Ahu Uraz

Clinical and radiographic evaluations of chitosan gel in periodontal intraosseous defects: A pilot study

Periodontitis is a chronic infection in the supportive tissue of the teeth which eventually leads to tooth loss. Various grafting materials and barrier membranes have been used to repair periodontal intraosseous lesions. Chitosan is a derivative of chitin, a natural biopolymer, which is biologically safe, biodegradable, and nontoxic and has been applied in a variety of forms in dentistry. It also exerts bioactive properties such as wound healing, antimicrobial, tissue regeneration, and hemostatic activities. The aim of this study was to evaluate effects of chitosan on periodontal regeneration. Twenty chronic periodontitis patients were recruited. Following initial therapy, the patients were divided into four groups: group A, receiving chitosan gel (1% w/v); group B, receiving chitosan gel + demineralize bone matrix; group C: receiving chitosan gel + collagenous membrane; and group D, receiving flap only (control group). Clinical and radiographic measurements were recorded at baseline, day 90 (3rd month), and day 180 (6th month) after surgery. For clinical data, no significant differences were obtained among the treatment groups. However, radiographic data revealed that except control group, all the other groups showed statistically significant bone fills when compared with baseline indicating that chitosan gel alone or its combination with demineralize bone matrix/collagenous membrane is promising for periodontal regeneration.

The efficacy of 8% Arginine-CaCO3 applications on dentine hypersensitivity following periodontal therapy: A clinical and scanning electron microscopic study

Objectives: Periodontal therapy is one of the etiological factors of dentine hypersensitivity (DH). This study aimed to evaluate the efficacy of %8Arginine-CaCO3 on DH that affects patients after periodontal treatment. Study design: Seventy-one teeth from the volunteers (n=36) with history of DH caused by periodontal therapy were included in this study, and randomly divided into two groups: group-1, who received 8%Arginine-CaCO3 and group-2, who received 1.23%NaF-gel. The clinical indices were recorded at first visit.DH was evaluated by using tactile, air-blast, and thermal stimuli. The subject’s response was recorded at baseline, immediately (Day-0) and one month after the application. Results and conclusions: The results were statistically analyzed, and it was found that 8% Arginine-CaCO3 treatment was more effective than 1.23% NaF-gel at time intervals. Sensitivity score differences between the groups were statistically significant at Day-28. The 8% Arginine-CaCO3 group exhibited statistically significant reduction in DH on three stimuli at baseline to Day-28. It was concluded that 8% Arginine-CaCO3 is more effective than 1.23% NaF-gel in reduction of patients’ pain. Key words:Arginine, desensitizing agent, hypersensitivity, periodontal treatment, scaling and root planning, sodium fluoride.

Neopterin Profile to Evaluate the Effectiveness of Treatment in Aggressive Periodontitis

Abstract Periodontal disease results from the interaction of the host defence mechanisms with the microbial dental plaque. Analysis of gingival crevicular Huid (GCF) provides a non-invasive means of evaluating the role of the host response in periodontal disease. Based on our previous study, demonstrating increased levels of neopterin in GCF and saliva from patients with aggressive periodontitis (AgP), the aim of this study was to evaluate the effect of periodontal treatment on the levels of neopterin in GCF, saliva and urine of patients with AgP. Pre-treatment values of neopterin in GCF were 4.04 ± 0.86 nmol/ml for the AgP group (n=8) and 2.68 ± 0.90 nmol/ml fyr the control group (n=8; difference not significant). After periodontal treatment, the level of ncoptei in was found 2.38 ± 0.72 nmol/ml in the patient group which did not differ f r om pre-treatment levels. The salivary neopterin concentration was higher in both AgP groups (14.14 ± 2.85 nmol/1 and 8.02 ± 3.12 nmol/1, before and after periodontal treatment) than in controls (2.58 ± 0.3 nmol/1; both p<0.05). No significant difference in salivary neopterin level was observed in patients before and after periodontal treatment. Concentrations of urine neopterin in patients before treatment were 188.5 ± 30.98 μηιοί neopterin/mol creatinine and 168.1 + 20.21 μηιοί in controls (difference not significant). Following periodontal treatment, the urinary neopterin levels (310.1 ± 39.82 μηιοί neopterin/mol creatinine) were higher when compared to the baseline levels and to controls (p<0.05). Our results suggest that neopterin in saliva and GCF might be associated with the periodontal diseases process.

