Background: Patients with rheumatoid arthritis (RA) may have more prevalent and severe periodontitis than healthy controls. Periodontitis may increase the systemic inflammation in RA. The aim of this study is to assess periodontitis prevalence and severity and its potential association with systemic inflammation in Indonesian patients with RA.Methods: A full‐mouth periodontal examination including probing depth, gingival recession, plaque index, and bleeding on probing was performed in 75 Indonesians with RA and 75 age‐, sex‐, and smoking‐matched Indonesian controls. A validated questionnaire was used to assess smoking, body mass index, education, and medical conditions. In addition, in all participants, the use of drugs was noted, and erythrocyte sedimentation rates and serum levels of high‐sensitivity C‐reactive protein (hsCRP), rheumatoid factor, and anti‐citrullinated protein antibodies were measured. Differences in periodontitis prevalence and 12 measures of periodontitis severity between patients with RA and controls were analyzed using univariate analyses.Results: No significant differences in periodontitis prevalence and 11 measures of periodontitis severity between patients with RA and controls were observed. Conversely, patients with RA had a significantly lower surface area of healthy pocket epithelium versus controls (P = 0.008), and a tendency toward higher hsCRP levels was observed in patients with RA with severe periodontitis compared with patients with RA with no mild or moderate periodontitis (P = 0.063). It has to be noted that all patients with RA were on anti‐inflammatory drugs, whereas none of the controls used such drugs.Conclusion: Prevalence and severity of periodontitis in Indonesian patients with RA is comparable to controls but with less healthy pocket epithelium than in controls and a tendency toward a higher inflammatory state in patients with RA and severe periodontitis.

Periodontitis may exert an infectious and inflammatory burden, evidenced by increased C-reactive protein (CRP). This burden may impair blood glucose control (HbA1c). The aim of our study was to analyze whether periodontitis severity as measured with the periodontal inflamed surface area (PISA) and CRP predict HbA1c levels in a group of healthy Indonesians and a group of Indonesians treated for type 2 diabetes mellitus (DM2). A full-mouth periodontal examination, including probing pocket depth, gingival recession, clinical attachment loss, plaque index and bleeding on probing, was performed in 132 healthy Indonesians and 101 Indonesians treated for DM2. Using these data, PISA was calculated. In addition, HbA1c and CRP were analyzed. A validated questionnaire was used to assess smoking, body mass index (BMI), education and medical conditions. In regression analyses, it was assessed whether periodontitis severity and CRP predict HbA1c, controlling for confounding and effect modification (i.e., age, sex, BMI, pack years, and education). In healthy Indonesians, PISA and CRP predicted HbA1c as did age, sex, and smoking. In Indonesians treated for DM2, PISA did not predict HbA1c. Periodontitis may impair blood glucose regulation in healthy Indonesians in conjunction with elevated CRP levels. The potential effect of periodontitis on glucose control in DM2 patients may be masked by DM2 treatment. Clinical relevance: periodontitis may impair blood glucose control through exerting an inflammatory and infectious burden evidenced by increased levels of CRP.

Indonesian subjects with DM2 had more prevalent and more severe periodontitis than healthy Indonesian subjects, independent of confounding factors or the methods used to operationalize periodontitis.

We built the photoacoustic imaging (PAI) systems to image oral soft tissue. To reduce the cost and size significantly, the PAI system used an intensity-modulated continuous-wave (CW) diode laser with a wavelength of 532nm and output peak power of 200mW as an excitation source, combined with a condenser microphone as photoacoustic signals detector. The Pulse Width Modulation technique was applied to form a square wave fluctuation of laser radiation by using certain duty cycle on singlefrequency of 17.8 kHz. Sample of this study was Sprague Dawley rats tongue on plasticine media, irradiated by modulated CW diode laser. The result of this study showed that modulated laser exposure on one certain spot of the sample produced PA-signals in polynomial correlation with a duty cycle of laser modulation. Based on it, the photoacoustic imaging then was done by using gradual duty cycles, i.e., 20%, 30%, and 40%. This study also showed that using CW diode laser which is modulated with low duty cycle can produce most accurate PA image, as well as keeping the sample from the high energy of laser exposure that may cause biological changes. Furthermore, the maximum duty cycle to modulate laser for oral soft tissue imaging in this system was 30%.

Introduction: Imaging technologies have been developed to assist physicians and dentists in detecting various diseases. Photoacoustic imaging (PAI) is a new technique that shows great applicability to soft tissues. This study aimed to investigate the effect of diode laser intensity modulation on photoacoustic (PA) image quality. Methods: The prototype of the PAI system in this study utilized a non-ionizing 532 nm continuouswave (CW) diode laser illumination. Samples in this study were oral soft tissues of Sprague-Dawley rats fixed in 10% formalin solution. PA images were taken ex vivo by using the PAI system. The laser exposure for oral soft tissue imaging was set in various duty cycles (16%, 24%, 31%, 39%, and 47%). The samples were embedded in paraffin, and PA images were taken from the paraffinembedded tissue blocks in a similar method by using duty cycles of 40%, 45%, 50%, 55%, 60% respectively to reveal the influence of the laser duty cycle on PA image quality. Results: The oral soft tissue is clearly shown as a yellow to red area in PA images, whereas the nonbiological material appears as a blue background. The color of the PA image is determined by the PA intensity. Hence, the PA intensity of oral soft tissue was generally higher than that of the nonbiological material around it. The Kruskal-Wallis test followed by Mann-Whitney post-hoc analysis revealed significant differences (P < 0.05) in the quality of PA images produced by using a 16%-47% duty cycle of laser intensity modulation for direct imaging of oral soft tissue fixed in 10% formalin solution. The PA image quality of paraffin-embedded tissue was higher than that of direct oral soft tissue images, but no significant differences in PA image quality were found between the groups. Conclusion:The PAI system built in this study can image oral soft tissue. The sample preparation and the diode laser intensity modulation may influence the PA image quality for oral soft tissue imaging. Nonetheless, the influence of diode laser intensity modulation is not significant for the PA image quality of paraffin-embedded tissue.