Cankat Kara

Evaluation of Patient Perceptions of Frenectomy: A Comparison of Nd:YAG Laser and Conventional Techniques

OBJECTIVE The aim of the randomized controlled clinical trial described here was to determine the anxiety levels of patients prior to frenectomy using the Nd:YAG laser and conventional technique, and to compare the effects of these two methods on the degree of postoperative pain, discomfort, and functional complications (eating and speech). METHODS Forty patients with mucogingival problems due to labial frenums (both maxillary and mandibular) were included in the study. Ratings of preoperative fear and postoperative pain and functional complications for each patient were recorded using a visual analog scale at 3 h, 1 d, and 1 wk post-surgery. RESULTS The results indicated that patients treated with the Nd:YAG laser had less postoperative pain and fewer functional complications (p < 0.05). CONCLUSION The results suggest that in the population studied, Nd:YAG laser treatment of soft tissue disorders provides better patient perceptions of success than those seen with conventional surgery.

Comparative Evaluation of Nd:YAG Laser and Fluoride Varnish for the Treatment of Dentinal Hypersensitivity

INTRODUCTION Various methods and materials are used in the treatment of dentin hypersensitivity. The aim of this randomized prospective controlled clinical trial was to evaluate and compare the desensitizing effects of the neodymium-doped yttrium aluminium garnet (Nd:YAG) laser and fluoride varnish by considering the degree of pre- and posttreatment pain, discomfort, and functional complications. METHODS Twenty patients with clinically diagnosed cervical dentin hypersensitive teeth were included and randomly allocated to either the application of fluoride varnish (group fluoride) or Nd:YAG laser (100 mJ, 20 Hz; group Nd:YAG). The assessment of pain and discomfort was performed by a visual analog scale after an air blast at baseline, immediately after treatment, and at patient visits on weeks 1, 2, 3, and 4. RESULTS Laser treatment resulted in significant improvements of discomfort immediately after treatment and after 1 week. At the 2-, 3-, and 4-week examination, the discomfort in group fluoride decreased up to nearly 75% to 85% of baseline scores, whereas the effect of the laser stayed nearly unchanged. The visual analog scale scores for pain at 4 weeks examination were significantly lower in the fluoride group compared with those in the laser group (p < 0.05). CONCLUSIONS Nd:YAG laser is a suitable tool for the immediately successful reduction of dentinal hypersensitivity and has better patient satisfaction and shorter treatment time.

Musculoskeletal Disorders in Left- and Right-Handed Turkish Dental Students

The purpose of this study was two-fold: first, to find out the musculoskeletal disorders between left- and right-handed dentists and second, to describe the prevalence and distribution of symptoms of musculoskeletal disorders among Turkish students who are practicing general dentistry. The investigation was carried out on 221 dental students; group I consisted of 24 left-handed students (18 male, 6 female), aged 24.2 ± 2.24 years; group II comprised 24 right-handed students (14 male, 10 female), aged 25.1 ± 3.14 years; and group III included 173 right-handed students (102 male, 71 female), aged 24.3 ± 1.45 years. The study consists of a questionnaire to identify work tasks and working conditions, and a field study to assess the pain of the neck, shoulders, and other disorders during the dental practice. Data were analyzed through tests for the difference between two population proportion, percentage, and Chi-square. Left- and right-handed students had headaches (34%, 22%), pins and needles (35%, 22%), weakness (42%, 40%), numbness (23%, 19%), neck pain (67%, 43%), back pain (56%, 47%), upper limp pain (46%, 43%) and shoulder pain (78%, 58%), respectively (Table ). Female students were not significantly different from males in musculoskeletal symptoms (p > .05). The position adopted by the student was significantly related to the intensity of pain. Left-handed students especially suffered from neck and shoulder pain when compared with right-handed students (p < .06). The authors think that a modification of work practices appears to be effective in decreasing the prevalence of symptoms. The best ergonomic working principles should be taught to the students, dental schools should provide a comfortable working environment, and further study is required to identify factors that will reduce the prevalence of symptoms among those practicing general dentistry. TABLE 3. Distribution of symptoms in left and right handedSymptomsLeft-handed (Group I)Right-handed (Group II)n%n%Headache834522*Numbness623419Weakness10421040Neck pain16671143*Shoulder pain19781458*Back pain13561247*Pain in trunk and upper limb12461143Pain in trunk and lower limb625522 Percentages do not total 100 as they are proportion of all the groups. Statistical evaluation by the difference between two population proportion. *p < .05.

