Evaluation of oxidative status in patients with chronic periodontitis and polycystic ovary syndrome: A cross-sectional study.

BACKGROUND: In patients with polycystic ovary syndrome (PCOS), chronic periodontitis (CP) contributed to increased oxidative stress (OS), owing to an increase in serum and salivary 8-hydroxy-2'-deoxyguanosine (8-OHdG) and malondialdehyde (MDA) levels and a decrease in serum total antioxidant status (TAS) levels. The aim of the present study is to investigate salivary and serum 8-OHdG and MDA levels as well as total antioxidant status (TAS) in females with CP and PCOS compared with healthy females. METHODS: Four groups, each consisting of 22 individuals, were: 1) women with both PCOS and CP (PCOSCP); 2) systemically healthy women with CP; 3) periodontally healthy women with PCOS (PCOSPH); and 4) periodontally and systemically healthy women (PH). Demographic and clinical periodontal parameters were measured. Oxidative parameters were evaluated in serum and salivary samples. RESULTS: Salivary 8-OHdG levels in the PCOSCP and CP groups were statistically higher than those in both the PCOSPH and the PH groups (P < 0.05). There was no statistical difference between the PCOSCP, CP, and PCOSPH groups with regard to salivary MDA and TAS levels (P > 0.05). Highest serum 8-OHdG and MDA levels and lowest serum TAS levels were seen in the PCOSCP group (P < 0.05). Serum 8-OHdG and MDA levels in the PCOSPH group were higher than those in both systemically healthy groups (PH and CP) (P < 0.05). Salivary TAS levels were highest (P < 0.05) in the PH group. There was no statistical difference between the CP and PCOSPH groups, but serum TAS levels were lower than those in the PH group (P < 0.05). CONCLUSIONS: CP, which led to an increase in serum and salivary 8-OHdG and MDA levels and a decrease in serum TAS levels in patients with PCOS, contributed to increased OS. This effect was more prominent in serum levels than in salivary levels.

Marginal Bone Loss Around Early-Loaded SLA and SLActive Implants: Radiological Follow-Up Evaluation Up to 6.5 Years.

PURPOSE: The aim of this study was to compare marginal bone loss around early-loaded SLA and SLActive tissue-level implants (Straumann Dental Implants; Institut Straumann AG, Basel, Switzerland) after a mean of 81-month follow-up period. MATERIAL AND METHODS: One hundred seven SLA and 68 SLActive implants were placed in 55 patients and loaded with final restoration after 8 and 3 weeks of healing time, respectively. Marginal bone loss around implants was determined radiographically at initial and after a mean observation time ranging between 20 and 81 months. The effect of location (mandible vs maxilla), smoking habit, sex, implant length and diameter, and the type of prosthesis on the marginal bone loss was evaluated. RESULTS: The overall cumulative survival rate was 98.2% being 99% for SLA implants and 97% for SLActive implants. After 20-month follow-up period, mean marginal bone loss values for the SLA and SLActive implants were 0.24 and 0.17 mm, respectively. After 81 months, mean marginal bone loss for the SLA and SLActive implants reached 0.71 and 0.53 mm, respectively. Marginal bone loss was affected by the length and type of implant and patients' smoking habit after a mean observation time of 20 months. However, none of the parameters had any significant effect on the marginal bone loss after a follow-up period of 81 months. CONCLUSION: With both SLA and SLActive implants, successful clinical results could be achieved up to 6.5 years of follow-up period.

Evaluation of oxidative stress biomarkers in patients with fixed orthodontic appliances.

