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Objective The aim of this study is to compare the effectiveness of oral irrigator (OI) with interdental brush (IB) clinically and biochemically in orthodontic patients. Materials and Methods Thirty patients were randomly divided into two equal groups; patients using OI in addition to manuel brushing (OI-group), patients using IB in addition to manual brushing (IB-group). The data was collected in the baseline, 2nd, 4th and 8th weeks. Periodontal indexes were recorded clinically and interleukin (IL)-1β, IL-10, matrix metalloproteinase (MMP)-1, MMP-8 levels in gingival crevicular fluid were evaluated biochemically. Results The gingival index and bleeding on probing values at the 8th week and plaque index values at the 2nd, 4th and 8th weeks were found to be statistically lower in the OI-group compared to IB-group. IL-1β total and concentration values at the 2nd week, MMP-8 total and concentration values at the 4th and 8th weeks were statistically lower in the OI-group compared to IB-group. There were no significant differences in MMP-1 and IL-10 total and concentration values between the groups at any time interval of the study. Conclusions The result of our study showed that usage of oral irrigator in addition to toothbrush appears to be as effective as interdental brush in patients under orthodontic treatment. Clinical Revelance There is limited information about OI’s using in orthodontic patients. The results of this study showed that oral irrigators can be used as an alternative oral care device for the interdental cleaning (NCT05562986).

OBJECTIVES The present study was performed to compare the effectiveness of Ankaferd Blood Stopper® (ABS) with enamel matrix derivatives (EMD) for treating fenestration defects in rats. MATERIALS AND METHODS Forty-eight male Wistar rats were randomly divided into six groups (each n = 8). Fenestration defects were created in all rats, to which ABS, EMD, or saline (S) was then applied. The rats were grouped and sacrificed at one of two different time points, as follows: ABS-10-group, ABS-treatment/sacrifice on day 10; EMD-10-group, EMD-treatment/sacrifice on day 10; S-10-group, S-treatment/sacrifice on day 10; ABS-38-group, ABS-treatment/sacrifice on day 38; EMD-38-group, EMD-treatment/sacrifice on day 38; and S-38-group, S-treatment/sacrifice on day 38. Then, histomorphometric analysis including measurements of new bone area (NBA) and new bone ratio (NBR), and immunohistochemical analysis including the determination of osteopontin (OPN) and type-III-collagen (C-III) expression were performed. RESULTS The NBA and NBR were significantly higher in the ABS-10-group and EMD-10-group compared to the S-10-group (p

WOS: 000509391800015 PubMed: 31588098 The purpose of this study was to evaluate the effects of administered Paeoniflorin (Pae) on periodontal tissues within an experimental periodontitis model. Forty male Wistar rats were used in this study and experimental periodontitis was created in all rats except in the control group (n = 10, first group). In the periodontitis group, experimental periodontitis was created but no other application was performed (n = 10, second group). In the other groups created experimental periodontitis, systemic Pae (n = 10, third group) or saline (n = 10, fourth group) was applied. A biochemical analysis of the gingival vascular endothelial growth factor (VEGF) levels and a histomorphometric analysis (measurements of the area of alveolar bone, alveolar bone resorption, and attachment loss) were performed. In the Pae group, the area of the alveolar bone was increased, while alveolar bone resorption and attachment loss decreased. Gingival VEGF levels increased in all groups that created experimental periodontitis and the greatest increase seen in the Pae group. Histomorphometric and biochemical analyses in this study suggest that Pae has a curative effect on periodontal tissues. However, additional studies are needed to confirm these results. Scientific Research Fund of Ondokuz Mayis University in Samsun/TurkeyOndokuz Mayis University [PYO.DIS.1904.15.001] This study was supported by the Scientific Research Fund of Ondokuz Mayis University in Samsun/Turkey (Project number: PYO.DIS.1904.15.001).

The present study was performed to compare the effectiveness of Ankaferd Blood StopperForty-eight male Wistar rats were randomly divided into six groups (each n = 8). Fenestration defects were created in all rats, to which ABS, EMD, or saline (S) was then applied. The rats were grouped and sacrificed at one of two different time points, as follows: ABS-10-group, ABS-treatment/sacrifice on day 10; EMD-10-group, EMD-treatment/sacrifice on day 10; S-10-group, S-treatment/sacrifice on day 10; ABS-38-group, ABS-treatment/sacrifice on day 38; EMD-38-group, EMD-treatment/sacrifice on day 38; and S-38-group, S-treatment/sacrifice on day 38. Then, histomorphometric analysis including measurements of new bone area (NBA) and new bone ratio (NBR), and immunohistochemical analysis including the determination of osteopontin (OPN) and type-III-collagen (C-III) expression were performed.The NBA and NBR were significantly higher in the ABS-10-group and EMD-10-group compared to the S-10-group (p .05), and in the EMD-38-group compared to the S-38-group (p .05). The levels of C-III and OPN immunoreactivity were significantly higher in the ABS-10-group compared to the S-10-group (p .017).The results of this study suggested that ABS can promote early periodontal regeneration, although its efficacy seems to decrease over time.

