Tolga Tozum - Academia.edu (original) (raw)

Papers by Tolga Tozum

Research paper thumbnail of Inpatient Evaluation of Periodontal, Esthetic and Inflammatory Parameters around Dental Implants and Natural Teeth

The Journal of Contemporary Dental Practice, 2013

Research paper thumbnail of Tetraploid/Diploid Mosaicism With Generalized Aggressive Periodontitis

Journal of Periodontology, 2005

Research paper thumbnail of ABM/P-15 modulates proliferation and mRNA synthesis of growth factors of periodontal ligament cells

Acta Odontologica Scandinavica, 2009

Periodontal regeneration is histologically defined as regeneration of the tooth supporting struct... more Periodontal regeneration is histologically defined as regeneration of the tooth supporting structures, including alveolar bone, periodontal ligament, and cementum. Cells in the remaining periodontal tissues need optimal conditions if they are to perform their functions in the regeneration process. The present study is an investigation of the molecular effects of ABM/P-15 on human periodontal ligament cells (PDL) in vitro. PDL cells obtained from healthy subjects were used for in vitro experiments. Cell proliferation, morphology, and mineralization using Von kossa staining were evaluated. mRNA expressions for transforming growth factor-beta (TGF-beta), insulin-like growth factor-I (IGF-I), basic fibroblast growth factor (b-FGF), vascular endothelial growth factor (VEGF), bone morphogenic protein-2 (BMP-2), platelet-derived growth factor (PDGF), and type 1 collagen (COL1) were assessed on days 3 and 7 using RT-PCR. ABM/P-15 enhanced proliferation of cultured PDL cells. It increased the mRNA expression of TGF-beta and BMP-2 in cultured PDL cells on days 3 and 7. IGF-I and b-FGF mRNA expressions showed a slight decrease, while PDGF expression was observed to have increased on day 3. VEGF and COL1 mRNA expressions were found not to be different on days 3 and 7. No differences were observed in the mineralization properties of cultured PDL cells treated with or without ABM/P-15. Based on the results of this in vitro study, it may be concluded that ABM/P-15 enhanced the regenerative capacity of PDL by regulating specific gene expressions of cells during early wound healing.

Research paper thumbnail of The Impact of Prosthetic Design on the Stability, Marginal Bone Loss, Peri-Implant Sulcus Fluid Volume, and Nitric Oxide Metabolism of Conventionally Loaded Endosseous Dental Implants: A 12Month Clinical Study

Journal of Periodontology, 2008

Research paper thumbnail of Transgenic Models of Metabolic Bone Disease: Impact of Estrogen Receptor Deficiency on Skeletal Metabolism

Connective Tissue Research, 2003

Research paper thumbnail of Estrogen Receptors in Skeletal Metabolism: Lessons from Genetically Modified Models of Receptor Function

Critical Reviews in Eukaryotic Gene Expression, 2002

Research paper thumbnail of Diagnosis and treatment of a large periapical implant lesion associated with adjacent natural tooth: A case report

Research paper thumbnail of Diagnosis and treatment of a large periapical implant lesion associated with adjacent natural tooth: A case report

Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology, 2006

Research paper thumbnail of Vertical and horizontal dimensional evaluation of free gingival grafts in the anterior mandible: a case report series

Clinical Oral Investigations, 2007

The shrinkage of free gingival grafts (FGGs) is a well-known clinical phenomenon but there are li... more The shrinkage of free gingival grafts (FGGs) is a well-known clinical phenomenon but there are limited studies demonstrating the dimensional changes during healing in FGGs. The aim of the study is to examine the shrinkage of FGG in both horizontal and vertical dimensions and calculate the changes in the surface area of the graft at early and delayed periods of healing. The FGG procedure was applied to 15 consecutive patients in their mandibular anterior area. The graft sizes and areas were measured and the shrinkage of the graft was calculated at baseline and days 10, 21 and 180. Hemorrhage, sense alteration and pain symptoms were also examined. Change in the horizontal direction was not statistically significant during the whole study period (p > 0.05). However, there was a statistically significant reduction in the vertical direction in all visits, except day 10 (p p

