Salivary and serum asprosin hormone levels in the 2018 EFP/AAP classification of periodontitis stages and body mass index status: a case-control study.

OBJECTIVES: A newly discovered adipokine known asprosin in serum and saliva in patients with periodontitis has not been explored. The aim of this study was to determine the relationship between serum and saliva asprosin levels and periodontitis by grouping it according to body mass index (BMI). MATERIALS AND METHODS: The study was conducted on 65 systemically healthy patients (35 patients with periodontitis (periodontitis group), 30 periodontally healthy patients (control group)). In each patient, age, BMI, and clinical periodontal parameters (plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL)) were evaluated. Statistical analyses were conducted utilizing the Student t-test, ANOVA, and Pearson correlation analysis. For the significance level of the tests, p<0.05 were accepted. RESULTS: The serum and saliva were collected to assess asprosin levels. Both the serum and saliva asprosin levels were statistically significantly higher in the periodontitis group than in the control group (p<0.001). Saliva and serum asprosin levels were directly proportional to the severity of the periodontal disease (p<0.05). Asprosin levels were higher in patients with a higher BMI (p<0.05). CONCLUSION: Asprosin levels were increased in periodontitis, and even a high BMI status apparently affected the levels of this hormone. It is thought that asprosin may be a useful biomarker in evaluating the relationship between periodontal status and BMI. CLINICAL RELEVANCE: Asprosin may be a useful parameter as a biomarker of periodontal disease progression. However, BMI status should be considered when evaluating asprosin levels in patients with periodontitis.

Total, free, and bioavailable 25-hydroxyvitamin D levels in patients with periodontitis (stage III): a case-control study.

OBJECTIVE: The aim of this study was to investigate the relationship between total, free and bioavailable 25-hydroxyvitamin D levels, and periodontitis. MATERIALS AND METHODS: Thirty-nine patients with periodontitis diagnosis and 44 healthy participants were included in this study. 25-Hydroxyvitamin D, vitamin D-binding protein, procalcitonin, and albumin levels were measured from the serum samples obtained. Free and bioavailable 25-hydroxyvitamin D levels were calculated. Total, free, and bioavailable 25-hydroxyvitamin D levels were compared between the healthy control and periodontitis groups. The association of total 25 (OH)D levels with periodontitis was tested through univariate analysis and multivariate logistic regression. RESULTS: Total 25-hydroxyvitamin D, bioavailable 25-hydroxyvitamin D, and free 25-hydroxyvitamin D levels were significantly lower in the periodontitis group than in the healthy control group (p < 0.001). In the logistic regression analysis, a significant correlation was observed between total 25-hydroxyvitamin D and periodontitis (p<0.001). CONCLUSION: Our study shows that there is a relationship between total, free and bioavailable 25-hydroxyvitamin D levels and periodontitis. In addition, it has been shown that the determination of free and bioavailable 25-hydroxyvitamin D levels does not provide additional advantages in terms of the relationship between periodontitis and vitamin D. CLINICAL RELEVANCE: In this case-control study, we examined the relationship between total, free and bioavailable 25-hydroxyvitamin D and periodontitis. We found lower total, free, and bioavailable 25-hydroxyvitamin D levels in periodontitis patients. It was also found that vitamin D-binding protein may be an important biomarker in the identification of various forms of periodontal disease. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT05343273.

The effects of overhang amalgam restoration on levels of cytokines, gingival crevicular fluid volume and some periodontal parameters.

PURPOSE: To evaluate clinical periodontal findings and GCF levels of tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6) and interleukin 8 (IL-8) in patients with overhang amalgam restorations before and after overhang restoration removal. METHODS: 22 volunteer subjects (age range: 22-42 years old) with 22 overhang Class II amalgam restorations were selected. GCF samples were obtained from adjacent and contralateral teeth for IL-6, IL-8 and TNF-α measurements and analyzed using enzyme-linked immunosorbent assay (ELISA) kits. The amalgam overhangs were removed and the readings were repeated at the end of 1 week. Clinical periodontal assessments, including gingival index (GI) and plaque index (PI) were performed at baseline and after 1 week. Data were analyzed using the paired t-test and independent sample t-test at a significance level of 0.05. Correlations were investigated using Pearson correlation analysis. RESULTS: A significant reduction in GI and PI was observed after removal of the overhanging restoration on Day 7. (P< 0.05) However, there was no significant difference between IL-6 (P= 0.857), IL-8 (P= 0.579) and TNF-α (P= 0.958) levels before and after overhang restoration removal. There were no significant correlations between laboratory findings and clinical parameters. CLINICAL SIGNIFICANCE: Dental restorations may produce periodontal disease and may alter tooth form, surface integrity, relationship with the periodontium and adjacent teeth. The marginal edge located in the gingival sulcus is likely the cause of the inflammatory reaction. This study showed significant improvement in clinical periodontal parameters after removing the overhangs of restorations.