An Evaluation of Different Treatments for Recurrent Aphthous Stomatitis and Patient Perceptions: Nd:YAG Laser versus Medication

OBJECTIVE The aim of this randomized controlled clinical trial was to determine the anxiety levels of patients with recurrent aphthous stomatitis (RAS) prior to therapy with the Nd:YAG laser or medication, and to compare the effects of these different treatment methods on the degree of post-treatment pain, discomfort, and functional complications (eating and speech) experienced. MATERIALS AND METHODS Twenty patients with RAS-related oral problems were included in the study. Levels of pre- and post-treatment pain and functional complications were assessed at patient visits on days 1, 4, and 7. RESULTS The results indicated that patients treated with the Nd:YAG laser had less post-treatment pain and fewer functional complications, and reported immediate relief of pain and faster healing (p +/- 0.05). However, only after 5 d was there a significant reduction in the pain levels of the patients treated with medication. CONCLUSION Our results suggest that the Nd:YAG laser has better patient acceptance, shorter treatment time, and lower rates of pain and post-treatment adverse events among patients with RAS.

Relationship between periodontal parameters and Behçet’s disease and evaluation of different treatments for oral recurrent aphthous stomatitis

BACKGROUND AND OBJECTIVE The highest prevalence of Behçets disease (BD) has been reported in Turkey, and therefore research of relations between BD and other disorders have become important in the Turkish population. Since oral aphthous ulcers impair tooth brushing, reducing complaints about aphthous ulcers will motivate the patient to maintain better oral hygiene performance and will thus reduce plaque accumulation and periodontal scores. The purpose of this controlled case study was to evaluate the relationship between the severity of periodontal scores and Behçets disease, and to compare the treatment modalities with neodymium-doped yttrium aluminium garnet (Nd:YAG) laser and medication on the recurrent aphthous ulcers in BD patients by considering the degree of pre- and post-treatment pain, discomfort and functional complications. MATERIAL AND METHODS The periodontal status of 28 BD patients was evaluated according to periodontal indices. The BD patients were also assessed for clinical severity score as described previously. Levels of pre- and post-treatment pain and functional complications were assessed at patient visits on days 1, 4 and 7. RESULTS Periodontal indices, the number of oral ulcers and the daily frequency of tooth brushing were related to the severity scores of BD (p < 0.001). The results indicated that BD patients treated with the Nd:YAG laser had less post-treatment pain and fewer functional complications and reported immediate relief of pain and faster healing (p < 0.001). CONCLUSION Our results suggest that periodontal status is worse in BD patients and is associated with disease severity; also, the Nd:YAG laser has better patient acceptance, shorter treatment time and lower rates of pain and post-treatment adverse events among BD patients with oral recurrent aphthous stomatitis.

Evaluation of Neodymium-Doped Yttrium Aluminium Garnet Laser, Scalpel Incision Wounds, and Low-Level Laser Therapy for Wound Healing in Rabbit Oral Mucosa: A Pilot Study

OBJECTIVE The aim of the present randomized controlled clinical trial was to assess the clinical and histopathological effects of laser and low-level laser therapy (LLLT) on healing of the oral mucosa after vestibuloplasty surgery. METHODS The alterations at the end of healing in scalpel- and laser-incised and LLLT-applied oral mucosa were studied in eight healthy adult New Zealand white rabbits by taking specimens for light microscopic inspection. For the evaluation of wound healing, the surgical areas were stained using a solution (Mira-2-tones), and the stained surfaces were measured horizontally immediately after the surgery and on postoperative days 4, 7, and 10. RESULTS Although the stained surface areas of the groups were similar immediately after the surgical procedures, the LLLT-applied sites had significantly fewer stained surface areas than the other groups on postoperative days 4, 7, and 10. Areas of hyperkeratosis and parakeratinization were observed in the epithelia of the laser surgery groups. A significant increase in epithelial thickness was found, suggesting increased scar tissue after wound repair; long and irregular connective tissue protrusions projecting into the undersurface of the epithelium were noted in these groups. CONCLUSION LLLT used for soft tissue operations provides better and faster wound healing, and LLLT enhances epithelization.

Evaluation of pain levels after Nd: YAG laser and scalpel incisions: an experimental study in rats.

BACKGROUND Postoperative pain is a recognized sequel of periodontal surgery. The pain experience has been shown to peak in the first 24 hours following the procedure, and to decrease rapidly in subsequent days. The aim of the present study was to evaluate the pain levels following scalpel- and laser-incision of rat hind paws. METHODS The study was carried out on 10 albino Wistar male rats. Rats were randomly assigned to two groups: Group I (n = 5, laser surgery), or Group II (n = 5, conventional surgery with scalpel). For measuring mechanical hyperalgesia, the nociceptive threshold of the hind paw after mechanical stimulation was quantified using a Basile algesimeter. The measurements were done before the surgery and on the postoperative 1(st), 2(nd), 3(rd), and 7(th) days. RESULTS While the pain levels of the groups were similar before the surgical procedures, the laser-applied rats had significantly fewer nociceptive thresholds of the hind paw after mechanical stimulation compared with the scalpel-incised rats on the postoperative 1(st), 2(nd), 3(rd), and 7(th) days. Functional complications were not observed in the laser groups at three days after the surgery. CONCLUSION The results suggested that, for soft tissue surgery, Nd: YAG lasers have often led to shorter operative times, less pain, and fewer postoperative adverse events.

