Filiz Namdar Pekiner

Cytokine profiles in serum of patients with oral lichen planus.

OBJECTIVEnOral lichen planus (OLP) is a chronic inflammatory disorder of oral mucosa, which represents T-cell-mediated autoimmune diseases. The inflammatory response in OLP is characterized by the accumulation and expansion of T-helper 1 (Th1) lymphocytes. Several lines of evidence have suggested that a complex cytokine network plays an important role in the exacerbation and perpetuation of OLP. The aim of this study was to evaluate Th1 and T-helper 2 (Th2) cytokine profile in serum of patients with OLP in comparison to healthy controls.nnnMETHODSnThirty patients with OLP, and 30 healthy controls participated in the study. Tumor necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin (IL)-2, IL-4, IL-5 and IL-10 levels have been measured in flow cytometry by bead based cytokine measurement.nnnRESULTSnAlthough no statistical differences were observed in the serum levels of TNF-α, IFN-γ, IL-5 and IL-4 between OLP patients and controls (p>0.05), there were statistically significant differences in the serum levels of IL-2 and IL-10 (p<0.05 and p<0.01, respectively). A significantly decreased tendency towards the levels of IL-2 were observed in OLP patients when compared to controls (p<0.05), and the mean level of IL-10 in serum increased remarkably in the OLP patients than those in the controls (p<0.01).nnnCONCLUSIONSnThe finding of higher serum levels of IL-10 in patients in presence of low serum IL-2 levels, shows us that there is a dominance of Th2 response. This makes us think that there is a change in Th1/Th2 balance. Dominance of the Th2 response may indicate that OLP could be a result of a delayed type hypersensitivity.

Burning mouth syndrome and saliva: detection of salivary trace elements and cytokines.

BACKGROUNDnBurning mouth syndrome (BMS) is considered a syndrome with an unknown cause. Roles of various trace elements and cytokines in saliva have been implicated in the development of BMS. The aim of the present study was to compare the levels of salivary trace elements [magnesium (Mg), zinc (Zn), copper (Cu)] and interleukin (IL)-2 and IL-6, and to search for a correlation between depression/anxiety and salivary trace elements and cytokines in BMS patients and controls.nnnMETHODSnThirty patients with BMS and 30 matched healthy controls participated in the study. Unstimulated saliva was collected from participants and salivary flow rates were determined. Mg, Zn and Cu levels were determined by atomic absorbance spectrophotometry. Cytokine immunoassay kits were used to determine the concentration of IL-2 and IL-6 in the whole saliva samples. Anxiety and depression were analyzed by means of the Speilberger State-Trait Anxiety Inventory (SAI-TAI) and Zung Self-Rating Depression Scale.nnnRESULTSnAlthough subjects in the control group had significantly higher mean levels for Mg compared with BMS patients (P < 0.01), no statistically significant differences were observed in relation to Zn and Cu levels between the two groups (P < 0.001). There were no statistically significant differences in IL-2 and IL-6 levels of BMS and control groups, but subjects in BMS group had slightly, not significantly, higher mean levels for IL-6 compared with controls. Subjects in BMS group had significantly higher mean values for TAI compared with controls (P < 0.05). There were no statistically significant differences in relation to salivary levels of Mg, Zn, Cu, IL-2, IL-6 and depression/anxiety between BMS and control groups.nnnCONCLUSIONSnThe results of our study indicate that Mg levels could have an impact on symptoms of BMS and further studies are necessary to determine the importance of cytokines in the pathogenesis of BMS.

