Does YouTube™ provide reliable information on oral candidiasis?

OBJECTIVE: To evaluate the quality, source, usefulness and/or reliability, visibility, and popularity of YouTube™ videos on oral candidiasis. MATERIALS AND METHODS: A YouTube™ search for "oral candidiasis" was performed, setting the English language. 133 of the 351 videos watched were included in the study. Two periodontologists scored the videos for visibility, popularity, quality, utility, and reliability. Videos' quality was evaluated using the DISCERN and the Global Quality Scale (GQS) tools, by categorizing them through quality assessment, source, duration, views, likes, and dislikes of each video were noted. RESULTS: 82.7% of the videos were moderately or very useful, and the GQS scores were mostly good (41.4%-Score 4) and excellent (42.1%-Score 5). Significant relationships were obtained between Source of Upload, Video Type, Total Discern, and GQS variables and Usefulness scores (p < 0.05). The 53.4% of the video sources were Healthcare professionals and their video usefulness scores were mostly "moderately useful" (47.9%) and "very useful" (%42.3). There was a significant positive correlation between the usefulness scores of the videos and the number of likes (p = 0.004), comments (p = 0.019), and the viewing rate (p = 0.006). CONCLUSIONS: The videos that rank high in searches for oral candidiasis on YouTube™ are mostly useful and comprehensive videos uploaded for educational purposes.

Is Online Video a Suitable Source to Obtain Sufficient and Useful Information About Peri-Implantitis?

PURPOSE: Recently, with the increase in cases of peri-implantitis, the amount of data patients can receive via social media about the condition has increased. The study presented here aims to examine what online videos (YouTubeTM, Google LLC, San Bruno, California) offer patients about peri-implantitis and to evaluate the quality of the information presented. MATERIALS AND METHODS: In this cross-sectional study, a systematic search was conducted into online videos containing information about peri-implantitis using the keyword "peri-implantitis" by an experienced periodontologist. The source of videos, video type, duration, number of days since upload, number of views, comments, likes, dislikes, and interaction index of each video were recorded. Videos were scored according to content; Score 0 (low content): videos with no description of clinical presentations, risk factors, or management options; Score 1 (moderate content): videos that described 1 clinical presentation and 1 etiologic factor and did not describe management options; Score 2 (high content): videos with the description of at least 2 clinical presentations, 2 etiologic factors, and 1 management option. The quality of each video was evaluated using the Global Quality Scale and DISCERN. Data were analyzed using the Kruskal-Wallis test, Spearman's test, and multinomial logistic regression analysis. Intraobserver agreement was calculated as the intraclass correlation coefficient. RESULTS: The first 200 videos were screened and, after exclusions, 103 videos were included for further analysis. United States-based videos were the majority (14 videos), 46.6% of the videos were uploaded by healthcare professionals, and 99% were in the educational videos category. Video content score 2 videos have higher mean values with 4,871.945 views, 6.002 comments, 50.729 likes, 7.751 viewing rate, and 0.023 interaction index than score 0 videos (P < .05). Statistically significant positive correlations were found between the video content score, Global Quality Scale, DISCERN, and the data showing the popularity and visibility of the videos (P < .01). CONCLUSIONS: Overall, half of the top-ranked online videos are valuable sources of information about peri-implantitis. Videos with high content are more popular and are of greater quality than videos with low content.

Evaluation of Bacterial Colonization and Clinical Properties of Different Suture Materials in Dentoalveoler Surgery.

