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  • Küçük Resim
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    Effect of adjunctive amoxicillin/metronidazole treatment on the recolonization levels of subgingival Tannerella forsythia, Prevotella intermedia and Fusobacterium nucleatum in periodontitis patients
    (Selçuk Üniversitesi, 2019) Yaprak, Emre
    Background: The use of antibiotics adjunctive to non-surgical periodontal treatment is an accepted approach in the treatment of periodontitis. However, bacterial recolonization is a major drawback which complicates the maintenance of therapeutic acquisitions. The aim of this study was to evaluate the clinical and microbiological effects of adjunctive amoxicillin and metronidazole combination in the treatment of periodontitis during 6 months follow-up. Materials and Methods: Twenty-two periodontitis patients were assigned as test (n=12) and control (n=10) groups. While test group received amoxicillin and metronidazole combination as an adjunct to scaling and root planing, control group treated with scaling and root planing alone. Clinical examinations and subgingival dental plaque sampling were conducted at baseline and 1, 3 and 6. months during the follow-up. Fusobacterium nucleatum, Tannerella forsythia and Prevotella intermedia levels were determined using real time polymerase chain reaction method. Results: Both groups exhibited significant improvements in each follow-up period when compared to baseline. However, clinical improvements in test group were more prominent than control group as 3rd and 6th months. While some decrease was notable in the counts of all investigated bacteria in both groups, only T. forsythia levels significantly reduced at all follow-up months in test group comparing with controls. Conclusion: The results of this study indicated that amoxicillin/metronidazole treatment adjunctive to scaling and root planing provided additional clinical benefits and suppressed the T. forsythia recolonization.
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    Effect of diode laser application on root surface carbon, calcium and phosphorus levels: A SEM-EDX study
    (Selçuk Üniversitesi, 2019) Yaprak, Emre
    Background: Preservation of the organic ingredients on the root surfaces during the periodontal therapy has been emphasized in the literature. Scanning electron microscopy energy-dispersive X-ray (SEM-EDX) analysis is an accepted approach to evaluate organic and inorganic components on investigated samples in terms of carbon, calcium and phosphor levels. The aim of this study was to evaluate the effects of diode laser application with periodontal pocket decontamination energy setting to the organic content of intact root surfaces via SEM-EDX analysis. Materials and Methods: Each proximal root surfaces of the root surfaces of 10 teeth which were extracted due to orthodontic reasons were divided as test (n=20) and control (n=20) sites. Diode laser (810 nm) applications were done to the test sites of root surfaces. All specimens were analyzed using SEM-EDX with respect to carbon, calcium and phosphor levels. Results: Diode laser applied root surfaces exhibit significantly lower carbon levels comparing with control sites. Additionally, increased calcium and phosphor levels were detected in the test sites. Conclusion: Within the limitations of this study, it can be concluded that, diode laser applications may alter organic content of intact root surface. Further studies are required to elucidate potential effects of diode laser application to specific protein components on the root surfaces.
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    Generalize agresif periodontitis hastalarında cerrahisiz periodontal tedavi ve sistemik antibiyotik uygulamasının seçilmis periodotontopatojenler üzerine etkisi
    (Selçuk Üniversitesi Sağlık Bilimleri Enstitüsü, 2010) Yaprak, Emre; Ataoğlu, Tamer
    Bu çalısmanın amacı; generalize agresif periodontitis (GAP) hastalarında cerrahisiz periodontal tedavi ile es zamanlı sistemik kombine antibiyotik (amoksisilin & metronidazol) uygulamasının subgingival Fusobacterium nucleatum, Prevotella intermedia ve Tannerella forsythia miktarlarına etkisini klinik parametrelerle birlikte değerlendirilmistir. Ayrıca, GAP ve gingivitis teshisi konmus bireyler ile periodontal olarak sağlıklı bireylerin subgingival F. nucleatum, P. intermedia ve T. forsythia miktarları açısından kıyaslanmasıdır. Sistemik olarak sağlıklı 22 GAP hastasının 10'una yalnızca cerrahisiz periodontal tedavi (SRB grubu), 12'sine cerrahisiz periodontal tedavi ile es zamanlı sistemik kombine antibiyotik tedavisi (SRBab grubu) uygulanmıstır. Subgingival plak örneklemesi ve klinik periodontal değerlendirmeler tedavi öncesi ve cerrahisiz periodontal tedavi sonrası 1, 3 ve 6. aylarda gerçeklestirilmistir. Bununla birlikte, 15 gingivitisli (G) ve 15 periodontal olarak sağlıklı (S) bireyden subgingival plak örnekleri toplanmıstır. Hedef bakterilerin varlığı ve miktarı real time PCR yöntemi ile incelenmistir. SPRab grubunda 6 aylık kontrol periyodu boyunca hedef bakterilerin tamamının miktarlarında baslangıca göre anlamlı derecede azalmalar tespit edilmistir. SRPab grubunda SRP grubuna göre cep derinliklerinnin, klinik atasman seviyelerinin ve T. forsythia'nın 3 ve 6. aylarda istatistiksel olarak anlamlı olarak düsük miktarda olduğu saptanmıstır (p<0.05). GAP hastalarında gingivitisli bireylere göre F. nucleatum ve T. forsythia açısından anlamlı bir fazlalık tespit edilmistir (p<0.001). Bu çalısmanın sınırları içerisinde, GAP hastalarında cerrahisiz periodontal tedavi ile es zamanlı sistemik antibiyotik uygulamasının, tedavi sonrası erken dönemde subgingival T. forsythia miktarının anlamlı derecede düsük kalmasında etkili olabileceği düsünülmektedir.
