Leyla Kuru

Treatment of lateral periodontal cyst with guided tissue regeneration

Lateral periodontal cyst (LPC), originated from epithelial rests in the periodontal ligament, is a noninflammatory cyst on the lateral surface of the root of a vital tooth. LPC is generally asymptomatic and presents a round or oval uniform lucency with well-defined borders radiographically. In this case report, clinical, histological and radiographical findings and periodontal treatment of 32-year-old female patient, who was referred to Department of Periodontology Clinic of Faculty of Dentistry, Marmara University with a painless hyperplastic lesion on the distobuccal site of the tooth number 12, were presented. The tooth number 12 was vital and a well-defined round radiolucent area with corticated borders was determined radiographically. Preliminary diagnosis was LPC based on clinical and radiographical findings. Mechanical periodontal treatment consisted of oral hygiene instructions, scaling and root planing was applied and flap operation was performed to gain access to the lesion. Following enucleation of the lesion, alveolar bone destruction shaped as a tunnel from labial to palatinal site was observed. The bone cavity was grafted with bovine-derived xenograft, followed by placement of a resorbable collagen membrane. Tissues removed from of the lesion were examined histologically. Hematoxylen-eosin stained sections showed vasculature granulomatous structure underlying squamous epithelium, and destructed bone spaces, all of which were consisted with LPC. Acceptable clinical healing was achieved at 6 months follow-up period. Satisfactory clinical and radiographical outcome can be achieved in the treatment of LPC using regenerative periodontal approach.

The Influence of a Bifidobacterium animalis Probiotic on Gingival Health: A Randomized Controlled Clinical Trial

BACKGROUND There is growing interest in the use of probiotics in periodontal therapy; however, until now, most research has focused on lactobacilli probiotics. The aim of this study is to evaluate the effect of 4-week use of yogurt supplemented with Bifidobacterium animalis subsp. lactis DN-173010 versus a placebo yogurt, followed by a 5-day non-brushing period. METHODS Individuals were included in this single-mask, randomized, controlled study if probing depth (PD) was ≤3 mm and attachment loss was ≤2 mm. After professional prophylaxis, they were randomized into two groups receiving yogurt containing either placebo or B. animalis for 28 days, followed by a 5-day non-brushing period. Outcome measures were plaque index (PI), gingival index (GI), bleeding on probing (BOP), PD, gingival crevicular fluid (GCF) volume, and total amount and concentration of interleukin (IL)-1β in GCF. These were measured at baseline, after 28 days of study product use, and subsequently after 5 days of plaque accumulation. RESULTS Fifty-one patients were analyzed. No intergroup differences could be detected before and after intake of study products. However, after plaque accumulation, significantly better results for all parameters were seen in the probiotic group compared with the control group (P <0.001): lower PI and GI, less BOP, less increase in GCF volume, and lower IL-1β total amount/concentration. CONCLUSION The use of a probiotic yogurt supplemented with B. animalis can have a positive effect on plaque accumulation and gingival inflammatory parameters after refraining from oral hygiene practices.

Adjunctive Systemic Use of Beta-Glucan in the Nonsurgical Treatment of Chronic Periodontitis

