• Nu S-Au Găsit Rezultate

View of Prevalence of Furcation Involvement in Patients with Chronic Periodontitis Visiting Dental College - Retrospective Study

N/A
N/A
Protected

Academic year: 2022

Share "View of Prevalence of Furcation Involvement in Patients with Chronic Periodontitis Visiting Dental College - Retrospective Study"

Copied!
17
0
0

Text complet

(1)

Prevalence of Furcation Involvement in Patients with Chronic Periodontitis Visiting Dental College - Retrospective Study

Type of Manuscript: A Retrospective Study

Running Title: Prevalence of furcation involvement in patients with chronic periodontitis visiting dental college.

G.NithyaKarpagam

Saveetha Dental College And Hospital Saveetha Institute of Medical and Technical Science

Saveetha University Chennai, India

Email: [email protected] SankariMalaiappan

Professor,

Department of Periodontics, Saveetha Dental College And Hospital Saveetha Institute of Medical and Technical Science

Saveetha University Chennai, India

Email id: [email protected] Dinesh Prabu

Senior Lecturer,

Department of Oral and maxillofacial surgery Saveetha Dental College And Hospital Saveetha Institute of Medical and Technical Science

Saveetha University Chennai, India

Email id: [email protected] Corresponding Author:

SankariMalaiappan Professor,

Department of Periodontics, Saveetha Dental College And Hospital Saveetha Institute of Medical and Technical Science

Saveetha University 162,Poonamallee High Road

Chennai, 600077 Tamil Nadu , India Email id: [email protected]

(2)

ABSTRACT:

The aim of the study is to assess the furcation involvement among chronic periodontitis patients visiting dental college. It was a retrospective study of patients reported toSaveetha Dental College And Hospitals, with periodontitis.Data was obtained by evaluating 86000 patients records. Out of which 72 patients with chronic periodontitis were evaluated in this study. Data extraction was done and was segregated based on demographic data age and gender. The periodontal parameters namely clinical attachment loss, probing depth and furcation involvement based on Glickman's classification were recorded. The data were collected and entered in the excel sheet. After data collection descriptive and inferential statistical analysis was done in IBM SPSS software version 20. This study shows that the most prevalent age group with furcation involvement in chronic periodontitis was 46-55 years. Males were more commonly affected than females. Prevalence of furcation involvement was found to be more in maxillary molar than in the mandibular molar. The most prevalent grade of furcation involved in the maxillary first molar is grade II. The association between the grade of furcation with age and gender was found to be statistically significant.

KEYWORDS: Furcation, Periodontal patients, Probing depth.

INTRODUCTION:

Periodontitis is a chronic inflammatory response which is due to excessive microbial load including bacterial and viral origin ,aggravated by effect of proinflammatory cytokines like TNF alpha and interleukin I beta,[(1–3)]which leads to destruction of the bone around the tooth, progression of attachment loss and mobility.Furcation Involvement means loss of attachment, subsequent bone loss from progressive periodontal inflammatory disease At and around the bifurcation or trifurcation of the root.It is an important clinical sign in diagnosis of advanced periodontitis and also helps in determining the affected tooth prognosis[(4,5)]The condition takes place as a chronic course, it can include both the local and systemic factors of great importance(6)].Assess the periodontal lesion in the furcation It’s difficult for both the patient and the dental professionals and the treatment is of great challenge. The reason is that periodontium, once damaged, has a limited capacity for regeneration.Periodontal therapy has been directed primarily at the elimination of disease and maintenance of a functional, healthy dentition and supporting tissues. More recently however it has become increasingly focused on esthetic outcomes, which extend beyond tooth replacement and tooth color to include the soft tissues framing the dentition.

Plaque does not just contain bacteria but it also contains viruses which can cause disease progression [(7)]Various risk factors that lead to the furcation environment that includes anatomic factors like cervical enamel projections, root trunk length , root divergence, root length, Root concavities ,narrow furcation entrance etc,pulp Infection, trauma from occlusion, age, smoking and a bad oral hygiene maintenance[(8)] Higher morbidity and compromised prognosis molars with for furcation Involvement have been reported in several retrospective studies of tooth loss[(9)]Similarly in a recent study it has been reported the association between Interleukin-21 levels with periodontitis[(10)]. ET-1 has also been identified in periodontal diseases [(11,12)]. Periodontitis can be associated with various systemic

(3)

conditions[(13)].Presence of the furcation involvement is one of the clinical findings that helps in the diagnosis of advanced periodontitis[(14)]Disease progression occur due to the host-immune response to the bacteria, leading to the destruction of connective tissue and alveolar bone.

