Peridontoloji/Makale Koleksiyonu

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https://hdl.handle.net/20.500.12395/15340

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Quality and leakage of perforation repair-materials: A comparison of intracoronal and retrograde techniques
(Selçuk Üniversitesi, 2014) Özçopur, Betül; Akman, Melek; Hakkı, Sema; Belli, Sema
The objective of this in vitro study was to evaluate the quality and leakage of repair materials when perforation sites were challenged from an orthograde or retrograde direction. Intentional perforations were created on the mesial and distal root surfaces of the extracted human molar teeth (below the CEJ) using a diamond bur at a 45 degree angle to the long axis. Mesial perforations were repaired intracoronally using the following materials (n=15): IRM (Dentsply), amalgam (Dentsply), Dyract (Dentsply), SuperBond C&B (Sun Medical) and MTA (Dentsply). After filling the access cavities with cement, distal perforations were repaired retrogradely using the same materials. The teeth were kept at humid conditions (100%, 24hrs), the perforation sites were stained with 2%methylene blue (24hrs), sectioned and examined under a stereomicroscope at 20x and 40x magnifications and scored as extruded, insufficient or adequate in combination with the dye penetration. The data was statistically analyzed (Kruskal-Wallis and Mann-Whitney U-tests). A significant difference was found among the restoration techniques (p<0.05). All the materials showed less leakage when used retrogradely (p<0.05). Repair of the perforation through the access cavity resulted in 86% extruded or insufficient restorations with leakage. IRM restoration showed 80% and MTA showed 60% adequate restoration without leakage when applied retrogradely. Repair of the perforations using the retrograde technique has significantly increased the number of the adequate restorations regardless the effect of the material factor. IRM showed the best sealing followed by MTA when applied retrogradely.
İzole bir dental klinikte ultrasonik skaler kullanımı sonrası oluşan aerosol kontaminasyonunun gözlenmesi
(Selçuk Üniversitesi, 2020) Aydındoğan, Sefa; Sayın, Zafer; Marakoğlu, İsmail
Amaç: Dental tedaviler sırasında önemli miktarda mikrobiyal aerosol ortaya çıkmaktadır. Aerosoller diş hekimi, dental personel ve hasta arasında enfeksiyonun yayılımında önemli yer tutmaktadır. Bu çalışmanın amacı ultrasonik skaler kullanımına bağlı oluşan total bakteriyel aerosol kontaminasyonlarının farklı zaman aralıklarında değerlendirilmesidir. Gereç ve Yöntemler: Kliniğimize rutin periodontal tedavi için başvuran benzer ağız içi kondisyonlara sahip 7 hastanın başlangıç periodontal tedavisi, izole bir tedavi odasında ultrasonik skaler kullanılarak yapıldı. Tedavi öncesi, tedavinin hemen sonrası ve tedavi sonrası 2 saate kadar 15dk aralıklarla hava örnekleri alındı. Hava örneklemesi, aktif hava örnekleme cihazı kullanılarak yapıldı (Biomerieux Air İdeal, France). Total bakteriyel konsantrasyonun belirlenmesi amacıyla PCA (Plate Count Agar) besiyeri kullanıldı. 37 °C’de 48 saat inkübasyon sonrası CFU (colony forming ünit) sayımı yapıldı. Bulgular: Tedavi sonrasında, öncesine göre aerosol kontaminasyonunun istatistiksel olarak anlamlı şekilde yüksek olduğu görüldü (230,429 ± 60,458 CFU/m3 - 780,143 ± 130,979 CFU/m3 ) (p<0,05). Kontaminasyonun tedavi hemen sonrasında pik değerlerine ulaştığı ve saçılan aerosollerin 60 dk’ ya kadar ortamda kaldığı sonrasında istatistiksel olarak anlamlı olarak azalmaya başladığı görüldü (p<0,05). Tedaviden 75, 90 ve 120 dk sonrasında alınan hava örnekleriyle tedavi öncesi alınan örnekler arasında fark olmadığı görüldü. Sonuç: Periodontal tedaviler sırasında önemli oranda aerosol kontaminasyonu oluşmakta ve ortamda uzun süre varlığını devam ettirmektedir. Bu durum aerosolle bulaşa sahip hastalıkların çapraz enfeksiyonunda önemli bir yer tutmaktadır.