Trauma from instrumentation after non-surgical periodontal treatment with ultrasonic scalers and Nd:YAG laser.

OBJECTIVE: Periodontal therapies aimed at altering the progression of periodontal diseases must include meticulous mechanical debridement during both the non-surgical and the surgical phases of periodontal treatment. The aim of this study was to evaluate and compare the immediate effect of trauma from instrumentation on clinical attachment level after non-surgical periodontal treatment with ultrasonic scalers and a Nd:YAG laser. MATERIALS AND METHODS: Twenty-four patients with untreated chronic periodontitis, presenting probing depths of 4-6 mm on anterior teeth, upper and lower, were entered into the study. The selected teeth were probed with a pressure-controlled probe, guided by stents. Each quadrant was randomly allocated in a split-mouth design either to treatment with Nd:YAG laser using an energy of 1W, 100mj, 1064nm (test group) or to periodontal treatment using ultrasonic scalers (control group). Clinical parameters, including plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD) and probing attachment level (PAL) were acquired prior to and immediately after treatment. RESULTS: Statistical analysis demonstrated no differences between groups at baseline for all parameters (p > 0.05). Immediately after treatment, the control group showed a greater PAL loss than the test group (p < 0.05). For the control group, there were statistically significant differences between PAL immediately before and after treatment (p < 0.05), but not test group (p > 0.05). CONCLUSIONS: Within the limits of the present study, it may be concluded that non-surgical periodontal treatment with ultrasonic scalers causes a mean immediate attachment loss of 0.68 mm and that a Nd:YAG laser seems to reduce significantly the trauma the instrumentation produced.

KTP laser therapy as an adjunctive to scaling and root planing in treatment of chronic periodontitis.

OBJECTIVE: The main goal of periodontal treatment is to control infection and, thereby, curb disease progression. Recent studies have suggested that the use of a laser as an adjunct to scaling and root planing (SRP) might improve the effectiveness of conventional periodontal treatment. The aim of this study was to evaluate and compare the clinical effects of potassium-titanyl-phosphate (KTP) laser therapy in the treatment of chronic periodontitis in combination with traditional SRP. MATERIALS AND METHODS: Twenty-four patients with untreated chronic periodontitis were treated using a split-mouth study design in which each side was randomly treated by SRP alone (control group) or KTP laser (0.8W, time on 50 ms, time off 50 ms, 30 s, 532 nm) followed by SRP (test group). In the distribution of the teeth (total = 124 teeth) in the patients, 106 (86%) were molars and 18 (14%) were premolars. The selected teeth were probed with a pressure-controlled probe, guided by stents. Clinical periodontal parameters including plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD) and probing attachment level (PAL) were recorded at baseline and at 2 and 12 months following therapy. RESULTS: Statistical analysis demonstrated no differences between groups at baseline for all parameters (p > 0.05). BOP and PPD reductions and PAL gains were statistically significant both between baseline and 2 months and between baseline and 12 months in both groups (p < 0.05). The test group showed a greater reduction in PPD compared to the control group (p < 0.05). In addition, the test group showed a greater probing attachment gain compared to the control group (p < 0.05). CONCLUSIONS: In patients with chronic periodontitis, clinical outcomes of conventional periodontal treatment can be improved by using an adjunctive KTP laser.

Investigation of Biopsied Non-Plaque-Induced Gingival Lesions in a Turkish Population: A 5-Year Retrospective Study.

