Varol Canakci

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.

Reactive oxygen species and human inflammatory periodontal diseases

Reactive oxygen species (ROS) have emerged as important signaling molecules in the regulation of various cellular processes. They can be generated by the mitochondrial electron transport chain in mitochondria and activation of polymorphonuclear leukocytes (PMN) during inflammatory conditions. Excessive generation of ROS may result in attack of and damage to most intracellular and extracellular components in a living organism. Moreover, ROS can directly induce and/or regulate apoptotic and necrotic cell death. Periodontal pathologies are inflammatory and degenerative diseases. Several forms of periodontal diseases are associated with activated PMN. Damage of tissues in inflammatory periodontal pathologies can be mediated by ROS resulting from the physiological activity of PMN during the phagocytosis of periodontopathic bacteria.

Clinical Evaluation of Nd:YAG and 685-nm Diode Laser Therapy for Desensitization of Teeth with Gingival Recession

OBJECTIVES The aim of this study was to evaluate the effectiveness of two types of lasers, the Nd:YAG laser and the 685-nm diode laser, as dentin desensitizers as well as both the immediate and late therapeutic effects on teeth with gingival recession. MATERIALS AND METHODS The study was conducted on 56 teeth in 14 patients with Millers class 1 and 2 gingival recession with clinically elicitable dentin hypersensitivity (DH). The patients were divided into two groups: a Nd:YAG-laser-treated group and a 685-nm diode laser-treated group. DH was assessed by means of an air stimulus, and a visual analog scale (VAS) was used to measure DH. The selected teeth in the two groups received laser therapy for three sessions. Teeth subjected to Nd:YAG-laser treatment were irradiated at 1 W and 10 Hz for 60 sec at 1064 nm, and those receiving 685-nm diode laser treatment were irradiated at 25 mW and 9 Hz for 100 sec. RESULTS Significant reductions in DH occurred at all time points measured during the three treatment sessions in both treatment groups. Comparing the means of the responses in the three treatment sessions for the two groups revealed that the Nd:YAG laser group had a higher degree of desensitization compared to the other group (p<0.01). The immediate and late therapeutic effects of the Nd:YAG laser were more evident than those of the 685-nm diode laser. CONCLUSIONS Both of these lasers can be used to reduce DH without adverse effects. Desensitization of teeth with gingival recession with the Nd:YAG laser was more effective than with the diode laser. The Nd:YAG laser appears to be a promising new tool for successfully reducing DH.

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.

Therapeutic Effects of Alpha Lipoic Acid and Vitamin C on Alveolar Bone Resorption After Experimental Periodontitis in Rats: A Biochemical, Histochemical, and Stereologic Study

BACKGROUND Alpha lipoic acid (ALA) and vitamin C (Vit-C) are very important and powerful antioxidants that have been used for the treatment of many diseases. The present study aims to investigate the role of ALA and Vit-C substances in the treatment of alveolar bone resorption in periodontal diseases. METHODS Thirty-six male Wistar albino rats were randomly divided into four groups as follows: 1) control rats; 2) rats with experimental periodontitis (PED); 3) rats with PED treated with ALA (ALA); and 4) rats with PED treated with ALA+Vit-C (ALA+Vit-C). PED was simulated by placing ligatures around the neck of teeth for 5 weeks. After ligature removal, the PED group was given a single intragastric dose of 1 mL saline, and the ALA and ALA+Vit-C groups were treated with an intragastric dose of 50 mg/kg ALA and ALA+Vit-C for 15 days, respectively. Levels of serum bone alkaline phosphatase (B-ALP) and myeloperoxidase (MPO) activity in gingival tissues were analyzed. To evaluate the osteoclast activation, expression of activated receptor activator nuclear factor-kappa B ligand (RANKL) and bone density index (BDI) were determined stereologically in the bone sections obtained from the mandibles of the rats. RESULTS The results showed statistically significant differences between the PED group and groups treated with antioxidant according to B-ALP, MPO, RANKL, and BDI values (P <0.05). ALA and ALA+Vit-C treatments showed beneficial effects on the mesial/distal periodontal bone support at the ligature-induced periodontitis tooth areas. CONCLUSION This study shows that ALA and Vit-C treatment provides therapeutic effects on inhibition of alveolar bone resorption and periodontal tissue destruction.

