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Sarsilmazer G, Atilla G. The relationship between oral hygiene-related self-efficacy, general self-efficacy and daily plaque control. Int J Dent Hyg 2020; 18:182-191. [PMID: 32027452 DOI: 10.1111/idh.12429] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 01/10/2020] [Accepted: 01/31/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To assess validity and reliability of Turkish oral hygiene-related self-efficacy (OHSE) scale, and the scores of general self-efficacy (GSE) and OHSE in the patients with gingivitis and chronic periodontitis (CP). Additionally, the effect of motivation and oral hygiene instructions on the OHSE scores and plaque index (PI) was also aimed. MATERIALS AND METHODS GSE and OHSE scores were obtained from 210 patients with gingivitis and CP (Group A). After determination of "cut-off" values on OHSE scores, patients with OHSE scores <30 (OHSE-low) and ≥50 (OHSE-high) were included in Group B (gingivitis, N = 25; CP, N = 27). PI values were determined, and motivation and oral hygiene instructions were performed in Group B at baseline. PI measurements and OHSE questionnaire were repeated at 1 and 3 months. RESULTS The intraclass reliability coefficient and Cronbach's alpha for Turkish translation of OHSE scale were 0.920 and 0.911. OHSE scores significantly correlated with GSE scores and smokers had lower OHSE scores than those of non-smokers in patients (n = 210). In both gingivitis and CP groups, OHSE scores increased and PI values decreased at 3 months. PI values were lower in gingivitis and CP groups with OHSE-high scores compared to patients with OHSE-low scores at 3 months. CONCLUSIONS Within the limitations of this study, it seems that Turkish version of OHSE questionnaire is reliable and valid. Patients with OHSE-low scores in both gingivitis and CP groups were less successful in performing daily plaque control, compared to patients with OHSE-high scores.
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Affiliation(s)
- Gülçin Sarsilmazer
- Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - Gül Atilla
- Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey
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Becerik S, Öztürk VÖ, Celec P, Kamodyova N, Atilla G, Emingil G. Gingival crevicular fluid and plasma oxidative stress markers and TGM-2 levels in chronic periodontitis. Arch Oral Biol 2017; 83:47-54. [PMID: 28711023 DOI: 10.1016/j.archoralbio.2017.06.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 06/24/2017] [Accepted: 06/28/2017] [Indexed: 12/28/2022]
Abstract
OBJECTIVE This study was aimed to evaluate the gingival crevicular fluid (GCF) and plasma transglutaminase-2 (TGM-2), total antioxidant capacity (TAC), total oxidant status (TOS), ferric reducing antioxidant power (FRAP) and thiobarbituric acid reactive substances (TBARS) in patients with chronic periodontal disease. MATERIALS AND METHODS Twenty patients with chronic periodontitis (CP), 20 patients with gingivitis and 20 healthy subjects were enrolled in the study. Clinical periodontal parameters including probing depth, clinical attachment level, plaque index and papillary bleeding index were recorded. GCF and plasma levels of TGM-2, TAC, TOS, TBARS and FRAP were analyzed. RESULTS GCF TGM-2 was significantly lower in CP group than in gingivitis patients (P=0.006). GCF FRAP in CP and gingivitis groups was significantly lower than in healthy subjects (P<0.001). Plasma FRAP level was lower in gingivitis group when compared to healthy subjects (P=0.003). There was no significant difference in GCF and plasma TAC, TOS, TBARS and plasma TGM-2 levels among the study groups (P>0.05). GCF TGM-2 level was positively correlated with GCF TAC and negatively correlated with CAL. CONCLUSIONS Decreased FRAP in GCF and plasma indicating lower antioxidant status of CP patients might suggest the role of oxidative stress in periodontitis. GCF TGM-2 data might suggest that TGM2 is associated with stabilization of the extracellular matrix and wound healing in periodontium rather than gingival inflammation.
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Affiliation(s)
- Sema Becerik
- Ege University, School of Dentistry, Department of Periodontology, İzmir, Turkey.
| | - Veli Özgen Öztürk
- Adnan Menderes University, School of Dentistry, Department of Periodontology, Aydın, Turkey
| | - Peter Celec
- Institute of Molecular Biomedicine, Comenius University, Bratislava, Slovakia; Institute of Clinical and Translational Research, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Natalia Kamodyova
- Institute of Molecular Biomedicine, Comenius University, Bratislava, Slovakia; Institute of Clinical and Translational Research, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Gül Atilla
- Ege University, School of Dentistry, Department of Periodontology, İzmir, Turkey
| | - Gülnur Emingil
- Ege University, School of Dentistry, Department of Periodontology, İzmir, Turkey
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Becerik S, Celec P, Gürkan A, Öztürk VÖ, Kamodyova N, Atilla G, Emingil G. Gingival Crevicular Fluid and Plasma Levels of Transglutaminase-2 and Oxidative Stress Markers in Cyclosporin A-Induced Gingival Overgrowth. J Periodontol 2016; 87:1508-1516. [PMID: 27468796 DOI: 10.1902/jop.2016.160031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Transglutaminase (TGM)-2 has been shown to contribute to fibrosis by extracellular matrix accumulation in some organs and is activated by intracellular reactive oxygen species. The aim of this study is to investigate levels of gingival crevicular fluid (GCF) and plasma TGM-2 and oxidative stress markers (OSMs) in cyclosporin A (CsA)-induced gingival overgrowth (GO). METHODS The study enrolled 20 healthy (H) individuals; 20 patients with gingivitis (G); 20 CsA-medicated patients with GO (CsA GO+); and 20 CsA-medicated patients without GO (CsA GO-). GCF and plasma levels of TGM-2 were analyzed by enzyme-linked immunosorbent assay. Spectrofluorometry was used to analyze thiobarbituric acid reactive substance (TBARS); ferric-reducing antioxidant power (FRAP); total oxidant status (TOS); and total antioxidant capacity (TAC). RESULTS GCF TGM-2 level was elevated in CsA GO+ compared with G (P = 0.048) and H (P = 0.001) groups. GCF TBARS level was elevated in CsA GO+ compared with other groups (CsA GO- group: P = 0.003; G group: P <0.001; and H group: P <0.001) and was higher in CsA GO- than in H (P = 0.048). GCF FRAP level was lower in CsA GO- than in H (P = 0.04). Both CsA GO+ and CsA GO- groups had lower GCF TOS levels than H (P <0.001 and P = 0.002) and G (P = 0.003 and P = 0.04). GCF TAC was higher in CsA GO+ than in H (P = 0.02). Plasma TGM-2 level was elevated in CsA GO+ compared with G (P = 0.048) and H (P = 0.002). Plasma FRAP level was higher in H and CsA GO- than in CsA GO+ (P = 0.008 and P = 0.02). CONCLUSIONS CsA use significantly alters GCF and plasma levels of TGM-2 and OSMs. TGM-2 may contribute to CsA-induced GO in CsA-treated patients by changing GCF and plasma levels of OSMs. Further studies are needed to prove causality and its direction.
