Semih Özbayrak

Cytokine profiles in serum of patients with oral lichen planus.

OBJECTIVE Oral lichen planus (OLP) is a chronic inflammatory disorder of oral mucosa, which represents T-cell-mediated autoimmune diseases. The inflammatory response in OLP is characterized by the accumulation and expansion of T-helper 1 (Th1) lymphocytes. Several lines of evidence have suggested that a complex cytokine network plays an important role in the exacerbation and perpetuation of OLP. The aim of this study was to evaluate Th1 and T-helper 2 (Th2) cytokine profile in serum of patients with OLP in comparison to healthy controls. METHODS Thirty patients with OLP, and 30 healthy controls participated in the study. Tumor necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin (IL)-2, IL-4, IL-5 and IL-10 levels have been measured in flow cytometry by bead based cytokine measurement. RESULTS Although no statistical differences were observed in the serum levels of TNF-α, IFN-γ, IL-5 and IL-4 between OLP patients and controls (p>0.05), there were statistically significant differences in the serum levels of IL-2 and IL-10 (p<0.05 and p<0.01, respectively). A significantly decreased tendency towards the levels of IL-2 were observed in OLP patients when compared to controls (p<0.05), and the mean level of IL-10 in serum increased remarkably in the OLP patients than those in the controls (p<0.01). CONCLUSIONS The finding of higher serum levels of IL-10 in patients in presence of low serum IL-2 levels, shows us that there is a dominance of Th2 response. This makes us think that there is a change in Th1/Th2 balance. Dominance of the Th2 response may indicate that OLP could be a result of a delayed type hypersensitivity.

Burning mouth syndrome and saliva: detection of salivary trace elements and cytokines.

BACKGROUND Burning mouth syndrome (BMS) is considered a syndrome with an unknown cause. Roles of various trace elements and cytokines in saliva have been implicated in the development of BMS. The aim of the present study was to compare the levels of salivary trace elements [magnesium (Mg), zinc (Zn), copper (Cu)] and interleukin (IL)-2 and IL-6, and to search for a correlation between depression/anxiety and salivary trace elements and cytokines in BMS patients and controls. METHODS Thirty patients with BMS and 30 matched healthy controls participated in the study. Unstimulated saliva was collected from participants and salivary flow rates were determined. Mg, Zn and Cu levels were determined by atomic absorbance spectrophotometry. Cytokine immunoassay kits were used to determine the concentration of IL-2 and IL-6 in the whole saliva samples. Anxiety and depression were analyzed by means of the Speilberger State-Trait Anxiety Inventory (SAI-TAI) and Zung Self-Rating Depression Scale. RESULTS Although subjects in the control group had significantly higher mean levels for Mg compared with BMS patients (P < 0.01), no statistically significant differences were observed in relation to Zn and Cu levels between the two groups (P < 0.001). There were no statistically significant differences in IL-2 and IL-6 levels of BMS and control groups, but subjects in BMS group had slightly, not significantly, higher mean levels for IL-6 compared with controls. Subjects in BMS group had significantly higher mean values for TAI compared with controls (P < 0.05). There were no statistically significant differences in relation to salivary levels of Mg, Zn, Cu, IL-2, IL-6 and depression/anxiety between BMS and control groups. CONCLUSIONS The results of our study indicate that Mg levels could have an impact on symptoms of BMS and further studies are necessary to determine the importance of cytokines in the pathogenesis of BMS.

