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Abdulkareem AA, Al-Taweel FB, Al-Sharqi AJ, Gul SS, Sha A, Chapple IL. Current concepts in the pathogenesis of periodontitis: from symbiosis to dysbiosis. J Oral Microbiol 2023; 15:2197779. [PMID: 37025387 PMCID: PMC10071981 DOI: 10.1080/20002297.2023.2197779] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
The primary etiological agent for the initiation and progression of periodontal disease is the dental plaque biofilm which is an organized aggregation of microorganisms residing within a complex intercellular matrix. The non-specific plaque hypothesis was the first attempt to explain the role of the dental biofilm in the pathogenesis of periodontal diseases. However, the introduction of sophisticated diagnostic and laboratory assays has led to the realisation that the development of periodontitis requires more than a mere increase in the biomass of dental plaque. Indeed, multispecies biofilms exhibit complex interactions between the bacteria and the host. In addition, not all resident microorganisms within the biofilm are pathogenic, since beneficial bacteria exist that serve to maintain a symbiotic relationship between the plaque microbiome and the host’s immune-inflammatory response, preventing the emergence of pathogenic microorganisms and the development of dysbiosis. This review aims to highlight the development and structure of the dental plaque biofilm and to explore current literature on the transition from a healthy (symbiotic) to a diseased (dysbiotic) biofilm in periodontitis and the associated immune-inflammatory responses that drive periodontal tissue destruction and form mechanistic pathways that impact other systemic non-communicable diseases.
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Affiliation(s)
- Ali A. Abdulkareem
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
- CONTACT Ali A. Abdulkareem College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Firas B. Al-Taweel
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Ali J.B. Al-Sharqi
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Sarhang S. Gul
- College of Dentistry, University of Sulaimani, Sulaimani, Iraq
| | - Aram Sha
- College of Dentistry, University of Sulaimani, Sulaimani, Iraq
| | - Iain L.C. Chapple
- Periodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, University of Birmingham, Birmingham, UK
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Alshami ML, Abdulkareem AA, Gul SS, Shareef YA. Impact of COVID-19 on the frequency of dental appointments and types of dental health care services. d3000 2022. [DOI: 10.5195/d3000.2022.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objectives: To investigate the impact of the COVID-19 pandemic on the frequency of provision of dental appointments and types of dental care services.Methods: The dental records of three dental health services, over 3 months, in the year before (2019) and a year during (2020) the pandemic were retrieved. The dental records were categorized according to the referral after diagnosis into prosthodontics, pedodontics, orthodontics, conservative, endodontics, periodontics, and oral surgery. The demographic variables and types of treatment provided were recorded and analyzed. The frequency of appointments was determined from overall dental records and departmental dental records. Chi square test was used to determine the effect of gender and age on dental appointments.Results: According to the dental records for 2019, 7286 appointments were provided, and this number decreased by 2.4-fold to 3090 appointments in 2020. The records indicated that the highest decreases were in non-urgent dental appointments in the periodontics, orthodontics and conservative departments (8, 8, and 4.6-fold, respectively). Statistically significant differences in dental pre-pandemic and pandemic appointments were identified for gender and age group. Female and older (>64 years old) subjects appeared to be less willing to attend dental appointments (OR=1.2 and 1.3, respectively) compared to their male and younger counterparts.Conclusion: The COVID-19 pandemic has had significant influence on decreasing attendance at dental appointments and the records show that the highest decreases were in non-urgent dental departments.