Clinical Effects of Potassium–Titanyl–Phosphate Laser and Photodynamic Therapy on Outcomes of Treatment of Chronic Periodontitis: A Randomized Controlled Clinical Trial

BACKGROUND The main objective of periodontal treatment is to control infection and thereby curb disease progression. Recent studies have demonstrated that adjunctive treatment procedures, such as laser irradiation or photodynamic therapy (PDT), may provide some additional benefit in the treatment of chronic periodontitis (CP). The aim of this randomized controlled trial is to clinically evaluate and compare the clinical effects of potassium-titanyl-phosphate (KTP) laser and PDT on outcomes of CP treatment. METHODS Twenty-four patients with untreated CP were treated using a split-mouth study design in which the teeth in each quadrant were randomly treated by scaling and root planing (SRP) alone (group A), PDT followed by SRP (group B), or KTP laser followed by SRP (group C). The periodontal pockets were exposed to a KTP laser with the following parameters: 0.8 W output power, 50 milliseconds time on/50 milliseconds time off, 30 seconds per irradiation at 532 nm and 11.7 J/cm(2) fluence, with a flexible fiberoptic tip with a diameter of 200 µm. The selected pockets were probed with a pressure-controlled probe, guided by stents. Clinical periodontal parameters assessed included plaque index, gingival index, bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL), which were recorded at baseline and at 6 months after therapy. RESULTS Statistical analysis demonstrated no differences between groups at baseline for all parameters (P >0.05). All treatments yielded significant improvements in terms of BOP and PD decrease and CAL gain compared to baseline values (P <0.05). Group C showed a greater reduction in PD compared to the other groups (P <0.05). In addition, group C showed a greater CAL gain compared to the other groups (P <0.05). CONCLUSION In patients with CP, clinical outcomes from conventional periodontal treatment of deeper pockets can be improved by using adjunctive KTP laser.

RIGHT- AND LEFT-HANDED DENTISTS USING RIGHT- AND LEFT-SIDED DENTAL CHAIRS IN TREATMENT OF CALCULUS

The aim of the present study was to evaluate the association of hand preference of dentists and the position of dental chairs in treatment of dental calculus. The dentists were last-class students from the School of Dentistry (Erzurum, Turkey). They were directed to dental chairs designed for right- and left-handers (right-sided and left-sided chairs) to remove calculus from the lower anterior teeth in volunteer patients having similar amounts of calculus, which was measured by Calculus index (CI). The right-handed dentists were more successful in right-sided (traditional) chairs than left-sided chairs; the left-handed dentists were more successful on left-sided chairs than right-sided chairs. The highest posttreatment CI (lowest success) was due to the right-handed dentists on the left-sided chairs. The lowest posttreatment CI (highest success) belonged to the left-handers working on the left-sided chairs. The left-handed dentists were better than right-handed dentists in the treatment of the mesial and distal surfaces of teeth, whereas the right-handers were successful only in the treatment of the distal parts of teeth. These results were explained by a better coordination between right and left hands and with higher skill in both hands in left-handers than right-handers.

The Effect of Right or Left-Handedness on Oral Hygiene

It has been shown that there is a strong relation between periodontal diseases and bacterial plaque with clinical and experimental studies. According to scientific data, the best way to protect against the periodontal diseases is to remove bacterial plaque from tooth surface mechanically. To remove bacterial plaque from tooth surface completely, the patient must have good hand skill and motivation in addition to professional treatment. The aim of our study was to examine whether there is a difference between the left-handed who are known as skilful at drawing, geometry, and graphics and the right-handed at oral hygiene check. The study included 28 persons, 12 female and 16 male, ranging in age from 19 to 26. Subjects were divided into two groups according to their right or left hand use. Being right- or left-handed was determined with Edinburgh Handedness Inventory (Oidfield). Both groups were given oral hygiene education with a systematic treatment at the beginning of the study. At the beginning of the study, GI (Silness-Löe) and PI (Quigley-Hein) scores were taken from all subjects. Then, those scores were repeated in the 1st and 3rd month. Received scores were evaluated statistically with Wilcoxon test. While there was no statistical difference between both groups initially p <. 05, there was a statistical difference between them in the 1st and 3rd month in favour of the left-handed p <.05. Consequently, it was found that the left-handed were more successful at oral hygiene check than the right-handed.

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.

Root Surface Biomodification with Nd:YAG Laser for the Treatment of Gingival Recession with Subepithelial Connective Tissue Grafts

BACKGROUND/AIM Root surface biomodification has been used to treat gingival recession and periodontitis. The principle for this procedure is that removing the smear layer from the root surfaces exposes collagen fibers, which leads to improved healing. Clinical studies generally have failed to find any improvement in clinical parameters when using such procedures, however. The aim of this study was to evaluate and compare the outcome of gingival recession therapy using the subepithelial connective tissue graft (SCTG) with or without Nd:YAG laser application for root surface biomodification. MATERIALS AND METHODS Thirty-four teeth in 17 patients with Miller Class 1 and 2 recession were treated with SCTG with (test group) or without (control group) the application of Nd:YAG laser (1 W, 10 Hz, 100 mj, 60 s, 1064 nm). Clinical attachment level (CAL), recession depth (RD), recession width (RW), and probing depth (PD) were measured at baseline and six months postsurgery. RESULTS Both treatments yielded significant improvements in terms of RD and RW decrease and CAL gain compared to baseline values. For test and control groups, the average root coverage was 33% and 77%, respectively (p < 0.05), and the complete root coverage was 18% and 65%, respectively (p < 0.05). The control group showed a greater reduction in RD and RW compared with the test group (p < 0.05). CONCLUSIONS The use of Nd:YAG laser as a root surface biomodifier negatively affected the outcome of root coverage with the SCTG.