Masseter muscle thickness and elasticity in periodontitis.

This study aimed to compare the thickness and elasticity of the masseter muscle between patients with gingivitis and patients with periodontitis. A total of 124 patients (63 gingivitis, 61 chronic periodontitis) were recruited at the start of the study, but only 84 patients were declared as final participants. Patients were divided into two groups: (1) patients suffering from gingivitis and (2) those with generalized chronic periodontitis. Clinical (PI, plaque index; GI, gingival index; PD, probing depth; CAL, clinical attachment loss; and BOP, bleeding on probing scores) and ultrasonographic (thickness and elasticity of the masseter muscle) measurements of periodontitis were performed. There were no significant differences in gender, age, body mass index, education status, income level, or marital status between the two groups (P > 0.05). The mean age ± SD for the gingivitis and periodontitis groups was 39.5 ± 10.8 years and 44.8 ± 8.8 years, respectively. There were significant differences between the two groups in the number of PI, GI, PD, CAL, and BOP scores. There were significant differences between the two groups when thickness of masseter during contraction and at rest was taken into account. The gingivitis group had significantly thicker masseter during both contraction and rest. On the other hand, when the elasticity of the masseter was evaluated, there were no significant differences found between the two groups and two sides for each group. Masseter muscle thickness in the periodontitis group was found to be decreased compared with that in the gingivitis group. Furthermore, loss of periodontal tissues due to periodontitis reduces the masticatory ability.

The effects of ozone therapy on periodontal therapy: A randomized placebo-controlled clinical trial.

OBJECTIVES: The aim of this randomized split-mouth clinical trial was to evaluate the effects of ozone therapy on clinical and biochemical parameters of moderate to severe generalized periodontitis patients after non-surgical periodontal therapy. METHODS: A total of 36 moderate to severe generalized periodontitis patients were included in the study. The patients were systemically healthy and 18 to 64 years of age. Periodontal parameters, including plaque index (PI), gingival index (GI), probing depth (PD), percentage of bleeding on probing, percentage of pockets deeper than 5 mm and clinical attachment level (CAL), and percentage of ≥3 mm CAL, were evaluated at baseline and 3 months following periodontal therapy. All participants were treated non-surgically. Topical gaseous ozone was applied into periodontal pockets twice a week for 2 weeks during active periodontal therapy. Gingival crevicular fluid pentraxin-3 (PTX-3), interleukin-1ß (IL-1ß), and high sensitivity C-reactive protein (Hs-CRP) were evaluated. All statistical data were analyzed using SPSS software. RESULTS: Total of 36 participants completed the study (18 males, 18 females). PI, GI, PD, percentage of bleeding on probing, percentage of pockets deeper than 5 mm and CAL, and percentage of ≥3 mm CAL were improved, and there were no significant differences between the two sides. All inflammatory parameters, PTX-3, Hs-CRP, and IL-1, were reduced at 3-month follow-up. Only the decrease in PTX-3 levels between baseline and 3-month follow-up was statistically significant. CONCLUSIONS: Ozone therapy did not have any additional effect on periodontal parameters. All cytokines were reduced after periodontal therapy. Only PTX-3 levels were significantly lower at ozone sites compared to those at the control sites.

Investigation of Entamoeba gingivalis and Trichomonas tenax in Periodontitis or Gingivitis Patients in Kayseri.

OBJECTIVE: The aim of this study was to determine the prevalence of Entamoeba gingivalis and Trichomonas tenax in periodontitis and gingivitis patients. METHODS: The study consisted of 107 periodontitis patients and 68 gingivitis patients. Bacterial plaque samples were collected with a curette from the deepest pocket in each quadrant and placed into separate tubes containing sterile 0.9% saline solution. Samples were examined at a magnification of ×400 by light microscopy. Cultivation for T. tenax was performed using the same samples, and the cultures were examined after 48 hours. RESULTS: E. gingivalis was present in the samples from 38 periodontitis patients, whereas T. tenax was present in samples from only 3 periodontitis patients. Both E. gingivalis and T. tenax were found together in the samples from 2 periodontitis patients. In total, 22 and 2 gingivitis patients were found to be infected with E. gingivalis and with T. tenax, respectively. Only 1 gingivitis patient was found to be infected with both E. gingivalis and T. tenax. CONCLUSION: In our study, oral protozoa were found in a high percentage in periodontitis and gingivitis patients. We believe that the prevalence of E. gingivalis and T. tenax should be determined via new studies and, in particular, the protection principles should be complied with.

Relationship Between Psychological Factors and Oral Health Status and Behaviours.