Serum cytokine and T regulatory cell levels in patients with burning mouth syndrome

BACKGROUNDnBurning mouth syndrome is a disorder usually associated with an unexplained, prolonged sensation of burning inside the oral cavity. Although the etiology is unknown, neural and psychologic factors and cytokines may be implicated in the pathogenesis of burning mouth syndrome. The aim of this study was to investigate the relationship between serum cytokine and T regulatory cell levels in patients with burning mouth syndrome with regard to depression and anxiety.nnnMETHODSnThirty patients with burning mouth syndrome and 30 matched controls participated in the study. Serum cytokine levels were measured with cytometric bead array and T regulatory cells were defined as CD4(+)CD25(+)Foxp-3(+) cells by flow cytometry. The level of anxiety and depression were analyzed by means of the Speilberger State-Trait Anxiety Inventory and Zung Self-Rating Depression Scale. Visual analogue scale was used in the quantification of burning levels of patients.nnnRESULTSnSerum IL-2 and TNF-alpha levels were significantly decreased in patients with burning mouth syndrome compared with controls [mean 16.79 +/- 8.70 vs. 37.73 +/- 41.05 pg / ml (P < 0.05) and mean 39.09 +/- 29.40 vs. 70.83 +/- 42.44 pg / ml (P < 0.01) respectively].nnnCONCLUSIONSnIL-2 and TNF-alpha might play a role in burning mouth syndrome. Burning mouth syndrome may occur as a sign of predisposition to autoimmunity. Presence of low levels of CD28(+) supports the provision that BMS might be a pre-autoimmune disease.

Interleukin-2, interleukin-6 and T regulatory cells in peripheral blood of patients with Behçet's disease and recurrent aphthous ulcerations.

BACKGROUNDnOne of the factors involved in the pathogenesis of Behçet disease (BD) and recurrent aphthous ulcerations (RAU) is a cell-mediated immune response in which several cytokines (interleukin-2, interleukin-6) and T regulatory cell (T reg cell) population seem to play a major role. The aim of this study was to measured the interleukin-2 (IL-2), interleukin-6 (IL-6) levels and analysis of CD4(+) CD25(+) Foxp-3(+) Treg cells in peripheral blood from patients with BD and RAU. In addition; we also analysed peripheral blood from healthy subjects for comparison.nnnMETHODSnThirty patients (15 men and 15 women) with BD, 30 patients (12 men and 18 women) with RAU and 15 healthy control subjects (nine men and six women) participated in the study. Analysis of CD4(+) CD25(+) Foxp-3(+) Treg cells, IL-2 and IL-6 levels have been measured in flow cytometry.nnnRESULTSnNo statistical differences were observed in the serum levels of IL-2 and IL-6 between BD and RAU patients, and healthy subjects. Although there were no statistical differences in the number of CD4(+) CD25(+) Foxp-3(+) cells between groups, there were statistically significant differences in the number of CD4(+) CD25(bright) Treg cells. CD4(+) CD25(bright) Treg cells were significantly increased in BD and RAU patients compared to healthy subjects. Statistical analysis revealed no difference according to the number of CD4(+) CD25(bright) cells between BD and RAU patients.nnnCONCLUSIONSnThese results indicate that CD4(+) CD25(bright) T regulatory cells may be contributing factor in the pathogenesis of BD and RAU.

Retrospective radiological assessment of root canal treatment in young permanent dentition in a Turkish subpopulation.

AIMnTo determine the technical quality of root fillings as well as the periapical status of root filled teeth and non-root filled teeth in young permanent dentitions using a retrospective analysis of orthopantomographs (OPTGs) in a Turkish subpopulation.nnnMETHODOLOGYnIncluded in this study were the digital OPTGs taken as a part of diagnostic and planning procedures for all 19-year-old adolescents who attended the Faculty of Dentistry, Marmara University (Istanbul, Turkey) for the first time during the period from June 2007 to May 2009. The periapical status of all teeth and the technical quality of the root fillings were assessed by radiographic criteria. Statistical analysis was performed by the Mann-Whitney U, chi-squared, Fishers exact and Cohens kappa tests.nnnRESULTSnThe survey involved OPTGs of 1077 19-year-old adolescents: 663 (61.6%) women and 414 (38.4%) men. Of the 28974 teeth examined, 459 (1.6%) were root filled, of which 193 (42.0%) had radiological signs of apical periodontitis (AP), and 454 (1.6%) were non-root filled teeth with AP. No significant difference was found between women and men regarding the number of teeth present, the number of root filled teeth and the number of non-root filled teeth with AP (P>0.05). The most commonly treated teeth were molars (54.2%), followed by pre-molars (27.0%) and incisors (18.8%). Length was adequate in 57.3%, and homogeneity was adequate in 50.5% of the root fillings. Statistically, both the length and the homogeneity of the root fillings were significantly associated with periapical status individually (P<0.01). The overall technical quality was inadequate in 60.1% of the root fillings, and 67.0% of these were associated with signs of AP. Amongst root filled teeth, the frequency of AP in connection with molars was significantly higher (57.0%) than that for incisors (27.9%) and pre-molars (21.8%) (P<0.01).nnnCONCLUSIONSnu2002 The results of this study indicated that the frequency of root filled teeth with AP, non-root filled teeth with AP and of technically inadequate root fillings amongst all root filled teeth was high in this selected adolescent Turkish population.

