[Predictive value of tooth loss risk with 2018 new classification of periodontitis:a literature review].

The occurrence, progression and treatment efficacy of periodontitis are affected by many factors. Development on accurate estimation of prognosis is essential for treatment plan determination. The application of the 2018 new classification of periodontitis is one of the most important advances in the prognosis and risk assessment of periodontitis. The predictive value of the new classification on tooth loss risk had been evaluated by several latest researches, however, consensus still lacks. This review focused on the predictive efficacy of the 2018 new classification of periodontitis on tooth loss risk in periodontitis patients, in order to provide scientific evidence for clinical application and further improvement of the new classification system.

Classification of presence of missing teeth in each quadrant using deep learning artificial intelligence on panoramic radiographs of pediatric patients.

Early tooth loss in pediatric patients can lead to various complications, making quick and accurate diagnosis essential. This study aimed to develop a novel deep learning model for classification of missing teeth on panoramic radiographs in pediatric patients and to assess the accuracy. The study included patients aged 8-16 years who visited the Pusan National University Dental Hospital and underwent panoramic radiography. A total of 806 panoramic radiographs were retrospectively analyzed to determine the presence or absence of missing teeth for each tooth number. Moreover, each panoramic radiograph was divided into four quadrants, each of a smaller size, containing both primary and permanent teeth, generating 3224 data. Quadrants with missing teeth (n = 1457) were set as the experimental group, and quadrants without missing teeth (n = 1767) were set as the control group. The data were split into training and validation sets in a 4:1 ratio, and a 5-fold cross-validation was conducted. A gradient-weighted class activation map was used to visualize the deep learning model. The average values of sensitivity, specificity, accuracy, precision, recall and F1-score of this deep learning model were 0.635, 0.814, 0.738, 0.730, 0.732 and 0.731, respectively. In the experimental group, the accuracy was the highest for missing canines and premolars, and the lowest for molars. The deep learning model exhibited a moderate to good distinguishing power with a classification performance of 0.730. This deep learning model and the newly defined small sized region of interest proved adequate for classifying the presence of missing teeth.

Interproximal caries and premature tooth loss in primary dentition as risk factors for loss of space in the posterior sector: A cross-sectional study.

Dental caries-a highly prevalent public health problem in preschoolers and school children-is the main cause of premature dental loss during childhood, and this may be related to loss of space in the posterior sector. The objective of this study was to evaluate whether interproximal caries and premature tooth loss (D and/or E) are risk factors for loss of space in the posterior sector.A comparative cross-sectional study (split-mouth type) was performed in schoolchildren (6-8 years old). Seventeen gypsum models were evaluated. These children presented with unilateral loss of a dental organ or interproximal caries (teeth D and/or E) and without such affectations on the other side. Measurements were made with a digital Vernier caliper. The dependent variable was the difference (loss of space, mm) between the control and case sides. The independent variables were type of affectation (interproximal caries or tooth loss), sex, age, arcade, and number of interproximal surfaces affected.The mean age was 6.82 ±â€Š0.44 years and 64.7% were boys. The average space loss was 1.09 ±â€Š0.18 mm (control vs case; P < .0001). A greater loss of space was observed among those who lost a dental organ than those with interproximal caries (P = .0119). A correlation was observed between the variable loss of space and the number of interproximal surfaces affected (r = 0.5712, P = .0166).Interproximal caries and tooth loss were risk factors for loss of space in the posterior segment in this sample of Mexican schoolchildren.

Derivation and Validation of the Periodontal and Tooth Profile Classification System for Patient Stratification.