Furcation Problems increase with age, when the furcation becomes visible, the risk of losing the affected tooth increases.The frequently more common are the maxillary molar than mandibular molars[(15)]The furcation involvement are more prevalant among molars is that these teeth have complex anatomy and approachable to the non-surgical periodontal therapy. The meticulous oral hygiene maintenance and good plaque control measures serve as an effective mode of therapy [(16)]Treatment of the furcation involvement remains a clinical challenge, It is often hardly accessible for effective debridement,Since its entrance is very small for routine periodontal curettes To enter and adapt properly and they present with ridge and concavities that frequently interfere with instrumentation.[(17)] If the esthetics and function had to be restored dental implants and implant-supported prosthesis can be a predictable treatment modality in periodontal diseases [(18)].While performing surgical therapy trauma to the inferior alveolar nerve is one of the complications during surgical procedures in the posterior mandible[(19)].Herbal medicines and preparations can also be used for the management of periodontal diseases [(20)] The management for furcation is surgical therapy like free graft and pedicle flap are indicated when the furcation causes functional or esthetic problems.Coronally displaced flap is a treatment of choice for recession defects [(21)]Our team has worked on various regenerative therapy that has been indicated for periodontally compromised patients[(22–

24)]and other treatments such as lip repositioning[(25)]Our team has rich experience in research and we have collaborated with numerous authors over various topics in the past decade (26–

50).

The aim of the study is to assess the furcation involvement in patients with chronic periodontitis visiting a dental college.

MATERIALS AND METHODS:

Study Setting:

The study was conducted with the approval of the Institutional Ethics Committee [SDC/SIHEC/2020/DIASDATA/0619-0320]. The study consisted of one reviewer, one assessor and one guide.

Study Design:

The study was designed to include all chronic periodontitis patients with furcation involvement.

The patients who did not fall under this inclusion criteria were excluded.

Sampling technique:

The study was based on Retrospective study .Tominimise the sampling bias, all the cases were reviewed priorly and included.

Data Collection And Tabulation:

Data collection was done using the patient database with the timeframe work of 1st June 2019 to 31st th March 2020. About 86000 patients databases were reviewed and those fitting under the

(4)

inclusion criteria were included. Cross verification of data was done by a reviewer. The collected data was tabulated based on the following parameters:

● Patients demographic details

● Furcation grades in maxillary first molar(16) and mandibular first molar(36) based on Glickman's classification.

● Clinical attachment loss

● Probing depth Statistical Analysis:

The variables were coded and the data was imported to SPSS. Using SPSS Version 20.0 categorical variables were expressed in terms of frequency and percentage and bar graphs were plotted.The statistical significance of the associations were tested using the Chi-square test.

RESULTS:

This study shows that the most common age group with furcation is between 46-55 years and it is more prevalent in males than females.The most commonly involved maxillary tooth is 16 and mandibular tooth is 36.It was found that there is a correlation between grade of furcation in 16 with age (p value 0.007) and with gender (p value 0.031) in 16 and between age and grade of furcation in 36 showed (p value 0.05).Prevalence of furcation Was found to be more in maxillary tooth than in the mandible tooth.

DISCUSSION:

Patients who reported with periodontal disease were selected for this study.In this study prevalence of furcation Was found to be more in maxillary tooth (16) than in the mandible or tooth (36).The most prevalent gender affected with furcation is males 76.39% than females 23.61%.(Figure 2)Previous study showed the prevalence of furcation involvement in 222 patients who had been referred for the treatment of periodontitis.The prevalence of furcation Involved molars was higher in maxilla than mandible.the result appeared to be in agreement with the study[(51)].

