Evaluation of the effectiveness of diode laser therapy in conjunction with nonsurgical treatment of peri-implantitis.

PURPOSE: Peri-implantitis (PI) is an inflammatory condition associated with the destruction of bone tissue around a dental implant, and diode lasers can be used to treat this disease. In this study, we aimed to evaluate the effectiveness of a 940-nm diode laser for the nonsurgical treatment of PI. METHODS: Twenty patients (8 women and 12 men) were enrolled in a split-mouth randomized controlled study. In the control group (CG), mechanical debridement with titanium curettes accompanied by airflow was performed around the implants. The test group (TG) was treated similarly, but with the use of a diode laser. Clinical measurements (plaque index, gingival index [GI], probing pocket depth [PPD], bleeding on probing [BOP], clinical attachment level, and interleukin-1ß [IL-1ß] in the peri-implant crevicular fluid) were evaluated and recorded at baseline and 3 months. IL-1ß levels were determined using the enzyme-linked immunosorbent assay method. RESULTS: The symptoms were alleviated in both groups at 3 months as assessed through clinical measurements. GI, BOP, and PPD were significantly lower in the TG than in the CG (P<0.05). The IL-1ß level increased post-treatment in both groups, but this increase was only statistically significant (P<0.05) in the CG. CONCLUSIONS: The diode laser enabled improvements in clinical parameters in the peri-implant tissue. However, it did not reduce IL-1ß levels after treatment. Further studies about the use of diode lasers in the treatment of PI will be necessary to evaluate the effects of diode lasers in PI treatment.

Effects of thyme on halitosis in gingivitis patients: Can thyme mouthwash prevent halitosis-A randomized trial.

OBJECTIVES: Bad breath is a condition that negatively affects people's social interactions and quality of life. The aim of this study was to evaluate the effect of thyme mouthwash on intraoral halitosis, gingival index (GI) and plaque index (PI) in patients with gingivitis. METHODS: In this retrospective study, 60 gingivitis patients (30 women/30 men) received initial periodontal treatment followed by oral hygiene instructions (OHI) and then were divided into four groups: The control group (C) received only OHI, while chlorhexidine (CHX) mouthwash was prescribed to the CHX group, Zinc acetate and CHX diacetate mouthwash was prescribed to the zinc acetate and CHX diacetate (ZnA) group, and the thyme (T) group was instructed to use thyme mouthwash. GI, PI and volatile sulfur compound (VSC) values were recorded at baseline and at the first week of treatment. RESULTS: The initial values of the recorded parameters did not differ significantly between the groups. In all groups, VSCs, GI and PI decreased after treatment (p = 0.001). There was no significant difference between the PI values of the groups after treatment (p = 0.188). On the contrary, the GI and VSC values after treatment were significantly different between the groups (p = 0.001). GI values were highest in the control group and lowest in the CHX group. In terms of VSCs, a significant difference was found between groups T and C, and between groups T and ZnA (p = 0.001). CONCLUSION: This study showed that the use of thyme mouthwash after periodontal treatment was effective in improving bad breath and gingivitis in gingivitis patients.

Investigation of human ß-defensins 1, 2 and 3 in human saliva by molecular dynamics.

Human ß-defensins present in saliva have a broad spectrum of antimicrobial activities that work against infections in oral cavity. To provide a better understanding of these molecules' properties and functions at the molecular level, we have investigated and compared the important structural properties of human ß-defensin-1, -2 and -3 using molecular dynamics simulations. Our results have shown that human ß-defensin-3 has a more flexible structure in water than the other two because of its high hydrophilicity, low ß-sheet content and high repulsive forces between its charged residues. Moreover, we found that the location of the salt bridges is important in protein's stability in water. Molecular dynamics simulations of human ß-defensins 1, 2 and 3 revealed that the hbd-3 is more flexible in water than hbd-1 and hbd-2.

The Effect of Two Different Doses of Astaxanthin on Alveolar Bone Loss in an Experimental Model of Periodontitis in Diabetic Rats.

