Adjunctive use of laser biostimulation with nonsurgical periodontal therapy: a split-mouth, randomized, case-control study in diabetic and nondiabetic periodontitis patients.

Background/aim: Laser biostimulation therapy (LBT) is suggested to have positive effects on periodontal healing. This study evaluated LBT with nonsurgical periodontal therapy (NSPT) in diabetes mellitus (DM) and systemic health (SH) conditions. Materials and methods: Thirty periodontitis patients (15 with DM and 15 with SH) were included in the study, which had a split-mouth design, by applying LBT in the mouth of the same systemic condition. Thus, 4 study groups were formed, as 1) NSPT - DM: NSPT alone in DM, 2) NSPT + LBT - DM: NSPT + LBT application in DM, 3) NSPT - SH: NSPT alone in SH, and 4) NSPT + LBT - SH: NSPT + LBT application in SH. NSPT was performed on days 15, 30, 37, 44, 51, 58, and 65. LBT was performed 6 times on days 30, 37, 44, 51, 58, and 65 with an Nd:YAG laser. The plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) were assessed as the clinical parameters and recorded at baseline and days 30, 37, and 72. Gingival crevicular fluid levels of interleukin 1 beta (IL-1ß) and IL-10 were evaluated by ELISA as the biochemical parameters at baseline and on days 30, 37, and 72. Results: Clinical parameters had improved in all of the groups on day 72 (p < 0.01). PPD and CAL improved more in the DM group with NSPT and LBT group than in the DM group with NSPT without LBT on day 37 (p < 0.05). IL-1ß decreased and IL-10 increased in all of the groups on day 72 (p < 0.01). This change was more evident in the DM group with NSPT and LBT than in the DM group with NSPT without LBT on day 7 (p < 0.05). Conclusion: These results revealed the short-term impacts of LBT on periodontal healing, which return to ineffectiveness with repeated irradiation. Therefore, it may be speculated that LBT via the protocol herein may have a short-term antiinflammatory contribution to NSPT, only in impaired healing conditions such as DM.

Effects of periodontal and bisphosphonate treatment on the gingival crevicular levels of sclerostin and dickkopf-1 in postmenopausal osteoporosis with and without periodontitis.

OBJECTIVE AND BACKGROUND: Both periodontitis and osteoporosis are associated with osteoclast-related bone resorption. Bone metabolism is regulated by wingless-type MMTV integration site family (WNT), and WNT/ß-catenin signals are controlled by physiological antagonists including dickkopf-1 (DKK-1) and sclerostin (SOST). This study examined the effects of periodontal and bisphosphonate (BP) treatment on the gingival crevicular fluid (GCF) sclerostin (SOST) and dickkopf-related protein-1 (DKK-1) levels in osteoporotic and systemically healthy postmenopausal women with and without periodontitis. MATERIALS AND METHODS: A total of 48 postmenopausal women were divided into 4 groups (n = 12) according to periodontal health and osteoporosis status, as follows: Group OP/P: subjects with both osteoporosis and periodontitis; Group P: systemically healthy subjects with periodontitis; Group OP: periodontally healthy subjects with osteoporosis; Group H: systemically and periodontally healthy controls. Clinical data and GCF SOST and DKK-1 levels of the participants were collected at baseline and at 6 and 12 months following the initiation of periodontal and/or BP treatment in the experimental groups. GCF SOST and DKK-1 data were obtained by ELISA. RESULTS: Clinical improvements were observed in all experimental groups. GCF SOST and DKK1 baseline levels varied significantly between groups due to periodontal disease (p < .001). Following treatment, significant increases in SOST and DKK-1 concentrations and significant decreases in total amounts of SOST were observed in both periodontitis groups (OP/P, P). However, while total amounts of DKK-1 decreased in Group OP/P, in Group P, these amounts had significantly increased at 12 months post-treatment (p < .05). At both 6 and 12 months post-treatment, SOST and DDK1 total amounts in Groups OP/P, OP, and H were similar (p > .05), whereas significant differences were observed between Groups H and P, indicating a deviation from periodontal health in Group P (p < .01). CONCLUSIONS: Significant changes in GCF SOST and DKK-1 levels were observed among women with osteoporosis who received both periodontal and BP treatment. A more detailed examination of how these treatment protocols can be combined may lead to new therapeutic approaches towards periodontal disease.

Effects of grape seed extract on periodontal disease: an experimental study in rats.