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Affiliation(s)
- Sema Becerik
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - Peter Celec
- Faculty of Medicine, Institute of Molecular Biomedicine, Comenius University, Bratislava, Slovakia
| | - Ali Gürkan
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - Veli Özgen Öztürk
- Department of Periodontology, School of Dentistry, Adnan Menderes University, Aydın, Turkey
| | - Natalia Kamodyova
- Faculty of Medicine, Institute of Molecular Biomedicine, Comenius University, Bratislava, Slovakia
| | - Gül Atilla
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - Gülnur Emingil
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
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Eren G, Türkoğlu O, Atmaca H, Atilla G. Evaluation of gingival crevicular fluid cyclophilin a and extracellular matrix metalloproteinase inducer levels in different periodontal diseases. Arch Oral Biol 2016; 68:162-6. [PMID: 27176139 DOI: 10.1016/j.archoralbio.2016.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 03/15/2016] [Accepted: 05/03/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Cyclophilin A (CypA) is able to regulate inflammatory responses and matrix metalloproteinase production via its interaction with extracellular matrix metalloproteinase inducer (EMMPRIN). EMMPRIN is the cell surface receptor of CypA. The aim of the present study was to evaluate the gingival crevicular fluid (GCF) CypA and EMMPRIN levels in patients with chronic periodontitis (CP), generalized aggressive periodontitis (G-AgP) and periodontally healthy controls. METHODS Twenty CP patients, 19 G-AgP patients and 20 healthy control subjects were included in the present study. All study participants were non-smokers. Full mouth clinical periodontal parameters including probing depth, clinical attachment level, plaque index, and papilla bleeding index were recorded. GCF CypA and EMMPRIN levels were analyzed by enzyme-linked immunosorbent assay. Data were analyzed statistically with parametric and non-parametric tests. RESULTS GCF CypA total amount was higher in the G-AgP group compared to healthy controls (p<0.05), whereas CypA total amounts were similar in CP and healthy controls (p>0.05). No significant difference in GCF CypA total amount between CP and G-AgP was observed (p>0.05). Also, there was no significant difference in GCF EMMPRIN total amounts among the study groups (p>0.05). CONCLUSION Higher levels of GCF CypA in patients with G-AgP might demonstrate that CypA is associated with the inflammatory infiltrate and alveolar bone destruction of G-AgP. However, GCF CypA level does not seem to be affected by CP. Similar GCF EMMPRIN levels in diseased and healthy groups might suggest that EMMPRIN has role in the turn over of connective tissues in physiological conditions as well as pathological state.
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Affiliation(s)
- Gülnihal Eren
- Ege University, School of Dentistry, Department of Periodontology, İzmir, Turkey.
| | - Oya Türkoğlu
- Ege University, School of Dentistry, Department of Periodontology, İzmir, Turkey
| | - Harika Atmaca
- Celal Bayar University, Faculty of Science, Department of Biology, Manisa, Turkey
| | - Gül Atilla
- Ege University, School of Dentistry, Department of Periodontology, İzmir, Turkey
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Gürkan A, Eren G, Çetinkalp Ş, Akçay YD, Emingil G, Atilla G. Monocyte chemotactic protein-1, RANTES and macrophage migration inhibitory factor levels in gingival crevicular fluid of metabolic syndrome patients with gingivitis. Arch Oral Biol 2016; 69:82-8. [PMID: 27270225 DOI: 10.1016/j.archoralbio.2016.05.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 05/09/2016] [Accepted: 05/10/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of the present study was to determine gingival crevicular fluid (GCF) levels of monocyte chemotactic protein-1 (MCP-1), regulated on activation, normal T-cell expressed and secreted protein (RANTES) and macrophage migration inhibitory factor (MIF) in metabolic syndrome patients with gingivitis. DESIGN Twenty metabolic syndrome patients with gingivitis (MSG), 20 MetS patients with clinically healthy periodontium (MSH), 20 systemically healthy subjects with gingivitis and 20 subjects who were both systemically and periodontally healthy were included. Periodontal and systemical parameters were recorded. GCF MCP-1, RANTES and MIF levels were assayed by enzyme-linked immunosorbent assay method. RESULTS MSG and MSH groups had elevated blood pressure, triglyceride, waist circumference and fasting glucose values in comparison to gingivitis and healthy groups (P<0.0001). Clinical periodontal parameters were higher in MSG and gingivitis groups when compared to those of the MSH and healthy groups (P<0.0001). MCP-1 and RANTES levels (ng/mg total protein) of MSG group were higher than those of the MSH groups (P=0.005, P=0.0001, respectively). Also gingivitis group had higher MCP-1, RANTES and MIF levels compared to the healthy group (P=0.011, P=0.0001, P=0.011 respectively). The RANTES level of MSG group was significantly higher than those of the gingivitis group (P=0.01), but MCP-1 and MIF levels were similar in the MSG and gingivitis groups (P>0.05). CONCLUSION Elevated levels of GCF RANTES in MetS patients with gingivitis might associate with the presence of increased gingival inflammation by MetS. Low-grade systemic inflammation associated with MetS and adipose tissue-derived RANTES might lead to altered GCF RANTES levels in the presence of gingival inflammation.
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Affiliation(s)
- Ali Gürkan
- Ege University, School of Dentistry, Department of Periodontology, İzmir, Turkey.
| | - Gülnihal Eren
- Ege University, School of Dentistry, Department of Periodontology, İzmir, Turkey
| | - Şevki Çetinkalp
- Ege University, School of Medicine, Department of Metabolic Diseases and Endocrinology, İzmir, Turkey
| | - Yasemin Delen Akçay
- Ege University, School of Medicine, Department of Biochemistry, İzmir, Turkey
| | - Gülnur Emingil
- Ege University, School of Dentistry, Department of Periodontology, İzmir, Turkey
| | - Gül Atilla
- Ege University, School of Dentistry, Department of Periodontology, İzmir, Turkey
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Turkoglu O, Emingil G, Eren G, Atmaca H, Kutukculer N, Atilla G. Gingival crevicular fluid and serum hCAP18/LL-37 levels in generalized aggressive periodontitis. Clin Oral Investig 2016; 21:763-769. [DOI: 10.1007/s00784-016-1834-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 04/20/2016] [Indexed: 12/14/2022]
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Eren G, Gürkan A, Atmaca H, Dönmez A, Atilla G. Effect of centrifugation time on growth factor and MMP release of an experimental platelet-rich fibrin-type product. Platelets 2016; 27:427-32. [DOI: 10.3109/09537104.2015.1131253] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Gülnihal Eren
- Department of Periodontology, Ege University School of Dentistry, İzmir, Turkey
| | - Ali Gürkan
- Department of Periodontology, Ege University School of Dentistry, İzmir, Turkey
| | - Harika Atmaca
- Department of Biology, Celal Bayar University, School of Science, Manisa, Turkey
| | - Ayhan Dönmez
- Department of Hematology, Ege University, Medical School, Izmir, Turkey
| | - Gül Atilla
- Department of Periodontology, Ege University School of Dentistry, İzmir, Turkey
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Türkoğlu O, Eren G, Emingil G, Azarsız E, Kutukculer N, Atilla G. Does smoking affect gingival crevicular fluid LL-37 levels following non-surgical periodontal treatment in chronic periodontitis? Arch Oral Biol 2016; 61:98-105. [DOI: 10.1016/j.archoralbio.2015.10.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 08/20/2015] [Accepted: 10/20/2015] [Indexed: 02/01/2023]