More prevalent age group was seen between 46 to 55 years followed by 25-35 years 2.78%, 36- 45 years 8.33%, 56-65 years 31.94% and above 65 years it is 19.44%.(Figure 1) In maxillary molar (16) the maximum involved grade is grade II (37.21%) followed by grade I,III (30.23%) and grade IV (2.33%).(Figure 3) The attachment loss was found to be of about 6mm (62.5%) maximum followed by 5mm (32.50) and 4mm (5%).(Figure 4) The maximum value of pocket depth seen is about 5mm (33.3%) followed by 3mm (30.56%), 2mm, 3mm (13.89%),6mm (5.56%) and 7mm 2.78%.(Figure 5)

(Figure 6) shows the association between the age group and the grade of furcation involvement in maxillary first molar (16).There is a significant increase in grades of furcation as age increases. The P Value <0.05(chi square value) was statistically significant.(0.007).(Figure 7) shows the association between the gender and the grade of furcation involvement in 16.There is a significant increase in grades of furcation in male when compared to females. The P Value

<0.05(chi square value ) was statistically significant.(0.031)

(5)

In mandibular molar (36) the maximum involved grade is grade II (48.39%) followed by grade I (25.81%),grade III (19.35%)and grade IV (6.45%).(Figure 8) The attachment loss was found to be of about 6mm (53.33%) maximum followed by 5mm (30%), 7mm (13.33%) and 4mm (3.33%).(Figure 9) The maximum value of pocket depth seen is about 3mm (30%) followed by 5mm ,6mm(23.33%), 2mm (10%),2mm (6.67%), 7mm and 10mm (3.3%).(Figure 10)

(Figure 11) shows the association between the age and the grade of furcation involvement in 36..There is a significant increase in grades of furcation as age increases. The P Value <0.05(chi square value ) was statistically significant.(0.05). (Figure 12) shows the association between the gender and the grade of furcation involvement in mandibular first molar (36).There is a significant increase in grades of furcation in male when compared to females. The P Value

>0.05(chi square value ) was statistically not significant.(0.470)

There are multiple factors which are involved in the progression of the furcation involvement which includes smoking, age, dental plaque, gingival inflammation. Plaque is the initial factor for all the inflammatory changes in the periodontal tissue.And epidemiological study which was carried out in USA showed pocket death, attachment level and furcation involvement increases with age.Education and socio-economic status have a relatable impact on periodontal status (52)Our institution is passionate about high quality evidence based research and has excelled in various fields ( (53–63)

The limitation of the study was the limited sample size and it doesn't include the ethinic group. It was a single centered study.The future scope of the study is that a prospective study can be performed with a larger population.

CONCLUSION

Within the limits of the present study, it was concluded that the most common age group that was affected with furcation was between 46-55years. Males were more commonly affected than females. The most common type of furcation grades involved in both 16 and 36 was Grade II.

There was an association between the grade of furcation in 16 with age, and with gender.

Considering 36 there was an association between age and grade of furcation. Prevalence of furcation involvement was found to be more in maxillary tooth than in the mandible tooth.

ACKNOWLEDGMENT

The authors are thankful to the Director of Saveetha Dental College and Hospital, Chennai.

AUTHORS CONTRIBUTION

G.NithyaKarpagam , Dr ShankariMalaiappan were the main contributors to the concept, design, literature analysis, workshop discussions, and drafting and revising manuscript. Dr ShankariMalaiappan and Dr Dinesh Prabu contributed to drafting and revising manuscripts. All authors gave final approval of the version to be published.

(6)

CONFLICTS OF INTEREST

There were no conflicts of interest.

REFERENCE

1. Sánchez-Pérez A, Moya-Villaescusa MJ. Periodontal disease affecting tooth furcations. A review of the treatments available. Med Oral Patol Oral Cir Bucal. 2009 Oct 1;14(10):e554–

7.

2. Varghese SS, Thomas H, Jayakumar ND, Sankari M, Lakshmanan R. Estimation of salivary tumor necrosis factor-alpha in chronic and aggressive periodontitis patients. Contemp Clin Dent. 2015 Sep;6(Suppl 1):S152–6.

3. Gajendran PL, Parthasarathy H, Tadepalli A. Comparative evaluation of cathepsin K levels in gingival crevicular fluid among smoking and nonsmoking patients with chronic periodontitis. Indian J Dent Res. 2018 Sep;29(5):588–93.

