To study the impact of nonsurgical periodontal therapy on BMI and Hip-Waist ratio in obese patients with and without periodontitis

 

S. Sripradha

III BDS , Saveetha Dental College, Chennai – 600 007

 

ABSTRACT:

Increase in the Body Mass Index has been associated with various systemic conditions. High BMI has also shows a bi-directional relationship between inflammatory diseases like periodontitis. Periodontitis is a chronic immune-inflammatory disease which is caused by oral bacteria which causes heightened immune mediated reactions which ultimately leads  to the destruction of the host periodontal tissues itself. This study investigated the predictive role of obesity on clinical response following non surgical periodontal therapy in patients with and without periodontitis.60 patients received an intensive course of nonsurgical periodontal therapy. Probing depth and attachment loss were assessed. BMI and hip-waist ratio were also measured before and one month after the therapy.

 

 

 

 

INTRODUCTION:

Obesity has been defined by World Health Organisation (WHO) a medical condition in which excess body fat has accumulated to the extent that it may have a negative effect on health, leading to educed life expectancy and/or increased health problems.WHO defines overweight as BMI greater than equal to 25 and obesity as BMI greater than or equal to 30. According to WHO about 13% of world’s population (11%men and 15%women) were obese as on 2014. Prevalence of obesity in Asia is 4% of world’s population and that of India is 1.9% of Asian population. Obesity has become a epidemic disease. Obesity causes various systemic disease like hypertension, diabetes and cardiovascular diseases. Various studies have proven the association of obesity and periodontitis. Periodontitis involves progressive loss of the alveolar bone around the teeth, and if left untreated, can lead to the loosening and subsequent loss of teeth. This study focuses on the reduction in the obesity parameters after nonsurgical periodontal treatment.^1-3

 

AIM:

 The aim of this study is to compare the effects of nonsurgical periodontal therapy on BMI and waist-hip ratio in obese individuals with and without periodontitis.

 

MATERIALS AND METHODS:

Study sample

The sample selected for this analysis consisted of individuals under the following exclusion and inclusion criteria. The study included participants within the age group of 19-60 yrs. The participants were divided into three groups. Group I consisted of obese patients with periodontitis. Group II consisted of obese patients without periodontitis. Group III were a healthy control group. Group I and II were test groups and Group III were the control group. Group I had participants with either localised or generalised periodontitis.^4-7 All the patients were otherwise systemically healthy, were not taking any medications including non-steroidal anti-inflammatory drugs, and antibiotics for the past 6 months. Participants in group I and group II received non-surgical periodontal therapy consisting of oral hygiene instructions and full mouth mechanical periodontal debridement with ultrasonic instruments.^8-12

 

Data collection

Body mass index was calculated as kg/m²based upon height and weight of the individual, measured with a wall mounted height measure and a weighing machine. Waist-hip ratio was calculated using a measuring tape. Periodontal findings included pocket depth and attachment loss. Demographic information including name, age and sex were obtained. ^13-15

 

RESULT:

Table 1: Demographic table showing the number of samples in group I, II, III

Gender	I	II	III
Male	11	13	0
female	19	17	30

 

Table 2: comparison of mean pocket depth(P.D.) and attachment loss(A.L.) of group I and II before and one month after the nonsurgical periodontal  treatment

	I	II
	Before        After	Before           After
P.D.(mean)	2.6              2.56	1                    1
A.L.(mean)	2.61            2.58	0                    0

 

Table 3: comparison of BMI and W/H ratio of group I and II before and one month  after the nonsurgical periodontal treatment

	I	II
	P	P
	Before             After	Before          After
BMI(mean)	36.53                36.28	36.59            36.5
W/Ratio(mean)	0.934               0.928	0.928            0.938

P value of W/H ratio of group I is 0.0029 which is <0.05. This shows that the p value is significant. P value is not significant for other parameters.

 

Table 4: Comparison of BMI and W/H ratio,. of group I and II one month after the periodontal treatment

	P value
BMI	0.73954
W/H ratio	0.082246

 

Table 4 shows the comparison of BMI and W/H ratio,of group I and II one month after the periodontal treatment. The p value of BMI was 0.73954 which is not <0.05. This shows that the p value is not significant. The p value of W/H ratio was 0.082246 which is not <0.05. This shows that it is not significant.

 

DISCUSSION:

Periodontitis was  a chronic immune-inflammatory disease which is caused by oral bacteria which causes heightened immune mediated reactions which ultimately leads to the destruction of the host periodontal tissues itself. Obesity has been defined by World Health Organisation (WHO) a medical condition in which excess body fat has accumulated to the extent that it may have a negative effect on health, leading to educed life expectancy and/or increased health problems. Recent studies show the relationship between obesity and periodontitis. This study is done to see the impact of nonsurgical periodontal treatment on BMI and W/H ratio. The study was done taking 3 set of groups. Group I consisted of individuals who were obese and had periodontitis. Group II were obese and did not have periodontitis. Group III was a control group. They were neither obese nor had periodontitis. Each individual’s height, weight, W/H ratio, pocket depth and attachment loss were taken before the nonsurgical periodontal treatment. Group III did not undergo a periodontal treatment.

