Comparative examination of trabecular bone structure in healthy and diabetic patients with periodontitis using fractal analysis.

OBJECTIVES: Fractal analysis is a numerical method that indicates the structural patterns and complexity of the trabecular bone on radiographs. The aim of this cross-sectional study was to evaluate the trabecular bone structure in systemically healthy patients and diabetes mellitus patients with periodontitis using fractal analysis. METHOD AND MATERIALS: The study included 125 mandibular first molars of nonsmoker patients. The subjects were divided into five subgroups: diabetes mellitus patients with mild-moderate periodontitis, diabetes mellitus patients with advanced periodontitis, systemically healthy individuals with mild-moderate periodontitis, systemically healthy individuals with advanced periodontitis, and systemically healthy individuals with gingivitis (control group). Clinical periodontal parameters (pocket depth, bleeding on probing, clinical attachment loss, and bone loss) were recorded. Two specific sites located in the mesial-distal regions (n = 250) of the mandibular first molars were identified using periapical radiographs captured with a parallel technique. Fractal analysis values were calculated using the box-counting method. One-way analysis of variance (ANOVA), and Pearson correlation analysis were used for statistical evaluation. RESULTS: The highest fractal analysis values were observed in systemically healthy with gingivitis patients (mesial fractal analysis: 1.86 ± 0.01; distal fractal analysis: 1.85 ± 0.01). Patients with periodontitis (mesial fractal analysis: 1.78 ± 0.02; distal fractal analysis: 1.79 ± 0.01) exhibited lower fractal analysis values compared to the control group. There was no significant difference in mesial and distal fractal analysis values between all periodontitis groups. No correlation was found between age, sex, clinical attachment loss, bone loss, and fractal analysis (P > .05). CONCLUSIONS: Although fractal analysis values were lower in the periodontitis groups compared to the control group, fractal analysis did not demonstrate any periodontitis-associated changes of bone trabeculation in diabetes at any stage of periodontitis. Furthermore, there was no significant association between fractal analysis values and age, sex, clinical attachment, and bone loss.

Comparison of the effectiveness of Ankaferd Blood Stopper® and Emdogain in periodontal regeneration.

OBJECTIVES: The present study was performed to compare the effectiveness of Ankaferd Blood Stopper® (ABS) with enamel matrix derivatives (EMD) for treating fenestration defects in rats. MATERIALS AND METHODS: Forty-eight male Wistar rats were randomly divided into six groups (each n = 8). Fenestration defects were created in all rats, to which ABS, EMD, or saline (S) was then applied. The rats were grouped and sacrificed at one of two different time points, as follows: ABS-10-group, ABS-treatment/sacrifice on day 10; EMD-10-group, EMD-treatment/sacrifice on day 10; S-10-group, S-treatment/sacrifice on day 10; ABS-38-group, ABS-treatment/sacrifice on day 38; EMD-38-group, EMD-treatment/sacrifice on day 38; and S-38-group, S-treatment/sacrifice on day 38. Then, histomorphometric analysis including measurements of new bone area (NBA) and new bone ratio (NBR), and immunohistochemical analysis including the determination of osteopontin (OPN) and type-III-collagen (C-III) expression were performed. RESULTS: The NBA and NBR were significantly higher in the ABS-10-group and EMD-10-group compared to the S-10-group (p < .05), and in the EMD-38-group compared to the S-38-group (p < .05). The levels of C-III and OPN immunoreactivity were significantly higher in the ABS-10-group compared to the S-10-group (p < .017). CONCLUSIONS: The results of this study suggested that ABS can promote early periodontal regeneration, although its efficacy seems to decrease over time.

Clinical and biochemical evaluation of oral irrigation in patients with peri-implant mucositis: a randomized clinical trial.