PURPOSE: This study aimed to compare the effects of 10 different suture materials commonly used in dentoalveolar surgery on wound healing, their postoperative microbial colonization, and related clinical parameters. METHODS: A total of 172 suture samples from patients who had undergone extraction of impacted third molars were included in the study. The suture materials studied were poly-glycolide-colactide, fast absorbable poly-glycolide-colactide, poly-glycolic acid-cocaprolactone, polydioxanone, silk, polypropylene, polyvinylidene difluoride, polyamide, polyester, and polytetrafluoroethylene (PTFE). The microbial colonization in all sutures and clinical parameters were evaluated after 1 week. RESULTS: Multifilament sutures had higher bacterial colonization compared with monofilament sutures (P < .001). No dental plaque accumulation was observed in any samples of polypropylene sutures. Polydioxanone, PTFE, and poly-glycolic acid-cocaprolactone sutures exhibited less postoperative slack compared with all other sutures after 1 week. Patients with silk, polyvinylidene difluoride, and PTFE sutures had less suture-related discomfort. According to the Landry index score, monofilament sutures demonstrated superior wound healing to multifilament sutures (P = .019). In addition, nonabsorbable sutures showed significantly better wound epithelization than absorbable sutures (P ˂ .001). CONCLUSIONS: Bacterial colonization and tissue reactions due to the surface properties of the suture affected the wound healing after dentoalveolar surgery. Multifilament sutures should not be applied for prolonged periods because of their tendency for microbial colonization. The tissue reaction to the absorbable suture materials may adversely affect wound healing.

Influence of different anti-hypertensive drugs on gingival overgrowth: A cross-sectional study in a Turkish population.

OBJECTIVE: The purpose of this study was to evaluate the occurrence rate of drug-induced gingival overgrowth (DIGO) in patients treated with angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and calcium channel blockers (CCBs) such as amlodipine, lercanidipine, and benidipine, as well as to assess the relationship of those mentioned above with medication variables and oral hygiene. METHODS: Sociodemographic details, DIGO, and clinical periodontal parameters were obtained from one hundred and thirty-one patients receiving ACE inhibitors, ARBs, and CCBs for a period of at least 2 years. RESULTS: The occurrence rate of DIGO was 19.6% in patients using CCB, 12.5% in the ARB group, and 7.5% in the ACE inhibitor group. In a subgroup analysis of CCBs, DIGO was found to be 31.8% in the amlodipine group, 13.3% in the lercanidipine group, and 7.1% in the benidipine group. While there was a significant relationship between amlodipine drug dosage and DIGO, no association was found between the duration of therapy and DIGO in all CCB subgroups. CONCLUSION: There was no difference between the groups in terms of DIGO. Duration of therapy and drug dosage did not affect the severity of DIGO in both ACE inhibitors and ARB groups.

Dental and temporomandibular joint alterations in rheumatoid arthritis patients and their association with salivary oxidative stress

Background/aim: Rheumatoid arthritis (RA) is the most extensive inflammatory arthritis causing permanent deformities in the joint. Increasing evidence suggests that oxidative stress is a substantial factor in the pathogenesis of RA. This study aimed to examine the salivary oxidant-antioxidant status of RA and control groups and to compare these biomarkers by correlating them with disease activity, acute phase reactants, and clinical findings. Materials and methods: Age and sex-matched 60 participants including 30 patients with RA and 30 control (50 females, 10 males; mean age: 42.62 ± 10.89 years) were evaluated. RA disease activity and severity were evaluated by the disease activity score 28-C reactive protein (DAS 28-CRP). Rheumatoid factor (RF) positivity, anticitrullinated protein antibodies (ACPA) positivity, erythrocyte sedimentation rate (ESR), CRP, tender and swollen joint counts, and medical treatment regimens of the patients (glucocorticoids, conventional or biologic disease-modifying antirheumatic drugs) were recorded. In the radiographic examination, dental findings, and bone alterations of the temporomandibular joint (TMJ) were recorded and compared for both groups. Saliva samples were obtained for analysis of total antioxidant status (TAS), total oxidant status (TOS), arylesterase (ARE), and oxidative stress index (OSI) levels. The data analysis was conducted by independent sample t-test and chi-square test. Results: Condylar erosion was the most common radiographic change in TMJ of RA patients. Osteophyte formation was a prominent finding in the control group. Lower TAS and higher OSI levels were found in RA patients compared with controls (p = 0.013; p = 0.029, respectively). The effect of DAS 28-CRP score on the levels of oxidative stress biomarkers in RA patients was not significant. Conclusion: Oxidative stress causes tissue damage in response to excessive mechanical loading, which in turn promotes TMD. However, disease activity has not a prominent impact on the salivary oxidative stress status of RA patients.

