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Objectives The aim of this study was to compare clinical, cytokine and microbiological responses after quadrant-based scaling and root planing (Q-SRP), full-mouth SRP (FM-SRP) and full-mouth disinfection (FMD) in patients with generalized aggressive periodontitis (GAgP), which is currently termed as generalized stage-III and grade-C periodontitis. Methods Forty-two patients with GAgP were randomly assigned into groups as Q-SRP, FM-SRP or FMD with chlorhexidine. Clinical parameters were recorded, and gingival crevicular fluid (GCF) and subgingival plaque samples were collected at baseline, 3 and 6 months after treatment. GCF levels of interleukin (IL)-1 beta and IL-17 were analysed using ELISA. Quantities of six bacterial species were determined using qPCR. Results Clinical parameters improved significantly in all groups at 3 and 6 months (p 6 mm was lower in the FMD than Q-SRP group at 3 and 6 months (p < 0.05). FMD showed significantly higher percentage of pocket closure compared with Q-SRP and FM-SRP at both 3 and 6 months after treatment (p < 0.05). The IL-1 beta levels decreased only in the FMD group (p < 0.05), whereas no changes were found in IL-17 levels in any group. The levels of five out of six bacterial species decreased at 3 and/or 6 months only in the FMD group (p < 0.05). Conclusions The FMD treatment appears to offer superior outcome than Q-SRP and could be the first choice for patients with GAgP.

© 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.Objectives: The purpose of this study is to investigate the clinical and microbiological effects of Bifidobacterium animalis subsp. lactis DN-173010 containing yogurt as an adjunct to non-surgical periodontal treatment in periodontitis patients. Materials and methods: This is a prospective randomized controlled clinical study registered with NCT05408364 under clinical trial registration. Thirty periodontitis patients were divided into 2 groups at random. As adjunctive to supra and subgingival instrumentation, the test group consumed Bifidobacterium animalis subsp. lactis DN-173010 containing yogurt while the control group consumed natural yogurt, once daily for 28 days. The plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) were recorded at baseline, 28th day, and 3rd month. Microbiological analysis was performed using culture method by obtaining subgingival plaque samples from 2 periodontal sites with 4≤PD≤6 mm at the same time points. Results: The inter-group comparisons of PI, GI, and BOP as well as the changes between the measurement time points were statistically significant in favor of the test group. There were no significant differences in terms of PD and CAL changes between the study groups at all times (∆baseline–28 days, ∆baseline–3 months) (p>0.05). The number of patients presenting subgingival Bifidobacterium species was significantly greater in the test group than the control group at the 28th day (p

Purpose: the COVID-19 pandemic brought unprecedented conditions for overall health care systems by restricting resources for non-COVID-19 patients. As the burden of the disease escalates, routine elective surgeries are being cancelled. The aim of this paper was to provide a guideline for management of endocrine surgical disorders during a pandemic. Methods: we used Delphi method with a nine-scale Likert scale on two rounds of voting involving 64 experienced eminent surgeons and endocrinologists who had the necessary experience to provide insight on endocrine disorder management. All voting was done by email using a standard questionnaire. Results: overall, 37 recommendations were voted on. In two rounds, all recommendations reached an agreement and were either endorsed or rejected. Endorsed statements include dietary change in primary hyperparathyroidism, Cinacalcet treatment in secondary hyperparathyroidism, alpha-blocker administration for pheochromocytoma, methimazole ± β-blocker combination for Graves’ disease, and follow-up for fine-needle aspiration results of thyroid nodules indicated as Bethesda 3–4 cytological results and papillary microcarcinoma. Conclusion: this survey summarizes expert opinion for the management of endocrine surgical conditions during unprecedented times when access to surgical treatment is severely disrupted. The statements are not applicable in circumstances in which surgical treatment is possible., NA

The aim of the present study was to analyse the nitric oxide (NO) levels in gingival crevicular fluid (GCF) of patients with chronic periodontitis (CP) treated with probiotic-containing food supplements as an adjunct to initial periodontal therapy (IPT). The present study was a randomized, double blind clinical trial conducted in Yeditepe University Dental Hospital, Istanbul, Turkey. Thirty-six CP patients, with ?2 nonmolar teeth in each quadrant with probing depth (PD) of 5–7 mm at proximal sites and radiologically detectable horizontal alveolar bone loss were randomized into two treatment groups. The test group received IPT + probiotic-containing food supplements, whereas the control group received IPT + placebo. GCF sampling was performed at the baseline and 3 and 6 months after treatment. The biochemical evaluation of NO in GCF was performed using the Griess colourimetric method. Statistical analysis was performed by using statistical software. Significant reductions in GCF volume and GCF NO levels were detected in each group after the treatments (p < 0.05). Intergroup comparison of the NO levels revealed statistically significant differences in favour of the test group at both 3 and 6-month evaluation periods (p < 0.05). Adjunctive usage of probiotic comprising food supplements to IPT yielded significant reduction of the NO levels compared to the control for up to 6 months of follow-up. The present study is registered at Thai Clinical Trials Registry (TCTR identification number: TCTR20171114003). © 2019, © 2019 The Author(s). Published by Taylor & Francis Group on behalf of the Academy of Forensic Science.