AIM: The aim of this study was to examine the changes in the levels of interleukine-1 beta (IL-1 ß ), tumor necrosis factor alpha (TNF- α ), malondialdehyde (MDA), nitric oxide (NO), and 8-hydroxydeoxyguanosine (8-OHdG) in saliva and IL-1 ß , TNF- α , and NO in gingival crevicular fluid (GCF) samples of patients with fixed orthodontic appliances. MATERIAL AND METHOD: The subject population consisted of 50 volunteers who were in need of orthodontic treatment with fixed orthodontic appliances. GCF and saliva samples were obtained from all individuals before treatment, at 1st month of treatment and at 6th month of treatment. Periodontal clinical parameters were measured. Samples were investigated to detect IL-1 ß , TNF- α , and 8-OHdG levels using ELISA method and NO and MDA levels using spectrophotometric method. RESULTS: Since IL-1 ß level detected in GCF at the 6th month of orthodontic treatment is statistically significant according to baseline (P < 0.05), all other biochemical parameters detected both in saliva and in GCF did not show any significant change at any measurement periods. CONCLUSION: Orthodontic tooth movement and orthodontic materials used in orthodontic treatment do not lead to a change above the physiological limits that is suggestive of oxidative damage in both GCF and saliva.

Assessment of cytogenetic and cytotoxic effects of chlorhexidine digluconate on cultured human lymphocytes.

OBJECTIVE: The aim of this study was to assess the genetic and cellular toxicity of Chlorhexidine digluconate (CHX) on peripheral human lymphocytes in vitro. MATERIALS AND METHODS: Micronucleus assay was used to investigate the genotoxicity, while the cell viability and proliferation were evaluated by Trypan blue exclusion test and Nuclear Division Index in control and CHX-treated (0.05, 0.1, 0.2, 0.4, 0.5 mg/ml) human blood cultures. RESULTS: A dose-dependent toxic effect was found depending on CHX incubation on the genetic and cell viability of the lymphocytes. Micronucleus frequency was found to be statistically higher at 0.5 mg/ml concentration compared to lower doses and the control group (p < 0.05). A significant reduction was shown in the cell viability and cell proliferation of the exposed lymphocytes at the concentrations of 0.4 and 0.5 mg/ml (p < 0.05), while no significant toxicity was found at lower concentrations compared to control (p > 0.05). CONCLUSION: This study showed dose-dependent genotoxic and cytotoxic effects of CHX on human lymphocytes in vitro. It should be considered during periodontal irrigation or novel CHX products at lower concentrations should be manufactured for clinical usage.

Immune modulatory and antioxidant effects of melatonin in experimental periodontitis in rats.

Melatonin is an important antioxidant, and through its anti-inflammatory effects it can control immune responses, oxidative stress, and defense cell infiltration. Periodontitis is a disease of the oral cavity and the generation of free radicals is an important consideration in this disease. Therefore, we examined the immune-modulatory and antioxidant roles of melatonin in the treatment of periodontitis. In all, 30 male Wistar rats were randomly divided into three groups: the control group, the periodontitis-induced (PED) group, and the periodontitis+melatonin treatment (MEL+PED) group. The control group received no treatment, whereas periodontitis was induced in both the PED and the MEL+PED groups, with the MEL+PED group being treated with systemic melatonin. For the periodontitis-induced groups, the rats' mandibular first molar teeth were ligatured (3-0 cotton) in a submarginal position for 4 weeks, and then the ligature was removed. After removal of the ligature, melatonin was administered only to the MEL+PED group (an ip dose of 10mg/kg body wt for 15 days at 11:00 PM each day). In the histological examination, the MEL+PED group, which received the melatonin, showed reduced inflammatory cytokines (IL-1ß, from 97.47 to 84.24pg/ml; TNF-α, from 0.22530 to 0.22519pg/ml), regulated oxidative stress parameters (MDA, from 41,458 to 30,708nmol/g; GSH, from 18,166 to 25,858nmol/mg), and less periodontal tissue destruction (CEJ-PL, lingual, from 244.54 to 140.57µm; buccal, from 235.6 to 158.93µm; and CEJ-BC, lingual, from 383.65 to 287.76µm; buccal, from 391.92 to 296.12µm). From these findings we conclude that, even when periodontitis was induced, melatonin reduced the oxidative damage in the rats' periodontal tissue by inhibiting the inflammatory effects and by restoring the antioxidants.

