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"Oral lichen planus (OLP) is a rather common oral disease, mainly affecting adults, occurring more often in women than in men. The etiopathogenesis is still unclear. The diagnosis may be cumbersome, even in the presence of a biopsy. In addition, there are several lesions that may resemble lichen planus (lichenoid lesions) both clinicallyand histopathologically. Treatment of OLP can only be symptomatic and usually consists of topical application of corticosteroids. The disease is characterized by remissions and exacerbations and may persist in some patients lifelong. There is an ongoing debate in the literature as whether OLP is a potentially malignant disease. Because of this uncertainty, annual follow-up is advised."

"Lichen Planus is a chronic inflammatory disease that effects the skin and mucous membrane of squamous cell origin. Oral Lichen Planus can occur without the skin lesion and there are six types of the oral lesion, erosive, atrophic, bulla, papular, plaque like and retiqular. This disease can be caused by several factor, among them are antihypertensive drugs and emotional stress. In this case report we present a 43 years old female patient who suffered from several types of oral lichen planus that induced by ramipril, an antihypertensive drug, and emotional stress. There were some progressions after the drug was discontinued but the disease was worsening when emotional stress occured. The severity of the disease can be controlled by the use of topical corticosteroid and multivitamins."

"Oral lichen planus (OLP) is a chronic inflammatory condition that effects oral mucous membranes with a variety of clinical presentations including reticular, atrophic, plaque and ulcerative lesions. Corticosteroid is one of the effective therapy for OLP in reducing the sign and symptoms of this disease, but this therapy have a serious side effect, therefore to administering one must consider the patient?s systemic condition. We reported a case of OLP in 52 years old female patient who has no history of diabetes mellitus and unknown glucose level. Management of this patient included application of corticosteroid swish, topical 0.05% clobetasol propionate and 0,1% triamcinolone acetonide, antimycotics, improvement the oral hygiene status and referral to internal medicine specialist. The next treatments plan challenging because unstable blood glucose level which in turn effects the drug choice and teeth extraction plan. We concluded that the treatment of OLP requires a complete assessment of medical status and lab studies specially on the first visit so the drug selection with corticosteroid therapy and the treatment planning of predisposing factor are effective in reducing the sign and symptoms of OLP with minimum systemic side effect."

"Oral lichen planus (OLP) is a chronic inflammatory condition that affects the oral mucous membranes with a variety of clinical presentations, including reticular, atrophic (desquamative gingivitis) and ulcrative lesions. Treatment aims primarily to reduce the length and severity of symptomatic outbreaks. We report a case of OLP in 53 years old female patient with hypertension as underlying disease. The patient had been treated with nifedipine and reserpine for twelve years. Management of the patient included the application of 0.05% clobetasol propionate in a custom tray for erosive gingival lesions, nutritional supplementation, oral hygiene promotion and consultation to internal medicine specialist. The improvement of OLP requires a complete assessment of the medical status and elimination of local exacerbating factors. Systemic drug therapy is needed if OLP is suspected as the cause of oral lichenoid lesion. Changing to other drug regimes may also become necessary for improved immune status."

"Indonesian Journal of Dentistry 2006; Edisi Khusus KPPIKG XIV: 22-24Lichen planus is relatively common inflamatory disorder which may have cutaneous and/or mucosal manifestation. The maglinant potential of oral lichen planus is still debatable. Some authors are sceptical about the premaglinant nature of the disease, while other investigators have reporterd that maglinant transformation occur in 1-10% of the cases. The aim of this study is to report a case of erosive oral lichen planus which shows maglinant transformation on histopatologic examination. A man of 39 years old visited the Dental Departement of Kariadi's Hospital with pain symptom of palatum, buccal and gingival mucosa both side for 6 months. On the physical examination shows the white lesions with striae configuration and pain, red erosive area inside on the palatum extends to the buccal mucosa and the gingival. The suspect dignose is erosive lichen planus, but the histopathologic examination shows epidermoid carcinoma. lt is concluded that erosive oral lichen planus has the potential to transform into epidermoid carcinoma."

"Indonesian Journal of Dentistry 2006; Edisi Khusus KPPIKG XIV: 353-357Oral squamous cell carcinoma represents more than 90% of all oral cancers. Ten percent of the cases are found on the buccal mucosa and the gingiva. The World Health Organization defines a premalignant or precancerous lesion as a morphologically altered tissue in which cancer is more likely occur and includes oral leukoplakia, oral erythroplakia, and possibly oral lichen planus (OLP). The purpose of this study was to discuss the possibility of malignant transformation of OLP. The potency of OLP as a premalignant lesion is still an ongoing controversial discussion in the literature. The report a case of oral squamous cell carcinoma located on the left buccal mucosa accompanied by oral lichenoid lesions on the right buccal mucosa, lower labial mucosa, and left buccal mucosa. These findings led to a possibility of malignant transformation of the oral lichenoid lesions. Unfortunately, biopsy on the lichenoid lesions was not performed. Therefore, a definitive diagnosis of OLP could be established and the possibility of the lesions being dysplastic remained unclear. This study concluded that biopsy is mandatory to establish a definitive diagnosis of OLP and to investigate the possibility of dysplasia. It is necessary to perform examination of genetic alterations in dysplastic OLP in order to assess loss of heterozygosity (LOH), which may help to consider the risk of malignant transformation."

