Diş Hekimliği Fakültesi Koleksiyonu
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Article Citation - WoS: 2Citation - Scopus: 2The Effects of Abaloparatide on Alveolar Bone Loss in Postmenopausal Osteoporotic Rats with Periodontitis(BMC, 2025-09-29) Kizildag, Alper; Alpan, Aysan Lektemur; Ozdogan, Zeynep; Ozmen, Ozlem; Zavrak, Necati; Terzi, MithatBackground: Abaloparatide is a second-generation osteoporosis drug that prevents bone loss and stimulates bone fromation. This study evaluated the effects of abaloparatide treatment on alveolar bone loss (ABL) in osteoporotic rats with periodontitis by immunohistochemical and microcomputed tomography (micro-CT) in rats with periodontitis and osteoporosis. Methods: Forty adult female rats were divided into five equal groups: non-ligated (controls), periodontitis (P), periodontitis + osteoporosis (PO), PO treatment with 10 mu g/kg abaloparatide (PO-10), and PO treatment with 80 mu g/kg abaloparatide (PO-80). Bilateral ovariectomy was conducted in the osteoporosis groups. Three weeks after ovariectomy, experimental periodontitis was induced via Ligature. Abaloparatide was performed at the same time as the induction of experimental periodontitis. All rats were sacrificed at 30 days. ABL was determined via micro-CT and histological analyses. Bone morphogenetic protein 2 (BMP-2), alkaline phosphatase (ALP), receptor ligand for nuclear factor-kappa B (RANKL), osteocalcin (OCN), osteoprotegerin (OPG), and collagen 1 (Col-1) were evaluated immunohistochemically. In addition, the levels of C-terminal telopeptide of type I collagen (CTX), which is related to bone turnover, were analyzed. Results: Periodontitis with osteoporosis significantly increased ABL in the PO versus the P group. Abaloparatide treatment significantly reduced ABL in the treatment groups and significantly increased BMP-2, ALP, Col-1, OPG, OCN, and CTX levels. In particular, 80 mu g/kg abaloparatide treatment significantly modulated the RANKL, OPG, and CTX levels in the PO-80 group. The micro-CT results indicated that abaloparatide treatment significantly enhanced the percentage of bone, trabecular thickness, trabecular number, and bone surface density. Conclusion: Abaloparatide treatment regulates bone formation dose-dependently by decreasing ABL in rats with periodontitis and osteoporosis.Article Citation - WoS: 1Citation - Scopus: 1The Effects of Local and Systemic Metronidazole on Bone Healing in Mandibular Defects: a Rat Model(BioMed Central Ltd, 2025-07-02) Alpan, Aysan Lektemur; Kizildag, Alper; Ozmen, Ozlem; Zavrak, Necati; Ozdogan, Zeynep; Akpinar, AysunObjective: This study evaluated the effects of local and systemic Metronidazole (MTZ) on bone healing in infected mandibular defects using a rat model. Study design: Thirty Wistar rats were divided into Control, Local MTZ (L-MTZ), and Systemic MTZ (S-MTZ) groups. Mandibular defects were treated with xenograft mixed saliva from periodontitis patients. Bone regeneration was evaluated using micro-CT and histological analyses. Bone morphogenic protein-2 (BMP-2), alkaline phosphatase (ALP), receptor activator of nuclear factor kappaB ligand (RANKL), osteocalcin (OCN), and beta-catenin (β-catenin), high sensitivity C-reactive protein (hs-CRP) levels evaluated. Results: Increased bone formation and reduced osteoclast counts were detected in the L-MTZ group compared to the Control. β-catenin expression was significantly higher in the L-MTZ group, BMP-2 and Runx2 levels were elevated in both L-MTZ and S-MTZ groups. ALP and OCN levels were the highest in the L-MTZ group, with no significant difference between the L-MTZ and S-MTZ groups. hs-CRP levels were significantly lower in MTZ-treated groups. Micro-CT analysis revealed the highest bone volume/total volume (BV/TV) ratio in the S-MTZ group among all groups. Conclusion: Local MTZ application enhanced bone regeneration by promoting osteoblast activity, activating β-catenin and BMP-2/Runx2 signaling, and reducing inflammation. Systemic MTZ also improved bone healing, particularly in volumetric aspects. © 2025 Elsevier B.V., All rights reserved.Article Citation - WoS: 1Citation - Scopus: 1Assessment and comparative study of diosgenin doses in alleviating experimental periodontitis(BMC, 2024-07-28) Kizildag, Alper; Alpan, Aysan Lektemur; Aydin, Tugba Koseoglu; Ozdede, Melih; Ozmen, OzlemBackground This study was performed to determine the therapeutic effects of diosgenin (DG) which is a steroidal saponin, administered at different doses on alveolar bone loss (ABL) in rats with experimental periodontitis using immunohistochemical and cone-beam computed tomography (CBCT). Methods Thirty-two male Wistar rats divided into four equal groups: control (non-ligated), periodontitis (P), DG-48, and DG-96. Sutures were placed at the gingival margin of the lower first molars to induce experimental periodontitis. Then, 48 and 96 mg/kg of DG was administered to the study groups by oral gavage for 29 days. At day 30, the animals were sacrificed and ABL was determined via CBCT. The expression patterns of osteocalcin (OCN), alkaline phosphatase (ALP), type I collagen (Col-1), B cell lymphoma 2 (Bcl 2), Bcl 2-associated X protein (Bax), bone morphogenetic protein 2 (BMP-2), and receptor activator of NF kappa B ligand (RANKL) were examined immunohistochemically. Results Histopathologic examination showed all features of the advanced lesion in the P group. DG use decreased all these pathologic changes. It was observed that periodontitis pathology decreased as the dose increased. DG treatment increased the ALP, OCN, Bcl 2, Col-1, and BMP-2 levels in a dose-dependent manner, compared with the P group (p < 0.05). DG decreased the expression of RANKL and Bax in a dose-dependent manner (p < 0.05). ABL was significantly lower in the DG-48 and DG-96 groups than in the P group (p < 0.05). Conclusion Collectively, our findings suggest that DG administration protects rats from periodontal tissue damage with a dose-dependent manner, provides an increase in markers of bone formation, decreases in Bax/Bcl-2 ratio and osteoclast activation.Article Perceptions and surgical approaches of periodontists and residency students for bone augmentation procedures(2024) Lektemur Alpan, Aysan; Torumtay Cin, Gizem; Alpan, Aysan Lektemur; Cin, Gizem TorumtayAim: Bone deficiency due to various systemic and periodontal diseases, trauma, and tumors remains a major challenge for osseointegration in implant therapies. To provide implant survival, sufficient bone volume is mandatory. The purpose of the present study is to assess the techniques used by periodontists in implant applications, treatment plans, and solutions to the complications they experience. Material and Methods: 126 periodontists and/or residency students participated in this study. A questionnaire consisting of 20 questions was used. The knowledge and treatment methods about the technique, materials, and planning they use in bone regeneration and the management of complications were questioned. Descriptive statistics and the Pearson Chi-square test were used to analyze the data. Results: All participants needed bone regeneration in implant cases. The most used material for regeneration by the participants was xenograft, with 43.5%. The most preferred application in bone regeneration is guided bone regeneration (GBR) using the collagen membrane, with a rate of 78.3%. The most common complication was membrane exposure. In order to prevent complications, 77.3% of the participants performed adequate soft tissue release, while 63.6% controlled periodontitis. The most commonly used treatment option for complications was the use of postoperative antibiotics/antiseptics. 82.6% of the participants received support in the management of complications. Conclusion: In our study, it was observed that periodontists frequently chose different planning methods and treatment options when performing bone reconstruction/regeneration. It will be beneficial for periodontists to include the latest treatment models applied in the current literature in periodontology residency education.Article Citation - WoS: 8Citation - Scopus: 9Efficacy of injectable platelet-rich fibrin on clinical and biochemical parameters in non-surgical periodontal treatment: a split-mouth randomized controlled trial(Springer Science and Business Media Deutschland GmbH, 2023-12-28) Cin, Gizem Torumtay; Alpan, Aysan Lektemur; Cevik, OezgeAbstract: Objectives: The purpose of this clinical trial was to evaluate the potential clinical and biochemical effects of injectable platelet-rich fibrin (i-PRF) application adjunct to scaling and root planning (ScRp) in deep periodontal pockets. Materials and methods: In this split-mouth-designed study, 17 patients with 34 deep periodontal pockets were randomly treated with ScRp + i-PRF (test group) and ScRp + saline (control group). Clinical periodontal measurements were recorded at baseline, 1st, 3rd, and 6th months after the treatments. The levels of vascular endothelial growth factor (VEGF), tumor necrosis factor-α (TNF-α), and interleukin (IL)-10 in gingival crevicular fluid (GCF) samples were analyzed using the ELISA method at baseline, 7th, and 14th days. Results: Clinical periodontal parameters showed significant improvements with both treatment modalities. Mean pocket reduction (PD) and clinical attachment (CAL) gain were significantly higher in the test group than in controls at follow-up visits (p < 0.05). In the test group, gingival recession (GR) values were significantly lower compared to the control group. VEGF and IL-10 levels in the test group were significantly higher than in controls at the 14th day, and TNF-α levels were found significantly lower in the test group at the 7th and 14th days. Conclusions: Especially in the test group, the significant increase in VEGF and IL-10 expressions and the decrease in TNF-α levels may have accelerated the periodontal healing observed in the clinical parameters. Clinical relevance: The result of the present study demonstrated the beneficial effects of adjunctive i-PRF administration during non-surgical periodontal treatment of deep periodontal pockets. Clinical trial registration number: NCT05753631. © 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.Article Ratlarda Oluşturulan Kritik Boyutlu Kalvaryal Defektlerde Bakteriyel Selüloz Temelli Hidroksiapatit (BS-HAp) Nanokompozitinin Kemik Oluşumu Üzerine Etkisi(2022-12-24) Ozmen, Ozlem; Alpan, Aysan Lektemur; Doğan, Nazime Mercan; Denizli, Tuğba HilalBu çalışmada, sıçanlarda kritik boyuttaki kalvaryal defektlerde bakteriyel selüloz-hidroksiapatit (BS-HAp) kompozitinin kemik rejenerasyonundaki potansiyelinin değerlendirilmesi amaçlanmıştır. Komagataibacter xylinus S4 izolatından elde edilen BS-HAp taramalı elektron mikroskobunda (SEM) incelenerek içeriğindeki Ca ve P iyonlarının yoğunluğu tespit edilmiştir. Ratlarda oluşturulan kalvaryal defektlere elde edilen BS-HAp dondurulup kurutularak uygulanmıştır. 4. ve 8. haftanın sonunda alınan örnekler histopatolojik olarak incelenmiştir. SEM sonuçlarına göre BS lifleri, ince demetler halinde olup fibril çapı 42,11olarak tespit edilmiştir. HAp, BS pelikülüne dahil olarak içeriğinde yüksek oranda Ca ve P elementleri saptanmıştır. Yapılan in-vivo deneylerin sonunda 4. Haftada herhangi bir kemik oluşumuna rastlanmamıştır. BS-HAp grubunda düzgün bağ doku oluşumu gözlenmiştir. 8. haftanın sonunda BS-HAp grubunda biyomateryal komşuluğunda yeni kemik alanları izlenmiştir. Komagataibacter xylinus S4 izolatından elde edilen BS-HAp biyomateryal olarak kullanıldığında 8. haftada yeni kemik oluşumunu indüklemiştirArticle Citation - WoS: 1Citation - Scopus: 3Articaine versus lidocaine inferior alveolar nerve block in posterior mandible implant surgeries: a randomized controlled trial(Medicina Oral S L, 2023) Gulnahar, Yakup; Alpan, Aysan Lektemur; Gulnahar, EvremBackground: The aim of this study is to compare the effects of %4 articaine and %2 lidocaine on inferior alveolar nerve block (IANB) for implant surgery in the posterior mandible.Material and Methods: The patients who have inserted implants in the posterior mandible were divided into 2 groups for IANB: lidocaine and articaine. VAS = visual analog scale, pain during surgery and injection, lip numb-ness time, mandibular canal-implant apex distance, age, gender, bone density, implant number, release incision, adjacent teeth, and duration of surgery were analyzed using t-test, Mann-Whitney U test, Spearman's coefficient, and, Pearson's chi-squared test. This trial followed the recommendations of the Consort Statement for reporting randomized controlled trials. Results: 577 patients were included and 1185 dental implants were analyzed. There was no significant difference between the two groups in terms of injection and surgery VAS values (p>0.05). The lip numbness time of lido-caine was 3.06 +/- 3.22min while articaine was found to be 2.96 +/- 3.09min (p>0.05). Mandibular canal-implant apex distance was found to be 2.28 +/- 0.75mm in the articaine and 2.45 +/- 0.86mm in the lidocaine group (p<0.05). Release incision was made more in the articaine group (51/252) than in the lidocaine group (40/325) (p<0.05).Conclusions: There was no difference between the %4 articaine and %2 lidocaine in terms of pain perception in posterior mandible implant applications. Both anesthetics provided adequate anesthesia for implant application.Article Periodontal Parameters And Periodontitis Severity In Type 2 Diabetes Patients With Chronic Complications(Annals Dental Specialty, 2022) Cin, Gizem Torumtay; Fenkci, Semin Melahat; Yigit, Umut; Alpan, Aysan LektemurLong-term hyperglycemia is related to micro and/or macrovascular complications in diabetes mellitus. The interrelationship between diabetes and periodontitis is bi-directional and inflammation is the common feature of both diseases. This study aimed to search the effects of the number of chronic vascular complications in type 2 diabetics on the amount of periodontal tissue destruction and the periodontal disease severity. This cross-sectional study included 127 individuals with type 2 diabetes who developed at least one diabetes-related chronic complication. The severity of periodontitis and the amount of