Association of socio-demographic, behavioral, and comorbidity-related factors with severity of periodontitis in Turkish patients.

Objective: To assess the prevalence of comorbidities and periodontal diseases severity in dental patients and to determine the socio-demographic, behavioral, and comorbidity-related predictors of periodontal diseases severity.Material and methods: This retrospective study sample consisted of 2458 patients who referred to faculty dentistry clinic. Socio-demographic, behavioral, and comorbidity characteristics of study participants were collected using hospital database and self-reported questionnaire. Descriptive, bivariate, and multivariate analyses were used to analyze study data.Results: Of these patients, 55.2% had mild-to-moderate periodontitis and 44.8% had severe periodontitis. The severity of periodontal disease was significantly associated with the presence of comorbidity, the number of comorbidities, age, gender, income level, smoking, and alcohol consumption. Patients with severe periodontitis were more likely being a current smoker, to report drinking alcohol sometimes or every day, to be a male, to have a pulmonary disease, to have an endocrinological and metabolic disorder, to have a cardiovascular disorder and to have a neurological disorder than those with mild/moderate periodontitis. Having a hematological disorder, having a muscle, skeletal and connective tissue disorder, to be a current smoker and lower age were found to be predictors of moderate periodontitis whereas being a female and lower number of comorbidities were predictors of mild periodontitis.Conclusions: The severity of periodontitis was associated with socio-demographic, behavioral, and comorbidity characteristics of periodontal patients.

Titanium-Prepared Platelet-Rich Fibrin Versus Connective Tissue Graft on Peri-Implant Soft Tissue Thickening and Keratinized Mucosa Width: A Randomized, Controlled Trial.

PURPOSE: The health of peri-implant tissues is associated with the peri-implant soft tissue thickness (STT) and keratinized tissue width (KTW). Resorptive changes in the crestal bone around implant sites will be affected by the STT. The present randomized prospective study compared the effectiveness of titanium-prepared platelet-rich fibrin (T-PRF) with that of connective tissue graft (CTG) on peri-implant STT, KMW, and crestal bone level. PATIENTS AND METHODS: Through simultaneous augmentation of the soft tissue using T-PRF or CTG, 30 implants were placed in 30 patients. The implants were placed in thin, soft tissue areas and thickened simultaneously with a T-PRF membrane in the test group and a CTG in the control group. During surgery (T0) and at 3 months postoperatively (T1), the KTW and peri-implant STT were measured at 3 points: occlusal part of the alveolar crest (OAC), midbuccal mucosa level (MBML), and 1 mm above the mucogingival junction (MGJ1). The crestal bone changes were evaluated from a periapical radiograph at 3 months postoperatively. RESULTS: The baseline STT and KTW measurements showed no significant differences between the 2 groups (P < .05). Comparison of the T0 and T1 measurements from the 2 groups showed a significant increase in KTW and STT (P < .001). Compared with the test group, the control group showed a highly significant increase in the peri-implant STT at the MBML, MGJ1, and KTW levels (P < .05). No significant difference was found between the 2 groups in terms of the OAC changes (P > .05). No crestal bone loss was observed in any of the dental implants. CONCLUSIONS: Both groups experienced a greater increase in peri-implant STT at the OAC level, and T-PRF can be considered as an autogenous alternative to CTG. Also, peri-implant STT might prevent crestal bone resorption in the osseointegration period.

Comparison of clinical efficacy and patient acceptance of interdental brush and silicone coated interdental pick: a randomized split-mouth, prospective clinical trial.

