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All Journal Journal of Dentistry Indonesia Interdental Jurnal Kedokteran Gigi (IJKG) Makara Journal of Health Research
Subarnbhesaj, Ajiravudh
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Biochemistry, Genetics & Molecular Biology Dentistry Medicine & Pharmacology Public Health

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Oral Manifestations of Renal Osteodystrophy in a Patient with Systemic Lupus Erythematosus with Chronic Renal Failure and Secondary Hyperparathyroidism: A Case Report Riyachan, Inthivorn; Subarnbhesaj, Ajiravudh; Sarideechaigul, Wilairat; Klanrit, Poramaporn
Journal of Dentistry Indonesia Vol. 26, No. 3
Publisher : UI Scholars Hub

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Abstract

Systemic lupus erythematosus (SLE) is one of the chronic autoimmune diseases that leads to multiple manifestations in several organ systems, including chronic renal failure (CRF). Renal osteodystrophy (ROD) is one of the most common complications of CRF associated with secondary hyperparathyroidism (HPT). A combination of CRF and HPT can result in broad-spectrum disorders in the metabolism of minerals such as calcium, phosphorus, and vitamin D, which can affect bone turnover, mineralization, and volume. Radiographic alterations of ROD are considered as one of the earliest signs of CRF. Objective: To describe the oral manifestations in both the maxilla and mandible of a patient with ROD resulting from SLE with CRF and secondary HPT. Case report: A 37-yearold female patient visited the Faculty of Dentistry, Khon Kaen University, for the management of traumatic ulcers on the left and right buccal mucosa and generalized maxillary and mandibular bony hard swellings with mild paresthesia in the lower left mandible for a period of 4 months. The patient had been suffering from SLE for approximately 20 years. However, secondary HPT and CRF as consequences of refractory SLE were being treated concomitantly. Intraoral examination showed several nonpainful ulcers on the left and right buccal mucosa. Radiographic findings revealed generalized loss of lamina dura with thinning of cortical outlines of the maxilla and mandible. Due to complications associated with treatment and the general conditions of this patient, she was referred for treatment to a palliative care unit. Conclusion: Systemic symptoms and complications of patient with ROD with CRF and secondary HPT are seriously problematic. The role of the dentist in this case is to detect the disease, lessen the complications, and make the patient experience minimal pain and side effects in palliative care.
Primary Amelanotic Melanoma of the Maxillary Gingiva: A Case Report Sungkhao, Wipasinee; Klanrit, Poramaporn; Jinaporntham, Suthin; Subarnbhesaj, Ajiravudh
Journal of Dentistry Indonesia Vol. 26, No. 3
Publisher : UI Scholars Hub

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Malignant melanoma arising in the oral cavity is particularly rare. The clinical presentations of malignant melanoma can range from a benign-looking pigmented macule or nodule to a non-pigmented neoplasm which can be categorized into primary or metastatic lesions. Less than 2% of all melanomas show no pigmentation and could lead to misdiagnosis. Objective: To present a benign looking but life-threatening malignancy of melanotic melanoma. Case report: A 59-year-old female patient was referred to a regional hospital for further treatment of a localized gingival swelling with no ulceration at the anterior maxilla. An incisional biopsy was performed, with initial histopathologic result of a peripheral giant cell granuloma. CT images demonstrated a locally invasive bone destruction compromising the buccal cortical plate. The second biopsy revealed a non- demarcated mass consisting of spindle-shaped to ovoid cells of variable sizes, shapes and staining characteristics, forming short fascicles of various directions in hyalinized and myxoid stroma with focal areas of necrosis, bone invasion and infiltration of vascular wall. The tumor cells strongly expressed Vimentin, S-100, HMB- 45 and Melan-A and the diagnosis of amelanotic melanoma was finally made. Conclusion: Oral amelanotic melanoma is extremely rare and difficult to diagnose because of the absence of melanin pigment. Immunohistochemistr y is a significant tool being used to establish the correct diagnosis.
Differential Diagnosis and Histopathological Analysis of Localized Gingival Overgrowths: Study of 218 Cases from Northeast Thailand Morilla, Lordjie Marr; Subarnbhesaj, Ajiravudh; Klanrit, Poramaporn
Journal of Dentistry Indonesia Vol. 27, No. 1
Publisher : UI Scholars Hub