Research paper thumbnail of Effects of Sex Steroid Receptor Specificity in the Regulation of Skeletal Metabolism

Calcified Tissue International, 2004

The interaction between estrogens and androgens, with their protective effects in bone, and parat... more The interaction between estrogens and androgens, with their protective effects in bone, and parathyroid hormone (PTH), a calcitropic peptide hormone, is complex but may be better understood with murine models. The purpose of this study was to characterize skeletal phenotypes of mice deficient in estrogen receptor alpha (ERα), androgen receptor (AR, mutant tfm), or both, and determine if ERα and AR alter osteoblast differentiation and/or PTH response in vitro. Loss of ERα resulted in increased long bone length in females, but reduced length in males, suggesting loss of ERα reversed sex steroid-dependent skeletal dimorphism. The AR deficient tfm mice (genetically male but phenotypically female) had the longest bones and, similar to males, lengths were reduced with loss of ERα. Loss of AR and/or ERα resulted in a reduction in femoral bone mineral density (BMD) compared to male wildtype (WT) mice, suggesting tfm mice follow the female sex for BMD. In males or tfm mice, but not females, loss of AR and/or ERα caused a reduction in cortical width of the tibia compared to male WT mice. Reduced trabecular bone was found in tibiae of female and tfm mice versus male littermates, suggesting that tfm mice follow the female sex for trabecular bone but loss of ERα did not alter trabecular bone levels. Primary calvarial osteoblasts of male WT mice were less responsive to PTH stimulation of cAMP than all other genotypes, suggesting the female chromosomal sex and/or loss of ERα or AR results in increased sensitivity to PTH. In conclusion, tfm mice follow the male pattern of long bone development, but imitate females in bone density and trabecular bone. Loss of ERα and/or AR results in increased osteoblast sensitivity to PTH and may explain actions of PTH noted in hypogonadal humans.

Research paper thumbnail of Effects of endogenous sex hormones on the periodontium — Review of literature

Australian Dental Journal, 2005

Research paper thumbnail of Biomechanical Aspects of Primary Implant Stability: A Human Cadaver Study

Clinical Implant Dentistry and Related Research, 2009

Background: The quality of bone is an important factor in the successful implant treatment, and i... more Background: The quality of bone is an important factor in the successful implant treatment, and it is evident that higher implant failure is more likely in poor quality of bone. The primary stability of oral implants related to resistance to micromotion during healing is influenced by bone quality, surgical technique, and implant design.Purposes: The aims of this biomechanical study were to explore the effect of bone quality on initial intraosseous stability of implants, and to determine the correlations between the bone quality and implant stability parameters.Materials and Methods: Twenty-four implants (Neoss Ltd., Mölnlycke, Sweden) were placed into anterior and posterior regions of three human cadaver mandibles. The bone densities of implant recipient sites were preoperatively determined using computerized tomography (CT) in Hounsfield unit (HU). The maximum insertion torque values were recorded, and primary implant stability measurements were noninvasively performed by means of resonance frequency analysis (RFA).Results: The bone density values ranged from −267 HU to 553 HU. It was found that mean bone density, insertion torque, and RFA values were 113 ± 270 HU, 41.9 ± 5 Ncm, and 70 ± 7 implant stability quotient (ISQ), respectively. Statistically significant correlations were found between bone density and insertion torque values (r = 0.690, p < .001); bone density and ISQ values (r = 0.557, p < .05); and insertion torque and ISQ values (r = 0.853, p < .001).Conclusion: CT is a useful tool to assess bone quantity and quality in implant recipient sites, and bone density has a prevailing effect on implant stability at placement.