Periodontal lesions in chronic periodontitis are associated with a subgingival microbiota predominated by gram-negative anaerobic rods, spirochetes and other motile microorganisms (Tanner et al., 1979). Chronic periodontitis is a complex process itself involving periodontal microorganisms, immune system and host factors. One reason for the augmented colonization of these periodontopathogens is believed to be related with a weak specific T helper 1-mediated immunity (Bartova et al., 2000; Breivik & Thrane, 2001; Wassenar et al., 1998) and, the immune response in patients with periodontal lesions may be inclined towards a strong T helper 2-mediated immunity. Immune functions can be enhanced by activating macrophages and establishing Th1 dominance (Inoue et al., 2002; Lee et al., 2002). The use of certain immunomodulating agents may stimulate immune response and activate macrophages and neutrophils. Beta-glucan (┚-glucan), a polysaccharide extracted from cell walls of Saccharomyces cerevisiae, has been found to have immunomodulatory effects in animals and humans (Babineau et al., 1994; Bleicher & Mackin, 1995; Chan et al., 2009; Engstad, 1994; Engstad et al., 2002). It increases resistance to bacterial infections and cancer cells while stimulating wound healing (Brown & Gordon, 2001; Chan et al., 2009; Yun et al., 2003). Numerous studies have shown that ┚-glucan is a stimulator activating phagocytosis, respiratory burst, and the production of cytokines and chemokines in macrophages (Kankkunen et al., 2010; Sherwood et al., 1987, Williams & Di Luzio, 1980). Recently, the possibility of subcutaneous injections of ┚-glucan being able to modulate allergic sensitisation has been demonstrated in children (Sarinho et al., 2009). The authors proposed a new therapeutic strategy in allergic diseases as ┚-glucan possesses a beneficial action in restoring T helper 2 function (Sarinho et al., 2009). Furthermore, besides its antibacterial effects, antiviral and antifungal properties of ┚-glucan have been put forward (Bedirli et al., 2003; Di Luzio et al., 1980; Jung et al., 2004; Kenyon, 1983; Kernodle et al., 1998; Leblanc et al., 2006; Nicoletti et al., 1992; Tzianabos, 2000). The protective effect of ┚-glucan has been established to Staphylococcus aureus (Di Luzio & Williams, 1978), Escherichia coli, Listeria monocytogenes, Mycobacterium leprae, Candida albicans (Williams et al., 1978), Pneumocytis carinii, Leishmania donovani and Influenza virus (Jung et al., 2004).

Clinical Findings of Children With Epidermolysis Bullosa: Case Reports of Three Siblings

Epidermolizis bulloza, (EB) deri ve mukozada travmaya karsi cevap olarak meydana gelen bul olusumuyla karakterize ailesel gecisli bir vezikulobulloz hastaliktir. EB hastalarinin dental tedavilerinde kullanilan aletlerin yumusak doku lezyonu olusturmasi riski yuksektir ve ozel onlem gerektirmektedir. Bu vaka raporunda, ebeveynleri akraba olan, EB’li uc kardesin klinik ve oral bulgulari sunuldu. Birinci vaka deri lezyonlari, mikrostomi, ankiloglossi ve kotu agiz hijyenine sahip 5 yasindaki bir kiz cocugu idi. Ikinci vaka olan 4 yasindaki kiz cocugunda sadece ayak tirnaginda deformite mevcuttu. Ucuncu vaka, deride cok sayida kabarcigi bulunan ankiloglossi ve kotu agiz sagligina sahip 2 yasindaki bir erkek cocuk idi. Bu cocuklarin agiz sagligi, oral hijyenin saglanmasi, koruyucu uygulamalar ve duzenli kontroller ile idame edildi.

Efficacy of adjunctive photodynamic therapy in the treatment of generalized aggressive periodontitis: A randomized controlled clinical trial: PHOTODYNAMIC THERAPY IN AGGRESSIVE PERIODONTITIS

Generalized aggressive periodontitis (GAgP) is a distinct type of periodontal disease characterized by rapid loss of attachment and alveolar bone occurring in young individuals. Photodynamic therapy (PDT) was introduced in periodontology as an adjunctive approach to non‐surgical periodontal treatment (NPT) in periodontitis patients. In this trial, the aim was to evaluate the clinical and microbiological effects of adjunctive PDT to NPT in patients with GAgP.

