Quantitative investigation of the bacterial content of periodontal abscess samples by real-time PCR.

OBJECTIVES: Periodontal abscesses, which are part of the acute periodontal disease group characterized by the destruction of periodontal tissue with deep periodontal pockets, bleeding on probing, suppuration, and localized pus accumulation, cause rapid destruction of tooth-supporting tissues. This study aimed to evaluate the microbial content of periodontal abscesses by specific and culture-independent qPCR. METHODS: This study was conducted on 30 volunteers diagnosed with periodontal abscesses and presenting with complaints of localized pain, swelling, and tenderness in the gingiva. Genomic DNA was isolated from the samples taken. Escherichia coli bacteria were used for the standard curve created to calculate the prevalence of target bacteria in the total bacterial load. 16S rRNA Universal primers were used to assess the total bacterial load and prevalence. Bacterial counts were analyzed with Spearman's rank correlation coefficients (ρ) matrix. RESULTS: From the analysis of Real-Time PCR, Porphyromonas gingivalis (30, 100%), Prevotella intermedia (30, 100%), and Fusobacterium nucleatum (30, 100%) were detected in all samples. Campylobacter rectus (29, 96.6%), Porphyromonas endodontalis (29, 96.6%), Tannerella forsythia (28, 93.3%), Filifactor alocis (28, 93.3%), and Actinomyces naeslundii (28, 93.3%) were also frequently detected. CONCLUSIONS: Periodontal abscesses were found to be polymicrobial, and not only periodontal pathogens appeared to be associated with the development of periodontal abscesses. The presence, prevalence, and number of Porphyromonas endodontalis and Propionibacterium acnes in the contents of periodontal abscesses were determined for the first time in our study. Further studies are needed to better understand the roles of bacteria in periodontal disease, including abscesses.

Patients with dental calculus have increased saliva and gingival crevicular fluid fetuin-A levels but no association with fetuin-A polymorphisms.

Fetuin-A is a potent inhibitor of calcium-phosphate precipitation and of the calcification process, therefore it can also be related with dental calculus. Thus, we aimed to investigate a possible relationship between fetuin-A gene polymorphism and the presence of dental calculus. A possible relationship between serum, saliva and gingival crevicular fluid (GCF) levels of fetuin-A was also investigated. Fetuin-A c.742C > T and c.766C > G polymorphisms were investigated in 103 patients with or without dental calculus. Additionally, serum, saliva and GCF fetuin-A levels of patients were compared according to dental calculus presence. A significant difference was not observed in the distribution of the fetuin-A c.742C > T and c.766C > G polymorphisms between patients with or without dental calculus. Saliva and GCF fetuin-A concentrations of patients with dental calculus were statistically higher than those without dental calculus (P=0.001, P=0.036 respectively). According to our results, fetuin-A c.742C > T and c.766C > G polymorphisms were not associated with presence of dental calculus. However, higher GCF and saliva fetuin-A levels were detected in patients with dental calculus than in patients without dental calculus, which may result from an adaptive mechanism to inhibit mineral precipitation and eventually calculus formation.

Matrix-Gla Protein rs4236 [A/G] gene polymorphism and serum and GCF levels of MGP in patients with subgingival dental calculus.

AIM: Matrix-Gla Protein (MGP) is one of the major Gla-containing protein associated with calcification process. It also has a high affinity for Ca2+ and hydroxyapatite. In this study we aimed to evaluate the MGP rs4236 [A/G] gene polymorphism in association with subgingival dental calculus. Also a possible relationship between MGP gene polymorphism and serum and GCF levels of MGP were examined. MATERIAL AND METHODS: MGP rs4236 [A/G] gene polymorphism was investigated in 110 patients with or without subgingival dental calculus, using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) techniques. Additionally, serum and GCF levels of MGP of the patients were compared according to subgingival dental calculus. RESULTS: Comparison of patients with and without subgingival dental calculus showed no statistically significant difference in MGP rs4236 [A/G] gene polymorphism (p=0.368). MGP concentrations in GCF of patients with subgingival dental calculus were statistically higher than those without subgingival dental calculus (p=0.032). However, a significant association was not observed between the genotypes of AA, AG and GG of the MGP rs4236 gene and the serum and GCF concentrations of MGP in subjects. CONCLUSION: In this study, it was found that MGP rs4236 [A/G] gene polymorphism was not to be associated with subgingival dental calculus. Also, that GCF MGP levels were detected higher in patients with subgingival dental calculus than those without subgingival dental calculus independently of polymorphism, may be the effect of adaptive mechanism to inhibit calculus formation.

