Conclusion: There is a correlation between the degree of differentiation of OSCC and stage, suggesting significant prognostic implications that can aid in treatment planning and outcome prediction. However, further studies are needed due to the lack of comprehensive data on risk factors and survival rates of oral cancer patients, which is essential for enhancing prevention and treatment strategies for OSCC. [ABSTRACT FROM AUTHOR]

Introduction: Human immunodeficiency virus (HIV) impairs immune function leading to oral mucosal lesions. While highly active antiretroviral therapy (HAART) has reduced the incidence of HIV-associated oral lesions (HIV-OLs), these lesions can still manifest across all HIV stages due to various patient-related factors. Purpose: To evaluate the occurrence of HIV-OLs and clinical characteristics across all HIV stages in people living with HIV (PLWH). Patients and Methods: Five patients aged 7 to 60 with canker sores visited the Oral Medicine Clinic. One newly diagnosed patient with stage II HIV had not yet started ART, while others in stages I, III, and IV were already receiving ART. Diagnosed oral lesions included recurrent intraoral herpes (RIH) in patients with stages I, II, and III; linear gingival erythema (LGE) in stages I; acute pseudomembranous candidiasis (APC) and oral hairy leukoplakia (OHL) in stages II; traumatic ulcers in stages III; erythema multiforme (EM) and angular cheilitis (AC) in stages IV. Potential risk factors for these oral lesions included poor oral hygiene, low CD4+ T-cell counts, detectable viral load, non-adherence to ART, smoking, medication use for systemic diseases, nutritional deficiency, and comorbidities. Results: Treatment included antiviral for RIH; antifungal for APC and AC; topical corticosteroid and antiseptic mouthwash for oral ulcers and improving oral hygiene; application of normal saline-soaked gauze dressing followed by topical steroid for EM; petroleum jelly for dry lips; and multivitamins. Lesions improved over 5– 15 days. Addressing risk factors involved improving oral hygiene, treating comorbidities, promoting weight gain, smoking cessation, and starting ART for those untreated. Conclusion: Oral lesions are prevalent throughout the stages of HIV and are influenced by immune status, medication adherence, and overall health, underscoring the need for holistic care to enhance the quality of life, potentially alter HIV progression, and reduce morbidity through integrated oral health assessments in routine care. [ABSTRACT FROM AUTHOR]

Human Immunodeficiency Virus (HIV) infection has been a global concern since its discovery in 1984 due to its high morbidity and mortality rates. Currently, over 75 million people worldwide have been infected with HIV, and 37 million individuals are living with the virus. Oral manifestations may serve as significant diagnostic and prognostic indicators for HIV/AIDS patients. This study was conducted to analyze research articles on oral manifestations in HIV/AIDS patient using visual mapping methods from 1987 to 2023. Articles were extracted from Scopus and screened using advanced search with keywords "Human Immunodeficiency Virus" and "oral manifestation line". The contributions made by authors, journals, institutions, and countries were described using Microsoft Excel 2010 and VOSviewer. A total of 1574 articles were collected between 1987 and 2023. Countries that published the most articles were United States, India and Brazil. The top three authors are Deborah Greenspan, John S Greenspan, and Lauren L Patton, from United States with number of articles respectively 43, 39, and 23. Oral Surgery and the Journal of Oral Pathology & Medicine ranked as the top two, with 92 and 78 articles respectively. The central themes of the articles are oral candidiasis and oral hairy leukoplakia, followed by periodontal disease, Kaposi's sarcoma, and xerostomia. Oral manifestations in HIV/AIDS patients continue to be a persistent issue, particularly in countries with high prevalence, such as Africa and Asia. The limited coverage of certain topics in existing articles presents potential research opportunities for the future. [ABSTRACT FROM AUTHOR]

