Background: Enterococcus faecalis is the frequent cause of oral infections, such as periodontitis, infected root canals, and peri-radicular abscesses. Pineapple (Ananas comosus) fruit contains bromelain, one of proteolytic enzymes associated with several health benefits. Bromelain has been shown to promote healthy digestion, stimulate the immune system, improve cardiovascular conditions, and accelerate wound healing. Bromelain compounds possess antiinflammatory and anticancer properties and exhibit antibacterial activity. Objectives: To analyze the enzymatic activity of bromelain extracted from pineapple hump and investigate the antibacterial effect of bromelain against E. faecalis. Methods: Pineapple hump was dried and extracted with maceration technique. Further purification was obtained by ammonium sulfate fractionation, dialysis and ion exchange chromatography. Minimum inhibitory concentration (MIC) test using diffusion and dilution techniques tested the antibacterial activity of the bromelain extract towards E. faecalis. A one-way analysis of variance (ANOVA) test analyzed the significance of the differences in the E. faecalis inhibition zones after treatment with a range of bromelain extract concentrations. Differences were considered statistically significant if p < 0.05. Results: The specific activity of bromelain in the crude extract was 62.89 U/mg. Furthermore, bromelain activity using ammonium sulfate fractionation was 50.99 U/mg, dialysis was 54.59 U/mg, and ion exchange chromatography was 152.38 U/mg. The bromelain extract showed effective inhibitory and bactericidal activity against E. faecalis. The results of the inhibition test using a bromelain extract purified by ion exchange chromatography demonstrated that a concentration as small as 12.5% was effective in inhibiting the growth of E. faecalis (p < 0.05). Conclusion: The highest enzymatic activity of bromelain was found after purification with ion exchange chromatography. Bromelain exerted an antibacterial effect against a potent endodontic pathogen, but further studies are needed to explore this effect.

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Background: Biofilms are involved in a wide variety of microbial infections, including dental caries and periodontitis. The use of probiotics has been a promising prevention and treatment modality with which to combat biofilm-related diseases in the oral cavity. The probiotic Lactobacillus reuteri has been proven to reduce gingivitis and plaque index inside the oral cavity. These bacteria can be found in the digestive system and also in the human oral cavity. Objective: The aim of this study was to identify L. reuteri in the saliva of Indonesian young adults. Methods: Forty saliva samples were collected from 18–24 year-old Indonesian subjects. DNA extraction was performed, and then, the identification of L. reuteri was accomplished using PCR. Six subjects showed positive results. The positive samples were cultured in Rogosa Agar for 24 hours at 37°C anaerobically. Several single colonies were further cultured separately in broth medium before DNA extraction and PCR identification were performed. The four thickest bands were selected for DNA sequencing. Results: An analysis performed using BLAST showed that two of the L. reuteri strains obtained from the Indonesian saliva isolates had 96% (isolate 3.11) and 95% (isolate 5.14) values. This confirmed the presence of new strains based on average nucleotide identity (ANI). The isolate strains of 3.11 and 5.14 have been registered at DDBJ/EMBL/GenBank under the accession number LC382415 and LC382416, respectively. Conclusion: L. reuteri novel strain can be isolated from the saliva of Indonesian young adults. Further studies involving biochemical tests and phenotypic analysis are needed to better understand these new L. reuteri strains.