Clinical and biochemical comparison of guided tissue regeneration versus guided tissue regeneration plus low-level laser therapy in the treatment of class II furcation defects: A clinical study.

OBJECTIVE: The present study was aimed to compare the clinical and biochemical effectiveness of guided tissue regeneration (GTR) alone and combined with low-level laser therapy (LLLT) application in the treatment of furcation II periodontal defects, over a period of 6 months. MATERIAL AND METHODS: Thirty-three furcation defects were included in the study. Seventeen of these defects were treated with GTR plus LLLT, and sixteen of them were treated with GTR alone. Probing pocket depth (PPD), clinical attachment level (CAL), horizontal probing depth (HPD), and alkaline phosphatase (ALP) and osteocalcin (OC) levels in the gingival crevicular fluid (GCF) were recorded at baseline and at postoperative 3rd and 6th months. RESULTS: Healing was uneventful in all cases. At the 3rd and 6th months, both treatment modalities-GTR and GTR plus LLLT--showed improved PPD, CAL, and HPD values compared to their baseline values. ALP and OC levels in GCF increased after the treatment in both groups (p < 0.05). When compared the two groups, at the 6th month, PPD, CAL, HPD, and ALP values showed significantly more improvement in laser group than non-laser group (p < 0.05). CONCLUSIONS: The results of this study showed that both treatments led to significantly favorable clinical improvements in furcation periodontal defects. LLLT plus GTR may be a more effective treatment modality compared to GTR alone.

Patients with dental calculus have increased saliva and gingival crevicular fluid fetuin-A levels but no association with fetuin-A polymorphisms

ABSTRACT: Fetuin-A is a potent inhibitor of calcium-phosphate precipitation and of the calcification process, therefore it can also be related with dental calculus. Thus, we aimed to investigate a possible relationship between fetuin-A gene polymorphism and the presence of dental calculus. A possible relationship between serum, saliva and gingival crevicular fluid (GCF) levels of fetuin-A was also investigated. Fetuin-A c.742C > T and c.766C > G polymorphisms were investigated in 103 patients with or without dental calculus. Additionally, serum, saliva and GCF fetuin-A levels of patients were compared according to dental calculus presence. A significant difference was not observed in the distribution of the fetuin-A c.742C > T and c.766C > G polymorphisms between patients with or without dental calculus. Saliva and GCF fetuin-A concentrations of patients with dental calculus were statistically higher than those without dental calculus (P=0.001, P=0.036 respectively). According to our results, fetuin-A c.742C > T and c.766C > G polymorphisms were not associated with presence of dental calculus. However, higher GCF and saliva fetuin-A levels were detected in patients with dental calculus than in patients without dental calculus, which may result from an adaptive mechanism to inhibit mineral precipitation and eventually calculus formation.

Effect of low-level laser on guided tissue regeneration performed with equine bone and membrane in the treatment of intrabony defects: a clinical study.

OBJECTIVE: The purpose of the present study was to evaluate the clinical results of guided tissue regeneration (GTR) after the application of equine bone and membrane alone or combined with low-level laser therapy (LLLT) for the treatment of periodontal defects. MATERIALS AND METHODS: This study was an intra-individual longitudinal study of 6 months' duration conducted using a split-mouth and randomized design. In 13 periodontitis patients with bilateral intrabony periodontal defects, while one defect site was treated with GTR plus LLLT (1064 nm, 100 mW, with energy density of 4 J/cm(2)), the contralateral defect site was treated with guided GTR alone. GTR was performed with a combination of equine bone and membrane. LLLT was used both intra- and postoperatively. Clinical probing depth (PPD), clinical attachment level (CAL), clinical gingival recession level (REC), plaque index (PI) score, and sulcus blooding index (SBI) score were recorded at the time of surgery, and at the 3rd and 6th months after operation. RESULTS: The treatment of periodontal intrabony defects with equine bone and membrane in the operation of GTR alone or GTR plus LLLT in combination led to statistically significant PPD reduction, CAL gain, and lower SBI score at the end of the study (p<0.05). In addition, between the two groups, GTR plus LLLT resulted in statistically significant lower REC (p=0.025), lower SBI (p=0.008) score, more reduction of PPD (p=0.009) and CAL gain (p=0.002) compared with GTR alone at 6th month control. CONCLUSIONS: This study showed that GTR is an effective treatment for periodontal regeneration, and that LLLT may improve the effects of GTR in the treatment of periodontal defects.