OBJECTIVE: This randomized clinical trial aimed to compare the efficacy of an oral irrigator and an interdental brush in patients with peri-implant mucositis clinically and biochemically at different time points (at baseline and at the 2nd, 4th, and 12th weeks). MATERIALS AND METHODS: Forty-five patients with at least one implant with peri-implant mucositis were included in the present study (n = 45). The patients were divided into three groups: oral irrigator + toothbrush (OI group, n = 15), interdental brush + toothbrush (IB group, n = 15), and toothbrush only (control) (C group, n = 15). The modified plaque index (mPlI), modified sulcus bleeding index (mSBI), probing pocket depth (PPD), probing attachment level (PAL), and bleeding on probing (BOP) were recorded at baseline and at the 2nd, 4th, and 12th weeks. The levels of interleukin 1 beta (IL-1ß), transforming growth factor-beta (TGF-ß), tissue-type plasminogen activator (t-PA), and plasminogen activator inhibitor-1 (PAI-1) were also determined in the peri-implant crevicular fluid samples biochemically. RESULTS: The mSBI and t-PA at the 2nd week (p = 0.003; p = 0.003); the mPlI, mSBI, BOP, t-PA, and PAI-1 at the 4th week (p < 0.05; p < 0.001; p < 0.001; p = 0.015; p = 0.011); and the mPlI, mSBI, IL-1ß, t-PA, and PAI-1 at the 12th week (p < 0.05; p < 0.001; p = 0.013; p < 0.001; p = 0.002) were significantly lower in the OI group compared with those in the C group. Meanwhile, PAI-1 at the 2nd week, mSBI at the 4th week, and t-PA at the 12th week were significantly lower in the OI group compared with those in the IB group (p < 0.001; p = 0.011; p = 0.003). At the 2nd, 4th, and 12th weeks, all other parameters were not statistically different in the three groups. CONCLUSION: The clinical indexes (such as mSBI and BOP) that play an important role in the diagnosis of peri-implant mucositis showed the lowest means (although limited) in the OI group at all evaluation time points. Moreover, when the clinical and biochemistry results were interpreted altogether, it became apparent that the OI group exhibited similar or more effective results than the IB group in resolving peri-implant mucositis. In light of the foregoing, this study concluded that the use of an oral irrigator can be as effective as an interdental brush in interdental cleaning. CLINICAL RELEVANCE: In this study, it is suggested that the regular use of an oral irrigator along with a toothbrush could be an appropriate alternative to other oral hygiene products such as dental floss and interdental brush for the management of peri-implant mucositis by preventing the accumulation of dental plaque (NCT03844035).

Nonsurgical Periodontal Therapy Reduces Salivary and Gingival Crevicular Fluid YKL-40 and IL-6 Levels in Chronic Periodontitis.

PURPOSE: A novel acute-phase protein, YKL-40, is known as an inflammation-associated glycoprotein. YKL-40 is shown to be linked to inflammation, endothelial dysfunction and tissue remodeling secreted by various cells and is also considered to be stimulated by cytokines such as interleukin-6 (IL-6). The present study aimed to investigate YKL-40 and IL-6 levels in saliva and gingival crevicular fluid (GCF) of patients with chronic periodontitis (CP) after non-surgical periodontal therapy for the first time. MATERIALS AND METHODS: Twenty-six CP patients and 26 periodontally healthy individuals were enrolled. Clinical measurements were recorded; saliva and GCF samples were obtained at baseline and 1 and 3 months after non-surgical periodontal therapy. Levels of YKL-40 and IL-6 in saliva and GCF were analysed by ELISA. RESULTS: Salivary and GCF YKL-40 and IL-6 levels were found to be statistically significantly higher in CP patients compared to healthy controls at baseline (p < 0.001). At 1 and 3 months after the completion of treatment, both YKL-40 and IL-6 levels in saliva and GCF had statistically significantly decreased compared with baseline values in CP patients (p < 0.001). On the other hand, no statistically significant difference was observed between 1 and 3 months in terms of salivary and GCF YKL-40 and IL-6 levels or any of the clinical findings (p > 0.016). CONCLUSION: Salivary and GCF YKL-40 levels may be useful to evaluate resolution of periodontal inflammation. Within the limits of this study, YKL-40 acute-phase protein might be a potential biomarker for detection of periodontitis and monitoring the response to periodontal therapy.

The levels of visceral adipose tissue-derived serpin, omentin-1 and tumor necrosis factor-α in the gingival crevicular fluid of obese patients following periodontal therapy.