Research paper thumbnail of Assessment of correlation between computerized tomography values of the bone, and maximum torque and resonance frequency values at dental implant placement

Journal of Oral Rehabilitation, 2006

summary The aim of this study was to determine the bone density in the designated implant sites ... more summary The aim of this study was to determine the bone density in the designated implant sites using computerized tomography (CT), the fastening torque values of dental implants, and the implant stability values using resonance frequency analysis. Further aim was to evaluate a possible correlation between bone density, fastening torque and implant stability. Eighty-five patients were treated with 158 Brånemark System implants. CT machine was used for preoperative evaluation of the jawbone for each patient, and bone densities were recorded in Hounsfield units (HU). The fastening torque values of all implants were recorded with the OsseoCare equipment. Implant stability measurements were performed with the Osstell machine. The average bone density and fastening torque values were 751·4 ± 256 HU and 39·7 ± 7 Ncm for 158 implants. The average primary implant stability was 73·2 ± 6 ISQ for seventy implants. Strong correlations were observed between the bone density, fastening torque and implant stability values of Brånemark System TiUnite MKIII implants at implant placement (P < 0·001). These results strengthen the hypothesis that it may be possible to predict and quantify initial implant stability and bone quality from pre-surgical CT diagnosis.

Research paper thumbnail of The Impact of Primary Hyperparathyroidism on the Oral Cavity

Primary hyperparathyroidism (HPT) is a systemic disease causing bone loss. Periodontal disease is... more Primary hyperparathyroidism (HPT) is a systemic disease causing bone loss. Periodontal disease is a local inflammatory disease characterized by alveolar bone loss. The older literature records that HPT is associated with loss of radicular lamina dura and brown tumors of the bone, but contemporary studies are lacking. The objective of the study was to determine the effects of HPT on oral bony structures and periodontal disease in a contemporary population. This was a cross-sectional, case-controlled study. The study was conducted at the clinics of endocrine surgery and hospital dentistry. Fifty-nine patients, 39 with HPT and 20 thyroid controls, were included in the study. Periodontal clinical measures and dental radiographic analyses were used in this study. HPT patients were more likely to have tori and reductions in radicular lamina dura on dental radiographs. Widening of the periodontal ligament space surrounding teeth correlated with serum PTH levels. Panoramic radiographs demonstrated reduced cortical bone thickness at the angle of the mandible in HPT patients but no evidence of brown tumors or other overt pathologies. Changes in the oral cavity observed in patients with HPT suggested both decreased cortical density and increased likelihood of oral tori. The contemporary oral manifestations of primary HPT are different from those previously reported, and health care providers should be aware of newer, more subtle findings that may be present when treating patients with HPT.

Research paper thumbnail of Possible impact of inflammatory status on C-telopeptide pyridinoline cross-links of Type I collagen and osteocalcin levels around oral implants with peri-implantitis: a controlled clinical trial

Journal of Oral Rehabilitation, 2008

Summary Detection of progression level of peri-implantitis may help in the prevention of oral im... more Summary Detection of progression level of peri-implantitis may help in the prevention of oral implant failure. C-telopeptide pyridinoline crosslinks of Type I collagen (ICTP) and osteocalcin (OC) are specific markers of bone turnover and bone degradation. Determination of the ICTP and OC levels in the peri-implant sulcus fluid (PISF) may predict the metabolic and/or inflammatory changes in the peri-implant bone. The aim of this clinical study was to evaluate ICTP and OC levels in the PISF for oral implants with and without peri-implant bone destruction and correlate these levels with the traditional clinical peri-implant parameters (probing depth, plaque index, gingival index and gingival bleeding time index) and radiographic bone level measurements. Fifteen patients with 30 peri-implant sites with bone destruction (radiographic bone loss) and health were included. Clinical parameters were measured and PISF was collected from the sites. Peri-implant sulcus fluid ICTP and OC levels were detected by radioimmunoassay technique from PISF samples. All clinical parameters demonstrated a significant increase in peri-implantitis sites compared with healthy sites. The PISF volume of the peri-implantitis sites was also significantly higher than of the healthy peri-implant sites. Although not statistically significant, a trend of increase was demonstrated in ICTP PISF samples sampled from peri-implantitis sites compared with healthy sites. A significant increase was noticed for OC PISF level in peri-implantitis sites compared with healthy ones. As well as peri-implant clinical measurements, volumetric changes at PISF may be counted as an important clinical parameter to distinguish the bone destruction sites from healthy sites around oral implants.

