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KURU, LEYLA

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    Evaluation of gingival crevicular fluid transforming growth factor-1 level after treatment of intrabony periodontal defects with enamel matrix derivatives and autogenous bone graft: A randomized controlled clinical trial
    (MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2016) YARAT, AYŞEN; Agrali, O. B.; Kuru, B. E.; Yarat, A.; Kuru, L.
    Aim: The present study aimed to evaluate the effects of enamel matrix derivatives (EMD) either alone or combined with autogenous bone graft (ABG) applied to intrabony defects in chronic periodontitis patients on clinical/radiographic parameters and gingival crevicular fluid (GCF) transforming growth factor-1 (TGF-1) level and to compare with open flap debridement (OFD). Materials and Methods: A total of 30 deep intrabony defects in 12 patients were randomly treated with EMD + ABG (combination group), EMD alone (EMD group), or OFD (control group). Clinical parameters, including plaque index, gingival index, bleeding on probing, probing depth, relative attachment level, and recession were recorded at baseline and 6 months postsurgery. Intrabony defect fill percentage was calculated on the standardized radiographs. TGF-1 level was evaluated in GCF just before surgery and 7, 14, 30, 90, 180 days after surgery using enzyme-linked immunosorbent assay. Results: All treatment procedures led to significant improvements at 6 months (P 0.01). Gain in attachment level (P 0.01) and radiographic defect fill (P 0.05) of the combination and EMD groups were found to be significantly higher than those of the control group, while the use of EMD either with ABG or alone was observed to produce significantly less recession than the OFD (P 0.05). Conclusion: The findings suggest no clinical and radiographic differences between the combination and EMD groups whereas GCF TGF-1 level demonstrates an increase during the healing phase and is positively affected from EMD.
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    Oral squamous cell papilloma: a case report
    (AVES PRESS LTD, 2015) ÖZTÜRK ÖZENER, HAFİZE; Ozener, Hafize Ozturk; Kuru, Leyla; Kuru, Bahar
    Oral squamous cell papilloma (OSCP) is a benign proliferation of the stratified squamous epithelium, which results in a papillary or verrucous exophytic mass. OSCP is usually associated with human papilloma virus. Although any surface of the oral cavity can be affected, the sites of predilection for localization of the lesions include the tongue, lip and soft palate. In this report, treatment and histological findings of a local gingival enlargement at the vestibular side of the upper right central tooth of a 10 year-old systemically healthy girl are presented. The lesion was asymptomatic and had shown a slow growth. Solitary, exophytic lesion was clinically soft, pink-white in color and appeared as cauliflower. Dental and periodontal tissues were radiographically normal. One month after scaling and root planing, under local anesthesia the lesion was excised and this was followed by the use of Nd: YAG laser (1064 nm, 20 Hz, 3 W) to control bleeding, minimize pain and scarring in post-operative period, and provide sterilization. Macroscopic examination revealed that the lesion was 1.1x0.5x0.2 cm(3) in size, yellow in colour and had a rough surface, while histological examination showed multi-layer connective tissue underlying the squamous epithelium, numerous rete pegs and spinous cell proliferation at the papillary and OSCP was diagnosed. There was no evidence of viral cytopathic effect or malignancy of the lesion. No recurrence was observed during the 4-year follow-up period..
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    Changes in transforming growth factor-beta1 in gingival crevicular fluid following periodontal surgery
    (2004) KURU, LEYLA; Kuru, L.; Griffiths, G. S.; Petrie, A.; Olsen, I.