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Eren G, Tervahartiala T, Sorsa T, Atilla G. Cytokine (interleukin-1beta) and MMP levels in gingival crevicular fluid after use of platelet-rich fibrin or connective tissue graft in the treatment of localized gingival recessions. J Periodontal Res 2015; 51:481-8. [DOI: 10.1111/jre.12325] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2015] [Indexed: 11/28/2022]
Affiliation(s)
- G. Eren
- Department of Periodontology; School of Dentistry; Ege University; Bornova-İzmir Turkey
| | - T. Tervahartiala
- Department of Oral and Maxillofacial Diseases; Helsinki University and Helsinki University Hospital; Helsinki Finland
| | - T. Sorsa
- Department of Oral and Maxillofacial Diseases; Helsinki University and Helsinki University Hospital; Helsinki Finland
- Division of Periodontology; Department of Dental Medicine; Karolinska Institute; Huddinge Sweden
| | - G. Atilla
- Department of Periodontology; School of Dentistry; Ege University; Bornova-İzmir Turkey
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Gürkan A, Becerik S, Öztürk VÖ, Atmaca H, Atilla G, Emingil G. Interleukin-6 Family of Cytokines in Crevicular Fluid of Renal Transplant Recipients With and Without Cyclosporine A-Induced Gingival Overgrowth. J Periodontol 2015; 86:1069-77. [PMID: 25927423 DOI: 10.1902/jop.2015.150003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Interleukin (IL)-6 family of cytokines, including IL-6, oncostatin M (OSM), leukemia inhibitory factor (LIF), and IL-11, have fibrogenic features. The current study determines gingival crevicular fluid (GCF) levels of fibrosis-related IL-6-type cytokines in cyclosporine A (CsA)-induced gingival overgrowth (GO). METHODS Eighty non-smokers were included (40 CsA-medicated renal transplant patients with GO [GO+; n = 20] or without GO [GO-; n = 20], 20 individuals with gingivitis, and 20 healthy participants). Probing depth and plaque, papilla bleeding, and hyperplastic index scores were recorded. GCF samples were obtained from the mesio-buccal aspects of two teeth. GCF IL-6, IL-1β, OSM, LIF, and IL-11 levels were analyzed by enzyme-linked immunosorbent assay. RESULTS The GO+ and GO- groups had higher IL-6 total amounts than the healthy group (P <0.008). IL-1β total amounts in the GO+ group were significantly higher than in both the healthy and GO- groups (P <0.008). OSM total amount was elevated in the GO+ and GO- groups compared with both the gingivitis and healthy groups (P <0.008). All groups had similar LIF and IL-11 total amounts (P >0.008). Moderate positive correlations were detected among IL-6, IL-1β, OSM, and IL-11 total amount in GCF and clinical parameters (P <0.05). CONCLUSIONS IL-6 and OSM increases in GCF as a result of CsA usage or an immunosuppressed state irrespective of the severity of inflammation and the presence of GO. The IL-6 family of cytokines might not be directly involved in biologic mechanisms associated with CsA-induced GO. Lack of an association between assessed IL-6 cytokines and CsA-induced GO might indicate distinct effects of these cytokines on fibrotic changes of different tissues.
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Affiliation(s)
- Ali Gürkan
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - Sema Becerik
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - Veli Özgen Öztürk
- Department of Periodontology, School of Dentistry, Adnan Menderes University, Aydın, Turkey
| | - Harika Atmaca
- Department of Biology, School of Science, Celal Bayar University, Manisa, Turkey
| | - Gül Atilla
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - Gülnur Emingil
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
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Emingil G, Han B, Gürkan A, Berdeli A, Tervahartiala T, Salo T, Pussinen PJ, Köse T, Atilla G, Sorsa T. Matrix Metalloproteinase (MMP)-8 and Tissue Inhibitor of MMP-1 (TIMP-1) Gene Polymorphisms in Generalized Aggressive Periodontitis: Gingival Crevicular Fluid MMP-8 and TIMP-1 Levels and Outcome of Periodontal Therapy. J Periodontol 2014; 85:1070-80. [DOI: 10.1902/jop.2013.130365] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Türkoğlu O, Barış N, Tervahartiala T, Şenarslan Ö, Sorsa T, Atilla G. Evaluation of Systemic Levels of Neutrophilic Enzymes in Patients With Hypertension and Chronic Periodontitis. J Periodontol 2014; 85:908-16. [DOI: 10.1902/jop.2013.130346] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Türkoğlu O, Becerik S, Tervahartiala T, Sorsa T, Atilla G, Emingil G. The effect of adjunctive chlorhexidine mouthrinse on GCF MMP-8 and TIMP-1 levels in gingivitis: a randomized placebo-controlled study. BMC Oral Health 2014; 14:55. [PMID: 24886536 PMCID: PMC4045876 DOI: 10.1186/1472-6831-14-55] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 05/06/2014] [Indexed: 11/23/2022] Open
Abstract
Background The aim of the present study was to evaluate the effect of adjunctive chlorhexidine (CHX) mouthrinse on gingival crevicular fluid (GCF) MMP-8 and TIMP-1 levels in plaque-associated gingivitis. Methods A total of 50 gingivitis patients were included in the present study. In addition to daily plaque control, CHX group rinsed with CHX, while placebo group rinsed with placebo mouthrinse for 4 weeks. GCF samples were collected, and clinical parameters including plaque index, papillary bleeding index, calculus index and pocket depth were recorded at baseline and 4 weeks. GCF MMP-8 and TIMP-1 levels were determined by immunofluorometric assay (IFMA) and enzyme-linked immunosorbent assay (ELISA), respectively. Results In both groups, GCF MMP-8 levels of anterior and posterior sites at four weeks were not different from baseline (p > 0.05). There were no significant differences in GCF MMP-8 levels between the study groups at four weeks (p > 0.05). GCF TIMP-1 levels of anterior and posterior sites at four weeks were higher compared to baseline in both groups (p < 0.05). There was no significant difference in GCF TIMP level between the study groups at four weeks (p > 0.05). Conclusions CHX usage had no significant effects on the GCF MMP-8 and TIMP-1 levels in plaque-associate gingivitis. However, daily plaque control resulted in the increase of GCF TIMP-1 levels regardless of CHX usage.
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Affiliation(s)
- Oya Türkoğlu
- Department of Periodontology, Ege University, School of Dentistry, Izmir, Turkey.
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Gürkan A, Emingil G, Afacan B, Berdeli A, Atilla G. Alpha 2 integrin gene (ITGA2) polymorphism in renal transplant recipients with and without drug induced gingival overgrowth. Arch Oral Biol 2013; 59:283-8. [PMID: 24581850 DOI: 10.1016/j.archoralbio.2013.12.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 12/05/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Variances in fibroblasts' α2β1 integrin intensity may lead to altered adhesion to type I collagen and consequently to suppression of phagocytosis which may be one of the mechanisms for drug induced gingival overgrowth. The present study aimed to evaluate the genotype and allele frequencies of α2 integrin +807 gene in renal transplant patients with and without gingival overgrowth. MATERIAL AND METHODS Seventy renal transplant patients with cyclosporine A (CsA)-induced gingival overgrowth (CsA GO+) were enrolled. Renal transplant patients without GO medicated with CsA (CsA GO-; n=79) and tacrolimus (Tac; n=52) served as controls. DNA was obtained from peripheral blood and ITGA2 +807C/T polymorphism was genotyped by polymerase chain reaction and restriction fragment length polymorphism method. Clinical parameters including probing depth and plaque, papilla bleeding and hyperplasia indexes were recorded. Chi-square, Kruskal-Wallis and Mann-Whitney tests were used in statistical analysis. RESULTS Clinical parameters of CsA GO+ group were significantly higher than those of the CsA GO- and Tac groups (p<0.05). ITGA2 807C/T genotype and allele frequencies of study groups were similar (p>0.05). CONCLUSION Within the limits of the present study it can be concluded that ITGA2 +807 gene polymorphism is not associated with susceptibility to CsA-induced GO.
