Canan Bural

Evaluation of periodontal parameters in patients undergoing peritoneal dialysis or hemodialysis

OBJECTIVE To analyze and compare periodontal parameters in chronic renal failure (CRF) patients undergoing peritoneal dialysis (PD) therapy with a group of patients on hemodialysis (HD) treatment and healthy controls (C). PARTICIPANTS Seventy-five PD patients (mean age: 44 +/- 12 years) were matched with 41 HD patients (mean age: 46 +/- 15 years) and 61 C (mean age: 46 +/- 18 years). METHODS Plaque (PI) and calculus (CSI) accumulation and gingival bleeding (GI) were recorded with the appropriate indices. Periodontal condition was assessed using the probing pocket depth (PPD). One-way anova test, Pearson chi-squared test, Mann-Whitney U-test and Kruskal-Wallis test were performed to compare PD patients with HD patients and healthy C. RESULTS Plaque Index values were significantly higher (P < 0.001) in the PD and HD groups than the C group. GI values were significantly higher (P < 0.01) in the HD group than the PD group. Finally, CSI values in the PD and HD groups were also significantly higher (P < 0.001) than the C group. CONCLUSIONS Chronic renal failure patients on PD treatment are more susceptible to periodontal diseases like HD patients. Thus, it is very important to maintain an optimal oral hygiene level. Further studies on periodontal parameters of only PD patients are needed to get more information on the oral health status of this patient group.

Evaluation of possible prognostic factors for the success, survival, and failure of dental implants.

Purpose:To analyze the prognostic factors that are associated with the success, survival, and failure rates of dental implants. Material and Methods:Data including implant sizes, insertion time, implant location, and prosthetic treatment of 1656 implants have been collected, and the association of these factors with success, survival, and failure of implants was analyzed. Results:The success rate was lower for short and maxillary implants. The failure rate of maxillary implants exceeded that of mandibular implants, and the failure rate of implants that were placed in the maxillary anterior region was significantly higher than other regions. The failure rates of implants that were placed 5 years ago or more were higher than those that were placed later. Conclusions:Anterior maxilla is more critical for implant loss than other sites. Implants in the anterior mandible show better success compared with other locations, and longer implants show better success rates. The learning curve of the clinician influences survival and success rates of dental implants.

Effect of leaching residual methyl methacrylate concentrations on in vitro cytotoxicity of heat polymerized denture base acrylic resin processed with different polymerization cycles

Objectives Residual methyl methacrylate (MMA) may leach from the acrylic resin denture bases and have adverse effects on the oral mucosa. This in vitro study evaluated and correlated the effect of the leaching residual MMA concentrations ([MMA]r) on in vitro cytotoxicity of L-929 fibroblasts. Material and Methods A total of 144 heat-polymerized acrylic resin specimens were fabricated using 4 different polymerization cycles: (1) at 74ºC for 9 h, (2) at 74ºC for 9 h and terminal boiling (at 100ºC) for 30 min, (3) at 74ºC for 9 h and terminal boiling for 3 h, (4) at 74ºC for 30 min and terminal boiling for 30 min. Specimens were eluted in a complete cell culture medium at 37ºC for 1, 2, 5 and 7 days. [MMA]r in eluates was measured using high-performance liquid chromatography. In vitro cytotoxicity of eluates on L-929 fibroblasts was evaluated by means of cell proliferation using a tetrazolium salt XTT (sodium 3´-[1-phenyl-aminocarbonyl)-3,4-tetrazolium]bis(4-methoxy-6-nitro)benzenesulphonic acid) assay. Differences in [MMA]r of eluates and cell proliferation values between polymerization cycles were statistically analyzed by Kruskal-Wallis, Friedman and Dunns multiple comparison tests. The correlation between [MMA]r of eluates and cell proliferation was analyzed by Pearsons correlation test (p<0.05). Results [MMA]r was significantly (p≤0.001) higher in eluates of specimens polymerized with cycle without terminal boiling after elution of 1 and 2 days. Cell proliferation values for all cycles were significantly (p<0.01) lower in eluates of 1 day than those of 2 days. The correlation between [MMA]r and cell proliferation values was negative after all elution periods, showing significance (p<0.05) for elution of 1 and 2 days. MMA continued to leach from acrylic resin throughout 7 days and leaching concentrations markedly reduced after elution of 1 and 2 days. Conclusion Due to reduction of leaching residual MMA concentrations, use of terminal boiling in the polymerization process for at least 30 min and water storage of the heat-polymerized denture bases for at least 1 to 2 days before denture delivery is clinically recommended for minimizing the residual MMA and possible cytotoxic effects.

