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Objectives The aim of this systematic review was to evaluate the association between specific genetic polymorphisms and dental implant-related biological complications in patients having a follow-up period of at least 12-months post-loading. Material and methods A sensitive search strategy was developed to identify implant-related genetic-association studies. This was performed by searching five databases. A three-stage screening (titles, abstract, full text) was carried out in duplicate and independently by two reviewers. Assessment was carried out according to the suggested scale for quality assessment of periodontal genetic-association studies and adapted to genetic analyses of implant-related studies leading to an overall final score 0-20 based on the summation of positive answers. Results The initial search resulted in 1838 articles. Sixty-seven full-text articles were assessed for eligibility and four studies met the defined inclusion criteria. IL-6 G174C, TNF-alpha -308, IL-1A-889 and IL-1B+3954 and CD14-159 C/T polymorphisms were evaluated. The quality assessment scores ranged from 6 to 11 positive answers from out of a maximum score of 20. The great heterogeneity among the studies did not allow a meta-analysis. Conclusions The published evidence on genetic predisposition and implant biologic complications is limited. The small number of identified studies evaluating the association between genetic polymorphisms and peri-implant disease presented methodological and reporting inadequacies. Thus, the potential link between genetic polymorphisms and biological complications should be further investigated and clarified through well-designed clinical studies on adequately powered and appropriately included study populations.

The pulsatile fashion of the release of sex steroid hormones has an impact on periodontium. The aim of this systematic review was to determine whether sex steroid hormones influence periodontal diseases or not. MEDLINE via OVID, EMBASE, and the Cochrane Database updated until July 2017 were searched and, particularly, the papers published over the past 5 years were reviewed. The evidence is more supportive towards the effect of sex steroid hormone perturbations on an existing periodontal disease rather than the initiation of disease. Examination of potential diagnostics for preventive or therapeutic applications is needed in order to decrease the composite risks arising from the hormonal changes themselves. Also, further clinical trials comparing sex steroid hormone exposure on patients with similar baseline periodontal conditions are emerging in order to understand the causal mechanisms between the two, eventually, helping to make clearer clinical recommendations and guidelines for hormone-dominated periods in both men and women.

The aim of this systematic review was to evaluate the existing evidence on the association between Thalassemia major (TM) and periodontal condition.MEDLINE via OVID, EMBASE, and The Cochrane Database (including the Central Register of Controlled Trials (CENTER)), were searched up to September 2018 to identify observational studies eligible for systematic review and meta-analyses. Newcastle-Ottawa Scale (NOS) was used for quality assessment.The initial search resulted in 172 articles, and of these, 16 articles were included and a qualitative synthesis was carried out. Based on the quantitative data from 14 studies, significant differences were found in gingival index (GI) (p 0.001), bleeding on probing (p = 0.02) as well as plaque index (PI) (p 0.01) measures between TM and systemically healthy controls. Additional analyses (young vs. adult) for GI and PI revealed that such significant differences were only observed in adults, even though overall analysis showed no subgroup effect. The majority of the studies qualified as "intermediate quality".Patients with TM had significantly higher gingival inflammation scores compared to controls. Therefore, routine comprehensive periodontal screening in TM is recommended in order to prevent occurrence of periodontal diseases and eventually reduce the complexity of the oral health care. Also, conduction of further well-designed observational studies is recommended to contribute to this topic.

Background and objective The aim of this study was to describe the radiographic features of the first molars of patients with localized aggressive periodontitis (LAgP) and of their associated intrabony defects and to compare them with a control sample of chronic periodontitis cases and healthy subjects. Methods Data from a total of 93 patients were included in this analysis. First, dental panoramic tomograms of 34 patients with LAgP (131 first molars) and 30 periodontally healthy patients (110 first molars) were compared. Then, periapical radiographs of the first molars of the same patients with LAgP and of 29 patients with chronic periodontitis affected by intrabony defects were analysed. Results Shorter root trunks were associated with the presence of intrabony defects in patients with LAgP (P = .002 at multilevel logistic regression), also when LAgP molars were compared with healthy subjects (P = .036). Although no difference in defect depth and angle was noted between LAgP and chronic periodontitis intrabony defects, LAgP intrabony defects appeared to be more frequently symmetrical and arch-shaped than in chronic periodontitis (P = .008), with positive predictive value and negative predictive value of for 'wide arch' defect of 87.3% (95% CI = 77.2%-93.3%) and 32.3% (95% CI = 27.7%-37.2%) respectively. Conclusion First molars of patients with LAgP affected by intrabony defects may have some distinct radiographic anatomical characteristics to those of healthy subjects. The shape of intrabony defects seems to differ between LAgP and chronic periodontitis cases. Further studies need to confirm these features and investigate if they are related to the initiation and progression of periodontitis.

Dental calculus represents the first fossilized record of bacterial communities as a testimony of evolutionary biology. The development of dental calculus is a dynamic process that starts with a nonmineralized biofilm which eventually calcifies. Nonmineralized dental biofilm entraps particles from the oral cavity, including large amounts of oral bacteria, human proteins, viruses and food remnants, and preserves their DNA. The process of mineralization involves metabolic activities of the bacterial colonies and strengthens the attachment of nonmineralized biofilms to the tooth surface. From a clinical point of view, dental calculus always harbors a living, nonmineralized biofilm, jeopardizing the integrity of the dento-gingival or implanto-mucosal unit. This narrative review presents a brief historical overview of dental calculus formation and its clinical relevance in modern periodontal practice.