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Affiliation(s)
- Ali Gürkan
- Ege University, School of Dentistry, Department of Periodontology, Izmir, Turkey.
| | - Gülnur Emingil
- Ege University, School of Dentistry, Department of Periodontology, Izmir, Turkey
| | - Beral Afacan
- Ege University, School of Dentistry, Department of Periodontology, Izmir, Turkey
| | - Afig Berdeli
- Ege University, School of Medicine, Department of Pediatrics, Molecular Medicine Laboratory Izmir, Turkey
| | - Gül Atilla
- Ege University, School of Dentistry, Department of Periodontology, Izmir, Turkey
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Han B, Emingil G, Özdemir G, Tervahartiala T, Vural C, Atilla G, Baylas H, Sorsa T. Azithromycin as an Adjunctive Treatment of Generalized Severe Chronic Periodontitis: Clinical, Microbiologic, and Biochemical Parameters. J Periodontol 2012; 83:1480-91. [DOI: 10.1902/jop.2012.110519] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Emingil G, Han B, Özdemir G, Tervahartiala T, Vural C, Atilla G, Baylas H, Sorsa T. Effect of azithromycin, as an adjunct to nonsurgical periodontal treatment, on microbiological parameters and gingival crevicular fluid biomarkers in generalized aggressive periodontitis. J Periodontal Res 2012; 47:729-39. [DOI: 10.1111/j.1600-0765.2012.01488.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Becerik S, Öztürk VÖ, Atmaca H, Atilla G, Emingil G. Gingival crevicular fluid and plasma acute-phase cytokine levels in different periodontal diseases. J Periodontol 2012; 83:1304-13. [PMID: 22248224 DOI: 10.1902/jop.2012.110616] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of the present study is to investigate gingival crevicular fluid (GCF) and plasma acute-phase cytokines, interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-11 (IL-11), oncostatin M (OSM), and leukemia inhibitory factor (LIF) levels in patients with different periodontal diseases. METHODS Eighty individuals were included in this study; 20 with chronic periodontitis (CP), 20 with generalized aggressive periodontitis (GAgP), 20 with gingivitis, and 20 classified as healthy (H). Probing depth, clinical attachment level, plaque index, and papilla bleeding index were recorded. Plasma and GCF IL-1β, IL-6, IL-11, OSM, and LIF levels were analyzed by enzyme-linked immunosorbent assay. RESULTS CP and GAgP groups had significantly higher GCF IL-1β, IL-6, and IL-11 levels when compared with the H group (P <0.05). Conversely, GCF LIF levels of the CP and GAgP groups were lower than those of the H group (P <0.05). GCF OSM levels did not differ significantly among study groups. Plasma levels of all the cytokines studied were not significantly different among the study groups. CONCLUSIONS Based on the present data, elevated IL-1β, IL-6, and IL-11 GCF levels, but not plasma levels, are suggested as reliable inflammatory biomarkers in periodontal diseases. Decreased LIF levels in diseased groups might reflect the possible beneficial effects of LIF in the modulation of inflammatory response in gingiva.
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Affiliation(s)
- Sema Becerik
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey.
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Mäntylä P, Buduneli E, Emingil G, Tervahartiala T, Pussinen PJ, Barış N, Akıllı A, Atilla G, Sorsa T. Acute myocardial infarction elevates serine protease activity in saliva of patients with periodontitis. J Periodontal Res 2011; 47:345-53. [DOI: 10.1111/j.1600-0765.2011.01439.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Becerik S, Gürkan A, Afacan B, Özgen Öztürk V, Atmaca H, Töz H, Atilla G, Emingil G. Gingival Crevicular Fluid Osteocalcin, N-Terminal Telopeptides, and Calprotectin Levels in Cyclosporin A–Induced Gingival Overgrowth. J Periodontol 2011; 82:1490-7. [DOI: 10.1902/jop.2011.100600] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Türkoğlu O, Berdeli A, Emingil G, Atilla G. A novel p.S34N mutation of CAMP gene in patients with periodontal disease. Arch Oral Biol 2011; 56:573-9. [DOI: 10.1016/j.archoralbio.2010.11.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Revised: 11/07/2010] [Accepted: 11/15/2010] [Indexed: 11/30/2022]
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Becerik S, Özsan N, Gürkan A, Öztürk VÖ, Atilla G, Emingil G. Toll like receptor 4 and membrane-bound CD14 expressions in gingivitis, periodontitis and CsA-induced gingival overgrowth. Arch Oral Biol 2011; 56:456-65. [DOI: 10.1016/j.archoralbio.2010.11.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Revised: 10/19/2010] [Accepted: 11/14/2010] [Indexed: 10/18/2022]
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Buduneli E, Mäntylä P, Emingil G, Tervahartiala T, Pussinen P, Barış N, Akıllı A, Atilla G, Sorsa T. Acute Myocardial Infarction is Reflected in Salivary Matrix Metalloproteinase-8 Activation Level. J Periodontol 2011; 82:716-25. [DOI: 10.1902/jop.2010.100492] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Emingil G, Gürkan A, Atilla G, Kantarci A. Subantimicrobial-Dose Doxycycline and Cytokine-Chemokine Levels in Gingival Crevicular Fluid. J Periodontol 2011; 82:452-61. [DOI: 10.1902/jop.2010.100036] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Bostanci N, Saygan B, Emingil G, Atilla G, Belibasakis GN. Effect of periodontal treatment on receptor activator of NF-κB ligand and osteoprotegerin levels and relative ratio in gingival crevicular fluid. J Clin Periodontol 2011; 38:428-33. [DOI: 10.1111/j.1600-051x.2011.01701.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Türkoğlu O, Kandiloğlu G, Berdeli A, Emingil G, Atilla G. Antimicrobial peptide hCAP-18/LL-37 protein and mRNA expressions in different periodontal diseases. Oral Dis 2010; 17:60-7. [DOI: 10.1111/j.1601-0825.2010.01704.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Emingil G, Afacan B, Tervahartiala T, Töz H, Atilla G, Sorsa T. GCF and serum myeloperoxidase and matrix metalloproteinase-13 levels in renal transplant patients. Arch Oral Biol 2010; 55:719-27. [PMID: 20637451 DOI: 10.1016/j.archoralbio.2010.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Revised: 06/04/2010] [Accepted: 06/21/2010] [Indexed: 11/16/2022]
Abstract
AIM The rationale of this study was to address whether local or systemic changes reflect proteolytic (matrix metalloproteinase-13) or oxidative (myeloperoxidase) stress in renal transplant patients receiving cyclosporine-A (CsA) and having gingival overgrowth (GO), in patients receiving CsA therapy and having no GO and patients receiving tacrolimus therapy. MATERIAL AND METHODS Gingival crevicular fluid (GCF) samples were collected from sites with (GO+) and without GO (GO-) in CsA patients having GO; GO- sites in CsA patients having no GO; sites from tacrolimus, gingivitis and healthy subjects. GCF and serum myeloperoxidase (MPO) and matrix metalloproteinase-13 (MMP-13) levels were determined by ELISA. RESULTS GO+ sites in CsA patients having GO had elevated GCF MPO levels than those of CsA patients having no GO, tacrolimus and healthy subjects (p<0.005), but comparable to those of gingivitis. GCF MPO levels were higher in GO+ compared to GO- sites in CsA patients having GO (p<0.05). Patient groups had similar, but higher GCF MMP-13 levels than healthy group. CONCLUSIONS These results show that CsA and tacrolimus therapy have not a significant effect on GCF MPO and MMP-13 levels, and gingival inflammation seems to be the main reason for their elevations.
