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Background/Objectives: To appraise the mandibular bone structure of patients with rheumatoid arthritis (RA) who were treated with different drugs using fractal dimension (FD) analysis and panoramic radiomorphometric indices and investigate the effects of RA on the jaw bone. Methods: A total of 90 panoramic radiographs were analyzed in this study: 30 were from patients with RA using conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and glucocorticoids, 30 were from patients with RA using tumor necrosis factor-alpha (TNF-α) inhibitors, and 30 were from systemically healthy individuals. In panoramic radiographs, panoramic mandibular index (PMI), mandibular cortical thickness measurements, mandibular cortical index (MCI), and FD analysis taken from four different regions were evaluated. Results: The lowest FD analysis value was observed in patients using csDMARDs and glucocorticoids and in the condyle region (p = 0.001). Although PMI and posterior index (PI) were found to be significantly lower in patients using csDMARDs and glucocorticoids compared with the others (p = 0.001), no significant difference was observed between the groups in terms of anterior index (AI), symphysis index (SI), and molar index (MI) values (p > 0.05). When MCI was analyzed, there was no significant difference between the groups (p > 0.05). Conclusions: It was observed that the trabecular structure in the condyle and posterior region of the mandible was negatively influenced by RA and csDMARD and glucocorticoid drug use. Radiomorphometric indices and FD analysis on panoramic radiographs can be used to evaluate osteoporotic alterations in individuals with RA. These assessments are valuable in predicting the prognosis of conditions such as bone healing after tooth extraction and other surgical procedures and osseointegration after implant surgery. [ABSTRACT FROM AUTHOR]

Background: Zygomatic implants are becoming an ideal treatment approach for implant-supported prosthesis treatment developed for the atrophic maxilla. This study aims to evaluate the amount and distribution of stress in implants and peri-implant bone using different implant-supported prosthesis configurations in Aramany Class I maxillary defects through 3-dimensional finite element analysis. Methods: A 3-dimensional finite element model of the Aramany class I defect was created. Three different implant-supported prostheses were modelled: model 1: 1 zygomatic implant and 3 dental implants, model 2: 1 zygomatic implant and 2 dental implants, and model 3: 2 zygomatic implants. Vertical and horizontal loads of 150 N were applied in 6 different ways to the defected and non-defective areas. Maximum principal stress and von mises stresses in the bone surrounding the implants were evaluated. Results: When all loading conditions were evaluated with both porcelain layer on Co-Cr framework and acrylic layer on acrylic framework, the highest maximum principal stress value was observed in Model 3. In contrast, the lowest value was observed in Model 1. The highest maximum principal stress occurred when a horizontal load was applied simultaneously to both the defective and non-defective areas. In contrast, the lowest value was observed when a vertical load was applied to the non-defective area. The von Mises stress values were found to be similar across all models when both restoration materials were used. Conclusions: Based on the results of this study, it can be concluded that increasing the number of implants in the non-defective area reduces the highest stress value while using acrylic as a restoration material slightly increases the stress value. [ABSTRACT FROM AUTHOR]

Background: To investigate the preventive efficacy of methylsulfonylmethane (MSM) on alveolar bone destruction in rats with periodontitis. Methods: Twenty-four male Sprague-Dawley rats were randomly divided into three groups: control, experimental periodontitis (Ep), and Ep-MSM. Periodontitis was induced by placing 4.0 silk sutures in the subparamarginal position on the necks of the mandibular first molars and applying the suture for 5 weeks. The Ep-MSM group was given 500 mg/body weight/day MSM intraperitoneally for 35 days. At the end of the study, bilateral mandibular samples were taken. Periodontal bone loss was measured through histologic sections. Histomorphometric and immunohistochemical (receptor activator of nuclear factor kappa B ligand (RANKL), osteoprotegerin (OPG)) evaluations were performed on right mandibular tissue samples, and biochemical (interleukin (IL)-1 beta (β)/IL-10, malondialdehyde (MDA), glutathione (GSH), oxidative stress index (OSI)) evaluations were performed on left mandibular tissue samples. Results: No significant difference was found between the groups in IL-1β and IL-1β/IL-10 values ​​(p > 0.05). A significant decrease in IL-10 levels was observed in the Ep-MSM and Ep groups compared with the control group (p < 0.05). MDA levels significantly increased in the Ep and Ep-MSM groups compared with the control group, and GSH levels significantly decreased in the Ep group compared with the other groups (p < 0.05). OSI values ​​were significantly higher only in the Ep group (p < 0.05). RANKL levels showed a significant increase in the Ep group compared with the other groups. OPG levels were significantly increased only in the Ep-MSM group (p < 0.05). Conclusions: The results of this study may suggest that MSM has preventive effects on alveolar bone loss and oxidative stress. [ABSTRACT FROM AUTHOR]

