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International Journal of Dentistry and Oral Science (IJDOS)  /  IJDOS-2377-8075-08-6067

Correlation Of Chronic Periodontitis With Oral Hygiene Status: A Cross-Sectional Study


Thanish Ahamed. S1

, Jayakumar. ND2*
, Mebin George Mathew3

1 Saveetha Dental college and Hospitals, Saveetha Institute of medical and Technical Sciences, Saveetha University, Chennai, India.
2 Dean of Faculty, Professor and Head, Department of Periodontics, Saveetha Dental College and hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
3 Senior Lecturer, Department of Pedodontics, Saveetha Dental College and hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.


*Corresponding Author

Jayakumar. ND,
Dean of Faculty, Professor and Head, Department of Periodontics, Saveetha Dental College and hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
E-mail: jayakumarnd@saveetha.com

Received: May 28, 2021; Accepted: June 16, 2021; Published: June 26, 2021

Citation: Thanish Ahamed. S, Jayakumar. ND, Mebin George Mathew. Correlation Of Chronic Periodontitis With Oral Hygiene Status: A Cross-Sectional Study. Int J Dentistry Oral Sci. 2021;8(7):2911-2915.doi: dx.doi.org/10.19070/2377-8075-21000590

Copyright: Jayakumar. ND©2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.



Abstract

Periodontitis refers to chronic inflammatory disease affecting the supporting tissues of the teeth. It is a multifactorial disease. However, the primary etiology of this disease is bacterial plaque. Dental plaque accumulation and inadequate personal oral hygiene are major risk factors of periodontitis. The aim of the study was to correlate chronic periodontitis with oral hygiene status. The present retrospective study was conducted among 900 chronic periodontitis who reported to a private institution from June 2019 to March 2020. Data regarding oral hygiene status was collected from clinical records. Data were analysed to find out whether there was any significant difference in the oral hygiene status of the chronic periodontitis patients with respect to different age groups and gender, using Chi-square test (SPSS software). There was a statistical significant difference in the association between oral hygiene status and different age groups (p value-0.00). Also, there was a statistical significant difference in the association between oral hygiene status and gender (p value-0.00). The present study showed that the majority of the chronic periodontitis patients had poor oral hygiene with male predilection.


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1.Keywords
2.Introduction
6.Conclusion
8.References

Keywords

Dental Plaque; Gingivitis; Oral Hygiene; Periodontitis; Risk Factor.


Introduction

Periodontitis is the most common oral disease worldwide. There are two common diseases affecting the periodontium. The first is gingivitis, which is defined as inflammation of the gingiva in which the connective tissue attachment to the tooth remains at its original level. The disease is limited to the soft-tissue compartment of the gingival epithelium and connective tissue. The second is periodontitis, which is an inflammation of the supporting tissues of the teeth with progressive attachment loss and bone destruction. [1] The most common forms of periodontitis are chronic periodontitis, aggressive periodontitis, periodontitis as a manifestation of systemic diseases. [2]

Periodontitis is a multifactorial disease, with primary etiology being plaque microflora. The pathogenesis of periodontal diseases is mediated by the inflammatory response to bacteria in the dental biofilm. Research has also shown that periodontal microflora is similar to that found in atheromatous plaques. [3] Cytokines play an important role in the pathogenesis of periodontitis and the levels of tumor necrosis factor-a, interleukin-1 and endothelin varies in chronic and aggressive periodontitis. [4-7] Also, periodontal disease can be a risk factor for cardiac disease and chronic obstructive pulmonary disease. [3, 8] There are various regenerative treatment modalities available to successfully treat the osseous defects due to periodontal disease. Researchers have attempted various regenerative methods like bone grafts, platelet rich fibrin, growth factors, stem cells to salvage the destruction of periodontal tissues in chronic as well as aggressive forms of periodontitis. [9-15]

The treatment modalities for chronic and aggressive periodontitis though basically remains the same, antimicrobial therapy has provided added advantage in treating aggressive periodontitis cases.