 

Again all the parameters were taken one month after the nonsurgical periodontal treatment for group I and II. Statistical studies showed the comparison of various parameters with group I and II. Statistics was done using ANOVA software. Paired t test,  Pearson correlation, t test were done. According to the study there was a reduction in mean pocket depth and attachment loss by 0.04 and 0.03 respectively in group I after the nonsurgical periodontal treatment. On comparing the p value of BMI and W/H ratio before and one month after the nonsurgical periodontal treatment of group, the p value of BMI was 2.96 which was not <0.05 showing that it was not statistically significant.

 

The p value of W/H ratio of group I was 0.0029 which was <0.05 showing that the p value was statistically significant. The p value of BMI of group II was 0.062 which was not <0.05 showing that the p value was notstatistically significant. The p value of W/H ratio of group II was 1 which was not <0.05 showing that it was notstatistically significant. On comparing the p value of BMI and W/H ratio of group I and II , it showed that the p value of BMI was 0.7395 which was not <0.05 showing that it was not statistically significant. The p value of W/H ratio was 0.0822 which was not <0.05 showing that the p value was not statistically significant.

 

CONCLUSION:

This shows that there was a significant impact of nonsurgical periodontal therapy on W/H ratio but not on BMI. The main reason behind this was a small sample size and a follow up of 30days. Future studies with a long term follow up,  a larger sample size using various markers for obesity would be truthful.

 

REFERENCES:

1.     Haslam DW, James WP (2005). "Obesity". Lancet (Review) 366 (9492):1197–209.

2.     Parveen D, Reet K, Rajan Gupta. Obesity, periodontal and general health: Relationship and management. Indian J Endocrinol Metab. 2012;16(1):88–93.

3.     Pischon N, Heng N, Bernimoulin JP, Kleber BM, Willich SN, Pischon T. Obesity, inflammation,  and periodontal disease. J Dent Res. 2007;86(5):400-9.

4.     J. Suvan, A. Petrie, and F.D’ Aiuto, journal of dental research.2014 Jan:93(1):49-54

5.     Altay U, Gurgan CA, Agbaht K. (2013). Changes in inflammatory and metabolic parameters after periodontal treatment in patients with and without obesity. J Periodontol 84:13-23

6.     Chaffee BW, Weston SJ. (2010). Association between chronic periodontal disease and obesity: a systematic review and meta-analysis. J Periodontol 81:1708-1724

7.     D’Aiuto F, Nibali L, Parkar M, Suvan J, Tonetti MS. (2005). Short-term effects of intensive periodontal therapy on serum inflammatory markers and cholesterol. J Dent Res 84:269-273.

8.     Lakkis D, Bissada NF, Saber A, Khaitan L, Palomo L, Narendran S, et al. (2012). Response to periodontal therapy in patients who had weight loss after bariatric surgery and obese counterparts: a pilot study. J Periodontol 83:684-689

9.     Suvan J, D’Aiuto F, Moles DR, Petrie A, Donos N. (2011). Association between overweight/obesity and periodontitis in adults. A systematic review. Obes Rev 12:e381-e404

10.  ZuzaEP, Barroso EM, Carrareto AL, Pires JR, Carlos IZ, Theodoro LH, et al. (2011). The role of obesity as a modifying factor in patients undergoing non-surgical periodontal therapy. J Periodontol 82:676-682

11.  WHO (no authors listed) (2000). Obesity: preventing and managing the global epidemic: report of a WHO consultation. World Health Organ Tech Rep Ser 894:i-xii, 1-253

12.  WHO (2013). WHO Overweight and Obesity Fact Sheet No311. URL accessed on 10/10/2013

13.  Dickie de Castilhos E, Horta BL, Gigante DP, Demarco FF, Peres KG, Peres MA. Association between obesity and periodontal disease in young adults: a population-based birth cohort. J ClinPeriodontol 2012;39:717-724.

14.  Ylostalo P, Suominen-Taipale L, Reunanen A, Knuuttila M. Association between body weight and periodontal infection. J ClinPeriodontol. 2008;35:297–304.

15.  Ritchie CS. Obesity and periodontal disease. Periodontol 2000. 2007;44:154–63.

 

 

Accepted on 27.07.2016           © RJPT All right reserved

Research J. Pharm. and Tech 2016; 9(10):1704-1706.