Association Of Age And Gender Distribution In Patients Having Class II Caries Resulting In Root Canal Treatment In Lower Premolars And Molars
Lasya Genji1, Subash Sharma2*, Raghu Sandhya3
1 Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Science, Saveetha University, India.
2 Reader, Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospital, Saveetha Institute Of Medical and Technical Science, Saveetha University, India.
3 Reader, Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospital, Saveetha Institute Of Medical and Technical Science, Saveetha University, India.
*Corresponding Author
Subash Sharma,
Reader, Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospital, Saveetha Institute Of Medical and Technical Science, Saveetha University,
India.
Tel: +91 9884533118
E-mail: Subash@saveetha.com
Received: November 11, 2020 Accepted: November 22, 2020; Published: November 30, 2020
Citation:Lasya Genji, Subash Sharma, Raghu Sandhya. Association Of Age And Gender Distribution In Patients Having Class II Caries Resulting In Root Canal Treatment In Lower Premolars And Molars. Int J Dentistry Oral Sci. 2020;S10:02:0025:135-138. doi: dx.doi.org/10.19070/2377-8075-SI02-0100025
Copyright: Subash Sharma© 2020. 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
Caries or cavities, is breakdown of teeth due to acids made by bacteria. Individual tooth surfaces have different susceptibilities to
caries which vary overtime. Progress of caries towards the pulp lead to damage to pulp. Caries 2 caries involve proximal surfaces
of posterior teeth. The aim of the present study was to identify association of age and gender distribution in patients having class
II caries resulting in root canal treatment in lower premolars and molars.The data was collected from the DIAS - dental information
archiving software. All case sheets were reviewed and findings are recorded. The data was tabulated using excel and analysed
with the help of SPSS software. In this study class II caries were common in age group 60 to 70 years(73.9%). Males(63.8%) were
more affected than females(36%). Lower molars (51%) showed slightly higher incidence of class II caries when compared to premolars(
49.4%).Within the limitations of the study male patients showed higher incidence of class II caries resulting in root canal
treatment compared with female patients. 60 to 70 years was the commonly affected age group.
2.Introduction
3.Materials and Methods
4.Results and Discussion
5.Conclusion
6.Author Contribution
7.Acknowledgements
8.References
Keywords
Class II Caries; Gender; Lower Premolar; Lower Molar; Root Canal Treatment.
Introduction
Class II dental caries is described as caries in the proximal (mesial
or distal) surfaces of the premolars involving 2 or more surfaces
that is mesio-occlusal, disto-occlusal, mesio-occluso- distal,
mesio-occluso-distal buccal. class II caries have high incidence of
pulp involvement which results in root canal treatment.
The noteworthy effect of caries on the population makes the disease
a significant subject of comprehension. The improvement of
caries is multifactorial, contingent upon many factors to advance
its development. Specifically the presence of microbes, a substrate
for the microorganisms (food/sugar), the hosts oral condition,
progress of time are the fundamental contributing elements
in the development of caries [8]. The effect of gastroesophageal
reflux disease, bulimia cause the dissolution of organic matrix of
the tooth leading to softening of the tooth structure [20].
Recent studies showed that epidemiological and clinical investigations,
using tools, for example, DMFT and DMFS scores, have
uncovered a steady pattern in caries advancement, with females
having higher predominance than males [16, 24]. Several components
like poor dietary and oral hygiene habits along with social
class have been reported with caries occurrence [1, 25].
Individual tooth surfaces have massively different susceptibilities
to caries, with the pit and fissure (occlusal) surfaces the most
common, and the smooth (labial and lingual) surfaces the least
predominant [3, 10, 30]. There is an extended risk of dental caries
with age attributed by microbial and salivary conditions [9, 23]. It
is believed that prevalence of dental caries among adults is low
compared with the pre and post pubertal age groups [12, 20].
Most of the caries (recurrent) are related to the restoration than
primary caries [4, 15]. In the previous study it has been stated that, there is evidence indicating various risk factors with gender bias,
placing women at higher caries risk [18, 27]. The ability of saliva
to affect caries depends upon the quantity and composition of
the secretion [30, 23, 11].
This study spreads awareness, preventive measures with better
management protocol and helps to Understand association of age
and gender with class II caries resulting in root canal treatment in
lower premolars and molars. The aim of the present study was
to identify association of age and gender distribution in patients
having class II caries resulting in root canal treatment in lower
premolars and molars.
