Delirium is associated with increased mortality in the geriatric population.

OBJECTIVE: The aim of this study was to investigate the prevalence of delirium and its association with mortality rates in elderly inpatients. METHODS: The medical records of 1435 patients over 65 years old who were treated at a regional university hospital and were referred to the university's Consultation and Liaison Psychiatry Clinic for psychological evaluation were retrospectively analyzed. Patients with and without a diagnosis of delirium were compared. The National Survival Database was used to determine mortality rates. RESULTS: The prevalence of delirium was 25.5%. The delirium group was older (p < .0001) and had a larger proportion of males (p < .0001). Mortality rate was higher in the delirium group at 1, 2, 3, 4, and 5 years (p < .0001 for all). Age, gender, lower urinary system diseases, chronic liver disease, solid hematologic malignancy, infections, and Alzheimer's disease emerged as significant parameters associated with mortality. Multivariate analysis of these parameters indicated that comorbid diseases (lower urinary system diseases, chronic liver disease, solid hematologic malignancy, infections, and Alzheimer's disease) are risk factors for mortality independent of demographic data such as age and gender. CONCLUSIONS: Independent of all other factors, delirium is associated with higher mortality risk.

Association of Toll-like receptors 2, 3, and 4 genes polymorphisms with periapical pathosis risk

BACKGROUND: The aim of this study was to investigate the role of gene variations of Toll-like receptors (TLR) 2, 3, and 4 on genetic susceptibility to periapical pathosis. MATERIAL AND METHODS: One hundred patients were included in the study and divided into two groups as follows; Control Group (n=50) that have root canal treatment and no periapical lesion, Patient Group (n=50) that have root canal treatment and periapical lesion. TLR2 Arg753Gln, TLR3 (c.1377C/T) and TLR4 Asp299Gly and Thr399Ile polymorphisms were genotyped by using PCR-RFLP. Genotypical analysis of control and patient groups were investigated to disclose whether there is any association between periapical lesions and gene variations. RESULTS: There are no significant statistical differences between control and patient groups according to TLR 2 and 4 gene sequence. On the contrary, CC allele detected 74% for TLR 3 in patient group, and this difference was found to be statistically significant (p < 0.005). CONCLUSIONS: According to these results, it can be suggested that patients with Toll-like receptor 3 gene polymorphisms could be susceptible to periapical pathosis

Does stinging nettle (Urtica dioica) have an effect on bone formation in the expanded inter-premaxillary suture?

OBJECTIVE: To determine whether systemically given stinging nettle (SN) has an effect on bone formation in response to expansion of the rat inter-premaxillary suture. MATERIALS AND METHODS: A total of 28 male Wistar albino rats were randomly divided into 4 equal groups: control (C), only expansion (OE), SN extract given only during the expansion and retention periods (SN group; a total of 17days), and SN extract given during the nursery phase before expansion (a period of 40days) and during the expansion and retention periods (N+SN group; a total of 57days). After the 5-day expansion period was completed, the rats in the OE, SN, and N+SN groups underwent 12days of mechanical retention, after which they were sacrificed, and their premaxilla were dissected and fixed. A histologic evaluation was done to determine the number of osteoblasts, osteoclasts, and capillaries, as well as the number and intensity of inflammatory cells and new bone formation. RESULTS: Statistically significant differences were found between the groups in all histologic parameters except the ratio of intensities of inflammatory cells. New bone formation and the number of capillaries were significantly higher in the SN groups than in the other groups. The statistical analysis also showed that the numbers of osteoblasts, osteoclasts, and capillaries were highest in the N+SN group. CONCLUSION: Systemic administration of SN may be effective in accelerating new bone formation and reducing inflammation in the maxillary expansion procedure. It may also be beneficial in preventing relapse after the expansion procedure.

Effect of Royal Jelly on new bone formation in rapid maxillary expansion in rats

BACKGROUND: The aim of this study was to evaluate the effects of long and short term systemic usage of royal jelly on bone formation in the expanded maxillary suture in a rat model. MATERIAL AND METHODS: Twenty eight Wistar albino rats were randomly divided into 4 equal groups: Control (C); Only Expansion (OE), Royal Jelly (RJ) group, Royal Jelly was given to rats by oral gavage only during the expansion and retention period; Royal Jelly plus Nursery (RJN) group, Royal Jelly was given to rats by oral gavage during their nursery phase of 40 days and during the retention period. After the 5 day expansion period was completed, the rats underwent 12 days of mechanical retention. All rats were sacrificed in same time. Histological examination was performed to determine the number of osteoclasts, number of osteoblasts, number of capillaries, inflammatory cell infiltration, and new bone formation. RESULTS: New bone formation, number of osteoclasts, number of osteoblasts, and the number of capillaries in the expanded maxillary sutures were higher in the RJ and RJN groups than in the other groups. Statistical analysis also demonstrated that new bone formation and the number of osteoblasts was also highest in the RJN group. CONCLUSIONS: The systemic administration of Royal Jelly in conjunction with rapid maxillary expansion may increase the quality of regenerated bone

Effect of Royal Jelly on new bone formation in rapid maxillary expansion in rats.