    OBJECTIVES: Growth factors play a major part in wound healing, including in the periodontium. However, the presence of growth factors in gingival crevicular fluid (GCF) in humans during periodontal wound healing has not yet been determined. Our hypothesis is that such factors are present in GCF and that changes in their levels might be of value as a prognostic marker of wound-healing activity and therapeutic progress following periodontal surgery. The aim of this study was therefore to measure transforming growth factor-beta1 (TGF-beta1) in GCF collected from sites that have undergone guided tissue regeneration (GTR) and conventional flap (CF) surgery and to compare these with GCF collected from unaffected healthy sites. MATERIALS AND METHODS: GCF samples were collected, using filter paper strips, at baseline (pre-surgical) and then at intervals up to 26 weeks from 16 patients undergoing GTR and from 11 patients undergoing CF surgery. After elution and acid treatment, TGF-beta1 levels were measured by ELISA. RESULTS: Treatment of periodontal defect sites significantly reduced the mean probing pocket depth (PPD) and improved the mean lifetime cumulative attachment loss (LCAL). Average GCF volumes also significantly increased at all sites at 2 weeks post-surgery and thereafter declined to baseline levels, except at the GTR test sites that were still elevated at 7 weeks. TGF-beta1 could be detected in almost all GCF samples, and 2 weeks after surgery, the average levels increased two-fold at the surgically treated but not at the control sites, which remained unchanged. CONCLUSION: TGF-beta1 is readily detectable in GCF and increases transiently following periodontal surgery. This suggests that changes in the levels of this growth factor in GCF might be useful for monitoring the progress of periodontal repair and regeneration.
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    Effects of 810-nanometer diode laser as an adjunct to mechanical periodontal treatment on clinical periodontal parameters and gingival crevicular fluid volume of residual periodontal pockets
    (MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2017) KURU, LEYLA; Meseli, S. E.; Kuru, B.; Kuru, L.
    Background: Aim of this randomized controlled parallel-designed study was to evaluate the effects of diode laser as an adjunct to mechanical periodontal treatment on clinical parameters and gingival crevicular fluid (GCF) volume of the residual pockets diagnosed following initial periodontal treatment in chronic periodontitis (CP) patients. Materials and Methods: A total of 84 residual pockets on single-rooted teeth in 11 CP patients were included and randomly assigned into three groups. Residual pockets were treated either only by mechanical treatment (Group M) (n = 28) or only by diode laser disinfection (Group L) (n = 28) or by a combination of these techniques (Group M L) (n = 28). Plaque index, gingival index (GI), bleeding on probing (BoP), probing depth (PD), clinical attachment level and gingival recession were assessed at baseline and 8 weeks after treatment of residual pockets. GCF samples were collected at baseline, 1 and 8 weeks after treatment. Results: All treatment modalities resulted in significant reductions in PD and attachment gain. GI and BoP showed a greater reduction in both Group M and Group M L than Group L (P < 0.001), but there was no difference between the Groups M and M L (P 0.05). No difference was also found among groups for other clinical parameters. GCF volume decreased significantly in the Groups M and M L (P < 0.05) but there was no difference among the groups (P 0.05). Conclusion: Results demonstrated clinical improvements on residual pockets in CP patients treated with all three modalities. Moreover, our findings suggest that application of diode laser as an adjunct to mechanical periodontal treatment doesn't demonstrate any additional clinical effect on the residual pockets.