OBJECTIVES: The aim of this split-mouth, prospective controlled study was to compare the effects of two different interdental devices on clinical plaque elimination, gingival bleeding and patient acceptance and comfort. MATERIALS AND METHODS: Thirty participants who had been diagnosed with gingivitis were included in the study. After professional oral prophylaxis and a 3-day washout period, patients were advised to use two test devices (TePe Interdental Brushes Original and TePe EasyPick™, Malmö, Sweden) according to instructions. The plaque index (Turesky modification of the Quigley and Hein Index) and bleeding index (Papillary Bleeding Index) were recorded at baseline and after 2 weeks. Patient satisfaction and comfort were assessed with a questionnaire. RESULTS: Both of the tested devices improved the plaque and bleeding index scores. There were no differences between the two sides in terms of time-dependent changes. The patients felt more satisfied with the cleansing capacity and more comfortable with the use of SCIP compared with IDB (p = 0.001). Pain sensation with the use of SCIP was significantly lower than with IDB (p = 0.002). CONCLUSION: The clinical efficiency of the tested interdental devices was similar in terms of removing plaque and decreasing bleeding. However, SCIP were found to be more comfortable and preferable to IDB. CLINICAL RELEVANCE: The silicone coated interdental picks showed similar effects on plaque removal as interdental brushes and superiority in terms of ease to use than interdental brushes.

Evaluation of the effects of different forms of periodontal diseases on quality of life with OHIP-14 and SF-36 questionnaires: A cross-sectional study.

OBJECTIVES: To investigate the effect of generalized aggressive periodontitis (GAP), generalized chronic periodontitis (GCP) and gingivitis (G) on oral health-related quality of life (OHRQoL) with Oral Health Impact Profile-14 (OHIP-14) and Short Form-36 (SF-36) questionnaires. METHODS: One hundred GAP patients, 114 GCP and 109 G patients were included in the study. Age, gender, number of missing teeth, probing depth (PD), bleeding on probing (BOP), plaque index (PI) and clinical attachment level (CAL) of patients were recorded. The Turkish versions of OHIP-14 and SF-36 questionnaires were filled before any medication and dental treatment were approved. The one-way ANOVA test was used to compare three groups. RESULTS: Generalized aggressive periodontitis and GCP groups were similar to each other (P > 0.05) in most subscales except functional limitation and social disability of the OHIP-14 questionnaire (P = 0.034 and P = 0.018, respectively); conversely, there was no statistically difference between GAP and G groups in functional limitation and social disability subscales (P = 0.856 and P = 0.242, respectively). GAP group gave higher scores than GCP group in all subscales of SF-36 (P < 0.05). There was a negative correlation between OHIP-14 and SF-36 subscale scores in all groups. CONCLUSION: Study findings indicate that different forms of periodontal disease have different effects on quality of life of patients when measured by OHIP-14 and SF-36. Patients with GCP and GAP had poorer OHRQoL than G patients.

Evaluation of the Characteristics and Association Between Schneiderian Membrane Thickness and Nasal Septum Deviation.

OBJECTIVE: Nasal septum deviation (NSD) is an anomaly that disturbs normal mucus drainage in sinuses, leading to recurrent sinusitis. Sinusitis, infections, and mucosal irritations are the potential causes of Schneiderian membrane thickening (SMT). The aim of this study was to evaluate the characteristics and association between NSD and SMT along with factors such as age, gender, and tooth groups using cone-beam computed tomography (CBCT) imaging. METHODS: The maxillary sinus and nasal cavity of 249 patients (136 females and 113 males) were examined retrospectively using CBCT. The statistical analysis was performed to determine the association between SMT, NSD, gender, and age. RESULTS: No statistically significant relation was detected between NSD and SMT. The NSD was found in 50.6% of patients without gender predilection. Age was not associated with the presence of NSD. The mean thickness of the membrane was least in the third molar region and highest in the first molar region. The average SMT was found to be higher in males for all the examined tooth areas (P ≤ 0.05). CONCLUSION: A retrospective evaluation of CBCT images emphasized the concept that NSD was not a factor that affected the thickening of maxillary sinus mucosa. The CBCT imaging could be used for evaluating the maxillary sinuses and nasal septum.

The role of titanium-prepared platelet-rich fibrin in palatal mucosal wound healing and histoconduction.