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Ahmed AF, Naser RJ, Gul SS, Abdulkareem AA. Association between self-reported oral disease/conditions and symptoms of depression among Iraqi individuals. Spec Care Dentist 2022; 42:503-508. [PMID: 35043422 DOI: 10.1111/scd.12698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 11/27/2022]
Abstract
AIMS The negative impact of oral diseases on the function, economy, and general health of the population is well-documented. In the last decades, evidence linking increased expression of depression and oral diseases/conditions has significantly increased. The aim of this study is to assess the association between oral disease/conditions and self-reported symptoms of depression individuals. METHODS A specially designed questionnaire was distributed via social media for 1 week. It consisted of two main sections; the first section was dedicated to collect demographic variables and self-reported symptoms of oral diseases. The second section, Patient Health Questionnaire-9 (PHQ-9), was used to assess the severity of depression via nine questions using a 4-point Likert scale. Association between depression and oral disease was determined by linear regression analysis. RESULTS A total of 1975 participants responded fully to the questionnaire and were included in the final analysis. The majority of participants, about 60%, showed mild to moderate symptoms of depression, while 8.9% expressed severe symptoms. Oral diseases positively associated with depression were caries, missing teeth, gingival bleeding, gingival recession, teeth mobility, and dry mouth (R2 = .155). In contrast, increased esthetic level of teeth/gingiva significantly decreased the feeling of depression. CONCLUSIONS Results indicated that oral diseases, particularly those adversely affecting function and esthetics, were associated with symptoms of depression in Iraqi individuals. These findings highlighted the importance of maintaining oral health as part of the general psychological wellbeing of the population.
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Affiliation(s)
- Alaa F Ahmed
- College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Reyam J Naser
- College of Dentistry, Al-Rasheed University College, Baghdad, Iraq
| | - Sarhang S Gul
- College of Dentistry, University of Sulaimani, Sulaimani, Iraq
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Chasib NH, Alshami ML, Gul SS, Abdulbaqi HR, Abdulkareem AA, Al-Khdairy SA. Dentists' Practices and Attitudes Toward Using Personal Protection Equipment and Associated Drawbacks and Cost Implications During the COVID-19 Pandemic. Front Public Health 2021; 9:770164. [PMID: 34869182 PMCID: PMC8637868 DOI: 10.3389/fpubh.2021.770164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/12/2021] [Indexed: 12/23/2022] Open
Abstract
Objectives: During the COVID-19 pandemic, dentists have had to work under stressful conditions due to the nature of their work. Personal protection equipment (PPE) has become mandatory for work in the dentistry field. This study aimed to examine dentists' practices and attitudes regarding the use of PPE and the associated drawbacks and cost implications during the pandemic. Methods: A questionnaire-based survey was used and was divided into five sections dedicated to collect demographic variables and to examine the dentists' practices, attitudes toward PPE, drawbacks, and cost of using PPE. Mann-Whitney U and Kruskal-Wallis tests were used to compare different sections of the questionnaire and linear regression was used to determine the predictors of the dentists' practices and attitudes toward PPE. Results: The mean of practices regarding use of PPE was 5.41 ± 1.71 (median 6), attitude toward using PPE scored 2.26 ± 0.90 (median 2), while the means of drawbacks and cost recorded equal scores of 5.22 ± 1.24 (median 5) and 1.68 ± 0.74 (median 2), respectively. The recently graduated dentists, those with postgraduate degrees and those working in the private sector demonstrated higher levels of practices on PPE than their counterparts. Regression analysis revealed that practices of PPE can be predicted on the basis of qualifications and work place, whereas attitude toward PPE is significantly influenced by qualification only. Conclusions: The study participants demonstrated satisfactory levels of practices and positive attitudes toward PPE. While complaints from using PPE and their cost were moderately affected.
