Metin Çalişir

Background/Objectives: The aim of this study was to evaluate the effect of intraoperative gaseous ozone applied to the implant osteotomy immediately before implant placement on early implant stability using a split-mouth design and resonance frequency analysis (RFA). Methods: This prospective, randomized controlled split-mouth study included 40 patients receiving 106 implants in bilaterally symmetrical edentulous sites. Patients and outcome assessors were blinded. In the ozone group, ozone gas was applied to the implant site for 60 s immediately before implant placement; the control group underwent the same surgical protocol without ozone application. The primary outcome was the change in implant stability quotient from baseline to three months (ΔISQ). Secondary outcomes included baseline and three-month ISQ values, insertion torque, and postoperative pain assessed using a visual analog scale. Results: All 106 implants were analyzed. No significant between-group differences were observed in baseline ISQ (β = −0.49; 95% CI: −2.73 to 1.75; p = 0.668) or insertion torque (β = −0.62 Ncm; 95% CI: −1.96 to 0.72; p = 0.362). At three months, ISQ was higher in the ozone group (β = 1.91; 95% CI: 0.75 to 3.06; p = 0.001). ΔISQ was also significantly greater in the ozone group (β = 2.40; 95% CI: 0.34 to 4.45; p = 0.022; Cohen’s d = 0.42). Implant stability increased significantly in both groups (both p < 0.001). Postoperative pain did not differ between groups (β = −0.23; 95% CI: −0.83 to 0.36; p = 0.446). Although the effect direction was consistent across sensitivity analyses, ΔISQ was not statistically significant in the patient-level paired analysis (p = 0.089). No adverse events were reported. Conclusions: Intraoperative ozone application was associated with a modest increase in early implant stability without a significant difference in postoperative pain. However, given the small effect size and sensitivity of the findings to the analytical method, further large-scale, multicenter randomized controlled trials are required. Clinically, intraoperative ozone may be considered a potential adjunct to standard implant placement protocols, but the current evidence is insufficient to support its routine use.

Objectives This study aimed to evaluate asprosin, adropin, and irisin levels in gingival crevicular fluid (GCF) across different periodontal conditions and to analyze their relationship with clinical periodontal parameters. Materials and methods A total of 122 systemically healthy participants (25–60 years) were divided into four groups: healthy periodontium (n = 30), gingivitis (n = 30), Stage I–II periodontitis (n = 32), and Stage III–IV periodontitis (n = 30). Clinical parameters recorded included probing depth (PD), clinical attachment loss (CAL), bleeding on probing (BOP), plaque index (PI), and gingival index (GI). GCF samples were collected, and asprosin, adropin, and irisin levels were measured by ELISA. Statistical analyses included ANOVA/Kruskal–Wallis with post hoc tests, Pearson correlations, and receiver operating characteristic (ROC) analysis. Results Asprosin levels were significantly higher in Stage III–IV periodontitis compared with other groups (p < 0.05). Adropin and irisin levels were higher in the healthy group, although not statistically significant. Asprosin correlated positively with PI, PD, CAL, and BOP, while irisin correlated negatively with PI. ROC analysis indicated that asprosin had diagnostic potential for distinguishing between advanced periodontitis and other conditions. Conclusions Elevated GCF asprosin levels were found to be associated with periodontitis severity, whereas adropin and irisin were related to periodontal health. More research is needed to understand the role of irisin, asprosin, and adropin in periodontal pathogenesis. Clinical relevance This study provides novel insights into the potential role of asprosin, adropin, and irisin as biomarkers of periodontal status. Elevated GCF asprosin levels were associated with advanced periodontitis, reflecting the inflammatory burden of the disease. Conversely, higher levels of adropin and irisin were associated with better periodontal health, suggesting protective or homeostatic functions. These findings indicate that GCF asprosin, adropin, and irisin levels may serve as promising adjunctive diagnostic indicators for distinguishing between periodontal health and disease. Future longitudinal studies are needed to validate their prognostic value and to clarify their mechanistic involvement in periodontal pathogenesis.

