Epidemiological Study on the Prevalence and Incidence of Periodontal Disease of Patients Aged 4- 17 Years with Systemic Conditions

The aim of the study is to characterize from the epidemiological point of view a group of 122 patients with general diseases, supposed to install gingival overgrowth and to provide valid data related to some epidemiological variables (age, gender, type of disease, biological general data, and clinical aspects of periodontal involvement). Material and method. The study was conducted on a sample of hospitalized children and adolescents diagnosed with insulin-dependent diabetes type I, leukemia, chronic renal failure and epilepsy. The group consisted in 122 children, 60 girls and 62 boys, aged between 4 and 17 years, from the Clinic Pediatrics Hospital "St. Maria" Iaşi and Psychiatric Hospital No. 9 Iaşi, in the period 2005-2008. We used for comparison a control group, composed 30 children of the same age, without general systemic conditions, which were in dental treatment in assistance upon request. Periodontal status assessment was made by clinical general and local examination and comprehensive para-clinical tests. Indices of periodontal evaluation used: Plaque index (PI), Papillary bleeding index (PBI) and Gingival overgrowth index. Information on diabetes, chronic renal failure, epilepsy and leukemia were recorded from the medical records, discussions with the therapist or family. The systemic disease diagnostic for all children was made based on their general symptoms, most of them (92%) being hospitalized with complicated disease. Results and discussion. As regards the distribution group of study on gender is a predomination of female sex (53%). Batch distribution according to age groups is heterogeneous, with maximum values around the age of 17 years. The distribution by type of disease is as follows: 29 cases of insulin-dependent diabetes type I, 31 cases of chronic renal failure, 30 epileptic and 32 cases of leukemia. Graphical representation of classes of variation for plaque index was computed over 10 classes, observing the relative maximum frequency of 47.2% of values between 1.8 and 2.2, followed by values between 1.21 and 1.4 with relative frequency of 37.36% and between 2.61 and 2.8 with relative frequency of 15.38%. For bleeding index were built 10 variation classes; half of the values recorded were between 1-1.2 and 36.17% of records having values between 1.61 and 2.2. A relative frequency of 13 83% is observed for the PBI index values between 2.81 and 3. In our group of patients were recorded overgrowth indices between 1.21-1.4/2 with a relative frequency of 57.41%, from 1.81-2/2 with a relative frequency of 37.4% and higher values between 2.61-1.8/2 in 5.56% of cases. Conclusions Drug induced overgrowths are becoming more frequent because of the widespread use of phenytoin, cyclosporine A and calcium channel blockers. Among the factors that influence overgrowth, inflammation, through the oral plaque and pharmacokinetic variables appear to be most important. Hormonal disorders and some diseases may contribute to the overall growth rate of the gingival overgrowth.