Evaluation of low-level laser therapy in rabbit oral mucosa after soft tissue graft application: A pilot study.

The aim of the present study was to assess the histopathological effects of low-level laser therapy (LLLT) on healing of the oral mucosa after soft tissue graft operations. The alterations at the end of healing in normal and LLLT-applied oral mucosa were studied in two healthy adult New Zealand white rabbits by taking specimens for light microscopic inspection. There was no adverse event reported in the study and no post-operative complications, such as swelling, bleeding, or edema, were observed in the rabbits. Complete wound healing was faster in the LLLT-applied rabbit. Compared to the normal rabbit oral mucosa, thickening of the stratum corneum (hyperkeratosis) was found in the epithelia of the rabbits. A significant increase in the epithelial thickness was found in the samples of rabbits, suggesting increased scar tissue following the wound repair. Additionally, many mitotic figures were present in the epithelia of the LLLT-applied rabbit, indicating epithelial cell hyperplasia. Long and irregular connective tissue protrusions projecting into the undersurface of the epithelium and mononuclear cell infiltrations were noted in the rabbits. The results suggest that LLLT used for soft tissue operations provides better and faster wound healing and that LLLT enhances epithelization.

Evaluation of neodymium-doped yttrium aluminium garnet laser, scalpel incision wounds, and low-level laser therapy for wound healing in rabbit oral mucosa: a pilot study.

OBJECTIVE: The aim of the present randomized controlled clinical trial was to assess the clinical and histopathological effects of laser and low-level laser therapy (LLLT) on healing of the oral mucosa after vestibuloplasty surgery. METHODS: The alterations at the end of healing in scalpel- and laser-incised and LLLT-applied oral mucosa were studied in eight healthy adult New Zealand white rabbits by taking specimens for light microscopic inspection. For the evaluation of wound healing, the surgical areas were stained using a solution (Mira-2-tones), and the stained surfaces were measured horizontally immediately after the surgery and on postoperative days 4, 7, and 10. RESULTS: Although the stained surface areas of the groups were similar immediately after the surgical procedures, the LLLT-applied sites had significantly fewer stained surface areas than the other groups on postoperative days 4, 7, and 10. Areas of hyperkeratosis and parakeratinization were observed in the epithelia of the laser surgery groups. A significant increase in epithelial thickness was found, suggesting increased scar tissue after wound repair; long and irregular connective tissue protrusions projecting into the undersurface of the epithelium were noted in these groups. CONCLUSION: LLLT used for soft tissue operations provides better and faster wound healing, and LLLT enhances epithelization.

Effects of different blood groups on the reproduction of periodontal pocket bacteria.

BACKGROUND: Many studies have been conducted proving the relation between different blood groups and certain diseases. It was claimed in these studies that H pylori showed different distribution according to different blood groups. In dentistry, the relation between blood groups and dental diseases was investigated in a limited number of studies and it was concluded that there might be a relation between them. The aim of the present study was to determine whether the bacteria isolated from the periodontal pockets of individuals with periodontal diseases indicated differences in CFU amounts to form colonies in different ABO blood groups. METHODS: Bacterial samples obtained from the individuals with periodontal diseases from the worst affect sites were inoculated into culture media formed by blood taken from 32 individuals who were systemically and periodontally healthy and who had different blood groups. The colony numbers of these bacteria were observed. RESULTS: Although periodontal pocket bacteria formed colonies in different numbers in different ABO blood groups (p < 0.05), no statistically significant difference was determined in the reproduction of these bacteria in different Rh blood groups and different sexes (p > 0.05). CONCLUSION: Different ABO blood groups may show differences in significant rates in the colonisation numbers of the bacteria that are the main cause of periodontal diseases.

