Turgut Demir

Periodontal disease as a risk factor for pre‐eclampsia: A case control study

Objective: To investigate the association between periodontal disease and pre‐eclampsia, while controlling known risk factors for pre‐eclampsia.

Musculoskeletal Disorders in Left- and Right-Handed Turkish Dental Students

The purpose of this study was two-fold: first, to find out the musculoskeletal disorders between left- and right-handed dentists and second, to describe the prevalence and distribution of symptoms of musculoskeletal disorders among Turkish students who are practicing general dentistry. The investigation was carried out on 221 dental students; group I consisted of 24 left-handed students (18 male, 6 female), aged 24.2 ± 2.24 years; group II comprised 24 right-handed students (14 male, 10 female), aged 25.1 ± 3.14 years; and group III included 173 right-handed students (102 male, 71 female), aged 24.3 ± 1.45 years. The study consists of a questionnaire to identify work tasks and working conditions, and a field study to assess the pain of the neck, shoulders, and other disorders during the dental practice. Data were analyzed through tests for the difference between two population proportion, percentage, and Chi-square. Left- and right-handed students had headaches (34%, 22%), pins and needles (35%, 22%), weakness (42%, 40%), numbness (23%, 19%), neck pain (67%, 43%), back pain (56%, 47%), upper limp pain (46%, 43%) and shoulder pain (78%, 58%), respectively (Table ). Female students were not significantly different from males in musculoskeletal symptoms (p > .05). The position adopted by the student was significantly related to the intensity of pain. Left-handed students especially suffered from neck and shoulder pain when compared with right-handed students (p < .06). The authors think that a modification of work practices appears to be effective in decreasing the prevalence of symptoms. The best ergonomic working principles should be taught to the students, dental schools should provide a comfortable working environment, and further study is required to identify factors that will reduce the prevalence of symptoms among those practicing general dentistry. TABLE 3. Distribution of symptoms in left and right handedSymptomsLeft-handed (Group I)Right-handed (Group II)n%n%Headache834522*Numbness623419Weakness10421040Neck pain16671143*Shoulder pain19781458*Back pain13561247*Pain in trunk and upper limb12461143Pain in trunk and lower limb625522 Percentages do not total 100 as they are proportion of all the groups. Statistical evaluation by the difference between two population proportion. *p < .05.

The influence of smoking and non-insulin-dependent diabetes mellitus on periodontal disease

The periodontal health of smokers and non-smokers with non-insulin-dependent diabetes mellitus (NIDDM) and non-smokers with periodontitis who were not suffering from a systemic disease was assessed. The investigation was carried out on 60 adult subjects. Levels of blood glucose, glycosylated haemoglobin and immunoglobulins G, A and M were determined, together with the plaque index, gingival index, probing pocket depths and clinical attachment level. Periodontitis was more severe in smokers and non-smokers with NIDDM than non-smokers without NIDDM, and the periodontal condition (clinical attachment level, probing pocket depth and gingival bleeding) was better in non-smokers with NIDDM than smokers with NIDDM. The results suggest that diabetes and smoking are high-risk factors for periodontal disease.

Evaluation of Neodymium-Doped Yttrium Aluminium Garnet Laser, Scalpel Incision Wounds, and Low-Level Laser Therapy for Wound Healing in Rabbit Oral Mucosa: A Pilot Study

OBJECTIVE The aim of the present randomized controlled clinical trial was to assess the clinical and histopathological effects of laser and low-level laser therapy (LLLT) on healing of the oral mucosa after vestibuloplasty surgery. METHODS The alterations at the end of healing in scalpel- and laser-incised and LLLT-applied oral mucosa were studied in eight healthy adult New Zealand white rabbits by taking specimens for light microscopic inspection. For the evaluation of wound healing, the surgical areas were stained using a solution (Mira-2-tones), and the stained surfaces were measured horizontally immediately after the surgery and on postoperative days 4, 7, and 10. RESULTS Although the stained surface areas of the groups were similar immediately after the surgical procedures, the LLLT-applied sites had significantly fewer stained surface areas than the other groups on postoperative days 4, 7, and 10. Areas of hyperkeratosis and parakeratinization were observed in the epithelia of the laser surgery groups. A significant increase in epithelial thickness was found, suggesting increased scar tissue after wound repair; long and irregular connective tissue protrusions projecting into the undersurface of the epithelium were noted in these groups. CONCLUSION LLLT used for soft tissue operations provides better and faster wound healing, and LLLT enhances epithelization.