Evaluation of the Effectiveness of Esterified Hyaluronic Acid Fibers on Bone Regeneration in Rat Calvarial Defects

Hyaluronic acid (HA) constitutes one of the major components of the extracellular matrix domain in almost all mammals. The aim of this study was to evaluate the regenerative capacity of HA matrix in rat calvarial bone defects and compare with those of different combinations of resorbable collagen membrane (M) and bovine-derived xenograft (G). Twenty-four 3-month-old male Sprague-Dawley rats weighing 200-250 g were included. Control group was created by leaving one defect empty from 2 critical size defects with 5 mm diameter formed in the calvarial bones of 8 rats. In the same rats, the other defect was treated with HA matrix alone. One of the 2 defects formed in other 8 rats was treated with HA+G and the other with HA+M. One of the 2 defects formed in the remaining 8 rats was treated with G+M and the other with HA+G+M. The animals were sacrificed at 4 weeks. Histologic, histomorphometric, and immunohistochemical analyses were performed. Both HA matrix alone and its combinations with G and M supported new bone formation (NBF). However, NBF was significantly greater in G+M and HA+G+M groups compared to control and HA alone (P<0.001). Bone morphogenetic protein-2 was expressed with varying degrees in all groups, without any difference among them. Within the limitations of the present study, HA matrix, used alone or in combination with G and M, did not contribute significantly to bone regeneration in rat calvarial bone defects.

Is there a relationship between hyperlipidemia and periodontitis

Assist. Prof. Ömer Birkan Ağralı Marmara University, Faculty of Dentistry Department of Periodontology Başıbüyük Mahallesi, Başıbüyük Yolu 9/3, 34854, İstanbul Tel: +90505 906 00 38 E-Mail: omer.agrali@marmara.edu.tr SUMMARY Aim: The aim of present study is to investigate any relationship between hyperlipidemia and periodontal disease. Materials and Methods: In this cross sectional study, a total of 160 individuals were divided into two groups based on their metabolic status: hyperlipidemic group (n= 97) and normolipidemic group (n= 63). Plaque index, gingival index, bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL) and CPITN scores were measured. Triglyceride (TG), total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C) and high density lipoprotein-cholesterol (HDL-C) levels had been determined during previously routine systemic examinations. Daily brushing habits, interdental cleaning, dietary habits, alcohol consumption and physical activity were also recorded. Results: The mean BOP (%), PD, CAL, CPITN scores of the hyperlipidemic group were higher than the normolipidemic group (P< 0.05). TG showed positive association with TC, LDL-C, CAL, and negative association with HDL-C, CPITN (P< 0.05). Positive correlations were detected between TC and TG, LDL-C, HDL-C, BOP, PD, CAL, BMI (P< 0.05). LDL-C was positively correlated with PD, CAL (P< 0.05). Positive correlations were detected among all periodontal parameters as expected. Conclusion: Our findings suggest that patients with hyperlipidemia manifested higher values of periodontal parameters compared to normalipidemic individuals and are more prone to periodontal disease.

RELATIONSHIPS BETWEEN INITIAL PROBING DEPTH AND CHANGES IN THE CLINICAL PARAMETERS FOLLOWING NON-SURGICAL PERIODONTAL TREATMENT IN CHRONIC PERIODONTITIS

Purpose: The aim of this study was to evaluate the relationship between initial probing depth (IPD) and changes in clinical parameters following non-surgical periodontal treatment (NPT) in chronic periodontitis patients. Subjects and Methods: A total of 1672 periodontal pockets having 3mm≤IPD≤9mm of depth in 15 chronic periodontitis patients were included. NPT consisting of oral hygiene instructions, scaling and root planing was applied in two sessions. Probing depth (PD), clinical attachment level, gingival recessions (GR) were measured before and eight weeks after treatment. Pocket sites were grouped according to their IPD and root number as single- or multi-rooted teeth. Results: Other than the sites having 3 mm IPD, PD reduction and GR increase were significant in all groups (p<0.001). Attachment gains (AG) were significant in all single-rooted teeth (p<0.001) again except those having IPD=3mm. However, AG was significant in multi-rooted teeth having only 7mm≤IPD≤9mm (p<0.05). Positive correlations were observed between IPD and PD reduction, GR increase and AG in single-rooted teeth (p<0.001). Furthermore, positive correlations were found between IPD and PD reduction and GR increase in multi-rooted teeth (p<0.001), but there was no correlation between IPD and AG. Conclusion: NPT may lead to positive association between IPD and PD reduction as well as GR increase, which is independent from tooth root anatomy.