The aim of this clinical study was to determine levels of visceral adipose tissue-derived serpin (vaspin), omentin-1, and tumor necrosis factor-alpha (TNF-α) in the gingival crevicular fluid (GCF) of obese and non-obese periodontitis patients following nonsurgical periodontal therapy. Seventy-six subjects were separated into four groups according to periodontal and anthropometric measurements: a periodontal-healthy group, a chronic periodontitis (CP) group, a periodontal-healthy with obesity group, and a CP with obesity group. Nonsurgical periodontal treatment was administered to periodontitis patients. Before treatment and at 6 weeks after treatment, GCF samples were analyzed and clinical periodontal parameters were examined. Enzyme-linked immunosorbent assays were used to measure the levels of vaspin, omentin-1, and TNF-α. Obese and non-obese CP patients displayed higher levels of vaspin and TNF-α (P < 0.008), which declined following treatment (P < 0.025), and lower omentin levels (P < 0.008), which increased after treatment (P < 0.025). There was a negative correlation between the total amount of vaspin and omentin-1 in all groups. Obese and non-obese patients had opposing levels of vaspin and omentin-1 in the GCF; therefore, these may represent diagnostic and prognostic indicators of periodontal disease and therapeutic outcome.(J Oral Sci 58, 465-473, 2016).

Visfatin levels in gingival crevicular fluid and serum before and after non-surgical treatment for periodontal diseases.

The purpose of this study was to evaluate visfatin levels at different stages of periodontal disease and in healthy tissues. In addition, the effect of non-surgical periodontal therapy on visfatin levels in gingival crevicular fluid and serum was investigated. Forty-five patients were divided into three groups based on clinical and radiographical findings. Group 1 comprised periodontally healthy individuals (n = 15); group 2 comprised patients with gingivitis (n = 15); and group 3 was composed of patients with generalized chronic periodontitis (n = 15). Gingival crevicular fluid and serum samples were collected before treatment and at 1, 3, and 6 months after treatment. Visfatin levels were measured by enzyme-linked immunosorbent assays. Gingival crevicular fluid and serum visfatin levels were higher in patients with chronic periodontitis than those with gingivitis or healthy controls (P < 0.016). In addition, visfatin levels were higher in the gingivitis group than in healthy controls (P < 0.016). Non-surgical periodontal treatment resulted in a significant reduction in gingival crevicular fluid and serum visfatin levels. Furthermore, visfatin levels increased with inflammation and decreased following periodontal treatment. Our findings suggest that visfatin is an inflammatory biomarker of periodontal disease.(J Oral Sci 58, 491-499, 2016).

Assessment of MMP-1, MMP-8 and TIMP-2 in experimental periodontitis treated with kaempferol.

PURPOSE: The objective of this study was to investigate the effect of a dietary flavonoid, kaempferol, which has been shown to possess antiallergic, anti-inflammatory, anticarcinogenic, and antioxidant activities on the periodontium by histomorphometric analysis and on gingival tissue matrix metalloproteinase-1 (MMP-1), MMP-8, and tissue inhibitor of metalloproteinase-2 (TIMP-2) by biochemical analysis of rats after experimental periodontitis induction. METHODS: Sixty Wistar rats were randomly divided into six groups of ten rats each, and silk ligatures were placed around the cervical area of the mandibular first molars for 15 days, except in the healthy control rats. In the experimental periodontitis groups, systemic kaempferol (10 mg/kg/2d) and saline were administered by oral gavage at two different periods (with and without the presence of dental biofilm) to all rats except for the ten non-medicated rats. Alveolar bone area, alveolar bone level, and attachment level were determined by histomorphometric analysis, and gingival tissue levels of MMP-1, MMP-8, and TIMP-2 were detected by biochemical analysis. RESULTS: Significantly greater bone area and significantly less alveolar bone and attachment loss were observed in the kaempferol application groups compared to the control groups (P<0.05). In addition, gingival tissue MMP-1 and -8 levels were significantly lower in the kaempferol application groups compared to the control groups and the periodontitis group (P<0.001). There were no statistically significant differences in TIMP-2 levels between the kaempferol and saline application groups (P>0.05). CONCLUSIONS: Kaempferol application may be useful in decreasing alveolar bone resorption, attachment loss, and MMP-1 and -8 production in experimental periodontitis.