The changes in the T-lymphocyte subsets in a population of Turkish children with puberty gingivitis.

OBJECTIVE: The aim of the study was to investigate the number of CD4 and CD8 T lymphocytes, analyse subjects with gingivitis and those without, and determine the role of T lymphocytes in the pathobiology of puberty gingivitis. MATERIAL AND METHODS: Fifty individuals with and without puberty gingivitis were recruited for this study. The CD4(+) and CD8(+) T-lymphocyte counts were determined using flow cytometry on the biopsy samples, and the CD4(+)/CD8(+) ratio was calculated. At the same time, periodontal index scores were recorded to assess the periodontal status. Acquired data were analysed statistically using a paired t-test to compare laboratory values obtained before and after the treatment in individuals with puberty gingivitis and disease-free individuals. In addition, Pearson's correlation analysis was performed to investigate the relation between laboratory values and clinical measurements. RESULTS: The CD4(+)/CD8 ratio in gingival tissues obtained from test group was significantly higher (P < 0.05) than that found in the gingival tissue obtained from control group. We found that the CD4(+) and CD8(+) lymphocyte counts continued to increase significantly (P < 0.001) and the CD4(+)/CD8(+) ratio continued to drop significantly (P < 0.05) after treatment in test group. CONCLUSIONS: T lymphocytes could play a significant role in the pathobiology of puberty gingivitis.

The effects of age and gender on CD3+ and CD19+ lymphocyte in gingival tissue and peripheral blood: an animal study

Aim: The aim of the present study was to determine age- and gender-related values for healthy mice of CD3+ T and CD19+ B lymphocytes and CD3+/ CD19+ (T/B) ratios in peripheral blood and gingival tissue by the flow cytometry technique. Methods: The study was carried out on periodontally healthy 60 BALB/c mice. They were divided into five groups according to the their age (newborn, weaning, puberty, adult and elder). Males and females were equally represented in each group. CD3+ and CD19+ T lymphocytes and CD3+/CD19+ ratio values in gingival tissue and peripheral blood were determined using flow cytometry in the biopsy samples. Results: There were no significant differences in the CD3+ and CD19+ lymphocytes, and CD3+/ CD19+ ratios in gingival tissue for all age groups (p>0.05). Mean relative number of peripheral blood CD3+ T lymphocyte indicated a decrease in puberty group compared to the other groups (p<0.05), while relative number of peripheral blood CD19+ B lymphocyte increased in adult and aged group. The peripheral blood CD3+/ CD19+ T/B lymphocytes ratios decreased in adult and aged group. Conclusions: The results of the present study showed that differences were present in periods of life and gender in peripheral blood of mice. Moreover,significantly differences were found between genders in gingival tissue.

Effect of Nd: YAG laser irradiation on the treatment of oral malodour associated with chronic periodontitis.

AIM: To investigate, using a randomised-controlled, single clinical trial whether treating periodontitis with non-surgical periodontal treatment procedures and laser applications can decrease the effect of oral malodour and compare the effectiveness of the different therapies. METHODS: Sixty patients suffering from chronic periodontitis and complaining of oral malodour were included in the study. The parameters measured included organoleptic scoring, volatile sulphur compound (VSC) levels, gingival index, plaque index, probing depth and clinical attachment levels before and after the different treatment procedures (oral hygiene instructions, scaling-root planing-SRP and subgingival Nd: YAG laser irradiation). RESULTS: There were significant relationships between oral malodour and the specific periodontal parameters. For all patients, there were statistically significant (p < 0.05) decreases in the clinical index scores and VSC values after all treatments. Although the VSC values decreased in all groups after treatment, laser treatment alone did not cause as large decreases as that achieved by SRP and SRP + laser irradiation. CONCLUSION: The results confirmed that in the population studied, oral malodour levels were significantly reduced after treating chronic periodontitis. The data indicated a possible adjunctive role for Nd: YAG lasers in periodontal therapy and treatment of oral malodour.

The effects of age and gender on gingival tissue and peripheral blood T-lymphocyte subsets: a study in mice.