BACKGROUND: The goal of this study is to use bioinformatics tools to explore identification and definition of distinct periodontal and tooth profile classes (PPCs/TPCs) among a cohort of individuals by using detailed clinical measures at the tooth level, including both periodontal measurements and tooth loss. METHODS: Full-mouth clinical periodontal measurements (seven clinical parameters) from 6,793 individuals from the Dental Atherosclerosis Risk in Communities Study (DARIC) were used to identify PPC. A custom latent class analysis (LCA) procedure was developed to identify clinically distinct PPCs and TPCs. Three validation cohorts were used: NHANES (2009 to 2010 and 2011 to 2012) and the Piedmont Study population (7,785 individuals). RESULTS: The LCA method identified seven distinct periodontal profile classes (PPCs A to G) and seven distinct tooth profile classes (TPCs A to G) ranging from health to severe periodontal disease status. The method enabled identification of classes with common clinical manifestations that are hidden under the current periodontal classification schemas. Class assignment was robust with small misclassification error in the presence of missing data. The PPC algorithm was applied and confirmed in three distinct cohorts. CONCLUSIONS: The findings suggest PPC and TPC using LCA can provide robust periodontal clinical definitions that reflect disease patterns in the population at an individual and tooth level. These classifications can potentially be used for patient stratification and thus provide tools for integrating multiple datasets to assess risk for periodontitis progression and tooth loss in dental patients.

Possible Association Between the Mallampati Score of the Oropharynx and Measures of Tongue Coating, Oral Hygiene and Periodontal Status.

PURPOSE: To assess oral hygiene and the gingival and periodontal disease status in subjects scored under the modified Mallampati classification (MMC) of the oropharynx. PATIENTS AND METHODS: The clinical parameters included recording MMC scores, simplified oral hygiene index (OHI-S), modified gingival index (MGI), tongue coating index (TCI) and periodontal status of the subjects. Eight additional parameters, which included percentage of sites with bleeding on probing (BOP), sites with probing depth (PD) ≥ 5 mm, tooth loss, attachment loss (AL):age ratio, diabetic status, smoking, the interplay of dental status and systemic factors (DS-SFI), and background characteristics (socioeconomic status and stress) were also assessed. RESULTS: Class IV MMC group showed the highest mean scores for OHI-S, periodontal status, AL:age ratio, diabetic status, background characteristics, PD ≥ 5 mm and DS-SFI when compared to other groups. In measures of OHI-S, periodontal status, PD > 5 mm, AL:age ratio and background characteristics, Class IV MMC group showed significant intergroup differences over MMC class I. Regression analysis revealed a highly significant but low degree of correlation (R2 = 0.079; p ≤ 0.001) between the predictors and the dependent values. CONCLUSION: The results suggest that increasing MMC scores can be a possible determinant in identifying gingival and periodontal disease. Any dental professional dealing with a multifactorial disease such as periodontitis can use this classification as a basic screening tool in identifying the modifiable factors of periodontitis.

The Interaction Between ß-3 Adrenergic Receptor and Peroxisome Proliferator-Activated Receptor Gamma Gene Polymorphism to Periodontal Disease in Community-Dwelling Elderly Japanese.

BACKGROUND: It has been hypothesized that ß-3 adrenergic receptor and peroxisome proliferator-activated receptor gamma (PPARγ) might have gene-environmental and gene-gene interactions in periodontal disease. The purpose of this study is to elucidate the interaction between ß-3 adrenergic receptor and PPARγ gene polymorphism with periodontal disease. METHODS: Three hundred thirty-two postmenopausal females were enrolled, and their serum high-sensitivity C-reactive protein (hsCRP) and hemoglobin A1c (HbA1c) were examined. ß-3 adrenergic receptor and PPARγ genotypes were then determined. An oral examination was performed. The number of remaining teeth was counted, and the probing depth (PD) and clinical attachment level (CAL) were measured. Prevalence-rate ratios (PRRs) were calculated by multiple Poisson regression analyses to evaluate the relationship among periodontal disease markers, such as the number of sites with CAL 4 to 5 or ≥6 mm or PD 4 to 5 or ≥6 mm, and ß-3 adrenergic receptor polymorphisms, PPARγ polymorphisms, and the interaction term adjusted by age, hsCRP, and HbA1c, after converting the number of remaining teeth (n) to an offset variable. RESULTS: In the participants with body mass index (BMI) ≥25, PRRs of ß-3 adrenergic receptor genotype (Trp/Arg and Arg/Arg) for periodontal disease markers were 0.13 to 0.70 (P <0.0001 to 0.74), those of PPARγ genotype (Pro/Pro) were 0.66 to 3.14 (P = 0.01 to 0.68), and those of the interaction term for the two genotypes were 1.69 to 12.61 (P <0.0001 to 0.33). However, in the participants with BMI <25, a constant tendency was not observed. CONCLUSION: The results confirmed a positive relationship between the interaction term for ß-3 adrenergic receptor genotype and PPARγ genotype and various periodontal markers in obese elderly females.