Effect of post-polymerization heat-treatments on degree of conversion, leaching residual MMA and in vitro cytotoxicity of autopolymerizing acrylic repair resin

OBJECTIVES This study evaluated the effect of post-polymerization heat-treatments on degree of conversion (DC), residual methyl methacrylate concentration (MMA(r)) and in vitro cytotoxicity of autopolymerizing acrylic repair resin. METHODS A total of 336 specimens were prepared by bench- and hydroflask-curing and subjected to post-polymerization heat-treatments: a) water immersion at 60°C for 30 min, b) microwaving at 500 W for 3 min, c) combined use of water immersion and microwaving d) no treatment (as control). Specimens were eluted in cell culture medium for 1, 2, 5 and 7 days. DC and MMA(r) in eluates were measured by FTIR spectrometry and HPLC, respectively. In vitro cytotoxicity of eluates on L-929 fibroblasts was determined by XTT assay. Data were statistically analyzed with Dunns multiple comparison and Pearson correlation tests (p≤0.05). RESULTS DC was highest (99.9%) in bench- and hydroflask-cured groups which were subjected to water immersion. At all elution periods, MMA(r) was detected in eluates of all treatment groups and were higher in bench-cured groups than hydro-flask cured groups. Cell proliferation values indicated slightly cytotoxic effect throughout 7 days; regardless of the curing method or post-polymerization treatment. The correlation between MMA(r) and cell proliferation was negative after elution of 1, 2, 5 days and was only statistically significant (p<0.05) at 5 days. At elution of 7 days, the correlation was positive with no significance. SIGNIFICANCE Post-polymerization heat-treatment of autopolymerizing acrylic repair resin by immersion in water at 60°C for 30 min is clinically recommended to improve the DC while reducing the leaching residual MMA.

Flexural properties of repaired heat-polymerising acrylic resin after wetting with monomer and acetone.

OBJECTIVES Repair strength can be improved by treating fractured surfaces of a denture. BACKGROUND This study investigated flexural properties of heat-polymerised acrylic resin specimens repaired with auto-polymerising and visible light curing (VLC) resins after the repair surfaces were wetted with monomers or acetone. MATERIALS AND METHODS Fifty-four specimens (65 x 10 x 2.5 mm) were prepared and 48 of them were sectioned to simulate denture fracture. Butt-joint designed repair surfaces were wetted with heat-, auto-polymerising monomers and acetone for 180 s and repaired with auto-polymerising and VLC resins. After repairs, specimens were subjected to three-point bending test and flexural strength, strain, fracture load, modulus of elasticity and deflection values were recorded. Data were analysed with Student t and LSD tests (p < or = 0.05). RESULTS Overall flexural strength, strain, fracture load and deflection values of specimens repaired with VLC resin were significantly higher than the specimens repaired with auto-polymerising resin for all types of wetting agent (p < 0.05). Within the wetting agents, heat- and auto-polymerising monomers produced the best mechanical properties, while wetting with acetone did not provide superior effect over both monomers. CONCLUSION In clinical use, wetting the repair surfaces may result in stronger repairs. The use of bonding agent in VLC resin repairs in combination with wetting agent results in improved flexural properties.

A comparative in vitro evaluation of two different magnetic devices detecting the stability of osseo-integrated implants.

BACKGROUND AND OBJECTIVE It is unknown whether the resonance frequency analysis (RFA) measurements made by two different magnetic resonance frequency analysers are comparable. This in vitro study was designed to compare the RFA measurements made by the two magnetic resonance frequency analysers and to evaluate the intra- and interobserver reliability of the magnetic devices. MATERIAL AND METHODS Thirty-two implants were placed in four cow ribs. The RFA value of each implant was measured by five different examiners. The measurements were repeated five times, in both the buccal and mesial directions, for each implant at 2 h intervals, and the averages of registered implant stability quotient (ISQ) units were recorded as the buccal ISQ value and the mesial ISQ value for every implant. RESULTS No statistically significant differences (p>0.05) were observed between the RFA measurements made by the two magnetic devices. The intra-observer reliability of both devices was excellent, whereas the interobserver reliability of the devices was poor. CONCLUSION The results of the RFA measurements of both tested devices overlap. Although both devices show excellent intra-observer reliability, there are variations between the measurements of different examiners.

