Evaluating the Effect of Resveratrol on the Healing of Extraction Sockets in Cyclosporine A-Treated Rats.

PURPOSE: The objective of this study was to investigate the effects of resveratrol on alveolar socket healing after tooth extraction in normal and cyclosporin A (CsA)-treated rats. MATERIALS AND METHODS: Seventy-two female Sprague-Dawley rats were separated into 4 groups of 18. Group 1 was injected with a placebo solution intraperitoneally. Group 2 was injected with resveratrol (10 µmol/kg) intraperitoneally. Groups 3 and 4 were injected with CsA (10 mg/kg) subcutaneously for 8 days once daily before tooth extraction. Next, the teeth were extracted and CsA injection continued until the animals were sacrificed. Eight days after commencing the CsA injections, group 4 was injected with resveratrol while continuing with CsA injections. Nine rats from each group were sacrificed on days 14 and 28, and sections were examined to assess the degree of inflammation, formation of connective tissue, and new bone formation. Immunohistochemical analysis was used to evaluate the alveolar socket healing process using osteocalcin and osteopontin markers. A P value less than .05 was considered significant. RESULTS: There was more new bone formation in group 2 than in the other 3 groups on day 14 after tooth extraction (P < .05), and there was more new bone formation in group 2 than in groups 3 and 4 on day 28 after extraction (P < .05). Based on the immunohistochemical assessment, the amount of osteocalcin and osteopontin labeling was greater in group 2 compared with the other 3 groups on day 14 (P < .05); however, on day 28 after extraction, it was greater in group 4 compared with group 3 (P < .05). CONCLUSIONS: Resveratrol improves alveolar socket healing in normal and CsA-treated rats. Resveratrol also increases levels of osteocalcin and osteopontin in normal and CsA-treated rats. These results suggest that this natural compound is useful for alveolar socket healing after tooth extraction.

Displacement of Dental Implant Into the Submental Space After Surgical Integration.

Osseointegrated dental implants are common and widely used to treat edentulism. Implant displacement into the maxillofacial spaces during surgery or after a period of use is a complication recognized in the literature. Foreign objects such as titanium dental implants in the maxillofacial region must be removed because they cause infection due to tissue reaction. In this report, the authors present the case of a patient whose dental implant slipped into the submental space after surgical integration and describe the surgical removal of the implant via an extraoral approach.

Early Neurodegeneration of the Inner Retinal Layers in Type 1 Diabetes Mellitus.

PURPOSE: This study explores retinal structural changes in type 1 diabetes without clinically diagnosed diabetic retinopathy (DR). METHODS: Peripapillary retinal nerve fiber layer (RNFL) thickness, macular ganglion cell complex (GCC) thickness, and macular thickness (MT) were measured in 90 type 1 diabetic patients by using spectral domain optical coherence tomography. The values were compared with 100 sex- and age-matched healthy controls. The independent t test was used to assess differences in the mean age, mean diabetic and ocular parameters, and the thickness values between the diabetic and control groups. Multiple linear regression analysis was performed to investigate the correlation between the thickness values and diabetic and ocular parameters. RESULTS: Whole-RNFL, the superior and inferior quadrants, and the superior half of the peripapillary RNFL thicknesses were significantly thinner in diabetic patients compared with controls (p < 0.05). GCC thicknesses in the average macular, outer temporal superior and outer temporal inferior sectors were significantly thinner in diabetic patients (p < 0.05). Central and average MTs were similar in both groups (p > 0.05). There were significant negative correlations of the duration of type 1 diabetes with the inner nasal MT, inner temporal superior GCC thickness, inner nasal inferior GCC thickness, and outer nasal superior GCC thickness (p < 0.05). Similarly, there were significant negative correlations of the level of HbA1c with the whole-RNFL thickness, superior-half-RNFL thickness, and superior-quadrant-RNFL thickness (p < 0.05). CONCLUSIONS: Type 1 diabetic patients without clinically diagnosed DR had neurodegeneration in the inner retinal layers compared with healthy controls.

Histopathological Effects of Teriparatide in Medication-Related Osteonecrosis of the Jaw: An Animal Study.