[16] Herbs have been used as antimicrobial agents in treating periodontal diseases. Effectiveness of various herbal mouth rinses have been tested in different periodontal diseases. [17]) Dental plaque accumulation and inadequate personal oral hygiene are known major risk factors of periodontitis. The accumulation of dental plaque and calculus is usually caused by improper tooth brushing techniques, failure to carry out interdental cleaning and irregular dental visits. This accumulation predictably results in gingival inflammation. Persistent gingivitis is a key risk predictor for the breakdown of periodontal attachment. [18]

Oral hygiene is the level of oral cleanliness of an individual and is assessed based on the accumulation of hard and soft deposits on the surfaces of teeth, which are the etiological factors of periodontal disease. The simplified oral hygiene index (OHI-S) developed by Greene and Vermillion (1964) is a simple, standard and acceptable method of assessing oral hygiene. [19] Assessment of oral hygiene of individuals reasonably reflects their gingival and periodontal health.

Although poor oral hygiene is a well accepted and important risk factor for periodontitis, literature search reveals only few studies assessing the magnitude of association between oral hygiene and periodontitis.Previously our team has a rich experience in working on various research projects across multiple disciplines [20-34]. Therefore, to address this lacunae this research was undertaken to correlate chronic periodontitis with oral hygiene status. The objective was (i) to correlate chronic periodontitis with oral hygiene status (good/fair/poor); (ii) to assess the association of oral hygiene status of chronic periodontitis patients among different age groups; (iii) to assess the association of oral hygiene status of chronic periodontitis patients among males and females.


Materials And Methods

The present retrospective study was conducted among chronic periodontitis patients who reported to a private institution from June 2019 to March 2020. The study setting was a university setting. Ethical approval was obtained from the Institutional ethical committee (SDC/SIHEC/DIASDATA/ 0619-0320). Cross verification was done with an external examiner to avoid any missing data values. Sampling bias was minimised by including all available data.

Case sheets of patients visiting a private dental institution were reviewed and 900 patients diagnosed with chronic periodontitis were included in the study. Patients diagnosed with clinically healthy gingiva and gingivitis were excluded from the study. Incomplete data were excluded from this study. Independent variables were age, gender and the dependent variable was oral hygiene status. The oral hygiene status of the selected study participants were assessed based on simplified oral hygiene index (OHI-S) developed by Greene and Vermillion.

Data were analysed to find out whether there was any significant difference in the oral hygiene status of the chronic periodontitis patients with respect to different age groups and gender, using Chi-square test (SPSS software; Version 23). The level for a statistical significance was set at p<0.05.


Results And Discussion

In the present study, table 1 showed that among 900 chronic periodontitis patients, 22 patients (2.4%) had good oral hygiene status, 196 patients (21.8%) had fair oral hygiene status, 682 patients (75.8%) had poor oral hygiene status. Majority of the patients had poor oral hygiene status. This finding is in accordance with previous studies by Lertpimonchai A et al [35] and Torrungruang K et al.(36), where poor oral hygiene status was predominantly seen in chronic periodontitis patients.

The study population was categorized based on their age as follows: 15-30 years, 31-45 years, 46-60 years and 61-75 years. Table 2 showed distribution of chronic periodontitis patients based on their oral hygiene status among different age groups. Among 15-30 years, 10 patients (1.11%) had good oral hygiene status, 23 patients (2.56%) had good oral hygiene status and 70 patients (7.78%) had good oral hygiene status. Among 31-45 years, 6 patients (0.67%) had good oral hygiene status, 54 patients (6.00%) had good oral hygiene status and 179 patients (19.89%) had good oral hygiene status. Among 46-60 years, 3 patients (0.33%) had good oral hygiene status, 70 patients (7.78%) had good oral hygiene status and 213 patients (23.67%) had good oral hygiene status. Among 61-75 years, 3 patients (0.33%) had good oral hygiene status, 49 patients (5.44%) had good oral hygiene status and 220 patients (24.44%) had good oral hygiene status.

In the present study, poor oral hygiene status was commonly observed within the age group of 61-75 years. In a study by Lolita YM et al, [37] reported that the oral hygiene of the chronic periodontitis patients within the age range of 65–74 years were generally poor. Ngatia EM et al reported that poor oral hygiene status was observed predominantly among patients above the age of 60 years. [38]

Figure 1 showed that the association of oral hygiene status among different age groups. Good oral hygiene status was commonly observed within the age group of 15-30 years. Fair oral hygiene status was commonly observed within the age group of 46-60 years. Poor oral hygiene status was commonly observed within the age group of 61-75 years. Chi-square test was done, p value was 0.00. There was a statistical significant difference in the association of oral hygiene status among different age groups.