OBJECTIVE: We aimed to determine the clinical effects of titanium-prepared, platelet-rich fibrin (T-PRF) on human palatal mucosal wound healing (PMWH) and to identify its effect on time-dependent changes in palatal soft-tissue thickness (PSTT) in terms of histoconduction, which is a new concept. MATERIALS AND METHODS: Free gingival graft (FGG) donor sites were treated with T-PRF and compared with an untreated control group. The results of colour match and H2O2-bubbling tests for complete wound epithelization (CWE) were recorded on days 3, 7, 14 and 21. Pain level, number of analgesics used and bleeding status were recorded for the first 7 days. PSTT was measured at baseline and after 1 and 6 months. RESULTS: Colour match scores of the test group were significantly higher than those of the control group at 7 and 14 days. CWE was observed at a higher frequency in the test group than in the control group on day 14. Post-operative bleeding prevalence was lower in the test group than in the control group for the first 2 days. A time-dependent decrease in PSTT was observed at 1 and 6 months in the control group compared with baseline (baseline, 4.23 ± 0.62 mm; 1 month, 4.01 ± 0.68 mm; and 6 months, 3.93 ± 0.69 mm). However, no significant difference was found in the test group (baseline, 4.29 ± 0.64 mm; 1 month, 4.61 ± 0.51 mm; and 6 months, 4.51 ± 0.58 mm). CONCLUSION: The T-PRF membrane exhibited positive effects on PMWH. T-PRF, which is a promising autogenous matrix for histoconduction, may also be preferred as an autogenous alternative to connective tissue grafts in the treatment of gingival recessions and peri-implant mucosal recessions.

The relationship of the position of mandibular third molar impaction with the development of dental and periodontal lesions in adjacent second molars.

OBJECTIVE: The aim of this study was to evaluate the effect of different positions of Mandibular third molar impaction teeth on dental and periodontal lesions of mandibular second molars and correlate the lesion severity with patient age. MATERIALS AND METHODS: This retrospective study assessed 212 CBCT images of patients who visited the department of Oral and Maxillofacial radiology of XX university between 2017 and 2021. Periodontal and dental lesion effects of impacted third molars on mandibular second molars were evaluated. While dental lesions were classified as mild, moderate, and severe, periodontal lesions were classified as mild in cases not exceeding 2/3 of the root, and severe in cases exceeding 2/3 of the root. Pearson's chi-square tests, Mann-Whitney U or Kruskal-Wallis test were used for data analsis. A multivariate logistic regression model was constructed for further analysis. RESULTS: Periodontal lesions were frequently observed in the second molar adjacent to the third molar (157 teeth, 74.1%), dental lesions were observed in 10%. Among the third molar positions, the mesioangular position was associated with a high (88%) prevalence of periodontal lesions (p<0.001), followed by the horizontal position (71%). The periodontal lesion was more severe in cases 30-39 years old and over 40 years old than in cases under 20 years old and 21-24 years old. Distoangular, horizontal and vertical/inverse positions are less likely to increase the severity of the periodontal lesion than the mesioangular position. (OR = 0.02; p <0.001, OR = 0.28; p =0.008, OR = 0.14; p <0.001,respectively). CONCLUSIONS: The third molars are often impacted in the mesioangular position, and this position most increases the risk of periodontal infection in the second molars. Accurate diagnosis and evaluation can minimize complications, and CBCT is a reliable imaging technique in which the position of the third molars and their relationship with the 2nd molars can be evaluated.

Research trends and mapping knowledge for maxillary sinus augmentation in oral and maxillofacial surgery.