Objectives To evaluate the effect of leukocyte and platelet-rich fibrin (L-PRF) in combination with deproteinized bovine bone mineral (DBBM) on bone regeneration in maxillary sinus augmentation. Material and methods Thirteen patients (nine males and four females, mean age ± SD; 49.92 ± 10.37) were enrolled to the study. 26 maxillary sinus augmentation procedures were randomly performed using DBBM and L-PRF mixture (test) or DBBM alone (control) in a split-mouth design. The same surgical procedures were performed in both groups, and bone biopsies were harvested from the implant sites 6 months postoperatively for histological and histomorphometric evaluations as the primary outcome of the study. Implants were placed and then loaded in the augmented sites after 6 months. The secondary outcomes included clinical and radiographic data and were obtained pre- and postoperatively. Results There was no qualitative difference in histological analyses among the groups. In all samples, a newly formed bone was in direct contact with the residual material. The percentages of newly formed bone (test; 21.38 ± 8.78% and control; 21.25 ± 5.59%), residual bone graft (test; 25.95 ± 9.54% and control; 32.79 ± 5.89%), bone graft in contact with the newly formed bone (test; 47.33 ± 12.33% and control; 54.04 ± 8.36%), and soft tissue (test; 52.67 ± 12.53% and control; 45.96 ± 8.36%) were similar among the groups (p

A bstract Background Only a handful of studies have assessed tooth loss risk in chronic periodontitis patients following active therapy and factors associated with it. Aims The aim of this retrospective study was to assess tooth loss in a cohort of chronic periodontitis patients undergoing maintenance care in a UK private practice setting. Materials and Methods One hundred chronic periodontitis patients treated with active periodontal therapy (APT) were followed up in supportive periodontal therapy (SPT) for at least 5 years. Tooth loss rates and the effect of patient- and tooth-factors on tooth loss were assessed. Existing patient-based prognosis systems and a novel tooth-based prognosis system were tested for their association with tooth loss. Results Excluding third molars, 34 teeth were extracted during SPT, with an overall average tooth loss of 0.06 teeth/patient/year (0.02 for periodontal reasons). Multivariable analysis showed that age, patient-prognosis based on the PRA system, tooth prognosis, furcation involvement and previous endodontic therapy were significantly associated with tooth loss during SPT. Conclusion Good overall stability and a small tooth loss rate were observed in this cohort of chronic periodontitis cases under SPT in private practice. Patient-based and tooth-based prognosis systems may be used to estimate the risk of tooth loss. This article is protected by copyright. All rights reserved.

Background and objective Degree III furcation involvement (FI) represents a risk of molar tooth loss. A limited number of studies have assessed the survival of molars with degree III FI treated with tunnelling procedures. Aims The aim of the present study was to assess periodontal disease progression and tooth loss in a cohort of patients with degree III FI treated with tunnelling by two periodontists in a private practice setting in the UK and in a hospital setting in Sweden. Materials and methods A retrospective study was conducted on 102 consecutive surgically created tunnelled molars in 62 periodontitis patients and followed up at least 5 years later (average 7-year and 9-month follow-up). Results Overall tooth loss for tunnelled molars was 29.4%. Multivariate analysis revealed statistically significant associations with tooth loss for 'irregular supportive periodontal therapy (SPT'; p = .039) and age (p = .037). Tooth loss occurred only in the Swedish sample, not undergoing regular SPT. Conclusion A high rate of tooth loss was observed following tunnelling surgery, mainly in patients not undergoing regular supportive therapy. Clinical studies should be carried out to compare tunnelling with other treatment options for advanced furcation involvement in patients on SPT.

Objective: To evaluate local and systemic levels of interleukin-10 (IL-10), IL-33, and tumor necrosis factor alpha (TNF-?) in Thalassemia major (TM) in the presence of gingival inflammation. Material and Methods: 58 patients (TM, n=29 and systemically healthy controls, n=29) were included to the study. IL-10, IL-33, and TNF-a levels were evaluated in gingival crevicular fluid (GCF), saliva and serum. Clinical periodontal measurements were recorded. Results: GCF IL-33 total amounts in TM and gingivitis group were elevated compared to systemically and periodontally healthy group (p=0.01). GCF IL-10, IL- 33 and TNF-? concentrations were higher in TM and periodontally healthy group than the systemically healthy and gingivitis group (p=0.02, p=0.008, p=0.003). Serum IL-10 levels were elevated in TM and gingivitis compared to the systemically healthy and gingivitis (p=0.0009) and systemically and periodontally healthy (p=0.0007) groups. Serum IL-10 and TNF-? levels in TM and periodontally healthy group were higher than systemically and periodontally healthy group (p=0.01 and p=0.02). Conclusion: TM may potentially alter circulating levels of IL-33 and IL-10 and therefore, may affect the degree of periodontal inflammation locally or vice versa. Yet, the underlying mechanism linking the hematologic condition is not clear and deserves further investigation. © 2019, Universidade Estadual Paulista, Institute of Science and Technology of Sao Jose dos Campos. All rights reserved., 2013/DIS/030, This study was supported by a grant from the Research Foundation of Ege University, Izmir, Turkey (project no. 2013/DIS/030).