This study evaluated the effects of astaxanthin (ASX) on alveolar bone loss, receptor activator of nuclear factor-κB ligand (RANKL), and osteoprotegerin (OPG) activity in ligature-induced periodontitis in diabetic rats. Diabetes mellitus (DM) was induced with 50 mg/kg intraperitoneal streptozotocin in 40 male Wistar rats. The Wistar rats were divided into six experimental groups: non-ligated (NL; n = 6); ligature only (L; n = 6); DM only (D; n = 6); DM + ligature (DP; n = 6); DM + ligature + 1 mg/kg/day ASX (ASX 1 group; n = 8); and DM + ligature + astaxanthin 5 mg/kg/day ASX (ASX 5 group; n = 8). Silk ligatures were placed along the gingival margin of the left mandibular first molar tooth. The study duration was 11 days, after which the animals were euthanised. Changes in alveolar bone levels were clinically measured, and RANKL and OPG activities were immunohistochemically examined. Alveolar bone loss was the most significant in the DP group (p < 0.05). Decreased alveolar bone loss was observed in the ASX 5 group (p < 0.05). Although RANKL activity was highest in the DP group, it was observed at lower levels in the groups to which ASX was administered. OPG activity did not differ between groups (p > 0.05). The results of this study suggested that 1 and 5 mg/kg ASX administration reduced RANKL activity and alveolar bone loss in rats with experimentally induced periodontitis.

Incidence of orthodontic appliance failures during the COVID-19 lockdown period.

INTRODUCTION: As a result of the rapid spread of the disease caused by severe acute respiratory syndrome coronavirus 2, the World Health Organization declared a global pandemic on March 11, 2020. Governments worldwide adopted various measures to stop or slow the spread of coronavirus disease 2019 (COVID-19). One widely used measure was lockdown; workers who could work from home were instructed to do so, and nonessential businesses-including dental clinics-were closed for weeks or months. The purpose of this investigation was to document the incidence of fixed orthodontic appliance failures and the periodontal health status of patients undergoing fixed orthodontic treatment during and after the lockdown period. METHODS: The sample comprised 350 orthodontic patients (mean age, 16.85 ± 2.59 years; 249 female, 101 male) who underwent orthodontic and periodontal examinations in Adiyaman, Turkey, after a mean lockdown period of 103.7 ± 21.3 days. Frequencies of an orthodontic bracket, elastic ligature, molar band, and miniscrew failures of oral ulcers were recorded, and periodontal parameters were assessed. The effects of sex, age, and the bracket systems used in the patients on the frequencies of these failures were analyzed. RESULTS: It was revealed that 15.42% (n = 54) of all patients had ≥1 bracket bonding failure, and 8.16% (n = 4) of the patients with miniscrew implantation had ≥1 miniscrew failure. The incidence of bracket bonding failure was significantly higher in men than in women. No significant relationship was found between periodontal parameters and bracket bonding failure. Plaque and gingival scores were higher than those reported for a similar population before a lockdown. CONCLUSIONS: The results indicated that orthodontic appliances might have higher frequencies of failure during a lockdown than normal times, and lockdown periods may worsen the periodontal health status of the patients.

Comparing the efficiency of Er,Cr:YSGG laser and diode laser for the treatment of generalized aggressive periodontitis.

BACKGROUND: This study aims to determine the effects of Er,Cr:YSGG and diode laser treatments on IL-1ß, IL-8, and TNF-α levels in patients with generalized aggressive periodontitis. METHODS: Twenty-six generalized aggressive periodontitis patients were enrolled in the study. We performed three treatment models: "scaling and root planning (SRP-only)," "SRP + Er,Cr:YSGG laser," and "SRP + diode laser." Each experimental quadrant was randomly allocated to the control group or the test group. The IL-1ß, IL-8, and TNF-α levels were analyzed with an enzyme-linked immune-sorbent assay. RESULTS: When the baseline and post-treatment IL-1ß, IL-8, and TNF-α levels were compared, the most significant difference was observed in the SRP + Er,Cr:YSGG group and the least difference was observed in the SRP-only group. CONCLUSIONS: The use of Er,Cr:YSGG laser as an addition to the conventional mechanical periodontal treatment was found to be more successful than the diode laser + SRP use in aggressive periodontitis treatment.