Objective: The purposes of this split-mouth pilot study were to investigate the efficacy of the Er:YAG laser use for the de-epithelialization of the palatal graft in the treatment of the multiple gingival recessions using the bilaminar procedure and also to evaluate the patient-reported esthetic outcomes after 6 months. Materials and methods: Five systemically healthy participants with total 28 bilateral-multiple adjacent maxillary Miller I recessions were included. The treatment was performed with the bilaminar technique [coronally advanced flap (CAF)+de-epithelialized free gingival graft]. De-epithelialization procedure was done with scalpel (control site) or Er:YAG laser (Versawave, Hoya ConBio, San Francisco, CA; 40 hz, 50 mJ/pulse), under water irrigation, noncontact mode (~1 mm away from the target tissue) in sweeping motion with chisel-type laser (test site). Root coverage and patient-reported outcomes were evaluated at 6 months after the operations. Results: Clinical outcomes of the both treatment sites did not show any statistically significant differences except for the gingival thickness parameter. However, patient-reported outcomes regarding the esthetic appearance of the gingiva was detected in favor of the Er:YAG laser applied sites. Conclusions: Within the limits of the study, it can be concluded that both de-epithelialization techniques were highly effective at 6 months. However, Er:YAG laser-applied grafted sites revealed more uniform and esthetic gingival appearance compared with scalpel-used grafted sites. © 2019 Mary Ann Liebert, Inc.

Amelogenezis imperfekta (AI) herhangi bir sistemik hastalik olmaksizin sut ve daimi dislerde mine yapisinda belirgin bozuklukla karakterize kalitsal bir anomalidir. AI hastalarinin baslica kaygilari curuge yatkinlik, kotu estetik ve yaygin hassasiyettir. Bu defektlerin tedavisi, estetik ve fonksiyonun yani sira bunlara bagli olarak gorulen psikososyal sorunlarin duzeltilmesi bakimindan onemlidir. AI hastalarinin tedavi planlamasinda yas, sosyoekonomik durum, hastaligin tipi ve ciddiyeti, tedavi planlandigi anda agiz ici durumu gibi bircok faktor etkili olmaktadir. Bu olgu raporunda, hipomatur tip AI teshisi konulan kadin hastanin estetik ve fonksiyonel gereksinimlerini tekrar kazandirmak amaciyla yapilan periodontal seviyeleme islemi ve sabit protetik restorasyonlar ile 5 yillik sonuclari sunulmaktadir.

Oral squamous cell papilloma (OSCP) is a benign proliferation of the stratified squamous epithelium, which results in a papillary or verrucous exophytic mass. OSCP is usually associated with human papilloma virus. Although any surface of the oral cavity can be affected, the sites of predilection for localization of the lesions include the tongue, lip and soft palate. In this report, treatment and histological findings of a local gingival enlargement at the vestibular side of the upper right central tooth of a 10 year-old systemically healthy girl are presented. The lesion was asymptomatic and had shown a slow growth. Solitary, exophytic lesion was clinically soft, pink-white in color and appeared as cauliflower. Dental and periodontal tissues were radiographically normal. One month after scaling and root planing, under local anesthesia the lesion was excised and this was followed by the use of Nd: YAG laser (1064 nm, 20 Hz, 3 W) to control bleeding, minimize pain and scarring in post-operative period, and provide sterilization. Macroscopic examination revealed that the lesion was 1.1×0.5×0.2 cm3 in size, yellow in colour and had a rough surface, while histological examination showed multi-layer connective tissue underlying the squamous epithelium, numerous rete pegs and spinous cell proliferation at the papillary and OSCP was diagnosed. There was no evidence of viral cytopathic effect or malignancy of the lesion. No recurrence was observed during the 4-year follow-up period., Oral skuamöz hücreli papillom (OSHP), çok katlı epitelin benign proliferasyonu sonucu meydana gelen papiller veya verrüköz ekzofitik kitledir ve genellikle human papilloma virüs ile ilişkilendirilir. Ağzın herhangi bir yerinde görülebilen lezyonların yerleşim alanı sıklıkla dil, dudak ve yumuşak damaktır. Sistemik olarak sağlıklı 10 yaşındaki kız çocuğunun üst sağ santral dişinin vestibül yüzeyinde soliter saplı, yumuşak, pembe-beyaz renkli ve karnabahar görünümündeki lezyonun asemptomatik olduğu ve 1 yıldır yavaş büyüme gösterdiği öğrenildi. Bölgenin periapikal radyografisinde dental ve periodontal dokuların normal olduğu gözlendi. Diş yüzeyi temizliği ve kök yüzeyi düzleştirilmesinden 1 ay sonra lokal anestezi altında lezyon bistüriyle eksize edildi; takiben kanama kontrolünün sağlanması, post-operatif dönemde minimal ağrı ve skar oluşumu, ve dezenfeksiyon sağlanması amaçlarıyla Nd:YAG lazer (1064 nm, 20 Hz, 3 W) uygulandı. Makroskopik olarak 1.1×0.5×0.2 cm3 boyutlarında, sarı renkli ve yüzeyi pürtüklü lezyonun histolopatolojik incelemesinde, çok katlı epitel altında bağ dokusu, çok sayıda rete pegler ve papiller kısımda spinöz hücre proliferasyonu izlendi ve OSHP tanısı kondu. Lezyonda viral sitopatik etki veya malignite bulgusuna rastlanmadı. Hastanın 4 yıllık takibinde rekürrans görülmedi.