This randomized clinical trial aimed to compare the efficacy of an oral irrigator and an interdental brush in patients with peri-implant mucositis clinically and biochemically at different time points (at baseline and at the 2nd, 4th, and 12th weeks). Forty-five patients with at least one implant with peri-implant mucositis were included in the present study (n = 45). The patients were divided into three groups: oral irrigator + toothbrush (OI group, n = 15), interdental brush + toothbrush (IB group, n = 15), and toothbrush only (control) (C group, n = 15). The modified plaque index (mPlI), modified sulcus bleeding index (mSBI), probing pocket depth (PPD), probing attachment level (PAL), and bleeding on probing (BOP) were recorded at baseline and at the 2nd, 4th, and 12th weeks. The levels of interleukin 1 beta (IL-1β), transforming growth factor-beta (TGF-β), tissue-type plasminogen activator (t-PA), and plasminogen activator inhibitor-1 (PAI-1) were also determined in the peri-implant crevicular fluid samples biochemically. The mSBI and t-PA at the 2nd week (p = 0.003; p = 0.003); the mPlI, mSBI, BOP, t-PA, and PAI-1 at the 4th week (p

WOS: 000471206900018 PubMed: 31005686 Objectives: Appraise the effect of systemic Paeoniflorin (Pae) application on the periodontium during and after induction of experimental periodontitis in the presence of ligature and after its removal. Design: Seventy male Wistar rats were separated into seven equal groups. The first group was reserved as healthy control group (Group 1: no periodontitis, no medication) and experimental periodontitis was induced with ligature in the remaining rats. In experimental periodontitis groups, Pae or saline was administered systemically in three differet periods; during the experimental periodontitis induction (period 1), after experimental periodontitis induction which ligature removed (period 2) or ligature kept in position (period 3). Only, one of the groups acted as the control periodontitis group and received no treatment. Experimental periodontitis groups were as follows; Group 2: medication in period 1, Group 3: periodontitis and no medication, Group 4: medication in period 2, Group 5: saline application in period 2, Group 6: medication in period 3, Group 7: saline application in period 3. Matrix metalloproteinases-9 (MMP-9) levels and interleukin-10 (IL-10) levels were detected biochemically and histomorphometric analyses were performed. These analyses included measurements of the area of alveolar bone, the level of alveolar bone, and attachment loss. Results: Area of alveolar bone and IL-10 levels were higher in the Pae-administered groups; level of alveolar bone, attachment loss, and MMP-9 levels were correspondingly lower (P < 0.05). The beneficial effects at histomorphometrical and biochemical levels of Pae were the strongest in the rats that were administered Pae after the removal of ligature. Conclusions: Systemically administered Pae had a positive effect on the healing of periodontal tissues. Pae can be used as a new therapeutic agent for periodontal diseases, but microbiology-based studies and more extensive biochemistry-based experimental and clinical studies are needed to address this possibility. Scientific and Technological Research Council of Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [115S846] This study was supported by the The Scientific and Technological Research Council of Turkey (TUBITAK) (Project number: 115S846).

Background and Objective: Periostin, a secreted adhesion molecule essential for periodontal tissue integrity, is highly expressed in the periodontal ligament and plays a critical role in tooth and bone development. The purpose of this study was to investigate periostin levels in the gingival crevicular fluid and serum of patients with periodontal disease and compare them with those of healthy individuals. Material and Methods: Eighty individuals (41 males and 39 females; age range: 25-48 years) were enrolled in the study. Individuals were divided into three groups following clinical and radiographic examinations: the periodontal-healthy group (n = 20), gingivitis group (n = 30) and chronic periodontitis group (n = 30). Gingival crevicular fluid and serum samples were collected and periostin levels were determined using the enzyme-linked immunosorbent assay. Results: The total amount and concentration of periostin decreased in gingival crevicular fluid with the progression and severity of the disease from healthy controls to gingivitis and to chronic periodontitis groups and differed significantly (p < 0.05). However, there was no significant difference in serum periostin concentration within all groups (p > 0.05). Periostin in gingival crevicular fluid negatively correlated with the gingival index in the periodontal disease groups, whereas it is inversely correlated with the clinical attachment level only in the periodontitis group (p < 0.05). When all the clinical groups were examined together, the periostin concentration negatively correlated with clinical attachment level and gingival index; moreover, total periostin positively correlated with periostin concentration and clinical attachment level (p < 0.05). Conclusions: The periostin levels in gingival crevicular fluid decreased proportionally with the progression and severity of periodontal disease, and negatively correlated with the clinical parameters. Within the limits of the study, the periostin level in gingival crevicular fluid can be considered a reliable marker in the evaluation of periodontal disease susceptibility and activity. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Objectives: Ankaferd, medicinal plant extract, has previously been used in Turkish traditional medicine as a hemostatic agent. Bleeding disorders are rare condition require specialist management. Ankaferd Blood Stopper (ABS) may be a useful agent for non-surgical periodontal therapy in these patients. The aim of this case-series study was to estimate the effects of local ABS application to manage bleeding following non-surgical periodontal therapy in these patients. Methods: Ten gingivitis patients (9 males, 1 female) aged 20-33 years were selected with bleeding disorders (Haemophilia A, von Willebrand disease and Glanzmann’s Thrombasthenia). Non-surgical periodontal therapy including oral hygiene instructions and supraand subgingival scaling procedures were performed in one appointment, after consultation with the hematologist, without systemic substitution of coagulation factors. After the completion of scaling, ABS was locally applied to gingival crevicular to reduce bleeding. A secondary hemorrhage did not occur in any of the patients and gingival tissue healing proceeded without any complications. Results: In the present case series, local application of ABS to gingival pockets following supraand subgingival scaling procedures was effective to manage bleeding in these patients. Conclusion: Our cases clearly showed that ABS provides benefit for non-surgical periodontal therapy in bleeding disorders.

