Hulya Toker

Effect of periodontal treatment on IL‐1β, IL‐1ra, and IL‐10 levels in gingival crevicular fluid in patients with aggressive periodontitis

AIM The aim of this study was to examine the effect of phase I periodontal treatment on the levels of interleukin (IL)-1beta, IL-1ra, and IL-10 in gingival crevicular fluid (GCF) in patients with generalized aggressive periodontitis (G-AgP). MATERIAL AND METHODS Data were obtained from 15 patients with aggressive periodontitis and 15 healthy controls. GCF was collected from at least four pre-selected sites (one shallow, at least two moderate, or at least one deep pockets) in patients with G-AgP. In the healthy group, GCF samples were collected from one site. The cytokine levels were determined by an enzyme-linked immunosorbent assay. Probing depth, clinical attachment level (CAL), gingival and plaque indices, and bleeding on probing were measured. The GCF sampling and clinical measurements were recorded at baseline and 6 weeks later after periodontal treatment. RESULTS IL-1beta levels were significantly higher at the moderate and deep pocket sites compared with the shallow sites (p<0.05). After periodontal therapy, IL-1beta levels were significantly reduced in the moderate and deep pocket sites (p<0.05). IL-1ra levels at baseline of the moderate and deep pocket sites were significantly lower than the control sites (p<0.05). IL-10 levels were similar in all pockets and did not change after periodontal therapy. CONCLUSIONS The periodontal treatment improves the clinical parameters in G-AgP, and this improvement is evident in deep pocket sites for pocket depth and CAL values. These results confirm that IL-1beta is effective for evaluating the periodontal inflammation and can thus be used as a laboratory tool for assessing the activity of periodontal disease.

N-acetylcysteine, a thiol antioxidant, decreases alveolar bone loss in experimental periodontitis in rats.

BACKGROUND The purpose of this study was to analyze the morphometric and histopathologic changes associated with experimental periodontitis in rats in response to systemic administration of N-acetylcysteine (NAC). METHODS Forty-three Wistar rats were divided into five experimental groups: non-ligated (NL) group (n = 10), ligature only (LO) group (n = 10), and groups that were administered NAC systemically (7, 35, or 70 mg/kg body weight per day [NAC7, NAC35, and NAC70 groups, respectively]; n = 8, 9, and 6). Silk ligatures were placed at the gingival margin of the lower first molars in a mandibular quadrant. The study duration was 11 days, and the animals were sacrificed at the end of this period. Changes in alveolar bone levels were measured clinically and tissues were histopathologically examined to assess the differences among the study groups. RESULTS At the end of 11 days, the alveolar bone loss was significantly higher in the LO group compared to NL, NAC7, NAC35, and NAC70 groups (P <0.05). There was no statistically significant difference in the osteoclast numbers among the study groups (P >0.05), whereas the effect of NAC was dose-dependent. CONCLUSION NAC prevented alveolar bone loss in the rat model, in a dose-dependent manner, when administered systemically.

Influence of smoking on interleukin‐1beta level, oxidant status and antioxidant status in gingival crevicular fluid from chronic periodontitis patients before and after periodontal treatment

BACKGROUND AND OBJECTIVE The aim of this study was to evaluate the impact of smoking on the relationship between interleukin-1 (IL-1β) and oxidation in patients with periodontitis and response to nonsurgical periodontal therapy. MATERIAL AND METHODS Data were obtained from 30 patients with generalized chronic periodontitis (15 smokers and 15 nonsmokers) and from 10 periodontally healthy controls. IL-1β level, total oxidant status (TOS) and total antioxidant status (TAS) were recorded in gingival crevicular fluid. Probing depth, clinical attachment level, gingival and plaque indices and bleeding on probing were also measured. The gingival crevicular fluid and clinical parameters were recorded at baseline and 6 wk after periodontal treatment. RESULTS The study showed statistically significant improvement of clinical parameters in both smokers and nonsmokers after periodontal treatment. Moreover, the baseline IL-1β levels were significantly higher in smokers compared with nonsmokers (p < 0.05). After periodontal treatment, the IL-1β levels were significantly reduced in both smokers and nonsmokers (p < 0.05). There were no significant differences in TOS and TAS between periodontitis patients and healthy controls at baseline and 6 wk after periodontal treatment. The level of IL-1β in gingival crevicular fluid was positively correlated with TOS in both smokers and nonsmokers. CONCLUSIONS Periodontal treatment improved the clinical parameters in both smokers and nonsmokers. The results confirm that periodontal therapy has an effect on IL-1β levels in gingival crevicular fluid, but not on TOS and TAS.

