THE EFFECTS OF CHRONIC PERIODONTITIS AND OBESITY ON TOTAL ANTIOXIDANT/OXIDANT STATUS AND OXIDATIVE STRESS INDEX.

Objective: Both obesity and periodontal diseases are significant diseases that affect the quality of life. Recent studies have focused on the relationship between obesity and periodontal disease. The aim of this study is to determine the pathophysiological relationship between obesity and periodontal disease by evaluating the clinical periodontal parameters and oxidative status. Subjects and Methods: The study included 80 individuals divided into four groups including 20 individuals in each group as following; periodontally healthy patients with normal weight, (NH), patients with chronic periodontitis and normal weight (NCP), periodontally healthy patients with obesity (OH) and patients with chronic periodontitis and obesity (OCP). Clinical periodontal parameters were recorded, and serum, saliva and gingival crevicular fluid (GCF) samples were obtained. Local and systemic levels of total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI) were assessed biochemically. Results: No statistically significant difference was found among the groups regarding TAS, TOS and OSI values in serum and saliva samples (p>0.05). GCF-TAS values in NH group were statistically significantly higher compared with other groups (p<0,05) . GCF TOS values increased in obese groups (OH, OCP) compared with non-obese groups (NH, NCP) (p<0.05). Our results suggest that obesity and chronic periodontitis do not effect oxidant/antioxidant levels in serum and saliva. Conclusions: Many factors such as daily living conditions of the individual, stress and nutritional habits TAS and TOS levels of the individual may affect oxidative stress parameters. However, these factors could not be standardized in the study.

Evaluation of flow and structure abnormalities of splanchnic system veins in cirrhotic patients without portal hypertension.

AIM: The aim of this study was to evaluate hemodynamic and anatomic alterations of the splanchnic venous system and the efficiency and safety of color Doppler radial endosonography in the assessment of cirrhotic patients by comparing Child A cirrhotic patients without portal hypertension findings versus a non-cirrhotic group. METHODS: The study was carried out between January 2009 and February 2010; the study population was 38 cirrhotic patients without portal hypertension and 140 control patients. RESULTS: Hepatopedal flow was monophasic in all the control patients; the flow pattern was chaotic and irregular in 8% of the cirrhotic patients; in the cirrhotic patients the portal vein diameter was increased and the flow velocity reduced; no differences in flow volume were observed between the two groups. Splenic vein diameter and flow velocity were normal. In the majority of the Child A cirrhotic patients without portal hypertension, no changes were seen in portal vein diameter or flow volume; in some patients no significant increase portal vein diameter was observed and showed the flow volumes were unchanged. CONCLUSION: Radial Doppler endosonography may be efficient and safe for assessing the splanchnic system.

Toxic hepatitis associated with paroxetine.

Hepatotoxicity is a rare complication of paroxetine, a selective serotonin reuptake inhibitor. Regarded as safe in therapeutic use, there have been reports of cases of severe hepatic dysfunction with gross elevations of transaminase levels that may be related to this drug. We report here severe adverse cholestatic and hepatocellular injury in a patient taking paroxetine probably due to an immune-mediated hypersensitivity reaction.

Evaluation of initial attachment of human gingival fibroblast cells to biodegradable membranes in vitro by light and scanning electron microscopy.

Guided tissue regeneration procedures using resorbable membranes have become accepted therapy for treating periodontal defects. Resorbable collagen and synthetic polylactide and polyglycolide copolymer membranes have been found to support regeneration and preclude the need for surgical removal. This study was undertaken to assess and compare the initial attachment of human gingival fibroblast cells to four collagen-based membranes (fascia lata, fascia temporalis, dura mater, and Type I bovine collagen) and a synthetic polylactic acid-based membrane (resolut). Human gingival fibroblasts were grown from explants of normal tissue obtained during surgical reduction of retromolar tissues. Membrane specimens were placed in separate culture wells and incubated with fibroblasts for one hour. The number of adherent cells was evaluated by light microscopy using an ocular grid system and detailed examination was performed by scanning electron microscopy. The results of evaluation by light microscopy indicated that initial cell attachment was significantly less in the polylactic acid-based membrane group than in the collagen-based membrane groups (P < 0.01). However, no significant differences were found among the collagen membrane groups in terms of fibroblast attachment (P > 0.01). Scanning electron microscopy examination of fibroblasts cultured directly on barrier membranes indicated that the collagen-based membranes appeared to facilitate cell attachment, whereas the polylactic acid-based membrane exhibited a morphology that was not conducive to attachment of human gingival fibroblasts. Based on these limited in vitro results, it appears that collagen-based membranes offer greater potential than polylactic acid-based membranes for guided tissue regeneration at surgical sites.

