Mustafa Cenk Durmuşlar

Concentrated growth factor in the treatment of adjacent multiple gingival recessions: a split‐mouth randomized clinical trial

AIM The aim of this study was to determine the clinical effect of concentrated growth factor (CGF) in combination with coronally advanced flap (CAF) compared to CAF alone for the treatment of multiple adjacent gingival recessions (GRs). MATERIALS AND METHODS Twenty patients with a total of 119 Miller Class I and II GRs in the maxilla were included to this study. Recessions were randomly treated according to a split-mouth design by means of CAF + CGF (test; 60 defects) or CAF (control; 59 defects). Clinical outcomes were evaluated at baseline and 6 months after surgery. RESULTS The mean root coverage (MRC) was 82.06% and 86.67%, complete root coverage (CRC) was 45.8% (27/59) and 56.7% (34/60) for CAF and CAF + CGF, respectively at 6th month. Statistically no difference was demonstrated between the two groups in terms of recession depth (RD), MRC and CRC at 6th month. The increase in width of keratinized gingiva (KGW) and gingival thickness (GT) were statistically significant in the CAF + CGF group compared to the CAF group at 6th month. CONCLUSIONS The use of CGF in combination with CAF did not provide additional benefits in RD, CRC and MRC. This study suggests that use of CGF + CAF may increase the success of GRs because of a significant increase in KGW and GT.

Prevalence and characteristics of supernumerary teeth: A survey on 7348 people

Objective: The aim of the present study was to determine the prevalence of supernumerary teeth with by evaluating a large group of adult patients in Turkey and to investigate the characteristics of supernumerary teeth with their complications and treatment options. Study Design: This descriptive and retrospective study was carried out in 7348 adult patients aged over 18 years (3212 females and 4136 males). The characteristics of the supernumerary teeth were noted and the diagnosis was made during clinical and radiographic examination with the help of panaromic, periapical, and occlusal radiography. Information on the demographic variables for each patient, including age and gender, were colleceted. Materials and Methods: All supernumerary teeth were classfied under several titles such as location, position, morphology, eruption, clinical complications, and treatment protocols. The data obtained were subjected to statistical analysis. Chi-squared test was used to determine differences in distribution of supernumerary teeth when stratified by gender. The statistical significance was established by confidence interval of 95% (P ≤ 0.05). Results: 123 (2.14%) affected patients (69 females and 54 males) were observed with a female:male ratio of 1.28:1 (P < 0.05). One hundred and fifty-six supernumerary teeth were detected in all affected patients. Conclusion: Supernumerary teeth may be observed in adults patients with a similar frequency (2.14%) as in children and young adolescents, and clinicians should take measures and examine all patients carefully even at older ages.

Primary malignant melanoma

Malignant melanomas (MM) of the oral cavity are extremely rare, accounting for 0.2% to 8.0% of all malignant melanomas. Malignant melanomas is more frequently seen at the level of the hard palate and gingiva. Early diagnosis and treatment are important for reducing morbidity. Malignant melanoma cells stain positively with antibodies to human melanoma black 45, S-100 protein, and vimentin; therefore, immunohistochemistry can play an important role in evaluating the depth of invasion and the location of metastases. A 76-year-old man developed an oral malignant melanoma, which was originally diagnosed as a bluish reactive denture hyperplasia caused by an ill-fitting lower denture. The tumor was removed surgically, and histopathological examination revealed a nodular-type MM. There was no evidence of recurrence over a 4-year follow-up period.

Glutathione levels in plasma, saliva and gingival crevicular fluid after periodontal therapy in obese and normal weight individuals.

BACKGROUND AND OBJECTIVE The purpose of this study was to investigate the effects of obesity on reduced and oxidized glutathione (GSH and GSSG) levels in the gingival crevicular fluid, plasma and saliva of patients with chronic periodontitis and to evaluate the changes after nonsurgical periodontal therapy. MATERIAL AND METHODS The study included 60 patients: 30 patients with chronic periodontitis (15 obese patients and 15 normal weight patients) and 30 healthy control subjects (15 obese patients and 15 normal weight patients). Gingival crevicular fluid, plasma and saliva samples were collected, and clinical periodontal measurements were recorded at baseline and at the first month after periodontal therapy from patients with chronic periodontitis. GSH and GSSG levels were analyzed with spectrophotometry. RESULTS The GSH levels in the plasma, saliva and gingival crevicular fluid in obese individuals with chronic periodontitis were lower than in normal weight individuals at baseline (p < 0.01). There was a significant difference in the GSH/GSSG ratio in plasma and gingival crevicular fluid between the obese and normal weight groups at baseline (p < 0.01). The GSH levels in plasma, gingival crevicular fluid and saliva were significantly increased in both chronic periodontitis groups after nonsurgical periodontal therapy (p < 0.01). A significant positive correlation was found between GSH levels in saliva, plasma and gingival crevicular fluid in all groups (p < 0.001). CONCLUSIONS The study revealed that obesity in patients with chronic periodontitis is associated with decreased GSH levels and the GSH/GSSG ratio. Moreover, nonsurgical periodontal therapy may be helpful for improvement in glutathione values in obese and normal weight individuals with chronic periodontitis.