4. Bakutra G, Chandran S, Vishnoi S, Nadig P, Raval R. Prevalence, Extension and Severity Associated Risk Factors Associated with Furcation Involvement in an Adult Population. An Epidemiological Study. Acta Scientific Dental Sciences (ISSN: 2581-4893) [Internet].

2018;2(9). Available from:

https://www.researchgate.net/profile/Shivlal_Vishnoi/publication/327435372_Prevalence_E xtension_and_Severity_Associated_Risk_Factors_Associated_with_Furcation_Involvement _in_an_Adult_Population_An_Epidemiological_Study/links/5b8f6c4945851540d1c9d5e9/P revalence-Extension-and-Severity-Associated-Risk-Factors-Associated-with-Furcation- Involvement-in-an-Adult-Population-An-Epidemiological-Study.pdf

5. Carranza FA, Takei HH, Newman MG. Clinical periodontology 10th ed. St Louis: WB Saunders. 2006;137–43.

6. Ruiz EF, Martínez AB. Periodontal diseases as bacterial infection. Avancesenperiodoncia e implantologia Oral. 2005;17(3):111–8.

7. Priyanka S, Kaarthikeyan G, Nadathur JD, Mohanraj A, Kavarthapu A. Detection of cytomegalovirus, Epstein-Barr virus, and Torque Teno virus in subgingival and atheromatous plaques of cardiac patients with chronic periodontitis. J Indian Soc Periodontol. 2017 Nov;21(6):456–60.

8. Bhusari P, Sugandhi A, Belludi SA, Khan S. Prevalence of enamel projections and its co- relation with furcation involvement in maxillary and mandibular molars: A study on dry skull. J Indian Soc Periodontol. 2013 Sep;17(5):601–4.

9. Ramfjord SP, Caffesse RG, Morrison EC, Hill RW, Kerry GJ, Appleberry EA, et al. 4 modalities of periodontal treatment compared over 5 years. J Clin Periodontol. 1987 Sep;14(8):445–52.

10. Mootha A, Malaiappan S, Jayakumar ND, Varghese SS, Toby Thomas J. The Effect of

(7)

Periodontitis on Expression of Interleukin-21: A Systematic Review. Int J Inflam [Internet].

2016 Feb 22 [cited 2020 Jun 3];2016. Available from:

https://www.hindawi.com/journals/iji/2016/3507503/abs/

11. Khalid W, Vargheese SS, Lakshmanan R, Sankari M, Jayakumar ND. Role of endothelin-1 in periodontal diseases: A structured review. Indian J Dent Res. 2016 May;27(3):323–33.

12. Khalid W, Varghese SS, Sankari M, Jayakumar ND. Comparison of Serum Levels of Endothelin-1 in Chronic Periodontitis Patients Before and After Treatment. J Clin Diagn Res. 2017 Apr;11(4):ZC78–81.

13. Ramesh A, Varghese SS, Jayakumar ND, Malaiappan S. Chronic obstructive pulmonary disease and periodontitis--unwinding their linking mechanisms. J Oral Biosci.

2016;58(1):23–6.

14. Batra P, Das S, Jain S. Correlation of radiovisuographic analysis of interdental and interradicular bone loss in furcation involvement of mandibular first molars: A retrospective study. Indian J Dent Res. 2018 May;29(3):329–32.

15. Papapanou PN, Tonetti MS. Diagnosis and epidemiology of periodontal osseous lesions [Internet]. Vol. 22, Periodontology 2000. 2000. p. 8–21. Available from:

http://dx.doi.org/10.1034/j.1600-0757.2000.2220102.x

16. Bower RC. Furcation Morphology Relative to Periodontal Treatment: Furcation Entrance Architecture [Internet]. Vol. 50, Journal of Periodontology. 1979. p. 23–7. Available from:

http://dx.doi.org/10.1902/jop.1979.50.1.23

17. Wood WR, Greco GW, McFall WT Jr. Tooth Loss in Patients With Moderate Periodontitis After Treatment and Long–Term Maintenance Care. J Periodontol. 1989 Sep;60(9):516–20.

18. Ramesh A, Ravi S, Kaarthikeyan G. Comprehensive rehabilitation using dental implants in generalized aggressive periodontitis. J Indian Soc Periodontol. 2017 Mar;21(2):160–3.