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Background: Angiosarcoma is a rare malignant tumor, which most often occurs in the skin and soft tissue. Its occurrence in the head and neck region, and the intraoral region in particular, is uncommon. The aim of this case report is to highlight the importance of histopathological examination and to underscore the characteristic features of angiosarcoma. Case report: A 52-year-old female presented with a growth in the right maxillary portion of the interdental region of her molar teeth. The growth had been present for approximately one month. A computerized tomography (CT) scan showed metastatic tumors in the lungs, liver, bone, and soft tissue of maxillary gingiva. Intraoral examination found a soft and mobile pedunculated ovoid mass at the right palatal gingiva; the mass was reddish-blue in color. An incisional biopsy was performed to confirm the diagnosis and plan for further treatment. Histopathologic examination revealed malignant endothelial cells in a vasoformative growth pattern, with numerous vascular channels lined with neoplastic endotheliumforming intraluminal buds, projections, and papillae. These projections were interspersed with the tumor cells. Immunohistochemistry analysis showed these endothelial cells demonstrated strong positive immunoreactivity with CD31, factor VIII, and FLi-1. A diagnosis of angiosarcoma was made. Discussion: Because intraoral angiosarcoma is rare and its clinical presentation can resemble other vascular lesions, it can be a challenging diagnosis for clinicians and pathologists. In the present case, the diagnosis of intraoral angiosarcoma was made based on clinical and histopathology findings. The microscopic features of malignant endothelial cells and the presence of intraluminal projections, supported by positive immunoreactivity with CD31, factor VIII, and FLi-1, confirmed the diagnosis. Conclusion: Angiosarcoma poses a diagnostic challenge to dental practitioners and oral pathologists due to the rarity of occurrence in the oral cavity. Histopathological examination is critical for an accurate diagnosis.

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Background: Pain is a common problem encountered after fixed orthodontic appliance placement. Pain from orthodontic treatment can come from ischemia, inflammation, and edema in the periodontal ligaments that were depressed. Objectives: To determine whether there are differences in the pain reduction associated with chewing gum, taking acetaminophen, and gargling green tea after fixed orthodontic appliance placement. Methods: This study is a quasiexperimentwith a controlled randomized post-treatment approach using 40 subjects. The subjects were consecutively selected and then randomly assigned into four equal groups: a group assigned to chewing gum, a group assigned to take acetaminophen, a group assigned to gargle green tea, and a control group. The level of pain was measured using a Visual Analogue Scale (VAS). A one-way ANOVA test was used to analyse differences between the groups. Results: The VAS scores of the chewing gum and acetaminophen groups were lower than the green tea and control groups. At 24 hours after fixed orthodontic appliance placement, only the chewing gum group reported a decrease in the amount of pain experienced. Overall, the chewing gum group reported the lowest pain scores compared to other groups. However, there was no overall statistically significant difference between the chewing gum and acetaminophen group (p>0.05). Additionally, there was no statistically significant difference in the amount of pain reduction experienced by the green tea group and the control group (p>0.05). There was a significant difference in the amount of pain reduction reported between the chewing gum or acetaminophen groups and the green tea group (p<0.05). Conclusion: There was no significant difference between chewing gum and taking acetaminophen in the amount of pain reduction experienced after fixed orthodontic appliance placement, but gargling with green tea was found to be significantly less effective in reducing pain. Because it has fewer side effects, chewing gum may be a more preferable alternative to taking acetaminophen to reduce pain after fixed orthodontic appliance placement.

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Background: X-ray examinations are still a frequent diagnostic tool used by doctors in Indonesia. However, there is an apparent lack of descriptive data regarding the size and location of the maxillary sinus in Indonesian people. Objective: The aim of this study is to provide descriptive data on the size and location of the maxillary sinus among patients in the city of Bogor, West Java, Indonesia. Methods: Sixty eligible subjects aged 17 to 70 years old were randomized into six groups: male and female patients between 17 and 25 years old; male and female patients between 26 and 45 years old; and male and female patients aged 46 or older. Radiographic pictures were taken using the X-mind Novus Digital Panoramic X-ray unit and data were measured using the software Digora for Windows. Results: Using an analysis of variance, we found that men have significantly larger maxillary sinus dimensions than women (79.05 mm compared to 66.33 mm). It also reveals that there are significant differences (p<0.05) between male and female groups; whereas 2 groups aged less than 46 years old are significantly different with group aged 46 years or older in both gender. Conclusion: The study demonstrates that the size and location of maxillary sinus differ significantly between men and women in Bogor and that they follow a specific trend.

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