Histological assessment of root cementum at periodontally healthy and diseased human teeth.

This study aimed to investigate and compare the lipid and polysaccharide content of the cemental surfaces of healthy and periodontally-involved teeth. Thirty periodontally-involved single-rooted teeth from fifteen patients with localized juvenile, adult and rapidly progressive periodontitis were included in the experimental group and 5 healthy teeth were assessed in the control group. Frozen serial sections were obtained and stained with hematoxylin-eosin for morphological assessment. Oil-Red-O and Alcian Blue-Periodic Acid Schiff stains were used to evaluate the presence of lipids, neutral and acidic polysaccharides using light microscopy. It was found that with hematoxylin-eosin staining in the experimental group, both the involved and uninvolved cementum surfaces of teeth, which belong to all periodontitis groups, showed generally irregular surfaces that contain some resorption areas. Alcian Blue-Periodic Acid Schiff positive staining was observed only superficially and at the areas associated with microbial dental plaque. However, Oil-Red-O staining was positive only superficially at 5 teeth that belonged to localized juvenile and rapidly progressive periodontitis groups. Apparent lipopolysaccharide staining into cementum was not seen in any of the diseased teeth. The results presented here suggest that endotoxin was only localized in superficial layers and associated with only microbial colonization.

An investigation of resorption and tissue reaction after subcutaneous implantation of collagen based membrane materials in rats.

This study was undertaken to assess histologically the response to collagen based membrane materials that might be used for guided tissue regeneration (GTR) procedures, using a subcutaneous model on the dorsal surface of the rat. The commercially available materials included absorbable type I bovine collagen barrier, fascia lata, fascia temporalis and dura mater membranes. In the study 20 Wistar rats were used 80 implant materials were placed under general anaesthesia. Animals were sacrificed 7, 14, 28 and 42 days post-implantation. The specimens were assessed histologically for the composition of the tissue surrounding the membranes, the types of cells in infiltrate and the degree of resorption. It was concluded that these membrane materials were well tolerated and were gradually resorbed. Light microscopic examination showed that the type I bovine collagen and fascia lata were resorbed faster but fascia temporalis and dura mater were resorbed more slowly at 42 days. In addition the resorption process was continuing and these materials were evident histologically at 42 days.

Space maintainer effects on intercanine arch width and length.

In order to investigate the effects of space maintainers in intercanine arch width and length, twenty cases, characterized with the early loss of mandibular primary molars were selected and divided into two groups. The treatment group used removable space maintainers, while the other ten cases served as the control group. The first dental casts of the treatment and control groups were obtained when the primary canines were in the mouth. After the eruption of permanent canines second dental casts were obtained in both groups. Six measurements were made on the dental casts of each patient. No parameter was found to be statistically significant in the treatment group. In the control group the increase in intercanine arch width and perimeter were found to be statistically significant. Also the increase at the buccal and lingual bone measurements were found to be statistically significant. These results showed that space maintainers might cease the increase in intercanine arch width and length during the transition period between the primary and permanent canines.

Serum antibodies to Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in juvenile periodontitis and adult periodontitis (part I).

Recent microbiological studies support the concept that specific gram negative bacteria play a major role in the etiology and pathogenesis of human chronic inflammatory periodontal disease. Actinobacillus actinomycetemcomitans has been isolated frequently from juvenile periodontitis and Porphyromonas gingivalis has been shown to be a prominent species in adult periodontitis in humans. The purpose of this study was to determine levels of the specific antibodies to A.actinomycetemcomitans and P.gingivalis in 17 patients with juvenile and 15 patients with adult periodontitis and 24 healthy subjects. IgG and IgM antibody titers against these antigens were determined by enzyme-linked immunosorbent assay (ELISA). The levels of antibodies against A.actinomycetemcomitans were significantly higher in the juvenile periodontitis compared to the adult periodontitis patients and controls. Anti-P.gingivalis antibodies were elevated in adult periodontitis compared to juvenile periodontitis patients and controls.

The effects of periodontal therapy on serum antibody levels to Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis (part II).

Levels of IgG and IgM antibodies were estimated against Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis were determined by enzyme linked immunosorbent assay (ELISA) in 17 patients with juvenile periodontitis, 15 with adult periodontitis and 24 healthy controls at the beginning of treatment and 3 to 8 months after periodontal therapy. After treatment, antibodies to A. actinomycetemcomitans and P.gingivalis had decreased in patients, but the levels were still significantly higher than in healthy controls. Whether or not an of antibody level against a specific bacteria changes after periodontal treatment is however, still debatable.