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    Changes in soluble adhesion molecules in gingival crevicular fluid following periodontal surgery
    (AMER ACAD PERIODONTOLOGY, 2005) KURU, LEYLA; Kuru, L; Kirby, AC; Griffiths, GS; Petrie, A; Olsen, I
    Background: Inflammation of periodontal tissues during postoperative wound healing is mediated by cell surface adhesion molecules. Soluble forms of these antigens have also been identified and shown to be important in immunoregulatory processes, but have previously not been investigated during periodontal repair and regeneration. The present study has examined the presence and possible changes in soluble intercellular adhesion molecule-1 (sICAM-1; CD54) and lymphocyte function-associated antigen-3 (sLFA-3; CD8) in gingival crevical fluid (GCF) following periodontal surgery. Methods: GCF samples were collected from four groups: 1) a guided tissue regeneration (GTR) test; 2) a GTR control, at least one complete tooth unit away from the periodontal defect; 3) a conventional flap (CF) surgery; and 4) a crown lengthening (CL). Sandwich enzyme-linked immunosorbent assay (ELISA) was used to measure the levels of sICAM-1 and sLFA-3 in the GCF samples. Results: A marked increase in GCF volumes was found in all sites after surgery, although a persistent increase was associated only with the period of membrane retention at the GTR test sites. In addition, sICAM-1 and sLFA-3 were found in the GCF of healthy as well as diseased sites prior to treatment and the total amounts of both increased transiently following surgical intervention, especially sLFA-3. However, the concentrations of these GCF components, particularly sICAM-1, tended to decrease. Conclusions: The temporal decrease in the concentration of sICAM-1 and sLFA-3 in GCF may serve to enhance inflammatory reactions at surgically-treated periodontal sites, thereby limiting repair and regeneration in the periodontium. These soluble adhesion molecules may thereby be of potential therapeutic value and might also be useful markers for monitoring periodontal wound healing.
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    Alkaline phosphatase activity is unregulated in regenerating human periodontal cells
    (WILEY, 1999) KURU, LEYLA; Kuru, L; Griffiths, GS; Petrie, A; Olsen, I
    The activity of alkaline phosphatase (ALP) is considered to indicate the presence of osteoblast cells and the formation of new bone. In the present study this enzyme was investigated in cells obtained from retrieved polytetrafluoroethylene membranes (M cells) of periodontal disease patients treated by guided tissue regeneration (GTR) and from the regenerated tissue underlying the membrane (RT cells). Normal periodontal ligament (PL) and gingival cells were also grown from the corresponding healthy tissues of human subjects. ALP activity was measured colourimetrically, using paranitrophenyl phosphate as the substrate, after 4 and 7 d of culture in the absence and presence of dexamethasone (DEX), a synthetic glucocorticoid which induces osteoblast differentiation. The results showed that basal levels of ALP activity were expressed by all the cells and that DEX upregulated ALP levels in the M, RT and PL cells but not in the gingival cells. Moreover, both the basal and DEX-induced ALP activities were statistically significantly higher in the RT cells than in any of the other cells. Our results suggest that both the GTR-associated and normal PL cells express osteoblast-like characteristics and, furthermore, that the RT cultures in particular contain a high proportion of osteoprogenitor cells.
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    Is sialic acid a promising marker for periodontal diseases?
    (WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2020) KURU, LEYLA; Oktay, S.; Bal, O. Ozoner; Kuru, L.; Yarat, A.; Noyan, U.
    Objective: Periodontal diseases are inflammatory chronic infections. Sialic acid (SA) is an acute phase reactant by itself. The aim of this study is to investigate the relationship between salivary and serum SA levels and clinical parameters in different forms of periodontal diseases. Subject and Methods: Systemically healthy subjects were included in the study; patients with chronic gingivitis (CG) (n = 10), chronic periodontitis (CP) (n = 10), and aggressive periodontitis (AgP) (n = 10), and ten volunteers with healthy periodontium as the control group. Total SA levels were determined by Warren's thiobarbituric acid method in whole saliva, parotis saliva, and serum samples of subjects before and 3 months after nonsurgical periodontal treatment. Full mouth clinical parameters including plaque index, gingival index, probing depth, and bleeding on probing were also recorded. Results: Before treatment, in both periodontitis groups salivary and serum SA levels were higher than those of controls (P = 0.001). Both salivary and serum SA levels decreased significantly in the patient groups after treatment (P < 0.001). Multiple comparisons of baseline clinical parameters in all groups revealed significant differences (P = 0.001) and these parameters decreased significantly on the 90th day (P < 0.01). There were positive correlations between SA levels and periodontal indices of the CG, CP, and AgP groups (P < 0.05). Conclusion: Our results suggest that SA level in both saliva and serum may be a potentially useful marker to determine inflammatory changes and investigate different forms of periodontal diseases.
