ÖZHipertansiyon, anjina pektoris ve kardiyak aritmi gibi kardiyovasküler problemlerin tedavisi için sıklıkla kullanılan ilaçlardan olan kalsiyum kanal blokörlerinin, yan etki olarak dişeti büyümesine neden oldukları bilinmektedir. Kalsiyum kanal blokörü olan amlodipin, hipertansiyon tedavisinde antihipertansif bir ilaç olarak kullanılmaktadır. Yapılan birçok çalışmada, amlodipinin de diğer kalsiyum kanal blokörleri gibi dişeti büyümesini tetiklediği gösterilmiştir. Bu vakada amlodipin kullanımına bağlı gelişen dişeti büyümesinin ağız içi klinik özellikleri ve tedavi protokolleri sunulmuştur. Hipertansiyon tedavisi için 3 yıldır amlodipin kullanan 77 yaşındaki kadın hasta, üst çenesinde estetik ve fonksiyonel problemlere neden olan aşırı dişeti büyümesi şikâyeti ile kliniğimize başvurmuştur. Tedavisinde; kazıma ve kök yüzey düzlemesi işlemi, ilacın değiştirilmesi, cerrahi eksizyon ve klinik sonucun idame ve destekleyici tedavisi yapılmıştır. İlaca bağlı dişeti büyümelerinin tedavisi, ilacı kesme ya da başka bir ilaçla değiştirme ve dikkatli bir şekilde mekanik ve kimyasal olarak plak kontrolü ile risk faktörlerinin azaltılmasını içerir. Oral hijyeni ve fonksiyonu etkilemesi veya kozmetik nedenlerle, aşırı dişeti büyümesi görülen şiddetli vakalar eksize edilmelidir. Diş hekimlerinin kalsiyum kanal blokörü kullanan bireylerde dişeti büyümesi riski açısından dikkatli olmaları ve iyi plak kontrolü yapabilmeleri için hastalarını eğitmeleri önemlidir. Anahtar kelimeler: Dişeti büyümesi, kalsiyum kanal blokörü, hipertansiyon, amlodipin ABSTRACT Calcium channel blockers are among the most widely used drugs in the treatment of cardiovascular problems such as hypertension, angina pectoris and cardiac arrhythmia. These drugs cause gingival overgrowth as a side effect. Amlodipine is one of the calcium channel blocker, which is used to treat hypertension. Many studies have been shown that, amlodipine triggers gingival growth as other calcium channel blockers. In this case, the clinical features and developing treatment protocols of gingival enlargement due to use of amlodipine have been presented. A 77-years-old female patient who has used amlodipine for 3 years for hypertension referred to our clinic with the complain of maxillary massive gingival overgrowth causing functional and esthetic problems. The treatment aspect included scaling and root planning (SCRP), substitution of the drug, the surgical excision and the maintenance and supportive therapy resulting in excellent clinical outcome. Treatment of drug-induced gingival overgrowth includes cessation or replacement of the drug and decreasing other risk factors with meticulous mechanical and chemical plaque control. Excision of excessive gingival tissue should be reserved for severe cases that affect oral hygiene or functionality, or can be performed for cosmetic reasons. It is important that dentists are aware that individuals taking calcium channel blockers need to demonstrate excellent plaque control to reduce their risk of developing gingival overgrowth.