Papillon LeFèvre Sendromlu Hastalarda Alveoler Soket Koruma Yöntemi Olarak İmplant Yerleştirilmesi; İki Olgu Sunumu
(Selçuk Üniversitesi, 2021) İnönü, Elif; Dursun, Recep; Hakkı, Sema S.; Mutafcılar, Emine Elif
Papillon-Lefèvre sendromu, süt ve daimî dentisyonda erken diş kaybı ve palmaplantar hiperkeratoz ile karakterize otozomal resesif geçişli genetik bir hastalıktır. Bu olgu raporunda, PapillonLefèvre sendromlu (PLS) iki hastada, alveolar kemiği korumak için diş köklerinin diş eti altında bırakılması ve çekimlerini takiben çekim soketinin implant ile korunması sunuldu. PLS tanısı konmuş 18 yaşında erkek ve 29 yaşında kadın hasta Selçuk Üniversitesi Periodontoloji Anabilim Dalı kliniğinde 11-12 yaşlarından itibaren takip edilerek periodontal tedavi ile dişlerin ağızda tutulmasına çalışılmıştır. Şiddetli mobilitesi olan dişler çekildikten sonra birçok kez protezleri yenilenmiştir. 43 ve 33 nolu diş köklerinin diş eti altında bırakılmasının ardından kökler yaklaşık 5 yıl boyunca ağızda tutulabilmiştir. Dişlerin ağız ortamına açıldıktan sonra kaybedilmesinin ardından alveolar kemiğin korunması amacıyla aynı bölgelere dental implant yerleştirilerek alveolar kemik rezorpsiyonu riski nedeniyle diş eti altında bırakılmıştır. Klinik ve radyografik olarak kontrol edilen hastalarda yumuşak doku komplikasyonu gözlenmeksizin ve dişsiz sahalara kıyasla kemik seviyesi korunabilmiştir.
Effect of anatomical location (mandible vs maxilla) of dental implants on the BMP-2, BMP-7, sRANKL and OPG levels in periimplant crevicular fluid during osseointegration. A pilot study
(Selçuk Üniversitesi, 2019) Sağlam, Mehmet; Dolanmaz, Doğan; Koçak, Emrah; Gürsoytrak, Burcu; İnan, Özgür; Dündar, Niyazi; Hakkı, Sema S.
Background: The aim of this study was to investigate levels of bone morphogenetic protein-2 (BMP-2), BMP-7, soluble receptor activator of nuclear factor-kB ligand (sRANKL) and osteoprotegerin (OPG) in the peri-implant crevicular fluid (PICF) of implants placed in both maxilla and mandible during the osseointegration period. Materials and Methods: Thirty-three patients (17 females and 16 males; mean age 47.03±11.23 years) were included in this study. A total of 33 implants were placed in both of maxilla (Group 1/n=18) and mandible (group 2/n=15). Peri-implant crevicular fluid (PICF) samples, modified plaque index (MPI), gingival index (GI) and probing depth (PD) measurements were obtained at 1 and 3 months after surgery. PICF levels of BMP-2/-7, sRANKL and OPG were analyzed by ELISA. Results: No complications were observed during the healing period. No significant differences were observed in the PICF levels of sRANKL, OPG, BMP-2 and BMP-7 and evaluated clinical parameters between groups at any time point (p>0.05). While PICF volume of group 2 was greater than group 1 at first month, PICF volume of group 1 was greater than group 2 at 3 months (p<0.05). There was a positive correlation between sRANKL levels and PICF volume (p<0.05) and a strong correlation between BMP-2 and BMP-7 (p<0.01). Conclusion: The results of this pilot study didn’t show any significant difference in PICF levels of BMP-2, BMP-7, sRANKL, and OPG in terms of anatomic location of dental implants. Further welldesigned studies should be carried out to evaluate the relationship between bone related biomarkers and anatomic location of dental implants.
The association between some macro and trace elements in saliva and periodontal status
(Humana Press Inc., 2019) İnönü, Elif; S. Hakkı, Sema; Kayış, Seyit Ali; Nielsen, Forrest H.
Changes in the macro and trace element composition of saliva might be indicative for pathological changes in periodontal tissues. However, there is a lack of evidence in the literature showing associations between mineral elements and periodontal status. The aim of this study was to determine whether such associations occur. Totally, 190 systemically healthy non-smoker participants (mean age 32.2 ± 6.02; 50 periodontally healthy, 50 gingivitis, 50 chronic periodontitis, and 40 aggressive periodontitis individuals) were included in this cross-sectional study. Salivary levels of some macro and trace elements were measured by using inductively coupled plasma mass spectrometry (ICP-MS). Kruskal-Wallis’s test was used for statistical analysis. Statistically significant differences were found in sodium (Na), magnesium (Mg), potassium (K), calcium (Ca), vanadium (V), chromium Cr), manganese (Mn), iron (Fe), rubidium (Rb), strontium (Sr), and selenium (Se) concentrations among the groups. Significant increases in the essential minerals Na, Mg, K, Ca, Fe, and Se occurred in both periodontitis groups when compared to the gingivitis and periodontally healthy groups. Lower Se, Sr, Fe, Mn, and V concentrations were found in the aggressive periodontitis group than in the chronic periodontitis group. The results of this study demonstrated that assessment of mineral element concentrations in saliva might be useful in assessing periodontal health and disease. However, further studies are required to determine whether the change in a specific mineral element is the result of periodontal disease or is involved in its pathogenesis. © 2019, Springer Science+Business Media, LLC, part of Springer Nature.