OBJECTIVES: To test whether or not vascularized interpositional periosteal-connective tissue grafts are as successful as free subepithelial connective tissue grafts in augmenting volume defects in the anterior maxilla. MATERIAL AND METHODS: Twenty subjects with Seibert class 1 ridge defects in the anterior maxilla were randomly, equally assigned to augmentation by vascularized interpositional periosteal-connective tissue graft (test) or free subepithelial connective tissue graft (control). Clinical periodontal parameters at teeth adjacent to the gap were recorded, and conventional impressions were taken prior to surgery (baseline = t0 ) and 1 (t1 ), 3 (t3 ) and 6 (t6 ) months after surgery. The casts were optically scanned, digitized and analyzed for ridge contour changes in the augmented area. Data were subjected to nonparametric statistics. RESULTS: The contour changes in labial distance between baseline and follow-up for the control group were (median, range) 1 mm, 0.37-1.45 (t0 -t1 ); 1.18 mm, 0.39-1.40 (t0 -t3 ); and 0.63 mm, 0.28-1.22 (t0 -t6 ) and for test group 1.21 mm, 0.74-2.47 (t0 -t1 ); 1.26 mm, 0.50-1.71 (t0 -t3 ); and 1.18 mm, 0.16-1.75 (t0 -t6 ). Significantly less shrinkage of the graft was observed in the test group after 6 months (P = 0.03). Clinical periodontal parameters at the neighboring teeth were stable over the follow-up period and did not differ between groups. CONCLUSIONS: Augmentation of single tooth gaps with moderate ridge defects in the anterior maxilla was successfully performed using both techniques. However, after 6 months, sites treated by the pediculated graft were superior in maintaining the initially augmented volume and showed less shrinkage of the graft. This could be attributed to better perfusion of the pediculated graft.

Objectives The aim of this systematic review was to determine whether soft tissue biotype at implant placement has an influence on crestal bone loss (CBL) at 1 year after implant loading. Material and methods Following electronic search in three databases (MEDLINE via OVID, EMBASE and The Cochrane Database) and hand search up to April 2015, two reviewers screened independently and in duplicate the references to identify randomized controlled trials, controlled clinical trials (CCTs) and prospective case series eligible for systematic review and meta-analysis. Cochrane Collaboration's tool was used for assessing risk of bias. Results From 2944 citations, six studies (6 CCTs) met the inclusion criteria. Four of six individual studies that compared thin vs. thick biotype showed significantly higher CBL in thin biotype. Meta-analysis could only be performed with two studies and the differences did not reach significant level. None of the included studies was of low risk of bias. Conclusions At present, there is insufficient evidence to answer the question on the differences in clinical outcome in terms of CBL between implants placed in sites with initial soft tissue thickness

Background Fibromiyalgia (FM) patients are commonly suffer from balance problems and increased fall frequency. However, validity of any measurement tool has not been determined in clinical trials. Modified Clinical Test of Sensory Interaction and Balance Test (M-CTSIB) is a simple and easily administered test. Objectives The aim of the study was to investigate the validity and reliability of the M-CTSIB in FM patients. Methods Twenty-one FM patients and 15 age matched controls were evaluated M-CTSIB. M-CTSIB was evalueted by Biodex-BioSwayTM (Biodex Inc., Shirley, New York)]. M-CTSIB evaluates the relationship between balance and visual, somatosensory and vestibular system. Tests carried out were 4 conditions, condition-1: eyes open-firm surface, condition-2: eyes closed-firm surface, condition 3: eyes open-foam surface, and condition 4: eyes closed-foam surface, for 30 s intervals with two repetitions. Body oscillations of the participants were calculated by the system and Sway Index scores obtained. High scores indicate high postural sway of the test subject. Results The results of this study, FM patients had significantly impaired balance in all conditions of M-CTSIB compared to controls (p Conclusions These results suggest that FM may lead to increase balance problems. M-CTSIB has been proved to be valid, objective and clinically useful method to detect balance impairments in FM patients. Disclosure of Interest None declared

Background Kinesiophobia play an important role in the development of chronic pain in Fibromyalgia (FM) patients. This condition lead to increase clinical symptoms and reduce quality of life. Objectives The aim of the study is to examine the effects of kinesiophobia on pain, fatigue, functional exercise capacity,functional status and quality of life in FM patients. Methods Twenty-one FM patients were evaluated. We used Tampa Scale of Kinesiophobia (TSK) for perception kinesiophobia, Visual Analogue Scale (VAS) for pain intensity, Fatigue Severity Scale (FSS) for fatigue, six-minute walk test (6MWT) for functional capacity, Fibromyalgia Impact Questionnaire (FIQ) for the functional status, and Short-Form Health Survey (SF-36) for quality of life. Results The results of this study, there was a strong correlation between TSK and VAS, FSS, physical and mental components of SF-36 (r=0.754, r=0.762, r=0.780, and r=0.843, respectively; p Conclusions The results of the present study indicate that kinesiphobia can adversely affect pain, fatigue, functional status and functional exercise capacity, which is result in impaired quality of life in FM. Further, it demonstrates kinesiophobia can be a clinically appropriate assessment to evaluate patients and to determine the effectiveness of treatments in FM. Disclosure of Interest None declared