gingival inflammation and periodontal tissue destruction between patients with several vascular complications were compared. We also compared the periodontal parameters and the severity of periodontitis according to glycemic control levels and in terms of the preŞence of macrovascular complications. All periodontal clinical parameters and periodontal disease severity were significantly higher in patients with 3 and 4 diabetic vascular complications than in patients with fewer complications. In patients without macrovascular complications, the severity of periodontitis was significantly lower compared to those with macrovascular complications (p<0.05). WorŞened gingival inflammation was shown in patients with poor glycemic control, but there was no statistically significant difference in PD and CAL. Our findings showed that the severity of periodontal disease was higher as the number of diabetes-related chronic complications increased. The extent of gingival inflammation was elevated with poor glycemic control whereas the amount of periodontal tissue destruction did not change.Article Citation - WoS: 21Citation - Scopus: 21Comparison of hyaluronic acid, hypochlorous acid, and flurbiprofen on postoperative morbidity in palatal donor area: a randomized controlled clinical trial(Springer Heidelberg, 2023-01-03) Alpan, Aysan Lektemur; Cin, Gizem TorumtayObjectiveThis study aims to evaluate the effects of topical hyaluronic acid (HA), hypochlorous acid (HOCl), and flurbiprofen on postoperative morbidity of palatal donor sites after free gingival graft (FGG) surgery. Materials and methodsSixty patients requiring FGG were randomly assigned into four groups: control, HA gel (600 mg/100 g high molecular weight hyaluronic acid), HOCl spray (170-200 ppm, ph7.1), flurbiprofen spray (0.075gr flurbiprofen). Topical agents were applied for 14 days, according to groups. Patients were followed for 28 days. Palatal healing was assessed with the Laundry wound healing index (WHI). Complete epithelization (CE) was evaluated with photographs and H2O2 bubbling. Pain, burning Şensation, chewing efficacy, and tissue color match (CM) were evaluated using a visual analog scale (VAS). Postoperative analgesic consumption and delayed bleeding (DB) were also recorded. ResultsHA provided better WHI values on the 7(th), 14(th), and 21(st) days compared to the other groups, respectively (p < 0.05). CE was formed on the 21(st) day in the HA group but on the 28(th) day in the other groups. HOCl and flurbiprofen groups were not different from the control group or each other in terms of WHI. HOCl had the lowest VAS scores of all time periods. DB was not observed in any group. Significantly fewer analgesics were taken in the topical agent-applied groups compared to the control group. ConclusionsHA exhibits a positive impact on the epithelization of palatal wound healing and color matching. HOCl and flurbiprofen provided less pain; however, they might have negative effects on palatal wound healing.Article Ozone improves autogenous graft healing in experimental diabetes mellitus: A morphometric and immunohistochemical study(2020-04-01) Özer, Hatice; Alpan, Aysan Lektemur; Toker, HulyaBackground: Diabetes mellitus (DM) is a metabolic disorder whichplays crucial role in the pathogenesis of periodontitis. Ozone haveseveral actions such as antimicrobial, immunostimulating,antihypoxic effects, and activates antioxidant enzymes andangiogenesis. The aim of this study is to investigate the effect ofgaseous ozone on bone healing in diabetic rat calvarial defectstreated with autogenous bone graft, morphometrically andimmunohistochemically.Material and Methods: Diabetes was induced and critical sizedefects were created on rats. Study groups: 1-Empty defect(Control, n=14) group, 2-Autograft (AG, n=14) group, 3-Emptydefect+ozone therapy (Control+Ozone, n=14) group, 4-Autograft+ozone application (AG+Ozone, n=14) group. Gaseousozone was applied on the operation day and the following 2 weeksdaily (140ppm @ 2L/d, 2.24 mg). Total bone area was measured.Osteocalcin and Bone morphogenic protein-2 protein expressionswere evaluated.Results: Control and Control+Ozone groups had no osteoclastand residuel lacunae during the study . Osteoblasts in AG+Ozonegroup were higher than AG group at 4th week (p>0.05).AG+Ozone group had more total bone area than AG group at 4thweek. AG+Ozone group revealed more BMP-2 immune positivitycompared to the other groups. Osteocalcin immune positivity inAG groups was higher than those of the Control groups.Conclusion: Within the limitations of this study, gaseous ozoneapplication decreased osteoclast number and increasedosteoblast number and bone regeneration, especially, in earlystages of bone regeneration in diabetic rats