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Affiliation(s)
- Gülnur Emingil
- Ege University, School of Dentistry, Department of Periodontology, Bornova, 35100 Izmir, Turkey.
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Türkoğlu O, Emingil G, Kütükçüler N, Atilla G. Evaluation of gingival crevicular fluid adrenomedullin and human neutrophil peptide 1-3 levels of patients with different periodontal diseases. J Periodontol 2010; 81:284-91. [PMID: 20151808 DOI: 10.1902/jop.2009.090517] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Antimicrobial peptides participating in the innate host response are important contributors for maintaining the balance between health and disease. The aim of the present study is to investigate the levels of gingival crevicular fluid (GCF) adrenomedullin and human neutrophil peptides 1 through 3 (HNP1-3) in patients with different periodontal diseases. METHODS A total of 77 subjects, including 20 patients with chronic periodontitis, 18 patients with generalized aggressive periodontitis, 20 patients with gingivitis, and 19 healthy subjects, were included in the present study. The probing depth, clinical attachment level, plaque index, and papilla bleeding index were assessed in all study subjects. GCF samples were analyzed for evaluating adrenomedullin and HNP1-3 levels by enzyme-linked immunosorbent assay. RESULTS The present study demonstrated that the periodontitis groups had a significantly higher total amount of GCF adrenomedullin compared to the gingivitis and healthy control groups after adjusting for age and gender (P <0.05). Additionally, GCF adrenomedullin levels were positively correlated with clinical periodontal parameters of sampling sites (P <0.05). The total amount of GCF HNP1-3 was not different among the study groups, and there was no correlation between the total amount of GCF HNP1-3 and clinical periodontal parameters (P >0.05). CONCLUSIONS Our results suggest a defensive role for adrenomedullin during the host response in periodontal disease. Additionally, the lack of the HNP1-3 antimicrobial peptide might point to the deficiency of one of the protective mechanisms for periodontal tissues.
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Affiliation(s)
- Oya Türkoğlu
- Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey.
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Laaksonen M, Salo T, Vardar-Sengul S, Atilla G, Han Saygan B, Simmer JP, Baylas H, Sorsa T. Gingival crevicular fluid can degrade Emdogain and inhibit Emdogain-induced proliferation of periodontal ligament fibroblasts. J Periodontal Res 2010; 45:353-60. [DOI: 10.1111/j.1600-0765.2009.01244.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Becerik S, Özçaka Ö, Nalbantsoy A, Atilla G, Celec P, Behuliak M, Emingil G. Effects of Menstrual Cycle on Periodontal Health and Gingival Crevicular Fluid Markers. J Periodontol 2010; 81:673-81. [DOI: 10.1902/jop.2010.090590] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Türkoğlu O, Emingil G, Kütükçüler N, Atilla G. Gingival crevicular fluid levels of cathelicidin LL-37 and interleukin-18 in patients with chronic periodontitis. J Periodontol 2009; 80:969-76. [PMID: 19485828 DOI: 10.1902/jop.2009.080532] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Cathelicidin LL-37, an antimicrobial peptide, is part of the host innate immune response in the oral cavity. Interleukin (IL)-18, a proinflammatory cytokine, could play a role in the progression of the inflammatory response. The aim of the present study was to determine the levels of cathelicidin LL-37 and IL-18 in the gingival crevicular fluid (GCF) of patients with gingivitis and chronic periodontitis. METHODS Fifty-nine subjects were included in the present study. Probing depth (PD), clinical attachment level (CAL), plaque index (PI), bleeding on probing, and papilla bleeding index (PBI) were assessed in patients with chronic periodontitis or gingivitis and in healthy controls. GCF levels of cathelicidin LL-37 and IL-18 were analyzed by enzyme-linked immunosorbent assay. RESULTS GCF levels of cathelicidin LL-37 were significantly elevated in patients with chronic periodontitis compared to the other groups (P <0.05). No significant difference was found in the total amount of GCF IL-18 among the study groups (P >0.05). Spearman correlation analysis revealed a positive relationship between levels of GCF cathelicidin LL-37 and PD, CAL, PI, and PBI at the sampled sites (P <0.01), whereas no correlation was found between the total amount of GCF IL-18 and clinical periodontal parameters at the sampled sites (P >0.05). CONCLUSION Elevated levels of GCF cathelicidin LL-37 in chronic periodontitis suggest that it may play a role in the host innate immune response during periodontal inflammation.
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Affiliation(s)
- Oya Türkoğlu
- Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey.
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Bostanci N, Emingil G, Saygan B, Turkoglu O, Atilla G, Curtis MA, Belibasakis GN. Expression and regulation of the NALP3 inflammasome complex in periodontal diseases. Clin Exp Immunol 2009; 157:415-22. [PMID: 19664151 DOI: 10.1111/j.1365-2249.2009.03972.x] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Periodontitis is an infectious process characterized by inflammation affecting the supporting structures of the teeth. Porphyromonas gingivalis is a major oral bacterial species implicated in the pathogenesis of periodontitis. Processing of interleukin (IL)-1 family cytokines is regulated by an intracellular innate immune response system, known as the NALP3 [nacht domain-, leucine-rich repeat-, and pyrin domain (PYD)-containing protein 3] inflammasome complex. The aim of the present study was to investigate by quantitative real-time polymerase chain reaction (PCR) the mRNA expression of NALP3, its effector molecule apoptosis associated speck-like protein (ASC), its putative antagonist NLRP2 (NLR family, PYD-containing protein 2), IL-1beta and IL-18 (i) in gingival tissues from patients with gingivitis (n = 10), chronic periodontitis (n = 18), generalized aggressive periodontitis (n = 20), as well as in healthy subjects (n = 20), (ii) in vitro in a human monocytic cell line (Mono-Mac-6), in response to P. gingivalis challenge for 6 h. The clinical data indicate that NALP3 and NLRP2, but not ASC, are expressed at significantly higher levels in the three forms of inflammatory periodontal disease compared to health. Furthermore, a positive correlation was revealed between NALP3 and IL-1beta or IL-18 expression levels in these tissues. The in vitro data demonstrate that P. gingivalis deregulates the NALP3 inflammasome complex in Mono-Mac-6 cells by enhancing NALP3 and down-regulating NLRP2 and ASC expression. In conclusion, this study reveals a role for the NALP3 inflammasome complex in inflammatory periodontal disease, and provides a mechanistic insight to the host immune responses involved in the pathogenesis of the disease by demonstrating the modulation of this cytokine-signalling pathway by bacterial challenge.
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Affiliation(s)
- N Bostanci
- Department of Periodontology, University College London Eastman Dental Institute, London WC1X 8LD, UK.
