Effectiveness of periodontal therapies on the treatment of different aetiological factors induced gingival overgrowth in puberty.

OBJECTIVES: The aim of the present study was to compare oral improvement achieved by different periodontal therapies (surgical and non-surgical) for different aetiological factors induced gingival overgrowth in 60 subjects (mean age +/- SD = 12.33 +/- 1.05 years; age range = 12-15 years). METHODS: Subjects received oral hygiene instructions, scaling, surgical treatment (if necessary) and periodontal maintenance therapy. Clinical parameters were taken at baseline, after initial treatment and after periodontal surgery. RESULTS: The decrease in the clinical index values after all treatments compared to the initial values is found to be statistically significant (P < 0.05). Although there was a statistically significant difference in all aspects of the clinical index values of the study groups after initial treatments, for drug-induced gingival overgrowth subjects full improvement was seen only after periodontal surgery. CONCLUSION: Attention to plaque control and removal of local irritants is very important for the gingival health of the patients in puberty. In puberty, plaque-induced gingival overgrowth can be treated with plaque removal. However, these approaches alone do not prevent drug-induced gingival overgrowth and surgical therapy often becomes the treatment of choice.

Effects of zinc deficiency on oral and periodontal diseases in rats.

BACKGROUND AND OBJECTIVE: The aim of this study was to investigate the alterations of oral and periodontal tissues in zinc-deficient rats compared with control rats. MATERIAL AND METHODS: The study was carried out on 14 Sprague-Dawley rats, cessation of lactation on the 24th day after birth. Rats were randomly divided into two groups. Group I rats were fed with a zinc-deficient diet and group II rats were fed with a zinc-containing diet. At the end of the fourth week on experimental diets, alterations of the oral tissues in both groups were recorded. In addition, the gingival index (GI-Löe-Silness), plaque index (PI-Silness-Löe) and periodontal pocket depth scores were recorded in order to assess periodontal tissue health in the rats. Then, blood samples were taken and the serum zinc levels measured by atomic absorption spectrophotometry. At the end of the experiment, oral tissue samples were investigated by light microscopy. Finally, the results of the two groups were compared by using the Student's t-test. RESULTS: The effects of zinc deficiency were observed at 10-16 d in rats. Although body weight, body length and tail length were retarded in zinc-deficient rats, they were advanced in rats fed with a zinc-containing diet. The mean plaque index and gingival index for group II rats were significantly lower than for group I rats (p<0.001), but there was no significant difference regarding pocket depth between the two groups of rats (p>0.05). Aphthous ulcer was often seen in the study group, where it was observed on the alveolar mucosa with a high rate of 29.9%. According to histological findings, there was no difference related to the epithelial keratinization of the hard palate between the two groups. However, hyperkeratosis was found on the dorsal surface of the tongue in zinc-deficient rats. CONCLUSION: The findings indicated that oral health was better in group II rats (those fed with a zinc-containing diet) than in group I (zinc-deficient) rats. Hyperkeratinization was more prominent in zinc-deficient rats. We suggest that zinc deficiency is a potential risk factor for oral and periodontal diseases.

Effect of oral hygiene instruction and scaling on oral malodour in a population of Turkish children with gingival inflammation.

AIM: Oral malodour affects a large proportion of the population, and may cause a significant social or psychological handicap to those suffering from it. The condition has a positive correlation with the accumulation of bacterial plaque in the oral cavity. The aim of the present study was twofold: first, to determine whether oral malodour and periodontal disease parameters are associated with one another in 150 Turkish subjects (mean age +/- SD = 9.1 +/- 2.7 years; age range = 7-12 years); and secondly, to investigate the impact of oral hygiene instruction and scaling on oral malodour. DESIGN: The parameters measured included whole-mouth odour judge scoring, halimeter measurements, saliva pH scores, gingival index, plaque index, and probing depth before and after the treatment procedures. RESULTS: Odour judge scores were significantly associated with halimeter findings. However, gingival index, plaque index and probing depth were significantly associated with odour judge scores and halimeter scores. The statistical analysis revealed that periodontal treatments caused a significant reduction (P < 0.001) in volatile sulphur compound formation. CONCLUSION: These results suggest that, in the population studied, periodontal health and oral malodour are associated with one another. Oral malodour levels were significantly reduced after treating gingival inflammation. Thus, in order to avoid oral malodour in children, oral care should not be neglected.

