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Purpose: Despite being the gold standard antiplaque agent, chlorhexidine (CHX) has many adverse effects that make scientists search for new agents to combat biofilms as effective as CHX. Hyaluronan, also known as hyaluronic acid (HA), is a natural polysaccharide with anti-inflammatory, antioxidant and bacteriostatic properties. The objectives were to evaluate the plaque inhibitory, and anti-inflammatory effects of HA mouthwash compared to CHX and distilled water (DW) in a 4-day non-brushing model together with the participants' preference to the used products. Materials and Methods: Thirty-three systemically and periodontally healthy subjects were included in this randomised, double-blinded, crossover clinical study. Subjects were randomly assigned into three treatment-sequence groups to use three mouthwashes one after another, in three different time periods. After professional prophylaxis at day 1, subjects refrained from all oral hygiene measures and used mouthwashes that were individually allocated to them. On day 5, scoring of plaque index (PI) according to Turetsky modification of Quigley Hein Index system, modified gingival index (MGI) and measurement of gingival crevice fluid (GCF) volume were performed. Treatment satisfaction questionnaire form was given at the end of each experimental period. Results: CHX showed statistically significant reduction in PI followed by HA (p = 0.048). No statistically significant differences were detected between HA and CHX in terms of MGI and GCF volume. For HA, subjects reported significantly better taste, less sensitivity, burning sensation, mouth dryness and numbness perception compared to CHX and DW. Conclusions: CHX revealed the best plaque inhibition closely followed by HA. Early gingival inflammatory changes were found similar for CHX and HA. Furthermore, HA was well accepted with better perceptions than CHX and DW.

Background: This study aims to evaluate the effects of two different concentrations of topical hyaluronic acid (HA) on postoperative patient discomfort and wound healing of palatal donor sites after free gingival graft (FGG) surgery. Methods: Thirty-six patients requiring FGG were randomly assigned into three groups in an examiner-masked, randomized, controlled clinical trial. After harvesting palatal grafts, 0.2% and 0.8% HA gels were used in test groups 1 and 2, respectively. Gels were applied on donor sites and protected with periodontal dressing in the test groups, whereas the wound was covered only with periodontal dressing in the control group. On days 3, 7, 14, and 21, pain and burning sensation were recorded using a visual analog scale (VAS) as well as other parameters such as complete epithelization (CE) and color match on days 3, 7, 14, 21, and 42. Results: Test groups experienced less pain than the control group on days 3 and 7 (P

Objective: The (Aim of this study was to investigate the effects of local or systemic metronidazole as adjunctives to non-surgical periodontal treatment. on the clinical parameters and gingival crevicular fluid (GCE) levels of matrix metalloproteinase-8 (MMP-8) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in chronic periodontitis patients. Material and Method: Thirty patients were allocated into 3 groups: 10 were treated with scaling and root planing (SRP) only; 10 were treated with SRP and received adjunctive local metronidazole; 10 were treated with SRP and received adjunctive systemic metronidazole. Periodontal clinical parameters including plaque index, sulcus bleeding index, probing depth and relative attachment level were recorded before and after the treatments. The MMP-8 and TIMP-1 levels in GCF samples collected on days 0 and 49 were determined by using the enzyme-linked immunosorbent assay Results: All groups showed significant reductions in plaque index, sulcus bleeding index and probing depth (p

WOS: 000408735400313 …

MATERIAL AND METHODS: Forty dentine specimens obtained from freshly extracted impacted third molars were included and divided into four groups. Group I served as the control, whereas Group II, Group III, and Group IV recieved Er:YAG laser (30?Hz, 60?mJ/pulse, 10?sec), a desensitizing paste (DP) containing 8% arginine and calcium carbonate, and DP+Er:YAG laser in combination, respectively, evaluated under SEM.OBJECTIVE: The aim of this study was to evaluate the in vitro effects of Er:YAG laser and an in-office desensitizing paste alone or in combination by using scanning electron microscopic (SEM) analysis.BACKGROUND DATA: Various treatment modalities have been proposed for dentin hypersensitivity, but to date, no single agent or form of treatment has been found effective.RESULTS: SEM analysis presented occlusion and narrowing of dentinal tubules in all treatment groups, but more prominent occlusion was observed in the combined treatment group. Intergroup comparisons regarding the tubule diameters and the number of the open dentinal tubules per 100?µm2 revealed statistically significant difference in favor of combined group (p