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Affiliation(s)
| | | | - Sarhang S Gul
- College of Dentistry, University of Sulaimani, Sulaymaniyah, Iraq
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Abdulbaqi HR, Shaikh MS, Abdulkareem AA, Zafar MS, Gul SS, Sha AM. Efficacy of erythritol powder air-polishing in active and supportive periodontal therapy: A systematic review and meta-analysis. Int J Dent Hyg 2021; 20:62-74. [PMID: 34318577 DOI: 10.1111/idh.12539] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/08/2021] [Accepted: 07/22/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This systematic review aimed to analyse available evidence to answer two focused questions about the efficacy of erythritol powder air-polishing (EPAP) (i) as an adjunctive during active periodontal therapy (APT) and (ii) as an alternative to hand/ultrasonic instrumentation during supportive periodontal therapy (SPT). Additionally, microbiological outcomes and patient's comfort/perceptions were assessed as secondary outcomes. METHODS PubMed, Cochrane and Medline were searched for relevant articles published before February 2021 following PRISMA guidelines. The search was conducted by three independent reviewers, and the agreement was measured by Cohen's kappa score. Out of 1043 articles, eight randomized clinical trials were selected for systematic review and quantitative synthesis. Only periodontal parameters, such as clinical attachment level (CAL), probing pocket depth (PPD) and bleeding on probing (BoP), showed homogeneity and, thus, were selected for meta-analysis. RESULTS The improvement in PPD and BoP scores after using EPAP was comparable with hand/ultrasonic instrumentation during both APT and SPT. Significant CAL gain was achieved with EPAP during APT (0.16 mm, p < 0.02) compared with hand/ultrasonic instrumentation at the end point, whereas non-significant CAL gain was achieved during SPT. No differences were observed regarding microbiological outcomes between the two treatment modalities. However, EPAP inflicted less pain and was better perceived by the patients. CONCLUSION Erythritol powder air-polishing can substitute hand/ultrasonic instrumentation for SPT, and CAL gain is significantly improved when EPAP is used as an adjunct during APT. For microbiological outcomes, no significant differences were observed between the two approaches; however, EPAP was better tolerated by the patients than hand/ultrasonic instrumentation. CLINICAL RELEVANCE Erythritol powder air-polishing can be used as an adjunct during APT and as an alternative to conventional mechanical debridement during SPT.
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Affiliation(s)
- Hayder R Abdulbaqi
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Muhammad Saad Shaikh
- Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Ali A Abdulkareem
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Muhammad S Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Medina, Saudi Arabia.,Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, Pakistan
| | - Sarhang S Gul
- Department of Periodontics, College of Dentistry, University of Sulaimani, Sulaymaniyah, Iraq
| | - Aram M Sha
- Department of Periodontics, College of Dentistry, University of Sulaimani, Sulaymaniyah, Iraq.,Smart Health Tower, Sulaimani, Iraq
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Al-Taweel FB, Abdulkareem AA, Gul SS, Alshami ML. Evaluation of technology-based learning by dental students during the pandemic outbreak of coronavirus disease 2019. Eur J Dent Educ 2021; 25:183-190. [PMID: 32789943 PMCID: PMC7436321 DOI: 10.1111/eje.12589] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/25/2020] [Accepted: 08/04/2020] [Indexed: 05/04/2023]
Abstract
INTRODUCTION Although technology-based learning (TB learning) has been accepted as an efficient educational tool in the field of dentistry, the evaluation of TB learning in non-prepared situations such as pandemics has not been fully investigated. This study aimed to evaluate different aspects of TB learning amongst undergraduate dental students during the pandemic outbreak of COVID-19. MATERIALS AND METHODS Dental students in selected Iraqi universities (University of Baghdad, University of Sulaimani and Dijlah University College) were invited to join the study. A questionnaire was created using a Google platform and answered by students. Satisfaction and attitude towards TB learning plus total evaluation scores for lecturers were examined. RESULTS A total of 832 out of 1800 dental students participated in the study. The majority of participants have basic (40.7%) and intermediate (47.5%) computer skills, and more than half of them lack any experience in TB learning. The overall satisfaction and positive attitude towards TB learning were less than 50%. Students at final grade, with advanced computer skills and TB learning experience, showed higher satisfaction (OR: 3.031, 2.876, 3.644, respectively) and a more positive attitude (OR: 3.172, 3.035, 3.477, respectively) towards TB learning than those at earlier grades. Total evaluation scores for lecturers were higher amongst females (11.5 ± 5.8) than males (9.9 ± 7.2) as well as amongst participants at final grade (14.0 ± 6.2), with advanced computer skills (13.8 ± 6.1) and TB learning experience (16.2 ± 6.0). CONCLUSIONS Dental students demonstrated low-moderate satisfaction and positive attitude towards TB learning and the quality of material presented to them. Integrating TB learning into the dental education curriculum is an essential step in enhancing the acceptance of TB learning in the future.