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    Gingival ünite grefti ve trombositten zengin fibrin kullanılarak dişeti çekilmelerinin tedavisi: 3 Olgu sunumu
    (Selçuk Üniversitesi, 2016) Yaprak, Emre; Yüksek, Sibel Kayaaltı
    Dişeti çekilmesi; dişeti kenarının, mine-sement birleşiminden apikale yer değiştirmesi ile kök yüzeyinin açığa çıkması olarak tanımlanır. Dişeti çekilmeleri, çeşitli periodontal plastik cerrahi yöntemlerle tedavi edilebilmektedir. Serbest dişeti grefti (SDG), özellikle yapışık dişeti miktarını arttırmak adına yaygın olarak kullanılan ve öngörülebilir bir cerrahi yöntemdir. Bununla beraber, SDG ile yapışık dişeti miktarı arttırılırken, aynı zamanda belli ölçülerde kök kapanmasının elde edilmesi de mümkün olmaktadır. Son dönemde SDG’inin, marjinal ve interdental dişetini de içerecek şekilde modifiye edilmesi ile gingival ünite grefti (GÜG) geliştirilmiştir. Bu sayede daha başarılı kök kapanması elde edilebileceği literatürde belirtilmektir. Trombositten zengin fibrin (TZF), 2. nesil bir trombosit konsantrasyonudur ve lökositten ve trombositten zengin bir fibrin biyomateryalidir. Bu fibrin, büyüme faktörleri ve sitokinleri içerdiği için anjiogenezi ve yara iyileşmesini etkiler. Bu olgu raporunun amacı, mandibular anterior bölgede Miller II ve III dişeti çekilmeleri olan 3 hastanın, GÜG ve TZF ile tedavilerini ve bu tedavilerin sonuçlarını sunmaktır. Dişeti çekilme miktarı (DÇM), dişeti çekilme genişliği (DÇG), keratinize doku miktarı (KD), klinik ataçman seviyesi (KAS) ve sondlanabilir cep derinliği (CD) başlangıç ve post-operatif 6. ayda değerlendirildi. Elde edilen sonuçlarına göre, Miller Sınıf II ve III dişeti çekilmelerinde, kök kapanması ve KDM arttırılması açısından GÜG başarılı bulunmuştur.
  • Küçük Resim Yok
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    Gingivitis and Very High IgE Level in a Chronic Granulomatous Disease Patient with Unusual Presentation: A Case Report
    (MARY ANN LIEBERT, INC, 2011) Kurt-Sukur, Eda Didem; Turul-Ozgur, Tuba; Yaprak, Emre; Hakki, Sema; Sanal, Ozden
    Chronic granulomatous disease (CGD) is a rare primary immunodeficiency disease characterized by recurrent bacterial and fungal infections and is due to impaired function of superoxide-producing nicotinamide adenine dinucleotide phosphate oxidase. Patients may have elevated serum IgE levels mainly because of a high incidence of sensitization to Aspergillus species. In addition to a predisposition to infections, patients with CGD might have hyperinflammation presenting itself as chronic inflammatory lesions involving gastrointestinal mucosa, skin, lungs, eyes, and brain. Here, we present a case that mainly presented with chronic gingivitis and very high serum IgE levels and had been referred to our hospital with a probable diagnosis of hyper-IgE syndrome, another congenital immunodeficiency that is also characterized by increased susceptibility to bacterial or fungal infections and very high serum IgE levels. Detailed history of the patient revealed recurrent upper and lower respiratory tract and skin infections. He was diagnosed as having CGD by documenting defective phagocyte superoxide production and the diagnosis was then confirmed by mutation analysis. Family screening revealed that a younger brother was also affected. CGD should be considered in the differential diagnosis of patients with recurrent infections, chronic inflammatory lesions, and high serum IgE levels. These cases emphasize the importance of detailed history taking for diagnosis and family screening for identification of other affected members.
