Background: Recurrent Aphthous Stomatitis (RAS) is inflammation in oral mucosa characterized by recurrent single or multiple ulcers that usually affected in non keratinized mucosa. Etiology RAS is unknown but psychological stress, allergy, and gastrointestinal disease can be predisposing factors Case Management: A 23rd years old complained recurrent oral ulcer with free ulcer period for 3-5 days. The patient had a history of food allergy, GERD and psychological stress. Intraoral examination showed recurrent multiple ulcers in variation site of the mouth. DASS 42 screening showed high stress and high anxiety. Skin Prick Test showed positive allergy to kapok, beef, chicken, cow milk, white egg, duck egg, shrimp, cob fish, milkfish, chocolate, and peanut. Ulcers treated with nonsteroid antiinflammation Aloe Vera gel and stress management by reading assignment method.Discussion: Psychological stress altered the immune system so oral mucosa prone to inflammation, and make the history of GERD getting worse. Stress causes cortisol secretion that changes the imbalance of proinflammatory and antiinflammatory cytokines. Oral mucosa becomes more susceptible to hypersensitivity. In addition, stress decreased oral and esophageal mucosa resistance to GERDConclusion: RAS triggered by psychological stress, allergy, and GERD. Treatment of RAS is by elimination predisposing factors to prevent recurrence.

Background: Tooth development during the embryonic period is a complex process that needs enough nutrition for the formation of healthy dental tissue. Kallikrein-related peptidase-4 (KLK-4) is a serine proteinase secreted by ameloblast during transition and maturation stages in the amelogenesis process which functions to degrade protein matrices so enamel could reach the final hardness. Pregnancy milk contains various nutrients that can increase KLK-4 expression of ameloblast cells in the tooth development. This study aims to determine the impact of pregnancy milk against the KLK-4 expression of ameloblast cell in the tooth development process. Method: 12 pregnant female mice (Mus Musculus L.) divided into control group (given sterile aquadest) and treatment group (given pregnancy milk + sterile aquadest) for 18 days then the tooth germ was taken. Samples were stained to see the KLK-4 expression. Data were analyzed using an Independent sample t-test. Result: Our study showed that the average amounts of KLK-4 expression in the treatment group are higher than the control group. Based on the Independent sample t-test statistic methods, there is a significant difference with the value of p=0,017. Conclusion:The pregnancy milk could influence the Kallikrein-related peptidase-4 (KLK-4) expression of ameloblast cell in the mice fetus's tooth development.

Introduction : Herpes Labialis is the most common form of orofacial herpes, beginning with a feeling of vesicle formation at the vermilion margin of the lips and the surrounding area within 24 hours and then rupture, superficial erosion occurs which is then covered with crusts. Herpes labialis occurs in 50-75% of individuals exposed to HSV-1 infection in the oral cavity and often has a recurrence followed by prodromal symptoms. Reactivation can occur due to triggers in the form of decreased immune conditions due to weather changes, fever, sun exposure, emotional stress, trauma, menstruation, systemic diseases, allergies, and immunosuppression. Case: 22 years old female with a complaint of a wound on the angular lip, initially the patient had a fever for 2 days then a fluid-filled blister appeared which then rupture. Case Treatment: The diagnosis is made using anamnesis, clinical and supporting examination. CBC and Antybody Titer HSV-1 show value under normal for eosinophil and reactive for IgG HSV-1 established. Patient take medicine topical antiinflammation 3 time a day and multivitamins 1 time a day. Discussion: HSV-1 infektion is latent and can reaktivation. Under Stress Condition can caused a reduced circulating population of immune cells such as IL-6, TNFα, Lymphocites B, NK cell, dan Monocytes which HSV-1 Reactivation. Conclucion: Management in case can be successful if the clinician understand HSV-1 Infection Manifestation and added Suporting Examination. In Addition, cooperation from the patien is needed to manage stress so that the disease no more recurrence.

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