PURPOSE: Osteonecrosis of the jaw after tooth extraction is a major complication in patients using bisphosphonates (BPs) for bone lesions, such as for the treatment of osteoporosis. The purpose of this study was to investigate the histopathologic effects of teriparatide (a synthetic parathyroid hormone) on rats developing osteonecrosis with BP use. MATERIALS AND METHODS: Rats (n = 80) that had been injected intraperitoneally with zoledronic acid for 7 weeks were used. Maxillary first molar extractions and bone defects were established in the same region in the eighth week. Teriparatide was administered subcutaneously to prevent osteonecrosis. Animals were sacrificed and histopathologic changes were examined. Osteoblasts, osteoclasts, inflammatory phase of bone healing, and osteonecrotic areas were evaluated. RESULTS: The osteoclast numbers were larger in the experimental groups (teriparatide administered before and immediately after tooth extraction) than in the control group (administered zoledronic acid). The inflammatory phase of bone healing was more pronounced in the experimental group (teriparatide administered before tooth extraction) than in the control group. There were significant differences in osteoclast numbers and in the inflammatory phase of bone healing between the experimental and control groups (P < .05). The osteoblast numbers and osteonecrotic areas were similar in size between the experimental and control groups. There were no significant differences (P > .05). CONCLUSIONS: BPs have negative effects on osteoclasts and the inflammatory phase of bone healing, whereas teriparatide was found to be effective in eliminating the negative effects of BPs. Teriparatide had positive effects in preventing osteonecrosis; therefore, teriparatide could be an effective agent for MRONJ.

Acute and long-term ocular effects of acrolein vapor on the eyes and potential therapies.

Acrolein is an important agent in chemical ocular burns. With regard to the results of the study reported by Dachir et al.; we discuss the particular role of acrolein in chemical warfare and the beneficial effects of proanthocyanidins on the acrolein-induced ocular injuries.

Diabetic Macular Edema.

Diabetic macular edema (DME), one the most prevalent causes of visual loss in industrialized countries, may be diagnosed at any stage of diabetic retinopathy. The diagnosis, treatment, and follow up of DME have become straightforward with recent developments in fundus imaging, such as optical coherence tomography. Laser photocoagulation, intravitreal injections, and pars plana vitrectomy surgery are the current treatment modalities; however, the positive effects of currently available intravitreally injected agents are temporary. At this point, further treatment choices are needed for a permanent effect. SOURCES OF DATA SELECTION: The articles published between 1985-2015 years on major databases were searched and most appropriate 40 papers were used to write this review article.

Cytotoxicity Evaluation of Bioresorbable Fixation Screws on Human Gingival Fibroblasts and Mouse Osteoblasts by Real-Time Cell Analysis.

PURPOSE: To evaluate the effects of bioresorbable fixation screws (BFSs) on human gingival fibroblast (HGF) and mouse osteoblast (MC3T3-E1) cell viability. MATERIALS AND METHODS: The KLS Martin SonicPins Rx, Synthes RapidSorb Cortex Screws, and Inion CPS Bioabsorbable Fixation System each were incubated in Dulbecco's Modified Eagle Medium for 72 hours according to ISO 10993-5 standards. A real-time cell analyzer was used to evaluate cell survival. After seeding 200-µL cell suspensions in the wells of an E-plate View 96, HGF and MC3T3-E1 cells were treated with the bioactive components released by the bioresorbable materials and monitored every 15 minutes for 96 hours. Statistical significance was determined using 1-way analysis of variance and Tukey-Kramer tests. RESULTS: There were significant differences in the HGF responses to the untreated control conditions and the Synthes (P < .01), Inion (P < .05), and KLS Martin (P < .05) treatments over 48 hours. The Synthes (P < .01) and Inion (P < .01) treatments produced lower HGF cell index values than the untreated control at 72 hours, whereas the KLS Martin treatment did not. When left to elute for 96 hours, there were no significant differences in values among the control and study groups for HGFs (P > .05). All tested BFSs decreased cell survival rates of M3T3C1 cells for 48 hours (P < .01), 72 hours (P < .001), and 96 hours (P < .001). CONCLUSION: Differences in the sensitivities of the 2 tested cell lines to the different BFSs might be the result of the different materials used to manufacture the screws. These results provide fundamental knowledge and new insights for the future design and development of new biocompatible BFSs for oral and maxillofacial surgery.

Effects of laser irradiation at different wavelengths (660, 810, 980, and 1064 nm) on transient receptor potential melastatin channels in an animal model of wound healing.

The aim of the present study was to compare the effectiveness of four different laser wavelengths used for low-level laser therapy(LLLT) on healing of mucositis in an animal model of wound healing, by investigating expression of transient receptor potential melastatin(TRPM) ion channels. Forty-five rats were intraperitoneally injected with 100 mg/kg 5-fluorouracil on day 1 and 65 mg/kg on day 3. Superficial scratching on left cheek pouch mucosa was performed on days 3 and 5. After ulcerative mucositis was clinically detected, LLLT was started (660 nm, HELBO; 810 nm, Fotona-XD; 980 nm, ARC-Fox; and 1064 nm, Fidelis-Plus3) at 8 J/cm(2)/day from days 1 to 4. Oval excisional biopsy was performed at the wound site, and expression of TRPM2 to TRPM8 was evaluated. Student's t test was used for evaluation of significance of TRPM gene expression according to "0" value (α = 0.05). In 980-nm group, TRPM4, TRPM6, and TRPM7 were significantly higher than in the control group (p < 0.005). In 660, 810, and 1064 nm groups, only TRPM6 was significantly higher than in control group (p < 0.005). There were no significant differences between control and sham groups (p > 0.05). These findings suggest that expression of TRPM6 gene was significantly affected by irradiation with lasers at different wavelengths, whereas the TRPM4 and TRPM7 genes were only expressed in the 980-nm diode laser group. TRPM6 gene was highly expressed during LLLT, which may lead to accelerated wound healing and tissue repair. In contrast, there was some evidence that the 980-nm diode laser caused increased expression of TRPM4, TRPM6, and TRPM7 which are responsible for stimulation of Ca(2+) and Mg(2+) metabolism, as well as apoptotic pathways of controlled cell death.