WOS: 000464607900017, PubMed ID: 29451928, The aim of these case reports was to introduce a simplified novel connective tissue graft (CTG) harvesting technique, the ring method, which could be used in the maxillary tuberosity area in particular. A special CTG harvesting punch was fabricated to obtain a ring-shaped CTG that had a uniform thickness. The ring graft was then used for pen-implant soft tissue augmentation with successful clinical outcomes. The ring method is a technically insensitive and minimally invasive surgical procedure that provides a certain amount of CTG for various periodontal plastic surgical interventions.

WOS: 000452921800019, PubMed ID: 29451929, This case series describes a treatment method in which the natural tooth was used as the temporary and permanent reconstruction after immediate implantation in the esthetic zone of periodontally compromised patients. Five patients with a hopeless tooth in the esthetic zone due to periodontal causes were included. The tooth was extracted, and immediate implantation protocol was followed. The extracted tooth was adapted over a temporary abutment during the osseointegration period, and the same tooth served as the final prosthetic reconstruction with a customized zirconia abutment. Esthetic outcome was satisfactory to the patients, and no biologic or prosthetic complications were observed up to 3 years. The technique could be recommended, especially in the esthetic area of periodontally compromised patients who have intact clinical crowns.

Background Periodontal involvement of the furcation area (furcation involvement, FI) has been reported to confer molars a higher risk of tooth loss. Aims The aim of this retrospective analysis was to assess the effect of FI on disease progression and tooth loss in molars of patients with chronic periodontitis undergoing supportive periodontal therapy (SPT) in a UK private practice setting. Materials and methods Six-hundred and thirty-three molars were analysed in 100 chronic periodontitis patients treated with active periodontal therapy (APT) and followed up in SPT for at least 5 years. Molars were treated with a combination of resective, regenerative or conservative approaches, according to the different clinical needs. Results Twenty-three molars were extracted during APT and a further 23 were lost during SPT. Multivariable analysis showed that both horizontal FI and vertical furcation component were associated with increased risk of tooth loss during SPT (OR 5.26, 95% CI: 1.46-19.03, p = .012 and OR 9.83, 95% CI: 1.83-50.11, p = .006, respectively). Conclusion Attention should be placed on both horizontal and vertical FI in molars, owing to their association with tooth loss during SPT.

Aim: Type 1 diabetes which is a chronic metabolic disease can affect the quality of life of a person. The aim of this study is to evaluate the life quality of diabetic children and adolescents who are diagnosed with type 1 diabetes mellitus and compare the perceptions of life quality through the life quality scale before and after summer camp. Materials and Method: A scale of life quality was applied to 31 children/adolescents with type 1 Diabetes Mellitus between ages 9-16 years in the Diabetes Summer Camp. Results: The perceived quality of life of children / adolescents with type 1 diabetes were better after diabetes camp (p< 0.05). When the Quality of Life Scale scores compared by gender, it was found that the emotional well-being and self esteem subscale scores and the total scores of boys were statistically significantly higher after diabetes camp. But the Quality of Life Scale scores of girls did not show a significant increase. Conclusion: This study showed that the diabetes camp, which promoted the ability of diabetic children and adolescents to manage their illnesses, changed the perception of quality of life of male diabetic patients in particular. However, repeating similar studies involving a larger number of cases will allow better evaluation of the results of such activities.

Objective: This clinical study evaluated the success of two different splint materials bonded on periodontally treated mobile teeth.Methods: A total of 14 patients were included in the study. Patients were randomly assigned to the groups to receive either with or wire composite splint (WCS) or fiber-reinforced composite splint (FCS). Clinical periodontal parameters were performed and periotest values were recorded at baseline, and after 6 and 12 months. Patients were asked to complete a self-administered questionnaire after the splinting procedures. Failure types for the splints were categorized.Results: Baseline PI values showed significant decrease at 6 month follow up in the WCS (p=0.0019) and FCS (p

Alveolar ridge defects occur in edentulous ridges because of hard and soft tissue changes after tooth loss due to tumors, periodontal diseases, implant loss etc. Even alveolar ridge defects could be treated using both hard and soft tissue grafts or their combination, hard tissue augmentation may not be necessary and only augmentation of the soft tissue could be adequate if dental implant treatment is not to be undertaken. Both free and pediculated soft tissue grafts were described. Roll technique and vascularized interpositional periostealconnective tissue grafts are frequently used as pediculated connective tissue grafts, and most frequently used free grafts are connective tissue and free gingival grafts, interpositional, onlay, interpositional/onlay graft combinations and acelluler dermal matrix. Although the advantages of the techniques is well described, studies comparing the clinical outcomes of these methods are limited. The aim of the present review is to demonstrate the advantages and disadvantages of soft tissue augmentation techniques in the treatment of alveolar ridge defects and to compare the clinical outcomes of these techniques. It can be concluded that, selection criteria of the appropriate soft tissue augmentation technique today are generally based on the clinical predictability of the techniques and the experience level of the surgeon.