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Affiliation(s)
| | | | - Sarhang S Gul
- College of Dentistry, University of Sulaimani, Sulaimani, Iraq
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Abdulkareem AA, Imran NK, Abdulraheam RH, Gul SS. Prevalence and factors influencing reporting of true periodontal chief complaints: A retrospective analysis. Clin Exp Dent Res 2020; 7:443-449. [PMID: 33354853 PMCID: PMC8404502 DOI: 10.1002/cre2.385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/06/2020] [Accepted: 12/08/2020] [Indexed: 11/12/2022] Open
Abstract
Objectives To investigate the prevalence of true periodontal chief complaints (CC) and the factors affecting their reporting by patients with periodontal diseases (PD). Materials and Methods This cross‐sectional study was based on retrospective analysis of available periodontal records. Different personal and demographic variables were obtained from these records including CC, age, gender, working status, past medical/dental history, smoking status and diagnosis. In addition, clinical parameters of plaque index, gingival index, probing pocket depth (PPD), and number of missing teeth. Periodontal CC were retrieved and divided either into true periodontal (bleeding, tooth mobility, and alteration in gingival color/shape) or others (emergency and esthetic‐related) CC. Results A total of 1161 records were included in the final analysis. Results showed that only 287 (24.7%) of patients reported true periodontal CC whereas the remaining 874 (75.3%) patients were not aware about symptoms of PD. Regression modeling indicated that reporting of true CC was positively associated with smoking and PPD but negatively associated with number of missing teeth and gender (male). Conclusions Results suggested that recognition of true periodontal CC by the patients was low. Reporting of true periodontal CC was significantly associated with smoking, PPD, female and lower number of missing teeth. These results shed light on the importance of increasing public knowledge about PD which is essential to aid people in recognizing these diseases at early stages.
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Affiliation(s)
- Ali A Abdulkareem
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Nada K Imran
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Rukhosh H Abdulraheam
- Basic Science Department, College of Dentistry, University of Sulaimani, Sulaymaniyah, Iraq
| | - Sarhang S Gul
- Periodontics Department, College of Dentistry, University of Sulaimani, Sulaymaniyah, Iraq
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Mahdee AF, Gul SS, Abdulkareem AA, Qasim SSB. Anxiety, Practice Modification, and Economic Impact Among Iraqi Dentists During the COVID-19 Outbreak. Front Med (Lausanne) 2020; 7:595028. [PMID: 33425944 PMCID: PMC7793761 DOI: 10.3389/fmed.2020.595028] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 12/02/2020] [Indexed: 12/15/2022] Open
Abstract
Objectives: As health care workers on the front line during the coronavirus (COVID-19) pandemic, dental practitioners are amongst those at risk due to their close contact with potentially infected individuals. The aim of the current study was to assess the anxiety, awareness practice modification, and economic impact amongst Iraqi dentists whilst working during the outbreak. Methods: This study was performed using an online survey questionnaire with aid of Google forms from 2nd to 23rd July 2020. A total of 484 clinicians responded. The questionnaire was composed of open end, closed end, and Likert five-point scale questions to assess anxiety, awareness and financial impact of COVID-19 on dentists. Mann–Whitney test was used to compare two groups, whilst Kruskal–Wallis was performed by post-hoc test for multigroup comparisons. Results: The mean age of participants was 36.51 ± 9.164 years and the majority (75.2%) of these were graduate dentists only. More than 80% of participants reported anxiety of catching COVID-19. The recorded anxiety level was higher amongst younger dentists and females. Awareness and practice levels among these dentists of precautions and infection-control measures associated with COVID-19 (94%) was found to be high and to be statistically significantly affected by age, qualification and designation (except GP vs. Specialist). With respect to the economic impact, about 75% of practitioners, regardless of demographical variables, reported that their income had declined by about 50%. Conclusions: The investigation provides clear insights into the anxiety, practice modifications and economic impact on dentists working in Iraq. Although there is a high level of knowledge and awareness of required practice regarding the COVID-19 outbreak among Iraqi dentists, they also reported a high level of anxiety.