Is Conservative Surgical Treatment Sufficient to Treat Unicystic Mural Ameloblastoma in Infant?

Ameloblastoma, a benign neoplasm derived from odontogenic epithelium, is an aggressive and locally invasive tumor. It represents 11% of all odontogenic tumors and 1% of all oral odontogenic epithelial tumors. In this case report, a 20-month-old boy was referred to our clinic with complaint of collapse in his symphysis region of the mandible. Radiographic examination revealed unilocular radiolucency in this region. The lesion was enucleated with 1 tooth germ under general anesthesia and diagnosed as mural unicystic ameloblastoma by histopathologic examination. After the surgery, complete healing was obtained clinically and radiographically. No sign of recurrence has been seen during the follow-up period of 4.5 years. To our knowledge, this was the second youngest case of ameloblastoma in the English literature. However, it is the youngest case of ameloblastoma that occurred in an infant boy.

Comparison of the Effects of Low-Level Laser Therapy and Ozone Therapy on Bone Healing.

This study aims to compare the effect of low-level laser therapy (LLLT) and ozone therapy on the bone healing. Thirty-six adult male Wistar albino rats were used for this study. Monocortical defects were shaped in right femur of all rats. Defects were filled with nano-hydroxyapatite graft. The animals were divided into 3 groups and each group was than divided into 2 subgroups. Then, LLLT with a diode laser was applied to the first group (G1), ozone therapy was applied to the second group (G2), and no treatment was applied to the third group as a control group (G3). Animals were sacrificed after 4th and 8th weeks and the sections were examined to evaluate the density of the inflammation, the formation of connective tissue, the osteogenic potential, and osteocalcin activity. As a result, there were no significant differences among the groups of 4 weeks in terms of new bone formation. In the immunohistochemical assessment, the number of osteocalcin-positive cells was higher in the laser group compared to the other group of 4 weeks; this difference was statistically significant in the LLLT and ozone groups (P < 0.05). Histomorphometric assessment showed that the new bone areas were higher in the LLLT and ozone groups; furthermore, there was a statistically significant difference in the LLLT in comparison with the control group at 8th week (P < 0.05). At the same time immunohistochemical assessment showed that osteocalcin-positive cells were considerably higher in G2 than G1 at 8th week (P < 0.05). The findings of this study may be the result of differences in the number of treatment sessions. Further studies are therefore needed to determine the optimal treatment modality.

The effect of combined treatment of bevacizumab and triamcinolone for diabetic macular edema refractory to previous intravitreal mono-injections.

The purpose of this study is to evaluate the efficiency of combined treatment of bevacizumab and triamcinolone in refractory diffuse DME (DDME). Twenty-five pseudophakic eyes with DDME refractory to previous successive intravitreal bevacizumab (IVB, 1.25 and 2.5 mg/0.1 ml) and triamcinolone (IVT, 4 mg and 10 mg/0.1 ml) injections were included. The average number of injections was two (1-4). The mean best corrected visual acuity (BCVA) was 0.8 (0.3-1.5) logMAR before enrollment, 0.6 (0.0-1.5) logMAR at 6 months and 0.6 (0-1.8) logMAR at 12 months (p = 0.0001, p = 0.003). The median central macular thickness (CMT) of all the eyes was 575 (502-1049) µm at baseline, 370 (179-983) µm at 6 months, and 410 (198-929) µm at 12 months (p = 0.0001; p = 0.0001). At 6 months, the VA of 13 (52 %) patients was stabilized (± 0.2 logMAR of initial BCVA) and 12 (48 %) patients showed visual improvement (>0.2 logMAR). At 12 months, 10 (40 %) patients had stabilized vision, 13 (52 %) showed visual improvement and 2 (8 %) showed visual loss. At 6 months, 18 (72 %) patients showed anatomic stabilization (a decrease of 10 % to 50 % in initial CMT) and 7 (28 %) anatomical success (a decrease in CMT more than 50 % or ≤250 µm at final visit). At 12 months, 13 (52 %) patients showed anatomic stabilization, 10 (40 %) anatomic success, and 2 (8 %) anatomical failure (decrease in CMT less than 10 %). The combined application of IVB and triamcinolone may improve vision and decrease CMT in severe DDME cases refractory to previous monotherapies.