Background and Objective: The present study is aimed to describe short-term results on selected microbiological and clinical parameters obtained by treatment with soft laser in conjunction with methylene blue and/or mechanical subgingival debridement in human periodontal disease. Study Design/Materials and Methods: Ten patients, in whom each dental quadrant was randomly designated to receive one of four types of treatment procedures, were included in the study. Groups of quadrants received: scaling/root planing (SRP); laser application (L); SRP combined with L (SRP/L); oral hygiene instructions (OHI). Four single rooted teeth (one in each quadrant), having an interproximal site with a probing depth of 4 mm mesio-buccally, were selected in each patient. The selected teeth were first assessed for microbiological (one site/tooth) and then for clinical variables (six sites/tooth). Supragingival irrigation with methylene blue was performed prior to laser application. The microbiological (proportions of obligate anaerobes) and clinical measurements (plaque and gingival indices, bleeding on probing, probing pocket depth) were evaluated over a period of 32 days. Results: Only the SRP/L and SRP groups provided significant reductions in the proportions of obligate anaerobes before and after treatments with no significant differences in between. Parallel to the microbiological changes, both SRP/L and SRP resulted in similar clinical improvements, whereas L alone revealed a limited effect similar to OHI. Conclusion: Within the limits of this study, methylene blue/soft laser therapy provided no additional microbiological and clinical benefits over conventional mechanical debridement. (C) 2002 Wiley-Liss, Inc.

Objective: The objective of this preliminary study was to evaluate the occluding effect of topical gaseous ozone application and Er:YAG laser on human dentine tubules by scanning electron microscopic (SEM) analysis. Methods: Twenty-four dentine specimens were divided into three groups. Group I, including specimens treated only with citric acid, served as the control. Group II was treated with Er:YAG (30Hz 60mJ, 10sec), and Group III received only topical gaseous ozone application (10sec at level 2). Diameters and the number of open dentinal tubules per 100µm2 were counted from SEM photomigrophraphs at ×2000 magnification. Results: In terms of diameters and numbers of open dentinal tubules per 100µm2, both treatment modalities presented significant occlusion. The mean values of the diameters and the number of open dentinal tubules per 100µm2 were observed in Group I, Group II, and Group III, in decreasing order. Significant differences were found among the groups in favor of the topical gaseous ozone applied group. Conclusions: The dentine tubules in both treatment groups were occluded, however more marked occlusion were seen in ozone treated group. © Copyright 2012, Mary Ann Liebert, Inc. 2012.

Background: The purpose of this study is to assess the healing outcomes of intrabony defects after treatment with platelet-rich plasma (PRP) versus platelet-poor plasma (PPP) combined with bovine-derived xenograft (BDX). Methods: Using a split-mouth design, a total of 79 intrabony defects with an intrabony component of ?3 mm in 20 patients were treated either with PRP/BDX (group 1) or PPP/BDX (group 2). At baseline and 12 months after surgery, plaque and sulcus bleeding indices, probing depth (PD), relative attachment level, recession, and probing and radiographic bone levels were recorded. Results: After 12 months, groups 1 and 2 presented a mean PD reduction of 3.87 ± 0.86 and 3.76 ± 0.80 mm, recession of 1.35 ± 0.68 and 1.58 ± 0.54 mm, attachment gain of 2.51 ± 0.97 and 2.18 ± 0.87 mm, clinical bone gain of 2.18 ± 0.86 and 2.09 ± 0.89 mm, and radiographic bone gain of 2.11 ± 0.87 and 2.19 ± 0.96 mm, respectively. Intergroup differences were found to be insignificant. Conclusions: Within its limits, these results suggest that the outcomes of the treatment after PRP/BDX and PPP/BDX applications in intrabony defects are similar. When the platelet counts are taken into consideration, PPP seems to demonstrate similar clinical efficacy as the PRP.