Introduction: Studies on head and neck cancer (HNC) patients undergoing radiotherapy have revealed increased numbers of Candida spp., leading to oral candidiasis and oral mucositis. The effects of laser therapy on Candida spp. have been studied with varied results. This study aimed to investigate the effect of low-level laser therapy (LLLT) on C. albicans colonies isolated from HNC patients undergoing radiotherapy. Methods: This study included a treated group, wherein 11 C. albicans isolates were obtained from the saliva of HNC patients undergoing radiotherapy at a dose exceeding 30 Gy. The control groups consisted of an untreated negative control and a positive control treated with nystatin. The treatment groups were subjected to LLLT in continuous mode for 50 seconds at a wavelength of 976 nm, 0.1 W at a dose of 5 J/cm2 for Laser 1 (L1) group and 0.2 W at a dose of 10 J/cm2 for Laser 2 (L2) group. The tests were conducted using C. albicans inoculum equivalent to a 0.5-McFarland suspension on 96-well plates. All test group inoculums were then cultured on Sabouraud dextrose agar (SDA), and the colony count was assessed at 104 CFU/mL. Results: LLLT at 5 and 10 J/cm2 reduced C. albicans colonies by 7.01% and 10.94%, respectively, but the reductions were not statistically significant (P > 0.05). Nystatin eliminated all the colonies. Conclusion: LLLT shows potential for reducing C. albicans colonies in HNC patients undergoing radiotherapy. However, further studies with varied parameters and methods are necessary. [ABSTRACT FROM AUTHOR]

This study aimed to report the clinical profile of individuals with non-syndromic cleft lip with or without palate (NSCL/P) during community services in Indonesia in the period 2020-2022. We conducted a retrospective study of NSCL/P cases treated during community services in four provinces in Indonesia (West Java, Riau, South Sulawesi, and West Nusa Tenggara), for the period from 2020 to 2022. The medical records of the subjects found to be incomplete were excluded from the study. The chi-square tests were performed to calculate the relationship between gender, the type and the site affected of orofacial cleft. Total of 4565 individuals with NSCL/P registered during community services in the study period. The majority of the subjects were males (62.3%), in the age group of 3-6 months (24,18%). The most common cleft type was cleft lip (55.4%), and unilateral was the most prevalent site affected (80,5%). There was no significant relationship between the type of cleft and gender (p>0.05), but we found a significant relationship between cleft type and age (p<0.001) and the site affected (p<0.001). The most performed treatment was labiaplasty (56.1%), followed by palatoplasty (25.5%). The NSCL/P in this study were more common in males. The most frequent cleft type and treatment were unilateral cleft lip and labiaplasty. Cleft type was significantly associated with age and the site affected, but not with gender. Future research should consider investigating the risk factors of NSCLP that may explain the high prevalence of orofacial clefts in Indonesia. [ABSTRACT FROM AUTHOR]

Objective to evaluate the effect of calcitriol and cisplatin combination on MAPK2, p65, and NF- κB in OSCC CAL27 cell line. Using real-time polymerase chain reactions (PCR), we investigated the anti-proliferative and apoptotic effect of calcitriol-cisplatin combination on oral squamous cell carcinoma (OSCC) CAL27 cells by evaluating the expression MAPK2, NF-κB and its p65 subunit. The combination of calcitriol and cisplatin 36.91 ppm was more effective in decreasing MAPK2, p65, and NF-κB expression compared to cisplatin and calcitriol groups. The treatment of combined calcitriol and cisplatin on OSCC CAL27 cells led to decrease MAPK2, p65 and NF-κB expression resulting in inhibit cells proliferation and induce apoptosis. In CAL27 cells, the combination of calcitriol and cisplatin inhibits cell proliferation and induces apoptosis more potently than either substance alone, via downregulation of MAPK2, p65, and NF-κB. These effects of calcitriol demonstrate its potential as an effective adjuvant therapy for OSCC. [ABSTRACT FROM AUTHOR]