PURPOSE: To examine oral health related behaviours in relation to anxiety, depression and attention deficit hyperactivity disorder (ADHD). MATERIALS AND METHODS: This study included 364 subjects (195 female, age range 19-65 years; 169 male, age range 18-64 years). A psychological evaluation was performed using Beck's anxiety, Beck's depression and ADHD scales. A separate questionnaire covering oral health behaviours, including parafunctional habits, dental visits and toothbrushing frequency, was given to the subjects and completed before the clinical examination. The numbers of decayed, missing and filled teeth were recorded and the status of the subject's periodontal health was determined clinically using periodontal probes and panoramic radiographs. RESULTS: There were significant differences in the gender, level of education, level of income, household size, parafunctional habits and number of missing teeth in those with anxiety and depression (p<0.05) vs those without. Females and subjects with parafunctional habits and lower education and income level presented higher anxiety and depression scores. ADHD was associated negatively with household size and positively with dental visits and toothbrushing frequency (p<0.05). The results of structural equation modeling (SEM) revealed that anxiety, depression and ADHD were indirectly related to missing teeth and periodontal status: subjects with higher depression and anxiety scores had more missing teeth and worse periodontal health. However, there was no association between psychological factors and decayed teeth or toothbrushing frequency. CONCLUSIONS: Anxiety, depression and ADHD can result in poor oral hygiene, thereby having indirect, adverse effects on the periodontal health status of affected individuals. Although the frequency of dental visits seemed to be related to anxiety and ADHD, the frequency of toothbrushing showed no such association.

Platelet-rich plasma and autogenous bone graft combined with guided tissue regeneration in periodontal fenestration defects in dogs.

The aim of this study was to evaluate the effects of platelet-rich plasma (PRP), autogenous bone (AB), and guided tissue regeneration (GTR) combination therapy compared to GTR therapy alone on healing of bone and cementum in fenestration-type periodontal defects in dogs. Six dogs were included in this study. Fenestration-type defects were created, and the following treatment groups were established: a control group treated with GTR alone and experimental groups treated with a combination of GTR + PRP, GTR + AB, and GTR + AB + PRP. The defects were evaluated by stereologic method and histomorphometric analysis, which were performed 4, 8, and 12 weeks postoperatively. The results showed a significant increase in trabecular bone area in the GTR + PRP group as compared with the control at 4 and 8 weeks (P < .05). The GTR + AB + PRP group showed significantly more trabecular bone area than both GTR and GTR + PRP groups at all time intervals (P < .05). The 8- and 12-week results in terms of cementum area revealed a significant difference between the GTR + AB + PRP group and the control in favor of the former (P < .05). Cementum area in the GTR + AB group was significantly greater than that in the GTR group at all time intervals (P < .05). Within the limitations of this study, PRP and AB, when used under barrier membrane, resulted in significant improvement in bone and cementum formation compared to GTR alone in periodontal fenestration defects; AB, rather than PRP, was responsible for this outcome.

OPG and RANKL levels around miniscrew implants during orthodontic tooth movement.

INTRODUCTION: The aim of this study was to determine the peri-miniscrew implant crevicular fluid receptor activator of nuclear factor-кB ligand (RANKL) and osteoprotegerin (OPG) levels around loaded and unloaded miniscrew implants at different time intervals. METHODS: Twenty loaded and 16 unloaded miniscrew implants were included in this study. All miniscrew implants were placed bilaterally between the maxillary second premolars and first molars as anchorage units for canine distalization. Peri-miniscrew implant crevicular fluid was taken from the mesiobuccal aspects of the loaded and unloaded miniscrew implants before loading; at 24, 48, and 168 hours; and on day 30 after force application. Enzyme-linked immunosorbent assay kits were used to determine RANKL and OPG levels in the peri-miniscrew implant crevicular fluid samples. Wilcoxon, Mann-Whitney U, and Spearman correlation tests were used for statistical evaluations at the P <0.05 level. RESULTS: Although the total amount of OPG was not different between the groups, the total amount of RANKL was significantly elevated in the loaded miniscrew implant group (P <0.05) at all time periods. Peri-miniscrew implant crevicular fluid volume was the highest at 48 hours in the loaded group. Also, the OPG/RANKL ratio in the peri-miniscrew implant crevicular fluid was significantly decreased in the loaded miniscrew implant group. CONCLUSIONS: The OPG and RANKL levels vary around loaded and unloaded miniscrew implants as a result of force application.

Comparison of different toothbrushing protocols in poor-toothbrushing orthodontic patients.