Netrin-1 and its receptor Unc5b as markers of periodontal disease
(WILEY, 2019) Gunpinar, Sadiye; Meraci, Bilge; Dundar, Niyazi
Objectives The aim of this present study was to evaluate the levels of Netrin-1 and Unc5b in periodontal health and disease. Background Netrin-1, acting via its receptor UNC5b, regulates the inflammatory response and takes apart in bone destructive diseases. Methods Samples of gingival crevicular fluid (GCF), whole saliva, and serum were taken from systemically healthy, nonsmoking 20 periodontitis , 20 gingivitis patients, and 20 periodontally healthy subjects at baseline and 4 weeks after nonsurgical periodontal treatment (NSPT). Whole-mouth and site-specific clinical periodontal parameters were recorded. Netrin-1 and Unc5b levels were measured by enzyme-linked immunosorbent assay. Data were analyzed by nonparametric tests. Results Total amount of Netrin-1 in GCF was significantly higher in periodontitis than the others, and the levels were significantly reduced after NSPT. Salivary and serum concentrations of Netrin-1 were significantly different among the study groups (P = .000), and NSPT significantly increased the concentration levels of both salivary and serum Netrin-1 (P < .05). Healthy subjects had significantly lower GCF (P = .001) and conversely, higher salivary and serum levels of Unc5b than the other groups (P = .002). The GCF levels of Unc5b were significantly reduced (P < .01), and conversely, serum concentrations were significantly increased after NSPT (P < .05). GCF Netrin-1 and Unc5b total amounts were positively correlated with clinical parameters (P P < .05) whereas salivary Netrin-1 and Unc5b concentrations were negatively correlated with clinical parameters (P P < .05). Conclusions The results of this study indicate that Netrin-1 and its receptor Unc5b may have essential roles in periodontal inflammation and those can be assumed as useful therapeutic agent to control inflammation and periodontal breakdown.
Evaluation of long-term effects of diode laser application in periodontal treatment of poorly controlled type 2 diabetic patients with chronic periodontitis
(WILEY, 2019) Eltaş, Şeydanur Dengizek; Gürsel, Mihtikar; Eltaş, Abubekir; Alptekin, Nilgün Özlem; Ataoğlu, Tamer
Purpose This study aimed to investigate the effects of diode laser (DL) in addition to non-surgical periodontal treatment on periodontal parameters, systemic inflammatory response and serum haemoglobin A(1c) (HbA(1c)) level in patients with poorly controlled type 2 diabetes mellitus (T2DM) and chronic periodontitis. Methods Thirty-seven patients with poorly controlled T2DM and chronic periodontitis completed this study. The patients were divided into two groups. The individuals in the control group received placebo laser treatment in addition to scaling and root planing (SRP). The individuals in the study group received DL (1 watt) in addition to SRP. Clinical index measurements were performed before treatment (T0), 3 months after treatment (T1) and 6 months after treatment (T2). Plaque index, gingival index, bleeding on probing, clinical attachment level and probing depth were measured to determine periodontal status. HbA1(c) and C-reactive protein (CRP) levels were also analysed using blood samples. Results In both groups, clinical and laboratory parameters were significantly improved at T1 and T2 compared to baseline (P < 0.05). Gingival index, bleeding on probing and probing depth were more significantly reduced after treatment in the SRP+DL group than in the SRP group (P < 0.05). The serum CRP and HbA(1c) levels were similar between the groups (P > 0.05). Conclusion The use of DL in addition to SRP in periodontal treatment of T2DM individuals makes positive contribution to the reduction of local inflammation and to periodontal healing. On the other hand, it has no beneficial effects on systemic inflammatory response and glycaemic control.
Effects of diode laser application on inflammation and mpo in periodontal tissues in a rat model
(UNIV SAO PAULO FAC ODONTOLOGIA BAURU, 2018) Uslu, Mustafa Ozay.; Eltas, Abubekir.; Marakoglu, Ismail.; Dundar, Serkan.; Sahin, Kazim.; Ozercan, Ibrahim Hanifi.