Background and Objective: The aim of this clinical study were to compare the clinical efficacy of ankaferd blood stopper (ABS) when used in combination with autogenous cortical bone graft (ACB) in the treatment of intrabony periodontal defects. Material and Methods: The study was planned as a split-mouth design. Fifteen patients with chronic periodontitis at 30 sites (six men, nine women; 42 ± 7 years) were included. Treatment sites had probing pocket depths (PPD) of ? 6 mm and osseous defect depths of ? 4 mm as radiographically assessed. Following the initial periodontal therapy, patients were randomly assigned to two treatments in contralateral areas of the dentition: ACB + ABS or ACB alone. At baseline and 6 mo after surgery, clinical parameters of plaque index, gingival index, PPD, clinical attachment level and gingival recession (GR) were recorded. The primary outcome variable was the change in clinical attachment level between baseline and 24 wk after surgery. Gingival crevicular fluid samples were collected immediately before surgery and at 2, 4, 6, 12 and 24 wk after the surgery. Gingival crevicular fluid volume was calculated and vascular endothelial growth factor levels in gingival crevicular fluid were measured. Results: PPD decreased, clinical attachment level improved and gingival index decreased significantly in response to both modes of treatment (p < 0.05). Both treatment modalities resulted in a significant gain in radiographic bone levels compared to baseline (p < 0.05). Intergroup comparisons showed that there was a significantly higher gain in clinical attachment level in the ABS/ACB group compared to ACB group (p < 0.05) with significantly less GR (p < 0.05). Similarly, vascular endothelial growth factor concentration in gingival crevicular fluid was significantly higher in the ABS/ACB group at postoperative weeks 2 and 4 compared to the ACB group (p < 0.01). Conclusions: The findings suggest that ABS enhances the soft tissue healing during the periodontal defect fill by the ACB by stimulating angiogenesis and vascular endothelial cell function, prevents GR and thereby increases the clinical attachment gain. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

The purpose of this study was to evaluate visfatin levels at different stages of periodontal disease and in healthy tissues. In addition, the effect of non-surgical periodontal therapy on visfatin levels in gingival crevicular fluid and serum was investigated. Forty-five patients were divided into three groups based on clinical and radiographical findings. Group 1 comprised periodontally healthy individuals (n = 15); group 2 comprised patients with gingivitis (n = 15); and group 3 was composed of patients with generalized chronic periodontitis (n = 15). Gingival crevicular fluid and serum samples were collected before treatment and at 1, 3, and 6 months after treatment. Visfatin levels were measured by enzyme-linked immunosorbent assays. Gingival crevicular fluid and serum visfatin levels were higher in patients with chronic periodontitis than those with gingivitis or healthy controls (P < 0.016). In addition, visfatin levels were higher in the gingivitis group than in healthy controls (P < 0.016). Non-surgical periodontal treatment resulted in a significant reduction in gingival crevicular fluid and serum visfatin levels. Furthermore, visfatin levels increased with inflammation and decreased following periodontal treatment. Our findings suggest that visfatin is an inflammatorybiomarker of periodontal disease. ? 2016, Universidad de Granada. All rights reserved., 2013-62550515-04, This work was supported by Research Fund of Ondokuz May?s University Project (Number: 2013-62550515-04).

WOS: 000271722800006 PubMed: 19101738 The purpose of this study was to compare histological effectiveness of platelet pellet (PP), which has higher platelet content than platelet-rich plasma, and the combination of PP/guided tissue regeneration (GTR) for class II furcation defects in dogs. The mandibular second, third, and fourth premolars of both sides in four dogs were used. Class II furcation defects (5 mm in height and 2 mm in depth) were surgically created. Five weeks after the first operation, second premolars were treated with scaling and root planing (group 1); right third and fourth premolars received PP (group 2), and left premolars received the combination of PP/GTR (group 3). Percentage of cementum and alveolar bone formation were evaluated by histometric analysis after a healing period of 12 weeks. There was new cementum along with periodontal ligament and coronal growth of alveolar bone in all groups. Cementum formation was significantly higher in groups 2 and 3 compared to the control group (P < 0.05) with no significant difference between groups 2 and 3. Limited alveolar bone formation was statistically similar in all groups (P > 0.05). It is concluded that both PP and the combination of PP/GTR are effective in the treatment of class II furcation defects in dogs. PP thus appears to be a suitable alternative material in the regenerative periodontal therapy.