OBJECTIVE: The study aimed to analyze the distribution and frequency of individuals diagnosed with histopathologically non-plaque-induced gingival lesions and categorize them according to the non-plaque-induced gingival disease classification published at the 2017 World Workshop of Periodontology. MATERIALS AND METHODS: Clinical features of the gingival lesion with histopathological diagnosis data in the period 1998-2003 were retrospectively analyzed . The lesions were classified as reactive lesions, malignant neoplasms, premalignant neoplasms, autoimmune disorders, benign neoplasms, hypersensitive reactions, and genetic lesions. Their distribution according to age, gender, histopathological diagnosis, and oral sites was examined. Variables were analyzed using descriptive statistics. RESULTS: Among a total of 217 biopsied gingival samples, the most frequent pathologic nature of biopsied non-plaque gingival lesions were reactive lesions (n=80, 36.87%) and premalignant neoplasms (n=64, 29.49%). In addition, the 5 most frequent types of all cases included pyogenic granuloma (n=45, 20.74%), epithelial dysplasia (n = 40, 18.43%), papilloma (n = 33, 15.21%), epithelial hyperplasia (n = 24, 11.06%), and calcifying fibroblastic granuloma (n = 13, 5.99%). CONCLUSIONS: In a Turkish population, the most frequently biopsied non-plaque-induced gingival lesions were reactive lesions and premalignant neoplasms. This study shows that the types of lesions that clinicians, in gen- eral, especially periodontologists, can expect to encounter in their practice are the most frequently applied gingival lesions.

Effect of oral antiseptics on the viral load of SARS-CoV-2: A randomized controlled trial.

BACKGROUND: In the oral cavity, which plays an important role in the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), it is possible to reduce the viral load of SARS-CoV-2 with antiseptics, thereby minimizing the transmission of the virus during dental procedures. OBJECTIVES: The aim of this study was to clinically evaluate the effect of the hypochlorous acid (HClO) and povidone-iodine (PVP-I) solutions on the oral viral load of SARS-CoV-2. MATERIAL AND METHODS: This randomized controlled trial was conducted on 75 patients hospitalized in the COVID-19 ward of a local hospital. All the patients included in the study were within the first 24 h of hospitalization and the first 5 days of coronavirus disease 2019 (COVID-19) symptoms. The viral load of mouthwash samples was measured with the cycle threshold (Ct) value of SARS-CoV-2 through a realtime reverse transcription polymerase chain reaction (RT-PCR). The patients were divided into 3 groups. The effect on the patient's SARS-CoV-2 viral load was investigated after gargling the mouths and throats for 30 s with HClO, PVP-I and isotonic saline. First, a sample was taken after gargling with isotonic saline, then another sample was taken after gargling for 30 s with a particular antiseptic to determine the viral load of SARS-CoV-2. RESULTS: Comparing the before and after mouthwash samples from all 3 groups, there were no statistically significant differences in the Ct values before and after gargling (p > 0.05). However, there were statistically significant differences in the number of negative samples after the use of HClO and PVP-I, which were positive before gargling (p < 0.05). CONCLUSIONS: In the light of the data obtained in this study, there is insufficient evidence that gargling with HClO or PVP-I reduces viral load. Taken together, these findings imply no role for antiseptics in the transmission of SARS-CoV-2 by the aerosol generated during dental procedures, or more generally, SARS-CoV-2 infection control.

Leptin levels in gingival crevicular fluid during orthodontic tooth movement.

OBJECTIVES: To test if leptin can be detected in the gingival crevicular fluid (GCF) around moving teeth, and to determine whether any changes occur during orthodontic tooth movement. MATERIALS AND METHODS: An upper canine requiring distal movement served as the test tooth; the contralateral canine was used as a control tooth. The control tooth was included in the orthodontic appliance, but was not subjected to the orthodontic force. GCF sampling from the distal sites of the test and control teeth was done at baseline, 1 hour, 24 hours, and 168 hours. RESULTS: Leptin concentrations of the test teeth decreased in a time-dependent manner. When compared with the baseline measurement, the decrease was significant at 168 hours (P < .05). CONCLUSIONS: The concentration of leptin in GCF is decreased by orthodontic tooth movement; the results of the present study also suggest that leptin may have been one of the mediators responsible for orthodontic tooth movement.

Content and composition of fatty acids in normal and inflamed gingival tissues.