Research paper thumbnail of Analysis of the Potential Association of Implant Stability, Laboratory, and Image-Based Measures Used to Assess Osteotomy Sites: Early Versus Delayed Loading

Journal of Periodontology, 2007

During the assessments made at presurgical, surgical, and follow-up phases, the clinician may ben... more During the assessments made at presurgical, surgical, and follow-up phases, the clinician may benefit from a wide array of clinical and/or image-based measures. Because analysis of the potential associations among the various measures could improve the evaluation process for dental implants, this study attempted to determine the potential correlations among peri-implant sulcus fluid (PISF) volume, implant stability, nitric oxide content of PISF, and marginal bone loss. Seventeen completely edentulous patients seeking prosthetic rehabilitation were included. Two ball attachment mandibular overdentures were given to all patients, and early- (N = 18) and delayed-loaded (N = 16) dental implants were compared during 24-weeks of follow-up. Resonance frequency analysis (RFA), marginal bone level, and PISF samples were taken for all dental implants. A consistent and negative correlation was observed between RFA measurements and marginal bone level, whereas some correlations also existed between RFA and PISF volume. The pattern of loading seemed to affect the relationship between RFA measurements and marginal bone level and, to a limited extent, the association between PISF volume and nitrite levels. Where the potential associations among various implant-related measures are concerned, the factors that may affect such associations (e.g., healing and loading) need to be considered. Data arising from the analysis of the associations between the wide arrays of available implant-related measures may improve dental practitioners&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; assessment concerning endosseous dental implants.

Research paper thumbnail of Low-Level Laser Therapy in the Treatment of Mucous Membrane Pemphigoid: A Promising Procedure

Journal of Periodontology, 2010

Research paper thumbnail of Localized edentulous ridge augmentation with upside down osteotomy prior to implant placement

Dental Traumatology, 2004

Research paper thumbnail of Analysis of the possibility of the relationship between various implant-related measures: an 18-month follow-up study: IMPLANT-RELATED MEASURES AND LONG-TERM EVALUATION

Journal of Oral Rehabilitation, 2008

Summary Better clarification of the long-term relationship among the various implant-related mea... more Summary 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.

Research paper thumbnail of Relationship between dental implant stability determined by resonance frequency analysis measurements and peri-implant vertical defects: an in vitro study

Journal of Oral Rehabilitation, 2008

Summary Resonance frequency (RF) analysis is a non-invasive and objective technique developed fo... more Summary Resonance frequency (RF) analysis is a non-invasive and objective technique developed for implantology, where it measures the stability of the implant in the bone socket. A limited number of studies were performed to compare different stability measurement devices. The aim of the study was to evaluate the association between the implant stability and peri-implant vertical defect by using the new wireless RF analyser. Micro-textured rough-surfaced implants with diameters of 3·7 and 4·8 mm and with a length of 12 mm were used. The peak insertion torque was recorded with the help of the torque control system only during the implant placement. The peri-implant defects were created in millimetre increments ranging between 0 and 5 mm to the same extent on all implants. The RF analysis values were measured by using the RF analyser. Significant correlation was found between insertion torque (44·3 ± 3 N cm) and implant stability quotient (ISQ) (all implants: r = 0·76, 3·7 mm diameter: r = 0·65, 4·8 mm diameter: r = 0·80). For 3·7 × 12-mm2 implants, the mean ISQ values were 72·6 ± 2·4, 69·8 ± 2, 67·2 ± 1·8, 64·3 ± 1·9, 61·2 ± 2 and 57·2 ± 2·5 when peri-implant vertical defects were 0, 1, 2, 3, 4 and 5 mm; and the corresponding values were 76·5 ± 2·2, 74·5 ± 2·2, 72·3 ± 2, 70 ± 1·9, 67 ± 1·9 and 63·4 ± 2·3, respectively, for 4·8 × 12-mm2 implants. All values were significantly different when compared with each other. The wireless RF analyser seems to be a suitable and reliable device to determine the implant stability. Peri-implant bone loss simulated by using acrylic models may result with a decrease in ISQ values for osseo-integrated implants measured by the RF analyser.