Background: This cross-sectional study aims to investigate the retino-choroidal degenerative effects of periodontitis, metabolic syndrome (Mets), and the combination of these diseases using optical coherence tomography (OCT) measurements. Methods: Ninety-two patients selected according to inclusion criteria were divided into four groups: systemically and periodontally healthy (control), systemically healthy periodontitis (PD), periodontally healthy metabolic syndrome (MetS), and periodontitis and metabolic syndrome combined (PD-MetS). The systemic inflammatory–oxidative effects of periodontitis and MetS were biochemically evaluated using the serum TNF-α level, IL-1β/IL-10 ratio, and oxidative stress index (OSI: TOS/TAS). Retinal (AMT, pRNFLT, and GCL + T) and choroidal (SFCT) morphometric measurements and vascular evaluations (foveal capillary density) were performed via OCT Angio with swept-source technology. Results: Both periodontitis and Mets cause systemic inflammatory stress characterized by significant increases in the IL-1β/IL-10 ratio and OSI (p < 0.05). Compared to the control group, the AMT was significantly thinner in the MetS group, the pRNFLT was significantly thinner in the PD-MetS group, and the SFCT was significantly thinner in both groups (p < 0.05). The GCL+ was slightly thicker in the Mets groups. (p > 0.05) Foveal capillary density did not differ significantly among the groups. (p > 0.05). Conclusions: Periodontitis-related inflammatory stress alone causes changes in retinal and subfoveal choroidal thicknesses that are not statistically significant. On the other hand, when combined with Mets, it may significantly provoke the retinal neurodegenerative effects of this disease. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus (DM)‐associated hyperinflammatory host response significantly provokes periodontal tissue destruction. In this context, the support of nonsurgical periodontal therapy in diabetics with host modulation agents is a current field of study. This clinical study aims to investigate the clinical efficacy of melatonin supplementation and discuss its possible biological mechanisms in nonsurgical periodontal treatment in patients with DM and periodontitis through some fundamental markers. Methods: In this randomized controlled and single‐blind study, 27 of 55 diabetic patients with periodontitis (stage III/IV and grade C) underwent full‐mouth scaling and root planing (fmSRP) alone and 28 patients underwent melatonin administration (6 mg daily, 30 days) in addition to fmSRP (full‐mouth scaling and root planing plus melatonin, fmSRP‐mel). The potential therapeutic contribution of melatonin was evaluated clinically and biochemically (gingival crevicular fluid RANKL, OPG, MMP‐8, and serum IL‐1β levels) at 3rd and 6th months. Results: Melatonin (tablet, 6 mg daily, 30 days) did not cause any local or systemic side effects. fmSRP alone resulted in significant reduction in serum IL‐1β levels, pocket depths, gingival inflammation, and gingival crevicular fluid RANKL and MMP‐8 levels (p < 0.05). Moreover, melatonin supplementation resulted in a more significant decrease in bleeding and pocket depth scores at probing, especially at 3 months (p < 0.05). Furthermore, RANKL and MMP‐8 levels were significantly lower at 3 months and IL‐1β levels at 6 months compared to the control group (p < 0.05). However, OPG levels were not affected significantly by the treatments (p > 0.05). Conclusion: Melatonin, as a host modulation agent, significantly increases the clinical efficacy of fmSRP. The reduction in periodontal inflammation and pocket depths may be a result of marked suppression of RANKL‐associated osteoclastogenesis and extracellular matrix damage by melatonin. [ABSTRACT FROM AUTHOR]