Background and Objective It has previously been shown that both cyclosporine A and tacrolimus cause gingival overgrowth in the rat. We proposed that sirolimus may play an important role in decreasing the severity of gingival overgrowth. Therefore, the aim of this study was to evaluate the gingival changes induced by immunosuppressants, in the presence and absence of sirolimus, using histopathology and stereological methods. Material and Methods Thirty-six male Sprague-Dawley rats were distributed into six treatment groups, each containing six rats, as follows: (i) cyclosporine A for 8 wk; (ii) tacrolimus for 8 wk; (iii) sirolimus for 8 wk; (iv) cyclosporine A + sirolimus for 8 wk; (v) tacrolimus + sirolimus for 8 wk; and (vi) distilled water for 8 wk. Histomorphometric analyses included measurements of epithelial thickness and connective tissue width and height. Stereological analyses included measurements of volumetric densities of fibroblasts (Vf), collagen fibers (Vcf) and blood vessels (Vbv). Results Connective tissue width and height were significantly increased in cyclosporine A, tacrolimus and cyclosporine A + sirolimus groups compared with the control group (p

WOS: 000244186100007 PubMed: 17111121 Guided tissue regeneration is based on preventing the more rapidly proliferating epithelium from growing into the periodontal defect after surgical procedures incorporating barrier membranes. The aim of this study was to compare the proliferative activity of gingival epithelium using proliferating cell nuclear antigen (PCNA) as a marker of cell proliferation after surgical treatments with bioactive glass graft material and bioabsorbable membrane. Using split mouth design, 20 intrabony defects were randomly assigned treatments with bioactive glass (BG group) or bioabsorbable membrane (BM group). Gingival biopsies were taken at preoperative and postoperative 12 weeks. After histological processing, the number of the inflammatory cells was measured in hematoxylin and eosin-stained sections; PCNA expression was determined in immunohistochemically-stained sections. At postoperative 12 weeks, the number of the inflammatory cells was significantly decreased (p < 0.01), PCNA expression was significantly increased (p < 0.001) in both treatment groups compared to baseline data. There was no significant difference in PCNA expression between baseline values of two groups (p > 0.05), while at postoperative 12 weeks, increase in BG group was significantly greater than that in BM group (p < 0.001). These results suggest that epithelial cell proliferation is more prominent after treatment of intrabony defects with bioactive glass compared to the treatment with bioabsorbable membrane.

WOS: 000237512700006 PubMed: 16546941 The aim of this study was to investigate the relationship between Proliferating Cell Nuclear Antigen (PCNA) expression and histomorphometrical alterations in cyclosporin A (CsA)-induced gingival overgrowth with or without microbial dental plaque accumulation. Forty male Wistar rats were equally divided into 4 groups; Group I (control); Group II (CsA); Group III (ligature); Group IV (ligature and CsA). After 8 weeks of experimental period, rats were subsequently decapitated and mandibular molars were dissected. Gingival overgrowth was determined by measuring depth of the gingival sulcus, then the mandible were decalcified and serial sections were obtained for histomorphometric and immunohistochemical analysis. Histomorphometric analysis included the measurement of epithelial thickness; immunohistochemical analysis included the assessment of PCNA expression in the oral and sulcular epithelium of buccal and lingual gingiva. Epithelial thickness and PCNA expression were significantly increased in buccal oral epithelium of Group II (p < 0.05) and in all regions in Group IV (p < 0.05) compared to control group. Also gingival overgrowth was more prominent in Group IV in comparison to Group II. These results indicate that CsA-induced gingival alterations are closely accociated with increased epithelial proliferative activity, and dental plaque accumulation seems not to be an essential but to be an aggrevating factor for the progression of the lesion.

WOS: 000242333500001 PubMed: 17123908 Objective. In recent years, platelet-rich plasma combined with graft materials has been used for periodontal regeneration. The individual role of blood products with guided tissue regeneration in periodontal regenerative therapy is unclear and needs to be elucidated. The purpose of this study was to compare the clinical and radiological effectiveness of platelet pellet/guided tissue regeneration (PP/GTR) and bioactive glass/GTR (BG/GTR) treatments in patients with periodontal disease. Material and methods. Using a split mouth design, 15 chronic periodontitis patients with pocket depths >= 6 mm following periodontal initial therapy were randomly assigned to treatment with a combination of PP/GTR or BG/GTR in contralateral dentition areas. An absorbable membrane of polylactic acid was used for GTR. The criteria for the comparative study were preoperative and postoperative 6 months pocket depth, clinical attachment level, and radiological alveolar bone level. Results. Both treatment modalities resulted in significant pocket depth reduction and gain in clinical attachment and alveolar bone level compared to the preoperative values (pB < 0.01). Reduction in pocket depth, gain in clinical attachment and alveolar bone level were 4(3 - 6), 4.19 +/- 0.7, 4.99 +/- 1.4 mm in the PP/GTR group and 4(3 - 7), 4.19 +/- 1.2, 5.99 +/- 1.7 mm in the BG/GTR group, respectively. The differences between the two groups were not statistically significant (p > 0.05). Conclusions. Within the limits of this study, it was concluded that PP may be effective as a bioactive glass graft material and used as a graft material for treating intrabony defects. PP thus appears to be a suitable alternative in the regenerative treatment of intrabony periodontal defects.