Objective: In this study, we aimed to histologically and immunologically evaluate the effect of diode laser treatment when applied adjunctive to scaling and root planing (SRP) in an experimental periodontitis model. Materials and methods: We used Wistar-Albino rats (n=60) with average weight of 230 g. Experimental periodontitis was induced by ligature at the right and left first mandibular molar teeth in all rats. After 11 days, the ligature was removed and rats were divided into two groups. The control group (n=30) received only SRP treatment, while the laser group (n=30) received a diode laser (GaAlAs, 810 nm, 1 W, 10 J, 20 s) treatment adjunctive to SRP. Ten rats in each group were sacrificed after 7, 15, and 30 days. Histopathological examination was performed in the left mandible of rats. Myeloperoxidase (MPO) was evaluated by western blot in the gingival specimens from the right mandible. Results: MPO levels in the laser group were statistically significantly lower compared with the control group (p <= 0.05). There was no statistically significance at any time between MPO levels in the control group (p>0.05). MPO levels in the laser group at the 7th day were statistically significantly higher compared to the 15th (p <= 0.05) and the 30th day (p <= 0.05). Inflammatory cell infiltration decreased over time in both groups and was statistically significantly lower in the laser group than in the control group at all times (p <= 0.01). Conclusions: Within the limits of this study, we suggest that diode laser application is an adjunctive treatment because it reduced inflammation and MPO when applied in addition to SRP. On the other hand, more studies are needed for the assessment of the effects of diode laser application to periodontal tissues.
The effects of alpha-tocopherol on serum Il-1, Il-4 and Il-6 levels of rats with experimental periodontitis and type I diabetes
(2013) Hatipoğlu, Mükerrem; Alptekin, Nilgün Özlem; Haliloğlu, Seyfullah
Amaç: Epidemiyolojik ve klinik çalışmalar periodontal hastalığın diyabeti etkileyebileceğini göstermiştir, diğer taraftan periodontitis diyabetin komplikasyonlarından birisidir. Bu çalışmanın hedefi, deneysel periodontitis ve streptozotosin (STZ) ile diyabet oluşturulan/ oluşturulmayan sıçanlarda -tokoferol uygulamasının serum sitokin düzeyleri üzerine etkilerini araştırmaktır. Gereç ve Yöntemler: Toplam kırk adet erkek Sprague Dawley sıçana anestezi uygulandı ve mandi- bular sağ birinci molar dişlere subgingival olarak 3/0 ipek sütur bağlandı. Bu hayvanlar, sağlıklı grup (Grup I) ve tek seferde 50mg/kg STZ enjekte edilen diyabe- tik grup (Grup II) olmak üzere iki gruba ayrıldı. Bu gruplarda serum fizyolojik (Grup IA, Grup IIA) ve - tokoferol (40mg/kg/gün) enjekte edilen alt gruplara (Grup IB, Grup IIB) ayrıldı. Ligatür bağlandıktan 21 gün sonra sıçanlar kurban edildi. Aynı zaman aralı- ğında serum IL-1, IL-4 ve IL-6 konsantrasyonlarının (pg/ml) ticari ELISA kitleri kullanılarak ölçülebilmesi için kan örnekleri alındı. İstatistiksel kıyaslamalar için iki-yönlü varyans analizi kullanıldı p0.05 anlamlılık düzeyi kabul edildi. Bulgular: Verilerin analizi sonunda, gruplar arasında serum IL-1, IL-4 ve IL-6 konsantrasyonları istatistik- sel olarak farklı bulunmadı (p0.05). Sonuçlar: Elde edilen sonuçlara göre -tokoferol’ün deneysel periodontitisli, STZ ile diyabet oluşturulmuş/oluşturulmamış sıçanlarda serum IL-1, IL-4 ve IL-6 konsantrasyonlarını değiştirmediği belirlenmiştir.
Periodontal Ligament Fibroblast Response to Root Perforations Restored with Different Materials - A Laboratory Study
(WILEY-BLACKWELL, 2012) Hakkı, S. S.; Bozkurt, S. B.; Özcopur, B.; Puralı, N.; Belli, S.
Aim To compare the effect of several materials on the attachment of periodontal ligament (PDL) fibroblasts to experimentally perforated root surfaces. Methodology Root specimens (size 5 x 5 mm) were obtained from extracted human molar teeth and perforations with a 1 mm diameter were created. One group was kept as a control and the rest were repaired with the following materials: Amalgam, Dyract, IRM, Super Bond C&B and Mineral trioxide aggregate (MTA). PDL fibroblasts were placed at a density of 8 x 104 cells on the root specimens, incubated on tissue culture inserts (48 h) and then transferred to 48 well-plates. MTT assays were performed at 48 and 96 h for PDL fibroblast survival. Cell attachment was observed using confocal microscopy on days 2 and 5. Total RNAs from the root specimens were isolated on day 5 and type I collagen (COL I) and Runt-related transcription factor 2 (Runx2) mRNA expressions were checked using Quantitative-Polymerase Chain Reaction (QPCR). For the MTT assay and QPCR, one-way analysis of variance (anova) and Tukey HSD multiple comparison tests were used to compare the groups. Results Mineral trioxide aggregate resulted in a significantly higher cell density (P < 0.001). Dyract, IRM and Super Bond C&B groups had a lower cell density when compared with the control and MTA groups at 48 h (P < 0.001). Confocal microscopy revealed that, among the experimental groups, the MTA group had the largest viable cell population over the restoration site when compared with the other materials; however, reduced cell attachment was noted in all groups when compared with the control. Increased Runx2 mRNA expressions were noted in MTA (P < 0.001) and IRM (P < 0.01) groups when compared with control and other tested materials. COL I transcripts were increased in IRM (P < 0.01), D, C&B and MTA (P < 0.001) when compared with the control. Conclusion Mineral trioxide aggregate provided a more favorable environment for PDL cell adhesion and growth.
