Publication: Serbest diş eti grefti operasyonunda yaşın alıcı bölge yara iyileşmesi üzerine etkisinin değerlendirilmesi
Abstract
Serbest diş eti grefti operasyonunda yaşın alıcı bölge yara iyileşmesi üzerine etkisinin değerlendirilmesi Amaç: Bu çalışmanın amacı; yaşın, serbest dişeti greftinin (SDG) iyileşmesine etkilerinin klinik ve vasküler endotelyal büyüme faktörü-A (VEGF-A), epidermal büyüme faktörü (EGF) ve transforme edici büyüme faktörü β-1 (TGF-β1) seviyeleri ile biyokimyasal olarak değerlendirmesidir. Gereç ve Yöntem: Çalışmaya sistemik sağlıklı, genç grupta (GG) 20-35 yaş ve yetişkin grupta (YG) 50-65 yaş aralığında 15’er hasta dahil edildi. Plak (Pİ) ve gingival indeks (Gİ), sondalama derinliği (SD), sondalamada kanama (SK) ve klinik ataşman seviyesi (KAS), keratinize diş eti dikey boyutu (KDDB) ve kalınlığı (KDK), greft kalınlığı 0. gün, 1., 3. ve 6. aylarda, greft dikey boyutu (GDB), greft yatay boyutu (GYB) ve greft alanı (GA) fotoğraflar üzerinden bilgisayar programına aktarılarak ve greft büzülmesi (GB) 0. ve 14 gün, 1., 3., ve 6. aylarda hesaplandı. Operasyon öncesi ve 14. gün alıcı bölgedeki dişlerden diş eti oluğu sıvısı, 4. ve 7. günlerde alıcı bölgeden yara sıvısı toplandı. VEGF-A, EGF ve TGF- β1 analizi için ELISA kullanıldı. Bulgular: Operasyon bölgesi Gİ, SD ve KAS gruplarda azalırken, Pİ ve SK sadece GG’da azaldı (p<0,05). Pİ, Gİ, SD ve SK gruplarda benzerken (p>0,05), KAS YG’da yüksek bulundu (p<0,05). Gruplarda KDDB ve KDK’da artış görüldü (p<0,05), ancak gruplar arasında fark bulunmadı (p>0,05). Gruplarda GYB, GDB ve GA 3. ve 6. aylarda azaldı (p<0,05), gruplar arasında fark bulunmadı (p>0,05). GB 3. ay hariç diğer dönemlerde GG YG’dan yüksek bulundu (p<0,05). VEGF-A iki grupta 4. günde artış görülürken (p<0,05), 7. ve 14 günde GG’da artış bulundu (p<0,05). 7. gün VEGF-A GG yüksek tespit edilirken (p<0,05) diğer günlerde gruplar arasında fark görülmedi (p>0,05). EGF iki grupta da tüm ölçüm dönemlerinde başlangıca göre artış görüldü (p<0,05), ancak gruplar arasında fark bulunmadı (p>0,05). GG, TGF-β1 başlangıca göre 4., 7. ve 14. günlerde artış bulundu (p<0,05). YG ise yalnızca 4. günde artış tespit edildi (p<0,05). 7. ve 14. günlerde TGF-β1 GG YG’a göre yüksekti (p<0,05). 14. gün TGF-β1 ile yaş arasında ve 6. ay GB ile yaş arasında negatif korelasyon görüldü (p<0,05). 6. ay GB ile 4. gündeki TGF-β1 ilişkili olduğu tespit edildi (p<0,05).Sonuç: Çalışmamızın bulguları yaşın SDG iyileşme sürecini klinik ve biyokimyasal düzeyde etkileyebileceğini, özellikle genç bireylerde TGF-β1 seviyelerinin greft boyutlarındaki değişimle ilişkili olabileceğini gösterebilir.