BACKGROUND: The method most frequently employed to alleviate the deficiency of vertical bone volume in the maxillary posterior region is maxillary sinus augmentation. Given its importance in the field of dental implants and its possible impact on implant survival, it is crucial to assess the caliber and bibliometric characteristics of research related to maxillary sinus augmentation. This study aimed to understand the development and trends of studies and guide future studies by performing a bibliometric analysis of research related to maxillary sinus augmentation. METHODS: The Web of Science database was searched on 29.05.2024 with the developed search strategy. Articles were listed in descending order according to the number of citations and analyzed using the Bibliometrix program prepared in R base. The articles were analyzed in four sections: performance analysis, word analysis, collaboration analysis, and thematic analysis. RESULTS: Wang HL is the most frequently listed author on this topic with 24 h-indexes and 1686 total citations. The highest number of articles were published in 2017, with 102 articles with an average of 2.7 citations. The most popular keyword was "dental implants." with 426 usages. Italy and the USA are the countries that have published the most collaborative papers. Clinical Oral Implants Research comes at the top when evaluating the journals that publish on maxillary sinus augmentation based on the h-index. Basic research and technical-oriented studies between 1999 and 2005 have given way to more clinical and patient-oriented research. CONCLUSION: This bibliometric study will serve as a guide for future research by illustrating the existing state of knowledge and limitations regarding the development of sinus lifting methods, given the constantly growing demand for implant therapy.

What do TikTok videos offer us about dental implants treatment?

OBJECTIVE: To evaluate the quality, source, popularity, visibility and reliability of Tiktok videos on dental implants. MATERIALS AND METHODS: A Tiktok search for dental implants was performed English language setting. Search hashtags were determined as "#dentalimplants," "#dentalimplantsurgery," "#dentalimplantstreatment," and "#implantdentistry." 148 of the 300 videos watched were included the study. Two periodontologists scored the videos for quality, reliability, utility, visibility and popularity. Videos' quality was evaluated using the Global Quality Scale (GQS) and the DISCERN tools, by categorizing them through quality of communication, duration, likes and dislikes, views, source and video type of each video were recorded. RESULTS: There was significant positive correlation between "GQS" and "Total DISCERN" (Rho: 0.636) and "Duration in seconds" (Rho: 0.343) (p<0.05). For Total DISCERN, averages of the 31-45 seconds (p=0.010) and 46 seconds and above (p=.018) groups were higher than the averages of the 0-15 seconds group and average of the Educational group was higher than the average of the Testimonial, Product Advertisement and Entertainment groups (p=0.001, p=0.033 and p=0.041). Healthcare professionals mostly upload GQS 2 score videos and Hospital/Universities mostly upload GQS 2 and 3 score videos (p<0.05). Testimonial videos mostly receive GQS2 score videos and the 'Videos rich in supplementary visuals' quality also receives the most GQS4 score videos (p<0.05). CONCLUSIONS: The results of this study demonstrate that TikTok videos provide low to moderate quality information about dental implants and that TikTok may not provide reliable information about dental implants.

Assessment of Epstein-Barr virus, Candida albicans, and some periodontal pathogens in rheumatoid arthritis patients with periodontitis.

OBJECTIVE: To comparatively investigate the periodontal results and microbial load in subgingival biofilm samples (SBS) in rheumatoid arthritis subjects and healthy volunteers. METHODS: One hundred twenty subjects were classified into different cohorts: healthy (H-C); periodontitis with good systemic health (H-P); rheumatoid arthritis (RA) and good periodontal health (RA-C); and periodontitis with RA (RA-P). The periodontal parameters were recorded, and SBS were collected to determine periodontal pathogens including Epstein-Barr Virus (EBV) and Candida albicans using reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: Subjects that had greater disease course, determined by moderate or high disease activity scores 28 (DAS28), suffered from worse oral health conditions (higher plaque index, gingival index, bleeding on probing, probing depth, and excessive clinical attachment loss) than those with low DAS28 scores. A higher prevalence of Treponema denticola (T. denticola) was observed in the RA-P group. Cyclic citrullinated peptide was associated with the occurrence of T. denticola and Campylobacter rectus. DAS28 using C-reactive protein (DAS28-CRP) had a significant association with Capnocytophaga gingivalis and EBV. The duration of the RA disease was associated with the presence of T. denticola. CONCLUSION: Subgingival microbial difference could reliably discriminate RA from healthy individuals. Especially, T. denticola and EBV may play a key role in periodontitis associated with RA.

The effects of vitamin D deficiency on mandibular bone structure: a retrospective radiological study.