OBJECTIVE: This study aimed to demonstrate the effect of grape seed extract (GSE) on periodontitis. MATERIAL AND METHODS: Ligature induced periodontitis was created in 40 rats and they were assigned to four equal groups. One group was fed laboratory diet (group A) while three groups received GSE additionally. Silk ligatures were placed around the cervical area of the mandibular first molars for four weeks to induce periodontitis. The GSE groups were reallocated regarding GSE consumption as: for two weeks before ligation (group B; totally eight weeks), from ligation to two weeks after removal of the ligature (group C; totally six weeks), and for two weeks from ligature removal (group D; totally two weeks). Sections were assessed histologically and immunohistochemically. Inflammatory cell number (ICN), connective tissue attachment level (CAL), osteoclast density (OD), IL-10 and TGF-ß stainings in gingival epithelium (GE), connective tissue (GC), and periodontal ligament (PL) were used as the study parameters. RESULTS: Lower ICN, higher CAL, and lower OD were observed in the GSE groups (p<0.05). IL-10 was more intensive in the GSE groups and in the GEs (p<0.05). Group B showed the highest IL-10 for PL (p<0.05). TGF-ß was higher in the GEs of all groups (p<0.017). CONCLUSIONS: The results suggest anti-inflammatory activities of GSE, but further investigations are needed for clarification of these activities.

Effects of grape seed extract on periodontal disease: an experimental study in rats

Abstract Natural compounds capable of modulating the host response have received considerable attention, and herbal products are suggested as adjunctive agents in periodontal disease treatment. Objective This study aimed to demonstrate the effect of grape seed extract (GSE) on periodontitis. Material and Methods Ligature induced periodontitis was created in 40 rats and they were assigned to four equal groups. One group was fed laboratory diet (group A) while three groups received GSE additionally. Silk ligatures were placed around the cervical area of the mandibular first molars for four weeks to induce periodontitis. The GSE groups were reallocated regarding GSE consumption as: for two weeks before ligation (group B; totally eight weeks), from ligation to two weeks after removal of the ligature (group C; totally six weeks), and for two weeks from ligature removal (group D; totally two weeks). Sections were assessed histologically and immunohistochemically. Inflammatory cell number (ICN), connective tissue attachment level (CAL), osteoclast density (OD), IL-10 and TGF-β stainings in gingival epithelium (GE), connective tissue (GC), and periodontal ligament (PL) were used as the study parameters. Results Lower ICN, higher CAL, and lower OD were observed in the GSE groups (p<0.05). IL-10 was more intensive in the GSE groups and in the GEs (p<0.05). Group B showed the highest IL-10 for PL (p<0.05). TGF-ß was higher in the GEs of all groups (p<0.017). Conclusions The results suggest anti-inflammatory activities of GSE, but further investigations are needed for clarification of these activities.

8-hydroxy-deoxyguanosine levels in gingival crevicular fluid and saliva in patients with chronic periodontitis after initial periodontal treatment.

BACKGROUND: This study evaluates the effects of initial periodontal treatment on the gingival crevicular fluid (GCF) and salivary levels of 8-hydroxy-deoxyguanosine (8-OHdG) as a marker of oxidative deoxyribonucleic acid (DNA) damage in patients with chronic periodontitis (CP). METHODS: At baseline, clinical parameters were determined and GCF and saliva samples were obtained from 24 patients with CP and 24 individuals with clinically healthy periodontium. GCF, saliva samples, and clinical periodontal measurements were repeated at day 10, 1 month, and 3 months following initial periodontal therapy in patients with CP. 8-OHdG levels of GCF and saliva samples were investigated by using an enzyme-linked immunosorbent assay. RESULTS: Statistically significant higher 8-OHdG levels of GCF and a significant decrease after initial periodontal therapy were determined in the CP group (P <0.001). A significant positive correlation was found between 8-OHdG levels of GCF and clinical periodontal measurements (P <0.001). However, salivary levels of 8-OHdG did not differ between groups or during initial periodontal therapy (P >0.05). CONCLUSIONS: This study reveals that DNA injury and oxidative stress increase in tissue cells and especially in periodontal pockets in patients with CP, and the periodontal treatment results in a significant decrease of 8-OHdG levels in the GCF samples. To the best of our knowledge, this study evaluates for the first time, 8-OHdG levels in GCF, which is shown to be more useful as a biomarker than saliva. 8-OHdG was found to be important and may reveal the severity of periodontal disease and the effect of periodontal therapy.

Oral and dental manifestations of diamond-blackfan anemia: case reports.

Diamond-Blackfan Anemia (DBA) is a red cell aplasia characterized with physical abnormalities. The incidence of the disease is reported to be five to seven (5-7) cases per million births in Europe and 4-5 per million live births in the UK and Netherlands with equal sex ratio. It was first recognized in 1938 but an exact pathophysiology of the disease has not been described yet. These abnormalities are well known, however, detailed oral and dental conditions related with the disease have not been described previously. We herein presented two cases of DBA together with oral and dental findings. Our study is first to report the gingival status of the patients with a complete investigation of any orthodontic or dental abnormalities in these kind of patients. A careful follow up and preventive therapies should not be missed in these kind of patients.