Serum cytokine and T regulatory cell levels in patients with burning mouth syndrome

BACKGROUND Burning mouth syndrome is a disorder usually associated with an unexplained, prolonged sensation of burning inside the oral cavity. Although the etiology is unknown, neural and psychologic factors and cytokines may be implicated in the pathogenesis of burning mouth syndrome. The aim of this study was to investigate the relationship between serum cytokine and T regulatory cell levels in patients with burning mouth syndrome with regard to depression and anxiety. METHODS Thirty patients with burning mouth syndrome and 30 matched controls participated in the study. Serum cytokine levels were measured with cytometric bead array and T regulatory cells were defined as CD4(+)CD25(+)Foxp-3(+) cells by flow cytometry. The level of anxiety and depression were analyzed by means of the Speilberger State-Trait Anxiety Inventory and Zung Self-Rating Depression Scale. Visual analogue scale was used in the quantification of burning levels of patients. RESULTS Serum IL-2 and TNF-alpha levels were significantly decreased in patients with burning mouth syndrome compared with controls [mean 16.79 +/- 8.70 vs. 37.73 +/- 41.05 pg / ml (P < 0.05) and mean 39.09 +/- 29.40 vs. 70.83 +/- 42.44 pg / ml (P < 0.01) respectively]. CONCLUSIONS IL-2 and TNF-alpha might play a role in burning mouth syndrome. Burning mouth syndrome may occur as a sign of predisposition to autoimmunity. Presence of low levels of CD28(+) supports the provision that BMS might be a pre-autoimmune disease.

Retrospective radiological assessment of root canal treatment in young permanent dentition in a Turkish subpopulation.

AIM To determine the technical quality of root fillings as well as the periapical status of root filled teeth and non-root filled teeth in young permanent dentitions using a retrospective analysis of orthopantomographs (OPTGs) in a Turkish subpopulation. METHODOLOGY Included in this study were the digital OPTGs taken as a part of diagnostic and planning procedures for all 19-year-old adolescents who attended the Faculty of Dentistry, Marmara University (Istanbul, Turkey) for the first time during the period from June 2007 to May 2009. The periapical status of all teeth and the technical quality of the root fillings were assessed by radiographic criteria. Statistical analysis was performed by the Mann-Whitney U, chi-squared, Fishers exact and Cohens kappa tests. RESULTS The survey involved OPTGs of 1077 19-year-old adolescents: 663 (61.6%) women and 414 (38.4%) men. Of the 28974 teeth examined, 459 (1.6%) were root filled, of which 193 (42.0%) had radiological signs of apical periodontitis (AP), and 454 (1.6%) were non-root filled teeth with AP. No significant difference was found between women and men regarding the number of teeth present, the number of root filled teeth and the number of non-root filled teeth with AP (P>0.05). The most commonly treated teeth were molars (54.2%), followed by pre-molars (27.0%) and incisors (18.8%). Length was adequate in 57.3%, and homogeneity was adequate in 50.5% of the root fillings. Statistically, both the length and the homogeneity of the root fillings were significantly associated with periapical status individually (P<0.01). The overall technical quality was inadequate in 60.1% of the root fillings, and 67.0% of these were associated with signs of AP. Amongst root filled teeth, the frequency of AP in connection with molars was significantly higher (57.0%) than that for incisors (27.9%) and pre-molars (21.8%) (P<0.01). CONCLUSIONS   The results of this study indicated that the frequency of root filled teeth with AP, non-root filled teeth with AP and of technically inadequate root fillings amongst all root filled teeth was high in this selected adolescent Turkish population.

Evaluation of cytotoxic T‐cell activation, chemokine receptors, and adhesion molecules in blood and serum in patients with oral lichen planus

BACKGROUND Our purpose is to study cytotoxic T-cell activation (through evaluation of CD8+CD40+ and CD8+CD154+ cells), chemokine receptors (through evaluation of CD8+CD184+ and CD8+CD195+ cells), and adhesion molecules (through evaluation of CD8+CD152+ cells) which play a part in cell activation in blood and serum samples of patients with OLP and then to compare them with healthy controls. METHODS Thirty patients with OLP, and 30 matched healthy controls participated. The mean ages of OLP patients and controls were 51,10 ± 12,25 and 48,09 ± 11,92, respectively. Percentage of apoptotic cells, granzyme-B+, CD8+, CD8+CD40+, CD8+CD152+ (CTLA-4), CD8+CD154+(CD40L), CD8+CD184+(CXCR-4) and CD8+CD195+(CCR-5) were detected by immunophenotyping on flow cytometry. Apoptosis measurements were accomplished with Annexin V/Propidium Iodide kit. RESULTS A higher percentage of CD8+CD154+ and granzyme-B+ and a lower percentage of CD8+, CD8+CD184+ and apoptotic cells were found in OLP patients than in controls. No statistical differences were observed in the percentages of the other markers between groups. CONCLUSIONS It is observed that because of increase in granzyme B+ and CD154 which is the activation marker, CD8+ cells present efforts to sustain their activity even though decrease in their cell number. Lower levels of CD8+CD184+ cells in OLP than control is evaluated as a factor that makes OLP to be localised in our study. In addition, our findings lead us to think that there may be some changes in apoptosis pathways of the cells. But this needs to be clarified by further studies exploring the mechanisms of the apoptosis in OLP patients.

