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Ali Çekici

Other affiliations: The Forsyth Institute
Bio: Ali Çekici is an academic researcher from Istanbul University. The author has contributed to research in topics: Periodontitis & Bleeding on probing. The author has an hindex of 7, co-authored 15 publications receiving 840 citations. Previous affiliations of Ali Çekici include The Forsyth Institute.

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Journal ArticleDOI
TL;DR: Current knowledge of the host response in periodontitis is delineated to delineate the role of innate immunity, the failure of acute inflammation to resolve (thus becoming chronic), the cytokine pathways that regulate the activation of acquired immunity and the cells and products of the immune system are considered.
Abstract: The pathogenesis of periodontitis involves a complex immune/inflammatory cascade that is initiated by the bacteria of the oral biofilm that forms naturally on the teeth. The susceptibility to periodontitis appears to be determined by the host response; specifically, the magnitude of the inflammatory response and the differential activation of immune pathways. The purpose of this review was to delineate our current knowledge of the host response in periodontitis. The role of innate immunity, the failure of acute inflammation to resolve (thus becoming chronic), the cytokine pathways that regulate the activation of acquired immunity and the cells and products of the immune system are considered. New information relating to regulation of both inflammation and the immune response will be reviewed in the context of susceptibility to, and perhaps control of, periodontitis.

827 citations

Journal ArticleDOI
TL;DR: SS patients carry a higher risk of having periodontitis and are more predisposed to develop candidiasis.
Abstract: Objective: To determine the oral status, salivary flow rate, Candida carriage in saliva, and prevalence of Candida albicans colonization in several areas of the mouth in patients with primary and secondary Sjogren’s syndrome as opposed to those of healthy subjects. Study design: Thirty-seven patients with Sjogren’s syndrome (SS), [14 patients with primary SS (SS-1) and 23 patients with secondary SS (SS-2)], along with 37 healthy controls were examined in regard to number of teeth, pro-bing pocket depth (PPD), approximal plaque index (API), bleeding on probing (BOP), presence of prosthetic appliances and smoking habits. Salivary flow rate (SFR), Candida carriage in saliva, presence of Candida albicans colonization on buccal, angular, palatal and sulcular areas, on dentures and on the tongue’s dorsal surface were determined. Statistical analyses were performed using the 2-tailed Fisher exact and Kruskal-Wallis test. Results: No statistically significant difference was found between SS-1 and SS-2 groups based on the parameters analysed. Statistically significant differences were observed between patients with SS and healthy subjects in terms of SFR, oral signs and symptoms, API, BOP, C. albicans colonization on tongue and buccal area, and Candida carriage in saliva. In the gingival crevicular fluid positive C. albicans colonization was found in only one subject of SS subgroup. Conclusions: SS patients carry a higher risk of having periodontitis and are more predisposed to develop candidiasis. C. albicans is scarcely detected in gingival crevicular fluid despite high scores on C. albicans colonization in different areas of the oral cavity in SS patients.