Increased salivary levels of 8-hydroxydeoxyguanosine may be a marker for disease activity for periodontitis.

BACKGROUND: 8-hydroxydeoxyguanosine (8-OHdG) is commonly used as a marker to evaluate oxidative DNA damage in disorders including chronic inflammatory diseases such as inflammatory periodontal pathologies. In the current study we hypothesized that the level of 8-OHdG in saliva increases by the periodontal destruction severity determined by clinical parameters as clinical attachment level (CAL). MATERIALS AND METHODS: A cross-sectional study was conducted on a sum of 60 age gender balanced; chronic periodontitis (CP) (n=20), chronic gingivitis (CG) (n=20) and healthy (H) (n=20) individuals. Clinical periodontal parameters and salivary 8-OHdG levels were evaluated. RESULTS: The mean 8-OHdG level in the saliva of the CP group was significantly higher than H and CG groups (p< 0.001). Statistically significant correlation was only observed between the salivary levels of 8-OHdG and age (p< 0.05), probing depth (PD) and CAL (p< 0.001) in CP group. However, when CP patients were classified according to their CAL levels (CAL⩾ 3 mm (n=11) and CAL<3 mm (n=9)) statistically significant correlation was only observed between the salivary levels of 8-OHdG and CAL ⩾ 3 mm patients (p< 0.001). CONCLUSION: We suggest that elevated salivary levels of 8-OHdG may be a marker for disease activity and it may reflect indirectly disease severity parameters such as CAL.

Immunohistochemical and Stereologic Analysis of NF-κB Activation in Chronic Periodontitis.

OBJECTIVES: Nuclear factor kappa B (NF-κB) is a member of the transcription factor family, and it plays a key role in coordinating the expression of genes in many chronic inflammatory diseases. This study investigated the cytoplasmic and nuclear activation of (NF-κB) and the cytoplasmic expression of inhibitor kappa B (IκB) in gingival tissues of subjects who had chronic periodontitis. METHODS: Thirty-five patients were included in this study; 17 patients had chronic periodontitis, and 18 were healthy. Gingival tissues were obtained from each individual and then stained immunohistochemically. The obtained sections were examined under a stereomicroscope, and the numerical density values of the stained cells were computed using the stereologic method. A one-way analysis of variance (ANOVA) and a multiple range least significant difference (LSD) were used for intergroup comparisons (P=0.05). RESULTS: According to the immunohistochemical analysis of the cytoplasmic positive cells stained with IκB, statistically significant differences were found between the case and control groups. When comparing the cytoplasmic and nuclear positive immunoreactivity of p50 and p65, statistically significant differences were found between the diseased and control groups. Statistically significant correlations were also found between the clinical periodontal scores and the immunohistochemical results of the diseased subjects. CONCLUSIONS: It was shown that NF-κB was highly activated in subjects who had chronic periodontitis, compared to healthy controls. The findings of this study can be useful in planning new treatment strategies for periodontal diseases. Further investigations are needed to understand more about the signaling mechanisms of inflammatory mediators and their interactions with NF-κB in chronic periodontitis.

Evaluation of oral malodour in left- and right-handed individuals.

Halitosis is a common social problem in the worldwide population. It is frequently associated with oral hygiene performance, so it may depend on the hand skill and cognitive ability of individuals. This study aimed to determine the relationship between handedness and pathologic oral halitosis. The study included a total of 1510 participants, and daily oral hygiene activities, hand preference, VSCs scores (volatile sulphur compounds) and clinical oral indices such as plaque index (PI) and tongue coating index (TCI) of each individual were recorded. Results of this study showed that there were no statistically significant differences between right- and left-handers (Groups I and II, respectively) according to age and oral hygiene practices. But it was found that PI and TCI were statistically higher in Group I with respect to Group II (Table 1). VSC scores, PI, and TCI were statistically higher in men compared to women (p<.01) (Table 2). There were statistically significant differences between women and men in the right-handed participant group (p<.01), while there were no statistically significant differences among the left-handers (p> .05) (Figure 1). Furthermore, statistically significant correlations were found between VSC scores and individual oral hygiene indices (p<.01) (Table 3). The lower halimetric values and clinical indices in left-handed individuals may be related with their oral healthcare and daily brushing habits. But unless detailed neurological investigations are undertaken, it cannot be suggested that the left-handers have better coordination and better-developed spatial abilities in oral hygiene procedures than the right-handers.