The balance of essential fatty acid is important for good health and normal development. Essential fatty acids (EFA) are the precursors of prostaglandins (PGs), thromboxanes and leukotrienes (LT). The aim of this clinical study was to determine the total fatty acid level of polyunsaturated fatty acids (PUFA), monounsaturated fatty acids (MUFA), saturated fatty acids (SFA) and each fatty acids level of inflamed and normal gingival tissues. Twenty-seven subjects were included the present study. Nineteen samples of inflamed human gingival tissue (nine of fibrous hyperplasia (FH), ten of peripheral giant cell granuloma (PGCG) and eight samples of normal human gingival tissue were analyzed. The characteristics of inflammation were assessed histologically. Variance analyses were performed to assess the differences among tissues. The total cellular fatty acid profiles of the tissues in inflamed human gingival tissue and in eight samples of normal human gingival tissue were determined by gas chromatography using Sherlock microbial identification system (MIS) software (Microbial ID, Newark, DE, USA) with a database of FAME profiles for eukary. PUFAs, MUFAs, and SFAs were quantified by Sherlock microbial identification system (MIS) or database gas chromatography (DGC). There were statistically significant differences between the concentrations in inflamed (FH, PGCG) and healthy gingival tissues for PUFA and MUFA (P<0.001, P<0,011, respectively). There were statistically significant differences among the concentrations in FH, PGCG, and healthy gingival tissues for SFA (P<0.0001). Arachidonic acid, docosahexaenoic acid, linoleic acid were increased in inflamed tissue. The results of this study showed that unsaturated fatty acids (PUFA and MUFA) significantly increased in inflamed gingival tissues.

Abrasion resistance of veneering materials to tooth brushing.

This study was carried out to comparatively examine abrasion which occurred as a result of brushing as well as abrasives in veneering materials used in prosthetic restorations. Twenty out of forty specimens prepared at the dimensions of 14x5x3 mm, there being ten specimens of each veneering materials, were subjected to tooth brushing with water alone. The other twenty specimens were subjected to a tooth brushing procedure with a paste- water mixture with the aim of evaluating the effects of abrasives on abrasion. As a result, it was statistically determined that porcelain, an ideal facet material, had the best resistance to abrasion by toothbrush, light cured aesthetic materials being second Poly methyl methacrylate had the least abrasion resistance.

Clinical effects of potassium-titanyl-phosphate laser and photodynamic therapy on outcomes of treatment of chronic periodontitis: a randomized controlled clinical trial.

BACKGROUND: The main objective of periodontal treatment is to control infection and thereby curb disease progression. Recent studies have demonstrated that adjunctive treatment procedures, such as laser irradiation or photodynamic therapy (PDT), may provide some additional benefit in the treatment of chronic periodontitis (CP). The aim of this randomized controlled trial is to clinically evaluate and compare the clinical effects of potassium-titanyl-phosphate (KTP) laser and PDT on outcomes of CP treatment. METHODS: Twenty-four patients with untreated CP were treated using a split-mouth study design in which the teeth in each quadrant were randomly treated by scaling and root planing (SRP) alone (group A), PDT followed by SRP (group B), or KTP laser followed by SRP (group C). The periodontal pockets were exposed to a KTP laser with the following parameters: 0.8 W output power, 50 milliseconds time on/50 milliseconds time off, 30 seconds per irradiation at 532 nm and 11.7 J/cm(2) fluence, with a flexible fiberoptic tip with a diameter of 200 µm. The selected pockets were probed with a pressure-controlled probe, guided by stents. Clinical periodontal parameters assessed included plaque index, gingival index, bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL), which were recorded at baseline and at 6 months after therapy. RESULTS: Statistical analysis demonstrated no differences between groups at baseline for all parameters (P >0.05). All treatments yielded significant improvements in terms of BOP and PD decrease and CAL gain compared to baseline values (P <0.05). Group C showed a greater reduction in PD compared to the other groups (P <0.05). In addition, group C showed a greater CAL gain compared to the other groups (P <0.05). CONCLUSION: In patients with CP, clinical outcomes from conventional periodontal treatment of deeper pockets can be improved by using adjunctive KTP laser.

The effects of silorane composites on levels of cytokines and periodontal parameters.