WOS: 000241878100008 PubMed: 16579703 Background: Gingival overgrowth is a side effect associated with cyclosporin A (CsA) therapy. The lesion is characterized by increased epithelial thickness, enlargement of connective tissue, and increased vascularization. The aim of this experimental study was to examine the role of vascular endothelial growth factor (VEGF) in the pathogenesis of CsA-induced gingival overgrowth. Methods: Twenty male Wistar rats were divided into two groups of 10 animals each. For the development of gingival overgrowth, one group received CsA therapy subcutaneously in a daily dose of 10 mg/kg for 60 days, and the other group was used as a control. At the end of the experimental period, rats were subsequently decapitated, and the mandibles with the surrounding gingiva and soft tissue were removed. Half of each sample was used for histomorphometric analysis, and the other half was used for biochemical analysis. Histomorphometric analysis included the measurements of the number and diameter of blood vessel profiles under a microscope, and biochemical analysis included the assessment of VEGF concentration by enzyme-linked immunosorbent assay (ELISA). Results: The histomorphometric findings showed that the number of blood vessel profiles increased in the CsA group compared to the control group (P < 0.001), although the increase in the diameter of blood vessel profiles was not significant (P > 0.05). The biochemical findings showed that in vivo VEGF expression was higher in the CsA group compared to the control group (P < 0.001). Conclusion: The results of this study suggest that increased VEGF expression may be associated with the pathogenesis of CsA-induced gingival overgrowth.

AVCI, Bahattin/0000-0001-6471-6495; Emingil, Gulnur/0000-0002-4869-9629 WOS: 000341580700016 PubMed: 24635545 Background: YKL-40, a new acute-phase protein, is shown to be elevated in inflammatory diseases, such as rheumatoid arthritis, type 2 diabetes mellitus, and coronary artery diseases. However, there is no data indicating a relationship between YKL-40 and periodontal disease. Interleukin-6 (IL-6) is the major regulator of acute-phase protein synthesis and one of the most studied inflammatory markers in periodontal disease. The purpose of the present study is to evaluate YKL-40 and IL-6 levels in gingival crevicular fluid (GCF) and serum of patients with periodontal disease and healthy individuals. Methods: Periodontally healthy individuals (n = 15), patients with gingivitis (n = 15), and patients with severe chronic periodontitis (CP) (n = 15) without any systemic disease were included in the study. Clinical measurements were recorded; GCF and blood samples were obtained from each participant. GCF and serum YKL-40 and IL-6 levels were analyzed by enzyme-linked immunosorbent assay. Statistical analysis was performed by parametric and non-parametric tests. Results: Total amounts of YKL-40 and IL-6 in GCF as well as serum YKL-40 and IL-6 levels were significantly higher in patients with gingivitis and CP compared with healthy controls (P

WOS: 000335007600005 PubMed: 23782056 Background and Objective We proposed that phosphatase and tensin homolog (PTEN) might be one of the signaling proteins that alter the balance between cell growth and cell death in drug-induced gingival overgrowth. The aim of this study was to investigate the expression of PTEN in subjects using cyclosporine A and to analyze the relationship between PTEN and cell proliferation marker, proliferating cell nuclear antigen (PCNA), in cyclosporine A-induced gingival overgrowth. Material and Methods In total, samples from 36 subjects, i.e. 24 cyclosporine A-mediated renal transplant patients with gingival overgrowth (n=12) or without gingival overgrowth (n=12) and 12 matched periodontally healthy subjects, were included in the study. PTEN and PCNA expressions in gingival tissues were analyzed using immunohistochemistry, PTEN expression was also analyzed by western blot. PTEN immunoreactivity was calculated with a histologic score (HSCORE) value and PCNA immunoreactivity was calculated with the PCNA-proliferative index. Results Phosphatase and tensin homolog HSCORE for the group with gingival overgrowth was found to be significantly lowest compared to the group without gingival overgrowth and the control group (p0.05). Conclusion Our results showing decreased PTEN levels in patients with gingival overgrowth supported with increased PCNA expression suggested that PTEN might take part in the imbalance between cell proliferation and death in drug-induced gingival overgrowth.

WOS: 000331139400023 PubMed: 23646851 Background: The aim of this study is to examine, for the first time, the role of systemic and local atorvastatin application on periodontium using histomorphometric and immunohistochemical analysis during and after experimental periodontitis induction with or without the presence of microbial dental biofilm. Methods: One hundred ten male Wistar rats were used. Silk ligatures were placed around the cervical area of the mandibular first molars; rats in the healthy control group received no ligatures (n = 10). In experimental periodontitis groups (n = 90), systemic and local atorvastatin and saline were administered in three different periods; the control periodontitis group (n = 10) received no treatment. Histomorphometric analysis, which included alveolar bone area, alveolar bone level, and attachment loss, and immunohistochemical analysis, which included immunoreactivity of vascular endothelial growth factor (VEGF) and matrix metalloproteinase (MMP)-9, were performed after the rats were sacrificed at the end of the experimental procedure. Results: There was a greater increase in alveolar bone area and VEGF immunoreactivity, as well as a greater decrease in alveolar bone and attachment loss and MMP-9 immunoreactivity, with systemic and local atorvastatin application during and after induction of experimental periodontitis. Local atorvastatin application showed better results on periodontium with regard to alveolar bone findings. Conclusions: Systemic and local atorvastatin application showed beneficial effects on periodontium during and after induction of experimental periodontitis. Within the limits of this study, it can be concluded that atorvastatin, which is used for hypercholesterolemia treatment, can also be used as a protective and therapeutic agent for periodontal disease.

