Nermin Yamalik

Hacettepe University, Engüri, Ankara, Turkey

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Publications (65)92.2 Total impact

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    ABSTRACT: Background and aimA range of factors needs to be taken into account for an ideal oral health workforce plan. The figures related to dentists, specialists, auxiliaries, practice patterns, undergraduate and continuing dental education, laws/regulations, the attitudes of oral health-care providers and the general trends affecting the practice patterns, work conditions and preferences of oral health-care providers are among such determinants. Thus, the aim of the present study was to gather such information from a sample of World Dental Federation (FDI) member countries with different characteristics.MethodsA cross-sectional survey study was carried out among a sample of FDI member countries between March 2, 2012 and March 27, 2012. A questionnaire was developed addressing some main determinants of oral health workforce, such as its structure, involvement of the public/private sector to provide oral health-care services, specialty services, dental schools, trends in workforce and compliance with oral health needs, and a descriptive analysis was performed. The countries were classified as developed and developing countries and Mann–Whitney U-tests and chi-square tests were used to identify potential significant differences (P > 0.05) between developed and developing countries. All data were processed in SPSS v.19.ResultsIn the18 questionnaires processed, the median number of dentists (P = 0.005), dental practices (P = 0.002), hygienists (P = 0.005), technicians (P = 0.013) and graduates per year (P = 0.037) was higher in developed countries. Only 12.5% of developed and 22.2% of developing countries reported having optimal number of graduates per year. It was noted that 66.7% of developing countries had more regions lacking enough dentists to meet the demand (P = 0.050) and 77.8% lacked the necessary specialist care (P = 0.015). Although developing countries reported mostly an oversupply of dentists, regardless of the level of development most countries did not report an oversupply of specialists. Most developed countries did not feel that their regulations (87.5%) complied with the needs and demands of the population and most developing countries did not feel that their undergraduate dental education (62.5%) complied. Migrating to other countries was a trend seen in developing countries, while, despite increased numbers of dentists, underserved areas and communities were reported.DiscussionThe cross-sectional survey study suggests that figures related to optimum or ideal oral health workforce and fair distribution of the available workforce does not seem to be achieved in many parts of the world. Further attention also needs to be dedicated to general trends that have the capacity to affect future oral health workforce.
    International Dental Journal. 06/2014; 64(3).
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    ABSTRACT: Nitrosative stress plays an essential role in the pathogenesis of periodontal disease. The aim of this study is to analyze the gingival crevicular fluid and saliva nitrite and nitrate levels in periodontally healthy and diseased sites.
    Journal of oral & maxillofacial research. 04/2014; 5(2):e5.
  • Nermin Yamalik
    Indian journal of dental research: official publication of Indian Society for Dental Research 03/2014; 25(2):139-141.
  • Nermin Yamalik, Ward Van Dijk
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    ABSTRACT: Patient safety is a relatively new discipline aimed at improving the quality of care, minimising treatment errors and improving the safety of patients. Although health professions always have a specific concern for patient safety, few practitioners have a clear understanding of the broad context and not all health-care providers practice it. This might well be because of limited availability of information and materials as well as a lack of national or international laws and regulations. Thus, through member National Dental Associations (NDAs) of FDI (World Dental Federation), the present study aimed at analysing the attitudes of dental practitioners to the issues of patient safety and risk management, and the availability of materials and laws and regulations. Determination of their specific needs and demands in these fields was also attempted. For this purpose, an online questionnaire was developed for the member NDAs to respond. Questions mainly focused on the awareness regarding patient safety, availability of materials and regulations and the particular topics for which dentists needed further knowledge and information. A total of 40 responses were received. While some countries lack any documents, patient safety documents and materials were available in some countries but they were mostly limited to infection control and radiation protection and did not address other important aspects of patient safety. The NDAs clearly demanded more information. A significant number of countries also lacked national laws and/or regulations regarding patient safety. Although dentistry always has a genuine concern for patient safety, the findings of the survey suggest that yet more efforts are needed to improve the knowledge, understanding and awareness of dental practitioners regarding its broad context and the relatively 'new' patient safety culture. NDAs, dental educators, national, regional and international dental organisations and health authorities all can play significant roles to achieve these goals.
