RANJEET DESHMUKH DENTAL COLLEGE AND RESEARCH CENTRE,

DIGDOH HILLS, HINGNA ROAD, NAGPUR - 440019

DEPARTMENT OF PERIODONTICS AND IMPLANTOLOGY

Synopsis

Assessment and correlation of Anxiety, Metabolic Syndrome and Periodontal

disease in Smokers and Non-Smokers: A Cross-Sectional Study

PRINCIPAL INVESTIGATOR GUIDE

Pornima Dhote Dr. Vrushali Lathiya
Rishi Bora
HOD & DEAN
Dr. Abhay Kolte
 INTRODUCTION

• Metabolic syndrome (MetS) refers to a cluster of physical risk factors that are associated with increased risks of
cardiovascular disease [1], Type II Diabetes[2] and other chronic diseases [3,4].

• The National Cholesterol Education Program defines the five components of Metabolic Syndrome as: Obesity
(body mass index ≥ 25), high blood pressure (systolic blood pressure ≥ 130 mm Hg or diastolic blood pressure ≥ 85
mm Hg), low serum high-density lipoprotein (HDL) cholesterol (< 40 mg/dl for males and < 50 mg/dl for females),
hypertriglyceridemia (triglycerides ≥ 150 mg/dl), and high plasma glucose (fasting plasma glucose ≥ 110 mg/dl) [5].

• MetS is considered positives in the presence of 3 or more of the following 5 metabolic abnormalities: Elevated
levels of blood glucose, Serum triglycerides, and Blood Pressure; low serum High-Density Lipoprotein (HDL); and
large Waist Circumference[6].
 INTRODUCTION

• It was shown that periodontal disease can adversely affect MetS[7] and that MetS also affects periodontal disease.
[8]

• Psychological stress or anxiety is one of the important risk factor associated with inflammatory diseases like
periodontitis.

• Periodontal infections including acute necrotizing ulcerative gingivitis (ANUG) are known to be linked to
psychological risk factors. [9,10]
 AIM

To assess the relationship between Anxiety, Metabolic syndrome and Periodontal disease in smokers
and non-smokers.
 OBJECTIVES

1. To evaluate and compare the anxiety levels of the patients having Metabolic syndrome (MetS) with and
without smoking.
2. To evaluate and compare the prevalence of Probing Pocket Depth (PPD), Clinical Attachment Level
(CAL), Plaque Index (PI), Gingival Index (GI), Community Periodontal Index (CPI) among the patients
having Metabolic Syndrome (MetS) with and without smoking.
3. To evaluate and compare the distribution of radiographic bone loss among the patients having Metabolic
syndrome (MetS) with and without smoking.
REVIEW OF LITERATURE

1. Kolte et al. (2014) Kolte et al. 2016 found a clear link between PPD and anxiety
levels, as shown by a comparison of PPD in smokers with mild, moderate, and
severe anxiety levels. PPD values increased along with an increase in anxiety
levels.[10]
2. Campos et al (2020) evaluated the potential association between periodontitis
and MetS. The present study showed that individuals with MetS showed a
significantly worse periodontal clinical condition, expressed by higher PI, BOP,
PD, CAL and percentage of affected sites, when compared to individuals without
MetS.[11]
3. Gomes et al (2020) investigated the association between periodontitis severity
and metabolic syndrome and concluded that severe and moderate periodontitis
were positively associated with MetS.[12]
5. Pham (2018) investigated the association between severity of periodontal
disease and MetS. The prevalence of periodontitis in the MetS group was higher
than that in the control group. [13]
6. Fukui et al (2012) analysed the relationships of PD and CAL to MetS, using
cross-sectional data from periodic comprehensive health examinations and
concluded that having severe PD and severe CAL or having moderate PD and CAL
were significantly related to MetS, but severe CAL without severe PD was not.
[14]
7. Adachi et al (2020) examined the relationship between oral health conditions
and the development of MetS over one year and found no association between
periodontitis and MetS development22.[15]
8. Borges et al (2007) conducted a cross-sectional study focuses on the
relationship between periodontal disease and metabolic syndrome and found that
there was a slight increase in the prevalence of the metabolic syndrome in
periodontitis patients when compared to the group without periodontitis. [16]
5. Pham (2018) investigated the association between severity of periodontal
disease and MetS. The prevalence of periodontitis in the MetS group was higher
than that in the control group. [13]
6. Fukui et al (2012) analysed the relationships of PD and CAL to MetS, using
cross-sectional data from periodic comprehensive health examinations and
concluded that having severe PD and severe CAL or having moderate PD and CAL
were significantly related to MetS, but severe CAL without severe PD was not.
[14]
7. Adachi et al (2020) examined the relationship between oral health conditions
and the development of MetS over one year and found no association between
periodontitis and MetS development22.[15]
8. Borges et al (2007) conducted a cross-sectional study focuses on the
relationship between periodontal disease and metabolic syndrome and found that
there was a slight increase in the prevalence of the metabolic syndrome in
periodontitis patients when compared to the group without periodontitis. [16]
 METHODOLOGY

Study Design:
A Cross-sectional Study
Study Setting
It will be conducted in the Department of Periodontics & Implant dentistry, after
taking written informed consent from the patients.

Study Population
Patients having MetS as well as healthy subjects (without MetS), both smokers and
non-smokers visiting the Department of Periodontics & Implant dentistry, Ranjeet
Deshmukh Dental College and Research Centre, Nagpur.
Sample Size: 150

Study Groups
The study will comprise of total 150 patients, both males and females, divided into
three groups:
Group I: 50 systemically healthy patients without habit of smoking.
Group II: 50 patients having MetS without habit of smoking.
Group III: 50 patients having MetS with habit of smoking.

STUDY DURATION: 12 months.

STUDY EXPENDITURE: Approximately Rs. 25,000/-

Sampling Technique
Patients falling under inclusion criteria will be selected
 Inclusion Criteria

Group I
1. Systemically healthy patients.
2. Patients without the habit of smoking .
3. Patients having more than 20 functional teeth.

Group II
1. Known cases of MetS
2. Patients without the habit of smoking.
3. Patients having more than 20 functional teeth.

Group III
1. Known cases of MetS
2. Patients having the habit of smoking.
3. Patients having more than 20 functional teeth
 Exclusion Criteria

1. Patients suffering from any other systemic diseases except for MetS, allergies or
drug usage.
2. Pregnant and Lactating women.
3. Subjects who have undergone periodontal therapy in last 6 months.
METHODS OF MEASUREMENTS

Clinical parameters:

1) Probing pocket depth (PPD)

2) Clinical attachment level (CAL)
3) Plaque Index (PI) (Sillness and Loe)
4) Gingival Index (GI) (Loe and Sillness)
5) Community Periodontal Index (CPI Index)
Radiographic Parameters:

• Radiographic Bone loss will be evaluated by Radiographic-Based Periodontal

Bone Loss (PBL) Method on Orthopantomography (OPG) according to the
standardized protocol by Ryden et al.[17]
• Based on the PBL, in percentage, patients will be then divided into different
groups: Healthy Periodontium (if PBL ≥ 80%), Mild-to-Moderate Periodontitis
(if PBL: 79-66%), and Severe Periodontitis (if PBL < 66%).

Assessment of anxiety:
Anxiety levels of the subjects will be assessed using the Zung Self rating Anxiety
Scale (SAS).[18]

DATA ANALYSIS AND INTERPRETATION

After completion of the study, the data will be statistically analyzed using a
Statistical Software Package
REFERENCES
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16. Pollyanna Kaisa de Oliveira Borges Suely Godoy Agostinho Gimeno Nilce Emy
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Thank you