Effect of Educational Level on Oral Health in Peritoneal and Hemodialysis Patients

Background. In previous studies, the oral and dental health statuses were compared in hemodialysis (HD) and peritoneal dialysis (PD) patients without taking into account the effect of educational levels on oral health. Hence we aimed to make a comparison of these parameters based upon the subjects educational levels. Patients and Methods. 76 PD (33 males, 43 females-mean age: 44 ± 12 years) and 100 HD (56 males, 44 females-mean age: 46 ± 14 years) patients were included. The number of decayed, missing and filled teeth were detected, DMFT index was calculated and plaque index (PI) values were assessed. Results. Significantly higher numbers of filled teeth (P < .001) and lower PI values (P < .01) in the PD group were detected with higher educational levels, whereas no significance was detected in the HD group. Higher DMFT index values were assessed in the lower educated and high school levels in PD than HD patients (P < .05). Higher numbers of filled teeth (P < .05) were detected in the secondary school level in PD patients. This difference was even more significant in the high school level (P < .001). Conclusion. We assume that PD patients, who were found to be in a higher educational level, are more caring for their oral health as compared to HD patients.

Prosthetic rehabilitation of a patient after surgical reconstruction of the maxilla: a clinical report.

Prosthetic management of maxillectomy cases is challenging, and a multidisciplinary approach is usually needed. This clinical report describes the treatment provided to a patient who presented with a moderately differentiated squamous cell carcinoma. A two-stage surgical protocol was followed for this purpose. At the first surgery, the anterior maxilla was resected, and the oral and nasal mucosal and osseous defect was reconstructed with an osteocutaneous flap from the radial forearm. At the second surgery, all fascias and the connective tissue between the skin and the bone were resected to provide an optimal thickness for denture stability. Two months after the second surgery, prosthetic rehabilitation was completed with a maxillary telescopic overdenture. During the 15-month follow-up period, the patients oral condition and physical appearance improved, and no complications occurred.

Comparative Ex Vivo Evaluation of Two Electronic Percussive Testing Devices Measuring the Stability of Dental Implants

BACKGROUND A comparative ex vivo study was performed to determine electronic percussive test values (PTVs) measured by cabled and wireless electronic percussive testing (EPT) devices and to evaluate the intra- and interobserver reliability of the wireless EPT device. METHODS Forty implants were inserted into the vertebrae and forty into the pelvis of a steer, a safe distance apart. The implants were all 4.3 mm wide and 13 mm long, from the same manufacturer. PTV of each implant was measured by four different examiners, using both EPT devices, and compared. Additionally, the intra- and interobserver reliability of the wireless EPT device was evaluated. RESULTS Statistically significant differences (P <0.05) were observed between PTVs made by the two EPT devices. PTVs measured by the wireless EPT device were significantly higher than the cabled EPT device (P <0.05), indicating lower implant stability. The intraobserver reliability of the wireless EPT device was evaluated as excellent for the measurements in type II bone and good-to-excellent in type IV bone; interobserver reliability was evaluated as fair-to-good in both bone types. CONCLUSION The wireless EPT device gives PTVs higher than the cabled EPT device, indicating lower implant stability, and its inter- and intraobserver reliability is good and acceptable.

Assessment of demographic and clinical data related to dental implants in a group of Turkish patients treated at a university clinic.

PURPOSE This retrospective study analyzed the distribution of the dental implants with regards to age and gender of the patients and type of indication for the implant therapy, as well as the location, dimension and type of the implants. MATERIALS AND METHODS The data of demographics (age and gender), type of indication for implant therapy, anatomical location, dimensions (length and diameter) and type (bone and tissue level) of 1616 implants were recorded from patient charts between January 2000 and January 2010. Descriptive statistics were analyzed using a chi-squared test for demographic parameters, type of indication, tooth position, anatomical location, implant dimensions and type (α=.05). RESULTS The patient pool comprised of 350 women and 266 men, with a mean age of 52.12 ± 13.79 years. The difference in n% of the implants of the age groups was statistically significant between the types of indications. The difference in the position of the implants was statistically significant between the n% of the implants of all age groups. Gender did not significantly vary, except that the diameter of the implants was significantly higher for the standard diameter implants in males. The difference between the implant positions was statistically significant when considered according to indication. The relationship between implant length and anatomical location was statistically significant. CONCLUSION The indication for dental implant use is age dependent and the type and size of the implant seems to be strongly related to the location of the implant.