Inequality in oral health related to early and later life social conditions: a study of elderly in Norway and Sweden.

BACKGROUND: A life course perspective recognizes influences of socially patterned exposures on oral health across the life span. This study assessed the influence of early and later life social conditions on tooth loss and oral impacts on daily performances (OIDP) of people aged 65 and 70 years. Whether social inequalities in oral health changed after the usual age of retirement was also examined. In accordance with "the latent effect life course model", it was hypothesized that adverse early-life social conditions increase the risk of subsequent tooth loss and impaired OIDP, independent of later-life social conditions. METHODS: Data were obtained from two cohorts studies conducted in Sweden and Norway. The 2007 and 2012 waves of the surveys were used for the present study. Early-life social conditions were measured in terms of gender, education and country of birth, and later-life social conditions were assessed by working status, marital status and size of social network. Logistic regression and Generalized Estimating Equations (GEE) were used to analyse the data. Inverse probability weighting (IPW) was used to adjust estimates for missing responses and loss to follow-up. RESULTS: Early-life social conditions contributed to tooth loss and OIDP in each survey year and both countries independent of later-life social conditions. Lower education correlated positively with tooth loss, but did not influence OIDP. Foreign country of birth correlated positively with oral impacts in Sweden only. Later-life social conditions were the strongest predictors of tooth loss and OIDP across survey years and countries. GEE revealed significant interactions between social network and survey year, and between marital status and survey year on tooth loss. CONCLUSION: The results confirmed the latent effect life course model in that early and later life social conditions had independent effects on tooth loss and OIDP among the elderly in Norway and Sweden. Between age 65 and 70, inequalities in tooth loss related to marital status declined, and inequalities related to social network increased.

Functional occlusal patterns during lateral excursions in young adults.

STATEMENT OF PROBLEM: A valid system for assessing and classifying functional occlusion has not been established. The prevalence of anterior protected articulation is not known. PURPOSE: The purpose of this study was to quantify the prevalence of various functional occlusal contact patterns, including anterior protected articulation, among dental students. MATERIAL AND METHODS: Occlusal contacts were examined during lateral excursions from the maximal intercuspal position to the canine-to-canine position in 100 young adults. A combination of 3 common clinical methods was used: a visual examination, articulating paper, and feedback from the participants. RESULTS: Data from 3 classification systems were analyzed: (1) Occlusal contacts on the working side only ­ canine protected articulation was present in 25% of laterotrusions; anterior protected articulation was present in 18.5% of laterotrusions. Group function was present in 56% of laterotrusions. Other schemes were present in 0.5% of laterotrusions. (2) Contacts on both the working and the nonworking side. (3) Contacts on the working and nonworking side during both right and left laterotrusion. Nonworking side contacts were present in 33% of the participants. Nonworking side interference was present in 1 participant. CONCLUSIONS: The prevalence of anterior protected articulation found in this study was high enough to allow anterior protected articulation to be considered one of the fundamental working side occlusal contact patterns. More studies will be necessary to confirm this finding.

Loss of teeth in positions mesially adjacent to implant-supported fixed dentures: a retrospective clinical survey.

The aim of this study was to investigate the loss of teeth in positions mesially adjacent to implant-supported fixed dentures (IFDs) after insertion of IFDs in unilateral free-end edentulous spaces in the mandible at dental clinics. There were a total of 157 adjacent teeth. Nine adjacent teeth (5.73%, 9 of 157), 9 opposing teeth (2.59%, 9 of 348), 38 posterior teeth (1.93%, 38 of 1,964), and 3 anterior teeth (0.22%, 3 of 1,380) were lost during the observation period. The percentage of lost adjacent teeth was higher than that of posterior teeth (P = .002). Teeth in positions adjacent to the IFDs require more attention than other remaining teeth.