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    Efficacy of adjunctive photodynamic therapy in the treatment of generalized aggressive periodontitis: A randomized controlled clinical trial
    (WILEY, 2019) KURU, LEYLA; Borekci, Tugce; Meseli, Suleyman Emre; Noyan, Ulku; Kuru, Bahar Eren; Kuru, Leyla
    Objectives Generalized aggressive periodontitis (GAgP) is a distinct type of periodontal disease characterized by rapid loss of attachment and alveolar bone occurring in young individuals. Photodynamic therapy (PDT) was introduced in periodontology as an adjunctive approach to non-surgical periodontal treatment (NPT) in periodontitis patients. In this trial, the aim was to evaluate the clinical and microbiological effects of adjunctive PDT to NPT in patients with GAgP. Methods In this prospective controlled clinical study, 24 systemically healthy, non-smoking subjects with GAgP were enrolled. Subjects were randomly assigned into a control group (n = 12) treated with NPT only or to a test group (n = 12) treated with NPT and PDT. Plaque index, sulcus bleeding index (SBI), probing depth (PD), relative attachment level, gingival recession, and tooth mobility were recorded at baseline and on day 63. Microbiological samples were obtained from the sites with PD >= 5 mm at both time periods and evaluated for Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, and Treponema denticola via micro-IDent (R) test. Results Clinical and microbial parameters declined significantly in both groups after the treatments (P < 0.01). The comparisons between the groups showed that only the full mouth SBI score of the test group was significantly lower than the control group on day 63 (P < 0.05). Although the reduction in periodontopathogens of the test group was greater than the control group, there was no significant difference between the groups (P > 0.05). Conclusions Within the limits of this study, it can be concluded that in the treatment of GAgP, usage of PDT as an adjunct to NPT does not lead to any beneficial effects on the investigated clinical and microbiological parameters except for SBI. Nevertheless, the statistically significant difference for the SBI score demonstrates that PDT may have additional effect on the reduction in gingival bleeding. Lasers Surg. Med. 51:167-175, 2019. (c) 2018 Wiley Periodicals, Inc.
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    Do Platform Switching Together with Subcrestal Placement have a Benefit on Marginal Bone Levels Around Dental Implants?
    (AVES PRESS LTD, 2018) KURU, LEYLA; Agrali, Omer Birkan; Elemek, Eser; Dincer, Janberd; Kigili, Ahmet; Cilingir, Altug; Kuru, Leyla; Almas, Khalid
    Objective: The aim of this retrospective study was to assess the marginal bone levels around platform-switched dental implants placed subcrestally in partially or totally edentulous patients who had been treated in a private practice. Methods: A total of 200 implants placed in 64 patients, with a mean follow-up time of 5.3 +/- 1.7 years, were included in the study. Implants were placed 0.5 mm subcrestally via one-or two-stage surgical approach. Data regarding the distribution and diameter of the implants, the type of the prosthetic restoration, and marginal bone levels were assessed by one calibrated examiner. Results: Overall, the mean marginal bone loss was found to be 0.82 +/- 1.6 mm, and 66% of the implants (n=81) showed no bone loss, whereas 28% (n=35) showed bone loss >1mm, and 20% (n=25) showed bone loss >2mm. Out of 18 implants in use for 1-3 years, 14 of them showed no bone loss. Among implants that were in function for 3-5 years, 25% (n=15) showed bone loss >1mm, and 12% (n=7) showed bone loss >2mm. In this study, the majority of the implants were in use for more than 5 years (n=122). Out of them, 66% (n=81) showed no bone loss, whereas 28% (n=35) showed bone loss >1 mm, and 20% (n=25) showed bone loss >2mm. Conclusion: Within the limits of this retrospective study, one can say that slight amount of marginal bone loss is observed around the platform-switched implants placed subcrestally in a long-term follow-up. However, further studies are needed to confirm this finding.