Mehtap Muglali

Cytokine and chemokine levels in radicular and residual cyst fluids.

BACKGROUND Cytokines were thought to play an important role for the expansion of odontogenic cysts. The purpose of this study was to evaluate the cytokine and chemokine levels of radicular and residual cyst fluids. METHODS Cyst fluids were aspirated from 21 patients (11 radicular and 10 residual cysts) and the levels of interleukin-1 alpha (IL-1alpha), tumor necrosis factor-alpha (TNF-alpha), monocyte chemotactic protein-1 (MCP-1), and regulated upon activation normal T cell expressed and secreted (RANTES) were determined by ELISA using commercially available kits. RESULTS Both radicular and residual cyst fluids contained IL-1alpha, TNF-alpha, MCP-1, and RANTES, concentrations of which were significantly higher in the radicular cyst fluids than those in the residual cysts (P < 0.001 for IL-1alpha, TNF-alpha, and RANTES; P < 0.01 for MCP-1). Compared to the other mediators, the concentration of IL-1alpha was found to be highest in both of the cyst fluids. In addition, positive correlations were found between IL-1alpha, TNF-alpha, MCP-1, and RANTES in radicular and residual cyst fluids. CONCLUSION If the radicular cyst is inadvertently left behind following tooth extraction, some degree of inflammation may carry on. Residual cysts, although to a lesser extend than radicular cysts, have the potential to expand.

Immunohistochemical comparison of indermil with traditional suture materials in dental surgery.

The aim of this experimental study was to evaluate the effects of indermil on the closure of oral mucosa wounds in comparison with conventional sutures by investigating interleukin 1&bgr; (IL-1&bgr;) and tumor necrosis factor &agr; (TNF-&agr;) markers immunohistochemically in an animal model. The animals were anesthetized by intraperitoneal injection of ketamine (90 mg/kg body weight). Straight incisions were made to the buccal mucosa of the animals. Animals were randomly assigned to 5 groups. Five different materials were used in the study. These were silk, plain catgut, monocryl, vicryl rapide (polyglactin 910), and indermil (N-butyl-2-cyanoacrylate). The wounds were closed primarily. After the region of wounds was examined clinically at the 2nd, 7th, 14th, and 21st days, excisional biopsies were performed, and the tissue samples were examined histopathologically and immunohistochemically. On the 14th day, TNF-&agr; and IL-1&bgr; levels were high in the plain catgut group, moderate in the indermil group, and mild in the monocryl, silk, and vicryl rapide groups. On the 21st day, TNF-&agr; and IL-1&bgr; levels were moderate in the plain catgut group, mild in the indermil and monocryl groups, and nonsignificant in the silk group. After the second day, TNF-&agr; and IL-1&bgr; levels were mild in the monocryl, silk, and vicryl rapide groups. Plain catgut had more negative effects than indermil on wound healing. Indermil should be applied to oral mucosa wounds together with sutures to provide better tissue support.

Fixation of vertically distracted segment with dental implants after breakage of distraction device: case report.

Distraction osteogenesis is an efficient method to augment the mandibular alveolar process for dental implants. Complications of this procedure include fracture of the basal bone, breakage of distractor, wound dehiscenses, undesirable soft tissue changes, and defective movement of the transported segment. We report a case of breakage of the distractor after mandibular alveolar vertical distraction osteogenesis. Mandibular alveolar vertical distraction osteogenesis was applied to 53-year-old woman for prosthetic rehabilitation. Fracture of the distraction device occurred on the 13th day of the activation phase. Radiographic examination revealed the fracture of the distractor rod and lingually displaced alveolar segment. Lingually displaced segment was successfully advanced to the desired position, and fixed to the basal bone using dental implants before the maturation of the distracted bone. We consider that this technique is eligible for the management of these kind of complications.

Comparison of the planimetry and point-counting methods for the assessment of the size of the mandible cysts on orthopantomograms

Objective: The purpose of this study is to compare the computer-assisted planimetry and point-counting methods in evaluating the sizes of the mandibular cysts with respect to their agreement and the time required to analyze. Study Design: The surface areas of 46 mandibular cyst lesions on orthopantomograms were estimated using the point-counting and computer-assisted planimetry methods. Three observers evaluated the outlined areas twice, using the point-counting (PC) and computer-assisted planimetry (CAP) methods with an interval of two weeks. In the planimetry technique, digitalized images and ImageJ software were used to measure the surface area of the half mandibles and cysts. The grids were superimposed over the same images and the number of points hitting the interested structures was counted for the point-counting technique. The projection area fraction (PAF) of the cysts within the mandible was estimated using the obtained values by means of the two techniques. Intraclass correlation coefficient was used to assess the level of agreement between the two methods. Inter-rater reliability analysis using the Kappa statistic was performed to determine consistency among raters. Results: CAP and PC techniques showed consistent intra-observer values in all observers. Intraclass correlation between CAP and PC measurements of first, second and third observers were found to be 0.9986, 0.9988 and 0.9994 respectively. The durations of PC technique was 32% higher than the CAP technique. Conclusion: PC and CAP methods were seemed to show sufficient agreement to be used interchangeably. The main disadvantage of the PC analysis is it takes more time than CAP method. Key words:Orthopantomogram, mandible, cyst, point-counting, planimetry.