Aim: The purpose of this study was to assess the healing response of intrabony defects following regenerative treatment with platelet-rich plasma (PRP) combined with a bovine-derived xenograft (BDX) in smokers and non-smokers. Materials and Methods: A total of 24 advanced chronic periodontitis patients, 12 smokers and 12 non-smokers, with 113 intrabony defects with an intrabony component of ?3 mm were included in this study. 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, probing and radiographic bone levels. Results: Considering the soft tissue measurements, smokers and non-smokers presented a mean PD reduction of 3.97 ± 0.76 and 4.63 ± 0.52 mm, recession of 0.76 ± 0.44 and 0.50 ± 0.12 mm and attachment gain of 3.26 ± 0.42 and 4.06 ± 0.40 mm, respectively. Evaluation of the hard tissue findings revealed that the mean clinical and radiographic bone gains in smokers and non-smokers were 2.83 ± 0.47 and 3.63 ± 0.38 mm, 2.98 ± 0.38 and 3.67 ± 0.48 mm, respectively. Inter-group differences for PD reduction (p

Periodontitis is a ubiquitous and irreversible inflammatory condition and represents a significant public health burden. Severe periodontitis affects over 11% of adults, is a major cause of tooth loss impacting negatively upon speech, nutrition, quality of life and self-esteem, and has systemic inflammatory consequences. Periodontitis is preventable and treatment leads to reduced rates of tooth loss and improved quality of life. However, successful treatment necessitates behaviour change in patients to address lifestyle risk factors (e.g. smoking) and, most importantly, to attain and sustain high standards of daily plaque removal, lifelong. While mechanical plaque removal remains the bedrock of successful periodontal disease management, in high-risk patients it appears that the critical threshold for plaque accumulation to trigger periodontitis is low, and such patients may benefit from adjunctive agents for primary prevention of periodontitis. Aim The aims of this working group were to systematically review the evidence for primary prevention of periodontitis by preventing gingivitis via four approaches: 1) the efficacy of mechanical self-administered plaque control regimes; 2) the efficacy of self-administered inter-dental mechanical plaque control; 3) the efficacy of adjunctive chemical plaque control; and 4) anti-inflammatory (sole or adjunctive) approaches. Methods Two meta-reviews (mechanical plaque removal) and two traditional systematic reviews (chemical plaque control/anti-inflammatory agents) formed the basis of this consensus. Results Data support the belief that professionally administered plaque control significantly improves gingival inflammation and lowers plaque scores, with some evidence that reinforcement of oral hygiene provides further benefit. Re-chargeable power toothbrushes provide small but statistically significant additional reductions in gingival inflammation and plaque levels. Flossing cannot be recommended other than for sites of gingival and periodontal health, where inter-dental brushes (IDBs) will not pass through the interproximal area without trauma. Otherwise, IDBs are the device of choice for interproximal plaque removal. Use of local or systemic anti-inflammatory agents in the management of gingivitis has no robust evidence base. We support the almost universal recommendations that all people should brush their teeth twice a day for at least 2 min. with fluoridated dentifrice. Expert opinion is that for periodontitis patients 2 min. is likely to be insufficient, especially when considering the need for additional use of inter-dental cleaning devices. In patients with gingivitis once daily inter-dental cleaning is recommended and the adjunctive use of chemical plaque control agents offers advantages in this group. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

In this study, the fertilizing effect of struvite (MgNH(4)PO(4 center dot)6H(2)O) precipitate recovered from dairy industry wastewater on the growth and nutrition of maize plants was investigated. The obtained struvite precipitate was analyzed by XRD, FUR and SEM. XRD and FTIR results confirmed the identity of the struvite precipitate. The obtained struvite precipitate was found to have 3.30% N, 11.13% P, 8.64% Mg and 0.73% K contents. The contents of the heavy metals Cd, Cu, Ni, Pb, Zn and Hg were below their detection limits. The fertilizing effect of the struvite precipitate on the growth and nutrition of maize plants was investigated by conducting a pot trial employing control and chemical fertilizer applications. The trial was conducted with four replicates. Fresh and dry weights and nutrient elements of the maize plant were investigated under different fertilizer application conditions. There was a significant difference in the fresh weight and N, P, Ca, Fe, Mn and Pb concentrations of maize plants with all fertilizer applications within 95% confidence limits (P

