RESUMO
BACKGROUND: Tobacco smoking is an independent risk factor for periodontal disease which increases periodontal pocketing, attachment loss, as well as bone loss leading to varied severity and bone destruction in the form of horizontal and vertical patterns. AIM: The aim of the present study is to determine and measure the types and severity of bone destruction in chronic periodontitis (CP) patients with tobacco smoking habit using intraoral periapical (IOPA) radiographs and transgingival probing. MATERIALS AND METHODS: A total of 60 male participants with CP were included in the study. Group A comprised 30 heavy cigarette smokers and Group B comprised 30 nonsmokers. Clinical parameters such as plaque index (PI), probing pocket depth (PPD), and clinical attachment loss (CAL) were recorded. Amount and pattern of bone loss were assessed using IOPA and transgingival probing. RESULTS: The mean values of PI, PPD, and CAL were 2.50 ± 0.28 mm, 9.33 ± 1.42 mm, and 10.2 ± 1.62 mm, respectively, for cigarette smokers, which were found to be higher and statistically significant as compared to nonsmokers. Cigarette smokers showed more bone destruction than nonsmokers in respect to maxillary molars 4.42 ± 1.31 mm and incisors 3.90 ± 1.10 mm as compared to nonsmokers. Types of bone destruction were more of vertical patterns (93.3%) in cigarette smokers. CONCLUSIONS: Tobacco smoking was associated with severe attachment loss. Tobacco smoking not only affects soft tissues but also hard tissues such as bone. Palatal sides of maxillary molars showed significantly higher bone loss and also had more percentage of vertical patterns of bone loss compared to nonsmokers. IOPA and transgingival probing may be used as noninvasive methods for the determination of types and severity of bone destruction in CP patients with or without tobacco smoking habit.
RESUMO
AIM: To treat mucogingival problems palatal masticatory mucosa is used as a donor material. This study aimed to determine the thickness of donor palatal mucosa and associations of age and gender in Indian subjects aged 14 to 60 years by direct clinical technique. MATERIALS AND METHODS: Forty systemically and periodontally healthy Indian subjects (20 males; 20 females; age range of 14 to 60 years) enrolled in this study. Under local anesthesia bone sounding technique was performed at 15 defined and predetermined points. The Wilcoxon test was used to determine the difference in mucosal thickness between the age groups and between genders. Significance of the difference between individuals of different body mass index (BMI) was assessed by independent t-test. RESULTS: With mean thickness of 2.0 to 3.7 mm, the younger age group demonstrated significantly thinner donor mucosa (mean 2.8±0.3 mm) than the older age group (mean 3.1±0.3 mm). Within the same age group though statistically not significant; males had thicker mucosa than females. From the canine to second premolar areas and in the sites furthest from the gingival margin mucosa thickness increased. When correlated with subject's BMI, in all probed sites males demonstrated significantly a thicker mucosa than females. Within each group subjects with high BMI demonstrated thicker donor mucosa. CONCLUSION: Current study showed that in both adult and young individuals, premolar and canine areas can be the right site for harvesting donor tissue. Even in young subjects subepithelial connective tissue (CT) graft can be harvested in adequate volume. Donor tissue thickness can be influenced by factors like genetics and race, which need to be further evaluated. CLINICAL SIGNIFICANCE: Premolar and canine areas serve as appropriate choice to harvest palatal masticatory mucosa. Even in young patients the volume of donor tissue available is sufficient enough to consider the subepithelial CT graft procedure. Donor tissue thickness can be influenced by factors like genetics and race, which need to be further evaluated.