Introduction: Pain management becomes important in the treatment of oral mucosal diseases since it can impair the quality of life. Photobiomodulation (PBM) as an alternative therapy, has potency in reducing pain through several mechanisms targeting peripheral nerves in the target tissue.Purpose: To discuss the effectiveness of PBM in the management of four cases of oral mucosal diseases.Case: Four patients, two females and two males, with an age ranging from 24 to 63 years came to the Oral Medicine Department complaining of painful lesions in their oral cavity. Three cases showed ulceration of the oral mucosa and had been diagnosed with recurrent aphthous stomatitis, recalcitrant chronic ulcer, and non-specific chronic sialadenitis. One patient who complained of intense pain and swelling on the right side of the face was diagnosed with post-herpetic neuralgia (PHN).Case Management: PBM was administered in all four cases (976 nm diode laser, three cases with spot size 0.01 cm2, fluency 10 J/cm2, and one case with spot size 0.5 cm2; fluency 3 J/cm2). Visual analog scale (VAS) control was performed before and after the PBM at each visit. The recorded VAS results show a reduction in pain that started at the post-laser time, with VAS before PBM ranging from 5 to 7 and after PBM ranging from 0 to 4. Three patients were given triamcinolone acetonide 0.1%, chlorhexidine gluconate 0.2% mouthwash, petroleum jelly, and multivitamins. One patient was given mefenamic acid and multivitamins.Conclusion: PBM can be a useful adjunctive treatment to relieve the pain of oral mucosal diseases due to its ability to reduce pain intensity. [ABSTRACT FROM AUTHOR]

Aim: The primary aim of this study was to analyze differences in total antioxidant capacity (TAOC) levels in patients with HIV/ AIDS compared with healthy individuals. The secondary aim of this study was to investigate factors that may contribute to the TAOC level in patients with HIV/AIDS including viral load, CD4 counts, and oral lesions. Materials and Methods: This research was a cross-sectional study. Fifty-eight samples from patients with HIV/AIDS and healthy individuals were calculated using the purposive sampling method. The TAOC level from the stored biological material was measured using enzyme-linked immunosorbent assay (ELISA) with the colorimetric method. The data were analyzed statistically using the chi-square to see the difference in TAOC levels between HIV and healthy individuals. Spearman's correlation test was used to analyze the correlation between TAOC and other contributing factors. Results: The serum samples were collected from 35 patients with HIV/AIDS (74.3% men and 25.7% women) and 23 healthy individuals (65.2% men and 34.8% women). The samples were mostly obtained from healthy individuals aged 25-34 and 35-44 years old with a 47.8% and 37.1%, consecutively. Similarly, the HIV/AIDS samples are also dominated by the same age group which shares the exact percentage of both groups (37.1%). The TAOC level in patients with HIV/AIDS was lower significantly than the healthy individuals (P < 0.05). However, the TAOC level had a very weak statistical correlation with viral load (P = 0.03), CD4 (P = 0.46), and oral lesions (P = 0.44). Conclusions: In this study, the TAOC level in patients with HIV/AIDS was lower than the healthy individuals, and did not correlate to the number of viral loads, CD4 cell count, and oral lesions of patients with HIV/AIDS. [ABSTRACT FROM AUTHOR]

Actinomyces odontolyticus is an anaerobic gram-positive bacterium that rarely causes necrotizing ulcerative gingivitis (NUG). A 15-year-old male was referred to Oral Medicine Clinic with acute myeloblastic leukemia (AML) and long coronavirus disease 2019 (COVID-19) syndrome. The chief complaints were pain, spontaneous gum bleeding, and foul-smelling breath. Extraoral examination showed an anaemic, asymmetrical face, swelling at the left buccal, and lymphadenitis. Intraoral examination showed localized gingival enlargement, tend to bleed, crater-like with punched-out of interdental papilla at posterior left mandibular gingiva, and deep caries in tooth 36. Oral microbiological examination revealed Actinomyces odontolyticus. He was diagnosed with NUG. The treatment included debridement with 1.5% hydrogen peroxide followed by 0.9% NaCl, 0.12% chlorhexidine digluconate mouthwash, metronidazole tablets 500 mg, and amoxicillin-clavulanic acid tablets 500 mg/125 mg. In conclusion, NUG caused by Actinomyces odontolyticus in a leukemic child that may relate to pulmonary long COVID-19 syndrome is particularly rare. [ABSTRACT FROM AUTHOR]