    International Dental Journal 12/2013; 63(6):291-7. · 1.04 Impact Factor
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    ABSTRACT: Background: Volumetric alterations in gingival crevicular fluid (GCF) is widely accepted to be associated with periodontal health/disease. The volume/flow of GCF is shown to be affected by an array of methodological factors. However, relatively limited information is available whether GCF is subject to circadian rhythm. Thus, the main aim of the present study is to assess the possible presence/absence of circadian rhythm of GCF. The impact of the sampling technique on daytime volumetric variations was also analyzed. Methods: In 80 tooth sites and a total of 480 GCF samples, the possible daily volumetric variations of GCF with 2-hour intervals (08:00-18:00) were assessed. In order to eliminate any potential volumetric differences due to tooth dimensions, only maxillary incisors were included. To analyze the potential impact of sampling technique on GCF volume and daytime variations, at one site modified inracrevicular sampling technique (MIST) was used, while the contralateral site was sampled by use of deep inracrevicular sampling technique (DIST). Clinical periodontal parameters of the GCF sampling sites were also recorded. Results: No significant daily variations in GCF volume could be detected. Higher volumetric measures were observed in inflamed subgroups when compared to healthy subgroups (P<0,05). MIST was equivalent to DIST with regard to mean GCF volumes and the possible daytime volumetric alterations. Conclusions: In the limits of the present study, it can be suggested that daytime variations did not have significant impact on GCF volume. The sampling methodology had no apparent impact on the circadian periocidity of GCF.
    Journal of Periodontology 10/2013; · 2.40 Impact Factor
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    ABSTRACT: As National Dental Associations and dental faculties can be considered as the two major institutions representing national organised dentistry, their further extended collaboration is crucial in responding to the many global oral health matters and issues. The main aim of the present study is to analyse the nature and extent of the partnership between the dental faculties and NDAs. A questionnaire was developed focusing on the relationship between National Dental Associations and the dental faculties within the World Dental Federation-European Regional Organisation zone regarding their major professional activities such as dental education, workforce issues, improvement of national oral health, science and knowledge transfer. The questionnaire was sent to 173 dental faculties within the countries in the European Regional Organisation zone. Response rate was 62/173 (35.8%). Major activities of dental faculties were listed as implementation of new technologies into practice (72%), followed by improvement of national oral health (65%), while the least involved activity was dental workforce issues (42%). The dental faculties perceived their relationship with the National Dental Associations as quite satisfactory in the field of continuing education and science and knowledge transfer. However, their relationship was suggested to need significant improvement when dealing with undergraduate dental education curriculum, dental workforce issues and negotiations with the authorities regarding professional matters/issues. Despite the fact that there are differences between the perceived competences and responsibilities of the two bodies, the presence of so many potential areas of collaboration, the increasing expectations from the individual dentists/dental profession and the new challenges of the dental profession give this relationship significant importance. Communication, regular contacts, more joint activities and improved collaboration is needed between dental faculties and National Dental Associations to overcome such professional matters and issues.
    International Dental Journal 10/2013; 63(5):266-272. · 1.04 Impact Factor
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    ABSTRACT: Background & aim Workforce planning is a resource to measure and compare current versus future workforce. Organised dentistry needs to focus on the benefits and the determinants and various systems of workforce planning together with the challenges, new trends and threats. The aim of the study was to identify data sources from countries relating to a selection of oral health indicators in a sample of FDI member countries. The potential for differences between developed and developing countries was also examined. Methods A cross-sectional survey study was carried out among FDI member countries classified in developed and developing countries between October 2011 and January/February 2012. A questionnaire was developed addressing the availability of 40 selected indicators distributed in four domains. Mann–Whitney U-tests to identify differences between developed and developing countries and chi-square tests for the degree of information regularly available were carried out. Results There is an important lack of information about indicators relevant to oral health between FDI participating countries regardless of their level of economic development. Although not significant, the availability of indicators for developing countries showed higher variability and minimum values of zero for all domains. Surveys were the source of information more frequently reported. Discussion Standardised and reliable methodologies are needed to gather information for successful workforce planning. It is of utmost importance to increase the awareness and understanding of the member National Dental Associations regarding the role, basic elements, benefits, challenges, models and critical elements of an ideal workforce planning system.
    International Dental Journal. 01/2013; 63(6):298-305.
  • Nermin Yamalik, Bernardo Perea Pérez
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    ABSTRACT: Although concern for patient safety is inherent to the practice of the health care professions, its transformation into a specific body of knowledge is relatively recent and thus patient safety may be considered as a comparatively 'new' discipline. Its main objectives are to avoid the occurrence of preventable adverse events (accidents, errors and complications) associated with health care and to limit the impact of inevitable adverse events. Despite these simple definitions, patient safety is multifaceted, quite complex in nature and includes many key elements. Thus, it cannot be simply defined as the provision of safe health care or the protection of patients from harm by health care providers because there are economic, fiscal, social, cultural and organisational aspects of a patient safety climate. It is essential for all health care practitioners and health care organisations to become more familiar with the general context of patient safety, to actively participate in efforts to implement patient safety measures in daily practice and to establish a patient safety culture.