WOS: 000333047000002 PubMed: 24279607 Objective. The purpose of this clinical investigation was to evaluate long-term results obtained with the combination of platelet pellet(PP) plus bioabsorbable barriermembrane(BM) and to compare this outcome with the results obtained using bioactive glass (BG) graft material with a BM. Materials and methods. Using a split mouth design, 11 chronic periodontitis patients (power >= at least 80%) were randomly assigned to treatment with a combination of PP/GTR or BG/GTR in contra-lateral dentition areas. Clinical attachment level (CAL) as the primary outcome variable, calculated as the sum of probing pocket depth (PPD) and gingival recession, and radiological alveolar bone level were recorded at baseline, 6 months and 5 years. Results. There were no statistical differences between test and control defects at baseline. PPD reductions and CAL and radiological alveolar bone height gains were statistically significant between baseline and 6 months and between baseline and 5 years in both groups (p= 4 mm CAL gain in both groups, while 5 year results showed that 73% of the defects attained 2 mm 0.05). No statistically significant difference in any of the clinical parameters was observed at 6 months and 5 years between the groups (p > 0.05). Conclusions. The long-term efficacy of platelet concentrate combined with a barrier membrane is similar with the combination of bioactive glass graft material and barrier membrane, suggesting that results obtained with both treatment approaches can be maintained over a period of 5 years.

Objective: The aim of this 6-month prospective randomized clinical study was to compare the effectiveness of autogenous cortical bone (ACB) and bioactive glass (BG) grafting for the regenerative treatment of intraosseous periodontal defects. Methods: Via a split-mouth design, 15 chronic periodontitis patients (7 men, 8 women; mean age, 43.47 ± 1.45 years) who had probing pocket depths (PPDs) of ⩾6 mm following initial periodontal therapy were randomly assigned to receive 2 treatments in contralateral areas of the dentition: ACB grafting and BG grafting. The parameters compared in the patients were preoperative and 6-month postoperative PPDs, clinical attachment levels (CALs), and radiographic alveolar bone heights. Results: Both treatment modalities resulted in significant changes in postoperative measurements when compared to preoperative values (p < 0.01). PPDs were decreased, CALs were increased, and radiographic alveolar bone heights were increased by 5.00 ± 0.28, 4.60 ± 0.21, and 5.80 ± 0.43 mm in patients treated with ACB grafting and 5.13 ± 0.32, 4.67 ± 0.27, and 5.33 ± 0.36 mm in patients treated with BG grafting, respectively. Differences between the treatments were not statistically significant (P>.05). Conclusions: Within the limitations of this study, both ACB and BG grafting led to significant improvements in clinical and radiographic parameters 6 months postoperatively. These results suggest that either an ACB graft, which is completely safe with no associated concerns about disease transmission and immunogenic reactions, or a BG graft, which has an unlimited supply, can be selected for regenerative periodontal treatment.

GULBAHAR, MUSTAFA YAVUZ/0000-0001-8268-7659; Gulbahar, M. Yavuz/0000-0002-4129-4434 WOS: 000328686100019 PubMed: 23289868 Background: The aim of this study is to compare gingival changes induced by short-and long-term tacrolimus and nifedipine administration, alone or in combination, and evaluate the expression levels of tumor suppressor phosphatase and tensin homolog (PTEN) in drug-induced gingival over-growth. Methods: Eighty rats were equally divided into eight groups: 1) tacrolimus for 8 weeks; 2) nifedipine for 8 weeks; 3) tacrolimus and nifedipine for 8 weeks; 4) 8-week control; 5) tacrolimus for 24 weeks; 6) nifedipine for 24 weeks; 7) tacrolimus and nifedipine for 24 weeks; and 8) 24-week control. Histomorphometric analyses included measurements of epithelial thickness, connective tissue thickness, and height. Stereologic analyses included measurements of volumetric densities of fibroblasts (V-f), collagen fibers (V-cf), and blood vessels (V-b upsilon). In addition, PTEN expression was analyzed using immunohistochemistry. Results: Epithelial thickness and connective tissue thickness were significantly increased in groups 5, 6, and 7 compared to group 8 (P

