Search

Actinomyces spp. are members of normal oral flora that may give rise to a rare disease- oral actinomycosis . Here we present a case of early implant failure associated with actinomycosis in an otherwise -healthy 43-year-old female and the treatment adopted following explantation. Clinically, one month after the implant placement, the peri-implant soft tissues were hyperplastic and associated with an excessive tissue reaction, bleeding, suppuration, deep probing depth , and implant mobility at #19 and #20 implants. Both implants were removed and all granulomatous tissues were thoroughly debrided. Histopathological examination revealed signs of acute ulcerative inflammatory reaction and Actinomyces colonies. The patient was prescribed short-term oral penicillins. After six months following explantation, the deficient bone was augmented with using a combination of absorbable collagen membrane, autogenous block and xenograft. The patient was followed up for one year ; and subsequently, two implants were reinserted at the same positions. The patient was followed up and no recurrences were observed. Implant failure due to actinomycosis is an extremely rare condition , and a definitive diagnosis is therefore essential for successful treatment.

Background/aim: In this study, we aimed to assess the cancer risk among patients with periodontal disease.Materials and methods: Patients diagnosed with periodontal diseases at Hacettepe University between 2007 and 2012 were included and data on the diagnosis of any cancer after periodontal disease were collected from patient files. The age- and sex-standardized incidence rates (SIRs) were calculated using Turkish National Cancer Registry 2013 data.Results: A total of 5199 patients were included. Median follow-up was 7.2 years. Patients with periodontal diseases had 17% increased risk of cancer compared with the expected counts for the corresponding age and sex groups (SIR: 1.17; 95% CI: 1.04-1.3, P = 0.006). The increased cancer risk was statistically significant in women (SIR: 1.24; 95% CI: 1.05-1.45, P = 0.008) but not in men. Among women with periodontal disease, the risks of breast cancer (SIR: 2.19) and head and neck cancer (SIR: 4.71) were significantly increased. Among men, the risks of prostate cancer (SIR: 1.84), head and neck cancer (SIR: 3.55), and hematological cancers (SIR: 1.76) were significantly increased.Conclusion: This study showed that periodontal diseases were associated with increased risk of several cancers. Besides other well-known benefits for health, the provision of oral/dental health should be considered and employed as a cancer prevention measure.

The goal of periodontal tissue engineering is to repair or regenerate the destructed or lost periodontium by improving functions of cells in the remaining tissue. For continuty of cell growth process, two group of growth factors, i.e. competence factors and progression factors, are needed to act together. However, the short biological half-life of these factors limits their effects on cells and their clinical efficacy. The purpose of this study is to develop different microparticles-loaded chitosan carriers/scaffolds for controlled and sequential delivery of a competence factor, insulin-like growth factor (IGF-1), and progression factor, bone morphogenetic factor-6 (BMP-6). Alginate and poly (lactic-co-glycolic acid) (PLGA) microparticles provided release of IGF-1 and BMP-6 for early short period and for long period, respectively. The cell culture studies showed that, chitosan/alginate/PLGA hybrid scaffolds induced proliferation and osteoblastic differentiation of cementoblasts when compared with IGF-1 and BMP-6 free chitosan scaffold. (C) 2017 Elsevier B.V. All rights reserved.

Previous studies have noted a possible association between periodontal diseases and the risk of various cancers. We assessed cancer risk in a cohort of patients with moderate to severe periodontitis.Patients diagnosed with moderate to severe periodontitis by a periodontist between 2001 and 2010 were identified from the hospital registry. Patients younger than 35 years of age or with a prior cancer diagnosis were excluded. The age- and gender-standardized incidence rates (SIR) were calculated by dividing the number of observed cases by the number of expected cases from Turkish National Cancer Registry 2013 data.A total of 280 patients were included (median age 49.6, 54% female). Median follow-up was 12 years. Twenty-five new cancer cases were observed. Patients with periodontitis had 77% increased risk of cancer (SIR 1.77, 95% CI 1.17-2.58, p = .004). Women with periodontitis had significantly higher risk of breast cancer (SIR 2.40, 95% CI 0.88-5.33) and men with periodontitis had significantly higher risk of prostate cancer (SIR 3.75, 95% CI 0.95-10.21) and hematological cancers (SIR 6.97, 95% CI 1.77-18.98).Although showing a causal association necessitates further investigation, our results support the idea that periodontitis might be associated with increased cancer risk, particularly with hematological, breast and prostate cancers.