    International Dental Journal 08/2012; 62(4):189-96. · 1.04 Impact Factor
  • Sezen B Askin, Guliz N Guncu, Nermin Yamalik
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    ABSTRACT: "Gingival Wetness (GW)," which is the thickness of residual saliva on gingiva, functions as a moisture retainer and a protective barrier for microbial colonization. Whether dental implant (DI) treatment affects GW scores and whether gingival inflammation has the capacity to alter GW remains unknown. Thus, this study was designed to evaluate the potential impact of DI treatment on GW. A total of 118 DIs and natural teeth (NT) sites were comparatively analyzed. Clinical periodontal and periimplant status were determined. Sites were classified into 2 subgroups based on the clinical inflammatory status as inflamed or noninflamed. GW was measured by standardized paper strips and quantified by micromoisture meter. Gingival index, clinical attachment loss, plaque index, and gingival bleeding time index scores were generally lower at DI sites. Significant differences were seen in clinical attachment loss, plaque index, and gingival bleeding time index in inflamed sites, presenting higher scores for NT. Comparable values were observed for DI and NT regarding GW for all sites. No differences were noticed in GW scores between the noninflamed NT and DI sites and also wheninflamed sites were concerned. DI treatment does not seem to result in any apparent reduction in GW. Thus, it can be speculated that similar protective processes may occur at dental implant and NT sites. Furthermore, GW does not seem to depend on the local inflammatory status of the soft tissues.
    Implant dentistry 12/2011; 21(1):57-61. · 1.51 Impact Factor
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    ABSTRACT: Although improvements in certain oral health measures have been achieved, many global oral health matters and challenges exist. Collaborations and partnerships among various institutions are crucial in solving such problems. The main aim of the present study was to analyse the nature and extent of the partnership between dental faculties and National Dental Associations (NDAs). A questionnaire was developed, focusing on the relationship between NDAs and dental faculties within the World Dental Federation-European Regional Organization (FDI-ERO) zone with regard to major professional activities, such as dental education (both undergraduate and continuing education), workforce issues, improvement of national oral health, and science and knowledge transfer. The questionnaire was sent to all member NDAs within the ERO zone. The response rate was 21/41 (53.65%). The major activities in which NDAs were found to be involved were improvement of national oral health (100%), followed by continuing education activities (90%), whereas the activity which received least involvement was the development of an undergraduate dental curriculum (52%). The NDAs perceived their relationship with dental faculties to be quite satisfactory in the fields of continuing education, science and knowledge transfer, and the implementation of new technologies into daily dental practice. However, it was suggested that their relationship needed significant improvement with regard to the development of an undergraduate dental education curriculum, dental workforce issues and negotiations with the authorities regarding professional matters/issues. As the two important elements of organised dentistry, NDAs and dental faculties have a significant role to play in the improvement of oral health and in finding solutions to global oral health challenges; therefore, their collaboration and partnership are crucial for this purpose. On the basis of the perceptions of NDAs regarding their relationship with dental faculties, it can be concluded that their partnership can and should be further improved.
    International Dental Journal 12/2011; 61(6):307-13. · 1.04 Impact Factor
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    ABSTRACT: Cathepsin-K is an enzyme involved in bone metabolism which may make this feature important for both natural teeth and dental implants. The aims of the present study are to comparatively analyze the gingival crevicular fluid (GCF)/peri-implant sulcus fluid (PISF) cathepsin-K levels of natural teeth and dental implants, and to assess the potential relationship between this biochemical parameter and alveolar bone loss around natural teeth and dental implants. Probing depth, bleeding on probing, gingival index, and plaque index clinical parameters were assessed, and GCF/PISF samples were obtained from natural teeth/dental implants presenting with either clinical health, gingivitis/peri-implant mucositis, or chronic periodontitis/peri-implantitis. Cathepsin-K activity levels of 42 GCF samples and 54 PISF samples were determined, and marginal bone loss (MBL) measures were calculated from digitalized standardized intraoral periapical radiographs obtained from natural teeth and dental implants by using cemento-enamel junction and the actual distance between two consecutive threads of the dental implant as reference points for natural teeth and dental implants, respectively. Comparing the natural teeth group with dental implant group with regard to MBL measure, cathepsin-K activity, and GCF/PISF volume revealed no significant differences. In both natural teeth and dental implant groups, despite higher MBL measures, cathepsin-K activity, and GCF/PISF volumes with the presence of inflammation, it was the presence of alveolar bone loss that lead to significantly higher values for these parameters. We suggest cathepsin-K as a biochemical parameter for monitoring periodontal/peri-implant alveolar bone loss.