The Comparison of Porous Titanium Granule and Xenograft in the Surgical Treatment of Peri‐Implantitis: A Prospective Clinical Study

BACKGROUND Regarding the current approach, there is no evidence to show which treatment technique is the most accurate and useful in peri-implant defects. PURPOSE The aim of this study is comparing the effect of porous titanium granule (PTG) with rotary titanium brush and the use of xenograft and collagen membrane in the treatment of intra-bony peri-implant defects. MATERIALS AND METHODS Twenty-two patients, suffering peri-implantitis defects were included this study. Patients were divided into two groups: The PTG group used rotary titanium brush, PTG, and platelet rich fibrin (PRF) membrane. The XGF group used xenograft bone substitute, collagen membrane, and PRF membrane. Clinical measurements and cone beam computed tomography per region were recorded as baseline and sixth month after surgery. RESULTS The mean CAL values were improved from 5.29 ± 1.06 to 3.59 ± 0.88 mm in PTG group, while in XGF group; these values were improved from 4.77 ± 1.05 to 3.30 ± 0.58 mm. Radiographic bone filling values displayed a statistically significant difference between of groups. In PTG groups, these radiological values increased more than the XGF group. CONCLUSIONS PTG may be more appropriate for peri-implantitis surgery than xenograft due to inert structure and comfortable use of PTG to provide mechanical support for enlarging the surface area of the implant.

Changes of tumor necrosis factor-α, interleukin-10, and tartrate-resistant acid phosphatase5b in the crevicular fluid in relation to orthodontic movement

The aim of this study was to determine gingival crevicular fluid (GCF) expressions of tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), and tartrate-resistant acid phosphatase (TRAP) 5b in the mechanism of orthodontic tooth movement. Nine adolescents requiring canine distalization participated in the study. A canine undergoing distal movement served as the test tooth, and the contra-lateral canine served as the control. The clinical parameters were recorded and GCF samples were collected from the mesial and distal gingival crevices of teeth at baseline, 1 h, 24 h, 7 days, and 28 days following force application. GCF samples were analyzed using ELISA. The data were analyzed using three-way repeated measures analysis of variance. TNF-α and TRAP5b levels in distal and mesial sites of the test teeth were significantly higher than that at both sites of the controls. When compared with baseline values, increase was prominent at 1 h and 24 h. The IL-10 concentration decreased during experimental period at both sites of the control and test teeth. The results demonstrated that orthodontic forces evoke changes in the levels of TNF-α, IL-10, and TRAP5b during the initial stages of force application. The changes in local host response in periodontal tissues may be one of the triggers in regulating alveolar bone resorption during orthodontic tooth movement.

Histologic and histomorphometric assessment of eggshell-derived bone graft substitutes on bone healing in rats

Objective: The objective of this study was to histologically and histomorphometrically evaluate the efficacy of the new formulations of eggshell-derived calcium carbonate in rats. Study Design: The study was conducted on 30 adult male rats. Four standardized and circular intrabony defects were created in the both maxilla and mandibula of each animal. Three different graft materials were prepared as follows: 1) Material A: Eggshell-derived calcium carbonate combined with carrageenan gel, 2) Material B: Eggshell-derived calcium carbonate combined with xanthan gum gel, and 3) Material C: Eggshell-derived calcium carbonate powder. The right mandibular defect sites were grafted with Material A in all animals, and defects on the left were grafted with Material B. Defects on the right side of maxilla were received Material C in all animals, and all left maxillary defects were remained untreated as controls. The animals were sacrificed either postoperatively on the 15th day, postoperatively on the 30th day or postoperatively on the 45th day. Histomorphometric measurements were made of the areas of newly formed bone, necrotic bone, fibrous tissue and residual graft material. Results: Material A exhibited the highest level of osteoid formation followed by Material B and Material C on the 45th day. In terms of osteoid formation, statistically significant differences were observed between graft materials and controls at 45th day compared to 15th and 30th day (p<0.05). Conclusions: Eggshell-derived graft substitutes in both gel and powder forms are biocompatible materials which may have the potential to enhance the new bone formation. Key words:Bone graft material, bone defects, eggshell, histopathological evaluation, rat.

Effects of Laser Photobiomodulation and Ozone Therapy on Palatal Epithelial Wound Healing and Patient Morbidity

OBJECTIVE The aim of this study was to compare the effects of laser photobiomodulation (PBM) and topical ozone therapy on the reepithelialization of palatal donor site wounds through clinical assessment and computer-aided image analysis and to assess the patient morbidity following free gingival graft (FGG) surgeries. MATERIAL AND METHODS Thirty-six patients requiring FGG were randomly allocated into three groups: laser group (n = 12), ozone group (n = 12), and control group (n = 12). Epithelialization was evaluated by applying 3% hydrogen peroxide (H2O2) to the wound area and also measured by using digital image analysis (ImageJ). Bland-Altman plots were used for assessing agreement between H2O2 and ImageJ measurements. Parameters in relation to patient morbidity were assessed by using visual analog scale (VAS) on the first 3, 7, 14, and 30 days postoperatively. RESULTS At day 14, statistically significant smaller wounds were observed with digital image analysis in the ozone group as compared with the control group (p = 0.034). However, intergroup comparison of the remaining wound area evaluated by the clinician using the H2O2 method did not reveal any significant differences (p > 0.05). Nonetheless, according to Bland-Altman analysis, the lower and upper limits showed a moderate agreement between the two measurement methods. The mean VAS sores exhibiting postoperative discomfort was observed to be significantly higher in the control group compared with the laser group (p = 0.002) and ozone group (p < 0.001) at day 7. CONCLUSIONS Adjunctive ozone therapy could have a significantly beneficial effect on the acceleration of palatal wound healing following FGG procedures. Both PBM and ozone treatment modalities reduced postoperative discomfort as compared with spontaneous healing.