The changes in the T-lymphocyte subsets in a population of Turkish children with puberty gingivitis

OBJECTIVE The aim of the study was to investigate the number of CD4 and CD8 T lymphocytes, analyse subjects with gingivitis and those without, and determine the role of T lymphocytes in the pathobiology of puberty gingivitis. MATERIAL AND METHODS Fifty individuals with and without puberty gingivitis were recruited for this study. The CD4(+) and CD8(+) T-lymphocyte counts were determined using flow cytometry on the biopsy samples, and the CD4(+)/CD8(+) ratio was calculated. At the same time, periodontal index scores were recorded to assess the periodontal status. Acquired data were analysed statistically using a paired t-test to compare laboratory values obtained before and after the treatment in individuals with puberty gingivitis and disease-free individuals. In addition, Pearsons correlation analysis was performed to investigate the relation between laboratory values and clinical measurements. RESULTS The CD4(+)/CD8 ratio in gingival tissues obtained from test group was significantly higher (P < 0.05) than that found in the gingival tissue obtained from control group. We found that the CD4(+) and CD8(+) lymphocyte counts continued to increase significantly (P < 0.001) and the CD4(+)/CD8(+) ratio continued to drop significantly (P < 0.05) after treatment in test group. CONCLUSIONS T lymphocytes could play a significant role in the pathobiology of puberty gingivitis.

Effect of handedness on learning subgingival scaling with curettes: a study on manikins.

The aim of the present study was to evaluate the influence of systematic manikin–head training and the effectiveness of subgingival scaling applied with hand instruments (curettes) by right- and lefthanded dental students on dental chairs (traditional) designed for right handers. A questionnaire focusing on handedness was administered to 69 voluntary dental students in the third class at the School of Dentistry during preparticipation examination. Handedness was assessed using the Turkish version of the Edinburgh Handedness Inventory. Then, 18 dental students- were specially selected in 2 equal groups according to hand preference: consistent right handers with Geschwind Scores of–100 (5 female- and 4 male) and consistent left handers with Geschwind Scores of 100 (5 female and 4 male). These two untrained dental student groups received 10 weeks manikin head training. Subgingival scaling was performed with hand instruments (Gracey curettes) in manikin head mounted on right sided dental chairs. At 6 test days each dental student had to instrument 12 test teeth. Effectiveness of subgingival scaling was evaluated- by adoption of a grading system. This system had scores from 0 to 3 and was defined by illustrated and described criteria. Statistical analysis- was carried out with SPSS. Two groups were statistically compared on all test days. The yet untrained left handed dental students begin with a relatively high the mean score of 2.25, compared to the yet trained righthanded dental students with 1.93, which was statistically signi-ficant- (p > .05). The right handed dental students reached the mean score of 0.53, whereas the left anded dental students reached the mean score of 0.87 on test day 6. Significant differences in the mean scores were found between the two groups for overall surfaces (p < .05), the distal surfaces (p < .01), lingual surfaces (p < .01), and each group of teeth (p < .05). But there was no statistically significant difference between the 2 groups of students on all test day except for test day 3 in terms of the mean scores for the facial and mesial surfaces (p > .05). Learning success was observed a high level in both groups through –systematical training (p <.0001). The present study has documented that the left handed dental students were less successful than the righ thanded dental students in subgingival scaling, except for mesial and facial surfaces. However although training on right sided chairs, they were quite similar to their right handed counterparts in terms of learning- success.

Evaluation of low-level laser therapy in rabbit oral mucosa after soft tissue graft application: A pilot study

Abstract The aim of the present study was to assess the histopathological effects of low-level laser therapy (LLLT) on healing of the oral mucosa after soft tissue graft operations. The alterations at the end of healing in normal and LLLT-applied oral mucosa were studied in two healthy adult New Zealand white rabbits by taking specimens for light microscopic inspection. There was no adverse event reported in the study and no post-operative complications, such as swelling, bleeding, or edema, were observed in the rabbits. Complete wound healing was faster in the LLLT-applied rabbit. Compared to the normal rabbit oral mucosa, thickening of the stratum corneum (hyperkeratosis) was found in the epithelia of the rabbits. A significant increase in the epithelial thickness was found in the samples of rabbits, suggesting increased scar tissue following the wound repair. Additionally, many mitotic figures were present in the epithelia of the LLLT-applied rabbit, indicating epithelial cell hyperplasia. Long and irregular connective tissue protrusions projecting into the undersurface of the epithelium and mononuclear cell infiltrations were noted in the rabbits. The results suggest that LLLT used for soft tissue operations provides better and faster wound healing and that LLLT enhances epithelization.