    Journal of Periodontology 08/2011; 83(4):498-505. · 2.40 Impact Factor
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    ABSTRACT: Cathepsin-K is an enzyme involved in bone metabolism. This feature may make it important both for natural teeth and dental implants. The aims of the present study were to comparatively analyze cathepsin-K levels in gingival crevicular fluid (GCF) and peri-implant sulcus fluid (PISF) and to determine whether GCF and PISF cathepsin-K profiles reflect the clinical periodontal/peri-implant status. Clinical parameters (probing depth, Gingival Index, Plaque Index, and bleeding on probing) were recorded, and GCF/PISF samples were obtained from natural teeth (group T) and dental implants (group I), which were divided into groups based on health (clinically healthy, gingivitis/peri-implant mucositis, and periodontitis/peri-implantitis). Cathepsin-K activity was determined with a commercially available cathepsin-K activity assay kit (BioVision). Sixty natural teeth and 68 dental implants were examined. Teeth with periodontitis (group T-3) showed significantly higher total cathepsin-K activity (10.39 units) than teeth with gingivitis (group T-2, 1.71 units) and healthy teeth (group T-1, 1.90 units). The difference in cathepsin-K activity between groups T-2 and T-1 was not significant. Implants with peri-implantitis (group I-3) had higher total enzyme activity (10.26 units) than healthy implants (group I-1) (3.44 units). Although the difference between clinical parameters was not significant, group I-3 had higher cathepsin-K levels than group I-2 (4.74 units). When natural teeth (T-1, T-2, T-3) were compared to implants (I-1, I-2, I-3), no significant differences were observed for cathepsin-K levels. More cathepsin-K activity was clearly observed with inflammatory periodontal and peri-implant destruction. The highest cathepsin-K levels detected in GCF and PISF samples, obtained from sites with periodontitis and peri-implantitis, suggests the potential involvement of cathespin-K in increased bone metabolism around natural teeth and dental implants.
    The International journal of oral & maxillofacial implants 01/2011; 26(5):991-7. · 1.91 Impact Factor
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    ABSTRACT: Objective: Better understanding of the biodynamics of peri-implant sulcular fluid (PISF) may be an important concern both from a clinical perspective and research standing point. As peri-implant sulcular fluid volume is known to be effected by an array of factors, the aim of the present study was to analyze the potential impact of various peri-implant site-related and dental implant-related factors on PISF volume. Methods: PISF was obtained from a total of 128 implant sites and electronic volume quantification was performed by use of Periotron 8000. These sites were divided into different subgroups based on the presence/ severity of peri-implant inflammation, probing depths (PD), implant features (diameter and length), location of implant (maxilla or mandible) and surgical preference (one-stage or two-stage surgery). Differences between these subgroups were statistically analyzed. Results: PISF volume was higher at sites with peri-implant mucositis (0,190 l) and peri-implantitis (0,213 l) than clinically healthy sites (0,096 l). Although peri-implantitis group had the highest volumetric value, difference between peri-implantitis and mucositis groups was not significant (p= 0,629). Higher PD also lead to higher PISF volume. Despite the fact that higher PISF volume was detected at implant sites with one-stage surgery (0,198 l) compared to two-stage surgery (0,147 l), in mandible (0,166 l) compared to maxilla (0,149 l), in wide implants (0,167 l) compared to narrow ones (0,145 l), in long and medium implants compared to short ones, the difference was not significant (p>0,05). Conclusion: Findings of the present study suggest inflammatory peri-implant condition is the main factor that have an influence on PISF volume, while some other factors seemed to have less or limited impact. For reliable PISF analysis, all factors with the potential to influence the actual PISF volume at a distinct PISF sampling site are likely to need a particular corcern
    IADR General Session 2010; 07/2010
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    ABSTRACT: In order to identify what knowledge dental patients have of oral health and to analyze the potential relationship between knowledge, behavior and oral health status, 250 randomly selected patients were asked to complete a self-administered questionnaire. Responses were analyzed based on the age, gender and educational status of participants. It was determined that oral health-related behavior and knowledge were generally inadequate. Although knowledge had some influence on behavior, this was not constantly observed. The unmet need of patients with regard to getting information from professional resources emphasizes the need for dental professionals to dedicate more time to prevention and the promotion of oral health through efficient strategies.