Increased salivary level of 8-hydroxydeoxyguanosine is a marker of premature oxidative mitochondrial DNA damage in gingival tissue of patients with periodontitis.

INTRODUCTION: Oxidative stress may contribute to the pathogenesis of periodontitis. However, the detailed molecular mechanism remains unclear. Both 8-hydroxydeoxyguanosine (8-OHdG) and mitochondrial DNA (mtDNA) deletion have been reported as early oxidative DNA damage markers. In this study, 8-OHdG levels in saliva and mtDNA deletions in gingival tissue of patients with chronic periodontitis (CP) were evaluated. MATERIALS AND METHODS: Gingival tissue and whole saliva samples were collected from 32 patients with CP and 32 healthy control subjects. To determine the clinical condition of each subject, the plaque index, gingival index, clinical attachment level (CAL), and probing depth (PD) were measured. Using the ELISA and polymerase chain reaction methods, the salivary 8-OHdG levels and the 7.4-kbp and 5-kbp mtDNA deletions were examined. RESULTS: The 5-kbp mtDNA deletion was detected in 20 of the 32 periodontitis patients (62.5%), but was not detected in the healthy controls. The mean value of 8-OHdG in the saliva of the periodontitis patients with deleted mtDNA was significantly higher than in the patients with non-deleted mtDNA (p<0.01). Also, significant correlation was found between the occurrence of the 5-kbp mtDNA deletion and salivary 8-OHdG levels (p<0.01). Similar correlations were detected between salivary 8-OHdG levels and age, PD, and CAL (p<0.01, p<0.05). CONCLUSION: Increased oxidative stress may lead to premature oxidative DNA damage in the gingival tissue of periodontitis patients and the salivary 8-OHdG level may signify premature oxidative mtDNA damage in diseased gingival tissue.

Increased levels of 8-hydroxydeoxyguanosine and malondialdehyde and its relationship with antioxidant enzymes in saliva of periodontitis patients.

OBJECTIVES: The aim of this study was to evaluate 8-hydroxydeoxyguanosine (8-OHdG) and Malondialdehyde (MDA) levels, and superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities in whole saliva of patients with chronic periodontitis. Moreover, the relationship among the oxidative damage biomarkers, antioxidant enzymes activities and clinical periodontal status were investigated. METHODS: Whole saliva samples were collected from 30 patients with chronic periodontitis and 30 periodontally healthy control. To determine the clinical condition of each subject, the plaque index, gingival index, clinical attachment level, and probing depth were measured. The salivary 8-OHdG level was measured using the ELISA method. SOD and GPx activities and MDA levels were determined spectrophotometrically. RESULTS: Higher salivary 8-OHdG and MDA levels (P<.001), and lower salivary SOD and GPx activities (P<.05) were detected in periodontitis patients compared to the healthy controls. Additionally, there were significant negative correlations between salivary levels of 8-OHdG and both salivary SOD and GPx activities as well as between salivary levels of MDA and both salivary SOD and GPx activities (P<.001). CONCLUSIONS: Higher salivary 8-OHdG and MDA levels and lower salivary antioxidant activities seem to reflect increased oxygen radical activity during periodontal inflammation.