Osteogenic Differentiation of MC3T3-E1 Cells on Different Titanium Surfaces
(IOP PUBLISHING LTD, 2012) Hakkı, S. Sema; Bozkurt, S. Buket; Hakkı, Erdoğan E.; Korkusuz, Petek; Puralı, Nuhan; Koç, Nursen; Timuçin, Muharrem; Öztürk, Adnan; Korkusuz, Feza
mRNA expressions related to osteogenic differentiation of MC3T3-E1 cells on electro-polished smooth (S), sandblasted small-grit (SSG) and sandblasted large-grit (SLG) surfaces of titanium alloys were investigated in vitro. Gene expression profiles of cells were evaluated using the RT2 Profiler PCR microarray on day 7. Mineralizing tissue-associated proteins, differentiation factors and extracellular matrix enzymes mRNA expressions were measured using Q-PCR. SLG surface upregulated 23 genes over twofolds and downregulated 3 genes when compared to the S surface. In comparison to the SSG surface, at least a twofold increase in 25 genes was observed in the SLG surface. BSP, OCN, OPN, COL I and ALP mRNA expressions increased in the SLG group when compared to the S and the SSG groups. BMP-2, BMP-6 and TGF-beta mRNA expressions increased in both the SSG and the SLG surfaces. MMP-2 and MMP-9 mRNA expressions increased as the surface roughness increased. This study demonstrated that surface roughness of titanium implants has a significant effect on cellular behavior and SLG surface apparently increased gene expressions related to osteogenesis when compared to the S and the SSG surfaces.
Immunohistochemical Analysis of CD45RO(+) T Cells and Vascular Endothelial Growth Factor Expression in Cyclosporin A-Induced Rat Gingival Tissue
(Wiley, 2012) Alptekin, Nilgün Özlem; Üstün, Kemal; Yaprak, Emre; Avunduk, Mustafa Cihat; Ataoğlu, Tamer
Background: The aim of this study is to evaluate CD4(+), CD8(+), and CD45RO(+) T cells, and vascular endothelial growth factor (VEGF) expression in cyclosporin A (CsA) induced rat overgrown gingival tissue during an 8-week period. Methods: Sixty male Sprague-Dawley rats weighing 200 to 250 g were used in this study. Mandibular first molars were ligated with 3-0 silk suture. The rats received daily doses of 0.09% NaCl (control group) or 10 mg/kg body weight of CsA (test group) by intraperitoneal injections. Five rats from the control group and 10 rats from the test group were sacrificed at each experimental period (2, 4, 6, and 8 weeks after the beginning of CsA treatment). The specimens were examined immunohistochemically. Results: CD4(+), CD8(+), and CD45RO(+) T cells, and VEGF expression were more prevalent in the CsA-treated group than in the control group (P <0.05). VEGF was significantly correlated with CD4(+) T cells, CD4(+)/CD8(+) ratio, and CD45RO(+) cells (P<0.05). Conclusion: Based on our findings, we conclude that VEGF, a major regulator of angiogenesis, and CD4(+), CD8(+), and CD45RO(+) memory T cells play a key role in CsA-induced gingival overgrowth. J Periodontol 2012;83:248-255.
Klippel-Trenaunay Syndrome Manifesting as Gingival Overgrowth and Teeth Agenesis
(JOURNAL PEDODONTICS INC, 2010) Özdemir, Hakan; Marakoğlu, İsmail; Akyol, Melih; Göze, O. Fahrettin; Gürsoy, Ulvi Kahraman
Objective: Klippel-Trenaunay syndrome (KTS) is characterized by triad of venous varicosity, naevus flammeus, and soft/hard tissue hypertrophy. Manifestations of the syndrome in the head and neck region are rare, but in some cases hemangioma of the lips, tongue, and gums, open bite and cross bite, and early tooth eruption are associated with the disease. Study design: We report a 12-year-old KTS patient with gingival hyperplasia, congenital missing teeth, and increased mucosal vascularization as oral manifestations. Results and conclusion: All manifestations of the KTS were observed on the same side of the head, except bilateral missing teeth. Histological examination showed several vascular enlargements in enlarged gingiva. It is suggested that oral manifestations of the syndrome are generally related to the severity of the disease, but they do not always present in the same pattern.