    The New York state dental journal 04/2010; 76(3):16-21.
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    ABSTRACT: Objectives: Pro-inflammatory cytokines induce the inflammatory response leading to destruction of connective tissue and osteoclastic bone resorption. The balance between bone resorption by osteoclasts and bone formation by osteblasts regulated by RANKL and its decoy receptor, OPG, which both are essential molecules for differentiation of osteoclasts supported by osteoblasts. The aim of this study was to determine the levels of OPG, RANKL, IL-10 and IL-1 in GCF in untreated and treated chronic periodontitis patients. Methods: GCF was obtained both from chronic periodontitis (n=14) patients before and after periodontal therapy and from healthy subjects (n=14). OPG, RANKL, IL-10 and IL-1 levels in GCF were evaluated by ELISA. Results: OPG and IL-10 levels were higher in healthy subjects when compared to chronic periodontitis patients and IL-1 and RANKL levels were significantly higher in untreated chronic periodontitis group. IL 10: IL-1 and OPG:RANKL ratios were significantly higher in treated chronic periodontitis patients when compared to untreated group. Conclusions: These data indicates that the lower IL 10: IL-1 and OPG:RANKL ratios in chronic periodontitis may be one of the factors contributing to the persistence of chronic inflammation. Therefore, the inhibition of RANKL by OPG may represent an important therapeutic strategy for the prevention and treatment of periodontal disease.
    AADR Annual Meeting 2010; 03/2010
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    ABSTRACT: Objectives: As saliva and gingival crevicular fluid (GCF) both contribute to gingival defense, gingival wetness (residual saliva thickness) and GCF volume in patients with dry mouth (DM) may be of particular interest. Thus, the main objective was to assess gingival/mucosal wetness and GCF volume along with the major saliva-related measures in patients with and without DM complaints. Methods: Subjective complaints of DM and clinical periodontal status were determined in fourteen patients with Sjgren's syndrome (SS) and fourteen healthy subjects (HS). Unstimulated whole salivary flow rate, wetness of the 11 selected oral mucosal sites (including 5 gingival sites) and the minor salivary gland secretion rates (2 surfaces) were determined. Gingival/mucosal wetness and GCF volume were quantified with Periotron 8000 micro-moisture meter. Results: SS patients had significantly lower unstimulated whole saliva flow rate (0.31 0.11ml/min) than HS (0.42 0.08 ml/min) (p=0.004). Thirteen of 14 SS patients had also symptoms of lip dryness. Although lower mucosal wetness values were observed in SS patients, difference was significant at lower labial mucosa (p=0.001). Minor salivary gland secretions, gingival wetness, GCF volume, and periodontal parameters were comparable for SS patients and HS (p>0.05). HS presented with significant correlations between labial minor gland saliva secretion rate; and labial/buccal gingival wetness values of the lower teeth. When the bleeding and probing depth values were controlled, a significant positive relationship was also observed between GCF volume from the mandibular anterior area and the mucosal wetness values on lower labial mucosa. Conclusions: While lower labial mucosal wetting seems to be insufficient in patients with complaints for DM, gingival moisture seems to be acceptably maintained. A link between minor salivary gland secretions and gingival/mucosal wetness may exist in healthy individuals. Not all saliva-related measures seem to be interrelated and wide distribution range of most saliva-related measures needs particular concern.
    IADR General Session 2009; 04/2009
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    ABSTRACT: During bone remodeling, alignment of bone is affected by loading direction. Considerable amount of data also suggest nitric oxide (NO) to be involved in bone metabolism. This study was conducted to evaluate the potential changes in NO metabolism in relation to the loading style of dental implants by analyzing the nitrite content of peri-implant sulcus fluid. Dental implants were placed in 12 patients who had first molar loss bilaterally in the mandibular area. One site of the patient determined as immediately loaded and the other side were conventionally loaded. Clinical parameters were recorded and peri-implant sulcus fluid samples were obtained. Peri-implant sulcus fluid nitrite levels were spectrophoto-metrically determined. Clinical measurements and nitrite analysis were repeated at 1, 3, 6, 9, and 12 months. In both groups, there was a reduction between baseline and 12 months in all clinical parameters, except probing depth. Although, steady decrease was noticed in total nitrite levels during the whole experimental period in immediately loaded implants, more fluctuations were observed in conventionally loaded ones. The findings of this 12-month follow-up study support the association of NO in the bone metabolism around dental implants and further suggest the impact of different loading regimens on NO metabolism.