The combination of local and systemic factors play role in the pathogenesis of periodontal and peri-implant diseases. Host-derived enzymes, cytokines and other proinflammatory mediators play an integral role in this destruction. The aim of this study is to evaluate gingival crevicular fluid (GCF) and peri-implant crevicular (PICF) fluid levels of sclerostin, TNF-related weak inducer of apoptosis (TWEAK), receptor activator of nuclear factor kappa-beta ligand (RANKL) and osteoprotegerin OPG in periodontal and peri-implant tissues in disease and health conditions and also to assess the potential for use as biomarkers.The study population was consisted of 50 women and 41 men, in the total of 91 individuals, with a mean age of 51.84 ± 14.05. Periodontitis (n = 22), periodontal health (n = 17), peri-implantitis (n = 27) and peri-implant health (n = 25) groups were established according to clinical and radiographic examination results of 39 teeth and 52 implants restored with fixed prosthetic restorations. In all groups, periodontal and peri-implant parameters (probing depth, gingival recession, gingival bleeding time index, gingival index, and plaque index) were recorded and GCF and PICF samples were also collected. Sclerostin, TWEAK, RANKL and OPG levels in GCF and PICF were measured with ELISA tests.Peri-implantitis group presented significantly higher levels of Sclerostin (p = 0.002), TWEAK(p 0.0001), RANKL(p 0.0001), and OPG (p = 0.037) compared to peri-implant health group. Similarly, significantly higher levels of TWEAK (p = 0.001), RANKL(p 0.0001), and OPG(p = 0.025) were detected in periodontitis group when compared to periodontal health group. Statistically significant correlations were also noted between biochemical parameters and clinical parameters.Findings of this study evaluating four different bone metabolism related proteins at the same time, suggests levels of sclerostin may be a biomarker for peri-implant disease presenting significantly higher levels in the peri-implantitis group than in the peri-implant health group. Moreover, levels of TWEAK can be a good indicator for both periodontal and peri-implant disease, due to the correlations with periodontal clinical parameters and the higher levels of TWEAK in diseased sites compared to the healthy sites for both dental implants and teeth.

Periostin is a protein present in alveolar bone and periodontal ligament whose function is related to response to external forces. The aims of this study are to detect levels of periostin in peri-implant sulcular fluid (PISF) and gingival crevicular fluid (GCF) and to evaluate the relationship between periostin, pyridinoline cross-linked carboxyterminal telopeptide of Type I collagen (ICTP), and C-terminal cross-linked telopeptide of Type I collagen (CTX) levels and clinical inflammatory symptoms and duration of functional loading.The study population comprised nine women and four men with mean age 43.23 ± 12.48. Twenty "bone-level designed" dental implants (DIs) placed in molar or premolar sites, without any signs of peri-implant bone loss and with a restoration in function for at least 12 months, were included in the study with 20 contralateral natural teeth (NT) as controls. Clinical parameters and restoration dates of the implants were recorded. PISF, GCF, ICTP, CTX, and periostin levels were evaluated using enzyme-linked immunosorbent assay.ICTP, CTX, and periostin levels were similar between DI and NT groups. There were no statistically significant differences between PISF and GCF values. When implants were grouped as healthy (gingival index [GI] = 0) and inflamed (GI ≥0), ICTP levels and PISF volume were lower in healthy implants compared with the inflamed group. Both periostin and CTX levels were negatively correlated with functioning time, suggesting less bone remodeling around DIs at later stages of functioning.Findings of this study suggest collagen breakdown products may be used as markers to evaluate peri-implant metabolism.