The aim of the present cross-sectional study was to compare clinical periodontal findings as well as gingival crevicular fluid (GCF) and serum levels of tumour necrosis factor-alpha (TNF-α), interleukin-10 (IL-10), and IL-33 between women with and without gestational diabetes mellitus (GDM).Serum and GCF samples were collected, full-mouth recordings comprising plaque index, bleeding on probing and probing depth were performed in 96 females with GDM (cases) and 65 non-diabetic pregnant females (controls). Age, smoking status, pre-pregnancy body mass index, pregnancy outcomes were recorded. Serum and GCF IL-10, IL-33, TNF-α levels were determined.The GDM group was significantly older than the control group with an age difference of 3.27 years (mean ages were 32.05 and 28.78 years, respectively) (p0.0001). Plaque Index (50.0 and 30.0 p=0.005), bleeding on probing (50.0 and 30.0 p=0.003) values were significantly higher in the GDM group. Serum TNF-α concentrations were significantly higher in the nonGDM group than the GDM group (p=0.001). GCF IL-10 concentrations and total amounts were significantly higher in the GDM group than the controls (p=0.004 and p0.0001, respectively).Elevated GCF IL-10 levels may be a consequence of higher levels of inflammation as indicated by higher PI and BOP in the GDM group. However, the investigated clinical parameters may not have prominent effects on TNF-α and IL-33 levels. These findings provide further support for the importance of periodontal health during pregnancy.

WOS: 000342921200079, PubMed ID: 25232962, Polycystic ovary syndrome (PCOS) is a hormonal disorder of women that not only is the leading cause of infertility but also shows a reciprocal link with oral health. This study aimed to investigate the hypothesis that the levels of putative periodontal pathogens in saliva and their antibody response in serum are elevated in PCOS, compared to systemic health. A total of 125 women were included in four groups; 45 women with PCOS and healthy periodontium, 35 women with PCOS and gingivitis, 25 systemically and periodontally healthy women, 20 systemically healthy women with gingivitis. Salivary levels of seven putative periodontal pathogens were analyzed by quantitative real-time polymerase chain reaction and serum antibody levels were analyzed by ELISA. In women with PCOS, salivary Porphyromonas gingivalis, Fusobacterium nucleatum, Streptococcus oralis and Tannerella forsythia levels were higher than matched systemically healthy women, particularly in the case of gingivitis. Aggregatibacter actinomycetemcomitans and Treponema denticola levels were similar among study groups. The presence of PCOS also enhanced P. gingivalis, Prevotella intermedia and S. oralis serum antibody levels, when gingivitis was also present. Gingival inflammation correlated positively with levels of the studied taxa in saliva, particularly in PCOS. The presence of P. gingivalis and F. nucleatum in saliva also exhibited a strong positive correlation with the corresponding serum antibody levels. In conclusion, as an underlying systemic endocrine condition, PCOS may quantitatively affect the composition of oral microbiota and the raised systemic response to selective members of this microbial community, exerting a confounding role in resultant gingival inflammation and periodontal health. The most consistent effect appeared to be exerted on P. gingivalis., Continental European Division of the International Association of Dental Research; Institute of Oral Biology, Center of Dental Medicine, University of Zurich, This study was supported by a Visiting Research Fellowship (AA) of the Continental European Division of the International Association of Dental Research, and the Institute of Oral Biology, Center of Dental Medicine, University of Zurich. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

WOS: 000380166000002, PubMed ID: 27028890, ObjectivesThis study aimed to investigate the levels of 11 oral species in plaque samples and cytokine levels in biofluid samples of patients with idiopathic uveitis (IU) and systemically healthy individuals (H) with or without gingival inflammation. Material & MethodsTwenty-one patients with IU (n=21), and 22 systemically healthy individuals (n=22) were enrolled in the study. Clinical periodontal measurements were recorded. Cytokine levels in the biofluid samples were determined by ELISA. Bacterial gene copy numbers were determined by qPCR on plaque microbial DNA preparations. ResultsAccording to two-step cluster analysis, anova and t-test: GCF, serum and salivary TNF-, IL-17A, IL-17A/E; GCF and serum IL-6; salivary IL-17F, and salivary and serum IL-17A/F levels were higher in the IU group than the H group (p

Periodontal diseases are common chronic inflammatory diseases caused by pathogenic microorganisms colonising the subgingival area and inducing local and systemic elevations of pro-inflammatory cytokines resulting in tissue destruction. Apparition and evolution of periodontal diseases are influenced by many local or systemic risk factors. Psychological stress has been suggested as one of them and may negatively influence the outcome of periodontal treatment. However, mechanisms explaining the possible relationship between stress and increased susceptibility to periodontal disease remain poorly understood. Several stress markers are found in blood and saliva of patients with periodontal diseases and influence the development of periodontal diseases by several mechanisms including modifications of the inflammatory response and changes in the composition of the dental biofilm. The aim of this review is to provide an insight into the relationship between psychological stress and periodontal diseases.