BACKGROUND: The aim of this study was to evaluate the effects of long and short term systemic usage of royal jelly on bone formation in the expanded maxillary suture in a rat model. MATERIAL AND METHODS: Twenty eight Wistar albino rats were randomly divided into 4 equal groups: Control (C); Only Expansion (OE), Royal Jelly (RJ) group, Royal Jelly was given to rats by oral gavage only during the expansion and retention period; Royal Jelly plus Nursery (RJN) group, Royal Jelly was given to rats by oral gavage during their nursery phase of 40 days and during the retention period. After the 5 day expansion period was completed, the rats underwent 12 days of mechanical retention. All rats were sacrificed in same time. Histological examination was performed to determine the number of osteoclasts, number of osteoblasts, number of capillaries, inflammatory cell infiltration, and new bone formation. RESULTS: New bone formation, number of osteoclasts, number of osteoblasts, and the number of capillaries in the expanded maxillary sutures were higher in the RJ and RJN groups than in the other groups. Statistical analysis also demonstrated that new bone formation and the number of osteoblasts was also highest in the RJN group. CONCLUSIONS: The systemic administration of Royal Jelly in conjunction with rapid maxillary expansion may increase the quality of regenerated bone.

Segmental alveolar osteotomy by palatal approach to correct excessive angulated dental implants in anterior and posterior maxilla.

Dental implants have been used for a long time to achieve better prosthetic and health conditions in the mouth. With the increase in their usage, more complications have occurred, and methods of solving these problems have been developed. One complication is insertion of the implant in the wrong direction. The aim of this case report is to describe an osteotomy technique to reposition a malpositioned dental implant. A female patient, aged 38 years, and a male patient aged 48 years, were referred complaining of the malpositioned osseointegrated implants, which had been placed in the region of the left maxillary first premolar and molar tooth, and in the region of the left maxillary lateral incisor. Due to severe buccal positioning of the implant fixtures, acceptable prosthetic treatment was not possible. Alveolar osteotomy procedure was used to reposition the implants. Satisfactory results were obtained by osteotomy for 18-month of follow up. We conclude that inadequately axially inclined implants can be successfully treated by alveolar osteotomy. The preservation of marginal gingiva permits obtaining better prosthetic results. To avoid the recession of attached gingiva, palatal approach technique may help the clinicians.

Bilateral glandular odontogenic cyst of mandible: a rare occurrence.

Glandular odontogenic cysts (GOCs) of the jaw are rare with well-defined limits radiologically, unusual histopathological features and a high recurrence rate. The radiographic appearance of GOCs vary and are not pathognomonic. Definitive diagnosis of the GOC is established only by histopathological examinations. Histologically, GOC is characterized by a thin nonkeratinized squamous epithelial lining, with papillary projections, nodular thickenings, mucous (goblet) cells with intraepithelial mucous pools and intraepithelial glandular, microcystic or duct-like structures. We present an unusual case of a bilateral GOC in the mandible. This case report is also the first documented case of bilateral GOC in the mandible.

Effect of St John's wort on bone formation in the orthopaedically expanded premaxillary suture in rats: a histological study.

BACKGROUND/OBJECTIVE: The aim of this study was to investigate the effect of systemic St John's wort (Hypericum perforatum) on bone formation in the expanded premaxillary suture in rats. MATERIALS/METHODS: A total of 28 rats were randomly divided into four groups of equal numbers: control (C); only expansion (OE); St John's wort extract given only during the expansion and retention period (a total of 17 days; SJW group); and St John's wort extract given during the nursery phase before expansion (a period of 40 days), and during the expansion and retention periods (a total of 57 days; N + SJW group). After the 5 day expansion period was completed, the rats in the OE, SJW, and N + SJW groups underwent 12 days of mechanical retention, following which they were killed, and their premaxilla dissected and fixed. Histological examination was performed to determine the number of osteoclasts and capillaries, as well as the number of osteoblasts, inflammatory cell infiltration, and the amount of new bone formation. RESULTS: Statistical analysis showed that the number of osteoclasts and capillaries, and the inflammatory cell infiltration, as well as new bone formation, were higher in the SJW and N + SJW groups than in the other groups. However, statistical analysis demonstrated that among these two groups, all parameters, with the exception of the number of capillaries, were higher in the N + SJW group than the SJW group. CONCLUSIONS/IMPLICATIONS: Although more effective in long-term usage, systemic use of St John's wort hastens new bone regeneration at the premaxillary suture and may help prevent relapse after expansion.