This study aimed to investigate and compare the effect of chitosan sponge and platelet-rich plasma (PRP) gel alone as well as their combination on bone regeneration in rabbit cranial defects. Four cranial defects with a 4.5-mm diameter were created in rabbit cranium and grafted with PRP, chitosan sponge alone, and chitosan sponge incorporated with PRP. The rabbits were killed by the fourth and eighth weeks, and the defects were analyzed histologically. Higher bone formation was observed in the PRP group when compared with the other groups at weeks 4 and 8. All parts of the defects were filled with thick trabecular new bone in the PRP group. The amount of new bone formation in the control groups was found to be less when compared with the PRP group and the least in the chitosan group. The defects that were filled with chitosan sponge showed a limited amount of new bone formation and an obvious fibrous demarcation line between chitosan particles and bone. Application of PRP showed a histological tendency toward increased bone formation. Other forms or derivatives of chitosan may have beneficial effects to achieve new bone regeneration.

Periodontal regeneration is histologically defined as regeneration of the tooth supporting structures, including alveolar bone, periodontal ligament, and cementum. Cells in the remaining periodontal tissues need optimal conditions if they are to perform their functions in the regeneration process. The present study is an investigation of the molecular effects of ABM/P-15 on human periodontal ligament cells (PDL) in vitro.PDL cells obtained from healthy subjects were used for in vitro experiments. Cell proliferation, morphology, and mineralization using Von kossa staining were evaluated. mRNA expressions for transforming growth factor-beta (TGF-beta), insulin-like growth factor-I (IGF-I), basic fibroblast growth factor (b-FGF), vascular endothelial growth factor (VEGF), bone morphogenic protein-2 (BMP-2), platelet-derived growth factor (PDGF), and type 1 collagen (COL1) were assessed on days 3 and 7 using RT-PCR.ABM/P-15 enhanced proliferation of cultured PDL cells. It increased the mRNA expression of TGF-beta and BMP-2 in cultured PDL cells on days 3 and 7. IGF-I and b-FGF mRNA expressions showed a slight decrease, while PDGF expression was observed to have increased on day 3. VEGF and COL1 mRNA expressions were found not to be different on days 3 and 7. No differences were observed in the mineralization properties of cultured PDL cells treated with or without ABM/P-15.Based on the results of this in vitro study, it may be concluded that ABM/P-15 enhanced the regenerative capacity of PDL by regulating specific gene expressions of cells during early wound healing.

The treatment of periodontal diseases with their associated anomalies and replacement of lost teeth by endosseous dental implants sometimes undertakes a stringent process with high variations in success rates and predictability of regeneration. An applied biomedical research area, tissue engineering, aims to develop biomaterials or procedures for replacing damaged tissues with new ones by adhering to the principles of developmental biology, biomaterials science and cell biology. Nanotechnology came out as a new scientific discipline in 1990s and with significant developments on techniques and materials, various treatment strategies have been defined and functional tissue regeneration have become a reality. Today, an elaborated oral health care achievement is now beyond the expectance by the utilization of tissue engineering modalities and nanobiomaterials. This chapter aims to highlight and discuss the role of nanobiomaterials and their diagnostic, therapeutic and preventive potential in periodontics and implants dentistry, with particular emphasis given to current challenges and future possibilities related with the strategies of tissue engineering in periodontology and implant dentistry.

