Gönen Özcan

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.

Comparison of different methods to detect Helicobacter pylori in the dental plaque of dyspeptic patients

The aim of this study was to compare different methods of detection of Helicobacter pylori (H. pylori) in the dental plaque of dyspeptic patients. After recording the clinical indices, culture and polymerase chain reaction (PCR) methods were performed on plaque samples, while rapid urease test in addition to these tests was carried on gastric samples from 67 dyspeptic patients who attended for an upper gastrointestinal endoscopy. Forty-seven of 67 patients were H. pylori-positive in gastric biopsy material whereas the microbial dental plaque from 19 patients demonstrated H. pylori positivity detected by PCR. Among the patients, 25.4% harbored H. pylori both in the stomach and in microbial dental plaque. No significant correlations were found among the presence of H. pylori in the stomach, in plaque, and clinical variables (P > 0.05). Although oral hygiene was observed optimal and the mean of pocket depth was not found to be higher, the prevalence of H. pylori was observed to be higher in dental plaque. According to our results, PCR technique gave the highest detection rate both in gastric biopsy and in dental plaque compared to the other methods used.

Effect of Initial Periodontal Therapy on Oxidative Stress Markers in Gingival Crevicular Fluid, Saliva, and Serum in Smokers and Non-Smokers With Chronic Periodontitis

BACKGROUND The aim of this case-control study with an intervention arm is to determine the effect of initial periodontal treatment on oxidative stress biomarkers in smokers and non-smokers with chronic periodontitis (CP). METHODS The study included 47 patients with CP (24 smokers [S+P+] and 23 non-smokers [S-P+]) and 46 periodontally healthy individuals (23 smokers [S+P-] and 23 non-smokers [S-P-]) for a total of 93 participants. Gingival crevicular fluid (GCF), serum, and saliva samples were obtained and clinical periodontal measurements were recorded at baseline and at the first and third months after periodontal therapy. 8-hydroxydeoxyguanosine (OHdG) and 4-hydroxynonenal (HNE) and enzyme activity of glutathione peroxidase (GSH-Px) were analyzed with enzyme-linked immunosorbent assay. RESULTS The level of 8-OHdD in GCF was found to be significantly higher in both periodontitis groups compared with both periodontally healthy groups. 8-OHdG and GSH-Px in saliva in both periodontitis groups were significantly increased compared with the S-P- group. In the S+P+ group, 4-HNE in GCF was found to be significantly higher than in periodontally healthy participants. After initial periodontal treatment, the levels of 8-OHdG in GCF and saliva were significantly decreased in both periodontitis groups. CONCLUSION Initial periodontal therapy may be helpful for diminishing oxidative stress in periodontitis.

Double-application of platelet-rich plasma on bone healing in rabbits

Objective: Platelet-rich plasma (PRP) is considered to enhance bone formation especially at early stages of wound healing, depending on the limited and short life-span of platelets and growth factors. The aim of this study was to evaluate efficacy of double-application of PRP (DA-PRP) on bone healing in a rabbit calvarial defect model. Study design: Twenty-eight rabbits, each had two surgically prepared calvarial bone defects (10mm diameter), were included in this study and randomly divided into six groups. Defects (n=56) were treated with single-application of PRP (SA-PRP)(n=10), SA-PRP and beta-tricalciumphosphate (SA-PRP+TCP)(n=10), DA-PRP (n=8), DA-PRP and beta-tricalciumphosphate (DA-PRP+TCP)(n=8), beta-tricalciumphosphate (TCP)(n=10) or left empty (Control)(n=10). Animals were sacrificed at 30 days postoperatively. Results: The new bone (NB%) and defect fill (DF%) percentages were calculated from histological slides by image-analyzer software and statistically analysed. All test groups showed higher NB% than control, but differences among all groups were insignificant. The TCP treated groups had significantly higher DF% than groups treated without TCP, however the DF% differences between control, SA-PRP and DA-PRP or TCP, SA-PRP+TCP or DA-PRP+TCP were insignificant. Conclusion: Although new bone formation was histomorphologically remarkable at double-application PRP groups, statistical analyses of the histomorphometric data revealed no significant difference. Key words: Platelet-Rich Plasma, double application, bone formation, wound healing.

The effects of ozone therapy as an adjunct to the surgical treatment of peri-implantitis

Purpose The decontamination procedure is a challenging aspect of surgical regenerative therapy (SRT) of peri-implantitis that affects its success. The purpose of the present study was to determine the impact of additional topical gaseous ozone therapy on the decontamination of implant surfaces in SRT of peri-implantitis. Methods A total of 41 patients (22 males, 19 females; mean age, 53.55±8.98 years) with moderate or advanced peri-implantitis were randomly allocated to the test group (ozone group) with the use of sterile saline with additional ozone therapy or the control group with sterile saline alone for decontamination of the implant surfaces in SRT of peri-implantitis. Clinical and radiographic outcomes were evaluated over a period of 12 months. Results At the 12-month follow-up, the plaque and gingival index values were significantly better in the ozone group (P<0.05). Probing depth decreased from 6.27±1.42 mm and 5.73±1.11 mm at baseline to 2.75±0.7 mm and 3.34±0.85 mm at the end of the 12-month observation period in the ozone and control groups, respectively. Similarly, the clinical attachment level values changed from 6.39±1.23 mm and 5.89±1.23 mm at baseline to 3.23±1.24 mm and 3.91±1.36 mm at the 12-month follow-up in the ozone and control groups, respectively. According to the radiographic evidence, the defect fill between baseline and 12 months postoperatively was 2.32±1.28 mm in the ozone group and 1.17±0.77 mm in the control group, which was a statistically significant between-group difference (P<0.05). Conclusions Implant surface decontamination with the additional use of ozone therapy in SRT of peri-implantitis showed clinically and radiographically significant. Trial registry at ClinicalTrials.gov, NCT03018795.