Evaluation of cytotoxic T‐cell activation, chemokine receptors, and adhesion molecules in blood and serum in patients with oral lichen planus

BACKGROUNDnOur purpose is to study cytotoxic T-cell activation (through evaluation of CD8+CD40+ and CD8+CD154+ cells), chemokine receptors (through evaluation of CD8+CD184+ and CD8+CD195+ cells), and adhesion molecules (through evaluation of CD8+CD152+ cells) which play a part in cell activation in blood and serum samples of patients with OLP and then to compare them with healthy controls.nnnMETHODSnThirty patients with OLP, and 30 matched healthy controls participated. The mean ages of OLP patients and controls were 51,10 ± 12,25 and 48,09 ± 11,92, respectively. Percentage of apoptotic cells, granzyme-B+, CD8+, CD8+CD40+, CD8+CD152+ (CTLA-4), CD8+CD154+(CD40L), CD8+CD184+(CXCR-4) and CD8+CD195+(CCR-5) were detected by immunophenotyping on flow cytometry. Apoptosis measurements were accomplished with Annexin V/Propidium Iodide kit.nnnRESULTSnA higher percentage of CD8+CD154+ and granzyme-B+ and a lower percentage of CD8+, CD8+CD184+ and apoptotic cells were found in OLP patients than in controls. No statistical differences were observed in the percentages of the other markers between groups.nnnCONCLUSIONSnIt is observed that because of increase in granzyme B+ and CD154 which is the activation marker, CD8+ cells present efforts to sustain their activity even though decrease in their cell number. Lower levels of CD8+CD184+ cells in OLP than control is evaluated as a factor that makes OLP to be localised in our study. In addition, our findings lead us to think that there may be some changes in apoptosis pathways of the cells. But this needs to be clarified by further studies exploring the mechanisms of the apoptosis in OLP patients.

Assessing Oral Cancer Awareness Among Dentists.

The aim of this study was to assess oral cancer awareness among dentists who attended 101st FDI World Dental Congress, İstanbul, Turkey. Among 170 dentists who agreed to participate, there were 13 oral surgeons, 6 restorative dentists, 4 endodontists, 4 orthodontists, 6 periodontists, 5 pedodontists, and 14 prosthodontists. Knowledge of oral cancer risk factors and diagnosis procedures, dentists’ attitude towards oral cancers, management practice regarding oral cancer, and oral cancer information sources were assessed using 25 questions. The data were analyzed with IBM SPSS Statistics 22.0 program. Among 170 participant dentists, there were 69 (40.6%) male dentists and 101 (59.4%) female dentists. Largest number of them identified tobacco (98.8%) and alcohol usage (91.2%), prior oral cancer lesions (95.3%), viral infections (90.0%), UV exposure (86.5%), and betel quid chewing (80.6%), and lower numbers reported older age (56.5%) and low consumption of fruit and vegetables (52.4%). Oral medicine specialists scored marginally higher in indicating erythroplakia and leukoplakia most likely to be precancerous and squamous cell carcinoma as the most common form of oral cancer (pxa0<xa00.01). This study highlighted the importance of improved educational methods for dentists on oral cancer detection and prevention.