19. Kavarthapu A, Thamaraiselvan M. Assessing the variation in course and position of inferior alveolar nerve among south Indian population: A cone beam computed tomographic study.

Indian J Dent Res. 2018 Jul;29(4):405–9.

20. Ramesh A, Varghese SS, Doraiswamy JN, Malaiappan S. Herbs as an antioxidant arsenal for periodontal diseases. J IntercultEthnopharmacol. 2016 Jan;5(1):92–6.

21. Thamaraiselvan M, Elavarasu S, Thangakumaran S, Gadagi JS, Arthie T. Comparative clinical evaluation of coronally advanced flap with or without platelet rich fibrin membrane in the treatment of isolated gingival recession. J Indian Soc Periodontol. 2015 Jan;19(1):66–

71.

22. Avinash K, Malaippan S, Dooraiswamy JN. Methods of Isolation and Characterization of Stem Cells from Different Regions of Oral Cavity Using Markers: A Systematic Review.

Int J Stem Cells. 2017 May 30;10(1):12–20.

(8)

23. Panda S, Jayakumar ND, Sankari M, Varghese SS, Kumar DS. Platelet rich fibrin and xenograft in treatment of intrabony defect. Contemp Clin Dent. 2014 Oct;5(4):550–4.

24. Ravi S, Malaiappan S, Varghese S, Jayakumar ND, Prakasam G. Additive Effect of Plasma Rich in Growth Factors With Guided Tissue Regeneration in Treatment of Intrabony Defects in Patients With Chronic Periodontitis: A Split-Mouth Randomized Controlled Clinical Trial. J Periodontol. 2017;88(9):839–45.

25. Ramesh A, Vellayappan R, Ravi S, Gurumoorthy K. Esthetic lip repositioning: A cosmetic approach for correction of gummy smile - A case series. J Indian Soc Periodontol. 2019 May;23(3):290–4.

26. Duraisamy R, Krishnan CS, Ramasubramanian H, Sampathkumar J, Mariappan S, NavarasampattiSivaprakasam A. Compatibility of Nonoriginal Abutments With Implants:

Evaluation of Microgap at the Implant-Abutment Interface, With Original and Nonoriginal Abutments. Implant Dent. 2019 Jun;28(3):289–95.

27. Ariga P, Nallaswamy D, Jain AR, Ganapathy DM. Determination of correlation of width of Maxillary Anterior Teeth using Extraoral and Intraoral Factors in Indian Population: A systematic review. World J Dent. 2018 Feb;9(1):68–75.

28. Kannan A, Venugopalan S. A systematic review on the effect of use of impregnated retraction cords on gingiva. J Adv Pharm Technol Res. 2018;11(5):2121.

29. Basha FYS, Ganapathy D, Venugopalan S. Oral hygiene status among pregnant women. J Adv Pharm Technol Res. 2018;11(7):3099.

30. Rajakeerthi, Ms N. Natural Product as the Storage medium for an avulsed tooth – A Systematic Review. CumhurÜnivDişHekimFakderg. 2019 Jun 11;22(2):249–56.

31. Teja KV, Ramesh S, Priya V. Regulation of matrix metalloproteinase-3 gene expression in inflammation: A molecular study. J Conserv Dent. 2018 Nov;21(6):592–6.

32. Menon S, Ks SD, R S, S R, S VK. Selenium nanoparticles: A potent chemotherapeutic agent and an elucidation of its mechanism. Colloids Surf B Biointerfaces. 2018 Oct 1;170:280–92.

33. Siddique R, Sureshbabu NM, Somasundaram J, Jacob B, Selvam D. Qualitative and quantitative analysis of precipitate formation following interaction of chlorhexidine with sodium hypochlorite, neem, and tulsi. J Conserv Dent. 2019 Jan;22(1):40–7.

34. Nandakumar M, Nasim I. Comparative evaluation of grape seed and cranberry extracts in preventing enamel erosion: An optical emission spectrometric analysis. J Conserv Dent.

2018 Sep;21(5):516–20.

35. Manohar MP, Sharma S. A survey of the knowledge, attitude, and awareness about the principal choice of intracanal medicaments among the general dental practitioners and nonendodontic specialists. Indian J Dent Res. 2018 Nov;29(6):716–20.