Obtaining predictable and optimal coverage of exposed root surfaces and correction of corresponding gingival recessions have become important goals of periodontal plastic surgery. Various surgical techniques have been proposed for coverage of root surfaces. A therapeutic advantage may be gained if periodontal regeneration is obtained in addition to coverage of root with gingiva. In this case report, surgical recession coverage was performed as the bilaterally pedicled lateral sliding flap technique with the adjunctive use of enamel matrix derivative bioactive material (Emdogain). A female patient with gingival recession on maxillary central incisors is presented with 4-year follow-up observation. The surgical procedure used in this clinical pilot case study produced a marked reduction in gingival recession that was maintained for 4 years. Initial gingival recession averaged 4.25 mm with a probing depth of 1.25 mm. The 4-year follow-up demonstrated no significant changes in the degree of postoperative results obtained after 1 year. At the 4-year follow-up, a mean of 3.75 mm of root coverage was observed (93.8% root coverage). Probing depth averaged 0.75 mm, indicating a total of 4.25 mm gain of clinical attachment. Within the limits of this case, the results demonstrated the possibility of treating human buccal recessions by means of enamel matrix protein derivative together with the laterally repositioned flap technique, with a predictable reduction in recession and clinical gain in attachment.

This controlled clinical study investigated the clinical and radiographic outcome of wide intrabony periodontal defects treated by enamel matrix derivatives alone or in combination with a bioactive glass over a period of 8 months. Twenty-three chronic periodontitis patients, who received initial therapy and had radiographical interproximal defects with an associated probing depth of 6 mm or more and an intrabony component of at least 4 mm, were included. Each of the patients, contributing at least one intrabony defect, was treated with either enamel matrix derivative alone (group 1, n=10) or the combination (group 2, n=13). In both groups, all clinical and radiographical parameters were improved. Groups 1 and 2 presented a mean pocket reduction of 5.03±0.89 and 5.73±0.80 mm, recession of 0.97±0.24 and 0.56±0.18 mm, relative attachment gain of 4.06±1.06 and 5.17±0.85 mm, and radiographic bone gain of 2.15±0.42 and 2.76±0.69 mm, respectively. An intergroup comparison revealed significant differences for all of the parameters, yielding a more favorable outcome towards the combined approach. Within the limits of the study, both treatments resulted in marked clinical and radiographical improvements, but combined treatment seemed to enhance the results in the treatment of wide intrabony defects. © Springer-Verlag 2006.

Objectives: The present study aims to assess the clinical and radiographic outcome of horizontal type of bone loss over a period of 8 months following periodontal surgery with adjunctive use of enamel matrix proteins (EMP). Materials and Methods: Twenty patients, who received nonsurgical periodontal therapy and had radiographic horizontal bone loss with an associated probing depth (PD) of ?4 mm at the maxillary incisor/canine segment, were included. One side of the selected segment divided by the mid-sagittal plane was treated with EMP as part of a crevicular flap. The other side was treated either with a similar intracrevicular (ICI) or a reverse bevel incision (RBI) as part of a conventional flap debridement. Therefore, patients were divided into two groups of 10 patients according to the type of incision performed on the control side. The analysis was based on a classification of two severity groups according to preoperative PD, with the patient's means of measurements for each treatment being the experimental units for the statistical analysis. Results: For pockets of 4-6 mm, EMP treatment was significantly better than the ICI/ flap debridement in terms of PD reduction (p < 0.001), relative attachment level (RAL) gain (p < 0.001) and recession (REC) (p < 0.05). Although sites exposed to EMP treatment exhibited significantly greater RAL gain than RBI/flap debridement sites (p < 0.01), both treatments resulted in equally effective PD reduction. Less REC occurred with EMP application than with ICI-RBI/flap debridement (p < 0.05). Treatment of shallow sites by the conventional flap with both incisions resulted in a tendency for loss of attachment whereas EMP treatment maintained the attachment levels. No significant difference in the degree of probing and radiographic bone levels was found between the treatments. Conclusion: EMP treatment showed better clinical improvements as compared to the conventional flap debridement performed with two different incisions. Clinical improvements were more pronounced at periodontal sites with deep, rather than shallow, periodontal pockets. The results of this study provided an important preliminary base for further clinical and histologic studies.

