Evaluation of Glycosylated Hemoglobin Levels and Effect of Tobacco Smoking in Periodontally Diseased Non-Diabetic Patients.

Background and Objective: Chronic diseases have progressively increased worldwide, impacting all areas and socioeconomic groups. Periodontal disease is an increasing global concern and contains risk factors similar to other chronic illnesses. The main risk factor for periodontitis is smoking. Smoking not only hastens periodontal disease but also complicates periodontal therapy. Serum glycosylated hemoglobin levels, which are derived from the average life span of an erythrocyte, are a good indicator of glycemic management during the preceding one to three months. This study was undertaken to assess the association between tobacco smoking and periodontal disease by evaluating plaque score, gingival score, extent and severity index (ESI), and glycemic status by estimating serum HbA1c in cigarette smoker patients compared to non-smokers. Methods: The study was conducted with 40 patients in the age range of 20-40 years. Patients were divided into two groups: non-smokers (Group I) and cigarette smokers (Group II). Periodontal clinical parameters such as the plaque index (PI), gingival index (GI), and ESI were recorded during the oral cavity examination. The biochemical marker, serum glycosylated hemoglobin, was measured in both groups. All parameters were measured at baseline and three months after periodontal therapy. The statistical tests used were the paired t-test, and Chi-square test for comparison between both groups. Results: The mean difference of PI of non-smokers was 0.33 ± 0.30, and smokers were 0.52 ± 0.32, which was statistically significant. The mean difference of GI of non-smokers was 0.34 ± 0.19 and smokers 0.36 ± 0.303, which was statistically significant. The mean difference of extent in non-smokers was 5.33 ± 1.59, 5.52 ± 2.43, and smokers were 0.18 ± 0.17. The mean difference in severity in non-smokers was 0.18 ± 0.17, and smokers were 0.31 ± 0.25, which was statistically significant. The mean difference of HbA1c in non-smokers and smokers was 0.43 ± 0.277 and 0.415 ± 0.230, which shows a higher mean difference in non-smokers, which was statistically non-significant. Conclusion and Global Health Implications: This study concluded that each of Group I and Group II showed substantial improvements in all clinical periodontal variables, which include plaque index (PI), gingival index (GI), extent and severity index (ESI), and biochemical marker serum glycosylated hemoglobin. Controlling inflammation with SRP can improve insulin resistance, lower glucose levels, and prevent non-enzymatic glycation of hemoglobin.

Evaluation of hard and soft tissue changes around implant in partially edentulous patients: a clinico-radiographic study.

INTRODUCTION: implant supported prosthesis has become a viable treatment option for missing teeth. An important tool to detect early changes around implants is the standardized assessment of peri-implant hard and soft tissue parameters. The purpose of this prospective study was to clinically and radiographically assess the soft and hard tissues around implants. METHODS: ten (10) patients with 13 implant supported prosthesis were included in the study. Clinical parameters plaque index (PI), gingival index (GI), modified sulcus bleeding index (mSBI), peri-implant Probing Depth (PD), gingival margin Level, width of keratinized mucosa (WKM) and implant mobility were measured at loading and at 3 and 6 months. The radiographic crestal bone loss and peri-apical implant radiolucencies were also evaluated at loading and at 3 and 6 months. Student paired t test and correlation and regression analysis was done to evaluate the effect of clinical variables over bone loss. RESULTS: there was decrease in the site specific PI, GI, mSBI and peri-implant PD and an increase in the gingival recession from baseline to 6 months. The WKM remained stable throughout the study. Significant crestal bone loss was observed around implants more on the distal as compared to the mesial aspect. No mobility or peri-apical implant radiolucency was observed. Regression analysis of the confounding variables with bone loss showed no significant effect. CONCLUSION: the occlusal loading of implants after 6 months showed significant bone loss (<1mm), which was within acceptable limits and the soft tissues around implants were in good health.

Effect of cigarette smoking on the periodontal health status: A comparative, cross sectional study.

CONTEXT: Survey. AIMS: The objective of the study was to evaluate the periodontal health status among cigarette smokers and non cigarette smokers, and oral hygiene measures. SETTINGS AND DESIGN: Cross sectional study. MATERIALS AND METHODS: The study included 400 male (200 cigarette smokers and 200 non smokers) aged 18-65 years. The subjects were randomly selected from the patients attending dental out-patient department of civil hospital and Himachal Dental College, Sundernagar. Community Periodontal Index (CPI) score was recorded for each patient and a questionnaire was completed by each patient. STATISTICAL ANALYSIS USED: Chi square and t-test. RESULTS: Periodontal condition as assessed by CPI score showed that there was statistically significant difference in the findings between cigarette smokers and non-smokers. CONCLUSIONS: Within the limits of this study, positive association was observed between periodontal disease and cigarette smoking. It was found that cigarette smoking was associated with lesser gingival bleeding and deeper pockets as compared to non-smokers.