"Latar Belakang: Mukositis merupakan salah satu efek samping yang timbul akibat kemoterapi. Mukositis menyebabkan timbulnya rasa sakit, ketidaknyamanan, kesulitan berbicara, menelan, makan, minum, kekurangan nutrisi, kelemahan sistemik hingga infeksi. Probiotik mengandung mikroorganisme nonpatogen yang memberikan manfaat bagi kesehatan dan membantu dalam pencegahan inflamasi pada rongga mulut. Beberapa studi telah melaporkan manfaat probiotik bagi kesehatan oral. Tujuan: Menganalisis efek probiotik Lactobacillus casei terhadap keadaan klinis mukosa oral pada anak dengan Leukemia Limfositik Akut yang menjalani kemoterapi sebelum berkumur probiotik L.casei, setelah berkumur L.casei selama 7 hari dan 14 hari. Metode Penelitian: Penelitian dilakukan di RS Kanker Dharmais dan RS Kramat 128. Sebelas pasien yang memenuhi kriteria. Tiga hari setelah pemberian kemoterapi, peneliti memeriksa keadaan klinis rongga mulut menggunakan Oral Assessment Guide (OAG). Pasien kemudian mulai berkumur probiotik L.casei dua kali sehari selama 7 hari dan 14 hari. Skor OAG diperiksa kembali setelah berkumur probiotik L.casei selama 7 hari dan 14 hari. Hasil: Terdapat penurunan skor OAG yang bermakna antara sebelum berkumur dengan setelah berkumur probiotik L.casei selama 7 hari dan 14 hari. Kesimpulan: Probiotik L.casei memberikan efek pada anak dengan leukemia limfositik akut yang menjalani kemoterapi dan dapat menjadi terapi alternatif terhadap mukositis oral.

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Mucositis is one of the side effects induced by chemotherapy. It results in pain, discomfort, difficulties in talking, swallowing, eating, drinking, poor nutrition, systemic weakness and life-threatening infections. Probiotics contain nonpathogenic live microorganisms that give benefit to our health and help in preventing inflammation in the oral cavity. Several studies have reported the use of probiotics for oral health purposes. Objective: To analyze the effect of probiotic Lactobacillus casei to clinical appearance of oral mucosa in children with Acute Lymphocytic Leukemia that underwent the chemotherapy process before gargling, 7 days after gargling, and 14 days after gargling with probiotic. Methods: The study was held in National Cancer Hospital “Dharmais” and Kramat 128 Hospital. Eleven patients were meet the criteria. Three days after the chemotherapy started, the researcher checked the patient’s oral mucosa condition using Oral Assessment Guide (OAG). Then the patient started to gargle the probiotic twice a day for 7 days and the researcher rechecked the score of oral mucositis after 7 days and 14 days. Results: There was a significance decreasing OAG score between before gargling with 7 days and 14 days after gargling L.casei probiotics. Conclusion: L.casei probiotics gave effects in children with acute lymphocytic leukemia during chemotherapy and could be an alternative therapy for oral mucositis."

"Recurrent Aphthous Ulceration (RAU) is a type of local inflammation of the oral mucosa with symptomatic soft tissue damage. The prevalence of RAU is about 17-67 %. Dominant factors causing this disease are understood, but there are predicted internal and external factors that cause related immune disorders. RAU is initiated by mucous proteins which continuously stimulate a physiological response required for a pathophysiological reaction. The aim of this study was to characterize specific anomaly proteins in oral mucosa as causing the initiation of RAU. Samples of mucosal proteins from 30 RAU patients were analyzed with sodium dodexylsulphate polyacrylamid gelelectrophorese (SDS-PAGE) and visualized with silver stain (AgNO3) showing proteins with a range of molecular weight 27 - 180 kDa. Western blotting using a polyclonal antibody specific to RAU showed that the specific proteins of RAU have molecular weights of 23, 27, 65, 70 and 87 kDa. The finding of so many proteins appears to be a new phenomenon, suggesting that the initiation of RAU is possibly due to a continuous induction of internal and external reactions by several mucosal proteins, that become anomaly proteins of high reactivity and antigenicity. This situation can cause overreaction on the oral mucosa with specific symptoms that are known as a RAU."