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    Immunohistochemical Analysis of CD45RO(+) T Cells and Vascular Endothelial Growth Factor Expression in Cyclosporin A-Induced Rat Gingival Tissue
    (Wiley, 2012) Alptekin, Nilgün Özlem; Üstün, Kemal; Yaprak, Emre; Avunduk, Mustafa Cihat; Ataoğlu, Tamer
    Background: The aim of this study is to evaluate CD4(+), CD8(+), and CD45RO(+) T cells, and vascular endothelial growth factor (VEGF) expression in cyclosporin A (CsA) induced rat overgrown gingival tissue during an 8-week period. Methods: Sixty male Sprague-Dawley rats weighing 200 to 250 g were used in this study. Mandibular first molars were ligated with 3-0 silk suture. The rats received daily doses of 0.09% NaCl (control group) or 10 mg/kg body weight of CsA (test group) by intraperitoneal injections. Five rats from the control group and 10 rats from the test group were sacrificed at each experimental period (2, 4, 6, and 8 weeks after the beginning of CsA treatment). The specimens were examined immunohistochemically. Results: CD4(+), CD8(+), and CD45RO(+) T cells, and VEGF expression were more prevalent in the CsA-treated group than in the control group (P <0.05). VEGF was significantly correlated with CD4(+) T cells, CD4(+)/CD8(+) ratio, and CD45RO(+) cells (P<0.05). Conclusion: Based on our findings, we conclude that VEGF, a major regulator of angiogenesis, and CD4(+), CD8(+), and CD45RO(+) memory T cells play a key role in CsA-induced gingival overgrowth. J Periodontol 2012;83:248-255.
  • Küçük Resim
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    Lateral periodontal kist tedavisinde yönlendirilmiş doku rejenerasyonu: Bir olgu sunumu
    (Selçuk Üniversitesi, 2016) Yaprak, Emre; Kayaaltı Yüksek, Sibel; Müezzinoğlu, Bahar; Gür İlgen, Cansu; Sinanoğlu, Alper
    Lateral periodontal kist (LPK), nadir görülen bir gelişimsel odontojenik kist türüdür. Klinik olarak semptomsuzdur, fakat bazen dişetinde şişlik görülebilir. Genelde yetişkinlerin mandibular kanin ve premolar bölgesinde izlenir. Bu vaka raporunda, lateral periodontal kist teşhisi konmuş bir hastanın tedavisi sunulmaktadır. Sağ mandibular kanin ve premolar bölgesinde ağrısız şişlik şikayeti ile başvuran 41 yaşındaki bayan hastaya, klinik ve radyografik değerlendirmeler sonucunda lateral periodontal kist teşhisi kondu. Tedavi planı olarak, kist bölgesinin cerrahi olarak enükleasyonu ve eş zamanlı yönlendirilmiş doku rejenerasyonu amacı ile kemik grefti ve membran uygulaması planlandı. İlgili tedaviler sonrası 6 aylık takip sürecinde nüks izlenmedi ve ilgili bölgede radyolojik kemik dolumu görüldü. Histopatolojik inceleme sonucunda klinik ön tanı doğrulandı.
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    A Novel Platelet Concentrate: Titanium-Prepared Platelet-Rich Fibrin
    (HINDAWI LTD, 2014) Tunali, Mustafa; Ozdemir, Hakan; Kucukodaci, Zafer; Akman, Serhan; Yaprak, Emre; Toker, Hulya; Firatli, Erhan
    We developed a new product called titanium-prepared platelet-rich fibrin (T-PRF). The T-PRF method is based on the hypothesis that titanium may be more effective in activating platelets than the silica activators used with glass tubes in Chouckroun's leukocyte- and platelet-rich fibrin (L-PRF) method. In this study, we aimed to define the structural characteristics of T-PRF and compare it with L-PRF. Blood samples were collected from 10 healthy male volunteers. The blood samples were drawn using a syringe. Nine milliliters was transferred to a dry glass tube, and 9 mL was transferred to a titanium tube. Half of each clot (i.e., the blood that was clotted using T-PRF or L-PRF) was processed with a scanning electron microscope (SEM). The other half of each clot was processed for fluorescence microscopy analysis and light microscopy analysis. The T-PRF samples seemed to have a highly organized network with continuous integrity compared to the other L-PRF samples. Histomorphometric analysis showed that T-PRF fibrin network covers larger area than L-PRF fibrin network; also fibrin seemed thicker in the T-PRF samples. This is the first human study to define T-PRF as an autogenous leukocyte-and platelet-rich fibrin product. The platelet activation by titanium seems to offer some high characteristics to T-PRF.