Evaluation of the Effect of Topical Hypericum perforatum Oil on Excisional Palatal Wound Healing in Rabbits.

Aim: The aim of this study was to evaluate the effect of Hypericum perforatum (HP) oil on wound-healing process in rabbit palatal mucosa. Materials and Methods: Thirty-six New Zealand albino rabbits were randomly allocated to following groups; (1) HP oil (test, n = 18) and (2) olive oil (control, n = 18). Palatinal excisional wounds were created and the oils were topically applied (0.1 ml, 30 s, twice a day). Gingival biopsies were excised, and analyzed for re-epithelialization (RE) and granulation tissue maturation (GTM) on days 3, 7, and 14 after surgery. Levels of vascular endothelial growth factor (VEGF) and fibroblast growth factor 2 (FGF-2) were assessed using the immunohistochemical method. Apoptotic cells (ACs) were evaluated using TUNEL staining. Enzyme-linked immunosorbent assay was used to assess tissue catalase (CAT) and malondialdehyde (MDA) levels. Results: RE and GTM were completed earlier in the HP oil group than in the control group. The number of positively stained cells/vessels was higher in olive oil than in the test group on day 3 for FGF-2 and on days 3 and 7 for VEGF (p < 0.05). In contrast, on day 14, a higher number of vessels was observed in the HP oil group than in the control group. HP oil treatment reduced the number of ACs compared to olive oil (p < 0.05), but the difference during the healing period did not reach significance. Tissue CAT and MDA levels between groups were not different, and also the results were the same when the levels were analyzed by the evaluated time periods (p > 0.05). Conclusions: The results of this study demonstrated that topical HP oil treatment did not provide an additional benefit to its base, olive oil, in the early phase of secondary wound healing.

Attachment, proliferation and collagen type I mRNA expression of human gingival fibroblasts on different biodegradable membranes.

The purpose of this study was to investigate adhesion, proliferation and type I collagen (COL I) mRNA expression of gingival fibroblasts on different membranes used in periodontal applications. Collagen (C), acellular dermal matrix (ADM) and polylactic acid; polyglycolic acid; lactide/glycolide copolymer (PLGA) biodegradable membranes were combined with gingival fibroblasts in culture and incubated for 48 h. Cell adhesion was examined with scanning electron and confocal microscopy. MTT assay was used to measure proliferation. COL I mRNA expression was assessed using quantitative-polymerase chain reaction (QPCR). The PLGA group exhibited the lowest cell survival on day 5 and 10, and lowest cell proliferation on days 5, 10 and 14. While cell proliferation was similar in C and ADM groups, the C membrane showed a slightly greater increase in viable cells to day 10. Confocal and scanning electron microscopy confirmed the results of proliferation and MTT assays. The highest COL I mRNA expression was noted in the PLGA membrane group when compared to the C (p < 0.01) and ADM (p < 0.05) membrane groups. These data revealed that adherence and proliferation of primary gingival fibroblasts on collagen-based C and ADM membranes is better than that seen with PLGA membranes, and thus may be preferable in the treatment of gingival recession defects.

Efficacy of collagen membrane seeded with autologous gingival fibroblasts in gingival recession treatment: a randomized, controlled pilot study.

BACKGROUND: Gingival recession (GR) is one of the most common esthetic concerns associated with periodontal tissues. Recently, tissue engineering technology has been developed and applied in periodontology for the treatment of GR. The aim of this study is to compare the clinical efficacy of collagen membrane with or without autologous gingival fibroblasts under a coronally advanced flap for root coverage. METHODS: In this split-mouth, controlled clinical study, 22 sites are selected from 11 patients with Miller Class I recessions affecting canines or premolars in the maxillary arch. One tooth in each patient was randomized to receive either a collagen membrane (CM) (control group) or a collagen membrane seeded with autologous gingival fibroblasts (CM+GF) (test group) under a coronally advanced flap. Thickness of the gingiva, GR, and percentage of root coverage (PRC) were recorded by a calibrated examiner at baseline and 3, 6, and 12 months postoperatively. Furthermore, GR and PRC were evaluated using photogrammetric analysis at baseline and 3, 6, and 12 months. RESULTS: Both treatments resulted in a significant gain in root coverage compared with baseline. A statistically significant increase was detected in PRC in the test group compared with the control group. No significant difference was noted between the test and control sites regarding the thickness of the gingiva. CONCLUSIONS: The results indicated that CM+GF prepared by tissue engineering technology can be considered an alternative method for the treatment of Miller Class I recession defects.

Relationship between iron-deficiency anemia and periodontal status in female patients.