The effects of age and gender on CD3+ and CD19+ lymphocyte in gingival tissue and peripheral blood: an animal study

Aim: The aim of the present study was to determine age- and gender-related values for healthy mice of CD3+ T and CD19+ B lymphocytes and CD3+/ CD19+ (T/B) ratios in peripheral blood and gingival tissue by the flow cytometry technique. Methods: The study was carried out on periodontally healthy 60 BALB/c mice. They were divided into five groups according to the their age (newborn, weaning, puberty, adult and elder). Males and females were equally represented in each group. CD3+ and CD19+ T lymphocytes and CD3+/CD19+ ratio values in gingival tissue and peripheral blood were determined using flow cytometry in the biopsy samples. Results: There were no significant differences in the CD3+ and CD19+ lymphocytes, and CD3+/ CD19+ ratios in gingival tissue for all age groups (p>0.05). Mean relative number of peripheral blood CD3+ T lymphocyte indicated a decrease in puberty group compared to the other groups (p<0.05), while relative number of peripheral blood CD19+ B lymphocyte increased in adult and aged group. The peripheral blood CD3+/ CD19+ T/B lymphocytes ratios decreased in adult and aged group. Conclusions: The results of the present study showed that differences were present in periods of life and gender in peripheral blood of mice. Moreover,significantly differences were found between genders in gingival tissue.

The effects of age and gender on gingival tissue and peripheral blood T-lymphocyte subsets: a study in mice.

The aim of this study is to investigate the effects of age and gender on relative number of CD4+ and CD8+ T lymphocyte and CD4+/CD8+ ratios in gingival tissue and peripheral blood of periodontally healthy BALB/c mice with flow cytometric analysis. The study was carried out on periodontally healthy 60 BALB/c mice. They were separated into five groups according to the life expectancy: Group I (newborn, 1-10 days old), Group II (age at weaning, 21-28 days old), Group III (age of sexual maturity, puberty, 7-8 weeks old), Group IV (adult, 8 months old), and Group V (the aged, 14 and over). Males and females were equally represented in each group. CD4+ and CD8+ T lymphocytes and CD4+/CD8+ ratio values in gingival tissue and peripheral blood were determined using flow cytometry in the biopsy samples. The relative number of CD8+ T lymphocyte in gingival tissue was higher in puberty (p < 0.05) and the aged (p < 0.05), with more significantly difference in males (p < 0.05). The CD4+/CD8+ ratios in gingival tissue were lower in puberty group and the-aged groups compared to the other groups (p < 0.05). The peripheral blood CD4+/CD8+ ratio increased in puberty and the aged groups. These differences were more significant in females than in males (p < 0.05). There were considerable negative correlations between CD4+/CD8+ T lymphocyte ratio in gingival tissue and CD4+/CD8+ T lymphocyte ratio in peripheral blood in puberty (r = 0.647, p < 0.01) and the aged ( r = 0.599, p < 0.05). In conclusion, our data suggest that CD4+/CD8+ T lymphocyte ratios in peripheral blood increase periodontally healthy mice in puberty and the old groups, while CD4+/CD8+ T lymphocyte ratios in gingival tissue decrease in the same groups. The relative number of CD8+ T lymphocytes increases in gingival tissue in puberty and the old groups when it decreases in peripheral blood. Results from this study indicated that periodontally healthy BALB/c mice may represent important information to determine the character of an immune response in the course of a lifetime.

Pain experienced by patients undergoing different periodontal therapies.

BACKGROUND: The authors assessed the levels of postoperative pain, postoperative dentin hypersensitivity and discomfort patients experienced during various periodontal treatments by using a visual analog scale (VAS). They aimed to determine whether VAS scores could be predicted by patient's age and sex and to evaluate the factors associated with the pain. SUBJECTS AND METHODS: The study was carried out with 56 patients who had chronic periodontitis. Using a split-mouth design, the authors selected one quadrant in each patient and treated it with scaling and root planing (SRP). They treated other quadrants with the surgical therapies of modified Widman flap (MWF), flap with osseous resection (OF) and gingivectomy (GV), depending on the patient's diagnosis and treatment needs. They measured patients' discomfort during periodontal treatments, postoperative pain and postoperative dentin hypersensitivity by asking patients to mark a VAS. RESULTS: The authors' analysis showed no statistically significant differences between the patients' discomfort levels associated with the four therapy types during periodontal treatment. However, postoperative pain was significantly higher for OF (P < .01) and GV (P < .05) procedures than for SRP and MWF procedures. All surgical procedures produced significantly more dentin hypersensitivity than did nonsurgical therapy. The analysis showed no statistically significant differences between male and female patients' discomfort during periodontal treatments. For all periodontal treatments, VAS scores decreased with increasing age. CONCLUSIONS: Discomfort during periodontal treatments, postoperative pain and postoperative dentin hypersensitivity were associated significantly with age, type of therapy and higher scores on Corah's Dental Anxiety Scale. CLINICAL IMPLICATIONS: Periodontal treatment is experienced as painful by substantial numbers of patients. Therefore, the dentist should count the pain responses during and after treatment and estimate the degree of pain according to sex, age and therapy type.