Periodontal Health in Women With Early-Stage Postmenopausal Breast Cancer Newly on Aromatase Inhibitors: A Pilot Study.

BACKGROUND: Aromatase inhibitor (AI) use results in low estrogen levels, which in turn affect bone mineral density (BMD). Periodontitis, alveolar bone loss, and tooth loss are associated with low BMD. The goal of this study is to assess the prevalence of periodontitis and perceived oral health and evaluate salivary biomarkers in postmenopausal women who are survivors of early-stage (I to IIIA) breast cancer (BCa) and receive adjuvant AI therapy. METHODS: Participants included 58 postmenopausal women: 29 with BCa on AIs and 29 controls without BCa diagnoses. Baseline periodontal status was assessed with: 1) periodontal probing depth (PD); 2) bleeding on probing (BOP); and 3) attachment loss (AL). Demographic and dental utilization information was gathered by questionnaire. Linear regression modeling was used to analyze the outcomes. RESULTS: No differences were found in mean PD or number of teeth. The AI group had significantly more sites with BOP (27.8 versus 16.7; P = 0.02), higher worst-site AL (5.2 versus 4.0 mm; P <0.01), and more sites with dental calculus (18.2 versus 6.4; P <0.001) than controls. Linear regression adjusted for income, tobacco use, dental insurance, and previous radiation and chemotherapy exposure demonstrated that AI use increased AL by >2 mm (95% confidence interval, 0.46 to 3.92). Median salivary osteocalcin and tumor necrosis factor-α levels were significantly higher in the AI group than the control group. CONCLUSION: This first investigation of the periodontal status of women initiating adjuvant AI therapy identifies this population as having an increased risk for periodontitis.

Periodontal Status and Whole Salivary Cytokine Profile Among Smokers and Never-Smokers With and Without Prediabetes.

BACKGROUND: Whole salivary interleukin (IL)-1ß and IL-6 in smokers and never-smokers with prediabetes remains uninvestigated. The aim of this study is to assess the periodontal status and whole salivary IL-1ß and IL-6 levels among smokers and never-smokers with and without prediabetes (controls). METHODS: Ninety-five males (45 with prediabetes and 50 systemically healthy controls) were included. Twenty-seven controls and 29 patients with prediabetes were smokers. Periodontal parameters (plaque index, bleeding on probing, probing depth, clinical attachment loss, and marginal bone loss) were measured, and the number of missing teeth were recorded. Fasting blood glucose (FBG) and hemoglobin A1c (HbA1c) levels were recorded. Unstimulated whole saliva samples were collected, unstimulated whole salivary flow rate (UWSFR) was determined, and IL-1ß and IL-6 levels were measured. P values <0.05 were considered statistically significant. RESULTS: FBG (P <0.05) and HbA1c (P <0.05) levels were higher among patients with prediabetes than controls. All patients with prediabetes were hyperglycemic. UWSFR was significantly higher among controls than among patients with prediabetes (P <0.05). Periodontal parameters and whole salivary IL-1ß and IL-6 levels were comparable among smokers and never-smokers with prediabetes. Among controls, periodontal parameters and whole salivary IL-1ß and IL-6 levels were higher among smokers than never-smokers (P <0.05). CONCLUSIONS: Among controls, periodontal inflammation was worse, and whole salivary IL-1ß and IL-6 levels are higher in smokers than never-smokers. Among patients with prediabetes, periodontal inflammation and whole salivary IL-1ß and IL-6 levels were comparable between smokers and never-smokers.

Periodontal parameters and whole salivary cytokine profiles among habitual gutka chewers and non-chewers.