(9)

36. Hema Shree K, Ramani P, Sherlin H, Sukumaran G, Jeyaraj G, Don KR, et al. Saliva as a Diagnostic Tool in Oral Squamous Cell Carcinoma - a Systematic Review with Meta Analysis. Pathol Oncol Res. 2019 Apr;25(2):447–53.

37. Rajendran R, Kunjusankaran RN, Sandhya R, Anilkumar A, Santhosh R, Patil SR.

Comparative evaluation of remineralizing potential of a paste containing bioactive glass and a topical cream containing casein phosphopeptide-amorphous calcium phosphate: An in vitro study. Pesqui Bras Odontopediatria Clin Integr. 2019;19(1):1–10.

38. Gheena S, Ezhilarasan D. Syringic acid triggers reactive oxygen species-mediated cytotoxicity in HepG2 cells. Hum Exp Toxicol. 2019 Jun;38(6):694–702.

39. Hussainy SN, Nasim I, Thomas T, Ranjan M. Clinical performance of resin-modified glass ionomer cement, flowable composite, and polyacid-modified resin composite in noncarious cervical lesions: One-year follow-up. J Conserv Dent. 2018 Sep;21(5):510–5.

40. Hannah R, Ramani P, Herald. J. Sherlin, Ranjith G, Ramasubramanian A, Jayaraj G, et al.

Awareness about the use, ethics and scope of dental photography among undergraduate dental students dentist behind the lens. J Adv Pharm Technol Res. 2018;11(3):1012.

41. Sharma P, Mehta M, Dhanjal DS, Kaur S, Gupta G, Singh H, et al. Emerging trends in the novel drug delivery approaches for the treatment of lung cancer. Chem Biol Interact. 2019 Aug 25;309:108720.

42. Ravinthar K, Jayalakshmi. Recent advancements in laminates and veneers in dentistry. J Adv Pharm Technol Res. 2018;11(2):785.

43. Madeo, B., Diazzi, C., Granata, A.R.M., Ghoch, M.E., Greco, C., Romano, S., Scaltriti, S., Rochira, V. Effect of a standard schema of self-monitoring blood glucose in patients with poorly controlled, non-insulin-treated type 2 diabetes mellitus: A controlled longitudinal study, (2020) Journal of Population Therapeutics and Clinical Pharmacology, 27 (Special Issue 2), pp. e1-e11.

44. Sekar D, Lakshmanan G, Mani P, Biruntha M. Methylation-dependent circulating microRNA 510 in preeclampsia patients. Hypertens Res. 2019 Oct;42(10):1647–8.

45. Kumar D, Antony SDP. Calcified canal and negotiation-A review. J Adv Pharm Technol Res. 2018;11(8):3727.

46. Johnson J, Lakshmanan G, M B, R M V, Kalimuthu K, Sekar D. Computational identification of MiRNA-7110 from pulmonary arterial hypertension (PAH) ESTs: a new microRNA that links diabetes and PAH. Hypertens Res. 2020 Apr;43(4):360–2.

47. Janani K, Palanivelu A, Sandhya R. Diagnostic accuracy of dental pulse oximeter with customized sensor holder, thermal test and electric pulp test for the evaluation of pulp vitality: an in vivo study. Braz Dent Sci [Internet]. 2020 Jan 31;23(1). Available from:

https://bds.ict.unesp.br/index.php/cob/article/view/1805

(10)

48. Seppan P, Muhammed I, Mohanraj KG, Lakshmanan G, Premavathy D, Muthu SJ, et al.

Therapeutic potential of Mucuna pruriens (Linn.) on ageing induced damage in dorsal nerve of the penis and its implication on erectile function: an experimental study using albino rats.

Aging Male. 2018 Feb 15;1–14.

49. Jeevanandan G, Govindaraju L. Clinical comparison of Kedo-S paediatric rotary files vs manual instrumentation for root canal preparation in primary molars: a double blinded randomised clinical trial. Eur Arch Paediatr Dent. 2018 Aug;19(4):273–8.

50. Nandhini JST, Babu KY, Mohanraj KG. Size, shape, prominence and localization of gerdy’s tubercle in dry human tibial bones. J Adv Pharm Technol Res. 2018;11(8):3604.