Alendronate enhances osseous healing in a rat calvarial defect model

AIM The aim of this study was to evaluate the effect of alendronate on osseous wound healing in an experimental model. METHODS Critical size defects were created in calvaria of 40 male Wistar rats. The animals were divided into four groups of 10 animals each: autogenous bone graft group; autogenous bone graft with systemic alendronate group (0.01 mg/kg body weight per day for 8 weeks); autogenous bone graft with local alendronate group (1mg/mL for 5 min); non-treatment (control) group. Animals were sacrificed after 8 weeks; osteoblast number, lamellar bone formation, and area of newly formed bone were analysed. RESULTS The osteoblast number significantly increased in the autogenous bone graft with local alendronate group compared to the autogenous bone graft group (p<0.05). Both systemic and local application of the alendronate significantly increased the new bone formation compared to the autogenous bone graft group (p<0.05) with no significant difference between local or systemic use (p>0.05). Local alendronate and autogenous bone graft use significantly increased the total bone area compared to autogenous bone graft alone (p<0.05). CONCLUSION Alendronate enhances the new bone formation by autogenous bone graft in the rat calvarial defect model suggesting that the inhibition of the osteoclastic activity allows an increased rate of bone apposition, which could be applicable to the inflammation-induced destruction of the periodontal tissues during disease.

N-acetylcysteine decreases alveolar bone loss on experimental periodontitis in streptozotocin-induced diabetic rats

BACKGROUND AND OBJECTIVE The purpose of this study was to evaluate the morphometric and histopathological changes associated with experimental periodontitis in diabetic rats in response to systemic administration of N-acetylcysteine (NAC), a sulfhydryl-containing thiol antioxidant. MATERIAL AND METHODS  Sixty Wistar rats were divided into six experimental groups: nonligated (NL) group; ligature-only (L) group; streptozotocin-only (STZ) group; STZ and ligature (STZ + L) group; and systemic administration of NAC and ligature (70 and 100 mg/kg body weight per day, respectively) (NAC70 and NAC100 groups). Diabetes mellitus was induced by 60 mg/kg of streptozotocin. Silk ligatures were placed at the gingival margin of the lower first molars of the mandibular quadrant. The study duration was 30 d and the animals were killed at the end of this period. Changes in alveolar bone levels were clinically measured and tissues were histopathologically examined to assess the differences among the study groups. RESULTS At the end of the 30-d study period, alveolar bone loss was significantly higher in the STZ + L group compared with the other groups (p < 0.05). Also, alveolar bone loss in all the NAC groups was significantly lower than in the STZ + L and L groups (p < 0.05). The osteoblastic activity in the NAC100 group was significantly higher than in the other groups (p < 0.05). CONCLUSION Within the limits of this study, it can be suggested that NAC, when administered systemically, prevents alveolar bone loss in the diabetic rat model.

The histopathological and morphometric investigation of the effects of systemically administered boric acid on alveolar bone loss in ligature-induced periodontitis in diabetic rats.