BACKGROUND: Whole salivary interleukin (IL)-1ß, IL-6, matrix metalloproteinase (MMP)-8, and MMP-9 levels among habitual gutka chewers and non-chewers (controls) have not been investigated. The aim of the present study is to assess clinical periodontal parameters and whole salivary IL-1ß, IL-6, MMP-8, and MMP-9 levels among habitual gutka chewers and controls. METHODS: Forty-five gutka chewers and 45 controls were included. Demographic information regarding age, sex, duration and daily frequency of gutka chewing, duration of gutka placement in the mouth, and daily toothbrushing habits were collected using a questionnaire. Periodontal parameters, including plaque index (PI), bleeding on probing (BOP), probing depth (PD) >3 mm, clinical attachment loss (AL), marginal bone loss (MBL), and number of missing teeth, were recorded. Unstimulated whole saliva samples were collected, and unstimulated whole salivary flow rate (UWSFR) was determined. Levels of IL-6, IL-1ß, MMP-8, and MMP-9 were measured in UWS using an enzyme-linked immunosorbent assay. RESULTS: PI (P <0.01), BOP (P <0.01), PD >3 mm (P <0.01), and clinical AL (P <0.01) were significantly higher in gutka chewers than controls, as were whole salivary IL-6 (P <0.01), IL-1ß (P <0.01), MMP-8 (P <0.01), and MMP-9 (P <0.01) concentrations. There was no significant difference in UWSFR, number of missing teeth, or MBL among habitual gutka chewers and controls. CONCLUSION: Periodontal inflammatory conditions were worse, and whole salivary IL-6, IL-1ß, MMP-8, and MMP-9 levels were higher among gutka chewers than non-chewers.

Genetic susceptibility to dental caries differs between the sexes: a family-based study.

Many of the factors affecting susceptibility to dental caries are likely influenced by genetics. In fact, genetics accounts for up to 65% of inter-individual variation in dental caries experience. Sex differences in dental caries experience have been widely reported, with females usually exhibiting a higher prevalence and severity of disease across all ages. The cause for this sex bias is currently uncertain, although it may be partly due to the differential effects of genetic factors between the sexes: gene-by-sex interactions. In this family based study (N = 2,663; 740 families; ages 1-93 years), we assessed dental caries via intra-oral examination and generated six indices of caries experience (DMFS, dfs, and indices of both pit-and-fissure surface caries and smooth surface caries in both primary and permanent dentitions). We used likelihood-based methods to model the variance in caries experience conditional on the expected genetic sharing among relatives in our sample. This modeling framework allowed us to test two lines of evidence for gene-by-sex interactions: (1) whether the magnitude of the cumulative effect of genes differs between the sexes, and (2) whether different genes are involved. We observed significant evidence of gene-by-sex interactions for caries experience in both the primary and permanent dentitions. In the primary dentition, the magnitude of the effect of genes was greater in males than females. In the permanent dentition, different genes may play important roles in each of the sexes. Overall, this study provides the first direct evidence that sex differences in dental caries experiences may be explained, in part, by gene-by-sex interactions.

Dental caries experience and periodontal treatment needs of children with autistic spectrum disorder.

AIM: To assess dental caries experience and periodontal treatment needs among Libyan children diagnosed with autistic spectrum disorder (ASD). MATERIALS AND METHODS: A cross-sectional, comparative case-control study was used, in which dental caries experience of 50 children with ASD was compared with that of 50 controls. The children with ASD were recruited from Benghazi Centre of Children with ASD, Libya. Controls were recruited from school children and matched for age, gender and socioeconomic status. DMFT, dmft for dental caries experience and CPITN for periodontal treatment needs were calculated according to WHO criteria by a calibrated examiner. Scores for DMFT as well as CPITN indices were compared using bivariate analysis. RESULTS: The data analysed for this study comprised observations from a group of children (cases = 50) diagnosed with ASD matched with healthy children (controls = 50). Consequently, each group consisted of 40 males and 10 females aged between 3 and 14 years (mean 7.29 ± 3.11). The ASD children showed significantly lower means for DMFT and dmft teeth as well as higher periodontal treatment needs (p > 0.05). CONCLUSION: Children with ASD were found to be more likely caries-free and have lower DMFT scores and higher unmet periodontal treatment needs than did the unaffected control children.