The aim of this study is to investigate the effects of age and gender on relative number of CD4+ and CD8+ T lymphocyte and CD4+/CD8+ ratios in gingival tissue and peripheral blood of periodontally healthy BALB/c mice with flow cytometric analysis. The study was carried out on periodontally healthy 60 BALB/c mice. They were separated into five groups according to the life expectancy: Group I (newborn, 1-10 days old), Group II (age at weaning, 21-28 days old), Group III (age of sexual maturity, puberty, 7-8 weeks old), Group IV (adult, 8 months old), and Group V (the aged, 14 and over). Males and females were equally represented in each group. CD4+ and CD8+ T lymphocytes and CD4+/CD8+ ratio values in gingival tissue and peripheral blood were determined using flow cytometry in the biopsy samples. The relative number of CD8+ T lymphocyte in gingival tissue was higher in puberty (p < 0.05) and the aged (p < 0.05), with more significantly difference in males (p < 0.05). The CD4+/CD8+ ratios in gingival tissue were lower in puberty group and the-aged groups compared to the other groups (p < 0.05). The peripheral blood CD4+/CD8+ ratio increased in puberty and the aged groups. These differences were more significant in females than in males (p < 0.05). There were considerable negative correlations between CD4+/CD8+ T lymphocyte ratio in gingival tissue and CD4+/CD8+ T lymphocyte ratio in peripheral blood in puberty (r = 0.647, p < 0.01) and the aged ( r = 0.599, p < 0.05). In conclusion, our data suggest that CD4+/CD8+ T lymphocyte ratios in peripheral blood increase periodontally healthy mice in puberty and the old groups, while CD4+/CD8+ T lymphocyte ratios in gingival tissue decrease in the same groups. The relative number of CD8+ T lymphocytes increases in gingival tissue in puberty and the old groups when it decreases in peripheral blood. Results from this study indicated that periodontally healthy BALB/c mice may represent important information to determine the character of an immune response in the course of a lifetime.

Is there any relation of nanobacteria with periodontal diseases?

Periodontal diseases, including gingivitis and periodontitis, have been described as inflammation of the supporting tissues of the teeth. The main cause of periodontal disease is dental plaque. If dental plaque is not eliminated of dental surface, mineralized dental plaque (calculus) occur. The mineralization process of calculus is similar to that of other ectopic calcifications, such as kidney stones and gallstones. The presence of a certain type of microorganism discovered during the last decade in various pathogenic calcification such as renal stones, atherosclerotic plaques. This microorganism is nanobacterium that has unique characteristics in different regards. Nanobacteria appear as self-propagating calcifying macro-molecular complexes found in bovine and human blood and blood products. The fact that nanobacteria is present in various pathogenic calcification incidences in the body and that it is responsible for the formation of calcification may remind us the hypothesis that it may be present in dental calculus which has a similar mineralization formation process and that it may play an efficient role in the calcification of dental calculus. Thus, nanobacteria may be considered to be a risk factor for the periodontal diseases providing that it has effect on the formation of dental calculus. The nucleating role of the microorganisms in the formation of dental calculus show similarities to that of nanobacteria in calcification. What is more significant is that the presence of an alkali environment is essential for nanobacteria to cause calcification as is the case for dental calculus to occur. These significant conditions support the idea that nanobacteria may be present in the formation and in the contents of dental calculus. Unfortunately, there are only few studies on nanobacteria conducted in the field of dentistry. It is not known whether or not dental plaque is associated with nanobacteria. A study may reveal the fact whether nanobactera are really a new bacteria species or they were the bacteria previously found and given a different name, but not yet proved to be involved in calcification. Nanobacteria may be proved to be a helpful criterion in explaining the relation of nanobacteria with periodontal disease formation.

Aggressive periodontitis with streptococcal gingivitis: a case report.

Acute streptococcal gingivitis is an acute inflammation of the oral mucosa and also may be seen with the other oral diseases as aggressive periodontitis that is characterized by a considerable attachment loss over a relatively short period of time. Streptococcal infections of gingiva are seen rarely; also the origin of this gingival inflammation is occasionally different from that of routine plaque-associated gingivitis. The clinical features and treatment methods of these diseases are already reported in previous literatures. This case report describes a patient who presented with severe gingival inflammation and attachment loss that was diagnosed as an acute streptococcal infection associated with aggressive periodontitis. In this study a supportive treatment option was demonstrated based on these data and antacid treatment as adjunctive to the recommended treatment modalities was used for streptococcal gingivitis.