Burning mouth syndrome in patients wearing prothesis: evaluation of type I and type II

AbstractBurning mouth syndrome (BMS) is a fairly common condition: typically patients complain of a burning sensation affecting the oral mucosa that appears clinically normal. The history given by patients with BMS falls into two broad categories: patients complain either of burning not present on waking but which develops as the day goes on and is worse in the evening (Type I) or of a constant burning (Type II); in both cases burning is unremitting.We evaluated 57 patients, who complained of burning over a 4½-year-period. The present study aimed to determine the description of the pattern of the burning sensation by denture wearing patients with Type I and Type II BMS and to evaluate age, sex, history of symptoms, laboratory results and location.

Triester glycerol oxide in the treatment of recurrent aphthous stomatitis: A cytological investigation

Abstract Aim: The objective of the present study was to evaluate the clinical and cytological effects of a new topical gel, (Protefix) with triester glycerol oxide (TGO) on recurrent aphthous stomatitis (RAS). Method: In this study, 50 patients referred to the Department of Oral Diagnosis and Radiology, Marmara University, Faculty of Dentistry, were studied. A clinical examination, a complete review of past medical history, and a detailed history of RAS was performed in each patient. Clinical features of apthous ulcers and visual analogue scale values scraped (VAS) were recorded. Cytological examination was performed by collecting smear material scraped off the lesion surface. Triester glycerol oxide (TGO) gel (Protefix®, Queisser Pharma) was applied to lesions three times a day. Results: A significant reduction of the number of erythrocytes and inflammatory cells, and a significant increase of mature epithelial cells were observed. Conclusions: This treatment may be used as an initial strategy for reduct...

Oral Pseudolymphoma: A Report of 2 Cases

Abstract Objectives: The aim of this study was to present 2 infrequent cases pseudolymphoma in the oral cavity, to discuss their locations and to emphasize the importance of differential diagnosis for the prognosis. Methods: Excisional biopsies were performed in a 34 year-old women complaining for erythematous lesion in the oral floor and in a 44 year-old man who had a bluish lesion and erythema in the oral floor. Both specimens were investigated routinely and CD3, CD20, CD45, CD23, CD5 and FVIII markers. Immunohistochemical staining methods was applied and investigation was performed under light microscope. After the investigation, the cases were diagnosed as pseudolymphomas. Results: Pseudolymphoma may show clinical and histologic resemblance to lymphoma, so that differantiation with lymphoma can be very difficult. Conclusion: Pseudolymphomas have a tendency to malign differantiation; these differences must be evaluated clinically.

Sialadenoma papilliferum of the buccal mucosa: A case report of a rare localization and review of the literature

AbstractSialadenoma papilliferum is a rare, benign salivary gland tumor which most commonly arises in the palate. It is an exophytic papillary proliferation that involves mucosal surface or epidermis and salivary duct epithelium. Approximately 11% of sialadenoma papilliferum cases were reported in the buccal mucosa. The sialadenoma papilliferum is often misinterpreted as squamous papilloma by surgeons.In this case, sialadenoma papilliferum located in the buccal mucosa of a 64-year-old man is reported. The mass was asymptomatic, slow-growing, movable and was clinically similar to the lipoma. A surgical excision was performed and after 22 months there has been no recurrence.