Total antioxidant capacity and antioxidant enzymes in serum, saliva, and gingival crevicular fluid of preeclamptic women with and without periodontal disease.

BACKGROUND: The aim of this study was to investigate the total antioxidant capacity, superoxide dismutase and glutathione peroxidase activities, and malondialdehyde levels in serum, saliva, and gingival crevicular fluid (GCF) in preeclamptic and normotensive pregnant women with and without periodontal disease. METHODS: Forty pregnant women, consisting of 10 preeclamptic subjects with periodontal disease, 10 preeclamptic periodontally healthy subjects, 10 normotensive subjects with periodontal disease, and 10 normotensive periodontally healthy subjects, were included in this study. After clinical measurement and samplings, total antioxidant capacity, superoxide dismutase, glutathione peroxidase activities, and malondialdehyde levels in serum, saliva, and GCF of preeclamptic and normotensive pregnant women were determined, and the data were tested by non-parametric tests. Total antioxidant capacity of the clinical samples was measured using a novel automated colorimetric measurement method. Superoxide dismutase and glutathione peroxidase activities and malondialdehyde levels were determined spectrophotometrically. RESULTS: Superoxide dismutase and glutathione peroxidase activities in GCF and serum and total antioxidant capacity in saliva, GCF, and serum were the lowest in preeclamptic women with periodontal disease. However, serum and GCF levels of malondialdehyde were the highest in this group of pregnant women. CONCLUSIONS: Systemic and local antioxidant and total antioxidant capacities are affected by periodontal disease in addition to the impact of preeclamptic status. Similar comments may be made for the increases in systemic and local malondialdehyde levels.

Periodontal disease increases the risk of severe pre-eclampsia among pregnant women.

AIM: To evaluate the possible link between the severity of periodontal disease and pre-eclampsia and to correlate this link to clinical periodontal parameters and interleukin (IL)-1beta, tumour necrosis factor-alpha (TNF-alpha), and prostaglandins (PGE(2)) levels in both gingival crevicular fluid (GCF) and serum. MATERIAL AND METHODS: Fifty-nine pregnant women (20 mild pre-eclampsia, 18 severe pre-eclampsia, and 21 healthy pregnant women) were included in the study. Dental and periodontal recordings as well as GCF and blood samples were obtained within 48 h preceding delivery. RESULTS: The results of multivariate logistic regression showed a highly significant association between mild to severe pre-eclampsia and severe periodontal disease (p<0.001). After adjusting for potential confounders (smoking, body weight, socioeconomic status, education level, and age), severe pre-eclamptic women were 3.78 (1.77-12.74) times more likely to present severe periodontal disease than normotensive pregnant women. This odds ratio (OR) was 2.43 (1.13-8.19) for mild pre-eclamptic women. IL-1beta, TNF-alpha, and PGE(2) levels in both serum and GCF were also significantly higher in the pre-eclamptic groups than the normotensive women. CONCLUSIONS: These results indicate that the presence and severity of periodontal disease seems to increase the risk for not only the occurrence but also the severity of pre-eclampsia in pregnant women.

Pain levels in patients during periodontal probing and mechanical non-surgical therapy.