This study aimed to determine the value of salivary parameters (volume, pH, and calcium levels), calcium intake, and bleeding on probing (BOP) in women with type 2 diabetes mellitus (T2DM) who consume oral hypoglycemic agents (OHAs) and to compare them with women with T2DM who do not consume OHAs and healthy subjects. This cross-sectional study includes 24 women with T2DM (12 who consumed OHAs and 12 who did not consume OHAs), and healthy subjects as controls (n=35). The sampling technique was non-random sampling. The salivary volume was measured using the spitting method. The pH paper test was used to determine the salivary pH score. Salivary calcium levels were determined using an atomic absorption spectrophotometer (AAS). The semi-food frequency questionnaire (FFQ) method was used to determine calcium intake. BOP was measured by the method described by Ainamo and Bay in 1975. The Kruskal-Wallis test was used to compare variables among study groups, followed by post hoc Dunn's test. This study discovered significant differences in salivary parameters and BOP between subjects with T2DM (both consume and do not consume OHAs) and healthy subjects, but not between subjects who consume and do not consume OHAs. The difference in calcium intake between the three study groups is not statistically significant. Women with T2DM have lower salivary volume, pH, and calcium levels, as well as a higher BOP than healthy subjects. These variations were discovered to be caused by the manifestation of the disease rather than OHAs consumption. [ABSTRACT FROM AUTHOR]

The use of lasers in dentistry aims to overcome the disadvantages experienced in conventional treatment procedures. In the Oral Medicine field, the laser can be used as a primary or adjunctive therapy for oral mucosal diseases. This review aimed to evaluate the effectiveness of laser therapy in patients with a diagnosis of oral mucosal diseases, including oral mucositis, oral leukoplakia, oral lichen planus (OLP), and stomatitis aphthous recurrent (RAS). This research was a systematic review that followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The articles were obtained from the PubMed database from 2016 to 2021 with no age and sex restrictions. The inclusion criteria include the article was written in English, the study was conducted on humans designed with a Randomized Controlled Trial, Clinical Trial, or Cohort Study, and the research subjects were patients with oral mucositis, or oral leukoplakia, or OLP, or RAS. Exclusion criteria included comments, letters to editors, case reports, review articles, and conference papers. The initial search identified 316 articles, then 72 full-text articles were examined, and only 13 of them met the inclusion criteria. The clinical outcomes of all studies analysed indicated that laser therapy could reduce pain and bleeding, exhibit anti-inflammatory and antibacterial effects, accelerate the healing process, and reduce complications and recurrence rate of oral lesions including oral mucositis, oral leukoplakia, OLP, and RAS. Laser therapy is an advanced modern technology that has been proven to be effective in the treatment of oral mucosal diseases with many advantages. [ABSTRACT FROM AUTHOR]

Inherited Dystrophic Epidermolysis Bullous (DEB) is a rare disease, a subtype of Epidermolysis Bullous (EB) due to mutations in collagen VII, COL7A1. The clinical features of DEB were mucocutaneous blisters, hemorrhagic bullous, and secondary erosions due to minor mechanical trauma. Oral manifestations of DEB can affect the patient's Quality of Life (QoL). The objective of this case report is to describe the oral manifestation of DEB and its management to improve the QoL in a pediatric patient. A 12-year-old girl was referred to Oral Medicine Clinic with a chief complaint of pain throughout the oral mucosa. Based on the OHIP-14 assessment, the patient's QoL was categorized as poor with a score of 46. Extraoral examination revealed clear fluid-filled hemorrhagic bullous lesions and multiple erosive lesions over mostvof the body. Intraoral examination revealed hemorrhagic bullae on the left side of the buccal mucosa and erosive lesions on the mucobuccal folds. Hyperkeratotic lesions were found on the dorsum of the tongue that could not be scraped off. Diagnosis of DEB was established based on histopathology from the left-thigh skin which showed acantholysis with blister formation in the subepidermal layer. The patient was given systemic and topical corticosteroids, antiseptic mouthwash, and multivitamins. Oral lesions were improved after 5 weeks of treatment. Improvement of oral mucosal lesions appeared to be a particularly successful management intervention in improving the QoL for a pediatric patient with DEB. [ABSTRACT FROM AUTHOR]