Analysis of YKL-40 acute-phase protein and interleukin-6 levels in periodontal disease.

BACKGROUND: YKL-40, a new acute-phase protein, is shown to be elevated in inflammatory diseases, such as rheumatoid arthritis, type 2 diabetes mellitus, and coronary artery diseases. However, there is no data indicating a relationship between YKL-40 and periodontal disease. Interleukin-6 (IL-6) is the major regulator of acute-phase protein synthesis and one of the most studied inflammatory markers in periodontal disease. The purpose of the present study is to evaluate YKL-40 and IL-6 levels in gingival crevicular fluid (GCF) and serum of patients with periodontal disease and healthy individuals. METHODS: Periodontally healthy individuals (n = 15), patients with gingivitis (n = 15), and patients with severe chronic periodontitis (CP) (n = 15) without any systemic disease were included in the study. Clinical measurements were recorded; GCF and blood samples were obtained from each participant. GCF and serum YKL-40 and IL-6 levels were analyzed by enzyme-linked immunosorbent assay. Statistical analysis was performed by parametric and non-parametric tests. RESULTS: Total amounts of YKL-40 and IL-6 in GCF as well as serum YKL-40 and IL-6 levels were significantly higher in patients with gingivitis and CP compared with healthy controls (P <0.01). YKL-40 levels in GCF and serum as well as serum IL-6 levels were significantly higher in patients with CP compared with patients with gingivitis (P <0.01). CONCLUSIONS: YKL-40 levels in GCF as well as serum YKL-40 and IL-6 levels increased from gingivitis to periodontitis. Within the limits of the present study, the YKL-40 molecule might be a potential novel inflammatory marker of periodontal disease.

Assessment of vascular endothelial growth factor and matrix metalloproteinase-9 in the periodontium of rats treated with atorvastatin.

BACKGROUND: The aim of this study is to examine, for the first time, the role of systemic and local atorvastatin application on periodontium using histomorphometric and immunohistochemical analysis during and after experimental periodontitis induction with or without the presence of microbial dental biofilm. METHODS: One hundred ten male Wistar rats were used. Silk ligatures were placed around the cervical area of the mandibular first molars; rats in the healthy control group received no ligatures (n = 10). In experimental periodontitis groups (n = 90), systemic and local atorvastatin and saline were administered in three different periods; the control periodontitis group (n = 10) received no treatment. Histomorphometric analysis, which included alveolar bone area, alveolar bone level, and attachment loss, and immunohistochemical analysis, which included immunoreactivity of vascular endothelial growth factor (VEGF) and matrix metalloproteinase (MMP)-9, were performed after the rats were sacrificed at the end of the experimental procedure. RESULTS: There was a greater increase in alveolar bone area and VEGF immunoreactivity, as well as a greater decrease in alveolar bone and attachment loss and MMP-9 immunoreactivity, with systemic and local atorvastatin application during and after induction of experimental periodontitis. Local atorvastatin application showed better results on periodontium with regard to alveolar bone findings. CONCLUSIONS: Systemic and local atorvastatin application showed beneficial effects on periodontium during and after induction of experimental periodontitis. Within the limits of this study, it can be concluded that atorvastatin, which is used for hypercholesterolemia treatment, can also be used as a protective and therapeutic agent for periodontal disease.

Long-term clinical results on the use of platelet concentrate in the treatment of intrabony periodontal defects.