    Implant dentistry 04/2009; 18(1):27-37. · 1.51 Impact Factor
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    ABSTRACT: For monitoring of dental implants, practitioners seem to use simultaneously a variety of image-based and laboratory measurements. This longitudinal study was conducted to analyse the possible relationships between nitric oxide (NO) content of peri-implant sulcus fluid (PISF), marginal bone levels and implant stability in terms of resonance frequency analysis (RFA) at immediately (IL) and conventionally (CL) loaded mandibular molar dental implants from the same individuals. Dental implants were placed in 10 patients who had first molar loss bilaterally in the mandibular area. One site of the patient was determined as IL and the other site was CL. PISF samples, marginal bone level and RFA were taken for all dental implants during a 12-month follow-up period. For both types of loading, there were no significant changes at implant stability (ISQ) and PISF volume during the whole study period. The lowest total nitrite levels were observed at the end of 12 months. Marginal bone gain of 0.22 and 0.09 mm was noticed between 6 and 12 months in IL and CL groups, respectively. During the study period, negative correlation was noted between radiographic bone level and ISQ at both IL and CL sites; however, this correlation reached a significant level only at 6 months in CL implant group (P = 0.015). Although not significant, marginal bone loss seems to have a negative relationship with the implant stability values regardless of the mode of loading. NO metabolism around IL and CL dental implants may not demonstrate a significantly different pattern.
    Journal of Oral Rehabilitation 05/2008; 35(10):745-53. · 2.34 Impact Factor
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    ABSTRACT: Background: As well as gingival crevicular fluid (GCF), peri-implant sulcus fluid (PISF) may have a potential diagnostic value for the early identification of metabolic and destructive processes.Purpose: The aim of this study was to analyze the potential impact of inflammation and loading on PISF myeloperoxidase (MPO) levels, in comparison with GCF.Materials and Methods: A total of 220 sites, dental implant (immediately [IL] or delayed loaded [DL]), and natural tooth, either healthy/noninflamed or gingivitis/inflamed, were classified. Clinical parameters were recorded, and GCF/PISF samples were obtained. GCF/PISF MPO levels were spectrophotometrically determined.Results: Clinical parameters demonstrated increases with the presence of gingival/peri-implant inflammation. Total MPO levels were higher at inflamed tooth and implant sites compared to noninflamed/healthy sites (p < .05). Although they did not reach a significance level, inflamed IL sites had higher total MPO levels than inflamed DL sites (p = .401). Gingival index and total MPO levels exhibited significant correlations (p < .05).Conclusion: Using implants and natural teeth in the same study design, the findings of the present study support the close relationship between MPO production and inflammation, and may speculate a potential for loading of dental implants, contributing to the MPO content of PISF.
    Clinical Implant Dentistry and Related Research 02/2008; 10(1):30 - 39. · 3.82 Impact Factor
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    ABSTRACT: Better clarification of the long-term relationship among the various implant-related measures could improve the evaluation process for dental implants. Thus, the aim of the present study was to determine the potential correlations among the volumetric features and nitric oxide content of peri-implant sulcus fluid (PISF) and measures of implant stability, and the marginal bone loss. Completely edentulous patients (n=15) treated with dental implants and ball attachment mandibular over dentures were included. Resonance frequency analysis (RFA), marginal bone level measurements, PISF volume and spectrophotometrically determined nitrite levels were recorded for all dental implant sites. Measures for early (n=16) and delayed (n=14) loaded dental implants were comparatively analysed for a period of 18 months. Some random correlations between PISF volume and marginal bone level, PISF nitrite level and marginal bone level and PISF volume and PISF nitrite content, and RFA and PISF volume were observed. However, the only constant correlation was noticed between implant stability (RFA scores) and marginal bone level. This correlation was negative and significant for all dental implants and for delayed loaded implants (P<0.05). The pattern of loading seemed to affect the extent, but not the pattern of this relationship. While some of the implant-related measures may be strongly associated (e.g. dental implant stability and marginal bone level), not all measures from a single implant site are likely to be related. Such associations may be under the influence of a variety of factors including the loading protocol of dental implants.
    Journal of Oral Rehabilitation 02/2008; 35(2):95-104. · 2.34 Impact Factor