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Affiliation(s)
- Anas F Mahdee
- Department of Restorative and Aesthetic Dentistry, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Sarhang S Gul
- Department of Periodontics, College of Dentistry, University of Sulaimani, Sulaimani, Iraq
| | - Ali A Abdulkareem
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Syed Saad B Qasim
- Department of Bioclinical Sciences, Faculty of Dentistry, Kuwait University, Safat, Kuwait
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Gul SS, Abdulkareem AA, Sha AM, Rawlinson A. Diagnostic Accuracy of Oral Fluids Biomarker Profile to Determine the Current and Future Status of Periodontal and Peri-Implant Diseases. Diagnostics (Basel) 2020; 10:diagnostics10100838. [PMID: 33081038 PMCID: PMC7603129 DOI: 10.3390/diagnostics10100838] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/10/2020] [Accepted: 10/16/2020] [Indexed: 02/06/2023] Open
Abstract
Severe periodontitis is ranked as the sixth most prevalent disease affecting humankind, with an estimated 740 million people affected worldwide. The diagnosis of periodontal diseases mainly relies upon assessment of conventional clinical parameters. However, these parameters reflect past, rather than current, clinical status or future disease progression and, likely, outcome of periodontal treatment. Specific and sensitive biomarkers for periodontal diseases have been examined widely to address these issues and some biomarkers have been translated as point-of-care (PoC) tests. The aim of this review was to provide an update on PoC tests for use in the diagnosis and management of periodontal diseases. Among the PoC tests developed so far, active matrix metalloproteinase-8 has shown promising results in terms of diagnostic and prognostic values. However, further studies are required to increase the sensitivity and specificity via combining more than one biomarker and merging these test kits with periodontal risk assessment tools. Furthermore, the validity of these test kits needs to be investigated by applying the results in further independent studies and the impact on these test kits’, together with the results of risk factors for periodontal diseases, such as diabetes and smoking, also needs to be examined.
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Affiliation(s)
- Sarhang S. Gul
- College of Dentistry, Periodontics Department, University of Sulaimani, Sulaymaniyah 1124–30, Iraq;
- Correspondence: ; Tel.: +964-7701-447-723
| | - Ali A. Abdulkareem
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad 10011, Iraq;
| | - Aram M. Sha
- College of Dentistry, Periodontics Department, University of Sulaimani, Sulaymaniyah 1124–30, Iraq;
| | - Andrew Rawlinson
- Academic Unit of Restorative Dentistry, School of Clinical Dentistry, University of Sheffield, Sheffield S10 2TA, UK;
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Zardawi FM, Gul SS, Fatih MT, Hama BJ. Surgical Procedures Reducing Excessive Gingival Display in Gummy Smile Patients With Various Etiologic Backgrounds. Clin Adv Periodontics 2020; 10:130-134. [PMID: 31954090 DOI: 10.1002/cap.10089] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 08/25/2019] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Gummy smile (GS) is an esthetic issue which causes a person to show a larger than average amount of gum tissue when smiling. Lip repositioning procedure is a surgical treatment option performed by removing a partial thickness strip from the maxillary buccal vestibular mucosa and suturing back the lip mucosa to the mucogingival line. High rate of relapse has been recorded with this procedure. In this study, different treatment options were applied according to the etiology and clinical background of each individual case in an attempt to overcome relapse. Furthermore, modification of the conventional lip repositioning procedure and the clinical outcome of this technique will be demonstrated in this report. CASE SERIES Among the four selected patients who requested correction of their GS, the amounts of gingival display (GD) measured using digital Vernier were from 5 to 7 mm. Clinical examination revealed variation in the length of the clinical crowns, and vestibular depth and width of keratinized gingiva. Since the causes of their GS were different, different surgical modalities were applied to address GS in this case series. The procedures were gingivectomy, osteoplasty, and modification of lip repositioning procedure performed by removing a partial thickness ribbon of the keratinized attached gingiva and then suturing the labial alveolar mucosa to the attached gingiva at a level more coronal to its previous position. CONCLUSION One-year follow-up showed that all these surgical procedures reduced excessive GD by 2 mm without relapse and the patients were satisfied with the esthetic outcome.