Table 3 showed the distribution of chronic periodontitis patients based on their oral hygiene status among females and males. Among 900 chronic periodontitis patients, there were 420 females and 480 males. Among 420 females, 13 (1.44%) had good oral hygiene status, 125 (13.89%) had good oral hygiene status and 282 (31.33%) had good oral hygiene status. Among 480 males, 9 (1.00%) had good oral hygiene status, 71 (7.89%) had good oral hygiene status and 400 (44.44%) had good oral hygiene status. Good and fair oral hygiene status was commonly observed among females. Poor oral hygiene status was commonly observed among males. In a study by Homata EM et al, [39] confirmed that women have better oral hygiene compared to men. Also, Sanadi RM et al, in a study suggested that females had better oral health when compared to males. [40] Figure 2 showed that the association of oral hygiene status among males and females. Poor oral hygiene status was commonly observed among males when compared to females. Chi-square test was done, p value was 0.00. There was a statistical significant difference in the association of oral hygiene status among males and females.

The finding from the present study adds to the consensus of the previous studies. However, the study has some limitations like limited sample size and other confounding factors like smoking, systemic diseases, stress, genetic factors which contribute to periodontitis were not considered in the present study. Therefore, extensive research is required to assess the correlation of periodontitis with oral hygiene status by considering all the possible risk factors associated with periodontitis and among the larger population.Our institution is passionate about high quality evidence based research and has excelled in various fields [41-51].


Table 1: Table showing distribution of chronic periodontitis patients based on the oral hygiene status.

Table 2: Table depicts the distribution of chronic periodontitis patients based on their oral hygiene status among different age groups.

Table 3. Table depicts the distribution of chronic periodontitis patients based on their oral hygiene status among females and males.

Figure 1. Bar graph showing the association between the gender of the patient and no. of the patients who reported with root resorption post the orthodontic treatment. The X axis denotes the gender of the patient and the teeth no. Y axis represents the number of the patients who reported with root resorption post orthodontic treatment. It was found that both arch(Blue) resorption was more common in males and females than the single arch [either upper(Green) or lower arch(Red)] with root resorption. Chi square statistical test was done and the association was found to be not significant with p value .222 (P value - >0.005, statistically not significant).

Figure 2. Bar graph shows the association between the age of the patient and no. of the patients who reported with root resorption post the orthodontic treatment. The X axis represents the age of the patient and the teeth no. of the patient. Y axis represents the number of the patients who reported with root resorption post orthodontic treatment. It was found that root resorption in both arches(Blue) were more common in the 10-15 years age group, other age groups had most commonly single arch [either upper(Green) or lower arch(Red)] root resorption. Chi square statistical test was done and the association was found to be not significant with p value .461 (P value - >0.005, statistically not significant).

Conclusion

From the present study, we can conclude that poor oral hygiene status was predominantly seen in chronic periodontitis patients with male predilection. There was a statistical significant difference in the association between oral hygiene status and different age groups. Also, there was a statistical significant difference in the association between oral hygiene status and gender.