Effects of Root Planing Procedures with Hand Instrument or Erbium, Chromium: Yttrium-Scandium-Gallium-Garnet Laser Irradiation on the Root Surfaces: A Comparative Scanning Electron Microscopy Study
(Springer London Ltd, 2010) Hakkı, Sema S.; Berk, Gizem; Dündar, Niyazi; Sağlam, Mehmet; Berk, Nukhet
The purpose of this study was to investigate the efficiency of hand instrumentation and laser irradiation on calculus removal from the root surfaces, in vitro. Thirty-two human teeth, extracted for periodontal reasons, were used in this study. Root surfaces of single-rooted teeth were treated by different methods including (1) conventional hand instruments; (2) hand instruments and tetracycline-hydrochloride (Tet-HCl); (3) erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser irradiation, setting I (short pulse); (4) Er,Cr:YSGG laser irradiation, setting II (long pulse). Three premolar teeth, extracted for orthodontic reasons, served as control. The morphology of the root surfaces was evaluated by light and scanning electron microscopy. Energy dispersive X-ray (EDX) analysis was performed to compare the mineral content of root surfaces treated with hand instrumentation and lasing procedures. The results of this study demonstrated that all treatments were efficient in calculus removal from the root surfaces. Thermal changes, including melting and carbonization, were not observed in either lasing procedure. The surface was rougher in the laser groups than in the groups treated with hand instruments. Moreover, roughness was greater in the long-pulse laser setting than in the short-pulse setting. While increased calcium (Ca) and decreased phosphate (P) (weight concentration percent) were observed in all treatments when compared with the control, laser procedures resulted in a more similar mineral content than in the groups treated with hand instruments. Based on these findings, laser procedures, when used in appropriate settings, are capable of performing scaling and root planing in the treatment of periodontitis. It may be concluded that short pulse laser may be more suitable for the micro-morphology of the root surface. However, additional in vitro and clinical studies are necessary to clarify the success of laser in periodontal therapy.
Comparison of Er,Cr:YSGG Laser and Hand Instrumentation on the Attachment of Periodontal Ligament Fibroblasts to Periodontally Diseased Root Surfaces: An In Vitro Study
(Amer Acad Periodontology, 2010) Hakkı, Sema S.; Korkusuz, Petek; Berk, Gizem; Dündar, Niyazi; Sağlam, Mehmet; Bozkurt, Buket; Purali, Nuhan
Background: This study investigates the effects of erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser irradiation and hand instrumentation on the attachment of periodontal ligament (PDL) fibroblasts to periodontally involved root surfaces. Methods: Twenty-four single-rooted periodontally involved human teeth (test groups), and six healthy premolar teeth extracted for orthodontic reasons (control group) were included in this study. A total of 45 root slices were obtained from all selected teeth and assigned to the following five groups: 1) untreated healthy group (+control); 2) untreated periodontally diseased group ( control); 3) hand instrumentation group (scaled Gracey); 4) laser I, Er,Cr:YSGG laser irradiation setting-I (short pulse); and 5) laser II, Er,Cr:YSGG laser irradiation setting-II (long pulse). All of the root slices were autoclaved in phosphate buffered saline and slices were placed onto cell culture inserts. PDL fibroblasts were placed at the density of 80,000 cells on the root plate (5 x 6 mm) and incubated for 48 hours and transferred to 24-well plates. The attachment PDL fibroblasts on the root plates were observed using confocal microscopy (at 12 hours and on days 3 and 7) and scanning electron microscopy (at 12 hours and day 3). 3- (4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl-tetrazolium bromide assay was performed on day 5 for PDL fibroblast survival. Results: 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl-tetrazolium bromide assay shows that whereas laser-treated specimens showed a significantly higher cell density, the Gracey-treated group showed a lower cell density compared to the positive control group (P < 0.05). Based on confocal microscopy, apparent reduction was observed in the attachment of PDL cells to the periodontally diseased root surfaces. In the laser and Gracey groups, cells looked well-oriented to the root surfaces. Laser-treated groups provided suitable environment for cell adhesion and growth. Laser I treatment was more favorable for the attachment of PDL compared to scaled Gracey, laser II, and even healthy root surfaces. Conclusion: The results of the study indicate that short-pulse laser setup (laser I) looks more promising regarding the attachment, spreading, and orientation of PDL cells.
Boron Regulates Mineralized Tissue-Associated Proteins in Osteoblasts (MC3T3-E1)
(Elsevier Gmbh, Urban & Fischer Verlag, 2010) Hakkı, Sema S.; Bozkurt, Buket S.; Hakkı, Erdoğan E.