Excessıve fluorıde ıntake alters the MMP-2, TIMP-1 and TGF-β levels of perıodontal soft tıssues: an experımental study ın rabbıts

ObjectivesThis study evaluated the influence of fluoride on periodontal soft tissues by investigating any alterations in their MMP-2, TIMP-1 and TGF-β profiles secondary to excessive fluoride intake.Material and methodsFluorosis was induced in 18 rabbits (test group) through consumption of fluoride added to drinking water, whereas 10 rabbits consumed regular tap water as daily supply (control group). Following fluorosis verification, animals were sacrificed and their 1st mandibular molar teeth were utilized in the assessments. MMP-2, TIMP-1 and TGF-β were separately investigated for gingival epithelium (GE), gingival connective tissue (GC) and periodontal ligament (PL) to evaluate periodontal soft tissues. Histological sections were prepared from the groups, the parameters were determined by immunohistochemistry, and their levels were calculated by quantification of the immunostainings.ResultsStaining intensity of MMP-2 in GC and PL (p < 0.01); TIMP-1 and TGF-β of GE, GC and PL (p < 0.01) were higher in the test group compared to those of the control group. Intra-group staining of TIMP-1 was higher than MMP-2 in all test group compartments (p < 0.01) and in the control group GE (p < 0.01). TIMP-1 was also higher than TGF-β in the GE and PL of the test group (p < 0.05) and in the GE of the control group (p < 0.01).ConclusionThese results suggest that excessive fluoride intake may affect periodontal soft tissues by increasing MMP-2, TIMP-1 and TGF-β, and thereby altering the MMP-2/TIMP-1 and TIMP-1/TGF-β ratios.Clinical relevanceExcessive fluoride consumption may alter the periodontal tissue homeostasis which may be detrimental in the maintenance of periodontal health.

Horizontal alveolar distraction of the mandibular canine regions for implant placement.

Horizontal alveolar augmentation by distraction osteogenesis is an alternative method for reconstructing atrophic alveolar bone. A 65-year-old woman with atrophy of the alveolar rim in the anterior lower jaw, which had inadequate width for implant placement, was presented. Under general anesthesia, vertical and horizontal osteotomies of the buccolabial cortical bone were performed in the canine regions bilaterally. Modified horizontal distraction devices were stabilized to the mandible. Distraction proceeded from the seventh postoperative day at a rate of 0.450 mm twice a day for 6 days. After 3 months, distraction osteogenesis occurred and increased the alveolar width from 2 to 7 mm. Two implants were placed in the distracted areas. Marginal bone resorbtion around the implants was not observed 12 months after implant placement.

Assessment of the Effects of Curacel and Bone Wax on the Acute Oroantral Opening Site by means of Computer Tomography and Histopathology

PurposeIn this study, the effects of Curacel TM oxidized regenerated cellulose and bone wax on the healing bone were compared to each other by means of CT based bone density measurement and histopathological evaluation.MethodsThe bone density measurements of the control group were significantly higher than those of both Curacel and bone wax groups.ResultsThere was no significant difference between Curacel and bone wax. Histopathologically, the bone wax group showed more osteoblastic activation than Curacel group. For all measurement parameters (osteoblastic activation, osteoclastic activation, fibrous connective tissue, osseous trabeculae), Curacel and bone wax groups had worse results than control group. It is concluded that Curacel has no superiority over bone wax in terms of osseous healing in the oroantral region. There is no need to use oxidized regenerated cellulose or bone wax for small oroantral openings since the healing is better without any intervention. In addition, bone density measurement and histopathological evaluation were consistent in terms of osseous healing of the oroantral opening.

Comparison of lidocaine metabolism for different anesthesia techniques in rabbits with liver disease

OBJECTIVE This study was designed to investigate the serum lidocaine concentrations (SLC) after local infiltration anesthesia (IA) and mandibular anesthesias (MA) in rabbits with carbon tetrachloride (CCl₄)-induced chronic liver damage (CLD). STUDY DESIGN Fourteen rabbits were administered CCl₄ in group 1, MA (CLD-MA; n = 7); in group 2, IA (CLD-IA; n = 7); in group 3, MA (H-MA; n = 7); and in group 4, IA (H-IA; n = 6) was performed. SLC were measured. RESULTS SLC showed difference over time. At the 10th minute, mean SLC in IA groups were higher than in MA groups. At the 120th minute, the highest mean concentration was found in the CLD-IA group. CONCLUSIONS SLC increases in CLD, and serum lidocaine concentration after IA in the mandibular anterior region is higher than it is after MA.