AIMS: The purpose of this pilot study was to determine the effects of silorane composites on gingival crevicular fluid (GCF) levels of tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6) and IL-8, GCF volume and clinical periodontal parameters in patients with silorane composite restorations before and after restorative treatment. MATERIALS AND METHODS: A total of 20 systemically healthy non-smokers, 12 female and 8 male (age range: 24-46 years), presenting with 25 instances of primary dentine caries with subgingival margins were selected for this study. Approval was obtained from the university ethics committee and treatment plans were approved by the patients. GCF samples were obtained with periopaper strips from relevant teeth for IL-6, IL-8 and TNF-α measurements. Each sample was stored at - 80°C and analyzed using the enzyme-linked immunosorbent assay (ELISA) kits. Cavities were prepared according to the common principles for adhesive restorations and restored with a silorane adhesive system (Silorane System Adhesive (3M ESPE) and silorane composite (Filtek Silorane, 3M ESPE). Cytokine levels were reassessed 2 weeks after restorative treatment. Data were analyzed using the independent t-test at a significance level of α =0.05. Associations between parameters were analyzed using Pearson correlation analysis. RESULTS: A significant increase in gingival index (GI) and plaque index (PI) were observed after 15 days (P < 0.05). GCF volume, IL-6, IL-8 and TNF-α levels exhibited significant differences before and after restorative treatment (P < 0.05). There were strong positive correlations among parameters except for PI/GCF volume and GI/GCF volume. CONCLUSION: Within the limitations of this investigation, silorane composites may have some negative effects on cytokine levels, clinical parameters and GCF volume.

Effects of the combined desensitizing dentifrice and diode laser therapy in the treatment of desensitization of teeth with gingival recession.

OBJECTIVES: The purpose of this study was to evaluate and compare clinically the efficacy of desensitizer toothpaste alone and in combination with the diode laser in the management of dentin hypersensitivity (DH), as well as both the immediate and late therapeutic effects on teeth with gingival recessions. MATERIALS AND METHODS: In total, 52 teeth diagnosed with DH in 13 (seven women, six men, aged 16-48 years) healthy adult patients were included in this study, and teeth were randomly divided equally into two groups: the test group, which received treatment with desensitizer toothpaste and GaAlAs (diode) laser, and the control group, treated with desensitizer toothpaste. DH was assessed by means of an air stimulus, and a visual analogue scale (VAS) was used to measure DH. The selected teeth in the test group received laser therapy for three sessions. Teeth subjected to diode-laser treatment were irradiated at 100 mW for 25 sec at 808 nm, with continuous-emission, noncontact mode, perpendicular to the surface, with scanning movements on the region of exposed root surfaces. RESULTS: Significant reduction of DH occurred at all times measured during the three treatment sessions in the test group. When compared with the means of the responses in the three treatment sessions of the two groups, the test group showed a higher degree of desensitization in teeth with gingival recession than did the control group (p < 0.001). The immediate and late therapeutic effects of the diode laser were more evident compared with those of desensitizer toothpaste. CONCLUSIONS: Within the limitations of the present study, a significant effect of combined desensitizer toothpaste and diode laser therapy occurs in the treatment of desensitization of teeth with gingival recession. Desensitizer toothpaste appears to have the therapeutic potential to alleviate DH. Conversely, diode laser can be used to reduce DH.

The combined use of Nd:YAG laser and enamel matrix proteins in the treatment of periodontal infrabony defects.