The prevalence and causes of visual impairment in young Turkish men.

OBJECTIVE: To explore the causes and prevalence of visual impairment in young Turkish men. METHODS: The health examination data of the candidates that are saved in National Defense Ministry of Turkey was used. The data of the candidates examined between 1 January 2009 and 31 December 2011 were evaluated. The total number of the candidates was 1777500. The candidates requiring advanced examination are referred to secondary and tertiary examination hospitals. RESULTS: Fourteen thousand eight hundred sixty two(14862) out of 1777500 candidates were declared unfit for compulsory military service because of ophthalmic causes. The prevalence of ophthalmologic diseases causing unfitness for military service was found 0.746% for 2009, 0.871% for 2010 and 0.889% for 2011. These included high refractive errors which was the most frequent pathology causing unfitness (40.1%). Nonsurgical retina, vitreous and optic nerve diseases were the most frequent cause of visual impairment (0.212%). Corneal and lens pathologies were the second most frequent cause of blindness (0.101%). CONCLUSIONS: The data bank in National Defense Ministry analyzed in this study is not directly intended to explore the causes and prevalence of visual impairment in Turkey. However this study gives considerable knowledge about the causes and prevalence of visual impairment in Turkey.

Bilateral Simultaneous Nonarteritic Anterior Ischaemic Optic Neuropathy: Case Report.

Bilateral simultaneous nonarteritic anterior ischaemic optic neuropathy (NAION) is extremely rare. A 57-year-old woman presented with bilateral optic disc oedema and peripapillary splinter haemorrhages. Initial visual acuities were hand movements in the right eye and light perception in the left eye. The patient had a mildly elevated diastolic blood pressure and glucose intolerance. Erythrocyte sedimentation rate and C-reactive protein levels were within normal limits. Temporal artery biopsy was negative for temporal arteritis. Marked visual improvement occurred in both eyes (0.8 in the right eye, 0.6 in the left eye) after systemic steroid therapy in the 16th month of follow-up.

Zygomaticocoronoid ankylosis with possible myositis ossificans: a very rare case.

Ankylosis forming between the zygomatic arch and the coronoid process is a rarely encountered pathological extracapsular ankylosis. Its treatment protocol consists of surgical removal of the coronoid process with the ankylotic mass and jaw opening-closing exercises after surgery. Myositis ossificans (MO) is a self-limiting, benign ossifying lesion. It affects all types of soft tissues including subcutaneous adipose tissue, muscles, tendons and nerves. It is most frequently found in the muscle as a solitary lesion. The clinical appearance of MO is generally in the form of a mass characterized with an ossified soft tissue. When it develops alone, cross-sectional imaging might not be specific, and it may appear similar to worse etiologies. It is suggested multiple imaging modalities should be used in the assessment of a suspicious soft tissue mass. MO is a benign self-limiting disease. In this case report, in the radiographic examination of a 41-year-old female patient, ankylosis between the left coronoid process and the zygomatic bone accompanied by possible MO in the left medial pterygoid muscle was observed. Resection of the coronoid process with the ipsilateral route, resection of the ankylotic mass with the hemicoronal approach and resection of the contralateral coronoid process with the intraoral approach were performed, but the ossified formation in the medial pterygoid muscle was not touched.

Three-dimensional soft tissue evaluation after rapid maxillary expansion and mandibular midline distraction osteogenesis.

OBJECTIVES: To evaluate the effects of rapid maxillary expansion (RME) and mandibular midline distraction osteogenesis (MMDO) on facial soft tissues using three-dimensional (3D) images. MATERIALS AND METHODS: A total of 20 patients (average age 15.86 ± 2.17 years) were treated with RME and MMDO using tooth-borne distractors. Three-dimensional photographs of each patient were taken with a stereophotogrammetry system at baseline (T0), at the end of the distraction period (T1), and at the end of the consolidation period (T2). All data were analyzed using a dependent-samples t-test at a significance level of 5%. RESULTS: Total and lower face height increased after MMDO (P < .05). Nasal and mouth width increased after RME as compared with baseline (P < .05). The labiomental angle increased at T1 and decreased at T2 (P < .05). After MMDO, the convexity angle increased while the mandibular angle decreased (P < .05). Upper and lower lip angles increased after RME (P < .05). The distance from the lower lip to the E plane increased after MMDO and decreased after RME (P < .05). CONCLUSIONS: The MMDO and RME procedures provide an efficient nonextraction treatment alternative for transverse maxillomandibular deficiency. MMDO may improve the facial soft tissue profile in the transverse and vertical axis of the mandibular region.