Abstract Objective. The purpose of this study was to evaluate the effects of systemically administered boric acid on alveolar bone loss, histopathological changes and oxidant/antioxidant status in ligature-induced periodontitis in diabetic rats. Materials and methods. Forty-four Wistar rats were divided into six experimental groups: (1) non-ligated (NL, n = 6) group, (2) ligature only (LO, n = 6) group, (3) Streptozotocin only (STZ, n = 8) group, (4) STZ and ligature (STZ+LO, n = 8) group, (5) STZ, ligature and systemic administration of 15 mg/kg/day boric acid for 15 days (BA15, n = 8) group and (6) STZ, ligature and systemic administration of 30 mg/kg/day boric acid for 15 days (BA30, n = 8) group. Diabetes mellitus was induced by 60 mg/kg streptozotocin. Silk ligatures were placed at the gingival margin of lower first molars of the mandibular quadrant. The study duration was 15 days after diabetes induction and the animals were sacrificed at the end of this period. Changes in alveolar bone levels were clinically measured and tissues were histopathologically examined. Serum total antioxidant status (TAS), total oxidant status (TOS), calcium (Ca) and magnesium (Mg) levels and oxidative stress index (OSI) were evaluated. Primary outcome was alveolar bone loss. Seconder outcome (osteoblast number) was also measured. Results. At the end of 15 days, the alveolar bone loss was significantly higher in the STZ+LO group compared to the other groups (p < 0.05). There was no significant difference in alveolar bone loss between the STZ+LO 15 mg/kg boric acid and STZ+LO 30 mg/kg boric acid groups (p > 0.05). Systemically administered boric acid significantly decreased alveolar bone loss compared to the STZ+LO group (p < 0.05). The osteoblast number in the BA30 group was significantly higher than those of the NL, STZ and STZ+LO groups (p < 0.05). Inflammatory cell infiltration was significantly higher in the STZ+LO group the other groups (p < 0.05). Serum TAS levels were significantly higher in the NL and LO groups than the other groups (p < 0.05). The differences in TOS levels were not found to be significant among all the groups (p > 0.05). The OSI values of the BA30 group were significantly lower than the STZ+LO group (p < 0.05). Also, the differences in serum calcium and magnesium levels were insignificant among the all groups (p > 0.05). Conclusion. Within the limits of this study, it can be suggested that BA, when administered systemically, may reduce alveolar bone loss in the diabetic rat model.

The effects of non-surgical periodontal therapy on oxidant and anti-oxidant status in smokers with chronic periodontitis

AIM The aim of this study was to determine the effect of non-surgical periodontal treatment on gingival crevicular fluid (GCF) and serum oxidant-antioxidant levels in smoking and non-smoking patients with chronic periodontitis. METHODS Twenty-nine patients with chronic periodontitis (15 smokers (CP-S) and 14 non-smokers (CP-NS)) and 20 periodontally healthy subjects (10 smokers (H-S) and 10 non-smokers (H-NS)) totalling 49 subjects were included in this study. GCF was collected from at least two pre-selected sites (one moderate and one deep pocket) in patients with CP. In the healthy group, GCF samples were collected from one site. Probing pocket depth, clinical attachment level (CAL), gingival and plaque indices, and bleeding on probing were measured. To determine serum total oxidant status (TOS) and total antioxidant status (TAS), venous blood was drawn from each subject. The GCF, serum sampling, and clinical measurements were recorded at baseline and 6 weeks after periodontal treatment. RESULTS The study showed statistically significant improvement of clinical parameters after periodontal treatment in both smokers and non-smokers. In the CP-S group, there were no significant differences in GCF TAS levels at both moderate and deep pocket sites between baseline and 6 weeks (p>0.05). GCF TAS levels in the CP-NS groups were significantly increased (p<0.05) at moderate and deep pocket sites between baseline and 6 weeks. GCF TOS levels in the CP-S groups were significantly decreased (p<0.05) at deep pocket sites between baseline and 6 weeks. There was no significant difference in serum TAS levels of the all periodontitis patient groups between at baseline and 6 weeks (p>0.05). Serum TOS levels in the CP-S and CP-NS groups were significantly decreased (p<0.05) after periodontal treatments. CONCLUSIONS The periodontal treatment improves the clinical parameters in both smokers and non-smokers. These results confirm that non-surgical periodontal therapy can reduce oxidative stress.