51. Svardstrom G, Wennstrom JL. Furcation topography of the maxillary and mandibular first molars [Internet]. Vol. 15, Journal of Clinical Periodontology. 1988. p. 271–5. Available from: http://dx.doi.org/10.1111/j.1600-051x.1988.tb01583.x

52. Borrell LN, Burt BA, Gillespie BW, Lynch J, Neighbors H. Periodontitis in the United States: beyond black and white. J Public Health Dent. 2002 Spring;62(2):92–101.

53. VijayashreePriyadharsini J. In silico validation of the non-antibiotic drugs acetaminophen and ibuprofen as antibacterial agents against red complex pathogens. J Periodontol. 2019 Dec;90(12):1441–8.

54. Pc J, Marimuthu T, Devadoss P. Prevalence and measurement of anterior loop of the mandibular canal using CBCT: A cross sectional study. Clin Implant Dent Relat Res [Internet]. 2018; Available from: https://europepmc.org/article/med/29624863

55. Ramesh A, Varghese S, Jayakumar ND, Malaiappan S. Comparative estimation of sulfiredoxin levels between chronic periodontitis and healthy patients - A case-control study. J Periodontol. 2018 Oct;89(10):1241–8.

56. Ramadurai N, Gurunathan D, Samuel AV, Subramanian E, Rodrigues SJL. Effectiveness of 2% Articaine as an anesthetic agent in children: randomized controlled trial. Clin Oral Investig. 2019 Sep;23(9):3543–50.

57. Sridharan G, Ramani P, Patankar S, Vijayaraghavan R. Evaluation of salivary metabolomics in oral leukoplakia and oral squamous cell carcinoma. J Oral Pathol Med.

2019 Apr;48(4):299–306.

58. Ezhilarasan D, Apoorva VS, Ashok Vardhan N. Syzygiumcumini extract induced reactive oxygen species-mediated apoptosis in human oral squamous carcinoma cells. J Oral Pathol Med. 2019 Feb;48(2):115–21.

59. Mathew MG, Samuel SR, Soni AJ, Roopa KB. Evaluation of adhesion of Streptococcus mutans, plaque accumulation on zirconia and stainless steel crowns, and surrounding gingival inflammation in primary molars: Randomized controlled trial. Clin Oral Investig.

2020;1–6.

(11)

60. Samuel SR. Can 5-year-olds sensibly self-report the impact of developmental enamel defects on their quality of life? Int J Paediatr Dent. 2021 Mar;31(2):285–6.

61. R H, Hannah R, Ramani P, Ramanathan A, R JM, Gheena S, et al. CYP2 C9 polymorphism among patients with oral squamous cell carcinoma and its role in altering the metabolism of benzo[a]pyrene [Internet]. Vol. 130, Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2020. p. 306–12. Available from: http://dx.doi.org/10.1016/j.oooo.2020.06.021 62. Chandrasekar R, Chandrasekhar S, Sundari KKS, Ravi P. Development and validation of a

formula for objective assessment of cervical vertebral bone age. Prog Orthod. 2020 Oct 12;21(1):38.

63. VijayashreePriyadharsini J, SmilineGirijaAS, Paramasivam A. In silico analysis of virulence genes in an emerging dental pathogen A. baumannii and related species. Arch Oral Biol. 2018 Oct;94:93–8.

Figure 1: Bar graph depicting the distribution of age group among the study population.X axis represents the age group of the patients and Y axis represents the percentage of patients with chronic periodontitis.The most prevalent age group with chronic periodontitis and furcation involvement is seen between 46-55years.

(12)

Figure 2: Bar graph depicting the distribution of gender among chronic periodontitis patients. X axis represents the gender of the patients and Y axis represents the percentage of patients with chronic periodontitis. From the figure we can infer that the majority of patients with chronic periodontitis and furcation involvement were males.

(13)

Figure 3: Bar graph depicting the distribution of furcation grades in 16 among the chronic periodontitis patients. X axis represents the grades of furcation involvement and Y axis represents the percentage of patients with chronic periodontitis. The most prevalent grade of furcation involvement in maxillary first molar (16) was grade II.