Efficacy of gaseous ozone in smoking and non-smoking gingivitis patients.

BACKGROUND: The gingivitis treatment protocols aim to stop the progression of inflammation and prevent the affliction of deeper periodontal tissues. Current research focuses on novel methods that can be applied with handheld and ultrasonic devices to increase the effectiveness of non-surgical periodontal treatment. Ozone has been shown to have a strong antimicrobial effect against bacteria that play a role in the etiology of gingival/periodontal diseases. Research evaluating the effects of ozone gas on the treatment of gingival tissues is limited. AIM: We investigated the effects of ozone application during the scaling procedure on clinical parameters of gingivitis in smokers and non-smokers and to investigate the efficacy of ozone gas in periodontal treatment. METHODS: A total of 40 subjects, 27 males/13 females-20 smokers/20 non-smokers-with plaque-induced gingivitis, were selected. The patients underwent a single session of full-mouth supragingival and subgingival scaling. Gaseous ozone application was performed on a randomly selected maxillary quadrant. The other maxillary quadrant was designated as the control group receiving only initial periodontal treatment. Clinical parameters, such as PI, GI, GBTI, and PPD, were measured before and 1 week after treatment. RESULTS: Our study shows that ozone therapy significantly improves clinical parameters in smokers and non-smokers when applied in addition to periodontal therapy. CONCLUSIONS: Additional studies comparing the effect of ozone therapy on smokers and non-smokers to the effects of oral mouthwashes may provide valuable contributions to the field.

Effects of a Glycogen Synthase Kinase 3 Inhibitor Tideglusib on Bone Regeneration With Calvarial Defects.

Tideglusib is a glycogen synthase kinase 3 (GSK-3) inhibitor which has shown the effects of bone regeneration, used for the treatment of Alzheimer disease. The aim of the study was to determine the effects of Tideglusib in the apoptosis and the bone regeneration in rats with calvarial defects. Twenty male Wistar rats (aged 11-13 weeks) were used for the study. Full-thickness flap elevated to exposure calvarial bone. Two 5 mm critical size calvarial defects were created on each rat calvarium. The defects were divided into 4 study groups: 1-Control (n = 10); 2- Gelatin sponge+Tideglusib (Gs+TDG; n = 10); 3- Autogenous bone (AB; n = 10); 4-Autogenous bone+Tideglusib (AB+TDG; n = 10). Then, the rats were sacrificed at fourth week. Three-dimensional imaging, histopathologic and immunohistochemical examinations were performed to evaluate the samples. The most increased bone formation and interaction between graft and new bone were observed in AB+TDG group. Bone morphogenic protein-2 (BMP-2), alkaline phosphatase (ALP), collagen type 1 (Col 1) and osteocalcin (OCN) was determined significantly higher in Tideglusib received groups compared with those of Control and AB groups (P < 0.05). Osteoclast numbers found to be higher in Gs+TDG and AB+TDG groups as well as RANKL expression dis not affected in Gs+TDG group but decreased in AB+TDG group comparing those of Control and AB groups. In addition, Tideglusib increased the Bcl-2 levels (P < 0.05) and decreased Bax levels (P > 0.05) in Tideglusib received groups compared with their controls. The administration of Tideglusib in calvarial bone defects increased bone mineral density, new bone area and total bone area by decreasing apoptosis and increasing osteoblastogenesis.

Effects of Er,Cr:YSGG and Diode Lasers on Clinical Parameters and Gingival Crevicular Fluid IL-1ß and IL-37 Levels in Generalized Aggressive Periodontitis.