Background: Dental anxiety is a problem that develops against dental treatments and practices, has negative effects on the patient's oral health, and affects a large population. This situation may affect individuals' oral health-related quality of life. The purpose of this study was to determine the dental anxiety levels and oral health-related quality of life of patients admitted to our clinic and investigate the relationship between them. Materials and methods: Three hundred volunteer individuals were included in the study. Participants were asked questions to determine personal characteristics. The Oral Health Impact Profile-14 Scale (OHIP-14) was used to determine the level of quality of life related to oral health, and the Modified Dental Anxiety Scale (MDAS) was used to evaluate the level of dental anxiety. The periodontal status of the participants was evaluated using the gingival index, plaque index, clinical attachment levels, periodontal pocket depth, and the bleeding on probing index. Results: According to the results of the evaluations, a statistically significant relationship was found between educational status, the frequency of visiting the dentist, and OHIP-14 (p<0.05). MDAS scores of primary school graduates were significantly higher than the other groups (p<0.05). A positive correlation was observed between periodontal parameters and MDAS and OHIP-14 scores (p<0.001). There was also a statistically significant and positive correlation between MDAS and OHIP-14 scores (p<0.001). Conclusion: Within the limits of this study, high dental anxiety score may negatively affect periodontal parameters and quality of life. [ABSTRACT FROM AUTHOR]

Objective and Background: Psychological stress is a potential modifiable environmental risk factor causally related to the exacerbation of periodontitis and other chronic inflammatory diseases. This animal study aimed to investigate comprehensively the preventive efficacy of systemic melatonin administration on the possible effects of restraint stress on the periodontal structures of rats with periodontitis. Methods: Forty‐eight male Sprague Dawley rats were randomly divided into six groups: control, restraint stress (S), S‐melatonin (S‐Mel), experimental periodontitis (Ep), S‐Ep, and S‐Ep‐Mel. Periodontitis was induced by placing a 3.0 silk suture in a sub‐paramarginal position around the cervix of the right and left lower first molars of the rats and keeping the suture in place for 5 weeks. Restraint stress was applied simultaneously by ligation. Melatonin and carriers were administered to the control, S, Ep, and S‐Ep groups intraperitoneally (10 mg/body weight/day, 14 days) starting on day 21 following ligation and subjection to restraint stress. An open field test was performed on all groups on day 35 of the study. Periodontal bone loss was measured via histological sections. Histomorphometric and immunohistochemical (RANKL and OPG) evaluations were performed on right mandibular tissue samples and biochemical (TOS (total oxidant status), TAS (total antioxidant status), OSI (oxidative stress index), IL‐1β, IL‐10, and IL‐1β/IL‐10) evaluations were performed on left mandibular tissue samples. Results: Melatonin significantly limited serum corticosterone elevation related to restraint stress (p <.05). Restraint stress aggravated alveolar bone loss in rats with periodontitis, while systemic melatonin administration significantly reduced stress‐related periodontal bone loss. According to the biochemical analyses, melatonin significantly lowered IL‐1β/IL‐10, OSI (TOS/TAS), and RANKL/OPG rates, which were significantly elevated in the S‐Ep group. Conclusion: Melatonin can significantly prevent the limited destructive effects of stress on periodontal tissues by suppressing RANKL‐related osteoclastogenesis and oxidative stress. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the relationship between the severity of periodontal disease and the presence of pulp stones using panoramic radiographies. Material and Methods: The study included 96 individuals aged 18-45 years. The patients were divided into four groups as control (periodontally healthy), gingivitis, stage 1-2 periodontitis and stage 3-4 periodontitis. The patients' panoramic radiographs and dental examination records were evaluated retrospectively and any pulp stones were recorded. The Chi-square test was used to determine the relationship between the presence of pulp stones and other parameters. Results: Evaluating the findings on a patient basis, the highest pulp stones were seen in the stage 3-4 (79.2%) group, and the least pulp stones were observed in the control group (20.8%). There was a statistically significant difference between the control group and the gingivitis group (p=0.017), the control group and the stage 3-4 group (p<0.001), and the stage 1-2 and stage 3-4 groups (p=0.001). On a tooth basis, the most pulp stones were observed in the stage 3-4 (14.9%) group, and the least pulp stones were observed in the control group (1.7%). Conclusion: The severity of periodontitis was associated with increased pulp stones. The diagnosis and treatment of patients with endodontic-periodontal problems should be carefully planned accordingly. The presence of pulp stones, which can complicate accessing root canals in endodontic treatment, should be comprehensively investigated. [ABSTRACT FROM AUTHOR]