Evaluation of the effect of age on recipient area wound healing in free gingival graft operation Objective: This study aimed to evaluate the effects of age on free gingival graft (FGG) healing clinically and biochemically by analizing vascular endothelial growth factor-A (VEGF-A), epidermal growth factor (EGF), transforming growth factor beta-1 (TGF-β1). Materials and Methods: 30 systemically healthy patients were included, 15 in young group (YG) (aged 20–35) and 15 in adult group (AG) (aged 50–65). Plaque (PI) and gingival index (GI), probing depth (PD), bleeding on probing (BOP), clinical attachment level (CAL), keratinized tissue width (KTW) and thickness (KTT), graft thickness were recorded at baseline, 1st, 3rd, and 6th months. Vertical (VDG) and horizontal dimension of graft (HDG), graft area (GA) were measured from photographs using analysis software. Shrinkage (S) was calculated at baseline, day 14, 1st, 3rd, and 6th months. Gingival crevicular fluid were collected from recipient site teeth on day 0 and 14, wound fluid were obtained from recipient site on day 4 and 7. VEGF-A, EGF, and TGF-β1 were analyzed using ELISA. Results: GI, PD, CAL decreased in groups (p<0.05), while PI and BOP decreased in YG (p<0.05). PI, GI, PD, and BOP were similar between groups (p>0.05), CAL was higher in AG (p<0.05). KTW and KTT increased in both groups (p<0.05), without intergroup differences (p>0.05). HDG, VDG and GA decreased at 3rd and 6th months in both groups (p<0.05), with no differences between groups (p>0.05). Except 3rd month, S was higher in YG at all time points (p<0.05). VEGF-A levels increased in both groups on day 4, additionally in YG on days 7 and 14 (p<0.05). On day 7, VEGF-A was higher in YG (p<0.05), while no differences noted between groups on other days (p>0.05). EGF increased at all time points in groups (p<0.05), with no intergroup differences (p>0.05). In YG, TGF-β1 increased on days 4, 7, and 14 (p<0.05), whereas in AG, an increase was observed only on day 4 (p<0.05). TGF-β1 were higher in YG on days 7 and 14 (p<0.05). Between age and TGF-β1 on day 14 and S at 6 months negative correlation was found (p<0.05). An association revealed between S at 6 months and TGF-β1 on day 4 (p<0.05). Conclusion: The findings of this study suggest that age may affect FGG healing clinically and biochemically, and increased TGF-β1 in younger individuals may be associated with changes in graft dimensions.
Evaluation of the effect of age on recipient area wound healing in free gingival graft operation Objective: This study aimed to evaluate the effects of age on free gingival graft (FGG) healing clinically and biochemically by analizing vascular endothelial growth factor-A (VEGF-A), epidermal growth factor (EGF), transforming growth factor beta-1 (TGF-β1). Materials and Methods: 30 systemically healthy patients were included, 15 in young group (YG) (aged 20–35) and 15 in adult group (AG) (aged 50–65). Plaque (PI) and gingival index (GI), probing depth (PD), bleeding on probing (BOP), clinical attachment level (CAL), keratinized tissue width (KTW) and thickness (KTT), graft thickness were recorded at baseline, 1st, 3rd, and 6th months. Vertical (VDG) and horizontal dimension of graft (HDG), graft area (GA) were measured from photographs using analysis software. Shrinkage (S) was calculated at baseline, day 14, 1st, 3rd, and 6th months. Gingival crevicular fluid were collected from recipient site teeth on day 0 and 14, wound fluid were obtained from recipient site on day 4 and 7. VEGF-A, EGF, and TGF-β1 were analyzed using ELISA. Results: GI, PD, CAL decreased in groups (p<0.05), while PI and BOP decreased in YG (p<0.05). PI, GI, PD, and BOP were similar between groups (p>0.05), CAL was higher in AG (p<0.05). KTW and KTT increased in both groups (p<0.05), without intergroup differences (p>0.05). HDG, VDG and GA decreased at 3rd and 6th months in both groups (p<0.05), with no differences between groups (p>0.05). Except 3rd month, S was higher in YG at all time points (p<0.05). VEGF-A levels increased in both groups on day 4, additionally in YG on days 7 and 14 (p<0.05). On day 7, VEGF-A was higher in YG (p<0.05), while no differences noted between groups on other days (p>0.05). EGF increased at all time points in groups (p<0.05), with no intergroup differences (p>0.05). In YG, TGF-β1 increased on days 4, 7, and 14 (p<0.05), whereas in AG, an increase was observed only on day 4 (p<0.05). TGF-β1 were higher in YG on days 7 and 14 (p<0.05). Between age and TGF-β1 on day 14 and S at 6 months negative correlation was found (p<0.05). An association revealed between S at 6 months and TGF-β1 on day 4 (p<0.05). Conclusion: The findings of this study suggest that age may affect FGG healing clinically and biochemically, and increased TGF-β1 in younger individuals may be associated with changes in graft dimensions.