Research paper thumbnail of Inpatient Evaluation of Periodontal, Esthetic and Inflammatory Parameters around Dental Implants and Natural Teeth

The Journal of Contemporary Dental Practice, 2013

Research paper thumbnail of Tetraploid/Diploid Mosaicism With Generalized Aggressive Periodontitis

Journal of Periodontology, 2005

Research paper thumbnail of ABM/P-15 modulates proliferation and mRNA synthesis of growth factors of periodontal ligament cells

Acta Odontologica Scandinavica, 2009

Periodontal regeneration is histologically defined as regeneration of the tooth supporting struct... more Periodontal regeneration is histologically defined as regeneration of the tooth supporting structures, including alveolar bone, periodontal ligament, and cementum. Cells in the remaining periodontal tissues need optimal conditions if they are to perform their functions in the regeneration process. The present study is an investigation of the molecular effects of ABM/P-15 on human periodontal ligament cells (PDL) in vitro. PDL cells obtained from healthy subjects were used for in vitro experiments. Cell proliferation, morphology, and mineralization using Von kossa staining were evaluated. mRNA expressions for transforming growth factor-beta (TGF-beta), insulin-like growth factor-I (IGF-I), basic fibroblast growth factor (b-FGF), vascular endothelial growth factor (VEGF), bone morphogenic protein-2 (BMP-2), platelet-derived growth factor (PDGF), and type 1 collagen (COL1) were assessed on days 3 and 7 using RT-PCR. ABM/P-15 enhanced proliferation of cultured PDL cells. It increased the mRNA expression of TGF-beta and BMP-2 in cultured PDL cells on days 3 and 7. IGF-I and b-FGF mRNA expressions showed a slight decrease, while PDGF expression was observed to have increased on day 3. VEGF and COL1 mRNA expressions were found not to be different on days 3 and 7. No differences were observed in the mineralization properties of cultured PDL cells treated with or without ABM/P-15. Based on the results of this in vitro study, it may be concluded that ABM/P-15 enhanced the regenerative capacity of PDL by regulating specific gene expressions of cells during early wound healing.

Research paper thumbnail of The Impact of Prosthetic Design on the Stability, Marginal Bone Loss, Peri-Implant Sulcus Fluid Volume, and Nitric Oxide Metabolism of Conventionally Loaded Endosseous Dental Implants: A 12Month Clinical Study

Journal of Periodontology, 2008

Research paper thumbnail of Transgenic Models of Metabolic Bone Disease: Impact of Estrogen Receptor Deficiency on Skeletal Metabolism

Connective Tissue Research, 2003

Research paper thumbnail of Estrogen Receptors in Skeletal Metabolism: Lessons from Genetically Modified Models of Receptor Function

Critical Reviews in Eukaryotic Gene Expression, 2002

Research paper thumbnail of Diagnosis and treatment of a large periapical implant lesion associated with adjacent natural tooth: A case report

Research paper thumbnail of Diagnosis and treatment of a large periapical implant lesion associated with adjacent natural tooth: A case report

Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology, 2006

Research paper thumbnail of Vertical and horizontal dimensional evaluation of free gingival grafts in the anterior mandible: a case report series

Clinical Oral Investigations, 2007

The shrinkage of free gingival grafts (FGGs) is a well-known clinical phenomenon but there are li... more The shrinkage of free gingival grafts (FGGs) is a well-known clinical phenomenon but there are limited studies demonstrating the dimensional changes during healing in FGGs. The aim of the study is to examine the shrinkage of FGG in both horizontal and vertical dimensions and calculate the changes in the surface area of the graft at early and delayed periods of healing. The FGG procedure was applied to 15 consecutive patients in their mandibular anterior area. The graft sizes and areas were measured and the shrinkage of the graft was calculated at baseline and days 10, 21 and 180. Hemorrhage, sense alteration and pain symptoms were also examined. Change in the horizontal direction was not statistically significant during the whole study period (p > 0.05). However, there was a statistically significant reduction in the vertical direction in all visits, except day 10 (p p