"Indonesian Journal of Dentistry 2006; Edisi Khusus KPPIKG XIV: 12-16A case of chronic bullous type mucocutaneus disease involving oral mucosa was reported from a 56 years old man with never healed oral ulcers and wound on the perianal skin for three years. There were also red and black sports on the limb and back skin and a lesion on nail. Painful oral lesion consisted of mucous erosion, desquamative gingivitis, and sloughing area on palate and tongue. The patient is diabetic. The first perianal skin diagnosis was granulomatous candidiasis with differential diagnosis pemphigus vegetans and acuminatum condiloma. However, the histopathologic examination did not support those diagnosis. After several histopathologic examinations, the latest perianal skin diagnosis was lichen planus with differential diagnosis granulomatous vasculitis, bowenoid papulosis and pyoderma gangrenosum. Other skin diagnosis was erythema multiforme. Oral diagnosis was mucous membrane pemphigoid with differential diagnosis lichen planus, Behcet's syndrome and erythema multiforme oral histopathologic examination showed a sub-epithelial blister, which supported mucous membrane pemphigoid. A lip balm, prednisone 5 mg oral rinse and multivitamins were given but oral improvement started after blood sugar level controlled. Conclusion: lt is not yet known whether skin and oral mucous lesions are from the same disease or not."

"Stomatitis Aphtous Rekuren (SAR) merupakan kondisi inflamasi kronis yang terjadi pada mukosa mulut yang ditandai dengan terbentuknya ulser. Patch mukoadhesif dapat ditujukan untuk melindungi ulser dari lingkungan mulut dan meningkatkan efektivitas terapi RAS dengan memperpanjang durasi perlekatan. Kurkumin merupakan senyawa yang memiliki aktivitas antiinflamasi sedangkan brazilin memiliki aktivitas antimikroba yang keduanya dapat digunakan untuk terapi RAS. Oleh sebab itu, tujuan penelitian ini adalah membuat dan mengevaluasi patch mukoadhesif dari ekstrak kayu secang dan kurkumin untuk terapi RAS. Patch mukoadhesif dibuat dengan teknik solvent casting dengan menggunakan polikarbofil dan etil selulosa sebagai polimer. Bahan padat dilarutkan dengan etanol lalu ditambahkan plasticizer kemudian dituang ke dalam cawan petri. Patch dibuat dengan 3 formulasi kurkumin-ekstrak kayu secang yang berbeda, yaitu 1:1 (F1), 3:1 (F2), dan 1:3 (F3). Patch yang terbentuk dievaluasi sifat fisiko-mekanik serta profil pelepasannya. Patch memiliki bobot yang seragam dengan ketebalan kurang dari 0,1 mm. Nilai kekuatan tarik sekitar 10,0 N/cm2, kekuatan mukoadhesif berkisar 6,7 sampai 7,5 N/cm2 dan mampu melekat hingga 2 jam. Dalam waktu 2 jam, brazilin telah terdisolusi sebanyak 100,58 % (F1) hingga 104,75% (F3) sedangkan kurkumin terdisolusi sebanyak 97,15% (F3) hingga 101,64% (F1). Secara keseluruhan, patch dapat dibuat dan memiliki karakteristik fisiko-mekanik dan profil pelepasan obat yang baik.

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Recurrent Aphtous Stomatitis (RAS) is a chronic inflammatory disease of the oral mucosa characterized by the formation of ulcers. Mucoadhesive patch is designed to protect the ulcers from the oral environment and increase the effectiveness of RAS therapy by prolonging the duration of attachment. Curcumin is compound that have antiinflammatory activity while brazilin have antimicrobial activity, both of which can be used for RAS therapy. For those reasons, this study aimed to produce and evaluate mukoadhesive patch containing sappanwood extract and curcumin for RAS therapy. Mucoadhesive patch were prepared by solving casting method using polycarbophil and ethyl cellulose as polymers. The patch were made in 3 formulations with different concentration of curcumin and sappanwodd extract, namely 1:1 (F1), 3:1 (F2), and 1:3 (F3). Mucoadhesive patch were evaluated of physicomechanical properties and dissolution profile. The patch of all formulations have a uniform weight with a thickness of less than 0,1 mm. The tensile strength of the patch were around 10,0 N/cm2 and mucoadhesive strength were in range of 6,7 to 7,5 N/cm2 and was able to adhere for up to 2 hours. Within 2 hours, the release of brazilin reached 100,58 % (F1) to 104,75% (F3) while the release of curcumin was 97,15% (F3) to 101,64% (F1). In conclusion, the patch has been produced with good physicomechanical properties and drug release profile."