Effects of energy drinks on soft tissue healing.

The aim of the present study was to investigate the effects of an energy drink (ED) on soft tissue wound healing in the rat model. Thirty-six male Wistar albino rats were randomly divided into 2 groups. A full-thickness paravertebral linear incision wound model was created. The experimental group (EG) received an ED (Red Bull), and the control group (CG) received water. Red Bull (3.57 mL/kg/d) was administered to the rats by the oral gavage method on the day before the skin incision and continued for 14 days. The rats were sacrificed (n = 6 in each group) on the 3rd, 7th, and 14th day of the study. Sections were obtained from excised linear wound healing site and stained with hematoxylin-eosin and Masson trichrome for morphological analysis. To assess angiogenesis on the sections, immunohistochemical studies were carried out using vascular endothelial growth factor antibody and alpha smooth muscle actin Ab-1. The breaking strength of the wound healing site was measured in Newtons using a tensiometer. Morphological analysis showed that collagen deposition in the wound areas was statistically higher in the EG compared with that of the CG at both the third and seventh days (P < 0.05). Re-epithelialization on healing sites in the EG was statistically higher than in the CG on the seventh day (P < 0.05). The results of the immunohistochemical studies indicated that the numbers of new blood vessels in the wound healing sites of the EG were significantly higher at the 7th and 14th days when compared with the CG (P < 0.05). The breaking strength of the wound healing sites was also significantly higher on the 7th and 14th days in the EG (P < 0.05). The results demonstrate that ED accelerates soft tissue wound healing and that its effect may be due to increased collagen deposition, re-epithelialization, and new blood vessel formation in the wound.

Propolis accelerates the consolidation phase in distraction osteogenesis.

We evaluated the effect of propolis on new bone formation after distraction osteogenesis (DO). This study examined 3 groups: control group, P100, and P200. Rabbits underwent DO of the left mandible after an osteotomy between the first molar and the mental foramen. Bone mineral content and bone mineral density were evaluated using dual-energy x-ray absorption 1 and 4 weeks after the procedure. The volume of connective tissue and new bone and the number of capillaries were measured using stereologic analysis after the subjects were killed. Dual-energy x-ray absorption showed that the bone mineral content and bone mineral density were higher in the groups treated with propolis by week 4, and these parameters were higher in the P200 group. Stereologic analysis showed no significant differences in connective tissue volume and number of capillaries among the groups. New bone volume was lowest in the P200 group. We concluded that propolis accelerates bone formation and may shorten the consolidation phase with DO.

Intraosseous epidermoid cyst associated with impacted mandibular wisdom teeth: an uncommon entity.

Epidermoid and dermoid cysts of the jaws are seen rarely. The formation theories of the intraosseous epidermoid cyst (IEC) are not clear. The radiographic appearance is similar with unilocular cysts. Surgical enucleation is the suggested treatment method for epidermoid cysts. This case report presents bilateral mandibular intraosseous epidermoid cysts with impacted wisdom teeth which is the first documented case in the literature.

Systemic propolis stimulates new bone formation at the expanded suture: a histomorphometric study.

OBJECTIVE: To investigate the effects of systemically given propolis on the expanded premaxillary suture in a rat study model. MATERIALS AND METHODS: The 24 rats were randomly divided into three groups-only expansion (OE), expansion plus propolis (PRO), and nonexpansion (control) groups. After the 5-day expansion period was completed, the OE and PRO groups underwent 12 days of mechanical retention. At the end of this period, the animals were euthanatized and their pre-maxillae were dissected and fixed. Histomorphometric examination was performed to determine the number of osteoclasts, osteoblasts, and capillaries as well as the intensity of inflammatory cells and amount of new bone formation. RESULTS: Statistical analysis showed that the intensities of inflammatory cells, number of osteoblasts, and amount of new bone formation were greater in the PRO group than in the other groups. The PRO group also had more osteoclasts and new capillaries. CONCLUSION: Systemic use of propolis may hasten new bone formation at the expanded suture in rats.

In vitro antibacterial effects of glass-ionomer cement containing ethanolic extract of propolis on Streptococcus mutans.