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Gürkan A, Emingil G, Nizam N, Doğanavşargil B, Sezak M, Kütükçüler N, Atilla G. Therapeutic Efficacy of Vasoactive Intestinal Peptide inEscherichia coliLipopolysaccharide-Induced Experimental Periodontitis in Rats. J Periodontol 2009; 80:1655-64. [DOI: 10.1902/jop.2009.090031] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Gürkan A, Emingil G, Öktem G, Selvi N, Afacan B, Tunç İlgenli, Töz H, Atilla G. Immunohistochemical Analysis of Inducible and Endothelial Forms of Nitric Oxide Synthase in Cyclosporin A-Induced Gingival Overgrowth. J Periodontol 2009; 80:1638-47. [DOI: 10.1902/jop.2009.090138] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Pirhan D, Atilla G, Emingil G, Tervahartiala T, Sorsa T, Berdeli A. MMP-13 promoter polymorphisms in patients with chronic periodontitis: effects on GCF MMP-13 levels and outcome of periodontal therapy. J Clin Periodontol 2009; 36:474-81. [DOI: 10.1111/j.1600-051x.2009.01399.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gürkan A, Emingil G, Saygan BH, Atilla G, Köse T, Baylas H, Berdeli A. Renin-angiotensin gene polymorphisms in relation to severe chronic periodontitis. J Clin Periodontol 2009; 36:204-11. [DOI: 10.1111/j.1600-051x.2008.01379.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Türkoğlu O, Becerik S, Emingil G, Kütükçüler N, Baylas H, Atilla G. The effect of adjunctive chlorhexidine mouthrinse on clinical parameters and gingival crevicular fluid cytokine levels in untreated plaque-associated gingivitis. Inflamm Res 2009; 58:277-83. [DOI: 10.1007/s00011-008-8129-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Emingil G, Afacan B, Tervahartiala T, Töz H, Atilla G, Sorsa T. By mistakes we learn: determination of matrix metalloproteinase-8 and tissue inhibitor of matrix metalloproteinase-1 in serum yields doubtful results. J Clin Periodontol 2008; 35:1087-8. [DOI: 10.1111/j.1600-051x.2008.01336.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Pirhan D, Atilla G, Emingil G, Sorsa T, Tervahartiala T, Berdeli A. Effect of MMP-1 promoter polymorphisms on GCF MMP-1 levels and outcome of periodontal therapy in patients with severe chronic periodontitis. J Clin Periodontol 2008; 35:862-70. [DOI: 10.1111/j.1600-051x.2008.01302.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Vardar-Sengul S, Buduneli E, Turkoglu O, Buduneli N, Atilla G, Wahlgren J, Sorsa T, Baylas H. The Effects of Selective COX-2 Inhibitor/Celecoxib and Omega-3 Fatty Acid on Matrix Metalloproteinases, TIMP-1, and Laminin-5γ2-Chain Immunolocalization in Experimental Periodontitis. J Periodontol 2008; 79:1934-41. [DOI: 10.1902/jop.2008.080001] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Emingil G, Atilla G, Sorsa T, Tervahartiala T. The effect of adjunctive subantimicrobial dose doxycycline therapy on GCF EMMPRIN levels in chronic periodontitis. J Periodontol 2008; 79:469-76. [PMID: 18315429 DOI: 10.1902/jop.2008.070165] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of the present randomized, double-masked, placebo-controlled, parallel-arm study was to examine the effectiveness of a 3-month regimen of subantimicrobial dose doxycycline (SDD) in combination with scaling and root planing compared to scaling and root planing alone on levels of gingival crevicular fluid (GCF) extracellular matrix metalloproteinase inducer (EMMPRIN) in patients with chronic periodontitis. METHODS GCF samples were collected, and clinical parameters, including probing depth (PD), clinical attachment level, gingival index (GI), and plaque index, were recorded. Thirty chronic periodontitis subjects were randomized to receive SDD or placebo. The SDD group received SDD (20 mg, twice a day) for 3 months plus scaling and root planing, whereas the placebo group took placebo capsules twice a day for 3 months and received scaling and root planing. The subjects were reevaluated at 3 and 6 months. At each visit, all clinical parameters were measured and GCF was sampled. GCF EMMPRIN levels were determined by Western immunoblotting assay. Intragroup comparisons were tested by the Friedman test followed by the Wilcoxon signed-rank test to analyze the significance of changes over time. The Mann-Whitney test was used to determine differences between the SDD and placebo groups. RESULTS Significant improvements were observed in all clinical parameters in the SDD group over the 6-month study period (P <0.025). The SDD group showed a significantly greater reduction in mean PD scores at 6 months and in mean GI scores at 3 and 6 months than the placebo group (P <0.05). From baseline to 6 months, the GCF EMMPRIN levels were reduced significantly in the SDD group (P <0.025). The GCF EMMPRIN level in the SDD group was significantly lower than that of the placebo group at 3 and 6 months (P <0.05). CONCLUSIONS SDD therapy in combination with scaling and root planing reduced GCF EMMPRIN levels and improved clinical periodontal parameters in subjects with chronic periodontitis. The ability of SDD to downregulate, in vivo, the GCF levels of EMMPRIN, a unique upregulator of matrix metalloproteinase expression, is one of its beneficial host-modulatory properties. These results expand the usefulness of SDD therapy as an adjunct to scaling and root planing in the long-term management of periodontal disease.
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Affiliation(s)
- Gülnur Emingil
- Department of Periodontology, School of Dentistry, Ege University, Bornova, Izmir, Turkey.
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Emingil G, Afacan B, Tervahartiala T, Töz H, Atilla G, Sorsa T. Gingival crevicular fluid and serum matrix metalloproteinase-8 and tissue inhibitor of matrix metalloproteinase-1 levels in renal transplant patients undergoing different immunosuppressive therapy. J Clin Periodontol 2008; 35:221-9. [PMID: 18269661 DOI: 10.1111/j.1600-051x.2007.01192.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIM We investigated gingival crevicular fluid (GCF) and serum matrix metalloproteinase-8 (MMP-8) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) levels from renal transplant patients receiving cyclosporine-A (CsA) and having gingival overgrowth (GO), from patients receiving CsA therapy and having no GO and patients receiving tacrolimus therapy. MATERIAL AND METHODS GCF samples were collected from sites with GO (GO+) and without GO (GO-) in CsA patients having GO; and GO- sites in CsA patients having no GO; sites from tacrolimus, gingivitis and healthy subjects. GCF and serum MMP-8 and TIMP-1 levels were determined by a time-resolved immunofluorometric assay (IFMA) and enzyme-linked immunosorbent assay. RESULTS GO+ sites in CsA patients having GO had elevated GCF MMP-8 levels compared with those of CsA patients having no GO, tacrolimus and healthy subjects (p<0.005), but these levels were similar to those of gingivitis. The GCF MMP-8 level was higher in GO+ compared with GO- sites in CsA patients having GO (p<0.05). GCF TIMP-1 levels were similar between groups. Tacrolimus patients had lower GCF MMP-8 levels than gingivitis (p<0.005), but levels similar to the healthy group. CONCLUSION These results show that CsA and tacrolimus therapy has no significant effect on GCF MMP-8 levels, and gingival inflammation seems to be the main reason for their elevations.
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Affiliation(s)
- Gülnur Emingil
- Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey.