Wroclaw University of Medicine, Background: Matrix metalloproteinases (MMPs) and cytokines play a role of extracellular matrix degradation and remodelling, and are significantly involved in the course of periodontal disease. Objectives: The purpose of this study was to evaluate the adjunctive effect of administering an oxicam non-steroidal anti-inflammatory drug (NSAID), tenoxicam, during non-surgical (phase 1) periodontal treatment on clinical parameters and gingival crevicular fluid (GCF) levels of MMP-8 and TNF-? in subjects with chronic periodontitis. Material and Methods: A total of 32 subjects with chronic periodontitis were randomized into two groups: 1) phase I periodontal treatment + NSAID and 2) phase I periodontal treatment + placebo. Phase I periodontal therapy consisted of scaling and root planning (SPR), which was provided by a single therapist masked with respect to group assignment Patients in group 1 received a systemic NSAID (20 mg tenoxicam tablet Once daily for 10 days). Clinical measures and GCF samples were obtained immediately prior to periodontal treatment and 30 days afterwards from all subjects. Clinical measures included a plaque index, gingival index, gingival bleeding time index, probing depth, and clinical attachment level. The MMP-8 and TNF-? levels in the GCF were assayed using an enzyme-linked immunosorbent assay. Results: With the exception of clinical attachment level, all clinical measures showed a significant (p < 0.05) improvement following non-surgical treatment in both the NSAID and placebo groups. A significant decrease in MMP-8 levels (p < 0.05) was observed at post-treatment in the NSAID group but not in the placebo group (p > 0.05). Treatment exhibited no effect on TNF-? levels (p > 0.05). There was also no statistically significant difference in clinical measurements after treatment between the two groups (p > 0.05). Moreover, the post treatment MMP-8 level in group 1 was statistically significant higher than the placebo group (p < 0.05). Conclusions: The adjunctive administration of tenoxicam during phase I periodontal treatment decreases MMP-8 levels in gingival crevicular fluid in patients with chronic periodontitis. But no benefits were observed. © Copyright by Wroclaw Medical University., Develioglu, H.; Department of Periodontology, Faculty of Dentistry, Cumhuriyet UniversityTurkey; email: hdevelioglu@mynet.com.tr

The aim of this study is to compare the effects of different platelet-rich plasma (PRP) preparation methods on platelet activity and to investigate the growth factor (GF) release kinetics from PRP-loaded chitosan scaffolds for tissue engineering applications. Flow cytometry analysis showed that centrifugation processes used for PRP preparation did not cause significant effect on platelet activation levels by means of markers investigated. Two different methods were used to prepare PRP-loaded chitosan scaffolds: (i) PRP was added to chitosan gel before freeze-drying to prepare scaffolds called as “GEL” and (ii) PRP was embedded to freeze-dried chitosan scaffolds to prepare scaffolds called as “SPONGE.” In addition, nonactivated PRP and PRP activated with type-I collagen were used as control groups. Scanning electron microscopy images demonstrated that, in GEL group, there is no deterioration on the scaffolds porous, 3D, and interconnected structure. GF release kinetics was determined by enzyme-linked immunosorbent assay for platelet-derived GF-BB, transforming GF-β1, and insulin-like GF-1. A sustained release of GFs was achieved in GEL group while a sharp burst release was observed for all the GFs from the SPONGE groups. Moreover, platelet-derived GF-BB, insulin-like GF-1, and transforming GF-β1 releases were prolonged to 20 days in GEL groups, and the biological activities of all GFs released from GEL and SPONGE scaffolds were preserved. This study demonstrated that chitosan scaffold that was called GEL could be an appropriate carrier for PRP applications by providing sustained release of GFs. © 2012 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 101B: 28–35, 2013.

Objectives Since ingredients of peri-implant sulcus fluid (PISF) may be related to the bony structure surrounding dental implants, analyze of specific markers related to bone resorption in PISF seems to be suitable for long term monitoring of peri-implant health. It is suggested that analysis of PISF may serve for detection of inflammation. The aim of this study is to analyze PISF interleukin-1 beta (IL-1β), IL-10, osteoprotegerin (OPG), receptor activator of nuclear factor-kappa B ligand (RANKL) levels to determine whether the diagnostic value of PISF can be used to evaluate early changes around implants. Materials and methods A total of 47 dental implants either healthy/non-inflamed ( n = 20) (Group I), or gingivitis/inflamed ( n = 27) (Group II), were classified. Peri-implant status has been evaluated by clinical evaluation (plaque index, gingival index, probing depth and gingival bleeding time index) were recorded and PISF samples were also obtained. PISF IL-1β, IL-10, RANKL, and OPG levels were measured by enzyme-linked immunosorbent assay. Potential volumetric changes in PISF were also evaluated. Results All clinical parameters and volume of PISF were higher in Group II and these differences were statistically significant except volume values. IL-1β, IL-10 and OPG levels in PISF were significantly higher in Group II. Although the PISF RANKL level in Group II was higher than the level of Group I, the difference between groups did not reach the statistically significant level. Conclusions These data suggest that a balance of inflammatory- and osteoclastogenesis related molecules locally produced may play an important role in the development of inflammatory peri-implant lesions.