The aim of this study was to determine the effects of boron (B) on the cell-survival, proliferation, mineralization and mRNA expression of mineralized tissue-associated proteins. Additionally, determination of the effects of B on the BMP-4, -6 and -7 protein levels of pre-osteoblastic cells (MC3T3-E1) was also intended. The effects of B (pH 7.0) concentrations (0, 0.1, 1, 10, 100, 1000, 2000, 4000, 8000 and 10,000 ng/ml) on the survival of the cells were evaluated at 24 and 96 hrs with MTT assay. To evaluate the proliferation in long term, MC3T3-E1 cells were treated with different concentrations of B (0, 0.1, 1, 10, 100 and 1000 ng/ml) and were counted on days 2, 5, and 14. While in short term, decreased cell survival rate was observed at 1000 ng/ml and above, at long term no statistically significant difference was detected in different B concentrations applied. Slight decreases at the proliferation of the B-treated groups were determined on days 5 and 14 but one-way analysis of variance revealed that the difference was statistically insignificant. In mineralization assay, increased mineralized nodules were apparently observed in B treatment (1 and 10 ng/ml concentrations) groups. Based on quantitative RT-PCR results, remarkable regulation in favor of osteoblastic function for Collagen type I (COL I), Osteopontin (OPN), Bone Sialoprotein (BSP), Osteocalcin (OCN) and RunX2 mRNA expressions were observed in B treatment groups in comparison with untreated control groups. Increased BMP-4, -6 and -7 protein levels were detected at 0.1, 1, 10 and 100 ng/ml B concentrations. Results of the study suggest that at the molecular level B displays important roles on bone metabolism and may find novel usages at the regenerative medicine.
Bone Morphogenetic Protein-7 Enhances Cementoblast Function In Vitro
(Wiley, 2010) Hakkı, Sema S.; Foster, Brian L.; Nagatomo, Kanako J.; Bozkurt, S. Buket; Hakkı, Erdoğan E.; Somerman, Martha J.; Nohutcu, Rahime M.
Background: Bone morphogenetic protein (BMP)-7 is a potent bone-inducing factor and was shown to promote periodontal regeneration in vivo and in vitro; however, to our knowledge, the specific effect of BMP-7 on cementoblasts has not been defined. We aimed to investigate the effects of BMP-7 on cementoblasts, which are cells responsible for tooth root-cementum formation. We hypothesized that BMP-7 would regulate mineralized tissue-associated genes in cementoblasts and influence the expression profile of genes associated with cementoblast extracellular matrix (ECM) and cell adhesion molecules (CAMs). Methods: A murine immortalized cementoblast cell line (OCCM.30) was cultured with and without 50 ng/ml BMP-7. After 72 hours, total RNA was isolated, and mRNA levels for bone/cementum markers, including bone sialoprotein (BSP), osteocalcin (OCN), osteopontin (OPN), and runt-related transcription factor-2 (Runx2), were investigated by real-time quantitative reverse transcription-polymerase chain reaction (Q-PCR). In vitro mineral nodule formation was assayed on day 8 using von Kossa staining. A pathway-specific gene-expression array was used to determine BMP-7-responsive ECM and CAM genes in cementoblasts. Results: Mineralized tissue markers were strongly regulated by BMP-7, with an almost three-fold increase in BSP and OCN transcripts and significant increases in OPN and Runx2 mRNA expressions. BMP-7 treatment markedly stimulated cementoblast-mediated biomineralization in vitro compared to untreated cells at day 8. BMP-7 treatment altered the OCCM.30 expression profile for ECM and CAM functional gene groups. BMP-7 tended to increase the expression of collagens and matrix metalloproteinases (MMPs), mildly decreased tissue inhibitors of MMPs (TIMPs), and had mixed regulatory effects on integrins. Using Q-PCR, selected array results were confirmed, including a significant BMP-7-induced increase in MMP-3 and a decrease in TIMP-2 mRNA expression. Conclusion: These results support the promising applications of BMP-7 in therapies aimed at regenerating periodontal tissues lost as a consequence of disease.
Effect of Meloxicam on Gingival Crevicular Fluid IL-1beta and IL1 Receptor Antagonist Levels in Subjects With Chronic Periodontitis, and Its Effects on Clinical Parameters
(Springer Heidelberg, 2006) Toker, Hülya; Marakoğlu, İsmail; Poyraz, Ömer
The aim of the present study was to determine the effects of meloxicam after initial periodontal treatment on interleukin-1beta (IL-1 beta) and IL-1 receptor antagonist (IL-1ra) in gingival crevicular fluid (GCF) and clinical parameters in the chronic periodontitis patients. Data were obtained from 30 patients with chronic periodontitis. Fifteen chronic periodontitis patients received 7.5 mg meloxicam, and 15 patients received placebo tablets in a 1x1 regimen for 1 month. All subjects were nonsmokers and had not received any periodontal therapy. The plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) were recorded. The GCF was collected using a paper strip: eluted and enzyme-linked immunoabsorbent assays (ELISAs) were performed to determine the cytokine levels. The clinical data and GCF samples were obtained after periodontal therapy and 1 month after periodontal therapy. The PI, GI, PD, and GCF IL-1ra decreased significantly (p < 0.05) in meloxicam group at first month when comparing the initial levels. While decrease of the PI was statistically significant in control group (p < 0.05), statistically significant changes were not determined in the other clinical parameters and GCF cytokine levels (p > 0.05). There were no significant differences between two groups in any of the investigated parameters. Our observations did not reveal any influence of meloxicam on levels of IL-1 beta and IL-1ra in chronic periodontitis. Additional clinical studies are advisable to determine whether COX-2 selective drugs alter periodontal disease outcome with greater safety.