The Effect of ABO Blood Types on Periodontal Status.

OBJECTIVES: The purpose of the present study was to determine whether there was a relationship between periodontal diseases and ABO blood groups. METHODS: This epidemiological study was carried out on 1351 subjects who were randomly selected from individuals referred to the Faculty of Dentistry clinics for periodontal treatment or for other reasons regarding dental health. The study based on periodontal condition, blood group, and medical history. The subjects were divided into three groups as those with gingivitis, periodontitis, and the healthy ones. The effects of blood subgroups on periodontal health, gingivitis and periodontitis were investigated separately. RESULTS: A relatively higher percentage of A group patients was found in gingivitis group and relatively higher percentage of O group patients was found in periodontitis group. A significant relationship was also determined between Rh factor and gingivitis. CONCLUSIONS: ABO blood subgroups and Rh factor may constitute a risk factor on the development of periodontal disease. However, long-term studies are needed to make a more comprehensive assessment of the effects of ABO group on periodontal diseases.

The changes in T lymphocyte subsets following periodontal treatment in patients with chronic periodontitis.

OBJECTIVE: The aim of this study was to determine whether there was any change in T-lymphocyte subsets in patients with chronic periodontitis after applying different periodontal treatment methods. PATIENTS AND METHODS: Twenty-four patients with chronic periodontitis were included in the study. In every phase of the treatment (pretreatment, initial treatment, curettage and flap operations) the biopsy samples were taken from the gingival tissues at sites of chronic periodontitis. Then CD4(+) and CD8(+) lymphocyte and CD4(+)/CD8(+) ratio values were determined using flow cytometry in the biopsy samples. At the same time, gingival pocket depth, Löe-Silness gingival index, and Silness-Löe plaque index scores were recorded to assess the periodontal status in patients. To determine the correlation between the clinical measurements and the laboratory results obtained before the treatment, after initial treatment, after curettage and after flap operations, we conducted an analysis using a paired t-test. RESULTS: Flow cytometry findings in the patients with chronic periodontitis showed that CD4(+) and CD8(+) lymphocyte values before treatment were under the normal value and the CD4(+)/CD8(+) ratio was within the normal distribution interval. The CD4(+)/CD8(+) ratio decreased postcurettage and postflap operation. This decrease was statistically significant (p < 0.001). The CD4(+) and CD8(+) lymphocyte values were increased postcurettage and postflap operation. This increase was also statistically significant (p < 0.001). CONCLUSIONS: These findings suggest that local immune response was poor in the patients with chronic periodontitis. CD4(+) and CD8(+) T-lymphocytes could play a significant role in chronic periodontitis pathobiology.

Musculoskeletal disorders in left- and right-handed Turkish dental students.

The purpose of this study was two-fold: first, to find out the musculoskeletal disorders between left- and right-handed dentists and second, to describe the prevalence and distribution of symptoms of musculoskeletal disorders among Turkish students who are practicing general dentistry. The investigation was carried out on 221 dental students; group I consisted of 24 left-handed students (18 male, 6 female), aged 24.2+/-2.24 years; group II comprised 24 right-handed students (14 male, 10 female), aged 25.1+/-3.14 years; and group III included 173 right-handed students (102 male, 71 female), aged 24.3+/-1.45 years. The study consists of a questionnaire to identify work tasks and working conditions, and a field study to assess the pain of the neck, shoulders, and other disorders during the dental practice. Data were analyzed through tests for the difference between two population proportion, percentage, and Chi-square. Left- and right-handed students had headaches (34%, 22%), pins and needles (35%, 22%), weakness (42%, 40%), numbness (23%, 19%), neck pain (67%, 43%), back pain (56%, 47%), upper limp pain (46%, 43%) and shoulder pain (78%, 58%), respectively (Table 3). Female students were not significantly different from males in musculoskeletal symptoms (p>.05). The position adopted by the student was significantly related to the intensity of pain. Left-handed students especially suffered from neck and shoulder pain when compared with right-handed students (p<.06). The authors think that a modification of work practices appears to be effective in decreasing the prevalence of symptoms. The best ergonomic working principles should be taught to the students, dental schools should provide a comfortable working environment, and further study is required to identify factors that will reduce the prevalence of symptoms among those practicing general dentistry.