The aim of this study was to determine, using a computerized image analysing system, whether the use of a curved-bristle toothbrush (CBT) alone is more effective than two other toothbrushing protocols on dental plaque elimination in poor-toothbrushing orthodontic patients. The labial surfaces of the maxillary canine-to-canine anterior teeth of 30 patients (12 males and 18 females) were individually photographed following dental plaque staining before and 4 weeks after each toothbrushing protocol, with a 1-month washout interval. The toothbrushes used were (1) a CBT, (2) an orthodontic toothbrush (OT), and (3) an OT in combination with interproximal toothbrush (IT) (OT + IT). Total labial surfaces of the anterior teeth and stained plaque areas were measured and gingival indices (GIs) were also recorded. Repeated measures analysis of variance and Tukey's Honestly Significant Difference multiple range tests showed that the OT + IT produced a statistically significant decrease in the mean plaque percentage both for the total labial (7.2%) and interproximal (17.7%) tooth surfaces, when compared with the other toothbrushing protocols (P < 0.05). No statistically significant differences were found between the CBT and OT for the amount of bacterial plaque and GI scores (P > 0.05). Neither the CBT nor the OT alone was able to remove plaque under the archwires in poor-toothbrushing patients. Therefore, the use of ITs should be mandatory for effective plaque removal in these patients.

The effect of periodontitis on biting abilities.

BACKGROUND: The aim of this study was to compare the biting abilities (bite force [BF] and occlusal contact area [OCA]) of chronic periodontitis patients with those of control patients with healthy periodontia by using pressure-sensitive sheets. METHODS: The study population consisted of 20 patients with chronic periodontitis whose initial periodontal therapy was completed and 20 control subjects with healthy periodontia. Periodontitis was diagnosed by radiographs and measurements of probing depth and clinical attachment level. Pressure-sensitive sheets were used for the quantitative analysis of BF and OCA. RESULTS: Both mean BF and OCA values were greater in the healthy control group compared to those of the study group. The differences between the groups were statistically significant at the 95% confidence level. CONCLUSION: Reduced periodontal support in the absence of inflammation negatively affected biting abilities.

Connective tissue grafting on resin ionomer in localized gingival recession.

BACKGROUND: One of the main objectives of periodontal reconstructive surgery is the coverage of exposed roots that occur due to gingival recession. On some occasions, where a caries, root resorption, or amalgam restoration exists on the exposed root surface, the treatment planning becomes more complex. This case report describes the use of a subepithelial connective tissue graft (SCTG) on a resin ionomer-restored root surface to treat gingival recession that is complicated with the above-mentioned handicaps. METHODS: An amalgam restoration and carious lesion were removed following full-thickness flap reflection, and the cavity was restored with glass ionomer cement. An SCTG was placed onto the restoration, and the flap was coronally positioned. A porcelain crown restoration was performed 9 months after surgery. RESULTS: At 3-, 6-, and 9-month follow-ups, probing depths were reduced and gain in attachment level was obtained with no clinical signs of inflammation in gingiva. Monthly periodontal controls revealed that creeping attachment had occurred on the restoration during the follow-up periods. CONCLUSION: This single case report serves as a good example to show that SCTG can be successfully performed to treat gingival recession associated with a glass ionomer-restored root surface.

The effect of periodontal surgery on bite force, occlusal contact area and bite pressure.

BACKGROUND: Tooth mobility resulting from the loss of periodontal support or trauma induced by periodontal surgery may change the amount of bite force (BF) and bite pressure (BP) and number of occlusal contact areas (OCAs). The aim of the authors' study was to compare BF, BP and OCA of teeth with periodontal disease before and after periodontal surgery with similar values of healthy teeth. METHODS: The authors performed quantitative analysis of BF, BP and OCA using a pressure measurement film. Ten patients with periodontitis who needed periodontal surgery served as the test group. The authors took measurements of BF, BP, OCA and mobility (using Miller's Mobility Index) just before surgery and at one, four and 12 weeks after surgery. They also measured clinical attachment levels (CAL) before surgery and 12 weeks after surgery. Ten subjects without periodontitis served as the control group. RESULTS: Although BF and OCA increased the first week after periodontal surgery, analysis of variance (ANOVA) showed no statistically significant differences at a 95 percent confidence interval. There were statistically significant differences between first-week mobility and that at four and 12 weeks (P = .001). A factorial ANOVA showed significant interaction between BF and mobility (P < .05). CONCLUSIONS: The authors' findings suggest that changes in BF, BP and OCA were not affected by periodontal surgery. However, mean mobility values and BF are correlated. Further investigations of this measurement method involving larger study populations and a longer follow-up period are needed. CLINICAL IMPLICATIONS: It seems to be helpful to follow occlusal changes after periodontal surgery using a pressure measurement film. It also may be suggested that this measurement method could be used to evaluate the treatment prognosis.