Ufuk Sezer

Effects of periodontal therapy on disease activity and systemic inflammation in rheumatoid arthritis patients

OBJECTIVE This observational prospective cohort study aimed to evaluate the effects of non-surgical periodontal treatment on clinical periodontal measurements and systemic inflammatory mediator levels in low or moderate to highly active rheumatoid arthritis (RA) patients with chronic periodontitis. SUBJECTS AND METHODS Rheumatoid arthritis activity was assessed with disease activity score test (DAS28). Thirty patients with RA with moderate to high disease activity (DAS28 ≥ 3.2) and chronic periodontitis (MHDA group) and thirty patients with RA with low disease activity (DAS28 < 3.2) and chronic periodontitis (LDA group) were enrolled in the study. The patients were monitored at the beginning and 3 months after undergoing periodontal therapy. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), tumour necrosis factor-alpha (TNF-α) levels in serum, DAS28 and periodontal parameters were evaluated. RESULTS Erythrocyte sedimentation rate, CRP, TNF-α levels in serum, DAS28 and periodontal parameters exhibited similar and significant reduction 3 months after the non-surgical periodontal treatment. CONCLUSION Non-surgical periodontal treatment may prove beneficial in reducing RA severity as measured by ESR, CRP, TNF-α levels in serum and DAS28 in low or moderate to highly active RA patients with chronic periodontitis.

Increased salivary level of 8-hydroxydeoxyguanosine is a marker of premature oxidative mitochondrial DNA damage in gingival tissue of patients with periodontitis

Introduction:Oxidative stress may contribute to the pathogenesis of periodontitis. However, the detailed molecular mechanism remains unclear. Both 8-hydroxydeoxyguanosine (8-OHdG) and mitochondrial DNA (mtDNA) deletion have been reported as early oxidative DNA damage markers. In this study, 8-OHdG levels in saliva and mtDNA deletions in gingival tissue of patients with chronic periodontitis (CP) were evaluated.Materials and Methods:Gingival tissue and whole saliva samples were collected from 32 patients with CP and 32 healthy control subjects. To determine the clinical condition of each subject, the plaque index, gingival index, clinical attachment level (CAL), and probing depth (PD) were measured. Using the ELISA and polymerase chain reaction methods, the salivary 8-OHdG levels and the 7.4-kbp and 5-kbp mtDNA deletions were examined.Results:The 5-kbp mtDNA deletion was detected in 20 of the 32 periodontitis patients (62.5%), but was not detected in the healthy controls. The mean value of 8-OHdG in the saliva of the periodontitis patients with deleted mtDNA was significantly higher than in the patients with non-deleted mtDNA (p<0.01). Also, significant correlation was found between the occurrence of the 5-kbp mtDNA deletion and salivary 8-OHdG levels (p<0.01). Similar correlations were detected between salivary 8-OHdG levels and age, PD, and CAL (p<0.01, p<0.05).Conclusion:Increased oxidative stress may lead to premature oxidative DNA damage in the gingival tissue of periodontitis patients and the salivary 8-OHdG level may signify premature oxidative mtDNA damage in diseased gingival tissue.

Increased salivary levels of 8-hydroxydeoxyguanosine may be a marker for disease activity for periodontitis.

Background: 8-hydroxydeoxyguanosine (8-OHdG) is commonly used as a marker to evaluate oxidative DNA damage in disorders including chronic inflammatory diseases such as inflammatory periodontal pathologies. In the current study we hypothesized that the level of 8-OHdG in saliva increases by the periodontal destruction severity determined by clinical parameters as clinical attachment level (CAL). Materials and methods: A cross-sectional study was conducted on a sum of 60 age gender balanced; chronic periodontitis (CP) (n = 20), chronic gingivitis (CG) (n = 20) and healthy (H) (n = 20) individuals. Clinical periodontal parameters and salivary 8-OHdG levels were evaluated. Results: The mean 8-OHdG level in the saliva of the CP group was significantly higher than H and CG groups (p < 0.001). Statistically significant correlation was only observed between the salivary levels of 8-OHdG and age (p < 0.05), probing depth (PD) and CAL (p < 0.001) in CP group. However, when CP patients were classified according to their CAL levels (CAL≥ 3 mm (n = 11) and CAL<3 mm (n = 9)) statistically significant correlation was only observed between the salivary levels of 8-OHdG and CAL≥ 3 mm patients (p < 0.001). Conclusion: We suggest that elevated salivary levels of 8-OHdG may be a marker for disease activity and it may reflect indirectly disease severity parameters such as CAL.

Effect of chronic periodontitis on oxidative status in patients with rheumatoid arthritis.

