Zuhal Yetkin Ay

Pro‐inflammatory cytokine levels in association between periodontal disease and hyperlipidaemia

AIM The aim of this study was to evaluate serum and gingival crevicular fluid (GCF) pro-inflammatory cytokine levels in association between periodontal disease and hyperlipidaemia. MATERIAL AND METHODS One hundred and twenty-three subjects with hyperlipidaemia and 68 systemically healthy controls (C) were included in the study. Hyperlipidaemic groups were divided into two groups as suggested diet (HD) and prescribed statin (HS). Both groups were divided into three subgroups as healthy (h), gingivitis (g) and periodontitis (p). The clinical periodontal parameters, fasting venous blood and GCF samples were obtained, and serum tumour necrosis factor-alpha (TNF-α), interleukin (IL)-1β (IL-1β) and IL-6 levels were evaluated. RESULTS The ratio of total cholesterol to high-density lipoprotein (TC/HDL) was associated with gingival index and percentage of bleeding on probing (BOP%) in both hyperlipidaemic groups. In HS group, GCF and serum IL-6 were positively correlated with BOP% and TC/HDL. GCF TNF-α was positively associated with probing pocket depth and clinical attachment level, whereas serum TNF-α was associated with BOP% in the HD group. Serum and GCF TNF-α and IL-1β were significantly associated with TC/HDL in the HD group. CONCLUSIONS Serum pro-inflammatory cytokines may play an important role in the association between periodontal disease and hyperlipidaemia.

Appropriate oral hygiene motivation method for patients with fixed appliances.

OBJECTIVE To determine the most appropriate oral hygiene motivation method (OHMM) for orthodontic patients with fixed appliances. MATERIALS AND METHODS A total of 150 orthodontic patients, scheduled for their regular controls, were included in this study. The patients were divided into five groups (n = 30) according to the verbal OHMM and instructed as follows: only verbal information (V), verbal information with demonstration on model (M), verbal information with demonstration on model and self application by the patient (M+A), verbal information using the illustration catalog (I), and verbal information using the illustration catalog and self application by the patient (I+A). All of the applications of the patients were made under the supervision of the clinicians. The periodontal parameters (plaque index [PI], gingival index [GI], and bleeding on probing [BOP]) were recorded at the baseline (before the instructions of the OHMM), 1 week later, and 4 weeks after the OHMM. RESULTS All periodontal parameters showed significant decreases after 4 weeks in all OHMM groups (P < .05). I+A group has significantly lower PI scores and BOP percentages than the other groups (P < .05) after 4 weeks. The difference between the V group and M+A, I, and I+A groups in the GI scores were significant (P < .05), and the I+A group has presented the lowest GI score. CONCLUSIONS The OHMM applied by the patients under the supervision of the clinician seemed to be more successful in the elimination of plaque and inflammatory symptoms in patients with fixed appliances.

The Impact of Smoking Status on Antioxidant Enzyme Activity and Malondialdehyde Levels in Chronic Periodontitis

BACKGROUND The aim of this study is to investigate the impact of smoking status on the systemic and local superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase (CAT) activities and malondialdehyde (MDA) levels in subjects with chronic periodontitis (CP). METHODS Sixty-five CP patients (23 smokers [CP-S], 23 former smokers [CP-FS], and 19 non-smokers [CP-NS]) and 20 periodontally healthy non-smoker controls (PH-NS) were included in the study. After the clinical measurements, serum and gingival tissue samples were collected. SOD, GSH-Px, and CAT activities and MDA levels in hemolysates and gingival tissue samples were spectrophotometrically assayed. RESULTS Blood MDA levels in all the periodontitis groups were higher than in the PH-NS group but only the difference between CP-FS and PH-NS groups was significant (P <0.01). Gingival tissue MDA levels in the periodontitis groups were significantly higher than that in the control group (P <0.01). However, the control group had the highest gingival SOD, GSH-Px, and CAT activities compared with all the periodontitis groups (P <0.01). The CP-S group had the highest gingival MDA levels and SOD, GSH-Px, and CAT activities among the periodontitis groups, whereas the lowest values were observed in the CP-NS group (P <0.01). The blood and gingival MDA levels in the CP-FS group were similar in the CP-NS group, whereas they were lower than in the CP-S group. CONCLUSIONS Systemic and local MDA levels are increased by smoking in addition to the impact of periodontitis. The decreased local SOD, GSH-Px, and CAT activities observed in periodontitis patients may increase with smoking.