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Affiliation(s)
- Faraedon M Zardawi
- Department of Periodontics, College of Dentistry, University of Sulaimani, Sulaymaniyah, Iraq
| | - Sarhang S Gul
- Dean of College of Dentistry, University of Sulaimani, Sulaymaniyah, Iraq
| | - Mohammed T Fatih
- Shorsh Center for Restorative Dentistry, Kurdistan Board for Medical Specialties (KBMS), Erbil, Iraq
| | - Balen J Hama
- Shorsh Center for Restorative Dentistry, Kurdistan Board for Medical Specialties (KBMS), Erbil, Iraq
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Aygun H, Gul SS. Cardioprotective effect of melatonin and agomelatine on doxorubicin-induced cardiotoxicity in a rat model: an electrocardiographic, scintigraphic and biochemical study. ACTA ACUST UNITED AC 2019; 120:249-255. [PMID: 31023046 DOI: 10.4149/bll_2019_045] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
AIM The present study aimed to determine the protective effect of melatonin and agomelatine on DOX-induced cardiotoxicity in rats by electrocardiographic, scintigraphic and biochemical methods. MATERIALS AND METHODS Forty-nine male Wistar rats were randomly separated into seven groups; control (CON), doxorubicin (DOX), melatonin (MEL), agomelatine (AGO), melatonin+doxorubicin (MEL+DOX), agomelatine+doxorubicin (AGO+DOX) and melatonin+ agomelatine+ doxorubicin (MEL+AGO+DOX) groups. Cardiotoxicity was induced by intraperitoneal (i.p.) injection of DOX (18 mg/kg daily for three days). Rats receiving MEL and AGO treatment in the DOX-induced cardiotoxicity group received MEL and AGO (40 mg/kg/day, i.p., for seven days). They were injected with doxorubicin (18 mg/kg, i.p.) on days 5, 6, and 7. The rats were given MEL and AGO as substance control (40 mg/kg/day, i.p., for 7 days). On day 8 of the experiment, animals were evaluated by means of electrocardiography (ECG) and 99mtechnetium pyrophosphate (99mTc PYP) scintigraphy and their biochemical parameters [blood urea nitrogen (BUN), creatine kinase (CK), cardiac troponin T (cTnT)] were examined. RESULTS DOX-induced acute cardiotoxicity in rats is characterized by conduction abnormalities in the ECG pattern (including decreased P wave and QRS complex duration, increased QT and RR intervals, and ST-segment elevation), increased serum BUN, CK, and cTnT parameters and increased 99mTc PYP uptake (p < 0.001). Pretreatment with MEL, AGO, or MEL+AGO effectively alleviated DOX-induced ECG abnormalities close to normal (p < 0.001). Moreover, serum biochemical evidence and 99mTc PYP uptake values demonstrated that pretreatment with MEL, AGO, or MEL+AGO has the same protective effect against the abnormalities produced in the heart by DOX (p < 0.001). CONCLUSIONS MEL and AGO have a potential protective effect on DOX-induced cardiotoxicity. At the same time, this study suggests that 99mTc PYP is a non-invasive method suitable for early determination of DOX-induced cardiotoxicity (Tab. 3, Fig. 5, Ref. 41).