BACKGROUND: The aim of this study was to evaluate the periodontal status of patients with iron-deficiency anemia (IDA) and the correlation of changes in serum and gingival crevicular fluid (GCF) ferritin levels after periodontal therapy. METHODS: Nineteen female patients with anemic hematologic values were classified as group A, and 20 healthy females with normal hematologic values were classified as group B. After group A was recruited, group B was enrolled with patients who had similar gingival indices as group A. At baseline and the 3-month follow-up visit, clinical periodontal indices and hematologic parameters were recorded, and GCF samples were taken. All patients received an oral hygiene-improvement session followed by scaling, and sites with >4-mm probing depths received root planing. At the 3-month follow-up visit, all measurements and analyses were repeated. RESULTS: During the follow-up period, all clinical indices decreased in both groups (P <0.05), but the gingival index in group A did not change. The GCF ferritin concentration showed statistically significant decreases (P <0.05), but total amounts of ferritin in GCF did not change. No significant correlation was found between serum and GCF ferritin levels. CONCLUSION: The findings of this study showed that changes in serum ferritin levels did not correlate with the GCF ferritin levels, and IDA was not a direct risk factor for periodontal diseases.

Evaluation of Antibacterial Effectiveness of Desensitizers against Oral Bacteria.

OBJECTIVES: Desensitizers contribute to better clinical results by reducing the rate of cervical dentin sensitivity. However, information on their antibacterial effect is limited. This study examined the antibacterial activities of a triclosan containing (Seal & Protect), a benzalconium containing desensitizer (Micro Prime), a fluoride containing prophilaxy paste (Sultan Desensitizer), two fluoride containing varnishes (Cavity Shealth and Ultra EZ), and a dentin bonding primer (All Bond). METHODS: The test materials were inserted in the wells of Muller Hinton agar plates inoculated with Streptococcus mutans, Streptococcus salivarious, Staphylococcus aureus, Streptococcus faecalis and Pseudomonas aeruginosa. The diameters of the inhibition zones produced around the materials were measured after 24 h of incubation. The results were analyzed by the Kruskal Wallis one way ANOVA and the Mann-Whitney tests at a significance level of P<.05. RESULTS: Micro Prime Desensitizer containing benzalkonium chloride had the highest antibacterial effectiveness compared to other desensitizers used in this study. In addition, triclosan containing Seal & Protect and acidic components containing All Bond showed very high antibacterial efficacy. On the other hand, fluoride within both varnishes had little antibacterial effectiveness. However a fluoride component in a paste (Sultan Desensitizer) showed very high bactericidal effect. CONCLUSIONS: All desensitizers except fluoride varnishes showed various degrees of antibacterial effect against the bacteria tested in this study. If antibacterial effect is also required from the desensitizers' clinicians should avoid use of varnishes.

Severe gingival recession caused by traumatic occlusion and mucogingival stress: a case report.

Gingival recession is displacement of the soft tissue margin apically leading to root surface exposure. Tooth malpositions, high muscle attachment, frenal pull have been associated with gingival tissue recession. Occlusal trauma is defined as injury resulting in tissue changes within the attachment apparatus as a result of occlusal forces. Trauma from occlusion may cause a shift in tooth position and the direction of the movement depends on the occlusal force. We present the clinical and radiological findings and the limitation of periodontal treatment of a severe gingival recession in a case with traumatic occlusion. A 16 years old male, systemically healthy and non-smoking patient presented to our clinic with severe gingival recession of mandibular canines and incisors. Clinical evaluation revealed extensive gingival recession on the vestibules of mandibular anterior segment. Patient has an Angle class III malocclusion and deep bite. To maintain the teeth until orthodontic therapy and maxillofacial surgery, mucogingival surgeries were performed to obtain attached gingiva to provide oral hygiene and reduce inflammation. After mucogingival surgeries, limited attached gingiva was gained in this case. Regular periodontal maintenance therapy was performed at 2 month intervals to preserve mandibular anterior teeth. Multidisciplinary approach should be performed in this kind of case for satisfactory results. Unless occlusal relationship was corrected, treatment of severe gingival recession will be problematic. For satisfactory periodontal treatment, early diagnosis of trauma from occlusion and its treatment is very important.

Microscopic evaluation of mandibular symphyseal distraction osteogenesis.

The purpose of this study was to evaluate microscopically the newly formed hard tissue after a consolidation period of mandibular symphyseal distraction osteogenesis (MSDO). Sixteen patients underwent MSDO treatment. After a latency period of seven days, the distraction device was activated by the patient once in the morning and once in the evening, for a total of one mm per day for a mean 10.1 +/- 2.8 days, and the mean opening of the device was 8.1 +/- 1.7 mm. The device was usually maintained in position approximately 90 days after surgery. After the completion of the distraction period, the lower anterior teeth were bonded and tooth movement into the distraction site was initiated. After a consolidation period, second surgery was performed to remove the distraction devices. During the second surgery, hard tissue biopsies were taken on the apical region of the two central incisors and the left canine. The samples were fixed in 10% buffered formalin and decalcified in 3% HNO(3) solutions. New bone formation was present within the distraction gap immediately after the consolidation period. The cellular construction was more irregular in the distraction sections than in the normal bone sections. The newly distracted area was not complete immediately after the consolidation period. Furthermore, the newly formed bone had a membranous structure, which indicates continual maturation. Bone exposed to stretching forces undergoes new bone formation, and the newly formed bone is of a membranous type also named as a woven type.