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Amaç: Albümin, primer olarak karaciğerden sentezlenen majör bir plazma proteinidir. İskemi, hipoksi, asidozis, süperoksid-radikal yaralanmaları gibi birçok durum, albüminin metal iyon bağlama kapasitesinde azalmaya ve metabolik olarak farklı protein üretimine neden olmaktadır. Bu değişim, ölçülebilir bir değişim olup, iskemik modifiye albümin (IMA) olarak bilinir. Serumdaki artmış iskemik modifiye albümin seviyeleri, C-reaktif protein (CRP) ve interlökin-6 (IL-6) seviyeleri ile anlamlı derecede ilişkili bulunmuştur. Bu ön çalışmanın amacı, nekrotizan ülseratif periodontal hastalıklarda IMA seviyelerini, bu seviyelerin CRP ve IL-6 seviyeleri ile ilişkisini ve bu değerlerin periodontal tedaviden sonra nasıl değiştiğini incelemektir. Gereç veYöntem: Bu çalışmada, nekrotizan ülseratif gingivitis (NUG) (1 vaka) ve nekrotizan ülseratif periodontitisin (NUP) akut ve subakut fazlarında olan hastaların (2 vaka) başlangıçtaki ve cerrahi olmayan periodontal tedavi sonrası 1. aydaki ve sistemik ve periodontal olarak sağlıklı kontrol bireylerinin (3 vaka) başlangıçtaki serum IMA, CRP ve IL-6 seviyeleri değerlendirilmiştir. Bulgular: Başlangıçtaki CRP ve IL-6 seviyeleri NUP'un akut fazında olan hastada NUP'un subakut fazında olan hastaya ve NUG hastasına göre daha yüksek bulunmuştur. CRP ve IL-6 seviyeleri nekrotizan hastalıklarda kontrol bireylerine göre daha yüksek bulunmuştur. Başlangıçtaki IMA seviyelerinin NUP hastalarında, NUG hastasına göre daha yüksek olduğu gözlenirken; en düşük değerler kontrol bireylerinde bulunmuştur. IMA, CRP ve IL-6 değerlerinin her üçü de tedavi ile birlikte kontrol seviyelerine düşüş göstermiştir. Sonuç: Bu çalışmanın sonuçları göz önüne alınırsa, nekrotizan periodontal hastalıklarda artan IMA seviyelerinin, hastalık aktivite kriteri olarak kullanılabileceğini söyleyebiliriz. Anahtar kelimeler: Nekrotizan ülseratif gingivitis, nekrotizan ülseratif periodontitis, iskemik modifiye albümin ABSTRACTAim: Albumin is a major plasma protein synthesized primarily in the liver. Various conditions; such as ischemia, hypoxia, acidosis, superoxide-radical injury cause reduction of the binding capacity of albumin for metals and cause metabolic production of different proteins. This variation is measurable and it's known as ischemia modified albumin (IMA). Increased serum levels of IMA were significantly associated with serum levels of C-reactive protein (CRP) and interleukin-6 (IL-6). The aim of this preliminary study is to investigate the IMA levels, and the relationship between the levels of IMA and CRP and also IL-6 in patients with necrotizing ulcerative periodontal diseases. Case Reports: In this study, serum IMA, CRP and IL-6 levels were determined by ELISA method in patients with NUG, with acute and sub acute phases of NUP, and in systemically and periodontally healthy control subjects, before and after 1 month of non-surgical periodontal treatment. Results: Baseline CRP and IL-6 levels were higher inpatient with acute phase of NUP than the patients with sub acute phase of NUP, and NUG. At the same ti...

SummaryBackground/Aim: The aim of the present study was to assess prevalence and morphologic mandibular canal variations in dry skulls.Material and Methods: Panoramic radiographs were obtained of 57 skulls among the academic collection at the University of Pittsburgh. Orthodontic wire was inserted through the mandibular canal as a reference point at panoramic images for localization of the course of the mandibular canal.Results: Double mandibular canals were present in 2 out of 57 skulls (3,5%); one of them was unilateral the other one was bilateral. Additionally, bifurcation of the mandibular canal and different types of configurations were assessed. In five of the specimens (8,8%) bifid canals were identified. Among them, one case (1,7%) was identified as a forward type. In one case additional canal (1,7%), was detected in the retromolar region, which joined the main canal. Three of the specimens (5,3%) showed accessory canal types. These were the canals that detached from the main canal and proceeded towards the molar teeth roots (dental type). All of these bifid canal types were unilateral.Conclusions: Our results depicted the anatomical variations of the mandibular canal. Dental practitioners should be aware of this underestimated but not a rare occurrence of mandibular canal variations in order to avoid complication during surgical procedures.

IntroductionADAMTS is a 19‐membered gene family which was first discovered in colon cancer, is associated with inflammation. ADAMTS is a member of matrix metalloproteinases family and they are involved in degradation and repair of extracellular matrix. In recent studies, ADAMTSs are activated with lots of signaling pathways and regulated with lots of cytokines. They play an important role in pathogenesis of many diseases. Based on this information it has been hypothesized that ADAMTS levels would be increased in inflammatory diseases such as periodontal disease. Chronic periodontitis that is the most prevalent form of periodontitis, shows the characteristics of a slowly progressing inflammatory disease. Also, systemic and environmental factors (e.g., diabetes mellitus, smoking) may revise the host's immune response so that periodontal destruction becomes more progressive. The aim of this study is to investigate the presence of ADAMTS genes and proteins in chronic and aggressive periodontitis patients.MethodsFifteen aggressive and 15 chronic periodontitis patients that were systemically healthy were included in this study. Patients presented with chronic or aggressive periodontitis and needed tooth extractions were selected. Gingival biopsies containing epithelium and connective tissue were obtained during the extraction of periodontally involved teeth. Systemically healthy patients who need crown lengthening or gingivectomy procedure for aesthetic reasons were included to the control group. mRNA expression of ADAMTSs were evaluated by real‐time PCR method and position of the marked protein in the tissue is determined by Immunohistochemistry method.Results and ConclusionDifferences were observed between the control and disease groups. According to results of the study, it can be concluded that ADAMTS expressions have a potential to be a new marker in pathogenesis of periodontal disease. Western‐blot studies are continuing to determine the protein levels.