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Öğe The effect of periodontal therapy on serum TNF-? and HbA1c levels in type 2 diabetic patients(Wiley, 2009) Dag, A.; Firat, E. T.; Arikan, S.; Kadiroglu, A. K.; Kaplan, A.Background: To determine the effect of non-surgical periodontal therapy on serum TNF-alpha and HbA1c levels in poorly and well-controlled type 2 diabetic patients. Methods: In total, 45 patients were enrolled in the study; 30 patients with type 2 diabetes mellitus with periodontitis (15 with poorly controlled diabetes, HbA1c >= 7%, group 1A and 15 with well-controlled diabetes, HbA1c < 7%, group 1B) and 15 patients that were systemically healthy with periodontitis (group 2). The plaque index, gingival index, probing depth, clinical attachment loss, gingival bleeding index, HbA1c value, and circulating TNF-alpha concentration were measured at baseline and three months after the non-surgical periodontal therapy. Results: All periodontal parameters and serum TNF-alpha levels were significantly decreased three months after the nonsurgical periodontal therapy compared to the baseline values in all groups. The HbA1c values were significantly decreased only in well-controlled diabetic patients. We found no significant differences in the periodontal parameters or TNF-alpha levels at baseline and after three months between the two groups. Conclusions: Although non-surgical periodontal therapy eliminates local/systemic infection and inflammation via decreases in TNF-alpha, it is insufficient for significantly reducing HbA1c levels without strict glycaemic control in poorly controlled diabetic patients in a short time period.Öğe Morphological Changes Caused by Streptozotocin-Induced Diabetes in the Healthy Gingiva of Rats(Johann Ambrosius Barth Verlag Medizinverlage Heidelberg Gmbh, 2016) Dag, A.; Firat, E. T.; Uysal, E.; Ketani, M. A.; Seker, U.Background and Objective: Epidemiologic and clinical studies have indicated that diabetes is a risk factor for periodontal disease progression. The aim of the present study was to evaluate the morphological changes of gingiva in streptozotocin diabetic rats. Material and Methods: 30 male Wistar rats that weighed 250-300g were used in this study. The animals were randomly divided into 2 groups, one with streptozotocin-induced diabetes and another one with healthy (non-diabetic) animals. All rats were sacrificed after 21 days, and their maxillary first molars with surrounding tissues were observed morphological analyses. Results: In this study, it was observed that the epithelial thickness was greater in the diabetes group, compared to the control group. The statistical comparison of the diabetes and control groups for the thickness of each of the layers of the epithelium demonstrated that the thickness of the keratinized (corneum), granular and basal layers had significantly increased in the diabetic animals. Furthermore, the diabetes group displayed a decrease in the height of the connective tissue papillae, which was found to be statistically insignificant. Another important finding detected in the diabetes group was the congestion of the gingival capillaries, which showed that blood circulation is impaired in diabetes cases. Conclusion: On the basis of the results obtained in this study, it was concluded that streptozotocin-induced diabetes may increase predisposition to periodontal disease by causing morphological changes in the periodontal tissues.Öğe Significance of elevated gingival crevicular fluid tumor necrosis factor-? and interleukin-8 levels in chronic hemodialysis patients with periodontal disease(Wiley, 2010) Dag, A.; Firat, E. T.; Kadiroglu, A. K.; Kale, E.; Yilmaz, M. E.Background and Objective: The prevalence of chronic renal disease in industrialized countries is increasing, and chronic renal disease and periodontitis can have significant, reciprocal effects. The aim of this study was to evaluate the associations between specific clinical parameters and the levels of tumor necrosis factor-alpha (TNF-alpha) and interleukin-8 (IL-8) in the gingival crevicular fluid of hemodialysis (HD) patients with periodontal disease. Material and Methods: Forty-three HD patients and 43 systemically healthy subjects were enrolled in this study. Plaque index (PI), gingival index (GI) and pocket depth were used to determine periodontal status. Venous blood samples were obtained from each patient in the morning before the dialysis session and analyzed to determine the levels of inflammatory, biochemical and hematological parameters. Gingival crevicular fluid was collected from all subjects, and the levels of TNF-alpha and IL-8 were determined in the gingival crevicular fluid samples. Results: The following results were obtained from HD patients and controls: TNF-alpha (pg/mL), 31.40 +/- 1.46 and 3.06 +/- 0.15 (p < 0.001); IL-8 (pg/mL), 90.98 +/- 94.03 and 35.05 +/- 16.86 (p < 0.001); PI, 1.69 +/- 1.02 and 0.04 +/- 0.02 (p < 0.001); GI, 0.82 +/- 0.06 and 0.04 +/- 0.02 (p < 0.001); and pocket depth, 2.23 +/- 0.63 and 1.51 +/- 0.05 (p < 0.001), respectively. In addition, there were positive correlations between TNF-alpha and PI (r = 0.642, p < 0.001), between TNF-alpha and GI (r = 0.565, p < 0.001), between TNF-alpha and pocket depth (r = 0.522, p < 0.001), between IL-8 and PI (r = 0.402, p = 0.002), between IL-8 and GI (r = 0.396, p = 0.002), and between IL-8 and pocket depth (r = 0.326, p = 0.012). There were negative correlations between albumin and PI (r = -0.491, p < 0.001), albumin and GI (r = -0.406, p < 0.001), albumin and pocket depth (r = -0.464, p < 0.001) and albumin and CRP (r = -0.467, p = 0.002) and between the gingival crevicular fluid levels of TNF-alpha and IL-8, TNF-alpha and hemoglobin (r = -0.745, p < 0.001; r = -0.285, p < 0.05) (respectively). Conclusion: The levels of TNF-alpha and IL-8 in gingival crevicular fluid were significantly higher in HD patients than in controls. There were strong, positive correlations between clinical periodontal parameters and the levels of inflammatory cytokines in gingival crevicular fluid from the HD patients.