Objectives: The aim of this study was to investigate the possible effects of fixed dental prosthesis procedures with and without gingival retraction containing potassium aluminum sulfate on TNF-α, MMP -1 and MMP-8 levels at gingival crevicular fluid in periodontally healthy subjects and to demonstrate that these markers can be used for the assessment of disease activity. Methods: Eight healthy subjects, each with at least two abutment teeth, were included in our research. Gingival crevicular fluid (GCF) samples were obtained before initiation of fixed dental prosthesis treatment and repeated on days 2, 3, 7 and first month after cementation. GCF concentrations of MMP-1, MMP-8 and TNF-α were determined by ELISA. ANOVA was used for statistical analysis. Results: The GCF MMP-8 concentrations revealed significant differences among study groups (p 0.05). The MMP-8 concentrations of control group was significantly decreased in the first month (p

Background: The aim of this cross-sectional study is to compare the local and systemic levels of soluble receptor activator of nuclear factor-κB ligand (sRANKL), osteoprotegerin (OPG), a proliferation-inducing ligand (APRIL), B-cell activating factor (BAFF), interleukin (IL)-6, and IL-8 in biofluids of patients with thalassemia major (TM) with or without gingivitis. Methods: Seventy-seven patients are included in this study (TM, n = 29; systemically healthy, n = 48). Gingival crevicular fluid (GCF), saliva, and serum levels of IL-6, IL-8, sRANKL, OPG, BAFF, and APRIL were determined by enzyme-linked immunosorbent assay. Data were analyzed by appropriate non-parametric or parametric statistical tests. Results: Median GCF, serum, and saliva levels for BAFF (P

WOS: 000356367300002, PubMed ID: 25959628, AimGestational diabetes mellitus (GDM), gingivitis, infection with specific periodontal pathogens and systemic inflammation each increase the risk for poor pregnancy outcome. We set out to monitor the interactions of gingivitis and GDM with respect to oral infection and the systemic inflammatory burden. Materials and MethodsFour case-control groups (n=117) were recruited, (1) No gingivitis, No GDM (n=27); (2) Gingivitis, No GDM (n=31); (3) No gingivitis, GDM (n=21); and (4) Gingivitis, GDM (n=38). Oral infection with three key periodontal pathogens was determined by PCR. Systemic inflammation was determined by quantification of CRP by EIA. ResultsGingivitis during pregnancy was associated with oral infection with Porphyromonas gingivalis, Filifactor alocis and Treponema denticola and combinations thereof (all p, NIDCRUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of Dental & Craniofacial Research (NIDCR) [RO1 DE019826]; Ege University Research FoundationEge University [2013 DIS 026], The authors have no conflict of interest. This study was funded, in part, by NIDCR (Grant # RO1 DE019826, DAS) and the Ege University Research Foundation (Project No: 2013 DIS 026).

This study aimed to investigate the levels of matrix metalloproteinase-8 (MMP-8) and tissue inhibitors of MMP-1 (TIMP-1) in saliva and serum samples of women with polycystic ovary syndrome (PCOS; n = 80) and matched systemically healthy controls ( n = 45), with varying degrees of gingival inflammation. Salivary levels of MMP-8 and the MMP-8/TIMP-1 ratio were significantly elevated in women with PCOS, who also exhibited more gingivitis than systemically healthy women. No major changes were observed in salivary TIMP-1 levels with regard to PCOS. Serum levels of MMP-8 and the MMP-8/TIMP-1 ratio were significantly higher in women with PCOS, irrespective of the presence of gingivitis, while there were no differences in TIMP-1 levels. A positive correlation was indicated between probing depth, bleeding on probing, plaque index and salivary or serum MMP-8 levels or MMP-8/TIMP-1 ratio in the case of PCOS, while a negative such correlation was revealed for TIMP-1 in systemically healthy women. Increased levels of MMP-8 in saliva and serum seem to be more pronounced in women with PCOS, and potentiated in the presence of gingival inflammation. Alterations in MMP/TIMP system triggered by local and systemic inflammation may be implicated in the pathogenesis of PCOS, or the deterioration of its clinical presentation.

Gingival recession is the apical shift of gingival margin beyond the cemento-enamel junction. Even though different techniques was described for the treatment of the recessions, the increased success rate of microsurgery in a variety of periodontal surgical interventions brought its utilization forward in root coverage procedures. The aim of the present article is to show the advantages and disadvantages of microsurgery in root coverage procedures, to evaluate the features and efficiency of the equipment and to demonstrate the effect of microsurgery on root coverage procedures

Gestational diabetes mellitus (GDM) is defined as varying glucose intolerance, with first onset or recognition in pregnancy. This study evaluates clinical and biochemical parameters in a possible association between GDM and gingivitis.A total of 167 pregnant females was included in the study. There were 101 females with GDM and 66 females without GDM. Subgroups were created according to the presence or absence of gingival inflammation. Plaque index, bleeding on probing, and probing depth were recorded at four sites per tooth. Serum, saliva, and gingival crevicular fluid (GCF) levels of interleukin (IL)-6, IL-8, soluble receptor activator of nuclear factor-kappa B ligand (sRANKL), osteoprotegerin (OPG), B-cell activating factor (BAFF), and a proliferation-inducing ligand (APRIL) were determined by enzyme-linked immunosorbent assay. Data were analyzed by Kruskal-Wallis and Mann-Whitney U tests and Spearman correlation analysis.Age and anthropometric indices were higher in the GDM than non-GDM group (P0.0001). Clinical periodontal recordings, serum BAFF, IL-8, and saliva sRANKL levels were higher in the GDM group (P0.05). Saliva IL-6 level was higher in the GDM with gingivitis group than non-GDM with gingivitis group (P = 0.044). Serum and GCF BAFF (P0.0001), serum, saliva, and GCF APRIL (P0.0001; P0.0001; P = 0.032, respectively), GCF OPG (P = 0.036), and serum and saliva sRANKL (P0.0001) were higher in the GDM with gingivitis group than GDM without gingivitis group.The inflammatory response seems to be more pronounced in females with GDM. The observed increase in both local and systemic levels of inflammatory cytokines may suggest an interaction between gingivitis and GDM.