A Case Report of Focal Epithelial Hyperplasia (Heck's disease) with PCR Detection of Human Papillomavirus.

Focal epithelial hyperplasia or Heck's disease, is a rare viral infection of the oral mucosa caused by human papillomavirus. The frequency of this disease varies widely from one geographic region to another. In Caucasians there have been only few cases reported. This paper reports a case of focal epithelial hyperplasia and demonstrates the association with HPV subtype 32 through polymerase chain reaction (PCR) and sequencing of PCR products. A 7-year-old Caucasian girl was admitted to our clinic for investigation of multiple oral mucosal lesions in the mouth. Lesion was excised under local anesthesia without any complication. The lesion was diagnosed as focal epithelial hyperplasia according to both clinical and histopathological features. Dental staff should be aware of these kind of lesions and histopathological examination together with a careful clinical observation should be carried out for a definitive diagnosis.

Peripheral giant cell granuloma associated with dental implants: a rare case report.

The peripheral giant cell granuloma is a benign reactive exophytic lesion of unknown etiology occurring on the gingiva and alveolar ridge. Different local causal factors have been associated with this type of lesion. Although peripheral giant cell granuloma is the most common giant cell lesion of the jaws, it is rarely seen in association with implants. This report discusses the etiology and management of a peripheral giant cell granuloma around dental implants in a 60-year-old woman. A new implant-supported prosthesis with adequate marginal adaptation between the restoration and abutments was made. There were no complications during 1 year of clinical and radiologic follow-up.

The effects of combination treatment with a long-acting beta2-agonist and a corticosteroid on salivary flow rate, secretory immunoglobulin A, and oral health in children and adolescents with moderate asthma: a 1-month, single-blind clinical study.

BACKGROUND: Asthma is a common chronic disorder of childhood, and it is frequently accompanied by dental and other oral abnormalities. As such, oral and dental effects of asthma medications have been investigated in several studies. However, the effect of combination therapy with a long-acting beta(2)-agonist and a corticosteroid on oral health in children and adolescents has not been reported in the literature. OBJECTIVE: The aim of this study was to examine whether combination treatment with a long-acting beta(2)-agonist (salmeterol) and a corticosteroid (fluticasone propionate) administered by dry powder inhaler (DPI) affects oral health in children and adolescents with moderate asthma. METHODS: This 1-month, single-blind clinical study was conducted at the Department of Periodontology, Ondokuz Mayis University Faculty of Dentistry, Samsun, Turkey. Male and female children and adolescents aged 7 to 17 years with moderate persistent asthma, as classified by the Global Initiative for Asthma guidelines, were studied before and after 1 month of treatment with combination salmeterol 50 microg and fluticasone propionate 100 mug administered by DPI BID. Salivary flow rate and secretory immunoglobulin A (sIgA) level were measured, and periodontal health was assessed by gingival and dental plaque indices for buccal surfaces and periodontal pocket depth. RESULTS: The study enrolled 15 children and adolescents (8 girls, 7 boys; mean [SD] age, 11 years [45 months]; median age, 13 years; [range, 7-17 years]). At 1 month, mean sIgA, gingival index, buccal surface index, gingival index, dental plaque index, and periodontal pocket depth were not changed significantly from baseline, whereas mean (SD) salivary flow rate was significantly decreased (from 153.21 [39.29] to 113.16 [46.99] microL/5 s; P = 0.015) and dental plaque index on the buccal surface was significantly increased (from 1.43 [0.63] to 1.61 [0.67]; P = 0.01). CONCLUSIONS: In this small study, combination treatment with salmeterol 50 microg and fluticasone propionate 100 microg inhaled twice daily was associated with changes in oral health among these children and adolescents with moderate asthma. Regular follow-up of oral health status may be warranted in children and adolescents during long-term use of a long-acting beta2-agonist and a corticosteroid.

The treatment of unusual foreign objects in a root canal: a case report.

A 14-year-old female with a history of unsuccessful endodontic treatment of a maxillary central incisor was referred for treatment. Radiographic examination showed an unusual foreign object in the root canal. This report describes the permanent successful treatment of the tooth.

Oral and dental findings in Fanconi's anemia.

Fanconi's anemia is an autosomal recessive disorder characterized by progressive pancytopenia and congenital malformation of the skeleton. This study investigated the oral health status of 15 children with Fanconi's anemia, including oral lesions, gingival and periodontal status, and dental abnormalities. All children in the group were found to have a tendency to develop tooth decay and were in need of dental treatment. Two had aggressive periodontitis. In one patient supernumerary teeth were found, while in another teeth were congenitally missing. The increased tendency toward periodontal disease in patients with Fanconi's anemia may be due not only to the anemia, leukopenia, and defective detoxification of oxygen radicals that are characteristic of the disease itself, but also to medications applied during intense immunosuppressive treatment, such as prednisolone.