The Effects of Age and Gender on Gingival Tissue and Peripheral Blood T-Lymphocyte Subsets: A Study in Mice

The aim of this study is to investigate the effects of age and gender on relative number of CD4+ and CD8+ T lymphocyte and CD4+/CD8+ ratios in gingival tissue and peripheral blood of periodontally healthy BALB/c mice with flow cytometric analysis. The study was carried out on periodontally healthy 60 BALB/c mice. They were separated into five groups according to the life expectancy: Group I (newborn, 1–10 days old), Group II (age at weaning, 21–28 days old), Group III (age of sexual maturity, puberty, 7–8 weeks old), Group IV (adult, 8 months old), and Group V (the aged, 14 and over). Males and females were equally represented in each group. CD4+ and CD8+ T lymphocytes and CD4+/CD8+ ratio values in gingival tissue and peripheral blood were determined using flow cytometry in the biopsy samples. The relative number of CD8+ T lymphocyte in gingival tissue was higher in puberty (p < 0.05) and the aged (p < 0.05), with more significantly difference in males (p < 0.05). The CD4+/CD8+ ratios in gingival tissue were lower in puberty group and the-aged groups compared to the other groups (p < 0.05).The peripheral blood CD4+/CD8+ ratio increased in puberty and the aged groups. These differences were more significant in females than in males (p < 0.05). There were considerable negative correlations between CD4+/CD8+ T lymphocyte ratio in gingival tissue and CD4+/CD8+ T lymphocyte ratio in peripheral blood in puberty (r = 0.647, p < 0.01) and the aged ( r = 0.599, p < 0.05). In conclusion, our data suggest that CD4+/CD8+ T lymphocyte ratios in peripheral blood increase periodontally healthy mice in puberty and the old groups, while CD4+/CD8+ T lymphocyte ratios in gingival tissue decrease in the same groups. The relative number of CD8+ T lymphocytes increases in gingival tissue in puberty and the old groups when it decreases in peripheral blood. Results from this study indicated that periodontally healthy BALB/c mice may represent important information to determine the character of an immune response in the course of a lifetime.

An index developed for the determination of oral hygiene motivation success

Introduction: The purpose of this article is to develop a new index system to identify the individual oral hygiene score (OHS) and the level of the motivation success by using some scales, which are an indicator of the individual oral hygiene status. In this way, the level of personal oral hygiene would be determined and a standard motivation success scale would be presented by comparing the oral hygiene levels measured before and after the motivation application. The Hypothesis: In this hypothesis, an index was primarily formed in order to obtain an individual OHS with the total values of plaque index (PI), gingival index (GI), and calculus index (CI) scores. Motivation success levels of the individuals were calculated and classified by using the rate of change of OHS between the sessions. Evaluation of the Hypothesis: This index system would form a basis for future strategies in preventive dentistry. Standard and common scores in one individual or a wide population will be attained easily and effectively.

Clinical and biochemical comparison of guided tissue regeneration versus guided tissue regeneration plus low-level laser therapy in the treatment of class II furcation defects: A clinical study

Objective: The present study was aimed to compare the clinical and biochemical effectiveness of guided tissue regeneration (GTR) alone and combined with low-level laser therapy (LLLT) application in the treatment of furcation II periodontal defects, over a period of 6 months. Material and methods: Thirty-three furcation defects were included in the study. Seventeen of these defects were treated with GTR plus LLLT, and sixteen of them were treated with GTR alone. Probing pocket depth (PPD), clinical attachment level (CAL), horizontal probing depth (HPD), and alkaline phosphatase (ALP) and osteocalcin (OC) levels in the gingival crevicular fluid (GCF) were recorded at baseline and at postoperative 3rd and 6th months. Results: Healing was uneventful in all cases. At the 3rd and 6th months, both treatment modalities—GTR and GTR plus LLLT—showed improved PPD, CAL, and HPD values compared to their baseline values. ALP and OC levels in GCF increased after the treatment in both groups (p < 0.05). When compared the two groups, at the 6th month, PPD, CAL, HPD, and ALP values showed significantly more improvement in laser group than non-laser group (p < 0.05). Conclusions: The results of this study showed that both treatments led to significantly favorable clinical improvements in furcation periodontal defects. LLLT plus GTR may be a more effective treatment modality compared to GTR alone.