BACKGROUND Rheumatoid arthritis (RA) and chronic periodontitis (CP) are the most common chronic inflammatory diseases and have remarkable similar pathologies. The aim of this study is to investigate the impact of periodontal status on oxidative stress in patients with RA by evaluating serum oxidative parameters and prolidase levels. METHODS For this cross-sectional comparative study, the following four groups were composed of 20 individuals each (80 individuals total): 1) RA with CP (RA-CP group); 2) RA but periodontally healthy (RA-C group); 3) systemically healthy with CP (CP group); and 4) systemically and periodontally healthy (C group). Demographic, periodontal, rheumatological, and serum oxidative parameters as determined by serum total antioxidant status, total oxidant status, oxidative stress index (OSI), lipid hydroperoxide levels, paraoxonase, arylesterase, and ceruloplasmin activity, prolidase level, and total sulfhydryl groups were evaluated. RESULTS The OSI values of the RA-CP group were statistically significantly higher than those of the C group (P <0.05). The prolidase levels of the RA-C, RA-CP groups and the CP group were statistically higher than those of the C group (P = 0.001, P = 0.007, and P = 0.001, respectively). CONCLUSIONS Although CP and RA each increase oxidative stress, in a small sample size these effects are only significant when both CP and RA are combined relative to neither exposure. In addition, increased prolidase levels in patients with RA and CP may be related to increased oxidative tissue damage.

Cytotoxicity Analysis of Strontium Ranelate on Cultured Human Periodontal Ligament Fibroblasts: A Preliminary Report

BACKGROUND/PURPOSE The aim of this study was to analyze the cytotoxicity of strontium ranelate (SR) on human periodontal ligament fibroblasts (PDL cells) in vitro. METHODS PDL cells were obtained from healthy human third molars and cultured in Dulbeccos Modified Eagles Medium. The experimental groups were: G1, cultures treated with fresh medium (control); and G2, G3, G4 and G5: treated with SR at 20, 10, 5 and 2.5 mg/mL, respectively. The experimental times were 1, 6, 12 and 24 hours (short-term) for viability, and 2, 4, 6 and 8 days (long-term) for cell survival. The cells were counted using a hemocytometer. Data were then analyzed by one-way ANOVA and Tukeys tests (p < 0.05). RESULTS Cultures treated with the highest SR concentrations (G2 and G3) had significantly lower cell viability and cell numbers (p < 0.05) than those in G1, G4 and G5. SR at 2.5 mg/mL was non-cytotoxic to PDL cells. CONCLUSION SR was non-toxic at appropriate concentrations. Preclinical tests are needed to further assess its safety and effectiveness for tooth resorption prior to clinical use.

Radio‐protective effects of Nigella sativa oil on oxidative stress in tongue tissue of rats

OBJECTIVE The aim of this study was to evaluate the effects of Nigella sativa (N.S.) oil against radiation-induced oxidative stress in the rat tongue. MATERIAL AND METHODS Thirty-two Sprague-Dawley rats were randomly divided into four equal groups. Group 1 [control group(C)] did not receive N.S. oil or irradiation. Group 2 [sham control group(CN)] did not receive N.S. oil or irradiation but received 1-ml saline orally, plus sham irradiation. Group 3 [irradiation group(R)] received irradiation, plus 1-ml saline orally. Group 4 [irradiation plus N.S. oil group(RN)] received irradiation plus 1 g kg(-1) per day of N.S. oil orally for 10 days. The animals were euthanized on day 10, and tongue tissues were collected for evaluating biochemical oxidative parameters. RESULTS The oxidative stress index, total oxidant status and lipid hydroperoxides levels in the R group were statistically higher than those in the C, CN and RN groups. The paraoxonase levels in the R group were statistically lower than those in the C, CN and RN groups. No statistically significant differences were detected between any of the groups, in terms of total antioxidant status and the arylesterase, ceruloplasmin and total sulfhydryl group levels. CONCLUSION Nigella sativa (N.S.) oil may be a beneficial agent in protecting against ionizing radiation-related tissue injury.

Serum cytokine levels and periodontal parameters in ankylosing spondylitis.