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Gürkan A, Afacan B, Emingil G, Töz H, Başkesen A, Atilla G. Gingival crevicular fluid transforming growth factor-beta1 in cyclosporine and tacrolimus treated renal transplant patients without gingival overgrowth. Arch Oral Biol 2008; 53:723-8. [PMID: 18342291 DOI: 10.1016/j.archoralbio.2008.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2007] [Revised: 01/12/2008] [Accepted: 02/01/2008] [Indexed: 11/25/2022]
Abstract
BACKGROUND Gingival crevicular fluid (GCF) levels of transforming growth factor-beta(1) (TGF-beta(1)) have been previously investigated in relation to the pathogenesis of cyclosporine-A (CsA)-induced gingival overgrowth (GO) but no clinical data are available regarding the GCF levels of TGF-beta(1) in patients treated with tacrolimus (Tac). However, as gingival inflammation is pronounced at sites of GO and this consequently may lead to an elevation in TGF-beta(1) levels the present study aimed to evaluate gingival crevicular fluid (GCF) TGF-beta(1) levels in renal transplant patients using CsA or Tac without GO. METHODS GCF TGF-beta(1) levels were investigated in 30 renal transplant patients without GO medicated with either CsA (n=15) or Tac (n=15). Sixteen gingivitis patients and 15 periodontally healthy subjects were selected as controls. Periodontal status was evaluated by measuring probing depth, plaque index and papilla bleeding index. The TGF-beta(1) levels were analysed by enzyme-linked immunosorbent assay. RESULTS Both CsA and Tac groups had significantly elevated GCF TGF-beta(1) total amount compared to gingivitis and healthy groups (p<0.008). GCF TGF-beta(1) total amount of CsA and Tac groups was similar (p>0.008). Gingivitis and healthy groups had also similar GCF TGF-beta(1) total amount (p>0.008). CONCLUSIONS Within the limits of the present data it is unlikely that TGF-beta(1) is an exclusive mediator of CsA- or Tac-induced GO. However, pathogenesis of GO is multifactorial and contribution of TGF-beta(1) to the interrelations between cytokines and growth factors with fibrogenic potential cannot be disregarded.
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Affiliation(s)
- Ali Gürkan
- Ege University, School of Dentistry, Department of Periodontology, Bornova 35100, IZMIR, Turkey.
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Bostanci N, Emingil G, Afacan B, Han B, Ilgenli T, Atilla G, Hughes F, Belibasakis G. Tumor Necrosis Factor-α-converting Enzyme (TACE) Levels in Periodontal Diseases. J Dent Res 2008; 87:273-7. [DOI: 10.1177/154405910808700311] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Tumor necrosis factor-α-converting enzyme (TACE) is a metalloprotease which can shed several cytokines from the cell membrane, including receptor activator of NF-κB ligand (RANKL). This study aimed to investigate the hypothesis that TACE would be elevated in the gingival crevicular fluid (GCF) of persons with periodontitis. Total TACE amounts in GCF were higher in persons with chronic and aggressive periodontitis than in those with gingivitis or in healthy persons. TACE concentrations in GCF were higher in persons with chronic and aggressive periodontitis than in those with gingivitis, although not significantly higher than in healthy persons. Persons with chronic periodontitis receiving immunosuppressive treatment exhibited over 10-fold lower TACE levels than the other periodontitis groups. TACE was positively correlated with probing pocket depth, clinical attachment levels, and RANKL concentrations in GCF. In conclusion, the increased GCF TACE levels in persons with periodontitis and their positive correlation with RANKL may indicate an association of this enzyme with alveolar bone loss, and may warrant special attention in future therapeutic approaches.
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Affiliation(s)
- N. Bostanci
- Centre for Adult Oral Health, Bart’s and the London School of Medicine and Dentistry, Queen Mary University of London, Turner Street, E1 2AD London, UK; and
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - G. Emingil
- Centre for Adult Oral Health, Bart’s and the London School of Medicine and Dentistry, Queen Mary University of London, Turner Street, E1 2AD London, UK; and
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - B. Afacan
- Centre for Adult Oral Health, Bart’s and the London School of Medicine and Dentistry, Queen Mary University of London, Turner Street, E1 2AD London, UK; and
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - B. Han
- Centre for Adult Oral Health, Bart’s and the London School of Medicine and Dentistry, Queen Mary University of London, Turner Street, E1 2AD London, UK; and
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - T. Ilgenli
- Centre for Adult Oral Health, Bart’s and the London School of Medicine and Dentistry, Queen Mary University of London, Turner Street, E1 2AD London, UK; and
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - G. Atilla
- Centre for Adult Oral Health, Bart’s and the London School of Medicine and Dentistry, Queen Mary University of London, Turner Street, E1 2AD London, UK; and
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - F.J. Hughes
- Centre for Adult Oral Health, Bart’s and the London School of Medicine and Dentistry, Queen Mary University of London, Turner Street, E1 2AD London, UK; and
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | - G.N. Belibasakis
- Centre for Adult Oral Health, Bart’s and the London School of Medicine and Dentistry, Queen Mary University of London, Turner Street, E1 2AD London, UK; and
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
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Gürkan A, Emingil G, Saygan BH, Atilla G, Cinarcik S, Köse T, Berdeli A. Matrix metalloproteinase-2, -9, and -12 gene polymorphisms in generalized aggressive periodontitis. J Periodontol 2008; 78:2338-47. [PMID: 18052707 DOI: 10.1902/jop.2007.070148] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Matrix metalloproteinases (MMPs) are involved in periodontal tissue remodeling and degradation. Polymorphisms in the promoter region of the MMP-2 and -9 genes and in the coding region of the MMP-12 gene could affect transcription and the function of these enzymes. The aim of the present study was to determine the association between the aforementioned MMP polymorphisms and generalized aggressive periodontitis (GAgP). METHODS Genomic DNA was obtained from the peripheral blood of 92 subjects with GAgP and 157 periodontally healthy subjects. MMP-2 -735C/T, MMP-9 -1562C/T, and MMP-12 357Asn/Ser polymorphisms were genotyped by polymerase chain reaction and restriction fragment length polymorphism. Probing depth, clinical attachment loss, supragingival plaque accumulation, and bleeding on probing were recorded. The data were analyzed by chi(2), logistic regression, and Mann-Whitney U tests. RESULTS The genotype distributions, allele frequencies, and rare allele carriage of MMP-2 and MMP-12 genes were similar in GAgP and healthy subjects (P >0.05). T allele frequency and T allele carriage of the MMP-9 -1562 C/T polymorphism were significantly lower in the GAgP group than in the healthy group (P <0.05). In addition, logistic regression analysis revealed a protective effect for MMP-9 -1562 T allele carriers (odds ratio = 0.52; P = 0.04). CONCLUSIONS MMP-2 -735C/T and MMP-12 357Asn/Ser polymorphisms are not related to GAgP. Conversely, the MMP-9 -1562 gene T allele might be associated with a decreased risk for GAgP in the Turkish population.
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Affiliation(s)
- Ali Gürkan
- Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey.
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Türkoğlu O, Bariş N, Kütükçüler N, Senarslan O, Güneri S, Atilla G. Evaluation of Serum Anti-Cardiolipin and Oxidized Low-Density Lipoprotein Levels in Chronic Periodontitis Patients With Essential Hypertension. J Periodontol 2008; 79:332-40. [PMID: 18251648 DOI: 10.1902/jop.2008.070321] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Oya Türkoğlu
- Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey.
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47
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Gürkan A, Köse T, Atilla G. Oral health status and oral hygiene habits of an adult Turkish population on dialysis. Oral Health Prev Dent 2008; 6:37-43. [PMID: 18399306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE The present study was undertaken to evaluate the oral health status and oral hygiene habits of dialysis patients. MATERIALS AND METHODS A total of 145 patients on dialysis were evaluated in two centres. Evaluation included oral examination of soft and hard tissues and completion of a questionnaire that was used to gather information about demographic, socioeconomic, medical and dental status and oral hygiene attitudes of patients. Awareness of the importance of oral health was also determined by four yes/no questions within this questionnaire. RESULTS Of the 145 patients, 89 (61.4%) were presently candidates for renal transplantation. Nineteen patients (13.1%) were edentulous and nearly half of the patients (n=69, 47.6%) had 15 or fewer remaining teeth. Dentate patients who regularly brushed twice a day and flossed were few (n=18, 14.3%; n=3, 2.4%, respectively). In addition, plaque score was more than 50% in most of the dentate patients (93.7%). Gingival bleeding was reported by about two thirds of dentate patients (67.5%). None of the patients were referred to a dentist or were attending regular dental care. The percentage of patients who were aware of oral cavity-related infections and importance of oral hygiene following renal transplantation was very low (20.7% and 9.7%, respectively). CONCLUSIONS Poor oral health, unsatisfactory daily oral hygiene habits and insufficient awareness of the importance of oral health is frequent among Turkish dialysis patients. Dentists and nephrologists should work in close cooperation in order to raise awareness and encourage regular dental controls.
