The influence of type-1 diabetes mellitus on dentition and oral health in children and adolescents.

PURPOSE: The present study is to investigate the effects of type 1 diabetes mellitus on dentition and oral health for children and adolescents. MATERIALS AND METHODS: The investigation was carried out on 100 subjects. The first group consisted of 50 subjects with type 1 diabetes mellitus (21 females, 29 males), age 9+/-0.14 years; In the second group, there were 50 healthy subjects who did not suffer from any systemic disease (25 females, 25 males), age 9+/-0.11 years. The subjects were evaluated and divided into two groups of 5-9 years old, and 10-14 years old. The dentition of all participants was examined. Besides, the DFS/dfs index, oral hygiene conditions were evaluated, as well as the plaque index (PI), gingival index (GI) and calculus index (CI). The data obtained from each group were compared statistically. RESULTS: When compared to the non-diabetic group, we observed that dental development was accelerated until the age of 10 in the diabetic group, and there was a delay after the age of 10. The edentulous interval was longer in the group with type 1 diabetes mellitus. This was accompanied by a high ratio of gingival inflammation. Gingival inflammation was 69.7% in the group of 5-9 year-old, and 83.7% in the group of 10-14 year-old with type 1 diabetes mellitus. Though there was a greater loss of teeth in the group with type 1 diabetes mellitus, there were more caries in the control group. The PI, GI and CI values showed an increase with aging in favor of the group with type 1 diabetes mellitus. There was statistically significant difference in PI, GI and CI between the control and type 1 diabetes mellitus groups for 10-14 year-old patients (p<0.001). CONCLUSION: The findings we obtained showed that type 1 diabetes mellitus plays an important part in the dentition and oral health of children and adolescents.

The Effect of ABO Blood Types on Periodontal Status.

OBJECTIVES: The purpose of the present study was to determine whether there was a relationship between periodontal diseases and ABO blood groups. METHODS: This epidemiological study was carried out on 1351 subjects who were randomly selected from individuals referred to the Faculty of Dentistry clinics for periodontal treatment or for other reasons regarding dental health. The study based on periodontal condition, blood group, and medical history. The subjects were divided into three groups as those with gingivitis, periodontitis, and the healthy ones. The effects of blood subgroups on periodontal health, gingivitis and periodontitis were investigated separately. RESULTS: A relatively higher percentage of A group patients was found in gingivitis group and relatively higher percentage of O group patients was found in periodontitis group. A significant relationship was also determined between Rh factor and gingivitis. CONCLUSIONS: ABO blood subgroups and Rh factor may constitute a risk factor on the development of periodontal disease. However, long-term studies are needed to make a more comprehensive assessment of the effects of ABO group on periodontal diseases.

The changes in T lymphocyte subsets following periodontal treatment in patients with chronic periodontitis.

OBJECTIVE: The aim of this study was to determine whether there was any change in T-lymphocyte subsets in patients with chronic periodontitis after applying different periodontal treatment methods. PATIENTS AND METHODS: Twenty-four patients with chronic periodontitis were included in the study. In every phase of the treatment (pretreatment, initial treatment, curettage and flap operations) the biopsy samples were taken from the gingival tissues at sites of chronic periodontitis. Then CD4(+) and CD8(+) lymphocyte and CD4(+)/CD8(+) ratio values were determined using flow cytometry in the biopsy samples. At the same time, gingival pocket depth, Löe-Silness gingival index, and Silness-Löe plaque index scores were recorded to assess the periodontal status in patients. To determine the correlation between the clinical measurements and the laboratory results obtained before the treatment, after initial treatment, after curettage and after flap operations, we conducted an analysis using a paired t-test. RESULTS: Flow cytometry findings in the patients with chronic periodontitis showed that CD4(+) and CD8(+) lymphocyte values before treatment were under the normal value and the CD4(+)/CD8(+) ratio was within the normal distribution interval. The CD4(+)/CD8(+) ratio decreased postcurettage and postflap operation. This decrease was statistically significant (p < 0.001). The CD4(+) and CD8(+) lymphocyte values were increased postcurettage and postflap operation. This increase was also statistically significant (p < 0.001). CONCLUSIONS: These findings suggest that local immune response was poor in the patients with chronic periodontitis. CD4(+) and CD8(+) T-lymphocytes could play a significant role in chronic periodontitis pathobiology.

Differences in dental and bone maturation in regions with or without hemihypertrophy in two patients with Russell-Silver syndrome.