OBJECTIVE: The aim of the study was to evaluate the effects of vitamin D deficiency on the mandibular bone structure by fractal analysis and panoramic morphometric indices. METHODS: Ninety participants were divided into three groups as 30 individuals with severe vitamin D deficiency, 30 individuals with vitamin D deficiency, and 30 individuals with vitamin D sufficiency. Fractal dimension analysis (FD), panoramic mandibular index (PMI), mandibular cortical index (MCI), and mandibular cortical thickness measurement (CTM) were evaluated on panoramic radiographs. RESULTS: FD values of the patients with vitamin D deficiency were found to be statistically lower than the patients with vitamin D sufficiency (p < 0.05). FD value of supracortical area above the angulus mandible (FD2) in patients with severe vitamin D deficiency was significantly lower than FD values (p = 0.002). There was no statistically significant difference between the groups in the CTM (p > 0.05). PMI was significantly lower in patients with severe vitamin D deficiency (p < 0.001). There was a significant difference in MCI values between the groups (p < 0.05). CONCLUSION: Vitamin D deficiency causes a decrease in bone mineral density in the mandible, and an increase in alveolar porosity. FD analysis and radiomorphometric indices in panoramic radiographs can be used to assess osteoporotic changes in patients with vitamin D deficiency.

Effect of bromelain on periodontal destruction and alveolar bone in rats with experimental periodontitis.

PURPOSE: Several substances that have anti-inflammatory, antiproteinase, and anti-infective properties have been evaluated as modulators of the inflammatory response in periodontal disease. However, evidence for the anti-inflammatory and antioxidative activities of bromelain is limited. This study evaluated the impact of systemically administered bromelain on the progression of experimental periodontitis. METHODS: Four equal groups of 32 Wistar albino rats were created as follows (n = 8): control, periodontitis + saline, periodontitis + 5 mg/kg/day bromelain, and periodontitis + 10 mg/kg/day bromelain. To quantify the resorption of bone and bone volume/tissue volume, bone surface / bone volume, and connectivity, lower jawbones were fixed and then scanned using microcomputed tomography (micro CT). Blood samples were taken to measure the macrophage colony-stimulating factor(M-CSF) concentrations, receptor activator of nuclear factor kappa-Β ligand (RANKL), osteoprotegerin (OPG), tumor necrosis factor-alpha (TNF-α), matrix metalloproteinase-8 (MMP-8), interleukin-6(IL-6), glutathione peroxidase (GPx), superoxide dismutase (SOD), and malondialdehyde (MDA). Histopathological assessments were made to examine the tissue. RESULTS: Treatment with bromelain improved the healing of the periodontium by decreasing the number of leukocytes and ligament deterioration in the gingival connective tissue and by supporting reintegration with alveolar bone. Bromelain used in ligature-induced periodontitis reduced alveolar bone (AB) resorption as measured by microCT; reduced inflammatory parameters such as IL-6 and TNF-α; regulated oxidative-antioxidative processes by increasing GPx and SOD and reducing MDA levels; and regulated AB modeling by decreasing M-CSF, RANKL, and MMP-8 and increasing OPG levels. CONCLUSION: Bromelain may be an option in periodontal therapy by regulating cytokine levels, improving the healing process, and reducing bone resorption and oxidative stress.

Effects of hyperlipidemia on trabecular and cortical structures of the mandible.