OBJECTIVE: The aim of this study was to evaluate the antibacterial property of glass-ionomer cement (GIC) containing propolis against Streptococcus mutans and its effect on the in vitro S. mutans biofilm formation. METHODS: Ethanolic extract of propolis (EEP) was prepared at two concentrations as 25 and 50%. Three different experimental GIC disks were prepared using pure liquid and liquid solutions diluted with 25 and 50 percent of EEP concentrations. Minimum inhibitory concentration (MIC) of EEP on the growth of S. mutans ATCC 25175 was determined by using agar dilution method. Agar diffusion test and an in vitro S. mutans biofilm assay for GIC disks with and without EEP were performed. RESULTS: MIC values of Turkish propolis for S. mutans ATCC 25175 was found as 25 µg/mL. Experimental GICs containing propolis exhibited inhibition zones and their dry biofilm weights were less than the pure GIC. The bacterial density was lower in the GIC containing 50% EEP. CONCLUSIONS: A distinct antibacterial and antibiofilm efficacy of propolis containing GIC on S. mutans has been observed. Although further research is needed to show clinical results, antibacterial GIC containing propolis would be a promising material for restoration.

Impacted mandibular permanent incisors associated with a supernumerary tooth: a case report.

In this report, a rare case of impacted mandibular permanent incisors and supernumerary tooth associated with cystic degeneration and its treatment are described.

Dramatic oral findings belonging to a pica patient: a case report.

Pica is a compulsive eating of non-nutritive substances and can have serious medical implications. The causes are not known, but the symptom is often associated iron-deficiency. Pica is an under-diagnosed problem. Although few dental problems associated with pica have been reported, because of its potential impact on blood measures, dental professionals must be aware of this common, but commonly missed, condition. This is an unusual case of a patient diagnosed with aggressive periodontitis (AgP) who had a dirt eating habit (geophagia) and was diagnosed as having pica.

Influence of storage media containing Salvia officinalis on survival of periodontal ligament cells.

AIM: The purpose of this study was to determine the ability of Salvia officinalis (S. officinalis) extracts to serve as a storage medium for the maintenance of periodontal ligament (PDL) cell viability of avulsed teeth. METHODS AND MATERIALS: PDL cells were obtained from healthy third molars and cultured in Dulbecco's Modi?ed Eagle's Medium (DMEM). Cultures were subjected to 4, 2.5, 1.5, and 0.5% S. officinalis solutions, Hank's balanced salt solution (HBSS), phosphate buffered saline (PBS), and tap water. Tissue culture plates were incubated with experimental media at 37 masculineC for 1, 3, 6, 12 or 24 hours. PDL cell viability was assessed by trypan blue exclusion. Statistical analysis of the data was performed by one-way analysis of variance (ANOVA) complemented by the Tukey's test. The level of significance was 5% (p< 0.05). RESULTS: The results showed 2.5% S. officinalis was a more effective storage medium than the other experimental solutions (p<0.05). Only at 1 hour and 3 hours was there found similar effect between 2.5% S. officinalis and HBSS. At 24 hours, 2.5% S. officinalis was found to be significantly better than the other solutions tested. CONCLUSION: S. officinalis can be recommended as a suitable transport medium for avulsed teeth. CLINICAL SIGNIFICANCE: The findings of this study support the use of S. officinalis as another option for clinicians to use to store and transport avulsed teeth until reimplantation procedures can be done.

Cytotoxicity analysis of strontium ranelate on cultured human periodontal ligament fibroblasts: a preliminary report.

BACKGROUND/PURPOSE: The aim of this study was to analyze the cytotoxicity of strontium ranelate (SR) on human periodontal ligament fibroblasts (PDL cells) in vitro. METHODS: PDL cells were obtained from healthy human third molars and cultured in Dulbeccos Modified Eagles Medium. The experimental groups were: G1, cultures treated with fresh medium (control); and G2, G3, G4 and G5: treated with SR at 20, 10, 5 and 2.5 mg/mL, respectively. The experimental times were 1, 6, 12 and 24 hours (short-term) for viability, and 2, 4, 6 and 8 days (long-term) for cell survival. The cells were counted using a hemocytometer. Data were then analyzed by one-way ANOVA and Tukey's tests (p < 0.05). RESULTS: Cultures treated with the highest SR concentrations (G2 and G3) had significantly lower cell viability and cell numbers (p < 0.05) than those in G1, G4 and G5. SR at 2.5 mg/mL was non-cytotoxic to PDL cells. CONCLUSION: SR was non-toxic at appropriate concentrations. Preclinical tests are needed to further assess its safety and effectiveness for tooth resorption prior to clinical use.

