Gülsüm Ak

Oral and general health-related quality of life among young patients with haemophilia

Summary.  The clinical diagnosis of dental diseases may indicate their cause and prognosis, however it gives little information about resulting levels of impairment from the patients’ perspective. In this study, we aimed to investigate oral and general health‐related quality of life (OHRQoL‐HRQoL) in patients with haemophilia; and to test whether haemophiliacs would have worse or better OHRQoL compared with the general population. Data were collected from haemophiliacs (age range 14–35; mean 23 ± 6.58, n = 71) and age/sex‐matched controls (age range 14–35; mean 21.00 ± 6.45, n = 60) through face‐to‐face interviews including nine questions and using oral health impact profile (OHIP)‐14, oral health‐related quality of life‐UK (OHQoL‐UK), short‐form general measure of health (SF)‐36 to measure self‐rating oral health status, perceived dental treatment needs, tooth brushing frequencies, OHRQoL‐HRQoL. In the field of self‐rating oral health status, perceived dental treatment needs, tooth brushing frequencies and OHIP, OHQoL‐UK, SF‐36 scores – except the subscales including vitality, role emotional and mental health – the control group is in better conditions compared with the haemophilia group. At the same time, both the two groups are in good conditions in dental attendance, vitality, role emotional and mental health. Life quality is related with the perceived discrepancy between the reality of what a person has and the concept of what that person wants, needs or expects. In order to eliminate the dilemma in the field of health, we should facilitate the haemophiliacs’ lives by serving the health care in a multidisciplinary view.

Risk Factors Associated With Implant Marginal Bone Loss: A Retrospective 6-Year Follow-Up Study.

Purpose:To analyze the presented evidence behind suggested reasons for long-term marginal bone loss (MBL) around 600 endosseous titanium dental implants according to the radiological findings up to 60 months. Materials and Methods:The data of 151 patients are received from the prosthodontic department of a university clinic and analyzed for the effect of implant brand, location, implant diameter and length, implant occlusal table width, cantilever, and smoking on MBL in a 6-year period. Results:MBL is significantly higher in Zimmer SwissPlus implant system. The bone loss in posterior region was higher than anterior region for maxilla. There was no significant difference in mandible. Kruskal-Wallis test showed that MBL was significantly higher when the crown/implant (C/I) ratio was 1.5/2 (P < 0.05). Occlusal table width/implant diameter (OT/I) ratio was analyzed and it showed that MBL was significantly higher when the ratio was 2.5 to 2.99 and higher than 3. There were no significant associations between smoking and nonsmoking groups. Mann-Whitney U test revealed that cantilever does not affect MBL. Conclusion:The marginal bone loss is affected by location of the implants (higher in the maxillary posterior region). In addition, excessive C/I and OT/I ratios increase marginal bone loss.

The roles of matrix metalloproteinases-2, -7, -10 and tissue inhibitor of metalloproteinase-1 in the pathogenesis of oral lichen planus

BACKGROUND The aim of this study was to investigate the roles of Matrix Metalloproteinases (MMP)-2, Metalloproteinases-7, Metalloproteinases-10 and Tissue Inhibitors of Metalloproteinase-1 (TIMP-1) in the pathogenesis of oral lichen planus (OLP) disease in same tissue samples. METHODS Thirty-nine individuals [29 patients with OLP (74%) and 10 healthy control subjects (25%)] were included in our study. The mean age was 48 ± 14.39 with a range of 20-75. RESULTS MMP-2 and MMP-7 expression was significantly different in the patient and control groups in the epithelium and the connective tissue (P<0. 05). The ratio of MMP-2/TIMP-1 and MMP-7/TIMP-1 were higher in patient with OLP group than control group. CONCLUSIONS Along with the exposure of the role of MMPs activity on diseases characterized by the tissue destruction, several studies were conducted on the pharmacological control of MMPs activity. However, understanding of the biological functions of MMPs is very important for the development and implementation of MMP inhibitors in the treatment of diseases. According to the results of this study, we suggest that MMP-2, MMP-7, and TIMP-1 may be involved in the formation of OLP lesions. Further studies on MMPs may be useful for understanding and treating the diseases such as OLP.