Research paper thumbnail of Effects of Sex Steroid Receptor Specificity in the Regulation of Skeletal Metabolism

Calcified Tissue International, 2004

The interaction between estrogens and androgens, with their protective effects in bone, and parat... more The interaction between estrogens and androgens, with their protective effects in bone, and parathyroid hormone (PTH), a calcitropic peptide hormone, is complex but may be better understood with murine models. The purpose of this study was to characterize skeletal phenotypes of mice deficient in estrogen receptor alpha (ERα), androgen receptor (AR, mutant tfm), or both, and determine if ERα and AR alter osteoblast differentiation and/or PTH response in vitro. Loss of ERα resulted in increased long bone length in females, but reduced length in males, suggesting loss of ERα reversed sex steroid-dependent skeletal dimorphism. The AR deficient tfm mice (genetically male but phenotypically female) had the longest bones and, similar to males, lengths were reduced with loss of ERα. Loss of AR and/or ERα resulted in a reduction in femoral bone mineral density (BMD) compared to male wildtype (WT) mice, suggesting tfm mice follow the female sex for BMD. In males or tfm mice, but not females, loss of AR and/or ERα caused a reduction in cortical width of the tibia compared to male WT mice. Reduced trabecular bone was found in tibiae of female and tfm mice versus male littermates, suggesting that tfm mice follow the female sex for trabecular bone but loss of ERα did not alter trabecular bone levels. Primary calvarial osteoblasts of male WT mice were less responsive to PTH stimulation of cAMP than all other genotypes, suggesting the female chromosomal sex and/or loss of ERα or AR results in increased sensitivity to PTH. In conclusion, tfm mice follow the male pattern of long bone development, but imitate females in bone density and trabecular bone. Loss of ERα and/or AR results in increased osteoblast sensitivity to PTH and may explain actions of PTH noted in hypogonadal humans.

Research paper thumbnail of Effects of endogenous sex hormones on the periodontium — Review of literature

Australian Dental Journal, 2005

Research paper thumbnail of Biomechanical Aspects of Primary Implant Stability: A Human Cadaver Study

Clinical Implant Dentistry and Related Research, 2009

Background: The quality of bone is an important factor in the successful implant treatment, and i... more Background: The quality of bone is an important factor in the successful implant treatment, and it is evident that higher implant failure is more likely in poor quality of bone. The primary stability of oral implants related to resistance to micromotion during healing is influenced by bone quality, surgical technique, and implant design.Purposes: The aims of this biomechanical study were to explore the effect of bone quality on initial intraosseous stability of implants, and to determine the correlations between the bone quality and implant stability parameters.Materials and Methods: Twenty-four implants (Neoss Ltd., Mölnlycke, Sweden) were placed into anterior and posterior regions of three human cadaver mandibles. The bone densities of implant recipient sites were preoperatively determined using computerized tomography (CT) in Hounsfield unit (HU). The maximum insertion torque values were recorded, and primary implant stability measurements were noninvasively performed by means of resonance frequency analysis (RFA).Results: The bone density values ranged from −267 HU to 553 HU. It was found that mean bone density, insertion torque, and RFA values were 113 ± 270 HU, 41.9 ± 5 Ncm, and 70 ± 7 implant stability quotient (ISQ), respectively. Statistically significant correlations were found between bone density and insertion torque values (r = 0.690, p < .001); bone density and ISQ values (r = 0.557, p < .05); and insertion torque and ISQ values (r = 0.853, p < .001).Conclusion: CT is a useful tool to assess bone quantity and quality in implant recipient sites, and bone density has a prevailing effect on implant stability at placement.

