Farklı Klinik Periodontal Durumlarda Etkilenen Doku Yüzeyi Alanı ve Oral Sağlık Durumu İlişkisinin Belirlenmesi

Abstract

Several studies have been conducted to correlate linear measurements of periodontitis with the attachment loss surface area, but none of these studies have utilized the continuous variable of inflamed surface area measurement. Periodontal disease can impact individuals' quality of life; therefore, it should be subjectively assessed with measurements that reflect its influence on oral health-related quality of life. The aim of this study is to comparatively examine inflamed or damaged surface areas in different clinical periodontal conditions based on the diagnosis groups proposed in the most recent classification titled 'Classification of Periodontal and Peri-Implant Diseases and Conditions' in 2017, and to assess its

potential relationship with criteria reflecting oral health-related quality of life. Socio- demographic data of 240 patients who attended to the Department of Periodontology

at Hacettepe University Faculty of Dentistry was recorded, including age, gender, smoking habits, systemic health status, and medication use. The individuals in the study were categorized according to the Classification of Periodontal and Peri-Implant Diseases and Conditions as follows: clinical health on intact periodontium (group 1), clinical health on reduced periodontium (group 2), gingivitis on intact periodontium (group 3), gingivitis on reduced periodontium (group 4), stage 1 periodontitis (group 5), stage 2 periodontitis (group 6), stage 3 periodontitis (group 7), and stage 4 periodontitis (group 8). Periodontal indices reflecting their conditions, including probing depth (PD), clinical attachment loss (CAL), plaque index (PI), bleeding on probing (BOP), and gingival index (GI), were recorded. Using PD, CAL, and BOP values, the periodontal epithelial surface area (PESA), periodontal inflamed surface area (PISA), and attachment loss surface area (ALSA) were calculated. To determine oral health-related quality of life, the Oral Health Impact Profile-14 (OHIP-14), Visual Analog Scale (VAS) for patients' subjective symptoms, Oral Assessment Guide (OAG) for assessing overall oral condition, and the World Dental Federation's (FDI) risk assessment scoring were used. Sixty-eight percent of the included patients were

xi female, 32% were male, and eight groups were formed based on periodontal conditions in the study. Although there were statistically significant differences in age and gender among these groups, comparisons between groups were evaluated through covariance analyses to control for these variables. Significant differences were observed between groups in PI and PD values (p<0.05). Groups with stage 3 and stage 4 periodontitis had higher PI values compared to other groups (p<0.05). PD values were significantly higher in the stage 4 periodontitis group (p>0.05). The surface area measurements (PESA, PISA, ALSA) were significantly higher in periodontitis groups compared to other groups (p<0.05). There were no significant differences in OHIP and VAS scores between groups (p>0.05). Risk assessment scores of clinical health and gingivitis groups were significantly lower than those of stage 2, stage 3, and stage 4 periodontitis patients (p<0.05). Additionally, the OAG value of the clinical health group on intact periodontium was significantly lower than other groups (p<0.05). Considering that periodontal surface area measurements align with the severity of periodontal disease, especially the measurements of periodontal inflamed surface area, it can be said that they support the diagnostic criteria of the most recent classification proposed in 2017. Moreover, while subjective methods for oral health assessment, such as OHIP and VAS, were not able to between diffirentiate periodontal conditions, clinical records and findings-based OAG and risk assessment scoring are effective in diffirentiating between various periodontal conditions and also the disease severity. Thus, it can be suppested that these methods can be useful for personalized and patient-centered treatment approaches.