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Affiliation(s)
- Ali Gürkan
- Ege University, School of Dentistry, Department of Periodontology, Ege University, Bornova-35100, Izmir, Turkey.
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Emingil G, Berdeli A, Baylas H, Saygan BH, Gürkan A, Köse T, Atilla G. Toll-like receptor 2 and 4 gene polymorphisms in generalized aggressive periodontitis. J Periodontol 2007; 78:1968-77. [PMID: 18062119 DOI: 10.1902/jop.2007.060360] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Toll-like receptors (TLRs) recognize exogenous ligands such as lipopolysaccharide and bacterial lipoprotein during the immune responses to pathogens. The aim of the present study was to investigate whether TLR2 and TLR4 gene polymorphisms are related to susceptibility to generalized aggressive periodontitis (GAgP). METHODS A total of 245 subjects were included in the present study. Genomic DNA was obtained from the peripheral blood of 90 patients with GAgP and 155 periodontally healthy subjects. Probing depth, clinical attachment loss, plaque accumulation, and bleeding on probing were recorded. The TLR2 gene Arg753Gln and Arg677Trp polymorphisms and TLR4 gene Asp299Gly and Thr399Ile polymorphisms were genotyped by the polymerase chain reaction-restriction fragment length polymorphism method. The data were analyzed by chi2 and Mann-Whitney U tests and logistic regression analysis. RESULTS There was no significant difference in the distribution of TLR2 and TLR4 genotypes and allele frequencies between GAgP patients and healthy subjects (P > 0.05). The TLR2 753Gln allele was found in 3.9% of the GAgP patients compared to 6.1% in the healthy group. The GAgP patients and healthy subjects did not show homozygosity for the TLR2 mutant alleles. The TLR2 677Trp mutant allele was not found in any of the subjects; 2.2% of the GAgP patients and 2.9% of the periodontally healthy subjects were identified as having the TLR4 299Gly polymorphic allele. With regard to the TLR4 399Ile polymorphic allele, 1.1% of the GAgP patients and 2.3% of the periodontally healthy subjects had this allele. CONCLUSIONS The present study failed to find any significant association between the TLR polymorphisms and GAgP, potentially because of the small sample size. To the best of our knowledge, this was the first study to examine the prevalence of these polymorphisms in a Turkish population with aggressive periodontitis.
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Affiliation(s)
- Gülnur Emingil
- Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey.
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Bostanci N, Ilgenli T, Emingil G, Afacan B, Han B, Töz H, Berdeli A, Atilla G, McKay IJ, Hughes FJ, Belibasakis GN. Differential expression of receptor activator of nuclear factor-?B ligand and osteoprotegerin mRNA in periodontal diseases. J Periodontal Res 2007; 42:287-93. [PMID: 17559623 DOI: 10.1111/j.1600-0765.2006.00946.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVE Receptor activator of nuclear factor-kappaB ligand (RANKL) is responsible for the induction of osteoclastogenesis and bone resorption, whereas its decoy receptor, osteoprotegerin, can directly block this action. Because this dyad of cytokines is crucial for regulating the bone remodelling process, imbalances in their expression may cause a switch from the physiological state to enhanced bone resorption or formation. This study investigated the mRNA expression of RANKL and osteoprotegerin, as well as their relative ratio, in the gingival tissues of patients with various forms of periodontal diseases. MATERIAL AND METHODS Gingival tissue was obtained from nine healthy subjects and 41 patients, who had gingivitis, chronic periodontitis, generalized aggressive periodontitis, and chronic periodontitis and were receiving immunosuppressant therapy. Quantitative real-time polymerase chain reaction was employed to evaluate the mRNA expression of RANKL and osteoprotegerin in these tissues. RESULTS Compared with healthy individuals, patients in all periodontitis groups, but not those with gingivitis, exhibited stronger RANKL expression and a higher relative RANKL/osteoprotegerin ratio. In addition, osteoprotegerin expression was weaker in patients with chronic periodontitis. When patients with generalized aggressive periodontitis and chronic periodontitis were compared, the former exhibited stronger RANKL expression, whereas the latter exhibited weaker osteoprotegerin expression, and there was no difference in their relative ratio. When chronic periodontitis patients were compared with chronic periodontitis patients receiving immunosuppressant therapy, osteoprotegerin, but not RANKL, expression was stronger in the latter. CONCLUSION This study demonstrates that RANKL and osteoprotegerin expression are differentially regulated in various forms of periodontitis, and the relative RANKL/osteoprotegerin ratio appears to be indicative of disease occurrence. This information may confer diagnostic and therapeutic value in periodontitis.
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Affiliation(s)
- N Bostanci
- Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey.
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Gürkan A, Emingil G, Saygan BH, Cinarcik S, Atilla G, Köse T, Berdeli A. Tissue Plasminogen Activator and Plasminogen Activator Inhibitor-1 Gene Polymorphisms in Patients With Chronic Periodontitis. J Periodontol 2007; 78:1256-63. [PMID: 17608581 DOI: 10.1902/jop.2007.060383] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Tissue plasminogen activator (t-PA) and plasminogen activator inhibitor type 1 (PAI-1) are involved in the pathogenesis of periodontitis by controlling proteolytic events in the extracellular matrix. This study was designed to investigate the association of t-PA and PAI-1 gene polymorphisms with chronic periodontitis (CP). METHODS One hundred eighty-nine subjects were included. Genomic DNA was obtained from the peripheral blood of 84 patients with CP and 105 periodontally healthy subjects. Polymerase chain reaction and endonuclease digestion was used to genotype the 4G/5G polymorphism in the promoter region of the PAI-1 gene and the Alu-repeat insertion (I)/deletion (D) polymorphism in intron 8 of the t-PA gene. RESULTS The genotype distributions and allele frequencies of t-PA polymorphism were not different between patients with CP and healthy subjects (24.7% I/I, 45.7% I/D, and 29.6% D/D and 30.3% I/I, 45.5% I/D, and 24.2% D/D, respectively; P >0.05). The t-PA D allele frequency was similar in patients with CP (52.4%) and healthy subjects (46.5%). PAI-1 genotype distribution in patients with CP (30.9% 4G/4G, 35.8% 4G/5G, and 33.3% 5G/5G) and healthy subjects (36.2% 4G/4G, 41.9% 4G/5G, and 21.9% 5G/5G) was also similar. The 4G allele frequency was not different between patients with CP (48.8%) and healthy subjects (57.1%) (P >0.05). The 4G allele frequency in non-smoking CP patients was significantly lower than in non-smoking, healthy subjects (chi(2) = 4.201; P = 0.040). Non-smoking CP patients also had a significantly lower percentage of 4G-positive genotypes compared to non-smoking healthy subjects (chi(2) = 5.046; P = 0.025). CONCLUSIONS t-PA or PAI-1 genotypes are not associated with susceptibility to CP in Turkish subjects. Conversely, the 4G allele of the PAI-1 gene could be related to a decreased susceptibility to CP in non-smokers.
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Affiliation(s)
- Ali Gürkan
- Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey
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