Research paper thumbnail of Assessment of correlation between computerized tomography values of the bone, and maximum torque and resonance frequency values at dental implant placement

Journal of Oral Rehabilitation, 2006

summary The aim of this study was to determine the bone density in the designated implant sites ... more summary The aim of this study was to determine the bone density in the designated implant sites using computerized tomography (CT), the fastening torque values of dental implants, and the implant stability values using resonance frequency analysis. Further aim was to evaluate a possible correlation between bone density, fastening torque and implant stability. Eighty-five patients were treated with 158 Brånemark System implants. CT machine was used for preoperative evaluation of the jawbone for each patient, and bone densities were recorded in Hounsfield units (HU). The fastening torque values of all implants were recorded with the OsseoCare equipment. Implant stability measurements were performed with the Osstell machine. The average bone density and fastening torque values were 751·4 ± 256 HU and 39·7 ± 7 Ncm for 158 implants. The average primary implant stability was 73·2 ± 6 ISQ for seventy implants. Strong correlations were observed between the bone density, fastening torque and implant stability values of Brånemark System TiUnite MKIII implants at implant placement (P < 0·001). These results strengthen the hypothesis that it may be possible to predict and quantify initial implant stability and bone quality from pre-surgical CT diagnosis.

Research paper thumbnail of The Impact of Primary Hyperparathyroidism on the Oral Cavity

Primary hyperparathyroidism (HPT) is a systemic disease causing bone loss. Periodontal disease is... more Primary hyperparathyroidism (HPT) is a systemic disease causing bone loss. Periodontal disease is a local inflammatory disease characterized by alveolar bone loss. The older literature records that HPT is associated with loss of radicular lamina dura and brown tumors of the bone, but contemporary studies are lacking. The objective of the study was to determine the effects of HPT on oral bony structures and periodontal disease in a contemporary population. This was a cross-sectional, case-controlled study. The study was conducted at the clinics of endocrine surgery and hospital dentistry. Fifty-nine patients, 39 with HPT and 20 thyroid controls, were included in the study. Periodontal clinical measures and dental radiographic analyses were used in this study. HPT patients were more likely to have tori and reductions in radicular lamina dura on dental radiographs. Widening of the periodontal ligament space surrounding teeth correlated with serum PTH levels. Panoramic radiographs demonstrated reduced cortical bone thickness at the angle of the mandible in HPT patients but no evidence of brown tumors or other overt pathologies. Changes in the oral cavity observed in patients with HPT suggested both decreased cortical density and increased likelihood of oral tori. The contemporary oral manifestations of primary HPT are different from those previously reported, and health care providers should be aware of newer, more subtle findings that may be present when treating patients with HPT.

Research paper thumbnail of Possible impact of inflammatory status on C-telopeptide pyridinoline cross-links of Type I collagen and osteocalcin levels around oral implants with peri-implantitis: a controlled clinical trial

Journal of Oral Rehabilitation, 2008

Summary Detection of progression level of peri-implantitis may help in the prevention of oral im... more Summary Detection of progression level of peri-implantitis may help in the prevention of oral implant failure. C-telopeptide pyridinoline crosslinks of Type I collagen (ICTP) and osteocalcin (OC) are specific markers of bone turnover and bone degradation. Determination of the ICTP and OC levels in the peri-implant sulcus fluid (PISF) may predict the metabolic and/or inflammatory changes in the peri-implant bone. The aim of this clinical study was to evaluate ICTP and OC levels in the PISF for oral implants with and without peri-implant bone destruction and correlate these levels with the traditional clinical peri-implant parameters (probing depth, plaque index, gingival index and gingival bleeding time index) and radiographic bone level measurements. Fifteen patients with 30 peri-implant sites with bone destruction (radiographic bone loss) and health were included. Clinical parameters were measured and PISF was collected from the sites. Peri-implant sulcus fluid ICTP and OC levels were detected by radioimmunoassay technique from PISF samples. All clinical parameters demonstrated a significant increase in peri-implantitis sites compared with healthy sites. The PISF volume of the peri-implantitis sites was also significantly higher than of the healthy peri-implant sites. Although not statistically significant, a trend of increase was demonstrated in ICTP PISF samples sampled from peri-implantitis sites compared with healthy sites. A significant increase was noticed for OC PISF level in peri-implantitis sites compared with healthy ones. As well as peri-implant clinical measurements, volumetric changes at PISF may be counted as an important clinical parameter to distinguish the bone destruction sites from healthy sites around oral implants.

