Kamile Erciyas

Effects of periodontal therapy on disease activity and systemic inflammation in rheumatoid arthritis patients

OBJECTIVE This observational prospective cohort study aimed to evaluate the effects of non-surgical periodontal treatment on clinical periodontal measurements and systemic inflammatory mediator levels in low or moderate to highly active rheumatoid arthritis (RA) patients with chronic periodontitis. SUBJECTS AND METHODS Rheumatoid arthritis activity was assessed with disease activity score test (DAS28). Thirty patients with RA with moderate to high disease activity (DAS28 ≥ 3.2) and chronic periodontitis (MHDA group) and thirty patients with RA with low disease activity (DAS28 < 3.2) and chronic periodontitis (LDA group) were enrolled in the study. The patients were monitored at the beginning and 3 months after undergoing periodontal therapy. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), tumour necrosis factor-alpha (TNF-α) levels in serum, DAS28 and periodontal parameters were evaluated. RESULTS Erythrocyte sedimentation rate, CRP, TNF-α levels in serum, DAS28 and periodontal parameters exhibited similar and significant reduction 3 months after the non-surgical periodontal treatment. CONCLUSION Non-surgical periodontal treatment may prove beneficial in reducing RA severity as measured by ESR, CRP, TNF-α levels in serum and DAS28 in low or moderate to highly active RA patients with chronic periodontitis.

Effect of tongue brushing on oral malodor in adolescents

Abstract Background : Halitosis is a common problem in humans, and is a social and psychological handicap for those affected by it. Halitosis has a positive correlation with the accumulation of bacterial plaque in the oral cavity.

Preventive effects of thymoquinone in a rat periodontitis model: a morphometric and histopathological study.

BACKGROUND AND OBJECTIVE Thymoquinone has a variety of pharmacologic properties, including antihistaminic, antibacterial, antihypertensive, hypoglycemic, anti-inflammatory and anti-oxidative activities. Through its anti-inflammatory and antioxidant properties, thymoquinone may play an important role in preventing periodontal diseases. The aim of this study was to evaluate the effectiveness of thymoquinone in preventing the initiation and progression of periodontitis in a rat periodontitis model. MATERIAL AND METHODS Twenty-four rats were randomly divided into three experimental groups: a nonligated (NL) treatment group (n = 8), a ligature-only (LO) treatment group (n = 8) and a ligature plus thymoquinone (10 mg/kg, daily for 11 d) (TQ) treatment group. In order to induce experimental periodontitis, a 4/0 silk suture was placed at the gingival margin of the right-mandibular first molars of the rats. Thymoquinone was administered by gastric feeding until the animals were killed on day 11. Changes in the alveolar bone levels of rats in each group were measured clinically, and tissues of rats in each group were examined histopathologically to determine inflammatory cell infiltration (ICI), osteoblast and osteoclast activities, and osteoclast morphology. RESULTS Alveolar bone loss around the mandibular molar tooth was significantly higher in the LO group compared with NL and TQ groups (p < 0.05). The ratio of the presence of ICI and osteoclast numbers was significantly higher in the LO group than in the NL and TQ groups (p < 0.05). Osteoblastic activity was significantly lower in the LO group than in the NL and TQ groups (p < 0.05). CONCLUSION The present study showed that the oral administration of thymoquinone diminishes alveolar bone resorption in a rat periodontitis model.

Evaluation of the Relationship between Anxiety and Depression and Bruxism

This study examined the relationship between anxiety, depression and bruxism in 99 patients with temporomandibular disorders (TMD). Patients were divided into two groups: 58 patients with bruxism and 41 without bruxism. Symptoms of TMD were evaluated according to the Craniomandibular Index. The psychological condition of patients was assessed using the Beck Depression Inventory (BDI), the Hospital Anxiety Depression Scales (HADS) and the Hamilton Anxiety Rating Scale (HAMA). The mean anxiety and depression scores (HADS and HAMA) for patients with bruxism were statistically significant higher in patients with bruxism compared with those without bruxism. Thus, there may be an association between bruxism and higher levels of anxiety and/or depression in patients with TMD.

Thymoquinone accelerates new bone formation in the rapid maxillary expansion procedure

OBJECTIVE The aim of this study was to evaluate the effect of systemic thymoquinone (TQ) in a rat rapid maxillary expansion (RME) study. DESIGN Thirty-two Wistar albino rats were divided into 4 equal groups: only-expansion (OE), expansion plus TQ (TQ1 group, TQ given to the rats during their nursery phase and during the expansion and retention period), expansion plus TQ (TQ2 group, TQ given to the rats only during the retention period), and control group (no procedure done). Expansion appliances were placed on the maxillary incisors of all animals for 5days. The appliance was deactivated during the 12day retention period. The rats were sacrificed at the end of the retention period. Histomorphometric evaluation was carried out in order to compare the number of osteoclasts, osteoblasts, and capillaries, as well as the intensities of inflammatory cells, and new bone formation amongst the groups. RESULTS New bone formation, number of capillaries and the ratio of intensities of inflammatory cells in maxillary sutures was higher in the TQ groups than in the other groups. Statistical analysis also demonstrated that osteoblast and osteoclast numbers were also highest in the TQ1 group. CONCLUSION Histomorphometric analysis demonstrated that systemic use of thymoquinone may be effective in accelerating new bone formation in the RME procedure and that TQ may be beneficial in preventing relapse following the RME procedure.