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Localized gingival overgrowths (LGOs) are relatively common clinical findings. These lesions can be associated with chronic irritation, infections, or they can represent benign or malignant tumors that can either be primary or metastatic. The etiology of these lesions is multifactorial, but the most prevalent cause is reactive hyperplasia and inflammation induced by dental plaque. Objective: This study presents the prevalence of LGOs in Northeast Thailand and identifies the most common LGOs in the region. Methods: A series of 218 LGO cases was studied. Results: Pyogenic granuloma (PG), gingival squamous cell carcinoma (GSCC), and peripheral ossifying fibroma (POF) were the three most common LGOs in this study. There were also interesting cases of soft tissue counterparts of benign odontogenic tumors and metastatic carcinomas to the gingiva with no evidence of bone invasion observed. Conclusion: The three most common LGOs in Northeast Thailand were PG, GSCC, and POF. This study provides baseline data on the prevalence of LGOs in Northeast Thailand.
An experimental model of chemically-induced ulceration of the buccal mucosa of Mus musculus Idrus, Erik; Hartanti, Pratiwi Dwi; Suniarti, Dewi Fatma; Prasetyo, Sri Redjeki; Wimardhani, Yuniardini Septorini; Subarnbhesaj, Ajiravudh
Makara Journal of Health Research Vol. 23, No. 3
Publisher : UI Scholars Hub

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Background: Ulceration caused by chemical agents used in dental practice for in-office or home-used is a common event, resulting in discomfort and pain. Treatments for such conditions are still being developed, requiring extensive experiments both in vitro and in vivo studies. At present, a standardized experimental mouse model for mucosal ulceration caused by a chemical inducer to study the pathogenesis of ulceration and to develop medications for treatment of ulceration is still not available. The aim of this study was to create a chemically induced model of ulceration of the buccal mucosa of mice. Methods: An in vivo study model of ulceration using a total of 9 mice (Swiss Webster) was performed. All mice received 70% acetic acid application on the left buccal mucosa, while the right buccal mucosa received only saline. Clinical and histological observations of ulcer formation and healing were performed, including the presence of redness and swelling, ulcer diameter, bodyweight as well as epithelial disintegration, dilation of blood vessels, and infiltration of inflammatory cells. Results: Buccal mucosa application of 70% acetic acid generated ulcers on day 2, reached its peak on day 3 and recovered by day 14. The histological features of inflammation were also seen in the ulcer model, and the degree of inflammation was consistent with the day of ulcers. Conclusion: Chemical trauma by the administration of 70% acetic acid effectively induce ulceration on buccal mucosa in mice, and this method can be considered as a novel, reproducible, and clinically relevant model to study pathogenesis and therapeutic approach for treating oral mucosal ulceration.
Presence of Klebsiella Pneumoniae on Black Hairy Tongue as Oral Microbiome Dysbiosis Bakti, Reiska Kumala; Pradnyani , I Gusti Agung Sri; Subarnbhesaj, Ajiravudh; Radithia, Desiana
Interdental Jurnal Kedokteran Gigi (IJKG) Vol. 21 No. 2 (2025): Interdental Jurnal Kedokteran Gigi (IJKG)
Publisher : Fakultas Kedokteran Gigi, Universitas Mahasaraswati Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46862/interdental.v21i2.12176

Abstract

Introduction: Black hairy tongue (BHT) is a benign condition characterized by discoloration and elongation of filiform papillae. Although asymptomatic, it can trap microorganisms, potentially contributing to oral dysbiosis. The pathogenesis is still unclear, but smoking, drugs, alcohol, or excessive coffee/tea consumption trigger it. Diagnosis relies on history-taking, clinical assessment, and occasionally microscopic evaluation. This case report aims to show an interesting finding in the microbiological examination of black hairy tongue. Case: A 33-year-old male smoker and coffee drinker presented with black tongue discoloration. Any medication use and a history of systemic diseases are denied, but he had a habit of smoking, staying up late, and heavy coffee consumption. Case Management: Clinical assessment and microbiological swab analysis for bacterial and fungal identification were conducted. Microbiological examination revealed the presence of Klebsiella pneumoniae, a colonizing opportunistic pathogen. Discussion: The patient reported no systemic diseases or medication use, with lifestyle factors identified as potential triggers. This case underscores the role of lifestyle factors and oral hygiene in the development of BHT and its association with microbial dysbiosis. Conclusion: The detection of K. pneumoniae emphasizes the need for microbial evaluation in persistent cases to prevent potential systemic effects.
Co-Authors Desiana Radithia, Desiana Dewi Fatma Suniarti Erik Idrus Hartanti, Pratiwi Dwi Jinaporntham, Suthin Klanrit, Poramaporn Morilla, Lordjie Marr Pradnyani , I Gusti Agung Sri Prasetyo, Sri Redjeki Reiska Kumala Bakti Riyachan, Inthivorn Sarideechaigul, Wilairat Sungkhao, Wipasinee Yuniardini Septorini Wimardhani