Periodontal disease as a risk factor for pre-eclampsia: a case control study.

OBJECTIVE: To investigate the association between periodontal disease and pre-eclampsia, while controlling known risk factors for pre-eclampsia. METHODS: A matched case-control study was carried out on 41 pre-eclamptic women and 41 normotensive, healthy, pregnant, control women. The pre-eclamptic women and controls were individually matched for age, gravidity, parity, smoking and prenatal care. The number of teeth and the number of restorations and decay on all tooth surfaces, and clinical periodontal parameters, excluding third molars were determined within 48 h before delivery. The relation of independent variables to pre-eclampsia was assessed using conditional multiple logistic regression analysis on subject-based data. RESULTS: There were no statistically significant differences in mean percentages of sites with plaque between groups. The mean probing depth (PD) and mean clinical attachment level (CAL) for pre-eclamptic patients were significantly greater compared to those of normotensive patients (P < 0.01). The percentage of sites exhibiting bleeding on probing (BOP) (P < 0.05), the number of sites with PD >/= 4 mm and with CAL >/= 3 mm was significantly higher among pre-eclamptic patients than those with normotensive patients (P < 0.01). Conditional multiple logistic regression analysis indicated that periodontal disease and triglycerides level were significantly associated with pre-eclampsia. Other independent variables (maternal body weight and serum total cholesterol level) did not appear to be associated with pre-eclampsia. Conditional multiple logistic regression results showed that pre-eclamptic patients were 3.47 (95% CI = 1.07-11.95) times more likely to have periodontal disease than normotensive patients. CONCLUSION: The present study shows that maternal periodontal disease during pregnancy is associated with an increased risk for the development of pre-eclampsia. The higher incidence of periodontal disease parameters in pre-eclamptic group would suggest a possible role for periodontal disease in the development of pre-eclampsia. The nature both of periodontitis and pre-eclampsia is multifactorial, and caution should be exercised when implicating periodontal disease in causation of pre-eclampsia.

Effect of handedness on learning subgingival scaling with curettes: a study on manikins.

The aim of the present study was to evaluate the influence of systematic manikin-head training and the effectiveness of subgingival scaling applied with hand instruments (curettes) by right- and left-handed dental students on dental chairs (traditional) designed for right-handers. A questionnaire focusing on handedness was administered to 69 voluntary dental students in the third class at the School of Dentistry during pre-participation examination. Handedness was assessed using the Turkish version of the Edinburgh Handedness Inventory. Then, 18 dental students were specially selected in 2 equal groups according to hand preference: consistent right-handers with Geschwind Scores of +100 (5 female and 4 male) and consistent left-handers with Geschwind Scores of -100 (5 female and 4 male). These two untrained dental student groups received 10 weeks manikin-head training. Subgingival scaling was performed with hand instruments (Gracey curettes) in manikin-head mounted on right-sided dental chairs. At 6 test days each dental student had to instrument 12 test teeth. Effectiveness of subgingival scaling was evaluated by adoption of a grading system. This system had scores from 0 to 3 and was defined by illustrated and described criteria. Statistical analysis was carried out with SPSS. Two groups were statistically compared on all test days. The yet-untrained left-handed dental students begin with a relatively high the mean score of 2.25, compared to the yet-trained right-handed dental students with 1.93, which was statistically significant (p > .05). The right-handed dental students reached the mean score of 0.53, whereas the left-handed dental students reached the mean score of 0.87 on test day 6. Significant differences in the mean scores were found between the two groups for overall surfaces (p < .05), the distal surfaces (p < .01), lingual surfaces (p < .01), and each group of teeth (p < .05). But there was no statistically significant difference between the 2 groups of students on all test day, except for test day 3 in terms of the mean scores for the facial and mesial surfaces (p > .05). Learning success was observed a high level in both groups through systematical training (p < .0001). The present study has documented that the left-handed dental students were less successful than the right-handed dental students in subgingival scaling, except for mesial and facial surfaces. However although training on right-sided chairs, they were quite similar to their right-handed counterparts in terms of learning success.