Evaluation of the Efficacy of Mandibular Conventional and Implant Prostheses in a Group of Turkish Patients: A Quality of Life Study

PURPOSE The aim of this study was to compare the satisfaction and quality of life (QoL) in a group of patients using mandibular complete dentures, implant-retained overdentures, removable partial dentures (RPDs), or implant-supported fixed partial dentures (FPDs). MATERIALS AND METHODS A total of 116 patients (aged 36 to 81, mean age 58 ± 10.03 years) were assigned to four groups (n = 29) and treated with mandibular implant-retained overdentures, implant-supported FPDs (two implants/three unit FPDs), conventional complete dentures, or RPDs. The groups were well matched in terms of gender, age, and the edentulous period. All patients had edentulous maxillary arches and completely or partially edentulous mandibles. All prostheses were mandibular prostheses. The OHIP-14, OHQoL-UK, and SF-36 surveys were used to determine QoL before implant surgery and 1 year after prosthetic treatment. RESULTS The baseline and 1-year data from 116 patients were analyzed. A significant improvement was found among the QoL scales for all groups (p < 0.05). The most significant improvement was found in the implant-retained overdenture group (15.67 ± 2.47), while the least improvement was found among the implant-supported FPD group (5.14 ± 2.08). The SF-36 test revealed no differences between the before and after treatment scores for general health, pain, vitality, social function, and physical function difficulties (p > 0.05). The only significant difference was found for mental health (p = 0.011). CONCLUSION A positive influence on oral health-related QoL was observed in all groups. The QoL values were the most improved in the implant-retained overdenture group.

The Effectiveness of a New Hemostatic Agent (Ankaferd Blood Stopper) for the Control of Bleeding following Tooth Extraction in Hemophilia: A Controlled Clinical Trial

Objective: To assess the hemostatic efficacy of a new local hemostatic agent, Ankaferd Blood Stopper (ABS), for the control of bleeding following tooth extraction in hemophiliacs. Materials and Methods: Simple tooth extractions were performed in 27 hemophilia A patients. In the treatment group (n=17) local hemostasis was achieved via application of ABS to the extraction sockets, whereas in the control group (n=10) local hemostasis was achieved via direct packing with gauze. Results: In all, 57 (21 primary and 36 permanent) teeth extractions were performed in 27 hemophilia A patients. There were no significant differences in age or factor VIII level distribution between the 2 groups (p>0.05). The most significant clinical difference between the groups was associated with the use of ABS; those in the treatment group had significantly shorter duration of bleeding (p=0.002). Conclusion: This is the first study to evaluate the efficacy of ABS for the control of bleeding following tooth extraction in hemophiliacs. ABS can be considered an alternative local hemostatic agent for reducing clotting factor concentrates in hemophilia patients. Conflict of interest:None declared.

Surgery in patients with von Willebrand disease.

Von Willebrand disease (vWD) is the most common inherited bleeding disorder. The biggest challenge in the management of vWD is the difficulty in performing surgical procedures because of bleeding. Treatment guidelines recommend the use of pure von Willebrand factor or von Willebrand factor/factor VIII (vWF/FVIII) concentrate in patients with type 2 or type 3 vWD undergoing surgery, in patients with type 1 vWD undergoing surgery who are unresponsive, and in patients for whom desmopressin acetate is contraindicated. However, there is no consensus on the dosage and optimum levels of these factors to date. The aim of this study was to evaluate the perioperative management of patients with vWD during surgical procedures. Data pertaining to surgical procedures performed at our center from 2003 to 2014 were analyzed retrospectively. All operations, except one appendectomy, were elective, and a plan for the management of hemostasis was prepared for each patient. During this period, 37 surgical procedures (major, minor, and dental) were performed in 23 patients with vWD. Complications occurred in four out of 37 procedures (10.8%). No deaths or life-threatening bleeding occurred during any of the operations and no thromboembolic events were observed. The results from this retrospective study indicate that surgery can be safely performed by providing adequate and timely hemostasis during and after the procedure in patients with vWD. Perioperative and postoperative bleeding complications are rare when patients are closely and carefully monitored.