Cytotoxic Effects of Dental Desensitizers on Human Gingival Fibroblasts
(Wiley-Liss, 2006) Şengün, A.; Büyükbaş, S.; Hakkı, S. S.
The purpose of this study was to evaluate the effects of three different desensitizers on the cell viability and morphology of human gingival fibroblasts (HGF). Human gingival tissues were obtained from individuals who have clinically, healthy periodontium. HGF were grown at 37 degrees C in humidified atmosphere of 5% CO2 in Dulbecco's modified eagle's medium, supplemented with glutamine, penicillin, streptomycin, and 10% fetal bovine serum. The cells were treated with different concentrations (0.1, 0.3, and 0.5 mu L/mL) of desensitizers (Gluma Desensitizer, Seal&Protect, and MicroPrime). After 24- and 48-h exposure to the desensitizer solutions, the viable cells were examined using a hemocytometer. To monitor HGF viability, 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl tetrazolium bromide (MTT) colorimetric assay was used and cell morphology was also observed at 48 h. Following exposure to concentrations of 0.1 mu L/mL of test materials for 24 h, cell survival rates for Gluma Desensitizer (106%) and Micro Prime (62%) were not significantly different from the control, while it was significant for Seal&Protect (50%). Growing cells were significantly inhibited by all tested materials for 48 h (p < 0.05) in survival rates of 51, 47, and 31%, respectively. On the basis of the MTT assay, the cytotoxic effect of MicroPrime was more prominent, especially at high concentrations, than does Gluma Desensitizer and Seal&Protect. After exposure to Seal&Protect and MicroPrime, HGF became retracted, rounded in appearance and had loss of normal organization, leading to enlargement of intercellular space when compared with Gluma Desensitizer. As a conclusion, taking the limitations of an in vitro experiment into consideration, the cytotoxic effects were varied, depending on the chemical composition and exposure periods of the tested desensitizers.
Bone Sialoprotein Gene Transfer to Periodontal Ligament Cells May Not Be Sufficient to Promote Mineralization In Vitro or In Vivo
(Amer Acad Periodontology, 2006) Hakkı, Sema S.; Wang, Dian; Franceschi, Renny T.; Somerman, Martha J.
Background: To improve regenerative therapies, it is important to understand the cells and factors modulating periodontal tissues. Our group has focused on bone sialoprotein (BSP), a mineralized tissue-selective protein considered to be involved in the initiation of cementogenesis and osteogenesis. In this study, we examined whether gene transfer of BSP into periodontal ligament (PDL) cells would result in an increased ability of PDL cells to promote mineralization in vitro and in vivo. Methods: PDL cells obtained from CD-1 mice were immortalized using simian virus (SV) 40 large T antigen (TAg) and designated SV-PDL cells. SV-PDL cells were infected in vitro with LacZ gene-expressing control adenovirus vector. A 1,000 plaque-forming unit (pfu) titer was selected (based on X-gal staining) and cells were infected with mouse BSP-expressing replication-deficient adenoviral vector to determine the mRNA expression and protein level of BSP. Total RNA was isolated from cells on days 2, 4, and 6. Media were obtained on days 3, 5, and 7 for protein determination. Northern blot analysis was performed for mRNA expression and Western blot analysis for protein expression. To test the effect of BSP gene transfer on the mineralization of PDL cells, in vitro (von Kossa) and in vivo (severe combined immunodeficiency [SCID] mice) experiments were performed. Results: Under normal conditions, PDL cells do not express BSP transcripts and do not promote significant mineralization. SV-PDL cells infected with a BSP viral vector expressed and secreted substantial levels of BSP as confirmed by Northern and Western blot analysis. BSP mRNA and protein levels were strong on day 2 and still apparent on day 6, although not as great. However, no mineral nodule formation was noted either in vitro or in vivo. Conclusions: Although BSP is an important and necessary protein for mineralization, it may not be sufficient for promoting mineralization without the addition or removal of other factors. Further studies will help to clarify the specific factors required for promoting mineralization, a required step for designing predictable periodontal regenerative therapies.

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