Recurrent aphthous stomatitis (RAS)is a common oral mucosal disease in human. This disease affect 20-25% of
population. The etiology remains unclear, but some of cytokine such as TNF-α is suspected to contribute in the
pathogenesis of RAS. TNF-α is commonly measured by PBMC and lesional biopsy. These are invasive method and
high skilled requirement. Another study used lesional swab to measure this cytokine without correlating the result
with TNF-α measured by PBMC level. This study aimed to asses TNF-α level correlation between lesional swab and
PBM of RAS patients. The study involved 10 subjects by inclusion criteria. Subjects have lesion swab and PBMC
examined. Samples were analyzed by ELISA method. There is a correlation between lesional swab and PBMC of
TNF-α level RAS patients but this correlation did not statistically significant.

Individual perceptions towards denture wear’s are different from one to another, which are affected by number and
location of missing teeth, age, sex, functional factors, esthetic, cultural factors, socioeconomy and education. The
purpose of this study is to analyze the perceptions towards denture replacement among a rural community who
experienced tooth loss based on age groups, sex and education in Desa Ujung Rambung Kecamatan Pantai Cermin
Kabupaten Serdang Bedagai in February 2010. This study was an analytical observatory study. Samples are 200
subjects who lost at least one tooth, excluding third molar. Chi-square test shows no significant difference between
perceptions of appearance, mastication and speech and age groups, no significant difference between perceptions of
appearance, mastication and speech and sex, and no significant difference between perceptions of mastication and
speech and education (p>0,05), but shows statistically significant difference between perception of appearance and
education (p=0,004). It can be concluded that the overall perceptions of the rural community is poor.

Complete tooth eruption, especially canine, will affect facial esthetic and the harmony. Surgical procedure will help
to expose an impacted tooth determining orthodontically into dental arch. Clinical and radiographic examination
should be taken for locating the position of the tooth. The flap was designed differently between labially or palatally
impacted canine. A 16 years old female came to clinic with Class III Angle dental and skeletal malocclusion with an
impacted of upper left canine. She was treated with fixed orthodontic appliance using edgewise technique and
surgical exposure using closed-eruption technique. The proper diagnosis and management between oral and
maxillofacial surgery, and orthodontics will guarantee good result.

Metal framework denture is needed in patient with tooth loss accompanied by the presence of periodontal disease in
the remaining tooth is needed. This denture primarily maintains the existing teeth post periodontal treatment. The
use of metal framework in this case can help to prevent tooth movement and maintain tooth position after
periodontal treatment. Therefore, the success of the treatment can be achieved because the metal characteristic is
more rigid when compared to other dental materials. This paper discusses the use of frame denture in patient after
periodontal treatment on the remaining teeth in lower arch. It can be concluded that removable denture with metal
frame combined with splint must be done on mobile teeth, to decrease mobile teeth and to prevent
increasing of periodontal tissue damage after periodontal treatment.

Dental bleaching is a process making teeth look whiter. Bleaching may be performed in two methods; by using
bleaching products or non-bleaching products. Bleaching products contain peroxide assisting to remove intrinsic
and extrinsic stain, resulting in the changing of original color of teeth. Non-bleaching products contain materials
that may work to remove extrinsic stain only, through both physical and chemical actions. The use of bleaching
products is not always safe, therefore, they should be assumed that their benefits are over their recognized
biological risk. The choice of bleaching method for children depends on type and depth of the stain, and discoloring.
Stain on the enamel surface can be removed by microabration, deeper stain is removed by bleaching. Besides using
approved by ADA/ISO, a dental practitioner should have knowledge about dental bleaching and its use at clinic and
at home, including its contraindication as well as side effect in order to provide an effective and satisfying dental
bleaching care.

Oroantral communication (OAC)may occur when upper posterior teeth are removed, and occasionally, as a result
of trauma. This sinus perforation formed particularly when a maxillary molar with widely divergent roots adjacent
to edentulous spaces is extracted. In this instance the sinus is likely to be pneumatized into the edentulous alveolar
processus surrounding the tooth, which weakens the entire alveolus and brings the tooth apices into a closer
relationship with the sinus cavity. In order to avoid OAC, preoperative radiograph is needed. When perforation, if
sinus opening is small and disease free, effort should be made to establish blood clot in the extraction site and
preserve it in place. Soft tissue flap elevation is not required. Sutures are placed to reposition the soft tissue, and a
gauze pack is placed over the surgical site for 1-2 hours. Majority of patients treated in this manner showed
uneventful healing when no evidence of preexisting sinus disease.

Tooth mobility is often experienced by patients, especially patients with periodontal disease. Periodontal disease
causes the loss of tooth support so the tooth becomes mobile. The signs of periodontal disease or periodontitis
include occasional bleeding gums, bluish red gums, shiny, and tooth mobility. Splint is used to unite one or more
teeth to form a single entity so that it can reduce tooth mobility. There are some splints used as supporting therapy
of periodontal disease patients to stabilize the tooth before further actions are carried out.