BACKGROUND: The objective of regenerative periodontal therapy is the reconstitution of lost periodontal structures, such as cementum, periodontal ligament, and alveolar bone. Enamel matrix proteins (EMP) are used as a local adjunct to periodontal surgery to stimulate regeneration of periodontal tissues lost to periodontal disease. The aim of this split-mouth study evaluates and compares the healing of intrabony defects after treatment with an EMP with or without neodymium-doped:yttrium-aluminum-garnet (Nd:YAG) laser application for root surface conditioning. METHODS: Forty-two intrabony defects in 21 patients with chronic periodontitis were randomly assigned to an access flap surgery with application of Nd:YAG laser (1 W, 10 Hz, 100 mJ, 1064 nm) and EMP (test group), and on the contralateral defect to an access flap surgery with application of EDTA and EMP alone (control group). Clinical periodontal parameters were assessed at baseline and after 6 and 12 months. RESULTS: Both treatments yielded significant improvements in terms of decrease in probing depth (PD) and gain in clinical attachment level (CAL) compared to baseline values. At 12 months after therapy, in the test group, the mean PD value was reduced from 7.3 ± 0.6 to 3.3 ± 0.4 mm and the mean CAL value changed from 9.5 ± 0.7 to 6.9 ± 0.7 mm (P <0.001). The sites treated with EMP (control) showed a reduction in mean PD value from 7.3 ± 0.7 to 3 ± 0.4 mm and a change in mean CAL value from 9.3 ± 0.8 to 6.4 ± 0.5 mm (P <0.001). The control group showed a greater reduction in PD and gain in CAL compared to the test group (P <0.05). CONCLUSION: Within the limits of the present study, it may be concluded that both therapies led to improvements of the clinical parameters, and Nd:YAG laser root conditioning as used in this study compared to EDTA root conditioning did not improve the outcome of EMP use.

Clinical evaluation of Er:YAG, Nd:YAG, and diode laser therapy for desensitization of teeth with gingival recession.

OBJECTIVES: The aim of this study was to evaluate the effectiveness of three types of lasers, Er:YAG, Nd:YAG, and GaAlAs (Diode), as dentin desensitizers, as well as to determine both the immediate and late therapeutic effects on teeth with gingival recessions. MATERIALS AND METHODS: The study was conducted on 24 patients with 96 teeth with Miller's class I or class II gingival recessions with clinically elicitable dentin hypersensitivity (DH) divided into three test groups: (A) Er:YAG, 2,940 nm, 60 mJ/pulse, 2 Hz, 20 s; (B) Nd:YAG, 1,064 nm, 100 mJ/pulse, 15 Hz, 100 s, (C) diode; 808 nm, 100 mW, 20s; and one control group (d) control not irradiated. DH was assessed by means of air stimulus. A visual analogue scale (VAS) was used to measure DH. The selected teeth in three groups received laser therapy for three sessions. The measurements were performed before each treatment session and at 30 min after the laser application (immediate effect), and additional measurements were also performed at 15, 30, and 60 days after the conclusion of treatment (late effect) to assess the extent of desensitization obtained with the different laser devices. RESULTS: Significant reduction of DH occurred at all times measured during the three treatment sessions in groups treated with Er:YAG, Nd:YAG, and diode lasers. Comparing the means of the responses in the three treatment sessions of the four groups, Group b showed a higher degree of desensitization in teeth with gingival recession compared with the other groups (p < 0.001). The immediate and late therapeutic effects of group b were more evident compared with the other groups. CONCLUSIONS: The Er:YAG, Nd:YAG, and diode lasers can be used to reduce DH. Nd:YAG laser irradiation is more effective in the treatment of DH than are Er:YAG and diode laser. Within the limitations of the present study, the Nd:YAG laser seems to be a suitable tool for successful reduction of DH, especially because the 3-month results of this treatment modality are promising.

Root surface biomodification with Nd:YAG laser for the treatment of gingival recession with subepithelial connective tissue grafts.

BACKGROUND/AIM: Root surface biomodification has been used to treat gingival recession and periodontitis. The principle for this procedure is that removing the smear layer from the root surfaces exposes collagen fibers, which leads to improved healing. Clinical studies generally have failed to find any improvement in clinical parameters when using such procedures, however. The aim of this study was to evaluate and compare the outcome of gingival recession therapy using the subepithelial connective tissue graft (SCTG) with or without Nd:YAG laser application for root surface biomodification. MATERIALS AND METHODS: Thirty-four teeth in 17 patients with Miller Class 1 and 2 recession were treated with SCTG with (test group) or without (control group) the application of Nd:YAG laser (1 W, 10 Hz, 100 mj, 60 s, 1064 nm). Clinical attachment level (CAL), recession depth (RD), recession width (RW), and probing depth (PD) were measured at baseline and six months postsurgery. RESULTS: Both treatments yielded significant improvements in terms of RD and RW decrease and CAL gain compared to baseline values. For test and control groups, the average root coverage was 33% and 77%, respectively (p < 0.05), and the complete root coverage was 18% and 65%, respectively (p < 0.05). The control group showed a greater reduction in RD and RW compared with the test group (p < 0.05). CONCLUSIONS: The use of Nd:YAG laser as a root surface biomodifier negatively affected the outcome of root coverage with the SCTG.