Oral health status of elderly chinese with dementia in Hong Kong.

PURPOSE: To compare toothbrushing habits, unstimulated salivary flow rates and oral health status of elderly Hong Kong Chinese with and without dementia. MATERIALS AND METHODS: A sample size calculation was performed and a sample of 82 elderly Chinese with dementia were invited who were aged 60 or above, fit for periodontal assessment with probing and attended day-care centres. Age- and gender-matched generally healthy people without dementia were recruited as controls. Toothbrushing practices were recorded using a questionnaire. Additionally, unstimulated salivary flow rate was measured. Caries experience and periodontal status were assessed through clinical examination by the DMFT index and Community Periodontal Index (CPI), respectively. RESULTS: Fifty-nine people with dementia and 59 age- and gender-matched generally healthy controls were recruited. Their mean age was 80 (SD = 7). Compared with the individuals in the control group, fewer people with dementia performed toothbrushing twice daily (31% vs 5%; P < 0.001). Furthermore, their unstimulated salivary flow rate was lower than that of the control group (0.30 ml/min vs 0.41 ml/min; P = 0.043). Their caries experience in mean DMFT (± SD) was similar to the control group (22.3 ± 8.2 vs 21.5 ± 8.2, P = 0.59). There was also no significant difference in the prevalence of periodontal pockets (CPI  ≥ 3) between the two groups (78% vs 74%, P = 0.64). CONCLUSION: Compared to those without dementia, fewer elderly Chinese with dementia practiced toothbrushing twice daily. Although their resting salivary secretion was reduced, their caries experience and prevalence of advanced periodontal disease were not significantly different from those without dementia.

Is periodontitis a risk factor for cognitive impairment and dementia? A case-control study.

BACKGROUND: Dementia is a multi-etiologic syndrome characterized by multiple cognitive deficits but not always by the presence of cognitive impairment. Cognitive impairment is associated with multiple non-modifiable risk factors but few modifiable factors. Epidemiologic studies have shown an association between periodontitis, a potentially modifiable risk factor, and cognitive impairment. The objective of this study is to determine whether clinical periodontitis is associated with the diagnosis of cognitive impairment/dementia after controlling for known risk factors, including age, sex, and education level. METHODS: A case-control study was conducted in Granada, Spain, in two groups of dentate individuals aged >50 years: 1) cases with a firm diagnosis of mild cognitive impairment or dementia of any type or severity and 2) controls with no subjective memory loss complaints and a score >30 in the Phototest cognitive test (screening test for cognitive impairment). Periodontitis was evaluated by measuring tooth loss, plaque and bleeding indexes, probing depths, and clinical attachment loss (AL). RESULTS: The study included 409 dentate adults, 180 with cognitive impairment and 229 without. A moderate and statistically significant association was observed between AL and cognitive impairment after controlling for age, sex, education level, oral hygiene habits, and hyperlipidemia (P = 0.049). No significant association was found between tooth loss and cognitive impairment. CONCLUSION: Periodontitis appears to be associated with cognitive impairment after controlling for confounders such as age, sex, and education level.

The effect of lifetime fluoridation exposure on dental caries experience of younger rural adults.

BACKGROUND: The aim of this study was to confirm whether the level of lifetime fluoridation exposure is associated with lower dental caries experience in younger adults (15-46 years). METHODS: Data of the cohort born between 1960 and 1990 residing outside Australia's capital cities from the 2004-2006 Australian National Survey of Adult Oral Health were analysed. Residential history questionnaires were used to determine the percentage of each person's lifetime exposure to fluoridated water (<50%/50+%). Examiners recorded decayed, missing and filled permanent teeth (DMFT). Socio-demographic variables, periodontal risk factors, and access to dental care were included in multivariable least-squares regression models. RESULTS: In bivariate analysis, the higher level of fluoridation category had significantly lower DMFT (mean 6.01 [SE=0.62]) than the lower level of fluoridation group (9.14 [SE=0.73] p<0.01) and lower numbers of filled teeth (4.08 [SE=0.43], 7.06 [SE=0.62], p<0.01). In multivariate analysis, the higher number of full-time equivalent dentists per 100,000 people was associated with a lower mean number of missing teeth (regression coefficient estimate=-1.75, p=0.03), and the higher level of water fluoridation with a lower mean DMFT (-2.45, p<0.01) and mean number of filled teeth (-2.52, p<0.01). CONCLUSIONS: The higher level of lifetime fluoridation exposure was associated with substantially lower caries experience in younger rural adults, largely due to a lower number of filled teeth.