66 citations

Journal ArticleDOI
05 Apr 2013-PLOS ONE
TL;DR: This project identified biomarkers that are of acceptable quality in serum and to a lesser degree in saliva using Multiplex arrays that exhibit high levels of analytical imprecision, particularly at the batch level.
Abstract: Multiplexing arrays increase the throughput and decrease sample requirements for studies employing multiple biomarkers. The goal of this project was to examine the performance of Multiplex arrays for measuring multiple protein biomarkers in saliva and serum. Specimens from the OsteoPerio ancillary study of the Women’s Health Initiative Observational Study were used. Participants required the presence of at least 6 teeth and were excluded based on active cancer and certain bone issues but were not selected on any specific condition. Quality control (QC) samples were created from pooled serum and saliva. Twenty protein markers were measured on five multiplexing array panels. Sample pretreatment conditions were optimized for each panel. Recovery, lower limit of quantification (LLOQ) and imprecision were determined for each analyte. Statistical adjustment at the plate level was used to reduce imprecision estimates and increase the number of usable observations. Sample pre-treatment improved recovery estimates for many analytes. The LLOQ for each analyte agreed with manufacturer specifications except for MMP-1 and MMP-2 which were significantly higher than reported. Following batch adjustment, 17 of 20 biomarkers in serum and 9 of 20 biomarkers in saliva demonstrated acceptable precision, defined as <20% coefficient of variation (<25% at LLOQ). The percentage of cohort samples having levels within the reportable range for each analyte varied from 10% to 100%. The ratio of levels in saliva to serum varied from 1∶100 to 28∶1. Correlations between saliva and serum were of moderate positive magnitude and significant for CRP, MMP-2, insulin, adiponectin, GM-CSF and IL-5. Multiplex arrays exhibit high levels of analytical imprecision, particularly at the batch level. Careful sample pre-treatment can enhance recovery and reduce imprecision. Following statistical adjustments to reduce batch effects, we identified biomarkers that are of acceptable quality in serum and to a lesser degree in saliva using Multiplex arrays.

60 citations

Journal ArticleDOI
TL;DR: These results demonstrate that the fluctuation of sex steroid hormones impact gingival inflammation during menstruation.
Abstract: Background: Hormonal changes during puberty, pregnancy, and menopause may impact periodontal tissues by altering the host response. There are only a few studies that examined gingival changes during the menstrual cycle. This longitudinal and prospective study aims to investigate clinical and laboratory markers of gingival inflammation in women at different phases during their menstrual cycles.Methods: Twenty-seven females were included in this study. Subjects were given oral hygiene instructions before the study, and their plaque index scores were recorded once a week for 2 months. The duration and regularity of the menstrual cycle were also checked at the same time. The gingival index and bleeding on probing (BOP) were recorded. Probing depths were measured to assess the periodontal condition of the subjects. Gingival crevicular fluid (GCF) was collected to analyze the levels of interleukin (IL)-1β and tumor necrosis factor-alpha on the first menstruation day (MD), estimated ovulation day (OD), and estim...

41 citations

Journal ArticleDOI
TL;DR: There was no significant relationship between MBL and implant length or diameter, whereas age, gender, and cantilever prostheses affected bone loss rates, and MBL was elevated in older and female patients as well as in patients who received cantilevers.
Abstract: A key criterion of success following dental implants is the marginal bone level. Long-term clinical and radiographic evaluation is necessary to test the results of in vitro studies investigating how cantilevering of restorations or implant size affect bone level changes around implants. There is no consensus on the effect of several variables such as age, gender, implant size, and cantilever prostheses on marginal bone levels around fixed dentures supported by dental implants. Patients who received cemented, fixed restorations supported by implants and who were examined in routine recall sessions 6, 12, 24, and 36 months after loading were included in the study group. Comparative bone level measurements were obtained from images of radiographs at ×20 magnification using the CorelDraw 11.0 software program. Statistical analysis was performed using the Student t test and 1-way analysis of variance. In the 36-month observation period, there were no incidences of implant failure, excessive bone loss around im...