Effect of handedness on learning subgingival scaling with curettes: a study on manikins.

The aim of the present study was to evaluate the influence of systematic manikin–head training and the effectiveness of subgingival scaling applied with hand instruments (curettes) by right- and lefthanded dental students on dental chairs (traditional) designed for right handers. A questionnaire focusing on handedness was administered to 69 voluntary dental students in the third class at the School of Dentistry during preparticipation examination. Handedness was assessed using the Turkish version of the Edinburgh Handedness Inventory. Then, 18 dental students- were specially selected in 2 equal groups according to hand preference: consistent right handers with Geschwind Scores of–100 (5 female- and 4 male) and consistent left handers with Geschwind Scores of 100 (5 female and 4 male). These two untrained dental student groups received 10 weeks manikin head training. Subgingival scaling was performed with hand instruments (Gracey curettes) in manikin head mounted on right sided dental chairs. At 6 test days each dental student had to instrument 12 test teeth. Effectiveness of subgingival scaling was evaluated- by adoption of a grading system. This system had scores from 0 to 3 and was defined by illustrated and described criteria. Statistical analysis- was carried out with SPSS. Two groups were statistically compared on all test days. The yet untrained left handed dental students begin with a relatively high the mean score of 2.25, compared to the yet trained righthanded dental students with 1.93, which was statistically signi-ficant- (p > .05). The right handed dental students reached the mean score of 0.53, whereas the left anded dental students reached the mean score of 0.87 on test day 6. Significant differences in the mean scores were found between the two groups for overall surfaces (p < .05), the distal surfaces (p < .01), lingual surfaces (p < .01), and each group of teeth (p < .05). But there was no statistically significant difference between the 2 groups of students on all test day except for test day 3 in terms of the mean scores for the facial and mesial surfaces (p > .05). Learning success was observed a high level in both groups through –systematical training (p <.0001). The present study has documented that the left handed dental students were less successful than the righ thanded dental students in subgingival scaling, except for mesial and facial surfaces. However although training on right sided chairs, they were quite similar to their right handed counterparts in terms of learning- success.

The Effects of Age and Gender on Gingival Tissue and Peripheral Blood T-Lymphocyte Subsets: A Study in Mice

The aim of this study is to investigate the effects of age and gender on relative number of CD4+ and CD8+ T lymphocyte and CD4+/CD8+ ratios in gingival tissue and peripheral blood of periodontally healthy BALB/c mice with flow cytometric analysis. The study was carried out on periodontally healthy 60 BALB/c mice. They were separated into five groups according to the life expectancy: Group I (newborn, 1–10 days old), Group II (age at weaning, 21–28 days old), Group III (age of sexual maturity, puberty, 7–8 weeks old), Group IV (adult, 8 months old), and Group V (the aged, 14 and over). Males and females were equally represented in each group. CD4+ and CD8+ T lymphocytes and CD4+/CD8+ ratio values in gingival tissue and peripheral blood were determined using flow cytometry in the biopsy samples. The relative number of CD8+ T lymphocyte in gingival tissue was higher in puberty (p < 0.05) and the aged (p < 0.05), with more significantly difference in males (p < 0.05). The CD4+/CD8+ ratios in gingival tissue were lower in puberty group and the-aged groups compared to the other groups (p < 0.05).The peripheral blood CD4+/CD8+ ratio increased in puberty and the aged groups. These differences were more significant in females than in males (p < 0.05). There were considerable negative correlations between CD4+/CD8+ T lymphocyte ratio in gingival tissue and CD4+/CD8+ T lymphocyte ratio in peripheral blood in puberty (r = 0.647, p < 0.01) and the aged ( r = 0.599, p < 0.05). In conclusion, our data suggest that CD4+/CD8+ T lymphocyte ratios in peripheral blood increase periodontally healthy mice in puberty and the old groups, while CD4+/CD8+ T lymphocyte ratios in gingival tissue decrease in the same groups. The relative number of CD8+ T lymphocytes increases in gingival tissue in puberty and the old groups when it decreases in peripheral blood. Results from this study indicated that periodontally healthy BALB/c mice may represent important information to determine the character of an immune response in the course of a lifetime.

Differences in dental and bone maturation in regions with or without hemihypertrophy in two patients with Russell-Silver syndrome.

Hemihypertrophy (hemihyperplasia) is defined as asymmetric body overgrowth of one or more body parts. Hemihypertrophy can be isolated or be part of well-defined syndromes, such as Russell-Silver syndrome (RSS). RSS is characterized by severe intrauterine growth retardation, postnatal short stature, asymmetry of the face, body, and limbs, short and incurved fifth fingers, broad forehead, pointed small triangular shaped face, girdle nose, normal psychomotor development, variations in the pattern of sexual development, and dental and oral abnormalities. The aim of this study was to determine whether or not there was any difference in the maturity of bone in left and right hand-wrist radiographs and dental development in the right and left jaws of two patients with RSS. In addition, the clinical features of the syndrome are discussed.