Amaç: Çok az araştırmada, gestasyonel diabetes mellitus (GDM) ile enflamatuvar periodontal hastalıkların olası ilişkisi incelenmiştir. Bu çalışmanın amacı, GDM'si olan ve olmayan gebelerde klinik periodontal durum ve plazma NT-ProBNP düzeylerinin karşılaştırmalı olarak incelenmesidir. Gereç ve Yöntemler: Yükleme sonrası üç saat boyunca saatlik kan sekeri ölçümleri, açlık glukoz, açlık insülin ve HOMA-IR değerleri belirlenerek GDM tanısı konan 43 gebe ve GDM'si olmayan 41 gebe olmak üzere toplam 84 kadın çalışmaya dahil edildi. Plazma NT-ProBNP değerlendirmesi için venöz kan alınarak plazma örnekleri ayrıldı. Klinik periodontal durumun değerlendirilmesi için sondalama derinliği (mm), klinik ataşman seviyesi (mm), plak ve kanama indeksleri (%) ağızdaki tüm dişlerin 4 bölgesinde ölçüldü. Gebelere ait polikistik over, düşük hikayesi, insülin direnci, sosyo-demografik veriler, doğum haftası ve bebeklerin doğum ağırlığı kaydedildi. İstatistiksel analizler için MannWhitney U Testi ve Pearson ki-kare testi kullanıldı. Bulgular: GDM'si olan gebelerde yaş, açlık glukoz, açlık insülin, HOMA-IR, 1., 2. ve 3. saat glukoz değerlerinin GDM'si olmayan gebelere göre daha yüksek olduğu belirlendi (p < 0,05). Klinik periodontal veriler karşılaştırıldığında plak, kanama, ve sondalama derinliği ölçümleri her iki grupta benzer bulundu. Plazma NT-ProBNP seviyesi gruplar arasında anlamlı fark göstermedi. Sonuç: Çalışmamızın bulguları, GDM ile enflamatuvar periodontal hastalık şiddeti arasında anlamlı bir ilişki göstermemektedir. Ancak, konunun daha büyük çalışma gruplarında ve farklı biyokimyasal veriler aracılığıyla irdelenmesinin yararlı olacağını düşünüyoruz., Background: Few studies have investigated possible relationship between gestational diabetes mellitus (GDM) inflammatory periodontal diseases. The aim of this study was comparatively investigate clinical periodontal status and plasma NT-ProBNP levels in pregnant women with or without GDM.Methods: Forty-three pregnant women with diagnosis of GDM and 41 women without GDM were included in the present study. Venous blood samples were obtained for determination of plasma NT-ProBNP levels. Clinical periodontal status was evaluated by probing depth (mm), plaque and bleeding indices (%) in 4 sites of all teeth present. Presence of polycystic ovary syndrome, history of abortus insulin resistance, socio-demographic parameters, and delivery week, birth weight was recorded. Data were analysed statistically by Mann-Whitney U test and Pearson chi-square test.Results: In the GDM group, age, fasting glucose, fasting insulin, HOMA-IR, hour 1, 2 and 3 glucose levels were higher than those in the non-GDM group (p < 0,05). Clinical periodontal findings and plasma NT-ProBNP levels were similar in the study groups.Conclusion: The present findings do not indicate a significant relationship between GDM and inflammatory periodontal disease. However, larger scale studies evaluating various biochemical parameters may provide further insight to this subject.

Polycystic ovarian syndrome (PCOS) is a hormonal disorder of females of reproductive age that impacts their oral and systemic health. The aim of this study is to evaluate interleukin-17A (IL-17A), IL-17F, IL-17A/F, and IL-17E (IL-25) levels in gingival crevicular fluid (GCF), saliva, and serum of non-obese females with PCOS and with either a clinically healthy periodontium or gingivitis.Thirty-one females with PCOS, 30 females with PCOS and gingivitis, and 12 systemically and periodontally healthy females participated in the study. Clinical periodontal measurements, body mass index, and Ferriman-Gallwey score (FGS) (a measure of hirsutism in females) were recorded. Circulating levels of sex hormones, cortisol, and insulin were also determined. Levels of IL-17 cytokines were measured by enzyme-linked immunosorbent assay.The general linear model multivariate analysis, adjusting for age or plaque index, showed that the two groups with PCOS had higher concentrations of IL-17A, IL-17F, and IL-17A/F in serum and higher levels of IL-17A and IL-17F in GCF and saliva but lower serum IL-17E than systemically healthy females. Levels of IL-17E were lowest in females with PCOS and gingivitis who also had the highest FGS. Serum IL-17A and IL-17F levels correlated positively with FGS and periodontal probing depth (all ρ0.33; P0.005). Serum IL-17E showed the reverse relationship and also correlated negatively with IL-17A (ρ-0.28; P0.05).IL-17 levels are altered in non-obese females with PCOS and may influence gingival inflammation. Additional studies are warranted to clarify the relationship between PCOS and gingivitis.

