Study Of Occlusal And Masticatory Efficiency Before And After Periodontal Initial Therapy In Patients With Severe Periodontitis

Objectives: 1.To investigate the effect of initial periodontal therapy on masticatory function in patients with severe chronic periodontitis(SCP).The treatment changes in occlusal and masticatory efficiency was analysed by T-Scan III occlusal and Viewgum color analysis software.2.To study pre and post treatment changes in percentage of occlusal force and occlusal contact area in mobile teeth,and to analyze the influence of treatment on occlusion of same teeth.Method: 31 patients with SCP were included for the study whom underwent initial periodontal therapy,including scaling,subgingival curettage and root planning.Probing depth(PD),attachment loss(AL),bleeding index(BI),and tooth mobility(TM),were measured at baseline and 6 weeks post treatment.Similarly T-Scan III occlusion analysis system was used to record occlusion time(OT),maximum area frame bite force/max movie force(MABF/MMF),the bite force distribution balance between the left and right sides(BFDB)and chewing efficiency.The masticatory efficiency was recorded by assisting the patients to chew on a two-color chewing gum for 20 times,obtained photographs were evaluated using Viewgum software by calculating the standard deviation of hue(SDHue).The periodontal and occlusal indexes were analysed for total 285 mobile teeth selected from 31 patients.Differences in PD,AL,OT,MABF/MMF,BFDB,and SDHue,before and after treatment,were compared using paired t-test.Correlations between periodontal indexes,occlusal indexes,and SDHue were analyzed using bivariate Pearson correlation analysis.Before and after treatment,BI,TMI,occlusal force percentage,and occlusal contact area were compared using rank sum test.The difference in degree of mobility in different groups was compared using Chi-square test.Spearman rank correlation analysis was used to analyze the relationship between the percentage of occlusal force and the occlusal contact area.Results: 1.The following after treatment changes were observed in patients :(1)Decreased periodontal index: PD decreased from(4.28±0.45)mm to(3.14±0.34)mm,and AL decreased from(4.93±0.54)mm to(4.47±0.54)mm.BI decreased from 3.15(0.66)to 1.24(0.35),TM decreased from 0.57(0.44)to 0.41(0.39),the differences were statistically significant(P<0.05).(2)Improved occlusal status: OT decreased from(0.44±0.10)s to(0.25±0.04)s,MABF/MMF increased from(91.04±5.81)% to(96.48 ± 2.18)%,the difference being statistically significant(P<0.05);BFDB decreased from(15.37±8.53)% to(9.74±5.67)%,however,there was no significant difference between the two groups(P>0.05).(3)The chewing efficiency increased,and the SDHue value decreased from 0.77±0.35 to 0.58±0.24 which was also statistically significant(P<0.05).2.Correlation analysis showed that: PD,AL,BI were negatively correlated with MABF/MMF(r values were-0.471,-0.790,-0.531,P<0.05),and positively correlated with OT(r = 0.467,0.492,0.568,P<0.05);SDHue was negatively correlated with MABF/MMF(r=-0.549,P<0.05).3.After treatment,similar quality of improvement was provided between I°/II°/III°mobile teeth group(P>0.05)however,decrease in mobility for posterior teeth group was higher than that of the anterior teeth group which was found statistically significant(P<0.05).4.There was no significant before and after treatment difference in the percentage of occlusal force between I°/II°/III° mobile teeth group(P>0.05).After treatment,the percentage of occlusal force and the occlusal contact area decreased for posteriors,leading to reduction in mobility.Percentage increase for both,occlusal force and the occlusal contact area was noticed,and this difference was also statistically significant(P<0.05).Conclusions: 1.Periodontal initial therapy can effectively control periodontal inflammation,improve occlusal condition and masticatory efficiency of patients with severe periodontitis.2.The occlusal force in patients with severe periodontitis is positively correlated with periodontal status and masticatory efficiency.3.Just within a short duration post initial periodontal therapy,occlusion force and the occlusal contact area are increased in posterior mobile teeth in severe periodontitis,suggesting that periodontal initial therapy has an affirmative effect on the recovery of posterior teeth.