41 citations


Cited by
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Journal ArticleDOI
TL;DR: Findings indicate that some Prevotella strains may be clinically important pathobionts that can participate in human disease by promoting chronic inflammation.
Abstract: The microbiota plays a central role in human health and disease by shaping immune development, immune responses and metabolism, and by protecting from invading pathogens. Technical advances that allow comprehensive characterization of microbial communities by genetic sequencing have sparked the hunt for disease-modulating bacteria. Emerging studies in humans have linked the increased abundance of Prevotella species at mucosal sites to localized and systemic disease, including periodontitis, bacterial vaginosis, rheumatoid arthritis, metabolic disorders and low-grade systemic inflammation. Intriguingly, Prevotella abundance is reduced within the lung microbiota of patients with asthma and chronic obstructive pulmonary disease. Increased Prevotella abundance is associated with augmented T helper type 17 (Th17) -mediated mucosal inflammation, which is in line with the marked capacity of Prevotella in driving Th17 immune responses in vitro. Studies indicate that Prevotella predominantly activate Toll-like receptor 2, leading to production of Th17-polarizing cytokines by antigen-presenting cells, including interleukin-23 (IL-23) and IL-1. Furthermore, Prevotella stimulate epithelial cells to produce IL-8, IL-6 and CCL20, which can promote mucosal Th17 immune responses and neutrophil recruitment. Prevotella-mediated mucosal inflammation leads to systemic dissemination of inflammatory mediators, bacteria and bacterial products, which in turn may affect systemic disease outcomes. Studies in mice support a causal role of Prevotella as colonization experiments promote clinical and inflammatory features of human disease. When compared with strict commensal bacteria, Prevotella exhibit increased inflammatory properties, as demonstrated by augmented release of inflammatory mediators from immune cells and various stromal cells. These findings indicate that some Prevotella strains may be clinically important pathobionts that can participate in human disease by promoting chronic inflammation.

664 citations

Journal ArticleDOI
TL;DR: Research during the past 25 years has significantly changed the concepts of periodontitis pathobiology and has produced more-effective and less-costly therapeutic options.
Abstract: This volume of Periodontology 2000 represents the 25th anniversary of the Journal, and uses the occasion to assess important advancements in periodontology over the past quarter-century as well as the hurdles that remain. Periodontitis is defined by pathologic loss of the periodontal ligament and alveolar bone. The disease involves complex dynamic interactions among active herpesviruses, specific bacterial pathogens and destructive immune responses. Periodontal diagnostics is currently based on clinical rather than etiologic criteria, and provides limited therapeutic guidance. Periodontal causative treatment consists of scaling, antiseptic rinses and occasionally systemic antibiotics, and surgical intervention has been de-emphasized, except perhaps for the most advanced types of periodontitis. Plastic surgical therapy includes soft-tissue grafting to cover exposed root surfaces and bone grafting to provide support for implants. Dental implants are used to replace severely diseased or missing teeth, but implant overuse is of concern. The utility of laser treatment for periodontitis remains unresolved. Host modulation and risk-factor modification therapies may benefit select patient groups. Patient self-care is a critical part of periodontal health care, and twice-weekly oral rinsing with 0.10-0.25% sodium hypochlorite constitutes a valuable adjunct to conventional anti-plaque and anti-gingivitis treatments. A link between periodontal herpesviruses and systemic diseases is a strong biological plausibility. In summary, research during the past 25 years has significantly changed our concepts of periodontitis pathobiology and has produced more-effective and less-costly therapeutic options.

460 citations

Journal ArticleDOI
TL;DR: This study presents the global burden of major oral diseases with an exegetical commentary on their current profiles, the critical issues in oral healthcare and future perspectives, and it is of great importance to integrate oral health into global health agenda via the common risk factor approach.
Abstract: Objectives This study presents the global burden of major oral diseases with an exegetical commentary on their current profiles, the critical issues in oral healthcare and future perspectives. Methods A narrative overview of current literature was undertaken to synthesise the contexts with critical elaboration and commentary. Results Oral disease is one of the most common public health issues worldwide with significant socio-economic impacts, and yet it is frequently neglected in public health policy. The oral data extracted from the Global Burden of Disease Study in 2010 (Murray et al, 2012) show that caries, periodontal disease, edentulism, oral cancer and cleft lip/palate collectively accounted for 18 814 000 disability-adjusted life-years; and the global burden of periodontal disease, oral cancer and caries increased markedly by an average of 45.6% from 1990 to 2010 in parallel with the major non-communicable diseases like diabetes by 69.0%. Oral diseases and non-communicable diseases are closely interlinked through sharing common risk factors (e.g. excess sugar consumption and tobacco use) and underlying infection/inflammatory pathways. Conclusions Oral disease remains a major public health burden worldwide. It is of great importance to integrate oral health into global health agenda via the common risk factor approach. The long-term sustainable strategy for global oral health should focus on health promotion and disease prevention through effective multidisciplinary teamwork.