Using cone beam computed tomography to examine the prevalence of condylar bony changes in a Turkish subpopulation.

BACKGROUND/PURPOSEnThe aim of this study was to characterize the condylar bone changes in the temporomandibular region using cone-beam computed tomography (CBCT) and to determine the prevalence of these changes in a population.nnnMATERIALS AND METHODSnCBCT images of the temporomandibular joints (TMJs) of 795 patients (426 females, 369 males) were retrieved from the computer database. The cross-sectional, coronal and sagittal views of 1-mm-thick sections of the TMJ were generated using CBCT. Age, gender, and bone changes on both condyles were recorded, and data were analyzed using a Chi-square test and McNemars test to evaluate comparisons between qualitative data (IBM Corp., Armonk, NY).nnnRESULTSnNo bone changes were observed in 78.4% (n = 623) of the TMJ samples obtained from the right side. Osteoarthritic changes were observed in 17.9% (n = 142) and developmental changes in 2.6% (n = 21) of the cases. On the left side, osteoarthritic changes were observed in 11.6% (n = 142) of the cases while developmental changes were observed in 2.6% (n = 21). Moreover, 82.4% (n = 655) of the TMJ samples showed no changes. When the age groups were compared in samples obtained from both right and left TMJs, the prevalence of bone changes increased by the age of 60 years and older.nnnCONCLUSIONnThe prevalence of degenerative condylar bone changes increased with increasing age and was more frequent in women and right condyle.

Comparison of ultrasound-guided and conventional arthrocentesis of the temporomandibular joint

Arthrocentesis of the temporomandibular joint (TMJ) can be done either conventionally or under ultrasonographic guidance, and we have compared the effectiveness of the two techniques. Twenty patients who required arthrocentesis of the TMJ were randomly assigned to ultrasonographically guided (US-guided) and conservative arthrocentesis (n=10 in each group). The number of relocations of the first and second punctures, pain experienced during each procedure measured using a visual analogue scale (VAS), and the duration of the procedure were the main outcome variables. The pain score compared with the maximal interincisal mouth opening measured preoperatively, immediately after operation, at 1 week, and 1 and 3 months, were secondary outcome variables. No patient in either group developed a complication, and there was no significant difference between the two groups, except that US-guided arthrocentesis took significantly longer than the conventional technique (p=0.000). US-guided arthrocentesis of the TMJ was no more successful than the conventional technique, and took longer. Further studies with more patients are required to validate these findings.

Assessing Oral Cancer Awareness Among Dental Students

The aim of this study was to assess oral cancer awareness among undergraduate dental students in Marmara University Faculty of Dentistry. A validated questionnaire which tested oral cancer awareness was given to third- and fifth-year students of the dental faculty of Marmara University. A total of 198 students participated in this survey. Knowledge of oral cancer risk factors and diagnosis procedures, dentistry student’s attitude towards oral cancers, management practice regarding oral cancer, and oral cancer information sources were assessed using 25 questions. The data were analyzed with IBM SPSS Statistics 22.0 program. Among 198 participant dentistry students, there were 99 (50%) third-grade and 99 (50%) fifth-grade students. The largest number of the third- and last-grade students identified tobacco (98%) and alcohol usage (87.4%), prior oral cancer lesions (94.9%), viral infections (91.9%), UV exposure (94.4%), betel quid chewing (84.8%), older age (62.1%), and low consumption of fruit and vegetables (85.4%). Both groups showed higher scores in indicating squamous cell carcinoma as the most common form of oral cancer (pu2009<u20090.05); yet, third-grade students performed significantly higher scores in indicating erythroplakia and leukoplakia for most likely to be precancerous (pu2009=u20090.001; pu2009<u20090.05). This study highlighted the importance of improved educational methods for dentistry on oral cancer detection and prevention.