Patient perceptions and clinical efficacy of labial frenectomies using diode laser versus conventional techniques

INTRODUCTION The aim of present study was to compare the keratinized gingival tissue measurements, degree of subjective complaints and functional complications of using an 980nm diode laser versus a scalpel for labial frenectomies. MATERIAL AND METHODS Thirty-six patients requiring labial frenectomies, between 14 and 51 years old, were randomly assigned to either scalpel or diode laser treatments. The soft tissue measurements, including the keratinized gingiva width (KGW), attached gingiva width (AGW) and attached gingiva thickness (AGT), were recorded before surgery, immediately after, one week later and one, three and six months after surgery. In addition, the functional complications and the morbidity (level of pain, swelling and redness) were evaluated during the first postoperative week using a visual analog scale (VAS). RESULTS We determined statistically significant gains in the KGW, AGW and AGT after surgery in both groups; however, there was no significant difference between the study groups. The VAS scores indicated that the patients treated with a diode laser had less discomfort and functional complications compare with scalpel surgery. DISCUSSION The results described above show that diode laser surgery offers a safe, impressive alternative for labial frenectomies that are comfortable for the patients.

Ozone application as adjunctive therapy in chronic periodontitis: Clinical, microbiological and biochemical aspects

Background/purpose The application of ozone as an adjunctive treatment represents a new approach in the management of chronic periodontitis. The purpose of this study was to evaluate the clinical, biochemical and microbiological efficacy of ozone treatment as an adjunct to scaling and root planing (SRP) in generalized chronic periodontitis (GCP) patients. Materials and methods Eighteen patients (9 males and 9 females; aged from 28 to 47 years, mean age of 40 ± 6.51 years) with GCP were recruited in the study. In a split mouth design, two quadrants in each patient were randomly allocated to SRP-alone or SRP-ozone therapy (SRP + OT) groups by coin toss method. Subgingival plaque and gingival crevicular fluid (GCF) samples were collected at baseline, following 1st and 3rd months. The clinical parameters were monitored at baseline and after 3 months. Microbiological parameters were analyzed by quantitative-PCR and GCF biomarkers were determined by ELISA. Results were analyzed statistically. Results Statistically significant improvements in all clinical parameters were accompanied by a reduction in microbiological and biochemical parameters in both treatment groups. SRP treatment resulted in a significant reduction of Porphyromonas gingivalis (Pg) at 1st month and Tannerella forsythia (Tf) and Prevotella intermedia (Pi) at 3 months. Following SRP treatment the interleukin (IL)-8 levels were significantly reduced at month 1. There were no significant differences between two treatments for any of the parameters. Conclusion Within the limitations of this study, adjunctive ozone therapy did not provide additional benefits to clinical, microbiological and biochemical parameters over SRP in chronic periodontitis patients.

An Evaluation of the Relationship Between Peri-implant Soft Tissue Biotype and the Severity of Peri-implantitis: A Cross-Sectional Study

PURPOSE This cross-sectional study aimed to analyze the relation between peri-implant soft tissue biotype (STB) and different levels of peri-implantitis severity, and to identify the possible risk indicators that affect the severity of peri-implantitis with regard to STB around dental implants. MATERIALS AND METHODS Eighty-seven patients with 229 implants were diagnosed with peri-implantitis and recruited to the study. Clinical and radiographic parameters including Plaque Index (PI), probing depth (PD), bleeding on probing (BOP), gingival/mucosal recession (GR/MR), clinical attachment level (CAL), and marginal bone loss (BL) were analyzed. The periodontal status was assessed, and the levels of peri-implantitis severity were defined. These parameters were compared among the peri-implant STB groups (thick and thin biotype). To evaluate the effect of possible risk indicators on the levels of severity of peri-implantitis, univariate and multivariate logistic regression analyses were conducted for thick and thin biotype groups. RESULTS The mean values of BOP, MR, CAL, and marginal BL were significantly lower for the thick group compared with the thin group (P < .05). For PI and PD values, no significant differences were found between the groups (P > .05). Moreover, multivariate analysis revealed statistically significant associations between peri-implantitis severity and the risk indicators maintenance therapy compliance and current periodontitis for the thin group (P < .05). CONCLUSION The thin biotype could be more prone to increase in the severity of peri-implantitis. Maintenance therapy compliance and current periodontitis could be important risk indicators that affect the progression of the severity of peri-implantitis for implants where keratinized mucosa is thin or absent.