Clinical and radiological evaluation of inverse impaction of supernumerary teeth

Objective: To describe the clinical and radiological features of children with inverted supernumerary teeth. Study Design: Thirty eight patients with inverted supernumerary teeth (ST) were enrolled in this descriptive and restrospective study. Data from patient records including age, gender, status of dentition, number of ST, number of ST in inverted position, coexistence of ST in inverted and normal direction of eruption, location, orientation, morphology, clinical complications, management and radiography were assessed during 3-years period. Results: Thirty eight patients with a mean age of 9.10±1.97 years (range:6-13) and a strong male preponderance of 3.7:1 (male:30, female:8) had a total of 69 ST, of which 41 were in inverted position. Thirty five patients had one (92.1%) inverted tooth, whereas 3 patients had two inverted teeth per case (7.9%). All cases were located in the maxilla. Midline was the most frequent site for the single inverted supernumerary tooth in 18 (47.4%) patients, followed equally by the right and left premaxillary region in 10 patients each (26.3%). Regarding morphology, 30 patients had conical (78.9%) and 8 (21.1%) had incisiform ST. No tuberculate shaped ST was detected. There was no statistically significant difference between number of inverted teeth and delayed tooth eruption, diastema, local malocclusion, palatinal swelling (p>0.05). There was no statistically significant difference between complications and age (p>0.05). Surgical removal at the time of diagnosis with subsequent follow-up during completion of permanent dentition was the treatment approach in all cases. Conclusions: Thorough clinical examination followed by a comprehensive radiographic screening is the crucial determinant of an accurate diagnosis of an impacted ST. Early diagnosis and timely management are key factors to prevent or minimize the complications, which may influence function and esthetics of the teeth and even psychological condition of the growing child. Key words:Supernumerary tooth, impaction, inverted.

Quality of life in patients with recurrent aphthous stomatitis treated with a mucoadhesive patch containing citrus essential oil

Purpose To assess 1) patient satisfaction of a mucoadhesive biopatch with citrus essential oil and 2) the change in pain severity and the oral health-related quality of life in patients with recurrent aphthous stomatitis. Patients and methods Thirty-seven patients with recurrent aphthous stomatitis participated in the study. Baseline records of personal data, ulcer assessment, visual analog scale, and Oral Health Impact Profile-14 were documented. A mucoadhesive patch was applied over the ulcer. Patients were recommended more applications if pain continued. On the fifth day, a post-therapy assessment was made. Results The mean visual analog scale scores at baseline and posttreatment were significantly different (7.3±2.11 and 4.9±2.6, respectively; P=0.001). The mean duration of pain reduced after patch application. The mean total Oral Health Impact Profile-14 scores before and after treatment showed a statistically significant difference (P=0.001). In total, 78.4% of patients reported a considerable improvement in oral functions after treatment (P=0.008). Conclusion The mucoadhesive biopatch containing citrus essential oil resulted in satisfying pain alleviation and restoration of oral functions with a significant improvement in the oral health-related quality of life.

THE PREVALENCE OF DENTAL ANOMALIES IN A TURKISH POPULATION

Purpose: The aim of the present study was to investigate the prevalence of dental anomalies in a Turkish population according to the gender and age. Materials and Methods: A retrospective study was performed using panoramic radiographs of 2025 patients (885 males and 1140 females) ranging in age from 9 to 35 (mean age 25.61±10.04) years attending Department of Oral Radiology, University of Istanbul, Faculty of Dentistry. These patients were examined to determine the presence of developmental dental anomalies involving hypodontia, hyperdontia, microdontia, taurodontism and other root anomalies. The incidence of these anomalies were assessed according to the gender and age. Results: Among the 2025 subjects, a total of 96 individuals (42 males and 54 females) showed at least one of the selected dental anomalies (4.74%). Tooth agenesis was the most common dental abnormality (1.77%) followed by taurodontism (1.18%), hyperdontia (0.79%), microdontia (0.54%) and root anomalies (0.44%), respectively. Conclusion: Tooth agenesis is the most common developmental dental anomaly in the studied Turkish population followed by taurodontism.

The evaluation of fibrin sealants and tissue adhesives in oral surgery among patients with bleeding disorders.

Objective: The aim of this study was to evaluate the efficiency of two local hemostatic agents administered with apreoperative dose of replacement therapy in patients with bleeding disorders undergoing oral surgery. Material and Methods: The study included 21 patients that were randomly divided into 3 groups. Patients in Group1 (n = 7) received preoperative replacement therapy and postoperative fibrin sealant applied to the surgical site. Patientsin Group 2 (n = 7) received preoperative replacement therapy and postoperative tissue adhesive applied to the surgicalsite. Patients in Group 3 (n = 7) were given replacement therapy pre- and postoperatively. Results: Postoperative bleeding was not observed in 17 of the 21 patients, including 5 in Group 1 (71.42%), 6 in Group2 (85.71%), and 6 in Group 3 (85.71%). Hemorrhagic complications occurred in only 4 of the 21 patients. Conclusion: The use of fibrin sealant and tissue adhesive was beneficial, as they reduced the level of factor concentratesused for replacement therapy and resulted in rapid hemostasis at the surgical site, facilitating the ability to performserial surgical procedures concurrently.