Serum Lipoprotein-Associated Phospholipase A2 and C-Reactive Protein Levels in Association With Periodontal Disease and Hyperlipidemia

BACKGROUND The aim of this study is to evaluate the levels of serum lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) and high-sensitivity C-reactive protein (hsCRP) in association with periodontal disease and hyperlipidemia. METHODS A total of 123 subjects with hyperlipidemia and 68 systemically healthy controls were included in the study. Subjects with hyperlipidemia were divided into two groups: the suggested-diet (HD) and prescribed-statin (HS) groups and then into three subgroups: the healthy (HDh and HSh), gingivitis (HDg and HSg), and periodontitis (HDp and HSp) groups. Periodontal parameters were recorded and included the plaque index, gingival index (GI), probing depth (PD), clinical attachment level (CAL), and percentage of sites with bleeding on probing (BOP). Fasting venous blood samples were obtained, and serum lipid, Lp-PLA(2), and hsCRP levels were evaluated. RESULTS Median values for the GI, PD, BOP(%), and CAL in the HSg group were statistically significantly higher than those in the HDg and systemically healthy with gingivitis (Cg) groups. The HSp group had higher percentages of BOP compared to those of the chronic periodontitis and HDp groups. The HDg group had higher serum Lp-PLA(2) and hsCRP levels compared to those of the Cg and HSg groups. The ratio of total cholesterol to high-density lipoprotein cholesterol (TC/HDL) was significantly associated with the GI, PD, and BOP(%) in both groups with hyperlipidemia. Serum Lp-PLA(2) and hsCRP levels were significantly correlated with TC/HDL, the GI, PD, and BOP(%) in the HD group. CONCLUSIONS Serum Lp-PLA(2) and hsCRP levels may play an important role in the association between periodontal disease and hyperlipidemia, and the control of these mediators may affect the inflammatory control of patients with hyperlipidemia and periodontal disease.

The Gingival Crevicular Fluid Levels of Interleukin-11 and Interleukin-17 in Patients With Aggressive Periodontitis

BACKGROUND The balance (ratio) of anti-inflammatory and proinflammatory cytokines is thought to play an important role in the pathogenesis of chronic periodontitis. Moreover, the imbalance of anti-inflammatory/proinflammatory cytokines may modulate disease progression in aggressive periodontitis (AgP). This study aims to investigate the levels of interleukin (IL)-11 and IL-17 and their ratio in gingival crevicular fluid (GCF) in patients with AgP. METHODS This study included 20 patients with generalized AgP (GAgP) and 18 healthy controls (HC). For each patient, the values of clinical parameters, such as gingival index, plaque index, probing depth, and clinical attachment level, were recorded. Levels of IL-11 and IL-17 in GCF samples were evaluated using enzyme-linked immunosorbent assay. The values of clinical parameters, cytokine levels, and the ratios of cytokines were evaluated. RESULTS The values of all the clinical parameters were significantly higher in the GAgP group than in the HC group (P < 0.001). The total amount and concentration of IL-11 and the concentration of the IL-17 and IL-11/IL-17 ratio were significantly lower in the GAgP group than in the HC group (P < 0.001). The total amount of IL-17 was not significantly different between the groups (P = 0.317). CONCLUSIONS The IL-11/IL-17 ratio was decreased in the GAgP group because of the decreased IL-11 levels. The IL-11/IL-17 axis and the link between IL-17 and neutrophil function disorders in AgP should be investigated to clarify the role of the IL-11/IL-17 axis and its balance and imbalance in the pathogenesis of AgP.