… Int Assoc Dent Res

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Obligatory anaerobic treatment of agro-industrial waste-waters releases large amounts of nutrients into receiving water-bodies. In this study, response surface methodology was employed to optimize NH4+ and PO43- recovery from anaerobic effluent of a full-scale dairy processing industry by struvite precipitation. This study also examined the residual interfering ions (Na+, Ca2+, and K+) and COD removal efficiency during struvite precipitation. Removal efficiency rates of 88.4% for NH4+ and 79.3% for PO43- were obtained at optimized conditions with pH 9.60, mixing speed 260 rpm, and Mg2+:NH4+:PO43- molar ratio of 1:1:1, respectively. The experimental data suggested that the model described the experiments well (F-NH4(+)=14.08, F-PO4(3-)=40.22, F-Table = 2.9340). According to the quadratic regression model, the linear, quadratic and interaction terms of Mg2+, PO43- and pH had significant effects on NH4+ and PO43- recovery. It was found that high concentration of Na+ in the anaerobic effluent affected the formation of struvite. The formation of struvite (MgNH4PO4(H2O)(6)), ferroalluaudite (NaFe(Fe,Mn)(2)(PO4)(3)) and sodium carbonate sulfate (Na6CO3(SO4)(2)), as products under different reaction conditions, were confirmed by XRD, SEM and EDX. Considerable COD removal was also achieved, with a maximum removal efficiency of 68.4%.

Purpose: To query the sufficiency of fine needle aspiration biopsy for dominant nodule in terms of planning the surgical treatment and diagnosis of thyroid cancer. Materials and Methods: Medical records of 161 patients who underwent total thyroidectomy and had thyroid cancer on pathological examination in the period of 1998-2010, were retrospectively examined. We reviewed the pathological findings of 142 patients with fine needle aspiration directed to the nodule with a diameter greater than 1 cm which was palpable or ultrasonographically detected and termed as the dominant nodule. Numbers, and diameters of malignant foci, localization in the dominant nodule and/or out of it, and histological types were recorded. Results: 65.5% of the 208 cancerous areas were single, and 34.5% were multicentric, and the histological type of all multicentric cases was papillary carcinoma. Additionally, 57.7%, and 34.5% of the cancerous areas were observed outside the dominant nodule, and in the contralateral lobe of the dominant nodule, respectively. Conclusion: Our findings indicate that, if fine needle aspiration is carried out only in the dominant nodule, more than half of the thyroid cancer foci could be missed, and lobectomy for the lobe with the dominant nodule might be overlooked in one third of thyroid cancer foci. It was concluded that fine needle aspiration should be carried out also in at least one nodule other than the dominant nodule, especially in the contralateral lobe if there are suspicious nodules, and in the presence of the papillary cancer suspicion, and, because of possible multicentricity, total thyroidectomy should be considered.

Poorly differentiated thyroid carcinomas (PDTC) show minimal differentiation and have a moderate prognosis that is between the prognosis of differentiated thyroid carcinomas and anaplastic carcinomas. PTDC generally have a large size usually associate with bone and pulmonary metastasis. PTDC have solid, trabecular and insular variants. The well known variant is insular carcinoma. They are potentially radioactive iodine (RAI) avid and therefore after complete surgery, RAI therapy is suggested for patients with PTDC. Proof for postoperative radiotherapy is poor. However, radiotherapy is offered for T3 tumors without remote metastasis and T4 tumors and for patients with regional lymph node metastasis. © 2012 OMU.