The aim of this study is to evaluate the gingival crevicular fluid (GCF), saliva, and serum concentrations of tumor necrosis factor-α (TNF-α), TNF-α receptor-1 (TNF-αR1), TNF-αR2, and interleukin-6 (IL-6) in non-obese females with polycystic ovary syndrome (PCOS) and either clinically healthy periodontium or gingivitis.Thirty-one females with PCOS and healthy periodontium, 30 females with PCOS and gingivitis, and 12 systemically and periodontally healthy females were included in the study. GCF, saliva, and serum samples were collected, and clinical periodontal measurements, body mass index, and Ferriman-Gallwey score (FGS) were recorded. Sex hormones, cortisol, and insulin levels were measured. TNF-α, TNF-αR1, TNF-αR2, and IL-6 were determined by enzyme-linked immunosorbent assay. Kruskal-Wallis followed by Bonferroni-corrected post hoc Mann-Whitney U tests were used to analyze the data.The PCOS + gingivitis group revealed significantly higher GCF, saliva, and serum IL-6 concentrations than the PCOS + healthy group (P0.0001). The two PCOS groups exhibited significantly higher saliva TNF-α concentrations than the control group (P = 0.024 and P = 0.013, respectively). The FGS index was significantly higher in the PCOS + gingivitis group than the PCOS + healthy group (P = 0.030). The PCOS + gingivitis group revealed significantly higher insulin concentration than the PCOS + healthy and control groups (P = 0.014 and P0.0001, respectively). Serum TNF-α, TNF-αRs, and serum, GCF, and salivary IL-6 levels correlated with the clinical periodontal measurements.PCOS and gingival inflammation appear to act synergistically on the proinflammatory cytokines IL-6 and TNF-α. Thus, PCOS may have an impact on gingival inflammation or vice versa. Additional studies are warranted to clarify the possible relationship between PCOS and periodontal disease.

Objective: The present study was designed to evaluate the long-term efficacy and safety of once-daily enoxaparin plus warfarin for the outpatient ambulatory treatment of lower-limb deep venous thrombosis (DVT)., OBJECTIVE:The present study was designed to evaluate the long-term efficacy and safety of once-daily enoxaparin plus warfarin for the outpatient ambulatory treatment of lower-limb deep venous thrombosis (DVT).METHODS:A total of 246 patients, comprising 128 men (mean age, 54.28±16.48 years) and 118 women (mean age, 50.11±16.47 years) with symptomatic lower extremity DVT, were included in this open-label, single-arm, multicenter, phase IV clinical trial conducted at 14 centers in Turkey. All patients were administered subcutaneous enoxaparin (1.5 mg/kg, once-daily) until international normalized ratio (INR) levels reached to 2 to 3, followed by oral warfarin (5 mg/d) for at least 3 months and elastic compression stockings (30-40 mm Hg). Clinical signs (leg circumference), symptoms (edema, pain, tenderness), recanalization rates upon duplex ultrasound examination, laboratory findings (D-dimer and INR levels), and postthrombotic syndrome status with CEAP classification were the efficacy parameters evaluated every 3 months during 18 months of follow-up. Safety end points included minor and major bleeding as well as serious adverse events.RESULTS:Ambulatory treatment with enoxaparin plus warfarin significantly reduced physical symptoms, including tenderness, edema, pain (P

The aim of the present case series is to share the clinical results of double papilla flap and connective tissue graft in the coverage of gingival recession using microsurgery which is routinely used in our clinic. A total of 8 patients, mean age 29.75 ± 7.4 (6 female, 2 male) with 8 defects were included. Connective tissue graft was harvested from palate and sutured to the recipient area and then was completely covered with a double papilla flap. Plaque index (PI), gingival index (GI), probing pocket depth and clinical attachment levels were evaluated before the treatment (baseline) and at 6th month, recession depth was measured at baseline, 1st, 3rd and 6th month, and keratinized tissue width was assessed at baseline, 3rd and 6th month. Recession depth at baseline and 6th months were 4.38 ± 0.83 mm and 0.25 ± 0.46 mm, respectively with root coverage percentage of 94.72% ± 9.79. During the evaluation period partial coverage was observed in 2 patients and full coverage was detected in 6 patients. Clinical attachment levels at baseline and 6th month were 5.56 ± 0.67 mm, and 1.56 ± 0.56 mm respectively, and keratinized tissue width was 0.25 ± 0.46 mm and 3.00 ± 0.89 mm at the same evaluation period. According to the results of the present case series, it can be concluded that double papilla flap and connective tissue graft using microsurgery is effective in the treatment of gingival recessions and the newly formed attachment level maintained stability in short term.