Objectives: The aim of this clinical trial was to evaluate the additional benefit of using guided tissue regeneration (GTR) with autogenous cortical bone (ACB) grafting versus ACB grafting alone for the regenerative treatment of intraosseous periodontal defects.Methods: Via a split-mouth design, 12 patients with chronic periodontitis (five men, seven women; mean age, 45.3±4.6 years) who had probing pocket depths (PPDs) of ≥6 mm following initial periodontal therapy were randomly assigned to two treatments in contralateral areas of the dentition: a combination of ACB grafting and GTR (with a absorbable membrane of polylactic acid) or ACB grafting alone. The compared parameters were preoperative and 6-month postoperative PPDs, clinical attachment levels (CALs), and radiographic alveolar bone heights.Results: Both treatment modalities resulted in significant changes in the postoperative measurements from the preoperative values (P.05).Conclusions: Within the study limitations, both ACB grafting with GTR and ACB grafting alone lead to significant improvements in clinical and radiographic parameters at 6 months postoperatively. The combined approach does not provide any additional benefit for treating intraosseous periodontal defects. (Eur J Dent 2010;4:403-411)

WOS: 000299172000029 PubMed: 21086003 The purpose of this study was to compare the effectiveness of mesenchymal stem cells (MSCs) with platelet-rich plasma (PRP) as scaffold and autogenous cortical bone (ACB) graft with and without PRP in the regenerative treatment of class II furcation defects in dogs. The mandibular second, third, and fourth premolars (P2, P3, P4) and maxillary P3 and P4 of both sides in three dogs were selected for experimentation. Class II furcation defects (5 mm in height and 2 mm in depth) were surgically created. Five weeks after the first operation, scaling + root planning (group 1), PRP (group 2), ACB (group 3), combination of ACB/PRP (group 4), and combination of MSCs/PRP (group 5) treatments were performed during open flap debridement. The percentage of cementum and alveolar bone formation was evaluated by histomorphometric analysis after a healing period of 8 weeks. There was new cementum along with periodontal ligament and coronal growth of alveolar bone in all groups. Cementum formation was significantly higher in groups 3, 4, and 5 compared to the control group (P < 0.05) with no significant difference between groups 2, 3, 4, and 5. Alveolar bone formation was similar in all groups (P > 0.05). It can be concluded that periodontal regeneration with complete filling of class II furcation defects with cementum, alveolar bone, and periodontal ligament is obtained 8 weeks after ACB, ACB/PRP, and MSCs/PRP treatments; however, efficacy of none is higher than another. Ondokuzmayis UniversityOndokuz Mayis University [DHF 052] This study was supported by Ondokuzmayis University Research Fund (project DHF 052). We are especially grateful to Prof. Dr. Yuksel BEK (Chief of the Department of Biostatistics, Faculty of Medicine, University of Ondokuzmayis, Samsun, Turkey) for his precious contribution to the statistical analyses of our study.

WOS: 000278579000007 PubMed: 20127137 The aim of this study was to determine vascular endothelial growth factor (VEGF) mRNA expression levels in gingival tissues of gingivitis and periodontitis patients with diabetes mellitus and those without. The hypothesis tested is that expression of VEGF, considered the effective cytokine in the relationship between diabetes and periodontal disease, is differentially affected in gingivitis and periodontitis patients with or without diabetes mellitus compared to healthy controls. Forty-five subjects were evaluated in five groups; individuals with gingivitis (group 1; n = 10), individuals with periodontitis (group 2; n = 10), individuals with gingivitis + type II diabetes (group 3; n = 10), individuals with periodontitis + type II diabetes (group 4; n = 10), and individuals without periodontal and systemic disease (group 5; n = 5). VEGF mRNA levels in gingival tissues were measured by quantitative real-time PCR using Lightcycler. Expression of VEGF mRNA was detected in all groups. There was no significant difference in expression levels of VEGF mRNA between groups (P > 0.05). VEGF expression is probably related to both maintenance of periodontal health and periodontal tissue destruction. It can be concluded that systemic condition in type II diabetes mellitus under good metabolic control does not seem to have additional effects on gingival tissue VEGF mRNA levels in gingivitis and periodontitis patients. Ondokuzmayis University Research Fund [DHF.032] This study was supported by Ondokuzmayis University Research Fund (project DHF.032).

WOS: 000260142100017 PubMed: 18834251 Background: The present study was designed to evaluate the effects of risedronate, one of the most potent bisphosphonates, on alveolar bone resorption and angiogenesis in rats with experimental periodontitis to identify dose-response curves and treatment durations that can be therapeutic for periodontal therapy versus those associated with osteonecrosis of the jaws. Methods: Thirty-five rats, 25 with experimental periodontitis (groups I through 5) and 10 with healthy periodontium (groups 6 and 7), were divided into seven equal groups: group I received no treatment; groups 2 and 3 received risedronate, 0.1 and 1 mg/kg, respectively, for 3 weeks; groups 4 and 5 received risedronate, 0.1 and I mg/kg, respectively, for 8 weeks; and groups 6 and 7 received 0.9% NaCl for 3 and 8 weeks, respectively. Animals in groups 2 through 7 were administered treatment 5 days per week. After histologic processing, histomorphometric and stereologic analyses were carried out to estimate the number of blood vessels (NBV) and the volumetric densities of bone (Vb), marrow (Vm), osteoblasts (Vob), and osteoclasts (Voc). Results: A total of 0.1 and I mg/kg risedronate for 3 weeks (groups 2 and 3) significantly increased Vb and Vob and decreased Vm more prominently in group 2 (P 0.05). No significant decrease in Voc was found in drug -administered groups compared to group I (P >0.05). A significant decrease in NBV (P