8th European Breast Cancer Conference (EBCC) -- MAR 21-24, 2012 -- Vienna, AUSTRIA WOS: 000302804600520 … European Canc Org (ECCO)

Ozaslan, Cihangir/0000-0002-2611-4837; Kuru, Bekir/0000-0001-7774-6431 WOS: 000295563900011 PubMed: 22006749 Purpose: To evaluate the identification rate and the false-negative (FN) rate of sentinel lymph node biopsy (SLNB) using preoperative axillary ultrasound (AU) in patients with clinically negative and positive axilla and to prove that SLNB could also be performed in clinically axillary positive patients. Methods: Three hundred and fifty seven consecutive T1-2 invasive breast cancer patients with clinically negative or positive axilla were enrolled in our Institution between 2006 and 2011. All patients had preoperative AU, and underwent SLNB followed by breast conserving surgery or mastectomy with level 1, 2 axillary dissection. SLNB was performed using 5 mL of 1% methylene blue. The identification (ID) rate and the FN rate of SLNB were calculated for patients with clinically negative and positive axilla, and for patients with negative AU. Results: Two hundred thirty two patients (65%) were clinically axillary-negative and 125 (35%) were clinically axillary-positive. The ID rates of SLNB were 91 and 89% and the FN rates were 7 and 9%, respectively, in patients with clinically negative and positive axilla. The ID rate of SLNB increased to 94% and the FN rate decreased to 4% after the exclusion of 85 patients (24%) with metastatic lymph nodes on AU. Conclusion: SLNB can be safely applied to T1 tumors regardless of the clinical status of the axilla. Use of AU before SLNB significantly increases the ID rate and decreases the FN rate of SLNB in clinically axillary negative as well as in positive patients.

Kuru, Bekir/0000-0001-7774-6431 WOS: 000290953800019 PubMed: 21552792 Introduction: The aims of the present study were to define the prognostic factors for locoregional recurrence (LRR) and survival in stage IIIC breast carcinoma as well as to examine the impact of adjuvant radiotherapy on the outcome of the disease. Methods: The records of 586 consecutive patients with stage IIIC breast carcinoma who underwent modified radical mastectomy were evaluated, and the prognostic factors for LRR and survival were analysed. Survival curves were generated using the Kaplan-Meier method, and multivariate analysis was performed using the Cox proportional hazard model. Results: Five-year LRR and survival of stage IIIC breast carcinoma were 15 percent and 41.3 percent, respectively. Five-year LRR was significantly lower and five-year survival was significantly higher for all patients as well as for T1-2 patients with one to three apical node involvements who were treated with adjuvant radiotherapy. In multivariate analysis, apical node involvement, age below 35 years, T4 tumour, grade 3, extracapsular extension and lymphovascular invasion decreased survival, whereas adjuvant tamoxifen and adjuvant radiotherapy risk ratio [RR] 0.51, 95 percent confidence interval [CI] 0.39-0.67) increased survival. Adjuvant radiotherapy was the sole independent factor that was found to be significantly associated with decreased LRR (RR 0.25, 95 percent CI 0.16-0.38). Conclusion: Radiotherapy decreased LRR and increased survival significantly in all stage IIIC patients and in the subgroup of T1-2 patients with one to three apical node involvements. Thus, it should be considered in the treatment of stage IIIC breast carcinoma.

The rupture of the urinary bladder may cause acute abdomen. However, this has not been emphasized in the classical surgical textbooks (such as Sabiston, Schwarts). In the present manuscript we report two cases of bladder rupture with iatrogenic and spontaneous origin and suggested that bladder rupture has to be considered in the differential diagnosis of acute abdomen. We evaluated the importance of the physical examination laboratory findings and imaging modalities in the diagnosis of bladder rupture. The authors think that presentation of these cases were interesting, because we have found only 4 cases published in the literature which report the presence of urinary bladder rupture as a cause of pneumoperitoneum were found. We discussed the importance of pneumoperitoneum in the differential diagnosis in rupture of urinary bladder.