Histological Evaluation of the Effect of Concentrated Growth Factor on Bone Healing.

Objectives:The aim of this study was to evaluate the effects of concentrated growth factors (CGF) on the healing of peri-implant bone defects in an animal model. Study Design:Twenty 4-month-old New Zealand White rabbits, each with an average weight of 3.5 kg, were used in this blinded, prospective, experimental study. Two implants were placed and 2 peri-impant defects were prepared in each rabbit tibia. Bone defects were created monocortically in the tibia of each rabbit using a trephine burr with a diameter of 8 mm. The implants were installed in each hole. The rabbits were divided into 4 groups: in group E, the defect was left empty; in group CGF, the defects were filled only with CGF; in group AB, the defects were filled with autogenous bone; and in group AB+CGF, the defects were filled with autogenous bone and CGF. The animals were euthanized at week 8 postimplantation. All implants from the 20 animals were fixed in 10% formalin and evaluated histomorphometrically. Results:The mean defect area was highest in group E and lowest in group CGF+AB (P <0.05). The area of the defect differed significantly between groups AB and CGF+AB (P <0.05), but not between groups CGF and E. Implant-to-bone contact was lowest in group E. In the defect areas of groups CGF, AB and CGF+AB, a small amount of new bone formed around the implant. Conclusions:In this animal model of a peri-implant bone defect, restoration was achieved using a combination of autogenous bone and CGF. Further studies are needed to determine the behavior of CGF when used in the repair of bone defects in humans.

The effect of initial periodontal treatment on plasma, gingival crevicular fluid and salivary levels of 8-hydroxy-deoxyguanosine in obesity

OBJECTIVE Recent studies have shown adverse effects on the periodontium from the increased production of reactive oxygen species (ROS) in obesity. The purpose of this study was to investigate the effects of obesity on 8-hydroxy-deoxyguanosine (8-OHdG) levels in the bodily fluids of patients with and without periodontal disease and to evaluate changes after initial periodontal treatment. DESIGN Forty-five obese individuals and 45 normal-weight individuals were included in this study. Obese and normal-weight groups were classified into three sub-groups: chronic periodontitis (CP), gingivitis (G) and periodontally healthy controls (CTRL). Gingival crevicular fluid (GCF), plasma, saliva samples and clinical measurements were obtained at baseline and a month after initial periodontal treatment. Levels of 8-OHdG were analysed by ELISA. RESULTS While plasma 8-OHdG levels were significantly higher at baseline in the obese patients with periodontal disease than in the normal-weight individuals (P<0.05), no significant differences in GCF and saliva 8-OHdG levels were found (P ˃ 0.05). GCF and salivary 8-OHdG levels in obese patients with G and CP were significantly higher than in CTRL groups at baseline (P<0.05). After treatment, 8-OHdG levels were decreased in all groups with periodontal disease (P<0.01). Statistically significant positive correlations were observed between GCF 8-OHdG levels and GI in all the groups (P<0.001). CONCLUSIONS The significant increase of plasma 8-OHdG levels in obese patients did not correlate with saliva and GCF 8-OHdG levels when compared to normal-weight individuals. Periodontal treatment had a positive effect on the periodontal parameters and 8-OHdG levels of both obese and normal-weight individuals.