Figure 4: Bar graph depicting the distribution of clinical attachment (CAL) among the chronic periodontitis patients. X axis represents the clinical attachment loss in maxillary first molar and Y axis represents the percentage of patients with chronic periodontitis. From the figure we can infer that majority of the periodontitis patients with furcation involvement in maxillary first molar (16 ) had 6mm clinical attachment loss.

(14)

Figure 5: Bar graph depicting the distribution of probing depth (PD) among the chronic periodontitis patients. X axis represents the probing depth in maxillary first molar and Y axis represents the percentage of patients with chronic periodontitis. From the figure we can infer that the majority of the periodontitis patients with furcation involvement in maxillary first molar(16) had 5mm probing depth.

Figure 6: Bar graph depicting the association between the age group and the grade of furcation involvement in maxillary first molar. X axis represents the grades of furcation and Y axis represents percentage of patients with chronic periodontitis. Chi square test shows the p value 0.007 (p value <0.05) statistically significant. The most prevalent furcation involvement in maxillary first molar was grade II, and the association was statistically significant.

(15)

Figure 7: Bar graph depicting the association between the gender and the grade of furcation involvement in maxillary first molar. X axis represents the grades of furcation and Y axis represents percentage of patients with chronic periodontitis. It is inferred that the majority of male patients had grade 2 and female patients had grade 2 or grade 3 furcation involvement in 16. Chi square test shows the p value 0.031 (p value <0.05). The association was statistically significant.

Figure 8: Bar graph depicting the distribution of furcation grades in mandibular first molar among the chronic periodontitis patients. X axis represents the furcation grades and Y axis represents the percentage of patients with chronic periodontitis. The most prevalent grade of furcation involvement in mandibular first molar (36) was grade II.

(16)

Figure 9: Bar graph depicting the distribution of clinical attachment loss in mandibular first molar among chronic periodontitis patients. X axis represents the clinical attachment loss and Y axis represents the percentage of patients with chronic periodontitis. From the figure we can infer that majority of the periodontitis patients with furcation involvement in mandibular first molar (36) had 6mm clinical attachment loss.

Figure 10: Bar graph depicting the distribution of probing depth in mandibular first molar among chronic periodontitis patients. X axis represents the probing depth noted in this study and Y axis represents the percentage of patients with chronic periodontitis. From the figure we can infer that majority of the periodontitis patients with furcation involvement in mandibular first molar (36) had 3mm probing depth.

(17)

Figure 11: Bar graph depicting the association between the age and the grade of furcation involvement in mandibular first molar. X axis represents the grades of furcation in 36 and Y axis represents percentage of patients with chronic periodontitis.Chi square test shows the p value 0.05 (p value <0.05) statistically significant. From the figure we can infer that among all the age groups, the majority of patients with periodontitis had grade 2 furcation involvement, and the association was statistically significant.

Figure 12: Bar graph depicting the association between the gender and the grade of furcation involvement in mandibular first molar(36). X axis - grades of furcation and Y axis - percentage of patients with chronic periodontitis. From the figure we can infer that the majority of male (blue) and female (pink) patients had grade 2 furcation involvement in 36. Chi square test, p value 0.470 (p value >0.05). However the analysis showed the association was statistically not significant.

Referințe

DOCUMENTE SIMILARE

, Convergence of the family of the deformed Euler-Halley iterations under the H¨ older condition of the second derivative, Journal of Computational and Applied Mathematics,

Identity is thus constructed in interaction, which means that out of a whole host of potential identity features, those features become salient which permit a differentiation of

The evolution to globalization has been facilitated and amplified by a series of factors: capitals movements arising from the need of covering the external

The modification of the promotion criteria in the area of medical university education triggered an increase in the number of articles published by the

The number of vacancies for the doctoral field of Medicine, Dental Medicine and Pharmacy for the academic year 2022/2023, financed from the state budget, are distributed to

The results of the parsimonious ECM revealed amongst others that the recent global financial crisis does not have a severe negative impact on the performance of

Adrian Iftene, Faculty of Computer Science, “Alexandru Ioan Cuza” University of Iași Elena Irimia, Research Institute for Artificial Intelligence “Mihai Drăgănescu”, Romanian

Figure 9: Bar chart showing association between gender and their knowledge on necessity of the lockdown , X- axis represents the gender and Y-axis represents the number of responses