References

  1. Page RC, Kornman KS. The pathogenesis of human periodontitis: an introduction. Periodontol 2000. 1997 Jun;14(1):9-11.
  2. Flemmig TF. Periodontitis. Ann Periodontol. 1999 Dec;4(1):32-8.
  3. Priyanka S, Kaarthikeyan G, Nadathur JD, Mohanraj A, Kavarthapu A. Detection of cytomegalovirus, Epstein-Barr virus, and Torque Teno virus in subgingival and atheromatous plaques of cardiac patients with chronic periodontitis. J Indian Soc Periodontol. 2017 Nov-Dec;21(6):456-460.Pubmed PMID: 29551863.
  4. Varghese SS, Thomas H, Jayakumar ND, Sankari M, Lakshmanan R. Estimation of salivary tumor necrosis factor-alpha in chronic and aggressive periodontitis patients. Contemp Clin Dent. 2015 Sep;6(Suppl 1):S152-6. Pubmed PMID: 26604566.
  5. Mootha A, Malaiappan S, Jayakumar ND, Varghese SS, Toby Thomas J. The Effect of Periodontitis on Expression of Interleukin-21: A Systematic Review. Int J Inflam. 2016;2016:3507503.Pubmed PMID: 26998377.
  6. Khalid W, Vargheese SS, Lakshmanan R, Sankari M, Jayakumar ND. Role of endothelin-1 in periodontal diseases: A structured review. Indian J Dent Res. 2016 May-Jun;27(3):323-33.Pubmed PMID: 27411664.
  7. Khalid W, Varghese SS, Sankari M, Jayakumar ND. Comparison of Serum Levels of Endothelin-1 in Chronic Periodontitis Patients Before and After Treatment. J Clin Diagn Res. 2017 Apr;11(4):ZC78-ZC81.Pubmed PMID: 28571268.
  8. Ramesh A, Varghese SS, Jayakumar ND, Malaiappan S. Chronic obstructive pulmonary disease and periodontitis–unwinding their linking mechanisms. J. Oral Biosci. 2016 Feb 1;58(1):23-6.
  9. Ravi S, Malaiappan S, Varghese S, Jayakumar ND, Prakasam G. Additive Effect of Plasma Rich in Growth Factors With Guided Tissue Regeneration in Treatment of Intrabony Defects in Patients With Chronic Periodontitis: A Split-Mouth Randomized Controlled Clinical Trial. J Periodontol. 2017 Sep;88(9):839-845.Pubmed PMID: 28474968.
  10. Panda S, Jayakumar ND, Sankari M, Varghese SS, Kumar DS. Platelet rich fibrin and xenograft in treatment of intrabony defect. Contemp Clin Dent. 2014 Oct;5(4):550-4.
  11. Avinash K, Malaippan S, Dooraiswamy JN. Methods of Isolation and Characterization of Stem Cells from Different Regions of Oral Cavity Using Markers: A Systematic Review. Int J Stem Cells. 2017 May 30;10(1):12-20. Pubmed PMID: 28531913.
  12. Thamaraiselvan M, Elavarasu S, Thangakumaran S, Gadagi JS, Arthie T. Comparative clinical evaluation of coronally advanced flap with or without platelet rich fibrin membrane in the treatment of isolated gingival recession. J Indian Soc Periodontol. 2015 Jan;19(1):66-71.
  13. Ramesh A, Ravi S, Kaarthikeyan G. Comprehensive rehabilitation using dental implants in generalized aggressive periodontitis. J Indian Soc Periodontol. 2017 Mar;21(2):160-3.
  14. Ramesh A, Vellayappan R, Ravi S, Gurumoorthy K. Esthetic lip repositioning: A cosmetic approach for correction of gummy smile - A case series. J Indian Soc Periodontol. 2019 May-Jun;23(3):290-294.Pubmed PMID: 31143013.
  15. Kavarthapu A, Thamaraiselvan M. Assessing the variation in course and position of inferior alveolar nerve among south Indian population: A cone beam computed tomographic study. Indian J Dent Res. 2018 Jul- Aug;29(4):405-409.Pubmed PMID: 30127186.
  16. Ramesh A, Varghese SS, Doraiswamy JN, Malaiappan S. Herbs as an antioxidant arsenal for periodontal diseases. J Intercult Ethnopharmacol. 2016 Jan 27;5(1):92-6.Pubmed PMID: 27069730.
  17. Ramamurthy JA, Mg V. Comparison of effect of hiora mouthwash versus chlorhexidine mouthwash in gingivitis patients: a clinical trial. Asian J Pharm Clin Res. 2018;11(7):84-8.
