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Öğe The acute effects of chemotherapy upon the oral cavity: Prevention and management(2001) Ilgenli T.; Ören H.; Uysal K.The oral and dental complications arising in cancer patients can be attributable to the malignant disease itself and to the various modalities of cancer therapy. Up to 40% of all patients receiving cancer chemotherapy develop acute oral complications. Oral complications may result in significant morbidity, impaired nutrition, treatment delays, and dose reductions which are affecting the prognosis of the primary disease. Many investigators have developed a series of clinical trials designed to study treatment modalities for these pathologic processes. These trials have demonstrated clinically helpful therapies and also have demonstrated lack of benefit for other proposed treatments. In this article we aimed to assess acute oral complications in cancer patients due to chemotherapy and review the recent treatment modalities for prevention and management of those complications since these changes in physiologic process are still problems that need further investigation.Öğe Differential expression of receptor activator of nuclear factor-?B ligand and osteoprotegerin mRNA in periodontal diseases(2007) Bostanci N.; Ilgenli T.; Emingil G.; Afacan B.; Han B.; Töz H.; Berdeli A.; Atilla G.; McKay I.J.; Hughes F.J.; Belibasakis G.N.Background and Objective: Receptor activator of nuclear factor-?B ligand (RANKL) is responsible for the induction of osteoclastogenesis and bone resorption, whereas its decoy receptor, osteoprotegerin, can directly block this action. Because this dyad of cytokines is crucial for regulating the bone remodelling process, imbalances in their expression may cause a switch from the physiological state to enhanced bone resorption or formation. This study investigated the mRNA expression of RANKL and osteoprotegerin, as well as their relative ratio, in the gingival tissues of patients with various forms of periodontal diseases. Material and Methods: Gingival tissue was obtained from nine healthy subjects and 41 patients, who had gingivitis, chronic periodontitis, generalized aggressive periodontitis, and chronic periodontitis and were receiving immunosuppressant therapy. Quantitative real-time polymerase chain reaction was employed to evaluate the mRNA expression of RANKL and osteoprotegerin in these tissues. Results: Compared with healthy individuals, patients in all periodontitis groups, but not those with gingivitis, exhibited stronger RANKL expression and a higher relative RANKL/osteoprotegerin ratio. In addition, osteoprotegerin expression was weaker in patients with chronic periodontitis. When patients with generalized aggressive periodontitis and chronic periodontitis were compared, the former exhibited stronger RANKL expression, whereas the latter exhibited weaker osteoprotegerin expression, and there was no difference in their relative ratio. When chronic periodontitis patients were compared with chronic periodontitis patients receiving immunosuppressant therapy, osteoprotegerin, but not RANKL, expression was stronger in the latter. Conclusion: This study demonstrates that RANKL and osteoprotegerin expression are differentially regulated in various forms of periodontitis, and the relative RANKL/osteoprotegerin ratio appears to be indicative of disease occurrence. This information may confer diagnostic and therapeutic value in periodontitis. © 2007 Blackwell Munksgaard.Öğe Gingival crevicular fluid levels of RANKL and OPG in periodontal diseases: Implications of their relative ratio(2007) Bostanci N.; Ilgenli T.; Emingil G.; Afacan B.; Han B.; Töz H.; Atilla G.; Hughes F.J.; Belibasakis G.N.Aim: Receptor activator of NF-?B ligand (RANKL) and osteoprotegerin (OPG) are a system of molecules that regulate bone resorption. This study aims to compare the levels of RANKL, OPG and their relative ratio in gingival crevicular fluid (GCF) of healthy and periodontal disease subjects. Material and Methods: GCF was obtained from healthy (n = 21), gingivitis (n = 22), chronic periodontitis (n = 28), generalized aggressive periodontitis (n = 25) and chronic periodontitis subjects under immunosuppressant therapy (n = 11). RANKL and OPG concentrations in GCF were measured by enzyme-linked immunosorbent assays. Results: RANKL levels were low in health and gingivitis groups, but increased in all three forms of periodontitis. OPG levels were higher in health than all three periodontitis, or gingivitis groups. There were no differences in RANKL and OPG levels between chronic and generalized aggressive periodontitis groups, whereas these were lower in the immunosuppressed chronic periodontitis group. The RANKL/OPG ratio was significantly elevated in all three periodontitis forms, compared with health or gingivitis, and positively correlated to probing pocket depth and clinical attachment level. Conclusion: GCF RANKL and OPG levels were oppositely regulated in periodontitis, but not gingivitis, resulting in an enhanced RANKL/OPG ratio. This ratio was similar in all three periodontitis groups and may therefore predict disease occurrence. © 2007 Blackwell Munksgaard.Öğe Oral giant pyogenic granulomas associated with facial skin hemangiomas (Sturge-Weber syndrome).