Effect of Local Rosuvastatin Administration on Calvarial Bone Defects

AbstractThe purpose of this study is to investigate the potential of the local administration of different doses of rosuvastatin (RSV) on autogenous grafted critical-sized cortical bone defects. Twenty-four rats were divided into 3 groups: Group C (control), Group RSV-0.1, and Group RSV-1. A 5-mm diameter critical-size defect was created in the calvarium of each animal. In Group C, the defect was filled by autogenous graft and sterile saline–treated absorbable collagen sponge (ACS) was applied. Defects in the experimental groups (groups RSV-0.1 and RSV-1) were grafted by autogenous graft and ACS with saline solution containing 0.1- and 1-mg RSV were applied. All animals were euthanized at 28 days after operation. Stereologic and micro-computed tomography (&mgr;CT) analyses were performed. New bone area and connective tissue volumes were measured. Stereologic analysis showed that the difference between group RSV-1 with a mean bone formation of 1.79 ± 0.06 mm3 and groups RSV-0.1 and control (C) was statistically significant (P ⩽ 0.05) with a mean bone formation of 1.29 ± 0.28 mm3 and 1.08 ± 0.12 mm3, respectively. Connective tissue volume was also significantly higher in 1-mg RSV applicated group. Micro-CT results were similar with stereologic analyses. Local administered 1-mg RSV enhances bone regeneration in critical-size calvarial rat defects filled with autogenous graft.

Evaluation of the accuracy of cone beam computed tomography on measuring impacted supernumerary teeth.

Supernumerary teeth may affect the tooth eruption negatively if they occur on the eruption way, and the treatment choice is usually the extraction to prevent the impaction of adjacent permanent teeth. CBCT enables clear and three dimensional images, and it may be helpful to determine the exact location and to measure the dimensions of the supernumerary tooth to avoid any complication during the extraction process. The aim of the present study was to evaluate the accuracy of CBCT on measuring the tooth length and crown width of impacted supernumerary teeth. Twenty-five impacted supernumerary teeth were evaluated using CBCT, and each samples tooth length and crown width were measured prior to the extraction. After all the extractions were completed, the actual measurements were performed on the same samples. The differences between CBCT and actual measurements were evaluated statistically. Measurements on CBCT images were significantly larger than the actual measurements on tooth length and crown width. For tooth length and crown width, p value was found as 0.045, and <0.001, respectively. The results of the present study should be considered as important by clinicians during the treatment planning to decrease any complication risk under certain conditions such as being so close to an important anatomical structure or the root of an adjacent tooth. SCANNING 38:579-584, 2016.

The Local Effect of Puerarin on Critical-Sized Calvarial Defects

Abstract Pueraria, the root of Pueraria lobata, is a commonly used herb in alternative medicine. This study evaluates the effect of puerarin and autogenous graft material combination on bone regeneration in calvarial critical-sized bone defects. Twenty-four rats were randomly divided into 3 groups of 8 rats each. A 5-mm diameter critical-sized defect was created in the calvarium of each animal. In group C, defects were left unfilled and were allowed to heal spontaneously without the use of any grafting material. Critical-sized bone defect created in animals receiving no treatment. In group ABG, defects were filled with autologous bone graft only. In group P-ABG, defects were filled with autologous bone graft and puerarin combination. All animals were euthanized at 28 days postoperative. Stereologic analyses were performed. New bone area and connective tissue volumes were measured. Stereologic analysis showed that the difference between grafted groups (P-ABG and ABG) and group C was statistically significant with a mean bone formation of 1.13 ± 0.09, 1.11 ± 0.11, and 0.31 ± 0.09 mm3 respectively (P ⩽0.05). The connective tissue volumes were also statistically higher in groups P-ABG and ABG (P ⩽0.05). Puerarin has positive effect on new bone formation in autogenous grafted critical-sized bone defects.

Radiological and Stereological Evaluation of the Effect of Rifampin on Bone Healing in Critical-Size Defects.

Objectives:This study aimed to investigate the effect of rifampin with autogenous bone on bone regeneration in critical-size defects in the calvaria of rats. Materials and Methods:In total, 40 rats were divided into 4 groups and a 5-mm diameter of calvarial defect was made in each rats calvarium. Control group (C), bone defects were irrigated with sterile saline; rifampin group (R), bone defects were irrigated with rifampin. In the autogenous graft group (Ag), the autogenous graft was contaminated with saliva, and the defects were filled with an autogenous graft. In the autogenous graft + rifampin group (Ag+R), the autogenous graft was contaminated with saliva and was decontaminated with rifampin, and the defects were filled with the autogenous graft. The animals were killed at 4weeks. Bone formation was assessed by micro-computed tomography scanning and stereological analyses. Results:The mean new bone volume was the greatest in the Ag/rifampin group (1.73 ± 0.17), followed by the Ag group (1.50 ± 0.05) (statistically significant difference at P < 0.05). The new bone volume was the lowest in the control group (1.05 ± 0.09); however, no difference was observed compared with the rifampin group (1.08 ± 0.07) (P > 0.05). Conclusion:This study, despite its limitations, showed that rifampin with autogenous bone increased bone regeneration in rats with critical-size defects.