Gingival necrosis following the use of a paraformaldehyde-containing paste: a case report.

AIM: To report on an unusual case of gingival necrosis following the use of a paraformaldehyde-containing paste in root canal treatment. SUMMARY: Paraformaldehyde preparations are toxic to hard and soft tissues. In an era of effective local anaesthesia, toxic devitalizing preparations have few applications. However, in a mobile world population, severe tissue injury may occasionally be encountered after the use of paraformaldehyde or other toxic agents in some parts of the world. Dentists should avoid such preparations and be alert of the features and management of local toxicity if they encounter it in practice. KEY LEARNING POINTS: Paraformaldehyde-containing pastes have no application in contemporary dentistry. Dentists should avoid toxic preparations for pulp devitalization. Dentists should be aware of the features and management of tissue necrosis resulting from the use of toxic dressing materials.

Epidemiological features of ulcerative colitis in Trakya, Turkey.

To determine the epidemiological features of ulcerative colitis in the Trakya region of Turkey, southeast Europe, we conducted a descriptive, cross-sectional, hospital-based study. All subjects were followed, and age, sex, place of residence, family history, educational status, tobacco consumption and use of oral contraceptives were recorded. The study included 49 cases of ulcerative colitis. The incidence of the disease was 0.59 per 100,000 in 1998, 0.89 per 100,000 in 1999, 0.89 per 100,000 in 2000 and 0.69 per 100,000 in 2001. The overall prevalence of the disease was 4.9 per 100,000; it was 2.18 per 100,000 in rural areas and 5.87 per 100,000 in urban areas. As in the Mediterranean countries, both the incidence and the prevalence of ulcerative colitis were found to be low. The incidence was significantly higher in urban areas than in rural areas.

The influence of smoking and non-insulin-dependent diabetes mellitus on periodontal disease.

The periodontal health of smokers and non-smokers with non-insulin-dependent diabetes mellitus (NIDDM) and non-smokers with periodontitis who were not suffering from a systemic disease was assessed. The investigation was carried out on 60 adult subjects. Levels of blood glucose, glycosylated haemoglobin and immunoglobulins G, A and M were determined, together with the plaque index, gingival index, probing pocket depths and clinical attachment level. Periodontitis was more severe in smokers and non-smokers with NIDDM than non-smokers without NIDDM, and the periodontal condition (clinical attachment level, probing pocket depth and gingival bleeding) was better in non-smokers with NIDDM than smokers with NIDDM. The results suggest that diabetes and smoking are high-risk factors for periodontal disease.

The effect of right or left-handedness on oral hygiene.

It has been shown that there is a strong relation between periodontal diseases and bacterial plaque with clinical and experimental studies. According to scientific data, the best way to protect against the periodontal diseases is to remove bacterial plaque from tooth surface mechanically. To remove bacterial plaque from tooth surface completely, the patient must have good hand skill and motivation in addition to professional treatment. The aim of our study was to examine whether there is a difference between the left-handed who are known as skillful at drawing, geometry, and graphics and the right-handed at oral hygiene check. The study included 28 persons, 12 female and 16 male, ranging in age from 19 to 26. Subjects were divided into two groups according to their right or left hand use. Being right- or left-handed was determined with Edinburgh Handedness Inventory (Oldfield). Both groups were given oral hygiene education with a systematic treatment at the beginning of the study. At the beginning of the study, GI (Silness-Löe) and PI (Quigley-Hein) scores were taken from all subjects. Then, those scores were repeated in the 1st and 3rd month. Received scores were evaluated statistically with Wilcoxon test. While there was no statistical difference between both groups initially p > .05, there was a statistical difference between them in the 1st and 3rd month in favour of the left-handed p < .05. Consequently, it was found that the left-handed were more successful at oral hygiene check than the right-handed.

Clinical evaluation of an electron-ionizing toothbrush with a tooth paste containing stannous fluoride in treatment of dentine hypersensitivity following periodontal surgery.