  18. Van Dyke TE, Dave S. Risk factors for periodontitis. J Int Acad Periodontol. 2005 Jan;7(1):3-7.
  19. Greene JG, Vermillion JR. The simplified oral hygiene index. J Am Dent Assoc. 1964 Jan 1;68(1):7-13.
  20. Hafeez N. Accessory foramen in the middle cranial fossa. Res J Pharm Technol. 2016 Nov 1;9(11):1880.
  21. Krishnan RP, Ramani P, Sherlin HJ, Sukumaran G, Ramasubramanian A, Jayaraj G, et al. Surgical Specimen Handover from Operation Theater to Laboratory: A Survey. Ann Maxillofac Surg. 2018 Jul-Dec;8(2):234-238. Pubmed PMID: 30693238.
  22. Somasundaram S, Ravi K, Rajapandian K, Gurunathan D. Fluoride Content of Bottled Drinking Water in Chennai, Tamilnadu. J Clin Diagn Res. 2015 Oct;9(10):ZC32-4.Pubmed PMID: 26557612.
  23. Felicita AS. Orthodontic extrusion of Ellis Class VIII fracture of maxillary lateral incisor - The sling shot method. Saudi Dent J. 2018 Jul;30(3):265- 269.Pubmed PMID: 29942113.
  24. Kumar S, Rahman RE. Knowledge, awareness, and practices regarding biomedical waste management among undergraduate dental students. Asian J Pharm Clin Res. 2017;10(8):341.
  25. Gurunathan D, Shanmugaavel AK. Dental neglect among children in Chennai. J Indian Soc Pedod Prev Dent. 2016 Oct 1;34(4):364.
  26. Sneha S. Knowledge and awareness regarding antibiotic prophylaxis for infective endocarditis among undergraduate dental students. Asian J Pharm Clin Res. 2016 Oct 1:154-9.
  27. Dhinesh B, Lalvani JI, Parthasarathy M, Annamalai K. An assessment on performance, emission and combustion characteristics of single cylinder diesel engine powered by Cymbopogon flexuosus biofuel. Energy Convers. Manag. 2016 Jun 1;117:466-74.
  28. Choudhari S, Thenmozhi MS. Occurrence and Importance of Posterior Condylar Foramen. LATERALITY. 2016 Aug 28;8:11-43.
  29. Paramasivam A, Vijayashree Priyadharsini J, Raghunandhakumar S. N6- adenosine methylation (m6A): a promising new molecular target in hypertension and cardiovascular diseases. Hypertens Res. 2020 Feb;43(2):153- 154.Pubmed PMID: 31578458.
  30. Wu F, Zhu J, Li G, Wang J, Veeraraghavan VP, Krishna Mohan S, et al. Biologically synthesized green gold nanoparticles from Siberian ginseng induce growth-inhibitory effect on melanoma cells (B16). Artif Cells Nanomed Biotechnol. 2019 Dec;47(1):3297-3305.Pubmed PMID: 31379212.
  31. Palati S, Ramani P, Shrelin HJ, Sukumaran G, Ramasubramanian A, Don KR, et al. Knowledge, Attitude and practice survey on the perspective of oral lesions and dental health in geriatric patients residing in old age homes. Indian J Dent Res. 2020 Jan-Feb;31(1):22-25.Pubmed PMID: 32246676.
  32. Saravanan M, Arokiyaraj S, Lakshmi T, Pugazhendhi A. Synthesis of silver nanoparticles from Phenerochaete chrysosporium (MTCC-787) and their antibacterial activity against human pathogenic bacteria. Microb Pathog. 2018 Apr;117:68-72.Pubmed PMID: 29427709.
  33. Govindaraju L, Gurunathan D. Effectiveness of Chewable Tooth Brush in Children-A Prospective Clinical Study. J Clin Diagn Res. 2017 Mar;11(3):ZC31-ZC34.Pubmed PMID: 28511505.
  34. Vijayakumar Jain S, Muthusekhar MR, Baig MF, Senthilnathan P, Loganathan S, Abdul Wahab PU, et al. Evaluation of Three-Dimensional Changes in Pharyngeal Airway Following Isolated Lefort One Osteotomy for the Correction of Vertical Maxillary Excess: A Prospective Study. J Maxillofac Oral Surg. 2019 Mar;18(1):139-146.Pubmed PMID: 30728705.
  35. Lertpimonchai A, Rattanasiri S, Vallibhakara SA, Attia J, Thakkinstian A. The association between oral hygiene and periodontitis: a systematic review and meta-analysis. Int Dent J. 2017 Dec 1;67(6):332-43.