Do platform switching together with subcrestal placement have a benefit on marginal bone levels around dental implants

Amac: Bu retrospektif calismanin amaci ozel klinige basvuran tam veya kismi dissiz hastalara uygulanan subkrestal ve platform switch dental implantlarin etrafindaki marjinal kemik seviyelerini tespit etmektir. Gerec ve Yontemler: Ortalama 5.3±1.7 yildir fonksiyonda olan 200 dental implanta sahip 64 hasta bu calismaya dahil edilmistir. Implantlar tek ya da cift asamali cerrahi yontemle 0,5 mm subkrestal yerlestirilmistir. Implantlarin dagilimi, boyutlari, protetik restorasyon tipleri ve marjinal kemik seviyeleri kalibre edilmis tek bir arastirmaci tarafindan yapilmistir. Bugular: Genel olarak ortalama marjinal kemik kaybi 0.82±1.6 mm olarak bulundu. Implantlarin %66’sinda (n=81) kemik kaybi gorulmezken, %28’inde (n=35) >1 mm kemik kaybi, %20’sinde (n=25) >2 mm kemik kaybi goruldu. Ortlama 1-≤3 yildir fonksiyonda olan 18 implantin 14’unde kemik kaybi gorulmedi. Ortalama 3-≤5 yildir fonksiyonda olan implantlarin %25’inde (n=15) kemik kaybi >1 mm ve %12’sine (n=7) kemik kaybi >2 mm olarak bulundu. Bu calismada implantlarin buyuk bir cogunlugunun 5 yildan fazladir fonksiyonda oldugu tespit edildi (n=122). Bunlardan %66’sinda (n=81) kemik kaybi gorulmezken, %28’inde (n=35) >1 mm kemik kaybi ve %20’sinde (n=25) >2 mm kemik kaybi goruldu. Sonuc: Bu retrospektif calismanin sinirlari dahilinde, uzun bir takip donemi sonucunda platform switch ve subkrestal yerlestirilen implantlar etrafinda oldukca az kemik kaybi goruldugu soylenebilir. Ancak, bu bulguyu desteklemek icin daha fazla calismaya ihtiyac duyulmaktadir.

Evaluation of gingival crevicular fluid transforming growth factor-β1 level after treatment of intrabony periodontal defects with enamel matrix derivatives and autogenous bone graft: A randomized controlled clinical trial.

AIM The present study aimed to evaluate the effects of enamel matrix derivatives (EMD) either alone or combined with autogenous bone graft (ABG) applied to intrabony defects in chronic periodontitis patients on clinical/radiographic parameters and gingival crevicular fluid (GCF) transforming growth factor-β1 (TGF-β1) level and to compare with open flap debridement (OFD). MATERIALS AND METHODS A total of 30 deep intrabony defects in 12 patients were randomly treated with EMD + ABG (combination group), EMD alone (EMD group), or OFD (control group). Clinical parameters, including plaque index, gingival index, bleeding on probing, probing depth, relative attachment level, and recession were recorded at baseline and 6 months postsurgery. Intrabony defect fill percentage was calculated on the standardized radiographs. TGF-β1 level was evaluated in GCF just before surgery and 7, 14, 30, 90, 180 days after surgery using enzyme-linked immunosorbent assay. RESULTS All treatment procedures led to significant improvements at 6 months (P < 0.01). Gain in attachment level (P < 0.01) and radiographic defect fill (P < 0.05) of the combination and EMD groups were found to be significantly higher than those of the control group, while the use of EMD either with ABG or alone was observed to produce significantly less recession than the OFD (P < 0.05). CONCLUSION The findings suggest no clinical and radiographic differences between the combination and EMD groups whereas GCF TGF-β1 level demonstrates an increase during the healing phase and is positively affected from EMD.