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Aygun H, Gul SS. Protective effect of melatonin and agomelatine on adriamycin-induced nephrotoxicity in rat model: a renal scintigraphy and biochemical study. BRATISL MED J 2019; 120:113-118. [PMID: 30793614 DOI: 10.4149/bll_2019_018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE We aimed to determine the possible protective effects of melatonin and agomelatine on an animal model of adriamycin nephrotoxicity by 99mTc DMSA renal scintigraphy and biochemical methods. METHODS Ten weeks old 49 male Wistar rats were randomly separated into seven groups; namely control (CON), adriamycin (ADR), melatonin (MEL), agomelatine (AGO), melatonin + adriamycin (MEL+ADR), agomelatine + adriamycin (AGO+ADR) and melatonin + agomelatine + adriamycin (MEL+AGO+ADR) groups. Nephrotoxicity was induced by a three-dose of 18 mg/kg adriamycin, i.p. at a 24 h interval on the 5th, 6th and 7th days. A dose of melatonin and agomelatine (40 mg/kg/i.p, the same doses) were injected for 7 days before and after the injected of ADR (18 mg/kg, i.p.), respectively. On the 8th day of the experiment, all animals were evaluated and scintigraphic and biochemical parameters were assessed, respectively. RESULTS ADR significantly increased blood urea nitrogen (1040 %) and plasma creatinine (1020 %), and decreased 99mTc DMSA uptake levels (59 %) compared to the control (p < 0.001). Pretreatment with MEL, AGO, MEL+AGO mitigated these abnormalities produced by ADR in the kidney (p < 0.001). CONCLUSION 99mTc DMSA for the early determination of ADR-induced nephrotoxicity had an important role. Also, a significant correlation was found between biochemical and scintigraphy parameters. Adriamycin caused significant damages to kidneys that were reduced with MEL and AGO (Tab. 2, Fig. 3, Ref. 39).
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Gul SS, Griffiths GS, Stafford GP, Al-Zubidi MI, Rawlinson A, Douglas CWI. Investigation of a Novel Predictive Biomarker Profile for the Outcome of Periodontal Treatment. J Periodontol 2017; 88:1135-1144. [PMID: 28671508 DOI: 10.1902/jop.2017.170187] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND An ability to predict the response to conventional non-surgical treatment of a periodontal site would be advantageous. However, biomarkers or tests devised to achieve this have lacked sensitivity. The aim of this study is to assess the ability of a novel combination of biomarkers to predict treatment outcome of patients with chronic periodontitis. METHODS Gingival crevicular fluid (GCF) and subgingival plaque were collected from 77 patients at three representative sites, one healthy (probing depth [PD] ≤3 mm) and two diseased (PD ≥6 mm), at baseline and at 3 and 6 months after treatment. Patients received standard non-surgical periodontal treatment at each time point as appropriate. The outcome measure was improvement in probing depth of ≥2 mm. Concentrations of active enzymes (matrix metalloproteinase [MMP]-8, elastase, and sialidase) in GCF and subgingival plaque levels of Porphyromonas gingivalis, Tannerella forsythia, and Fusobacterium nucleatum were analyzed for prediction of the outcome measure. RESULTS Using threshold values of MMP-8 (94 ng/μL), elastase (33 ng/μL), sialidase (23 ng/μL), and levels of P. gingivalis (0.23%) and T. forsythia (0.35%), receiver operating characteristic curves analysis demonstrated that these biomarkers at baseline could differentiate healthy from diseased sites (sensitivity and specificity ≥77%). Furthermore, logistic regression showed that this combination of these biomarkers at baseline provided accurate predictions of treatment outcome (≥92%). CONCLUSION The "fingerprint" of GCF enzymes and bacteria described here offers a way to predict the outcome of non-surgical periodontal treatment on a site-specific basis.