Effects of boric acid on experimental periodontitis and alveolar bone loss in rats

OBJECTIVE The goal of the present study was to evaluate the histopathologic and morphometric effects of systemic boric acid in a rat periodontitis model. DESIGN Twenty-four Wistar rats were divided into three groups of eight animals each: non-ligated (NL), ligature only (LO), and ligature and treated with boric acid (BA) (3mg/kg per day for 11 days). A 4/0 silk suture was placed in a subgingival position around the mandibular first molars; after 11 days the rats were sacrificed, and changes in alveolar bone levels were measured clinically and tissues were histopathologically examined to assess the differences amongst the study groups. RESULTS The ratio of presence of inflammatory cell infiltration (ICI) and osteoclast number in the LO group was significantly higher than that of the NL and BA groups (p<0.05). The ratio of presence of osteoblastic activity in the LO group was significantly lower than that of the NL and BA groups (p<0.05). Alveolar bone loss was also significantly higher in the LO group compared to the BA and NL groups (p<005). CONCLUSIONS This study has demonstrated that systemic administration of boric acid reduced periodontal inflammation and alveolar bone loss in periodontal disease in rats.

Effect of chronic periodontitis on oxidative status in patients with rheumatoid arthritis.

BACKGROUND Rheumatoid arthritis (RA) and chronic periodontitis (CP) are the most common chronic inflammatory diseases and have remarkable similar pathologies. The aim of this study is to investigate the impact of periodontal status on oxidative stress in patients with RA by evaluating serum oxidative parameters and prolidase levels. METHODS For this cross-sectional comparative study, the following four groups were composed of 20 individuals each (80 individuals total): 1) RA with CP (RA-CP group); 2) RA but periodontally healthy (RA-C group); 3) systemically healthy with CP (CP group); and 4) systemically and periodontally healthy (C group). Demographic, periodontal, rheumatological, and serum oxidative parameters as determined by serum total antioxidant status, total oxidant status, oxidative stress index (OSI), lipid hydroperoxide levels, paraoxonase, arylesterase, and ceruloplasmin activity, prolidase level, and total sulfhydryl groups were evaluated. RESULTS The OSI values of the RA-CP group were statistically significantly higher than those of the C group (P <0.05). The prolidase levels of the RA-C, RA-CP groups and the CP group were statistically higher than those of the C group (P = 0.001, P = 0.007, and P = 0.001, respectively). CONCLUSIONS Although CP and RA each increase oxidative stress, in a small sample size these effects are only significant when both CP and RA are combined relative to neither exposure. In addition, increased prolidase levels in patients with RA and CP may be related to increased oxidative tissue damage.

Serum cytokine levels and periodontal parameters in ankylosing spondylitis.

BACKGROUND AND OBJECTIVE Multiple studies support the role of periodontal disease in contributing to the chronic systemic inflammatory burden in a variety of diseases, including ankylosing spondylitis (AS), in the progression which the inflammatory process plays an important role. We assume that patients with AS are more likely to have periodontal disease than healthy individuals. The aim of this study was to determine the possible relationship between inflammatory periodontal diseases and AS by evaluating clinical periodontal parameters and serum cytokine levels. MATERIAL AND METHODS Forty-eight adults with AS (35 women and 13 men; age range 18-56 years; mean age 34.27 years) and 48 age- and sex-matched systemically healthy control subjects participated in the study. The clinical periodontal parameters, venous blood and Bath Ankylosing Spondylitis Disease Activity Score were obtained, and serum C-reactive protein, tumour necrosis factor-α and interleukin-6 (IL-6) levels were evaluated. RESULTS There was statistically no significant difference in the frequency of periodontitis between AS patients and the control group. Furthermore, there was no significant difference in probing depth, clinical attachment level and plaque index, and the only significant clinical difference between groups was in levels of bleeding on probing (p < 0.001). Serum concentrations of IL-6, tumour necrosis factor-α and C-reactive protein in the AS group were significantly higher than those in the control group (p < 0.001). In the AS group, there was a correlation between serum IL-6 levels and clinical attachment level (p < 0.001). CONCLUSION The results of present study suggest that bleeding on probing was the only different periodontal parameter between the AS and the control group, and the periodontal status of patients with AS may be affected by IL-6 levels.

Protective effects of ginkgo biloba extract on ligature-induced periodontitis in rats

OBJECTIVE The aim of this study was to test the hypothesis that the systemic administration of extract of Ginkgo biloba (EGb) would prevent excessive tissue destruction in ligature-induced periodontitis in a rat model. MATERIALS AND METHODS Thirty-two male Wistar albino rats were used in the current study. The rats were randomly divided into four groups of eight rats each: (1) non-ligated treatment (NL) group, (2) ligature-only (LO) group, (3) ligature plus GB28 (28 mg/kg, daily for 11 days) group and (4) ligature plus GB56 (56 mg/kg, daily for 11 days) group. RESULTS Measurement of alveolar bone loss in the mandibular molar tooth revealed significantly lower bone loss values in the LO group compared to groups NL, GB28 and GB56 (p < 0.05). CONCLUSION The present results are the first data which suggests that host response in periodontitis can be modified by EGb administration. EGb minimized progression of periodontal disease.

Generalized Gingival Hyperplasia Occurring during Pregnancy

In this report, we present a case of generalized gingival hyperplasia related to pregnancy causing chewing, speaking, breathing and cosmetic problems. The patient was a 26-year-old woman in the fourth month of her second pregnancy, with generalized gingival hyperplasia affecting both buccal and lingual aspects of the maxilla and mandible. The hyperplastic tissues, together with mobile teeth, were excised completely; no recurrence was observed for the remainder of the pregnancy. Hormonal changes occurring during pregnancy have long been known to be associated with generalized gingival hyperplasia. Pregnancy does not cause the condition, but altered tissue metabolism in pregnancy accentuates the response to local irritants. This case was of clinical interest because of the extent of tissue proliferation, with the teeth in both the upper and lower jaw completely submerged.