The purpose of this study was to examine the effect of an electro-ionizing toothbrush with stannous fluoride in the treatment of dentin hypersensitivity following periodontal surgery. Thirty-two volunteers with dentin hypersensitivity were divided in two equal groups each using different methods: (Group I) stannous fluoride dentifrice and hyG Brnde ionizing brush without a battery and (Group II) stannous fluoride dentifrice and hyG Brnde ionizing brush with a battery. The volunteers brushed their teeth for 3 minutes twice a day for 12 weeks following one either of the test protocols. Mechanical (No 23 dental explorer), chemical (lemon juice) and thermal (dental air-water syringe) tests were used for the evaluation of the degree of dentin hypersensitivity. A subjective assessment of the degree of hypersensitivity for each stimulus was recorded. The evaluations were repeated at 4, 8 and 12 weeks after surgical treatment. The second group showed significantly less sensitivity than the first group. The findings appear to suggest that the ionizing brush may be an effective adjunct for the treatment of dentin hypersensitivity in post-periodontal surgery.

Evaluation of gingival recession in left- and right-handed adults.

Recession is the exposure of the root surface by an apical shift in the position of the gingiva. Several factors have been implicated in the etiology of gingival recession. The aim of this study was to assess the relationship between gingival recession and the hand, right or left, duration, frequency, and technique of tooth brushing in left- and right-handed adults in Erzurum, Turkey. Fifty five left-handed (35 female and 20 male) and 55 right-handed (35 female and 25 male) subjects were included in the study. The left and right hand positions of the subjects were determined by using Oldfield's Edinburg Inventory Index, and they were divided into two groups as left-handed and right-handed. The amount of gingival recession and localization, oral hygiene situations, gingival bleeding, toothbrushing duration, frequency, and techniques of subjects were evaluated. The relationship between the amount of gingival recession and localization and the subjects' hand, duration, frequency and technique of tooth brushing were examined. The data were evaluated with variance analysis and student's t test. The oral hygiene situations in right- and left-handed subjects were determined. On comparing the left-handed subjects with the right-handed ones, it was observed that the left-handed subjects had better oral hygiene than the right-handed. But, this case was not statistically significant (p > .05). In both right-handed and left-handed subjects, women had better oral hygiene than men (p < .01). The rate of gingival recession was found more in the left-handed than in the right-handed (p < .05). In the right-handed subjects, gingival recession was found in the premolar and canine regions of upper right and lower right jaw. A similar result was also observed in the left-handed subjects, because gingival recession was seen on their upper left and lower left jaw. Incisive teeth were affected at the same rate in the left-handed and right-handed. The gingival recession was seen more in maxillary jaw than in mandibular jaw in both groups. A statistically significant relationship between gingival recession and frequency duration, and technique of tooth brushing was found. While the greatest amount of gingival recession was found in horizontal scrub technique, gingival recession increased with increasing tooth brushing duration and frequency. The relationship between gingival recession and hand using in tooth brushing was determined.

Frequency dependence of sonophoresis.

PURPOSE: Application of low-frequency ultrasound has been shown to increase skin permeability, thereby facilitating delivery of macromolecules (low-frequency sonophoresis). In this study, we sought to determine the dependence of low-frequency sonophoresis on ultrasound frequency, intensity and energy density. METHODS: Pig skin was exposed to low-frequency ultrasound over a range of ultrasound frequency and intensity conditions. The degree of skin permeabilization was measured using its conductivity. Imaging experiments were also carried out to visualize the transport pathways created by ultrasound. RESULTS: The data showed that for each frequency (in the range of 19.6-93.4 kHz), there exists a threshold intensity below which no detectable conductivity enhancement was observed. The threshold intensity increased with frequency. It is feasible to achieve the desired conductivity (permeability) enhancement regardless of the choice of frequency, although the necessary energy density is higher at higher frequencies. Low frequencies (approximately 20 kHz) induced localized transport compared to a more dispersed effect seen with higher frequencies (approximately 58.9 kHz). CONCLUSIONS: This study provides a quantitative understanding of the effects of low-frequency ultrasound on skin permeability.

Transrectal ultrasound in the diagnosis and management of inflammatory bowel disease.

