Psychometric properties of a Turkish version of the oral health impact profile-14.

OBJECTIVES: The purpose of this study was to analyze and evaluate a Turkish translation of the oral health impact profile-14 (OHIP-14) in a Turkish population to provide an objective standard for future studies. METHODS: This cross-sectional research study consisted of three independent studies. Data were collected utilizing a personal interview and a review of periodontal records. This study was performed on 1205 subjects who were visiting for routine medical check-ups. The OHIP-14 was administered to measure oral health related to the quality of life, along with a questionnaire addressing demographic information, such as age, gender, and education. RESULTS: The reliability coefficient (Cronbach's alpha) of the Turkish version OHIP-14-TR (OHIP-14-TR) was reported to be nearly perfect in all 3 parts of our study (alpha 1: 0.82; alpha 2: 0.76; alpha 3: 0.91); additionally, values were greater than the recommended 0.70 threshold. Spearman's correlation coefficients showed that both OHIP scores significantly correlated with periodontal parameters, serving as proof of convergent validity (P < 0.01, P< 0.001). The principal component analysis with varimax rotation revealed seven factors. The OHIP-14-TR was more than 95% comprehensible. CONCLUSION: The OHIP-14-TR is a reliable, valid, and comprehensible scale for measuring oral health-related quality of life in the Turkish population.

Periodontal status and post-transplantation complications following intensive periodontal treatment in patients underwent allogenic hematopoietic stem cell transplantation conditioned with myeloablative regimen.

OBJECTIVES: Evaluation of the periodontal status is necessary prior to management with high-dose chemotherapy before hematopoietic stem cell therapy (HSCT). During medical therapy, pre-existing periodontal conditions may exacerbate and cause local and systemic complications. When possible, maximal oral health should be achieved prior to engraftment. In this study, we aimed to determine the alterations occurred in the periodontal status of the patients after periodontal treatment and allogenic HSCT and evaluate the effect of intensive periodontal approach on the short-term complications of HSCT. METHODS: The alterations occurred in the periodontal tissues 3-4 weeks after periodontal treatment and after HSCT periods of 3 months for 29 patients treated with full-mouth periodontal treatment completed in 24 h in addition to eradication of dental foci, and oral hygiene status were evaluated using pocket depth measurements, presence of bleeding on probing and plaque and gingival indices. The incidence and severity of acute graft-versus-host disease (GVHD) and oral mucositis (OM) were recorded. Duration of engraftment period and the episode of febrile neutropenia were also evaluated. RESULTS: There were significant improvements in periodontal status after periodontal treatment (P<0.001). There were 14 (48.3%) patients without acute GVHD and 17 (58.6%) patients with no sign of OM. The majority of OM was at grade II level. There was a negative relation that exists between the percentage of BOP (+) sites and presence of OM (r=-0.518, P<0.05). CONCLUSIONS: Together with a significant reduction in gingival inflammation and maintenance of the improvement in periodontal health, remarkable decrease in the incidence and severity of OM were observed.

Black hairy tongue after allogeneic stem cell transplantation: an unrecognized cutaneous presentation of graft-versus-host disease.

Black hairy tongue (BHT) is an unusual condition in adults characterized by marked accumulation of keratin on the dorsum of the tongue, resulting in a hair-like appearance. Herein, we have described 15 patients developing BHT after allogeneic stem cell transplantation (allo-SCT). BHT was generally accompanied by other cutaneous manifestations of cutaneous graft-versus-host disease (GVHD) or a precursor of GVHD. Our experience in this series emphasized that histopathologic evaluation is required for seemingly harmless eruptions like BHT in the posttransplantation period. Given the important prognostic implications of GVHD, physicians should be careful when confronted with BHT.

Short-term effects of periodontal therapy as an adjunct to anti-lipemic treatment.

OBJECTIVE: This study was conducted to assess the effect of improved periodontal health following periodontal treatment on metabolic lipid control of patients on anti-lipemic treatment. MATERIALS AND METHODS: The study population consisted of 20 patients aged 34-62 years with diagnoses of hyperlipidemia and chronic periodontitis. All patients used statin to treat their elevated levels of low-density lipoprotein cholesterol. Blood samples were obtained for measurement of serum lipids, fasting plasma glucose, and high sensitive C-reactive protein. Periodontal parameters, including plaque index, gingival index, probing pocket depth, clinical attachment level, and percentage of bleeding on probing, were evaluated. All parameters were assessed in each subject at baseline, after 3 months as a control (at the time of periodontal treatment), and 3 months after the non-surgical periodontal treatment that included scaling and root planning. RESULTS: All lipid parameters decreased after the periodontal treatment, but only the decreases in total cholesterol and low-density lipoprotein cholesterol levels reached statistical significance compared to baseline (P = 0.002 and P = 0.003, respectively). CONCLUSION: Improved periodontal health may influence metabolic control of hyperlipidemia and could be considered as an adjunct to the standard measures of hyperlipidemic patient care.

MMPs, IL-1, and TNF are regulated by IL-17 in periodontitis.