The purpose of this study was to assess the degree of pain during periodontal probing and mechanical non-surgical therapy according to age, gender, and intersubject variation such as tooth type, tooth surfaces or regions of mouth, probing depth, and bleeding on probing. The study was carried out on 64 patients with chronic periodontitis. Pain/discomfort of patients during both periodontal probing and scaling and root planing (SRP) was measured using a visual analog scale (VAS). During periodontal probing and SRP, VAS scores decreased with increasing age for two procedures (Spearman rho, -0.301 and -0.348, respectively; P < 0.01). VAS scores were considerably lower for oral sites than for facial sites. VAS scores in probing were significantly higher in sites > or =4 mm deep than sites <4 mm deep. Sites bleeding on probing had a significantly higher VAS scores than sites no bleeding on probing (p < 0.05). The results showed that although there is no difference between genders, the intensity of pain during periodontal probing and SRP was different dramatically between patients as well as vary between different locations in the same mouth. If pain responses for probing in different several regions in the same mouth during initial examination were noted into patient chart used for initial examination, the therapist will recognize patients with elevated pain responses. If need be, they will then apply some pain control medication or anesthetic for patients during probing and SRP.

New evidence of premature oxidative DNA damage: mitochondrial DNA deletion in gingival tissue of patients with periodontitis.

BACKGROUND: Overproduction of reactive oxygen species (ROS) causes increased oxidative stress in gingival tissue. It has been generally accepted that increased oxidative stress might contribute to additional damage of lipids, proteins, and DNA molecules. The mitochondrial DNA (mtDNA) mutation is a superb biomarker of oxidative damage. The aim of the present study was to investigate the mtDNA deletions in the gingival tissue of patients with periodontitis and to explain the correlations between mtDNA deletion in gingival tissue and clinical parameters of periodontitis and age. METHODS: Gingival tissue and blood samples were collected from 30 patients with chronic periodontitis (CP group) and 30 healthy control subjects (H group). To determine the clinical condition of each subject, the plaque index, gingival index, clinical attachment level, and probing depth were measured. Using the polymerase chain reaction (PCR) method, we examined the 7.4- and 5-kbp mtDNA deletions in tissue and blood samples. Three different pairs of PCR primers were used in this study. RESULTS: In this study, we did not detect any deletions in blood DNA samples in either the CP or H group. Also, the 7.4-kbp mtDNA deletion was not detected in gingival tissues of subjects. However, the 5-kbp mtDNA deletion was detected in 24 of the 30 subjects (80%) in the CP group and was not detected in the H group (0%). Significant correlations were found between the occurrence of the 5-kbp mtDNA deletion and all clinical parameters (P <0.01). A similar correlation was found between the occurrence of the 5-kbp mtDNA deletion and age (P <0.05). CONCLUSIONS: The overproduction of ROS by activated polymorphonuclear leukocytes in chronic inflammation may lead to premature oxidative damage of the mtDNA. In this study, the occurrence of the 5-kbp mtDNA deletion in 24 periodontitis subjects may be evidence of premature oxidative DNA damage.

Periodontal disease as a risk factor for pre-eclampsia: a case control study.

OBJECTIVE: To investigate the association between periodontal disease and pre-eclampsia, while controlling known risk factors for pre-eclampsia. METHODS: A matched case-control study was carried out on 41 pre-eclamptic women and 41 normotensive, healthy, pregnant, control women. The pre-eclamptic women and controls were individually matched for age, gravidity, parity, smoking and prenatal care. The number of teeth and the number of restorations and decay on all tooth surfaces, and clinical periodontal parameters, excluding third molars were determined within 48 h before delivery. The relation of independent variables to pre-eclampsia was assessed using conditional multiple logistic regression analysis on subject-based data. RESULTS: There were no statistically significant differences in mean percentages of sites with plaque between groups. The mean probing depth (PD) and mean clinical attachment level (CAL) for pre-eclamptic patients were significantly greater compared to those of normotensive patients (P < 0.01). The percentage of sites exhibiting bleeding on probing (BOP) (P < 0.05), the number of sites with PD >/= 4 mm and with CAL >/= 3 mm was significantly higher among pre-eclamptic patients than those with normotensive patients (P < 0.01). Conditional multiple logistic regression analysis indicated that periodontal disease and triglycerides level were significantly associated with pre-eclampsia. Other independent variables (maternal body weight and serum total cholesterol level) did not appear to be associated with pre-eclampsia. Conditional multiple logistic regression results showed that pre-eclamptic patients were 3.47 (95% CI = 1.07-11.95) times more likely to have periodontal disease than normotensive patients. CONCLUSION: The present study shows that maternal periodontal disease during pregnancy is associated with an increased risk for the development of pre-eclampsia. The higher incidence of periodontal disease parameters in pre-eclamptic group would suggest a possible role for periodontal disease in the development of pre-eclampsia. The nature both of periodontitis and pre-eclampsia is multifactorial, and caution should be exercised when implicating periodontal disease in causation of pre-eclampsia.