OBJECTIVE: The purpose of this clinical investigation was to evaluate long-term results obtained with the combination of platelet pellet (PP) plus bioabsorbable barrier membrane (BM) and to compare this outcome with the results obtained using bioactive glass (BG) graft material with a BM. MATERIALS AND METHODS: Using a split mouth design, 11 chronic periodontitis patients (power ≥ at least 80%) were randomly assigned to treatment with a combination of PP/GTR or BG/GTR in contra-lateral dentition areas. Clinical attachment level (CAL) as the primary outcome variable, calculated as the sum of probing pocket depth (PPD) and gingival recession, and radiological alveolar bone level were recorded at baseline, 6 months and 5 years. RESULTS: There were no statistical differences between test and control defects at baseline. PPD reductions and CAL and radiological alveolar bone height gains were statistically significant between baseline and 6 months and between baseline and 5 years in both groups (p < 0.01). Six months results of frequency distribution showed that 82% of the defects attained ≥ 4 mm CAL gain in both groups, while 5 year results showed that 73% of the defects attained 2 mm ≤ CAL gain < 4 mm in the PP/BM group and 55% of the defects attained 2 mm ≤ CAL gain < 4 mm in the BG/BM group. All parameters evaluated showed no significant differences between 6 months and 5 years in both groups (p > 0.05). No statistically significant difference in any of the clinical parameters was observed at 6 months and 5 years between the groups (p > 0.05). CONCLUSIONS: The long-term efficacy of platelet concentrate combined with a barrier membrane is similar with the combination of bioactive glass graft material and barrier membrane, suggesting that results obtained with both treatment approaches can be maintained over a period of 5 years.

Autogenous cortical bone and bioactive glass grafting for treatment of intraosseous periodontal defects.

OBJECTIVE: The aim of this 6-month prospective randomized clinical study was to compare the effectiveness of autogenous cortical bone (ACB) and bioactive glass (BG) grafting for the regenerative treatment of intraosseous periodontal defects. METHODS: Via a split-mouth design, 15 chronic periodontitis patients (7 men, 8 women; mean age, 43.47 ± 1.45 years) who had probing pocket depths (PPDs) of ⩾6 mm following initial periodontal therapy were randomly assigned to receive 2 treatments in contralateral areas of the dentition: ACB grafting and BG grafting. The parameters compared in the patients were preoperative and 6-month postoperative PPDs, clinical attachment levels (CALs), and radiographic alveolar bone heights. RESULTS: Both treatment modalities resulted in significant changes in postoperative measurements when compared to preoperative values (p < 0.01). PPDs were decreased, CALs were increased, and radiographic alveolar bone heights were increased by 5.00 ± 0.28, 4.60 ± 0.21, and 5.80 ± 0.43 mm in patients treated with ACB grafting and 5.13 ± 0.32, 4.67 ± 0.27, and 5.33 ± 0.36 mm in patients treated with BG grafting, respectively. Differences between the treatments were not statistically significant (P>.05). CONCLUSIONS: Within the limitations of this study, both ACB and BG grafting led to significant improvements in clinical and radiographic parameters 6 months postoperatively. These results suggest that either an ACB graft, which is completely safe with no associated concerns about disease transmission and immunogenic reactions, or a BG graft, which has an unlimited supply, can be selected for regenerative periodontal treatment.

Effects of tacrolimus and nifedipine, alone or in combination, on gingival tissues.

BACKGROUND: The aim of this study is to compare gingival changes induced by short- and long-term tacrolimus and nifedipine administration, alone or in combination, and evaluate the expression levels of tumor suppressor phosphatase and tensin homolog (PTEN) in drug-induced gingival overgrowth. METHODS: Eighty rats were equally divided into eight groups: 1) tacrolimus for 8 weeks; 2) nifedipine for 8 weeks; 3) tacrolimus and nifedipine for 8 weeks; 4) 8-week control; 5) tacrolimus for 24 weeks; 6) nifedipine for 24 weeks; 7) tacrolimus and nifedipine for 24 weeks; and 8) 24-week control. Histomorphometric analyses included measurements of epithelial thickness, connective tissue thickness, and height. Stereologic analyses included measurements of volumetric densities of fibroblasts (Vf), collagen fibers (Vcf), and blood vessels (Vbv). In addition, PTEN expression was analyzed using immunohistochemistry. RESULTS: Epithelial thickness and connective tissue thickness were significantly increased in groups 5, 6, and 7 compared to group 8 (P <0.05), whereas connective tissue height was significantly increased in groups 5 and 7 (P <0.001). Vf and Vcf were significantly increased in group 7 compared to group 8 (P <0.001). PTEN immunoreactivity was significantly decreased in all experimental groups compared to the control groups (P <0.05). CONCLUSIONS: Results suggest that duration of drug administration is a more important risk factor than drug combination. The results include a potentially new insight about PTEN's role in the etiology of drug-induced gingival overgrowth.