Objective: The objective of this randomized clinical trial was to describe the clinical and microbiological results obtained by treatment with Er:YAG laser and systemic metronidazole used as adjuncts to mechanical subgingival debridement in chronic periodontitis. Methods: Twenty-seven chronic periodontitis (CP) patients were randomly divided into three parallel groups each comprising nine individuals with at least four teeth having at least one approximal site with a probing depth (PD) of ? 5mm and gingival index (GI) of ? 2 in each quadrant. Groups of patients received: (1) Scaling and root planing (SRP) + Er:YAG laser (10 hz, 30 mJ/pulse, 1min per pocket, apico-coronal direction in parallel paths with 30 degree angle tips, under water irrigation), (2) SRP + systemic metronidazole, or (3) SRP alone. In all treatment groups, SRP was performed at 1 week intervals in two sessions. The microbiological and clinical effects of the treatments were evaluated after 90 days. Results: At the end of the experimental period, statistically significant improvements in plaque index, GI, PD and attachment level, as well as reductions in the number of total bacteria and proportions of obligately anaerobic microorganisms were observed within each group. Although intergroup comparisons revealed no significant microbiological differences, clinical parameters as attachment gain and PD reduction were found significantly higher in Group 1 compared with the other groups. Conclusions: Within its limits, this study demonstrated the possibility of better resolution of infection with combined SRP + Er:YAG laser treatment. However, microbiological results failed to demonstrate significant advantages of this combination in comparison with SRP alone or SRP + systemic metronidazole. © 2012 Mary Ann Liebert, Inc.

There is currently great interest concerning the use of platelet-rich plasma (PRP) in combination with bone grafts for predictably obtaining periodontal regeneration. The aim of the present study was to investigate the effectiveness of PRP and bovine derived xenograft (BDX) combination in the treatment of deep intrabony defects with an emphasis on the evaluation of early wound healing. A total of 85 intrabony defects with an intrabony component of ?3 mm were selected in 20 advanced chronic periodontitis patients. Defects were surgically treated with PRP/BDX. At baseline and 12 months after surgery, the following parameters were recorded: plaque and sulcus bleeding indices, probing depth (PD), relative attachment level, marginal recession (REc), probing bone and radiographic bone levels. Postoperative healing was evaluated by an early healing index at 1 and 2 weeks after surgery. At 12 months, all clinical and radiographic parameters were improved (p < 0.0001). The mean changes at 12 months were: PD reduction of 4.78 ± 1.20 mm, attachment gain of 4.24 ± 1.03 mm, REc of 0.54 ± 0.34 mm, clinical bone gain of 3.75 ± 0.97 mm, and radiographic bone gain of 3.79 ± 1.02 mm, respectively. Two weeks after surgery, primary closure was maintained in 95% of the defect sites. Treatment with a combination of PRP and BDX leads to a significantly favorable clinical and radiographic improvement in deep intrabony periodontal defects. © 2009 Informa UK Ltd All rights reserved.

Gingival crevicular fluid (GCF), reflects the immune and inflammatory reactions and is itself a location for specific host-microbe interactions that lead to periodontal diseases. Aspartate aminotransferase (AST) is one of the components of GCF that is released as a result of cell death. In this study, 40 periodontal sites in 10 early onset periodontitis patients before and after nonsurgical periodontal therapy, with and without local metronidazole administration, were first examined for the AST enzyme levels in GCF and then evaluated for microbiological and clinical variables. In each patient, 4 sites (one site/quadrant) with a probing depth of > or = 5 mm were selected and treated with separate treatment protocols. Certain microbial species including Prevotella intermedia, Porphyromonas gingivalis, and Actinobacillus actinomycetemcomitans(A. a.) were found more often and/or in higher levels in AST active sites (36/40 first measurement--9/36 second measurement), while other species (Streptococcus and Actinomyces) were found more often and/or in higher levels in AST inactive sites (4/40 first measurement--8/36 second measurement). Eight post-treatment AST active sites revealed 1.5 mm of attachment loss, whereas 8 post-treatment AST inactive sites showed 1.37 mm of attachment gain. AST activity and microbiological-clinical data presenting such an agreement suggests that, AST level assessment would be beneficial as an adjunctive method alongside other clinical criteria, in guiding the clinician in periodontal treatment.