AIM: The objective of the current study is to analyze the correlation between cytokine levels and periodontal parameters in aggressive periodontitis patients before and after periodontal treatment that was performed by using two different laser therapies. MATERIALS AND METHODS: Twenty-six generalized aggressive periodontitis patients were treated with three different methods (SRP, SRP+diode laser, and SRP+Er,Cr:YSGG laser) applied to three different half-jaws in the same patients. Pre- and posttreatment clinical periodontal parameters and GCF IL-1ß and IL-37 levels were measured. RESULTS: There was a statistically significant decrease (p < 0.05) between pretreatment and posttreatment clinical periodontal parameters and IL-1ß and IL-37 levels. When the reduction rates of IL-37 and IL-1ß levels after treatment were evaluated, the decrease in IL-37 and IL-1ß levels after treatment was lowest in the SRP group and highest in the SRP+Er,Cr:YSGG group. In addition, the amount of decrease in IL-1ß in SRP+diode and SRP+Er,Cr:YSGG groups was found to be higher than that in IL-37. Furthermore, there was a positive correlation between IL-37 and IL-1ß in all groups (p < 0.01). CONCLUSION: Er,Cr:YSGG laser is more effective than diode laser for the treatment of aggressive periodontitis. IL-37 and IL-1ß are cytokines that function together and thus must be evaluated together.

Humic Acid, a Polyphenolic Substance, Decreases Alveolar Bone Loss in Experimental Periodontitis in Rats.

The purpose of this study was to evaluate the biochemical, morphometric, and histopathological changes associated with experimental periodontitis in rats in response to local administration of humic acid. Thirty-eight Wistar rats were divided into 5 experimental groups: nonligated (NL) group, ligature-only (LO) group, and ligature + local administration of humic acid (20, 80, and 150 mg/kg body weight per day for 15 days, respectively; L-20, L-80, and L-150 groups). Changes in alveolar bone levels were clinically measured as the distance from the cementoenamel junction to the alveolar bone crest with a stereomicroscope. Tissues were histopathologically examined to assess the osteoclast numbers, osteoblastic activity, and inflammatory cell infiltration among the study groups. Enzyme-linked immunosorbent assay interleukin1ß (IL-1ß) and IL-10 levels in serum and gingival homogenates were evaluated. At the end of 15 days, the alveolar bone loss was significantly higher in the LO group compared to the NL, L-20, and L-150 groups (P < .05). The osteoclast number in the LO group was significantly higher than the NL, L-20, and L-150 groups (P < .05). Inflammatory cell infiltration was significantly higher in the LO and L-80 groups than the other groups (P < .05). The highest serum and gingival homogenate IL-10 levels were determined in the NL group (P < .05). The serum and gingival homogenate IL-1ß levels in LO group were significantly higher than the NL, L-20, and L-150 groups (P < .05). Within the limits of this study, it can be suggested that humic acid, when administered locally at 20 and 80 mg/kg doses, may prevent alveolar bone loss in the rat model.

Humic Acid Enhances Wound Healing in the Rat Palate.

INTRODUCTION: Humic acid was previously shown to enhance cutaneous wound healing and show antibacterial properties; however, it has not been used for wound healing in the oral cavity. Thus, the goal of this study was the evaluation of the effect of the humic acid on the healing of excisional wounds in an experimental rat study. MATERIALS AND METHODS: A circular wound on mid-palatal surfaces was made on a total of 77 Wistar rats by using a 3-mm biopsy punch under anesthesia. The animals were divided into 4 groups as baseline, saline control (0.09%), chlorhexidine gluconate (0.05%), and humic acid (80 mg/kg) and were treated with these materials for 7 days. RESULTS: The rats were observed for 3 weeks in order to track the wound closure rates. Both humic acid treatment and chlorhexidine gluconate treatment resulted in statistically significant enhanced rate of wound closure compared to the saline control on both the 1st and 2nd weeks of treatment. Humic acid treatment for the wounds in the palate resulted in enhanced recovery compared to not only saline control but also chlorhexidine gluconate treatment. CONCLUSION: In this study, humic acid was shown to enhance healing of oral wounds for the first time in the literature. These findings indicate that humic acid can be used as an alternative to current treatment methods for oral wounds.

Comparison of Local Anesthetic Efficiency of Tramadol Hydrochloride and Lidocaine Hydrochloride.