Biochemical analysis of pentraxin 3 and fibrinogen levels in experimental periodontitis model.

OBJECTIVE: Pentraxin 3 (PTX3), newly discovered inflammation marker, is a member of acute-phase proteins. The hypothesis, synthesis of gingival tissue and serum PTX-3 increases in the experimental periodontitis model (with 10-day and 40-day periods), was tested by detecting gingival tissue and serum PTX-3 levels in rats with experimental periodontitis. METHODS: Thirty rats were randomly divided into three groups of ten animals each: ligature-induced experimental periodontitis groups (with 10-day (Group1) and 40-day periods (Group2)) and healthy group (Group3). At the end of experimental period, rats were sacrificed, and radiological and histomorphometric analyses were performed on the mandibles. PTX3 levels were measured in gingival tissue and serum samples using ELISA. Plasma fibrinogen levels were measured according to the nephelometric method. RESULTS: Significant alveolar bone resorption and periodontal inflammation were evident in periodontitis groups. Levels of PTX3 in gingival tissue were statistically higher in Group 1 than those in groups 2 and 3 (P < 0.01). No significant difference was found in serum PTX3 levels between experimental periodontitis and control groups (P > 0.05). Plasma fibrinogen levels were significantly increased in the experimental periodontitis groups (P < 0.001). CONCLUSION: PTX3 seems to be associated with tissue destruction in earlier periods of inflammatory periodontal disease, contrary to the fibrinogen findings.

Comparison of mesenchymal stem cells and autogenous cortical bone graft in the treatment of class II furcation defects in dogs.

The purpose of this study was to compare the effectiveness of mesenchymal stem cells (MSCs) with platelet-rich plasma (PRP) as scaffold and autogenous cortical bone (ACB) graft with and without PRP in the regenerative treatment of class II furcation defects in dogs. The mandibular second, third, and fourth premolars (P2, P3, P4) and maxillary P3 and P4 of both sides in three dogs were selected for experimentation. Class II furcation defects (5 mm in height and 2 mm in depth) were surgically created. Five weeks after the first operation, scaling + root planning (group 1), PRP (group 2), ACB (group 3), combination of ACB/PRP (group 4), and combination of MSCs/PRP (group 5) treatments were performed during open flap debridement. The percentage of cementum and alveolar bone formation was evaluated by histomorphometric analysis after a healing period of 8 weeks. There was new cementum along with periodontal ligament and coronal growth of alveolar bone in all groups. Cementum formation was significantly higher in groups 3, 4, and 5 compared to the control group (P < 0.05) with no significant difference between groups 2, 3, 4, and 5. Alveolar bone formation was similar in all groups (P > 0.05). It can be concluded that periodontal regeneration with complete filling of class II furcation defects with cementum, alveolar bone, and periodontal ligament is obtained 8 weeks after ACB, ACB/PRP, and MSCs/PRP treatments; however, efficacy of none is higher than another.

Effect of autogenous cortical bone grafting in conjunction with guided tissue regeneration in the treatment of intraosseous periodontal defects.

OBJECTIVES: The aim of this clinical trial was to evaluate the additional benefit of using guided tissue regeneration (GTR) with autogenous cortical bone (ACB) grafting versus ACB grafting alone for the regenerative treatment of intraosseous periodontal defects. METHODS: Via a split-mouth design, 12 patients with chronic periodontitis (five men, seven women; mean age, 45.3±4.6 years) who had probing pocket depths (PPDs) of ≥6 mm following initial periodontal therapy were randomly assigned to two treatments in contralateral areas of the dentition: a combination of ACB grafting and GTR (with a absorbable membrane of polylactic acid) or ACB grafting alone. The compared parameters were preoperative and 6-month postoperative PPDs, clinical attachment levels (CALs), and radiographic alveolar bone heights. RESULTS: Both treatment modalities resulted in significant changes in the postoperative measurements from the preoperative values (P<.01). The reduction in the PPDs, gain in the CALs, and gain in the radiographic alveolar bone heights were 4.58±1.08, 4.25±1.06, and 5.50±2.24 mm in the patients treated with ACB grafting and GTR and 4.92±1.00, 4.50±0.80, and 5.92±1.83 mm in those treated with ACB grafting alone, respectively. The differences between the treatments were not statistically significant (P>.05). CONCLUSIONS: Within the study limitations, both ACB grafting with GTR and ACB grafting alone lead to significant improvements in clinical and radiographic parameters at 6 months postoperatively. The combined approach does not provide any additional benefit for treating intraosseous periodontal defects.