Periodontitis is characterized by periodontal tissue destruction. Since interleukin-17 (IL-17) has been reported to up-regulate IL-1beta and tumor necrosis factor-alpha (TNF-alpha), it was hypothesized that it is increased in periodontitis and up-regulates these cytokines and tissue-destructive matrix metalloproteinases (MMP) in local migrant and resident cells. Immunocytochemistry disclosed elevated IL-1beta, TNF-alpha, and IL-17 levels in periodontitis. These cytokines induced proMMP-1 and especially MMP-3 in gingival fibroblasts, whereas MMP-8 and MMP-9 were not induced. IL-17 was less potent as a direct MMP inducer than IL-1beta and TNF-alpha, but it induced IL-1beta and TNF-alpha production from macrophages, and IL-6 and IL-8 from gingival fibroblasts. In accordance with these findings, immunocytochemistry disclosed that MMP-1 and MMP-3 were increased in periodontitis. Gingival fibroblasts may play an important role in tissue destruction in periodontitis via cytokine-inducible MMP-1 and MMP-3 production, in which IL-17 plays a role as a key regulatory cytokine.

Morphological changes in diseased cementum layers: a scanning electron microscopy study.

The aim of this study was to compare the morphological changes that occurred in root cementum layers due to periodontal disease by using scanning electron microscopy (SEM). Ninety-two periodontally hopeless teeth extracted from 29 patients were studied. Measurements of probing depth (PD) and clinical attachment loss (CAL) were taken prior to extractions. After the longitudinal fracturing process of root specimens, healthy and diseased cementum layers of roots were evaluated by SEM for the thickness of the cementum and the morphological changes in collagen fibers. The result of SEM evaluation revealed a significant ( P < 0.001) decrease in the thickness of cementum layer on the diseased root surfaces compared to the healthy surfaces. There were denser and conspicuous collagen fibers with their interfibrillar matrix in cementum layers on the healthy root surfaces compared to the diseased surfaces. Within the limits of this study, the thickness of cementum layers in diseased areas was found to be significantly less than that in the healthy areas of root surfaces. However, there exist variations in the density and visibility of cemental fibers between individuals and within the individual.

Destructive membranous periodontal disease (Ligneous periodontitis).

Generalized membranous gingival enlargement due to accumulation of amyloid or fibrin-like material is a rare, destructive and poorly defined disease entity. Some patients also show extraoral manifestations. The lesion is an involvement of periodontal tissues caused by the same process as ligneous conjunctivitis. In this report, 3 new cases, two of whom are siblings, are presented. Defective fibrinolysis and abnormal wound healing seem to be the main pathogenetic mechanism of this unusual disease, which should be evaluated systemically considering other mucosal involvement.

Observer variation in the radiographic assessment of the bone level on the buccal and lingual surfaces of mandibular molars.

OBJECTIVES: To assess accuracy and precision of observers' diagnostic performance in locating the buccal/lingual bone level using conventional periapical radiographs. METHODS: Standardized radiographs of molar regions of 10 dried mandibles were obtained. The bone crest on buccal and lingual surfaces of first and second molars was then marked with thin lead foil strips and fresh radiographs taken. A series of increasingly extensive furcation defects was created by sequential bone removal and radiographs with and without markers obtained after each step. The radiographs without indicators were presented to 10 observers on two separate occasions and the most apically located bone level marked on a transparent film. The distance between observers' markings and 'true' bone level on the radiographs was determined. RESULTS: There was wide interobserver variation which increased as the bone loss increased. Lack of consistency was largely attributable to intra-observer variation except when a furcation defect was present. The underestimation of bone loss became more marked as the amount of bone loss increased. CONCLUSIONS: Radiographic determination of bone loss on buccal and lingual surfaces is associated with a considerable lack of accuracy and precision, both of which get worse as bone loss increases.

Observer performance in locating the bifurcation in mandibular molars on periapical radiographs.

The ability to identify radiographically the bifurcation in mandibular molars and the influence of morphological factors on the observers' decisions were investigated in 10 dry mandibles. Standardized periapical radiographs were obtained with and without lead markers in the bifurcation. Then 23 observers marked the bifurcation on tracing paper placed on the radiographs. The distance between the 'true' bifurcation (the lead indicators) and the observers' markings was assessed. On average, it was identified at a point 0.26 mm (s.d. 0.5) apical to its 'true' location on the first molar, and 0.65 mm (s.d. 1.15) coronal on the second molar. Interobserver variation for first and second molars was 0.5 mm and 1.06 mm respectively. Corresponding intraobserver variation was 0.47 mm and 1.14 mm. Of the four morphological characteristics analysed, the mesiodistal width of the bifurcation was found to have the strongest influence on the accuracy. It was concluded that the wide discrepancy in the ability of the observers to locate the bifurcation could be largely attributed to intraindividual variation.

Radiographic detectability of bone loss in the bifurcation of mandibular molars: an experimental study.

The aim of this study was to evaluate observer performance in the diagnosis of bone loss in the bifurcation of mandibular molars on conventional radiographs. Standardized radiographs were obtained of the first and second molars in 10 dry hemimandibles at baseline and after preparation of bony defects corresponding to degree I and degree II buccal furcation involvements. The radiographs were randomly presented to 12 observers who were asked to determine the presence or absence of bone loss. Receiver operating characteristic (ROC) curve analysis was used for evaluation. The mean AZ-value of all observers was 81% for the first molar and 80% for the second. As the degree of furcation involvement increased, the mean AZ-value of the observers also improved from 68% (furcation involvement degree I) to 86% (degree II). Multiple regression analysis revealed that lesion depth was the factor which most strongly influenced the observers' diagnostic performance.