PURPOSE: This study investigated the local anesthetic efficiency of tramadol versus lidocaine hydrochloride in maxillary infiltration anesthesia. MATERIALS AND METHODS: This study was a randomized double-blinded study involving 50 healthy volunteers. In the experimental part of this study, each volunteer received a buccal 0.5-mL injection of tramadol hydrochloride 25 mg on one side and a buccal 0.5-mL injection of vasoconstrictor-free lidocaine hydrochloride 20 mg on the other side. No other treatment was performed. After the injections, total duration of anesthesia, start and finish times of anesthesia, soft tissue (sensory) innervation, depth of anesthetic, possible side effects, and satisfaction levels were recorded from all volunteers. RESULTS: There was no relevant difference between solutions for total anesthesia duration and peak values. However, statistically, the effect of lidocaine started and ended early. The efficacy of tramadol was markedly more effective in the gingiva and skin, especially at 15 and 20 minutes, compared with lidocaine. Both anesthetic agents were well tolerated by the volunteers. CONCLUSION: Tramadol hydrochloride can be a good alternative to local anesthetic agents and beneficial to support anesthesia during long operations.

Effects of Curcumin on Alveolar Bone Loss in Experimental Periodontitis in Rats: A Morphometric and Histopathologic Study.

Background: Curcumin is found in the rhizomes of the turmeric plant that has been showed antioxidant and anti-inflammatory effect. The aim of this study was to evaluate the effects of systemic curcumin therapy on alveolar bone loss in an experimental periodontitis model in rats. Material and Methods: Thirty-two male Wistar rats were randomly divided to 4 groups: 75 mg/kg/daily curcumin (C75; n =8), 150 mg/kg/daily curcumin (C150; n =8), Control (n =8), and Ligated (n =8). Curcumin was administrated using gastric gavage. After 12 days, the rats were sacrificed. Right mandibles samples were histopathologically examined. Alveolar bone loss was measured. Interleukin 1ß (IL-1ß) and interleukin 10 (IL-10) were evaluated in the serum samples and gingival homogenates. Results: The measurements of alveolar bone loss in the mandibular molars revealed significantly higher bone-loss values in the Ligated group than the Control, C75 and C150 groups. The IL-1ß levels in the gingival homogenates were significantly increased in the Ligated group compared to those of the Control, C75 and C150 groups. The serum IL-1ß levels in the Ligated group were significantly higher than the Control group. The mean osteoblast numbers in the Ligated group were lower than those of the Control, C75 and C150 groups. The C150 groups showed significantly more osteoblasts than the Control group. The osteoclast numbers in the Ligated group increased significantly compared to the C75, C150 and control groups. Conclusion: This study demonstrates that systemic administration of curcumin at the 75 and 150mg/kg doses reduced alveolar bone loss in the periodontal disease in rats. Keywords: Alveolar bone loss, Antioxidant, Curcumin, Ligature-induced, Histomorphometric, Micronutrition.

The effect of fixed appliances on oral malodor from beginning of treatment till 1 year.

BACKGROUND: Orthodontic appliances can enhance plaque accumulation, and this can cause gingival inflammation. Halitosis of oral origin is associated with microbial metabolism on the tongue and in the saliva, dental plaque, and the amount of volatile sulfide-containing compounds. This study used a Halimeter to investigate fixed orthodontic therapy-associated increases in the oral malodor over a year. METHODS: Thirteen orthodontic patients with Angle Class I malocclusions receiving fixed orthodontic therapy formed the study group, and 12 dental students without any dental treatment formed the control group. The Halimeter was used to examine oral malodor by detecting volatile sulfur compounds (VSC). Plaque index (PI), gingival index (GI), and probing pocket depth (PPD) were also measured in both groups. The subjects in the study group had one visit before the orthodontic treatment started and seven visits during orthodontic therapy (1, 3, 5, 7, 9, 11, and 13 months after bonding), while the subjects in the control group had three visits, once per subsequent month. RESULTS: Oral malodor was significantly increased in the fixed orthodontic treatment group during treatment (p < .05). Increases were also observed in the PI, GI, and PPD measures (p < .05). The results of the control group were stable (p > .05). CONCLUSION: Oral malodor increased during fixed orthodontic treatments and reached a critical level 7 months later.