WOS: 000268052600004 PubMed: 19615653 Objective. The objective of this randomized controlled trial was to compare the effects of different suturing techniques (simple loop suture vs. anchor suture) on the periodontal health of the adjacent second molars after impacted mandibular third molar extraction. Study design. Fifteen patients with bilaterally identical impacted mandibular third molars were used. Using split-mouth design, flaps were closed with either anchor suture technique or simple loop suture technique after the extraction of third molars. Postoperative examination included probing pocket depth (PPD) and clinical attachment level (CAL) measured at the distal surface of the second molars before surgery and 6 months after surgery. Results. The PPD and CAL in the distal surfaces of the second molars were significantly higher after 6 months in the simple suture group (P = .001), whereas no differences were found in the anchor suture group (P > .05). Intergroup comparisons showed that the 6-month PPD and CAL values of the distal surfaces were significantly higher in the simple suture group compared with the anchor suture group (P = .015). Conclusion. The results suggest that anchor suture might be a better technique to use to maintain healthy periodontium and to prevent periodontal problems after the extraction of impacted third molars. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108: 156-161)

WOS: 000247229700022 PubMed: 17539728 Background: The major role of vascular endothelial growth factor (VEGF), an angiogenic mediator, in promoting the progression or the healing of periodontal disease is still unclear. The aim of this study was to evaluate the VEGF expression in the destruction and healing stages of periodontal disease and to investigate the association between VEGF expression and vascularization with regard to the number and diameters of blood vessels. Methods: Thirty rats were distributed equally into two test groups and a control group. Experimental periodontal disease was induced in the test groups by silk ligatures, which were kept in position for 40 days. On the 40th day, ligatures were removed from the healing group, whereas ligatures were left in position in the destruction group. On the 60th day, rats were sacrificed; histomorphometric and biochemical analyses were carried out to determine the number and diameters of blood vessels and the assessment of VEGF concentration by enzyme-linked immunosorbent assay, respectively. Results: There was a statistically significant increase in the number of blood vessels in the healing group and in the diameters of blood vessels in the destruction group compared to the control group (P < 0.001). In vivo VEGF expressions were highest in the healing group (P < 0.001) and correlated significantly with the number of blood vessels (r(2) = 0.814; P = 0.001). Conclusion: VEGF expression may be related more to the healing stage of periodontal disease than to the destruction stage of the lesion.

WOS: 000241625800004 PubMed: 17076775 Background and Objective: Elevated levels of platelet activating factor (PAF), a potent inflammatory phospholipid mediator, have been previously detected in gingival tissues and gingival crevice fluid (GCF) in periodontal disease. However, the role of this mediator during wound healing after periodontal surgery remains unclear. The hypothesis, a relationship between PAF levels and periodontal healing, was tested by measuring PAF levels in GCF samples collected from sites that had undergone guided tissue regeneration (GTR) or flap surgery. Material and Methods: Using a split-mouth design, 30 intrabony defects were randomly assigned to treatment with GTR (group 1) or to flap surgery (group 2). GCF was sampled pre-operatively and at 6-, 12- and 24-wk follow-up evaluation visits. PAF levels in GCF were analyzed by high-performance liquid chromatography (HPLC). Results: Both treatment modalities significantly reduced the probing pocket depth and improved the clinical attachment level (p < 0.01). Compared with pre-operative values, the GCF volume and PAF levels were significantly decreased at postoperative weeks 6, 12 and 24 in both groups (p < 0.01). There were also significant differences in GCF volume and PAF levels at all time points up to 24 wks in both groups (p < 0.01). No statistically significant differences were observed in any of the parameters investigated between the two groups (p > 0.05). Conclusion: PAF is detectable in GCF by HPLC and showed a continuous decrease at all the time points monitored following periodontal surgical therapy. This suggests that changes in the levels of this mediator in GCF might be useful for monitoring the progress of periodontal repair and regeneration.

WOS: 000251009800008 PubMed: 17522901 The hypothesis, a relationship between gingival tissue platelet activating factor (PAF) levels and healing after periodontal surgery, was tested by measuring PAF levels in gingival tissues collected from sites that had undergone flap surgery and guided tissue regeneration (GTR) or flap surgery alone. Using a split-mouth design, 20 intrabony defects were randomly assigned to treatment with flap surgery and GTR (group 1) or with flap surgery alone (group 2). Gingival tissue samples were obtained at surgery (baseline) and at 6-month follow-up evaluation visit. One half of each sample was used for analysis of PAF levels by high-performance liquid chromatography, and the other half of the sample was used for histomorphometric analysis that included measurements of number and diameter of blood vessels. PAF levels and diameter of blood vessels were significantly decreased (p < 0.01), and the number of blood vessels was significantly increased (p < 0.05) in both groups after 6 months compared to the baseline values. Postoperative number of blood vessels were significantly higher in group 1 (p < 0.05), whereas there was no significant difference in postoperative PAF levels between the two groups (p > 0.05). Based on the reported results, it is suggested that a decrease in gingival PAF levels might be found after conventional and regenerative periodontal surgery.