Objective The aim of this study is to evaluate the effectiveness of submucosal 8 mg (2 mL) dexamethasone (DEX) on postoperative pain, swelling, chewing efficiency, trismus, healing, and discomfort after periodontal flap surgery (PFS). Methods In this randomized controlled split-mouth study, 25 patients underwent PFS in the mandible, whereby postoperative, submucosal DEX was injected to the surgical field to the test group and submucosal normal saline was applied to the control group. Pain was evaluated using the Visual Analogue Scale (VAS) and the 101-point numeric rate scale in the first 8 h after PFS and on the 2nd, 3rd, 4th, and 7th days, whereas swelling, chewing efficiency, trismus, healing, discomfort and analgesic consumption were evaluated preoperatively on the 1st, 2nd and 7th days. Results In the intergroup evaluation, the VAS-7th hour value of the test group was lower than the control group(p < 0.05). On the 1st day, it was observed that there was less swelling and more chewing efficiency in the test group than in the control group(p < 0.05). When time-dependent changes were examined, the decrease in mouth opening due to trismus in the control group was greater than that in the test group on the 1st and the 2nd days compared to the preoperative period(p < 0.05). Finally, postoperative healing, discomfort, and analgesic consumption were similar between groups. Conclusion Within the limits of this study, the submucosal DEX may be an effective protocol in the management of pain, swelling, and trismus after PFS. Clinical relevance Our findings shed light on the possible effects of DEX after PFS. Trial registration This study was registered on ClinicalTrials.gov (NCT06119893).

Aim: Premature birth or low birth weight has an important place in neonatal mortality and morbidity. Today, there are still cases whose etiology has not been fully elucidated. The aim of this study is to evaluate the effect of periodontal diseases on adverse pregnancy outcomes by using the current classification system accepted at the 2017 World Workshop. Materials and Methods: This study was carried out on 172 women who were followed up and delivered in the department of obstetrics and gynecology of our university’s medical faculty hospital. Demographic characteristics of all individuals were recorded and laboratory values were examined. While those with a gestational age <37 weeks and/or baby birth weight < 2500 g were constituted to the case group (n=85), those with a gestational age ≥ 37 weeks and/or baby birth weight ≥ 2500 g constituted the control group (n=87). Clinical periodontal and radiographic evaluations including plaque index (PI), gingival index (GI), bleeding on probing (BOP %), probing pocket depth (PPD) and clinical attachment level (CAL) values were performed for all individuals, and the diagnoses were made by the applied classification system. Analyzes were performed between the two groups to examine the relationship between periodontal disease and adverse pregnancy. Results: PI, GI, BOP %, and PPD values in the case group were significantly higher compared to the control group (p<0.001). Although the CAL value was higher in the case group, the difference was not significant (p=0.058). WBC (p=0.020) and PLT (p<0.001) values were significantly higher in the case group. Conclusion: According to the results of this study, periodontal diseases are associated with adverse pregnancy outcomes independent of other risk factors. Women should pay attention to their oral hygiene and dental examinations before and during pregnancy.

Aim: The aim of this study is to evaluate the effect of Ankaferd Blood Stopper (ABS) on the palatal donor site following free gingival graft (FGG) surgery. Materials and Methods: A total of 12 patients (24 palatal sites) were included in the study. In each patient, the donor sites were randomly divided into two groups. ABS+collagen pads were applied to the test group. Only collagen pads were applied to the control group. Donor sites were evaluated in terms of bleeding, complete epithelialization, sensitivity, pain score, analgesic usage, wound size, Landry, Turnbull, and Howley (LTH) index, and tissue thickness (TT). Results: Intraoperative bleeding was observed in significantly more patients (n=9) in the control group, while it was not observed in any of the patients in the test group (p=0.000). Although higher complete epithelialization (33.3%) was detected in the test group on day 14, there was no significant difference in epithelization between the groups. There was no significant difference in pain score, analgesic usage, wound size, LTH index, or TT between the groups. When the amount of change between the times was analyzed, only the change in TT between the 21st day and the 6th week was found to be statistically significant (p=0.028). Conclusion: In our study, it can be said that the use of ABS following FGG surgery has a positive effect on intraoperative bleeding, shortterm complete epithelialization, and long-term TT, but it cannot provide superiority compared to collagen sponge alone in terms of early wound healing, postoperative pain, and analgesic usage.

Objective: The aim of our study is to evaluate the complications that occurred on rabbit tibia bones after implant placement. Material and Method: In our study, 10 adult male white healthy New Zealand rabbits (average weight: 3,000 to 3,500 g) were used. Different numbers of dental implants were placed in the experimental animals. Complications in rabbit tibias were observed and radiological results were reported. Results: Of the 10 rabbits included in the postoperative study, one (10%) died immediately after the operation, eight (80%) within the first 24 hours, and the last one (10%) died within the next 48 hours of the operation. Conclusion: Based on the complications experienced during this study and the data we obtained, we conclude that the rabbit tibia is not suitable for such studies. More comprehensive and multi-center studies are needed to draw more firm conclusions on this subject.

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.

Altindal D, et al. J Periodontal Implant Sci. 2023 Feb;53:e6. https://doi.org/10.5051/jpis.2203140157

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.

Background This study aims to determine the effects of Er,Cr:YSGG and diode laser treatments on IL-1β, 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-1β, IL-8, and TNF-α levels were analyzed with an enzyme-linked immune-sorbent assay. Results When the baseline and post-treatment IL-1β, 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.