A comparative evaluation of the systemic and local alendronate treatment in synthetic bone graft: a histologic and histomorphometric study in a rat calvarial defect model

OBJECTIVE The purpose of this study was to compare the relative efficacy of systemic and local alendronate treatment of synthetic bone graft in a rat calvarial defect model. STUDY DESIGN Forty Wistar rats were divided into 4 groups: experimental animals received alendronate systemically or locally combined with micro-macroporous biphasic calcium phosphate (MBCP) graft material. In the control group, the defect was left empty. On each animal, a 5-mm standardized bone defect was created with a standard trephine bur in calvarium. All animals were killed after 8 weeks. The number of osteoclasts, osteoclast morphology, resorption lacunae, osteoblastic activity, and lamellar bone formation were histopathologically evaluated and the newly formed bone area was analyzed histomorphometrically. RESULTS Eight weeks after surgery, the number of osteoclasts and the resorption lacunae in the MBCP group using systemic alendronate therapy was significantly higher than those of the other groups (P < .05). Osteoblast number in the MBCP group using systemic alendronate treatment was significantly increased (P < .05). No significant difference was found among all MBCP groups using local or systemic alendronate treatments with regard to new bone formation (P > .05). CONCLUSIONS Within the limits of the study, alendronate, when administered systemically or locally, did not increase bone regeneration with MBCP graft in the rat calvarial defect model.

A Novel Platelet Concentrate: Titanium-Prepared Platelet-Rich Fibrin

We developed a new product called titanium-prepared platelet-rich fibrin (T-PRF). The T-PRF method is based on the hypothesis that titanium may be more effective in activating platelets than the silica activators used with glass tubes in Chouckrouns leukocyte- and platelet-rich fibrin (L-PRF) method. In this study, we aimed to define the structural characteristics of T-PRF and compare it with L-PRF. Blood samples were collected from 10 healthy male volunteers. The blood samples were drawn using a syringe. Nine milliliters was transferred to a dry glass tube, and 9 mL was transferred to a titanium tube. Half of each clot (i.e., the blood that was clotted using T-PRF or L-PRF) was processed with a scanning electron microscope (SEM). The other half of each clot was processed for fluorescence microscopy analysis and light microscopy analysis. The T-PRF samples seemed to have a highly organized network with continuous integrity compared to the other L-PRF samples. Histomorphometric analysis showed that T-PRF fibrin network covers larger area than L-PRF fibrin network; also fibrin seemed thicker in the T-PRF samples. This is the first human study to define T-PRF as an autogenous leukocyte- and platelet-rich fibrin product. The platelet activation by titanium seems to offer some high characteristics to T-PRF.

Smoking Status and Smoke-Related Gingival Melanin Pigmentation in Army Recruitments

This study aimed to define the smoking status and smoke-related gingival melanin pigmentation in army recruitments and was conducted with army recruitments in Sivas. Nine hundred eight subjects were examined. The oral and dental health of those subjects was checked and recorded. The smoking status of the subjects was self-reported and recorded on questionnaires by researchers. The chi2 test and Kruskal-Wallis test were used for statistical analysis. More than one-half of the subjects (54.3%) were primary school graduates and the mean age was 20.2 +/- 0.95 years. The response rate regarding smoking was 100%. Of the respondents, 596 (65.7%) were current smokers, 12 (1.3%) were former smokers, and 300 (33.0%) were never smokers. The gingival melanin pigmentation rate was 27.5% in current smokers and 8.6% in those who never smoked (p = 0.000). Smoking five to nine cigarettes a day appeared to be sufficient to cause gingival melanin pigmentation. The proportion of smokers who had melanin pigmentation did not change after 10 cigarettes a day. A rehabilitation project on smoking prevention and smoking cessation for army recruitments is urgently needed.