Research paper thumbnail of Analysis of the Potential Association of Implant Stability, Laboratory, and Image-Based Measures Used to Assess Osteotomy Sites: Early Versus Delayed Loading

Journal of Periodontology, 2007

During the assessments made at presurgical, surgical, and follow-up phases, the clinician may ben... more During the assessments made at presurgical, surgical, and follow-up phases, the clinician may benefit from a wide array of clinical and/or image-based measures. Because analysis of the potential associations among the various measures could improve the evaluation process for dental implants, this study attempted to determine the potential correlations among peri-implant sulcus fluid (PISF) volume, implant stability, nitric oxide content of PISF, and marginal bone loss. Seventeen completely edentulous patients seeking prosthetic rehabilitation were included. Two ball attachment mandibular overdentures were given to all patients, and early- (N = 18) and delayed-loaded (N = 16) dental implants were compared during 24-weeks of follow-up. Resonance frequency analysis (RFA), marginal bone level, and PISF samples were taken for all dental implants. A consistent and negative correlation was observed between RFA measurements and marginal bone level, whereas some correlations also existed between RFA and PISF volume. The pattern of loading seemed to affect the relationship between RFA measurements and marginal bone level and, to a limited extent, the association between PISF volume and nitrite levels. Where the potential associations among various implant-related measures are concerned, the factors that may affect such associations (e.g., healing and loading) need to be considered. Data arising from the analysis of the associations between the wide arrays of available implant-related measures may improve dental practitioners&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; assessment concerning endosseous dental implants.

Research paper thumbnail of Low-Level Laser Therapy in the Treatment of Mucous Membrane Pemphigoid: A Promising Procedure

Journal of Periodontology, 2010

Research paper thumbnail of Localized edentulous ridge augmentation with upside down osteotomy prior to implant placement

Dental Traumatology, 2004

Research paper thumbnail of Analysis of the possibility of the relationship between various implant-related measures: an 18-month follow-up study: IMPLANT-RELATED MEASURES AND LONG-TERM EVALUATION

Journal of Oral Rehabilitation, 2008

Summary Better clarification of the long-term relationship among the various implant-related mea... more Summary 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.

Research paper thumbnail of Relationship between dental implant stability determined by resonance frequency analysis measurements and peri-implant vertical defects: an in vitro study

Journal of Oral Rehabilitation, 2008

Summary Resonance frequency (RF) analysis is a non-invasive and objective technique developed fo... more Summary Resonance frequency (RF) analysis is a non-invasive and objective technique developed for implantology, where it measures the stability of the implant in the bone socket. A limited number of studies were performed to compare different stability measurement devices. The aim of the study was to evaluate the association between the implant stability and peri-implant vertical defect by using the new wireless RF analyser. Micro-textured rough-surfaced implants with diameters of 3·7 and 4·8 mm and with a length of 12 mm were used. The peak insertion torque was recorded with the help of the torque control system only during the implant placement. The peri-implant defects were created in millimetre increments ranging between 0 and 5 mm to the same extent on all implants. The RF analysis values were measured by using the RF analyser. Significant correlation was found between insertion torque (44·3 ± 3 N cm) and implant stability quotient (ISQ) (all implants: r = 0·76, 3·7 mm diameter: r = 0·65, 4·8 mm diameter: r = 0·80). For 3·7 × 12-mm2 implants, the mean ISQ values were 72·6 ± 2·4, 69·8 ± 2, 67·2 ± 1·8, 64·3 ± 1·9, 61·2 ± 2 and 57·2 ± 2·5 when peri-implant vertical defects were 0, 1, 2, 3, 4 and 5 mm; and the corresponding values were 76·5 ± 2·2, 74·5 ± 2·2, 72·3 ± 2, 70 ± 1·9, 67 ± 1·9 and 63·4 ± 2·3, respectively, for 4·8 × 12-mm2 implants. All values were significantly different when compared with each other. The wireless RF analyser seems to be a suitable and reliable device to determine the implant stability. Peri-implant bone loss simulated by using acrylic models may result with a decrease in ISQ values for osseo-integrated implants measured by the RF analyser.