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Affiliation(s)
- Sarhang S Gul
- School of Clinical Dentistry, University of Sheffield, Sheffield, U.K
| | | | - Graham P Stafford
- School of Clinical Dentistry, University of Sheffield, Sheffield, U.K
| | | | - Andrew Rawlinson
- School of Clinical Dentistry, University of Sheffield, Sheffield, U.K
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Gul SS, Huesgen KW, Wang KK, Mark K, Tyndall JA. Prognostic utility of neuroinjury biomarkers in post out-of-hospital cardiac arrest (OHCA) patient management. Med Hypotheses 2017; 105:34-47. [PMID: 28735650 DOI: 10.1016/j.mehy.2017.06.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 05/04/2017] [Accepted: 06/23/2017] [Indexed: 12/30/2022]
Abstract
Despite aggressive intervention, patients who survive an out-of-hospital cardiac arrest (OHCA) generally have very poor prognoses, with nationwide survival rates of approximately 10-20%. Approximately 90% of survivors will have moderate to severe neurological injury ranging from moderate cognitive impairment to brain death. Currently, few early prognostic indicators are considered reliable enough to support patients' families and clinicians' in their decisions regarding medical futility. Blood biomarkers of neurological injury after OHCA may be of prognostic value in these cases. When most bodily tissues are oxygen-deprived, cellular metabolism switches from aerobic to anaerobic respiration. Neurons are a notable exception, however, being dependent solely upon aerobic respiration. Thus, after several minutes without circulating oxygen, neurons sustain irreversible damage, and certain measurable biomarkers are released into the circulation. Prior studies have demonstrated value in blood biomarkers in prediction of survival and neurologic impairment after OHCA. We hypothesize that understanding peptide biomarker kinetics in the early return of spontaneous circulation (ROSC) period, especially in the setting of refractory cardiac arrest, may assist clinicians in determining prognosis earlier in acute resuscitation. Specifically, during and after immediate resuscitation and return of ROSC, clinicians and families face a series of important questions regarding patient prognosis, futility of care and allocation of scarce resources such as the early initiation of extracorporeal cardiopulmonary resuscitation (ECPR). The ability to provide early prognostic information in this setting is highly valuable. Currently available, as well as potential biomarkers that could be good candidates in prognostication of neurological outcomes after OHCA or in the setting of refractory cardiac arrest will be reviewed and discussed.
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Affiliation(s)
- S S Gul
- Department of Emergency Medicine, University of Florida, 1329, SW 16th Street, Suite 5270, Gainesville, FL 32608, United States
| | - K W Huesgen
- Department of Emergency Medicine, University of Florida, 1329, SW 16th Street, Suite 5270, Gainesville, FL 32608, United States
| | - K K Wang
- Program for Neurotrauma, Neuroproteomics & Biomarker Research, Department of Psychiatry, McKnight Brain Institute, University of Florida, 1149 Newell Drive, Gainesville, FL 32610, United States
| | - K Mark
- Department of Emergency Medicine, University of Florida, 1329, SW 16th Street, Suite 5270, Gainesville, FL 32608, United States
| | - J A Tyndall
- Department of Emergency Medicine, University of Florida, 1329, SW 16th Street, Suite 5270, Gainesville, FL 32608, United States.
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Gul SS, Douglas CWI, Griffiths GS, Rawlinson A. A pilot study of active enzyme levels in gingival crevicular fluid of patients with chronic periodontal disease. J Clin Periodontol 2016; 43:629-36. [DOI: 10.1111/jcpe.12568] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2016] [Indexed: 01/06/2023]
Affiliation(s)
- Sarhang S. Gul
- Academic Unit of Restorative Dentistry; School of Clinical Dentistry; University of Sheffield; Sheffield UK
| | | | | | - Andrew Rawlinson
- Academic Unit of Restorative Dentistry; University of Sheffield; Sheffield UK
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