Vascular endothelial growth factor expression levels of gingiva in gingivitis and periodontitis patients with/without diabetes mellitus.

OBJECTIVE AND DESIGN: The aim of this study was to determine vascular endothelial growth factor (VEGF) mRNA expression levels in gingival tissues of gingivitis and periodontitis patients with diabetes mellitus and those without. The hypothesis tested is that expression of VEGF, considered the effective cytokine in the relationship between diabetes and periodontal disease, is differentially affected in gingivitis and periodontitis patients with or without diabetes mellitus compared to healthy controls. METHODS: Forty-five subjects were evaluated in five groups; individuals with gingivitis (group 1; n = 10), individuals with periodontitis (group 2; n = 10), individuals with gingivitis + type II diabetes (group 3; n = 10), individuals with periodontitis + type II diabetes (group 4; n = 10), and individuals without periodontal and systemic disease (group 5; n = 5). VEGF mRNA levels in gingival tissues were measured by quantitative real-time PCR using Lightcycler. RESULTS: Expression of VEGF mRNA was detected in all groups. There was no significant difference in expression levels of VEGF mRNA between groups (P > 0.05). CONCLUSIONS: VEGF expression is probably related to both maintenance of periodontal health and periodontal tissue destruction. It can be concluded that systemic condition in type II diabetes mellitus under good metabolic control does not seem to have additional effects on gingival tissue VEGF mRNA levels in gingivitis and periodontitis patients.

Comparison of platelet pellet with or without guided tissue regeneration in the treatment of class II furcation defects in dogs.

The purpose of this study was to compare histological effectiveness of platelet pellet (PP), which has higher platelet content than platelet-rich plasma, and the combination of PP/guided tissue regeneration (GTR) for class II furcation defects in dogs. The mandibular second, third, and fourth premolars of both sides in four dogs were used. Class II furcation defects (5 mm in height and 2 mm in depth) were surgically created. Five weeks after the first operation, second premolars were treated with scaling and root planing (group 1); right third and fourth premolars received PP (group 2), and left premolars received the combination of PP/GTR (group 3). Percentage of cementum and alveolar bone formation were evaluated by histometric analysis after a healing period of 12 weeks. There was new cementum along with periodontal ligament and coronal growth of alveolar bone in all groups. Cementum formation was significantly higher in groups 2 and 3 compared to the control group (P < 0.05) with no significant difference between groups 2 and 3. Limited alveolar bone formation was statistically similar in all groups (P > 0.05). It is concluded that both PP and the combination of PP/GTR are effective in the treatment of class II furcation defects in dogs. PP thus appears to be a suitable alternative material in the regenerative periodontal therapy.

Effects of risedronate on alveolar bone loss and angiogenesis: a stereologic study in rats.