Periodontal findings in individuals with newly identified pre-diabetes or diabetes mellitus.

AIM: To assess the periodontal status and number of missing teeth in patients with newly identified pre-diabetes or diabetes mellitus. METHODS: A total of 1097 subjects with previously undiagnosed diabetes were available for study, and were categorized into normoglycaemic, potentially pre-diabetes or potentially diabetes groups based on a point-of-care (POC) HbA1c test. RESULTS: In fully adjusted models, significant differences were observed between all groups for the per cent of teeth with at least one site with a probing depth of ≥5 mm. For bleeding on probing, there were significant differences between diabetes and pre-diabetes (p = 0.001), and between diabetes and normoglycaemic groups (p = 0.002). For missing teeth, there were significant differences between the pre-diabetes and normoglycaemic groups (p = 0.034), and the diabetes and normoglycaemic groups (p = 0.004). CONCLUSIONS: Individuals with previously unidentified pre-diabetes demonstrate a level of periodontal destruction between that observed for normoglycaemic individuals and persons with diabetes. These data emphasize the association of oral findings to dysglycaemia, and suggest that periodontal disease and tooth loss can be early complications of diabetes mellitus.

The impact of handicap severity on oral and periodontal status of patients with mental retardation.

AIM: Mental retardation (MR) subjects comprise a considerable amount of the community and are susceptible to oral and periodontal problems due to insufficient oral care. The aim of this cross-sectional study was to determine the oral health and periodontal status of MR patients in Turkey with regard to periodontal indices and Decay missed filling teeth (DMFT) scores and compare findings according to severity of the MR. MATERIALS AND METHODS: One hundred and five MR patients were included to the study and divided into 3 groups according to MR severity diagnoses. Demographic variables like age, gender, disabled sibling, BMI, living an institution and clinical parameters like plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), missing teeth and DMFT scores were recorded from all subjects. Appropriate statistical analyses were used to compare the findings. RESULTS: There were no statistically significant differences between groups according to age, gender, disabled sibling, living status and DMFT scores. Clinical periodontal indices and the number of missing teeth were showed a statistically significant increasing trend with the severity of MR (p < 0.05). Correlation analysis showed significant positive correlations between PI and periodontal disease measures like GI, PD, CAL and BOP and also between PI and DMFT (p < 0.05). CONCLUSION: The deteriorated teeth condition and deprived periodontal health of MR patients may be most likely caused by the poor oral hygiene and may be worsen with the severity of the MR. Clinical significance: Knowledge of oral and periodontal status of mental retardation patients has great importance for public health and family education.

Partial Edentulism based on Kennedy's classifcation: an epidemiological study.

BACKGROUND: The aim of this study was to determine the incidence of different Kennedy's classes of partial edentulism during 18 months period. MATERIALS AND METHODS: Patients were clinically examined for various Kennedy's classes of partial edentulism in the outpatient department (OPD), prosthodontics, GPRDCH, Kurnool (Andhra Pradesh). RESULTS: Of the total 1,420 OPD patients, Kennedy's class III was the most frequent classification encountered (62%) and followed by Kennedy's class I (18%), class II (11%), and class IV (9%) in decreasing order. CONCLUSION: The patients with various Kennedy's classes of partial edentulism can be offered various treatment modalities like removable cast partial dentures, fixed partial dentures, over dentures and implant supported dentures. This study can be crucial for screening the population for incidence of tooth loss as a factor of gender and age. Clinical significance: Tooth loss appears to have an important role in the loss of esthetics and mastication. Study of incidence of various classes of partial edentulism provides clinically useful information for dental training and continuing education.