Circulation levels of acute phase proteins pentraxin 3 and serum amyloid A in atherosclerosis have correlations with periodontal inflamed surface area

Abstract Objectives One of the plausible mechanisms in the relationship between periodontitis and coronary artery disease (CAD) is the systemic inflammatory burden comprised of circulating cytokines/mediators related to periodontitis. This study aims to test the hypothesis that periodontal inflamed surface area (PISA) is correlated with higher circulating levels of acute phase reactants (APR) and pro-inflammatory cytokines/mediators and lower anti-inflammatory cytokines/mediators in CAD patients. Material and Methods Patients aged from 30 to 75 years who underwent coronary angiography with CAD suspicion were included. Clinical periodontal parameters (probing depth - PD, clinical attachment loss, and bleeding on probing - BOP) were previously recorded and participants were divided into four groups after coronary angiography: Group 1: CAD (+) with periodontitis (n=20); Group 2: CAD (+) without periodontitis (n=20); Group 3: CAD (-) with periodontitis (n=21); Group 4: CAD (-) without periodontitis (n = 16). Serum interleukin (IL) −1, −6, −10, tumor necrosis factor (TNF)-α, serum amyloid A (SAA), pentraxin (PTX) 3, and high-sensitivity C-reactive protein (hs-CRP) levels were measured with ELISA. Results Groups 1 and 3 showed periodontal parameter values higher than Groups 2 and 4 (p<0.0125). None of the investigated serum parameters were statistically significantly different between the study groups (p>0.0125). In CAD (-) groups (Groups 3 and 4), PISA has shown positive correlations with PTX3 and SAA (p<0.05). Age was found to predict CAD significantly according to the results of the multivariate regression analysis (Odds Ratio: 1.17; 95% Confidence Interval: 1.08-1.27; p<0.001). Conclusions Although age was found to predict CAD significantly, the positive correlations between PISA and APR in CAD (-) groups deserve further attention, which might depend on the higher PISA values of periodontitis patients. In further studies conducted in a larger population, the stratification of age groups would provide us more accurate results.

Deneysel periodontitiste fazla kilolu olma durumunun dolaşımdaki sitokinler ve adipokinler üzerine etkisi

Amac: Interlokin (IL)-1β, IL-4, IL-6 ve tumor nekrozis faktor (TNF)-α periodontal patogenezde anahtar sitokinlerdir. Bu calisma periodontitisi olan fazla kilolu ratlarda serumda daha yuksek duzeyde pro-inflamatuvar sitokin ve adipokin (leptin, rezistin, adiponektin) duzeyi oldugu hipotezini test etmeyi amaclamaktadir. Materyal-Metot: Dort aylik 32 erkek Wistar rat normal agirlikli ve periodontal saglikli (n=8), normal agirlikli periodontitisli (n=8), fazla kilolu periodontitisli (n=8) ve fazla kilolu periodontal saglikli (n=8) olmak uzere dort gruba ayrildi. Periodontitis ligaturle 14 gunde olusturuldu. Serum sitokin ve adipokin duzeyleri ELISA ile incelendi. Bulgular: normal agirlikli periodontitisli olan ve olmayan ratlar fazla kilolu olan es gruplarindan daha yuksek IL-4 duzeyi sergiledi (P 0,0125). Sonuc: Bu deneysel modelde fazla kilolu olma durumu serum sitokin ve adipokin duzeylerini periodontitisten bagimsiz olarak etkilemistir.

Tekrarlı oral hijyen motivasyon yöntemlerinin sabit ortodontik tedavi gören adölesanların plak ve inflamasyon belirteçleri üzerine etkisi

Abstract Objective: High standard of oral hygiene is essential for patients undergoing fixed orthodontic treatment. The aim of this study is to investigate whether the repetitive and reinforced oral hygiene motivation methods (OHMM) will result in lower plaque index (PI), gingival index (GI) and bleeding on probing (BOP) scores in adolescents with fixed orthodontic appliances. Methods: The study group, composed of 90 patients, was divided into three groups; Group I: Only verbal information (n=30), Group II: Verbal information with demonstration on model and self application by the patient under supervision (n=30), Group III: Verbal information using the illustration catalogue and self application by the patient under supervision (n=30). The periodontal parameters (PI, GI and BOP) were recorded at the baseline, first and fourth week after. The patients received the same OHMM repetitively on the first and fourth weeks. Results: All of the groups have shown significant decreases in parameters when compared to the baseline values at the fourth week (P<0.05). The GI, PI and BOP values were significantly lower in Group III than the other groups (P<0.05) at the fourth week. Discussion: We suggest that the repetitive and reinforced OHMM in this study with the application under the supervision of the dentists/orthodontists can be realized easily in adolescents. These OHMM should be applied with tool(s) and equipment(s) which is (are) familiar to the adolescents and other target groups.