OBJECTIVES: To evaluate the mandibular bone structure of patients with hyperlipidemia by fractal dimension (FD) analysis and panoramic radiomorphometric indices including mandibular cortical thickness measurement, panoramic mandibular index (PMI), mandibular cortical index (MCI) and to compare with the healthy group. METHODS: In total, 60 panoramic radiographs were included, including panoramic radiographs of 30 individuals with hyperlipidemia and 30 individuals with systemically healthy. FD analysis in the mandibular condyle, angle of the mandible, the distal side of the second premolar and anterior to mental foramen, PMI, MCI, and mandibular cortical thickness measurements were evaluated on radiographs. Independent samples t-test was used for differences between healthy and hyperlipidemia groups with regard to age and PMI. Repeated measurement of variance with one within and one between factors in the comparison of four regions and two groups in terms of FD and cortical thickness measurements. Following this analysis, significant differences were detected by post-hoc Sidak test. Fisher-Freeman-Halton analysis was applied to determine the relationship between categorical variables. RESULTS: FD values of the hyperlipidemic patients were found to be lower than the healthy group. Between the hyperlipidemic and healthy groups, there was a difference in the angle of the mandible FD values (p = 0.020). There were no differences in the cortical thickness measurements and PMI between the groups (p > 0.05). There was a difference in MCI values between the groups (p < 0.05). CONCLUSION: The trabecular structure of the angle of the mandible and the cortical bone structure of the mandible were found to be negatively affected by hyperlipidemia.

In vivo evaluation of mandibular trabecular and cortical bone quality in psoriasis vulgaris.

OBJECTIVE: The aim of this study was to evaluate the effects of psoriasis vulgaris on mandibular structure by calculating fractal dimension (FD) and radiomorphometric indices. STUDY DESIGN: Panoramic radiographs of 58 patients with psoriasis and 58 healthy participants were assessed. FD was used to analyze trabecular bone architecture in the condyle, angle, and 2 sites in the alveolar bone. Five radiomorphometric indices based on cortical thickness and the mandibular cortical index (MCI) for structure were used to assess cortical bone porosity. Comparisons were made between sites in trabecular and cortical bone. Quantitative and categorical data were statistically analyzed with the significance level at P < .05. RESULTS: FD was significantly lower in the patients with psoriasis than in the controls in the alveolar bone sites (P ≤ .035). Differences between measurement sites were insignificant in psoriasis (P ≥ .617), but the FD values of some measurement sides in the control group differed significantly (P ≤ .004). All quantitative radiomorphometric indices were significantly lower in patients with psoriasis (P ≤ .034) with significant differences between some sites in both groups. No significant difference was found in MCI frequency distribution between the groups (P = .782). CONCLUSIONS: Trabecular architecture and cortical thickness were negatively affected in patients with psoriasis, but no differences in cortical porosity were detected between groups.

Applying nano-HA in addition to scaling and root planing increases clinical attachment gain.

PURPOSE: This study evaluated the efficacy of treating periodontitis using subgingival nano-hydroxyapatite powder with an air abrasion device (NHAPA) combined with scaling and root planing (SRP). METHODS: A total of 28 patients with stage III periodontitis (grade B) were included in this study, although 1 was lost during follow-up and 3 used antibiotics. The patients were divided into a test group and a control group. All patients first received whole-mouth SRP using hand instruments, and a split-mouth approach was used for the second treatment. In the test group, the teeth were treated with NHAPA for 15 seconds at 70% power per pocket. Subgingival plaque samples were obtained from the 2 deepest pockets at the test and control sites before treatment (baseline) and 3 months after treatment. The full-mouth plaque index (PI), gingival index (GI), papillary bleeding index (PBI), bleeding on probing (BOP), probing depth (PD) and clinical attachment level (CAL) were recorded at baseline and at 1- and 3-month post-treatment. Real-time polymerase chain reaction was used to determine the colonisation of Treponema denticola (Td), Porphyromonas gingivalis (Pg), and Aggregatibacter actinomycetemcomitans in the subgingival plaque. RESULTS: From baseline to the first month, the test group showed significantly larger changes in BOP and CAL (43.705%±27.495% and 1.160±0.747 mm, respectively) than the control group (36.311%±27.599% and 0.947±0.635 mm, respectively). Periodontal parameters had improved in both groups at 3 months. The reductions of PI, GI, BOP, PD, and CAL in the test group at 3 months were greater and statistically significant. The total bacterial count and Td and Pg species had decreased significantly by the third month in both groups (P<0.05). CONCLUSIONS: Applying NHAPA in addition to SRP improves clinical periodontal parameters more than SRP alone. Subgingival NHAPA may encourage clot adhesion to tooth surfaces by increasing surface wettability.