(1999) Ilgenli T.; Canda T.; Canda S.; Unal T.; Baylas H.This is a case report of two patients, aged 26 and 22, who suffered from congenital hemangioma on their faces and pronounced gingival overgrowth localized parallel to extraoral lesions. Prior to surgical intervention the hygienic conditions were improved in several sessions by means of professional preventive treatment and oral hygiene instructions. Histologic examination of both cases revealed a highly vascularized pattern of pyogenic granuloma. One of the cases was associated with a pregnancy. These patients can be classified as Sturge-Weber syndrome. Postsurgical treatment consisted of efficient plaque control and adequate oral prophylaxis sessions every 3 months. The large gingival overgrowth was not observed to recur in 2 and 4 years, respectively, of follow-up.Öğe Reattachment of a subgingivally fractured central incisor tooth fragment: Report of a case(1999) Koparal E.; Ilgenli T.A case report of a 9-year-old boy with a fractured maxillary right incisor and ulcerated pulp at the fracture line is presented. On satisfactory completion of a root canal filling one week later, the access cavity was restored with glass ionomer cement. The fragment was reattached by a light activated hybrid composite during the flap surgery. Tetracycline hydrochloride was applied on open root surface for a better healing.Öğe The role of serum lipids on cyclosporine-induced gingival overgrowth in renal transplant patients(1999) Ilgenli T.; Atilla G.; Cirit M.; Azmak N.Cyclosporine-A (CsA) is widely used to prevent organ rejection in recipients of transplanted organs and also in the treatment of various systemic diseases. CsA has a number of side effects, including gingival overgrowth (GO). However, the pathogenesis of CsA-induced GO remains uncertain. It has been postulated that CsA alters fibroblast activity. CsA is transported in plasma by binding to lipid components. It is possible that changes in serum lipid levels could alter the interaction between the CsA and gingival fibroblasts within the gingival tissues. It has also been reported that CsA may alter serum lipid levels in the transplant population. The aim of this study was to investigate the relationship between the serum lipids and CsA-induced GO. A total of 47 renal transplant recipients receiving CsA, azathioprine and prednisolone were the subjects of this study. Periodontal measurements were taken including plaque index (PII) and GO scores (GO). GO was classified into four categories according to the clinical changes. The whole blood CsA concentration, serum total cholesterol, triglyceride and ceratinine levels, and duration of CsA therapy of these patients were obtained from the subject's medical records. These were assessed monthly. CsA-treated recipients were divided for statistical purposes into two groups according to their GO scores. The recipients having sites with clinically significant GO (scores of 2 and 3) were classified as respondents, and those without evidence of overgrowth (GO score=0) as non-responders. There were no differences in age, plaque scores, duration of CsA therapy, and azathioprine and prednisolone dosage between responders and non-responders. Similarly, no statistically significant differences in serum lipids and whole blood CsA concentration were found between these two groups. These data indicate that CsA-induced GO is unrelated to serum lipid components. To our knowledge, this is the first report describing the relationship between the serum lipids and CsA-induced GO. We believe that additional studies will be necessary for complete understanding of the mechanism of gingival overgrowth.Öğe The treatment of a localized osseous sequestrum with porous bone mineral in combination with a collagen membrane and resorbable bone pins.(1999) Ilgenli T.; Günbay T.; Baylas H.The ultimate goal of periodontal therapy should not be limited to the establishment and maintenance of periodontal health. The potential regeneration of the hard and soft periodontal tissues lost due to disease also should be considered. This case presentation evaluated a new surgical technique for the treatment of a variety of localized bone defects, utilizing porous bone mineral in combination with collagen membrane and resorbable bone pins.Öğe Tumor necrosis factor-?-converting enzyme (TACE) levels in periodontal diseases(2008) Bostanci N.; Emingil G.; Afacan B.; Han B.; Ilgenli T.; Atilla G.; Hughes F.J.; Belibasakis G.N.Tumor necrosis factor-?-converting enzyme (TACE) is a metalloprotease which can shed several cytokines from the cell membrane, including receptor activator of NF-?B ligand (RANKL). This study aimed to investigate the hypothesis that TACE would be elevated in the gingival crevicular fluid (GCF) of persons with periodontitis. Total TACE amounts in GCF were higher in persons with chronic and aggressive periodontitis than in those with gingivitis or in healthy persons. TACE concentrations in GCF were higher in persons with chronic and aggressive periodontitis than in those with gingivitis, although not significantly higher than in healthy persons. Persons with chronic periodontitis receiving immunosuppressive treatment exhibited over 10-fold lower TACE levels than the other periodontitis groups. TACE was positively correlated with probing pocket depth, clinical attachment levels, and RANKL concentrations in GCF. In conclusion, the increased GCF TACE levels in persons with periodontitis and their positive correlation with RANKL may indicate an association of this enzyme with alveolar bone loss, and may warrant special attention in future therapeutic approaches.