A morphometric and histopathologic evaluation of the effects of propolis on alveolar bone loss in experimental periodontitis in rats.

BACKGROUND: Propolis collected by honeybees from various plant sources is a resinous hive product possessing a broad spectrum of biologic activities. Propolis has been used extensively in the diet to improve health and prevent disease. The purpose of this study was to analyze the morphometric and histopathologic changes associated with experimental periodontitis in rats in response to the systemic administration of propolis. METHODS: Forty Wistar rats were divided into four experimental groups: non-ligated (NL; N = 10); ligature only (LO; N = 10); and systemic administration of ligature and propolis (100 mg/kg body weight per day [Pro100; N = 10] or 200 mg/kg body weight per day [Pro200; N = 10]). Silk ligatures were placed at the gingival margin of the lower first molars in both mandibular quadrants. The study duration was 11 days, and the animals were sacrificed at the end of this period. Changes in alveolar bone levels were clinically measured, and tissues were histopathologically examined to assess the differences among the study groups. RESULTS: At the end of 11 days, alveolar bone loss was significantly higher in the LO group compared to the NL, Pro100, and Pro200 groups (P <0.05). Osteoclast numbers in the LO group were significantly higher than those of the NL, Pro100, and Pro200 groups (P <0.05). Both dosages of propolis significantly reduced the periodontitis-related bone loss, but the differences between the two propolis groups were not statistically significant (P >0.05). CONCLUSION: The findings of this study provide morphologic and histologic evidence that propolis, when administered systemically, prevents alveolar bone loss in the rat model.

Prevalence of commonly found pathoses associated with mandibular impacted third molars based on panoramic radiographs in Turkish population.

OBJECTIVE: The objective was to determine the association between commonly found pathologic conditions and angulations and impaction depths of lower third molar teeth. STUDY DESIGN: In this retrospective study 1,914 panoramic radiographs with 3,050 impacted lower third molars (ILTMs) were examined. RESULTS: The problems and the prevalence evaluated were caries on mandibular second molar (12.6%), caries on ILTM (5.3%), bone loss at the distal aspect of ILTM (9.7%), and periodontal tissue damage on adjacent tooth (8.9%). A total of 26.5% of all the cases were affected by any one of the 4 pathologic changes. It was determined that horizontal and mesioangular ILTMs had high risk of caries development on second or third molar; in contrast, vertical and distoangular ILTMs had low risk. Distoangular and vertical ILTMs had high risk of development of bone loss at the distal aspect. Mesioangular and horizontal ILTMs had a high risk for periodontal tissue damage on an adjacent tooth. When evaluating impaction depth of the ILTM, class A had a higher risk of pathology than class B or C. CONCLUSIONS: Horizontal and mesioangular impactions were found with more pathologic situations; especially in class A impaction depth. Angulation and impaction depth of the ILTM should be taken into consideration when making a decision whether to extract an ILTM or not.

In vitro evaluation of the amoebicidal activity of garlic (Allium sativum) extract on Acanthamoeba castellanii and its cytotoxic potential on corneal cells.

Free-living protozoa of the genus Acanthamoeba can cause one of the most severe, potentially sight-threatening infections of the eye, the so-called A. keratitis. A. keratitis is difficult to treat because, under adverse conditions, the amoeba encyst and medical therapy is often less effective against cysts than against trophozoites. The aim of this study was to investigate evaluate the in vitro effect of the nonpolar subfraction of the methanol extract of garlic (Allium sativum) on the growth of A. castellanii trophozoites and cysts and also its cytotoxicity on corneal cells in vitro. Extract was evaluated for its amoebicidal activity, using an inverted light microscope. The effect of the nonpolar extract with the concentrations, ranging from 0.78 to 62.5 mg/mL on the proliferation of A. castellanii trophozoites and cysts, were examined in vitro. For the determination of cytotoxicity of the extract on corneal cells, agar diffusion tests were performed. The present study demonstrates the in vitro effectiveness of the garlic against the A. castellanii growth curve. Evaluations revealed that garlic inhibits trophozoite growth in dose- and time-dependent ways. In the case of the cyctotoxic acitivities, it showed no cytotoxicity for the cornea cells in the concentration of 3.90 mg/mL. These findings indicate that nonpolar subfraction of the methanol extracts of garlic has amoebicidal, as well as its cysticidal, properties on Acanthamoeba trophozoites and cysts. Garlic alone, and in combination with other amoebicidal agents, may be used in clinical practices after further investigations.