BACKGROUND: The present study was designed to evaluate the effects of risedronate, one of the most potent bisphosphonates, on alveolar bone resorption and angiogenesis in rats with experimental periodontitis to identify dose-response curves and treatment durations that can be therapeutic for periodontal therapy versus those associated with osteonecrosis of the jaws. METHODS: Thirty-five rats, 25 with experimental periodontitis (groups 1 through 5) and 10 with healthy periodontium (groups 6 and 7), were divided into seven equal groups: group 1 received no treatment; groups 2 and 3 received risedronate, 0.1 and 1 mg/kg, respectively, for 3 weeks; groups 4 and 5 received risedronate, 0.1 and 1 mg/kg, respectively, for 8 weeks; and groups 6 and 7 received 0.9% NaCl for 3 and 8 weeks, respectively. Animals in groups 2 through 7 were administered treatment 5 days per week. After histologic processing, histomorphometric and stereologic analyses were carried out to estimate the number of blood vessels (NBV) and the volumetric densities of bone (Vb), marrow (Vm), osteoblasts (Vob), and osteoclasts (Voc). RESULTS: A total of 0.1 and 1 mg/kg risedronate for 3 weeks (groups 2 and 3) significantly increased Vb and Vob and decreased Vm more prominently in group 2 (P <0.001), whereas 1 mg/kg risedronate for 8 weeks (group 5) induced no significant improvement in these parameters compared to group 1 (P >0.05). No significant decrease in Voc was found in drug-administered groups compared to group 1 (P >0.05). A significant decrease in NBV (P <0.01) and positive correlation between NBV and Vb (r(2) = 0.941; P = 0.006) were found only in group 5. CONCLUSION: A short duration of risedronate administration may be useful in inhibiting bone resorption in periodontitis, whereas excessive dosages of the drug administered in longer durations can lead to impairment of bone formation and angiogenesis.

Analysis of vitamin D receptor gene polymorphisms in patients with chronic periodontitis.

BACKGROUND & OBJECTIVE: Genetic polymorphisms in the vitamin D receptor (VDR) gene are related to bone mineral density, bone turnover, and diseases with bone loss. Alveolar bone loss is a key feature in periodontitis. The aim of this study was to determine whether severe generalized chronic periodontitis (CP) in a Turkish population was associated with polymorphisms in the VDR gene. METHODS: Samples of venous blood and DNA were obtained from 72 patients with severe generalized chronic periodontitis and 102 healthy controls. The polymorphic regions were amplified using PCR followed by digestion with restriction enzymes BsmI A/G(rs1544410), ApaI G/T(rs11168271), TaqI T/C(rs731236), and analyzed electrophoretically. Genotype and allele frequencies were calculated. RESULTS: There were no statistically significant differences in the frequencies of VDR BsmI, ApaI, TaqI genotypes between the CP patients and healthy controls. The GTT haplotype, constructed from the three adjacent restriction fragment length polymorphisms was found to be over-represented among CP cases. This corresponded an OR of 2.4 (95% confidence interval, 1.12-5.18) for heterozygous carriers and 2.27 (95% confidence interval, 0.95-5.4) for homozygous carrier of the risk haplotype. INTERPRETATION & CONCLUSION: The present findings indicated that BsmI, ApaI, TaqI polymorphisms of the VDR gene were not associated with the severe generalized CP in the studied Turkish patients. Moreover, the VDR genotypes based on haplotype analysis may be associated with chronic periodontitis. In the future, diagnostic periodontal risk assessments like polymorphisms may be useful in detection of individuals susceptible for periodontitis.

Gingival levels of monocyte chemoattractant protein-1 (MCP-1) in diabetes mellitus and periodontitis: an experimental study in rats.

The objectives of this study were to investigate and compare the monocyte chemoattractant protein-1 (MCP-1) levels of gingival tissues in diabetes mellitus (DM) and periodontitis and to reveal the effects of MCP-1 on periodontal inflammation and destruction in these diseases. DM was created in 15 rats (group 1) by streptozotocin injection, and periodontitis was obtained by ligature induction in 15 rats (group 2). Fifteen systemically and periodontally healthy rats were used as control (group 3). Gingival MCP-1 levels were measured by enzyme-linked immunosorbent assay (ELISA). Periodontal inflammation was quantified by the inflammatory cell infiltration in the gingival samples, whereas periodontal destruction was assessed by the alveolar bone loss in the experimental regions. MCP-1 concentrations were higher in groups 1 and 2 than in group 3 (p < 0.001). Increased gingival inflammatory cell infiltration and alveolar bone loss were observed in groups 1 and 2 compared to group 3 (p < 0.001). There were positive correlations among the MCP-1 level, gingival inflammatory cell infiltration, and alveolar bone loss in groups 1 and 2 (p < 0.001). Our results suggest that (1) DM may lead to enhanced MCP-1 production in periodontal tissues likewise for periodontitis and (2) there may be a positive correlation between the MCP-1 concentration and diseased nature of periodontium in both diseases.