  36. Torrungruang K, Tamsailom S, Rojanasomsith K, Sutdhibhisal S, Nisapakultorn K, Vanichjakvong O, et al. Risk indicators of periodontal disease in older Thai adults. J Periodontol. 2005 Apr;76(4):558-65.
  37. Michele Lolita Y, Ashu Michael A, Hubert N, Florence D, Jacques B. Oral Health Status of the Elderly at Tonga, West Region, Cameroon. Int J Dent. 2015;2015:1-9.Pubmed PMID: 26633972.
  38. Ngatia EM, Gathece LW, Macigo FG, Mulli TK, Mutara LN, Wagaiyu LG. Nutritional and oral health status of an elderly population in Nairobi. East Afr Med J. 2008 Dec 15;85(8):378-85.
  39. Mamai-Homata E, Koletsi-Kounari H, Margaritis V. Gender differences in oral health status and behavior of Greek dental students: A meta-analysis of 1981, 2000, and 2010 data. J Int Soc Prev Community Dent. 2016 Jan- Feb;6(1):60-8.Pubmed PMID: 27011935.
  40. Sanadi RM, Chelani LR, Suthar NJ, Khuller N, Basavaraj P. Gender-based differences in occurrence of gingival disease among dental students: A survey. dent. med. res. 2017 Jan 1;5(1):17.
  41. Vijayashree Priyadharsini J. In silico validation of the non-antibiotic drugs acetaminophen and ibuprofen as antibacterial agents against red complex pathogens. J Periodontol. 2019 Dec;90(12):1441-1448.Pubmed PMID: 31257588.
  42. PC J, Marimuthu T, Devadoss P, Kumar SM. Prevalence and measurement of anterior loop of the mandibular canal using CBCT: A cross sectional study. Clin Implant Dent Relat Res. 2018 Apr 6;20(4):531-4.
  43. Ramesh A, Varghese S, Jayakumar ND, Malaiappan S. Comparative estimation of sulfiredoxin levels between chronic periodontitis and healthy patients - A case-control study. J Periodontol. 2018 Oct;89(10):1241-1248.Pubmed PMID: 30044495.
  44. Ramadurai N, Gurunathan D, Samuel AV, Subramanian E, Rodrigues SJ. Effectiveness of 2% Articaine as an anesthetic agent in children: randomized controlled trial. Clin Oral Investig. 2019 Sep;23(9):3543-50.
  45. Sridharan G, Ramani P, Patankar S, Vijayaraghavan R. Evaluation of salivary metabolomics in oral leukoplakia and oral squamous cell carcinoma. J. Oral Pathol. Med. 2019 Apr;48(4):299-306.
  46. Ezhilarasan D, Apoorva VS, Ashok Vardhan N. Syzygium cumini extract induced reactive oxygen species-mediated apoptosis in human oral squamous carcinoma cells. J Oral Pathol Med. 2019 Feb;48(2):115-121.Pubmed PMID: 30451321.
  47. Mathew MG, Samuel SR, Soni AJ, Roopa KB. Evaluation of adhesion of Streptococcus mutans, plaque accumulation on zirconia and stainless steel crowns, and surrounding gingival inflammation in primary molars: randomized controlled trial. Clin Oral Investig. 2020 Sep;24(9):1-6.Pubmed PMID: 31955271.
  48. Samuel SR. Can 5-year-olds sensibly self-report the impact of developmental enamel defects on their quality of life? Int J Paediatr Dent. 2021 Mar;31(2):285-286.Pubmed PMID: 32416620.
  49. R H, Ramani P, Ramanathan A, R JM, S G, Ramasubramanian A, et al. CYP2 C9 polymorphism among patients with oral squamous cell carcinoma and its role in altering the metabolism of benzo[a]pyrene. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020 Sep;130(3):306-312.Pubmed PMID: 32773350.
  50. Chandrasekar R, Chandrasekhar S, Sundari KKS, Ravi P. Development and validation of a formula for objective assessment of cervical vertebral bone age. Prog Orthod. 2020 Oct 12;21(1):38.Pubmed PMID: 33043408.
  51. Vijayashree Priyadharsini J, Smiline Girija AS, Paramasivam A. In silico analysis of virulence genes in an emerging dental pathogen A. baumannii and related species. Arch Oral Biol. 2018 Oct;94:93-98.Pubmed PMID: 30015217.

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