Effect of handedness on learning subgingival scaling with curettes: a study on manikins.

The aim of the present study was to evaluate the influence of systematic manikin-head training and the effectiveness of subgingival scaling applied with hand instruments (curettes) by right- and left-handed dental students on dental chairs (traditional) designed for right-handers. A questionnaire focusing on handedness was administered to 69 voluntary dental students in the third class at the School of Dentistry during pre-participation examination. Handedness was assessed using the Turkish version of the Edinburgh Handedness Inventory. Then, 18 dental students were specially selected in 2 equal groups according to hand preference: consistent right-handers with Geschwind Scores of +100 (5 female and 4 male) and consistent left-handers with Geschwind Scores of -100 (5 female and 4 male). These two untrained dental student groups received 10 weeks manikin-head training. Subgingival scaling was performed with hand instruments (Gracey curettes) in manikin-head mounted on right-sided dental chairs. At 6 test days each dental student had to instrument 12 test teeth. Effectiveness of subgingival scaling was evaluated by adoption of a grading system. This system had scores from 0 to 3 and was defined by illustrated and described criteria. Statistical analysis was carried out with SPSS. Two groups were statistically compared on all test days. The yet-untrained left-handed dental students begin with a relatively high the mean score of 2.25, compared to the yet-trained right-handed dental students with 1.93, which was statistically significant (p > .05). The right-handed dental students reached the mean score of 0.53, whereas the left-handed dental students reached the mean score of 0.87 on test day 6. Significant differences in the mean scores were found between the two groups for overall surfaces (p < .05), the distal surfaces (p < .01), lingual surfaces (p < .01), and each group of teeth (p < .05). But there was no statistically significant difference between the 2 groups of students on all test day, except for test day 3 in terms of the mean scores for the facial and mesial surfaces (p > .05). Learning success was observed a high level in both groups through systematical training (p < .0001). The present study has documented that the left-handed dental students were less successful than the right-handed dental students in subgingival scaling, except for mesial and facial surfaces. However although training on right-sided chairs, they were quite similar to their right-handed counterparts in terms of learning success.

Influence of different periodontal curette grips on the outcome of mechanical non-surgical therapy.

AIM: To determine to whether successful scaling and root planing (SRP) depends upon the grip used on the periodontal curette. METHODS: The hand grips used by dentists for holding periodontal curettes were examined and the dentists were allocated to one of two matched groups, one in which they used a modified pen grip, the other in which they did not. Using a split-mouth technique, patients scheduled for SRP had one quadrant treated by a dentist from each group. Instrument application force was recorded as were periodontal measures at operation and 3-months later. RESULTS: During scaling, forces reached a mean of 0.77N in dentists using a curette with a non-pen grip and 0.54N in those using a pen grip and during root planing, 0.93N and 0.64N respectively. These forces were statistically significantly different between the two groups. Pocket depth reduction in teeth treated by the two groups was similar but attachment levels were statistically significantly different. CONCLUSIONS: Instrument grip had a significant effect on response to SRP, suggesting that dentists using a modified pen grip achieved better clinical results.