Periodontal treatment needs of patients with renal disease receiving haemodialysis.

AIM/OBJECTIVE: The aim of this study was to perform periodontal assessment, using the CPITN index, on patients undergoing renal dialysis. METHODS: The periodontal conditions of 342 subjects undergoing renal dialysis from eight renal dialysis centres were examined using CPITN. Subjects were distributed into four age groups, 16-19, 20-34, 35-44 and > or =45 years. The study was conducted during a 6-month period. All clinical examinations were performed by one examiner. RESULTS: There was a significant positive relationship between the CPITN scores and age (r=0.164, p=0.002) and dialysis duration (r = 0.240, p=0.000). There was no statistically significant difference between male and female patients (p>0.05). None of the age groups had healthy sextants. The 35-44 year-age group had a higher number of sextants with deep pockets (0.19) than the other age groups and edentulous sextants were the highest among the oldest age group (1.89). CONCLUSION: A very small portion of the renal dialysis population is affected by severe forms of periodontitis requiring complex periodontal treatment. However, all such patients should be given oral hygiene education as a priority.

Evaluation of the dental plaque pH recovery effect of a xylitol lozenge on patients with fixed orthodontic appliances.

The purpose of this study was to evaluate the influence of a xylitol lozenge on the dental plaque pH profile of fixed orthodontic patients. Twelve volunteers participated in this study. Before the measurement of plaque pH, subjects were asked to refrain from brushing their teeth for 48 hours and from eating and drinking for two hours. The subjects' baseline dental plaque pH was recorded using the touch technique. It was followed by a one-minute rinse with 15 ml of a 10% solution of sucrose, and subsequent plaque pH measurements were carried out during the next one hour. Xylitol lozenges were taken five times a day during a 14-day period. The variables of resting-plaque pH, minimum-plaque pH (MP pH), time required to reach MP pH (TMP), last-plaque (LP) pH at the end of one hour, cH area (CH), and pH at each test time were calculated for each pH test of the subjects. The paired sample t-test was used for statistical comparison. The mean MP pH values increased from 4.81 to 5.09 in the experimental measurement (P < .05). The mean TMP was not affected by the use of xylitol (P > .05). Although the LP pH showed an increase during the experimental period, the difference between control and experimental periods was not statistically significant (P > .05). The CH of the experimental period was significantly less than that of the control period (P < .05). As a result, the use of a xylitol lozenge after a sucrose challenge can be an advisable practice for fixed orthodontic patients to prevent future dental caries.

Effects of smoking on clinical parameters and the gingival crevicular fluid levels of IL-6 and TNF-alpha in patients with chronic periodontitis.

OBJECTIVE: Smoking is an important environmental risk factor for the initiation and progression of periodontal diseases. The aim of this study was to evaluate the effects of smoking on clinical parameters and the gingival crevicular fluid (GCF) contents of the pro-inflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) levels in patients with chronic periodontitis. MATERIAL AND METHODS: The study base consisted of 41 patients including 22 volunteer current smokers with an age range of 32-59 (44.41+/-7.88) years and 19 volunteer non-smokers with an age range of 36-59 (46.94+/-6.07) years. The first month after non-surgical periodontal therapy was accepted as the baseline of the study. The clinical parameters including plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL) were recorded and GCF samples were collected for analysis of GCF contents of IL-6 and TNF-alpha levels. At the 3rd and 6th months, all of these procedures were repeated. RESULTS: In smokers, only CAL was significantly higher at the 3rd month compared with non-smokers (p<0.05). GI and BOP were higher in non-smokers than smokers in both periods (p<0.05). PI showed increases from the initial to the 6th month in smokers (p<0.05). Although the differences between two groups with regard to IL-6 and TNF-alpha were not significant (p>0.05), the total amount of TNF-alpha in GCF decreased from the initial to the 6th month in smokers (p<0.05). There were no significant correlations between the mean total amount of IL-6 and TNF-alpha in GCF and clinical parameters in both evaluation periods in smokers (p>0.05). CONCLUSION: The present study demonstrated that cigarette smoking increases the amount of dental plaque over time in smokers and does not influence GCF contents of IL-6 and TNF-alpha.