Root surface biomodification with an Er:YAG laser for the treatment of gingival recession with subepithelial connective tissue grafts.

BACKGROUND/AIM: Root surface biomodification has been used to treat gingival recession and periodontitis. The principle for this procedure is that removing the smear layer from the root surfaces exposes collagen fibers, which leads to improved healing. Clinical studies generally have failed to find any improvement in clinical parameters when using such agents. The aim of this study was to evaluate and compare the outcome of gingival recession therapy using the subepithelial connective tissue graft (SCTG) with or without Er:YAG laser application for root surface biomodification. MATERIALS AND METHODS: Twenty-four teeth in 12 patients with Miller class I and II recession were treated with SCTG with (test group) or without (control group) the application of an Er:YAG laser (2 Hz, 60 mJ/pulse, 40 s, with air spray). Clinical attachment level (CAL), recession depth (RD), recession width (RW), and probing depth (PD) were measured at baseline and 6 months postsurgery. RESULTS: There were no significant differences between test and control groups (p > 0.05). Postoperatively, significant root coverage, gains in CAL, and highly significant increases in the RW were observed in both groups. For test and control groups, the average root coverage was 80% and 86%, respectively (p > 0.05), and complete root coverage was 75% and 67%, respectively. CONCLUSIONS: The present study showed that root surface conditioning with an Er:YAG laser does not enhance the results achieved when SCTG was performed alone.

Self-inflicted gingival injury due to habitual fingernail scratching: a case report with a 1-year follow up.

Injuries to oral soft-tissues can occur due to accidental, iatrogenic, and factitious traumas. Traumatic lesions, whether chemical, physical, or thermal in nature, are among the most common in the mouth. A type of physical injury to the gingival tissues is self-inflicted. Sometimes the lesions are termed gingivitis artefacta. Self-inflicted gingival injuries in children and adolescents can occur as a result of accidental trauma, premeditated infliction, or chronic habits such as fingernail biting, digit sucking, or sucking on objects such as pens, pencils or pacifiers. The purpose of this case report was to illustrate the destructive nature of the habit and to describe the successful treatment of this case. A 14-year-old girl with moderate pain, gingival bleeding and recession in the anterior mandibulary region was admitted to periodontology clinic. Upon questioning, the patient readily admitted traumatizing her gingiva with her fingernail. Treatment consisted of oral hygiene instruction, mechanical debridement, psychological support and surgical periodontal treatment. Postoperatively, complete root coverage, gains in clinical attachment levels, and highly significant increases in the width of keratinized gingiva were observed. This case report shows that it is possible to treat gingival injury and maintain the periodontal health of a patient with destructive habit. Patient compliance, regular dental follow-ups, and psychological support may be useful in stabilizing the periodontal condition of these patients. Dentists must be aware that self-inflicted gingival injury, although thought to be uncommon, is quite widespread.

Capillary hemangioma as a rare benign tumor of the oral cavity: a case report.

INTRODUCTION: Hemangioma is a relatively common benign proliferation of blood vessels that primarily develops during childhood. Two main forms of hemangioma recognized: capillary and cavernous. The capillary form presents as a flat area consisting of numerous small capillaries. Cavernous hemangioma appears as an elevated lesion of a deep red color, and consists of large dilated sinuses filled with blood. The purpose of the study was to report the case of a capillary hemangioma in a patient and to describe the successful treatment of this case. CASE PRESENTATION: The patient was a 19-year-old female who presented herself to the Atatürk University, Faculty of Dentistry, Department of Periodontology, with the complaint of bleeding and slowly enlarging mass on the upper right molar region. The lesion was diagnosed as capillary hemangioma after clinical examination and biopsy. Treatment consisted of scaling, root planning and surgical excision. Four months after surgery healing was occurred and two years later area of the lesion appeared completely normal as clinically. CONCLUSIONS: The surface is highly keratinized and no further growth was evidenced during the two year of follow-up. Early detection and biopsy is necessary to determine the clinical behavior of the tumor and potential dentoalveolar complications.