424 citations

Journal ArticleDOI
TL;DR: The 5-year survival of screw-retained and full-arch FDPs was reported to be 96.9% (95% confidence interval (CI): 94.8-97.7%) and 89.3% respectively as discussed by the authors.
Abstract: OBJECTIVES: To assess the 5-year survival rates and incidences of complications of cemented and screw-retained implant reconstructions. METHODS: An electronic Medline search complemented by manual searching was conducted to identify randomized controlled clinical trials (RCTs), and prospective and retrospective studies giving information on cemented and screw-retained single-unit and multiple-unit implant reconstructions with a mean follow-up time of at least 1 year. Assessment of the identified studies and data abstraction were performed independently by three reviewers. Failure rates were analyzed using Poisson regression models to obtain summary estimates and 95% confidence intervals of failure rates and 5-year survival proportions. RESULTS: Fifty-nine clinical studies were selected from an initial yield of 4511 titles and the data were extracted. For cemented single crowns the estimated 5-year reconstruction survival was 96.5% (95% confidence interval (CI): 94.8-97.7%), for screw-retained single crowns it was 89.3% (95% CI: 64.9-97.1%) (P = 0.091 for difference). The 5-year survival for cemented partial fixed dental prostheses (FDPs) was 96.9% (95% CI: 90.8-99%), similar to the one for screw-retained partial FDPs with 98% (95% CI: 96.2-99%) (P = 0.47). For cemented full-arch FDPs the 5-year survival was 100% (95% CI: 88.9-100%), which was somewhat higher than that for screw-retained FDPs with 95.8% (95% CI: 91.9-97.9%) (P = 0.54). The estimated 5-year cumulative incidence of technical complications at cemented single crowns was 11.9% and 24.4% at screw-retained crowns. At the partial and full-arch FDPs, in contrast, a trend to less complication at the screw-retained was found than at the cemented ones (partial FDPs cemented 24.5%, screw-retained 22.1%; full-arch FDPs cemented 62.9%, screw-retained 54.1%). Biological complications like marginal bone loss >2 mm occurred more frequently at cemented crowns (5-year incidence: 2.8%) than at screw-retained ones (5-year incidence: 0%). CONCLUSION: Both types of reconstructions influenced the clinical outcomes in different ways, none of the fixation methods was clearly advantageous over the other. Cemented reconstructions exhibited more serious biological complications (implant loss, bone loss >2 mm), screw-retained reconstructions exhibited more technical problems. Screw-retained reconstructions are more easily retrievable than cemented reconstructions and, therefore, technical and eventually biological complications can be treated more easily. For this reason and for their apparently higher biological compatibility, these reconstructions seem to be preferable.

359 citations

Journal ArticleDOI
TL;DR: Periodontitis is an infection-driven inflammatory disease in which the composition of biofilms plays a significant role and characteristically results in irreversible loss of attachment and alveolar bone.
Abstract: Periodontitis is an infection-driven inflammatory disease in which the composition of biofilms plays a significant role. Dental plaque accumulation at the gingival margin initiates an inflammatory response that, in turn, causes microbial alterations and may lead to drastic consequences in the periodontium of susceptible individuals. Chronic inflammation affects the gingiva and can proceed to periodontitis, which characteristically results in irreversible loss of attachment and alveolar bone. Periodontitis appears typically in adult-aged populations, but young individuals can also experience it and its harmful outcome. Advanced disease is the major cause of tooth loss in adults. In addition, periodontitis is associated with many chronic diseases and conditions affecting general health.

326 citations