The effects of different restorative materials on periodontopathogens in combined restorative-periodontal treatment

Abstract Objective The aim of the study was to evaluate the association between subgingival restorations and the target periodontopathogenic bacteria (Pg, Td and Pi) in subgingival biofilm during one year after combined restorative-periodontal treatment. Material and Methods Seventeen systemically healthy subjects, who were positive for the presence of three cervical lesions associated with gingival recessions in three different adjacent teeth, were included in the study. A total of 51 combined defects were treated with connective tissue graft plus a nanofilled composite resin (NCR+CTG), a resin-modified glass ionemer cement (RMGI+CTG) and a fluoride-releasing resin material with pre-reacted glass (PRG), called giomer (Giomer+CTG). Periodontal clinical measurements and subgingival plaque samples were obtained from all combined defects at baseline and at 6 and 12 months after the surgery. The number of bacteria were evaluated by the real-time polymerase chain reaction (qPCR) method. Results No statistically significant difference in the amount of DNA copies of Pg, Td and Pi was observed in any of the groups at any time points (p>0.05). In addition, there was no statistically significant difference in the amount of DNA copies of the bacteria at baseline and at 6 and 12 months postoperatively, regardless of treatment group (p>0.05). Conclusion This study suggests that subgingivally placed NCR, RMGI and giomer restorations can show similar effects on periodontopathogenic bacteria in the treatment of gingival recessions that are associated with noncarious cervical lesions (NCCLs).

Clinical evaluation of combined surgical/ restorative treatment of gingival recession-type defects using different restorative materials: A randomized clinical trial

Background/purpose An ideal therapeutic procedure for the treatment of gingival recession associated with an NCCL has presented a challenge to clinicians. Various dental materials and surgical approaches have been used to manage gingival recessions associated with NCCLs for the most predictable combined surgical/restorative treatment. The objective of this study was to evaluate the treatment of gingival recessions associated with non-carious cervical lesions (NCCL) using a modified coronally advanced flap (MCAF) in combination with a connective tissue graft (CTG) on restored root surfaces. Materials and methods Twenty-three systemically healthy subjects, who were positive for the presence of three cervical lesions associated with gingival recessions in three different adjacent teeth, were enrolled in the study. The NCCL were each restored prior to surgery by using one of three different materials: nanofilled composite resin (NCR), resin-modified glass ionomer cement (RMGI) or giomer. The gingival recession defects were treated by CTG. Results Inter-group differences were not statistically significant for probing depth (PD), relative recession height (rRH), relative clinical attachment level (rCAL), keratinized tissue width (KTW) or keratinized tissue thickness (KTT) (p > 0.05) among the groups at any time. The mean percentage of defect coverage was 71.18 ± 23.16% for NCR + CTG group; 71.33 ± 22.33% for RMGI + CTG group; and 64.23 ± 20.33% for giomer + CTG group at 1 year postoperatively (p > 0.05). Conclusion The combined surgical/restorative treatments provided successful clinical results. Giomer + CTG may be less effective compared to other groups for treatment of gingival recession associated with NCCL.

OSTEOCALCIN AND OSTEONECTIN EXPRESSION AFTER DOUBLE-APPLICATION OF PLATELET-RICH PLASMA IN RABBITS

Purpose: Platelet-rich plasma (PRP) is a novel method for transferring autogenous growth factors to the wound area. The aim of this study was to evaluate the efficacy of double-application of PRP (DA-PRP) on bone healing in rabbit cranial defects by examining osteonectin (ON) and osteocalcin (OC) expression. Materials and Methods: Twenty-eight rabbits, each with two surgically prepared calvarial bone defects, were included in this study and divided into six groups: The defects (N=56) were treated with either a single-application of PRP (SA-PRP) (n=10), a combination of SA-PRP and betatricalciumphosphate (SA-PRP+β-TCP) (n=10), only DAPRP (n=8), both DA-PRP and beta-tricalciumphosphate (DA-PRP+β-TCP) (n=8), only beta-tricalciumphosphate (β-TCP) (n=10), or controls (n=10). The animals were sacrificed at 30th day postoperatively and samples were immunohistochemically examined for ON and OC expressions. Results: It was determined that DA-PRP did not significantly improve the ON and OC percentages achieved by SA-PRP or the controls. The three groups treated with β-TCP showed a higher percentage of ON than those treated without β-TCP (p<0.05). The β-TCP treated groups and SA-PRP group demonstrated higher OC percentage than DA-PRP and control groups (p<0.05). Conclusion: The present findings suggest that DAPRP did not have a significant effect on the healing of non-critical size rabbit cranial bone defects.