Hemihypertrophy (hemihyperplasia) is defined as asymmetric body overgrowth of one or more body parts. Hemihypertrophy can be isolated or be part of well-defined syndromes, such as Russell-Silver syndrome (RSS). RSS is characterized by severe intrauterine growth retardation, postnatal short stature, asymmetry of the face, body, and limbs, short and incurved fifth fingers, broad forehead, pointed small triangular shaped face, girdle nose, normal psychomotor development, variations in the pattern of sexual development, and dental and oral abnormalities. The aim of this study was to determine whether or not there was any difference in the maturity of bone in left and right hand-wrist radiographs and dental development in the right and left jaws of two patients with RSS. In addition, the clinical features of the syndrome are discussed.

The gingival crevicular fluid ciprofloxacin level in subjects with gingivitis and periodontitis, and its effects on clinical parameters.

OBJECTIVES: The purpose of this study, conducted on patients with gingivitis and periodontitis, was twofold: to find out the serum and gingival crevicular fluid concentration of ciprofloxacin, which is a common drug used effectively against Actinobacillus actinomycetemcomitans and to determine the effects of ciprofloxacin administration on clinical parameters. METHOD: A total of 32 adult patients, consisting of 16 subjects with gingivitis and 16 subjects with untreated chronic periodontitis, were included in the study. The subjects were divided into four groups: group I included eight subjects with chronic gingivitis who had not previously received any ciprofloxacin; group II included eight subjects with chronic gingivitis to whom three doses of ciprofloxacin were administered (Siprosan 500 mg) to establish adequate gingival crevicular fluid and serum concentrations of the agent; group III consisted of eight subjects with chronic periodontitis who had not received any ciprofloxacin; group IV included eight subjects with chronic periodontitis to whom three doses of ciprofloxacin were administered to establish adequate gingival crevicular fluid and serum concentrations of the agent. All patients were systemically healthy, free of pain and reported no current medication usage. Each patient was treated with scaling and/or root planing using specific hand instruments under local anesthesia. Gingival index, plaque index and clinical attachment levels of the teeth were used to determine the clinical condition of the subjects and findings were recorded at the beginning, seventh day, 21st day and third month of the study. Serum ciprofloxacin level was measured in venous blood. Approximately 5 ml of venous blood was drawn from subjects in groups II and IV using a standard venipuncture technique. Gingival crevicular fluid samples were sampled from six interproximal sites with six paper strips in the posterior region of upper jaw (excluding third molar) and all gingival crevicular fluid and serum samples were evaluated by high-performance liquid chromatography. RESULTS: The serum concentrations of ciprofloxacin at the first and 72nd hour were not significantly different in subjects with periodontitis compared to subjects with gingivitis. But the gingival crevicular fluid concentrations of ciprofloxacin at the same hours were significantly high in subjects with periodontitis compared to subjects with gingivitis. Both subjects with gingivitis and periodontitis had significantly higher ciprofloxacin levels in the gingival crevicular fluid than in serum. The application of ciprofloxacin did not have any positive or statistically significant effect upon the clinical parameters of the subjects with gingivitis. On the other hand, a significant decrease in the clinical attachment level scores of the subjects with periodontitis (group IV) was observed compared to group III in the 21st day and third month. CONCLUSION: According to these results, the use of ciprofloxacin as an alternative drug in subjects with periodontitis but not gingivitis can be recommended. However, long-term studies are also needed to assess the effects of ciprofloxacin on clinical parameters.

Musculoskeletal disorders in left- and right-handed Turkish dental students.

The purpose of this study was two-fold: first, to find out the musculoskeletal disorders between left- and right-handed dentists and second, to describe the prevalence and distribution of symptoms of musculoskeletal disorders among Turkish students who are practicing general dentistry. The investigation was carried out on 221 dental students; group I consisted of 24 left-handed students (18 male, 6 female), aged 24.2+/-2.24 years; group II comprised 24 right-handed students (14 male, 10 female), aged 25.1+/-3.14 years; and group III included 173 right-handed students (102 male, 71 female), aged 24.3+/-1.45 years. The study consists of a questionnaire to identify work tasks and working conditions, and a field study to assess the pain of the neck, shoulders, and other disorders during the dental practice. Data were analyzed through tests for the difference between two population proportion, percentage, and Chi-square. Left- and right-handed students had headaches (34%, 22%), pins and needles (35%, 22%), weakness (42%, 40%), numbness (23%, 19%), neck pain (67%, 43%), back pain (56%, 47%), upper limp pain (46%, 43%) and shoulder pain (78%, 58%), respectively (Table 3). Female students were not significantly different from males in musculoskeletal symptoms (p>.05). The position adopted by the student was significantly related to the intensity of pain. Left-handed students especially suffered from neck and shoulder pain when compared with right-handed students (p<.06). The authors think that a modification of work practices appears to be effective in decreasing the prevalence of symptoms. The best ergonomic working principles should be taught to the students, dental schools should provide a comfortable working environment, and further study is required to identify factors that will reduce the prevalence of symptoms among those practicing general dentistry.

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.