BACKGROUND AND OBJECTIVE Multiple studies support the role of periodontal disease in contributing to the chronic systemic inflammatory burden in a variety of diseases, including ankylosing spondylitis (AS), in the progression which the inflammatory process plays an important role. We assume that patients with AS are more likely to have periodontal disease than healthy individuals. The aim of this study was to determine the possible relationship between inflammatory periodontal diseases and AS by evaluating clinical periodontal parameters and serum cytokine levels. MATERIAL AND METHODS Forty-eight adults with AS (35 women and 13 men; age range 18-56 years; mean age 34.27 years) and 48 age- and sex-matched systemically healthy control subjects participated in the study. The clinical periodontal parameters, venous blood and Bath Ankylosing Spondylitis Disease Activity Score were obtained, and serum C-reactive protein, tumour necrosis factor-α and interleukin-6 (IL-6) levels were evaluated. RESULTS There was statistically no significant difference in the frequency of periodontitis between AS patients and the control group. Furthermore, there was no significant difference in probing depth, clinical attachment level and plaque index, and the only significant clinical difference between groups was in levels of bleeding on probing (p < 0.001). Serum concentrations of IL-6, tumour necrosis factor-α and C-reactive protein in the AS group were significantly higher than those in the control group (p < 0.001). In the AS group, there was a correlation between serum IL-6 levels and clinical attachment level (p < 0.001). CONCLUSION The results of present study suggest that bleeding on probing was the only different periodontal parameter between the AS and the control group, and the periodontal status of patients with AS may be affected by IL-6 levels.

Protective effects of ginkgo biloba extract on ligature-induced periodontitis in rats

OBJECTIVE The aim of this study was to test the hypothesis that the systemic administration of extract of Ginkgo biloba (EGb) would prevent excessive tissue destruction in ligature-induced periodontitis in a rat model. MATERIALS AND METHODS Thirty-two male Wistar albino rats were used in the current study. The rats were randomly divided into four groups of eight rats each: (1) non-ligated treatment (NL) group, (2) ligature-only (LO) group, (3) ligature plus GB28 (28 mg/kg, daily for 11 days) group and (4) ligature plus GB56 (56 mg/kg, daily for 11 days) group. RESULTS Measurement of alveolar bone loss in the mandibular molar tooth revealed significantly lower bone loss values in the LO group compared to groups NL, GB28 and GB56 (p < 0.05). CONCLUSION The present results are the first data which suggests that host response in periodontitis can be modified by EGb administration. EGb minimized progression of periodontal disease.

Effects of Low-Level Laser Therapy as an Adjunct to Standard Therapy in Acute Pericoronitis, and its Impact on Oral Health-Related Quality of Life

OBJECTIVE The purpose of this study was to evaluate the effect of low-level laser therapy (LLLT) as an adjunct to standard therapy in acute pericoronitis. METHODS Eighty acute pericoronitis patients were randomly assigned to one of four LLLT groups: (neodymium:yttrium-aluminum garnet [Nd:YAG] 1064-nm: n=20, 8 J/cm2, 0.25 W, 10 Hz, 10 sec; 808-nm diode: n=20, 8 J/cm2, 0.25 W, continuous mode, 10 sec; 660-nm diode: n=20, 8 J/cm2, 0.04 W, continuous mode, 60 sec; or a placebo laser control group: n=20). After standard treatment, LLLT or a placebo laser were applied to the treatment area at a distance of 1 cm from the buccal site. Interincisal opening, pain perception, and oral health-related quality of life (OHRQoL) were evaluated at baseline, 24 h, and 7 days after laser application. The data were analyzed by the one-way ANOVA test. RESULTS We found that the trismus and the OHRQoL in the Nd:YAG and the 808-nm diode groups were significantly improved when compared with the 660-nm diode and control groups at 24 h (p<0.05). No statistically significant differences were detected on day 7 among the groups with regard to any of the parameters evaluated. CONCLUSIONS The results demonstrate that both the 1064-nm Nd:YAG and the 808-nm diode lasers were effective in improving trismus and OHRQoL in acute pericoronitis. Taking into account the limitations of this study, we conclude that the 1064-nm Nd:YAG laser has biostimulatory effects and improves OHRQoL, making it suitable for LLLT.

Effects of Ginkgo biloba on experimental rapid maxillary expansion model: a histomorphometric study

OBJECTIVE We aimed to investigate the effect of systemic Ginkgo biloba in rapid maxillary expansion (RME). STUDY DESIGN We randomly divided 24 rats into 3 groups: expansion only (EO), expansion plus Ginkgo biloba (GB), and no expansion (NE). Expansion appliances were affixed to the maxillary incisors. After a 5-day expansion period, there was a consolidation period of 15 days, following which the rats were killed. Histomorphometric examination was performed to determine the number of osteoclasts, osteoblasts, and capillaries, the number and intensity of inflammatory cells, and new bone formation. RESULTS New bone formation, number of capillaries, and the ratio of inflammatory cells in maxillary sutures were higher in the GB group than in the other groups. Statistical analysis demonstrated that the GB group had more osteoblasts and osteoclasts than the other groups. CONCLUSIONS GB may hasten new bone regeneration in RME and prevent relapse after RME.