BACKGROUND AND STUDY AIMS: To aim of the present study was to determine the value of transrectal ultrasonography (TRUS) in the assessment of disease activity in ulcerative colitis patients, and in differentiating between mucosal inflammation and transmural inflammation. PATIENTS AND METHODS: TRUS examinations were used to study 30 control individuals and 76 patients with inflammatory bowel disease, including 50 cases of ulcerative colitis and 26 of Crohn's disease. A rigid linear endorectal probe was used to examine the rectal wall. RESULTS: In the 30 control individuals, the rectal wall showed five layers, with a mean total diameter of 2.6 mm. There were significant differences between patients with quiescent ulcerative colitis, active ulcerative colitis, and control individuals with regard to the total rectal wall thickness (P<0.001), submucosal thickness (P<0.001) and mucosal thickness (P<0.001). Using cut-off values, differentiation between active ulcerative colitis and remission ulcerative colitis was found to be 100% specific and 73 % sensitive for submucosal thicknesses. TRUS revealed a 100% specificity in differentiating between remission ulcerative colitis and control cases based on the total rectal wall thickness, submucosal, and mucosal thicknesses. In the differential diagnosis of active and remission ulcerative colitis, an increase in submucosal wall thickness and the existence of arterial and venous capillary flow in the submucosa were found to be specific and more sensitive than the other parameters. TRUS examination revealed transmural inflammation in 21 of the 26 Crohn's disease patients, and mucosal inflammation in all 50 of the ulcerative colitis patients. CONCLUSION: TRUS is a reliable and easy method of assessing ulcerative colitis activity and differentiating between rectal diseases.

Thrombophilia and inflammatory bowel disease: does factor V mutation have a role?

BACKGROUND: An increased tendency for thromboembolism is a well known problem of inflammatory bowel disease (IBD). Microvascular thrombosis has also been claimed as a pathogenic factor in IBD. Recently a point mutation in the gene coding factor V (FV Leiden) has been identified in various thromboembolic diseases, but the role in IBD is unknown. OBJECTIVE: To determine the frequency of FV Leiden in IBD patients and compare with a group of controls. METHODS: Sixty-three IBD patients [43 ulcerative colitis (UC) patients and 20 Crohn's disease (CD) patients] and 36 healthy controls were included in the study. Only one of the UC patients had a history of cerebral thromboembolism. The extracted DNA from frozen blood was subjected to polymerase chain reaction for the amplification of FV gene. The amplicons were hybridized both with the mutant and wild-type probes to detect FV mutation. Readings of optical density above 0.3 were considered as positive results. According to the patterns of ELISA, heterozygosity and homozygosity for normal and mutant alleles were determined. RESULTS: Eight (18%) of UC patients were heterozygous normal and one (2%) patient had homozygous mutation. Eight (45%) of the 20 CD patients had a heterozygous pattern and one (5%) had a homozygous pattern. In the control group four (11%) subjects showed a heterozygous genotype. FV Leiden was found to be statistically more frequent in CD patients (P < 0.005) (odds ratio 6.5, 95% confidence interval 1.3-18.), but not in the UC patients as compared with controls (P> 0.05). There was no significant correlation between FV Leiden presence and disease activity, gender or disease duration for both UC and CD. CONCLUSION: The results suggest that FV Leiden is more frequent in CD patients, but not in the UC patients as compared with controls. The high rate of factor V mutation in our CD patients suggests the need for further studies to confirm a relationship between this mutation and aetiology of the disease.

Endoscopic treatment of bronchobiliary fistula: report on 11 cases.

BACKGROUND/AIMS: There are reports of treatment of biliary cutaneous fistulae by endoscopically placed nasobiliary drains. We report our fistulae treatment results from this method. MATERIALS AND METHODS: We treated 11 patients with bronchobiliary fistulas (BBFs) endoscopically during the last 6 years. In most cases, the BBF's were the result of Hydatid cyst operations. Six patients had simultaneous biliocutaneous fistula (BCF). RESULTS: All BBFs and BCFs closed after the nasobiliary drain placement without any complication. Three patients who developed fistula recurrence healed with endoscopic treatment. CONCLUSION: Endoscopic treatment is a viable alternative to surgical treatment.