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      Reflex Gastroesophageal Disorders and Functional Dyspepsia: Potential Confounding Variables for the Progression of Chronic Periodontitis: A Clinical Study

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          Abstract

          Aim:

          To probe into the possible connection between gastroesophageal reflux disorders (GERDs) and functionally occurring dyspepsia as a factor raising the risk of chronic periodontitis.

          Materials and Methods:

          A cross-sectional study was carried out on 40 patients with chronic periodontitis with age group between 40–60 years. The test group included 20 people diagnosed with gastroesophageal reflux disease (GERD), according to the Montreal Definition and Classification agreement, and chronic periodontitis. Symptomatic diagnoses were done to confirm functional dyspepsia. The control group comprised 20 systematically healthy people suffering from chronic periodontitis. Indices measured included flow-rate of saliva, repetitive saliva swallowing test for swallowing function, papillary marginal attachment index of gingiva, oral hygiene index-simplified and decayed, missing, filled teeth index. Data was analyzed using SPSS version 22 (IBM Inc. Chicago, USA). Descriptive statistics, such as mean and standard deviation (SD) for continuous variables and frequency and percentage for categorical variables were determined. T test was performed for intergroup comparison and Pearson correlation test was done for evaluating correlation between various parameters. P ≤ 0.05 considered as significant.

          Results:

          Statistically significant differences were observed between the test and control groups with regard to all the clinical parameters of interest. Pearson's correlation test revealed a strong negative correlation between salivary flow rate and OHI-S and DMFT scores. The RSST swallow function values demonstrated a moderate negative correlation with OHI-S scores, while OHI-I scores and DMFT scores were observed to be strongly correlated in a positive direction. A statistically significant difference was present in the probing depth and CAL levels between both the groups with higher levels in test group.

          Conclusion:

          GERD was linked to incremental incidences of chronic periodontitis and was established as an independent risk-raising factor.

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          Most cited references32

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          Inflammation and cancer.

          Recent data have expanded the concept that inflammation is a critical component of tumour progression. Many cancers arise from sites of infection, chronic irritation and inflammation. It is now becoming clear that the tumour microenvironment, which is largely orchestrated by inflammatory cells, is an indispensable participant in the neoplastic process, fostering proliferation, survival and migration. In addition, tumour cells have co-opted some of the signalling molecules of the innate immune system, such as selectins, chemokines and their receptors for invasion, migration and metastasis. These insights are fostering new anti-inflammatory therapeutic approaches to cancer development.
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            Staging and grading of periodontitis: Framework and proposal of a new classification and case definition

            Authors were assigned the task to develop case definitions for periodontitis in the context of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. The aim of this manuscript is to review evidence and rationale for a revision of the current classification, to provide a framework for case definition that fully implicates state-of-the-art knowledge and can be adapted as new evidence emerges, and to suggest a case definition system that can be implemented in clinical practice, research and epidemiologic surveillance.
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              The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus.

              A globally acceptable definition and classification of gastroesophageal reflux disease (GERD) is desirable for research and clinical practice. The aim of this initiative was to develop a consensus definition and classification that would be useful for patients, physicians, and regulatory agencies. A modified Delphi process was employed to reach consensus using repeated iterative voting. A series of statements was developed by a working group of five experts after a systematic review of the literature in three databases (Embase, Cochrane trials register, Medline). Over a period of 2 yr, the statements were developed, modified, and approved through four rounds of voting. The voting group consisted of 44 experts from 18 countries. The final vote was conducted on a 6-point scale and consensus was defined a priori as agreement by two-thirds of the participants. The level of agreement strengthened throughout the process with two-thirds of the participants agreeing with 86%, 88%, 94%, and 100% of statements at each vote, respectively. At the final vote, 94% of the final 51 statements were approved by 90% of the Consensus Group, and 90% of statements were accepted with strong agreement or minor reservation. GERD was defined as a condition that develops when the reflux of stomach contents causes troublesome symptoms and/or complications. The disease was subclassified into esophageal and extraesophageal syndromes. Novel aspects of the new definition include a patient-centered approach that is independent of endoscopic findings, subclassification of the disease into discrete syndromes, and the recognition of laryngitis, cough, asthma, and dental erosions as possible GERD syndromes. It also proposes a new definition for suspected and proven Barrett's esophagus. Evidence-based global consensus definitions are possible despite differences in terminology and language, prevalence, and manifestations of the disease in different countries. A global consensus definition for GERD may simplify disease management, allow collaborative research, and make studies more generalizable, assisting patients, physicians, and regulatory agencies.
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                Author and article information

                Journal
                Int J Prev Med
                Int J Prev Med
                IJPVM
                International Journal of Preventive Medicine
                Wolters Kluwer - Medknow (India )
                2008-7802
                2008-8213
                2020
                03 September 2020
                : 11
                : 138
                Affiliations
                [1] Department of Periodontics, Sibar Institute of Dental Sciences, Takkellapadu, Guntur, Andhra Pradesh, India
                [1 ] Department of Internal Medicine, Physician, North Central Bronx Hospital, 3424 Kossuth Ave, Bronx, New York, USA
                [2 ] Department of Internal Medicine, Resident Physician, James J Peter VA Medical Center, 130W Kingsbridge Road, Bronx, New York, USA
                Author notes
                Address for correspondence: Dr. Ramanarayana Boyapati, Department of Periodontics, Sibar Institute of Dental Sciences, Takkellapadu, Guntur - 522 509, Andhra Pradesh, India. E-mail: dr.ramanarayana@ 123456gmail.com
                Article
                IJPVM-11-138
                10.4103/ijpvm.IJPVM_141_19
                7554558
                33088466
                828f7c69-1f49-41e6-9539-9eb82827d082
                Copyright: © 2020 International Journal of Preventive Medicine

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 22 April 2019
                : 08 August 2019
                Categories
                Original Article

                Health & Social care
                chronic periodontitis,functional dyspepsia,gastroesophageal reflux,risk factor

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