Materials And Methods
This retrospective study examined the records of patients from 01
june 2019 to 31st march 2020 who visited saveetha dental college
and hospital. Ethical approval was taken from the institutional
review board/SDC/SIHEC/2020/DIASDATA/0619-0320. The
study sample included both male and female gender, predominantly
south indians.
We reviewed the patients records and analysed data of 86,000 patients.
Sample size was 71 patients, in the hospital database were
diagnosed with class-II caries that progressed to Root canal treatment.
Necessary data such as age, gender, class 2 caries,caries in
close proximity to the pulp were tabulated in the excel.. Incomplete
patient records were excluded.
Data was recorded in Microsoft Excel and exported to the statistical
package of social science for windows (SPSS) and subjected
to statistical analysis. Chi square tests are used for comparison of
groups.
Results And Discussion
All the required data was collected and analysed using SPSS software.
About 44 (63.8%) were Male and 25 (36.2%) were female.
Among the total 69 study population 1.45% belong to 20-30
years, 73.9% belong to 61-70 years and 24.6% belong to 71-80
years ( Table -1).
In this study we observed class II caries treated with root canal
treatment were in the age group between 60-70 years where distal
class II is (37.68%) followed by mesial class II (31.88%) and mesio
occluso distal caries (4.35%). In the age group between 71-80
years distal class II caries is (11.59%) followed by mesial class II
caries (13.4%). However, between the age group between 20-30
years there is less incidence of class II caries that progressed to
root canal treatment(1.45%). Correlation between age and class
II caries resulting in RCT - chi square (p) =.679 -p value > 0.05
-stastistically not significant (Graph -1).
In association to gender, the analysed data revealed that, class II
caries progression to root canal treatment is observed to be higher
in males compared to females. Males account for distal class II
progression to root canal treatment is (27.54%) followed by mesial
class -2 caries progression to root canal treatment is (31.88%)
and mesio occluso distal caries [MOD] is 4.35%. Whereas in females
distal class II caries progression to root canal treatment is
(23.19%) and mesial class II caries progression to root canal treatment
is (13.04%). Correlation between gender and class -2 caries
resulting in root canal treatment - chi square (p) = .152 -p value >
0.005 - statistically not significant (Graph -2).
Among the teeth considered in this study lower left molars 36,37
(30.43%) and lower right molar 46,47 (24.74%) are prone to class
II caries when compared to lower left premolars 34,35(21.74%)
followed by lower right premolars (21.74%) and least incidence
of caries recorded in lower left third molar 38(1.45%) (Graph -3).
On data collection it also revealed that most of the caries involving
the molar proximal surfaces have poor prognosis which lead
to extractions and intentional root canal treatments. It is stated
that neighbouring approximately tooth surfaces differed in caries
susceptibility [2, 7].
The results of earlier studies explained broadly about incidence
of all the caries. However specific study on class-2 and its association
is not well defined. In the previous study it has been reported
that caries have significant incidence among the age group more
than 65 years (80%) [5]. and stated this can be due to factors like
improper oral hygiene, nutrition and salivary hypofunction. The
present study confirmed the same with respect to age. However,
results are lower than what was obtained in a study conducted in
2009 [21]. Some studies showed age does not affect caries prevalence
[5].
Matrix metalloproteinases are produced by odontoblasts and they also play a major role in formation of dental caries and extensive
periapical inflammation [26]. In case of trauma or due to any
emergency, it is important for the dentist to consider the location
and circumstances of the accident and suggest an proper transport
medium for the avulsed tooth [29].
Chlorhexidine is a broad spectrum biocide. It is effective against
gram positive bacteria, gram negative bacteria and fungi. The bactericidal
effect is a result of the binding of this cationic molecule
to negatively charged bacterial cell wall [22]. Janani et al showed
consistent pulse oximeter readings in study confirmed that pulp
circulation and blood oxygen saturation can be detected by the
pulse oximeter [13]. It is recommended that endodontic therapy
should be delayed on the traumatised teeth, and the affected pulp
tissue should be considered vital unless apical radiolucency or sinus
tract start to develop [14].
At this time the prevalence of caries in male was more compared
to females according to this study. In the previous literature it has
been mentioned that women showed higher incidence of caries
(59.1%) than males (40.9%). This is justified as frequent hormonal
fluctuation is experienced in women, type of diet, difference
in habits, rate of flow of saliva this is contrast to our study. Moreover
this study didn’t do any targeted study on the caries [6].
Molars had the highest incidence of caries rate in all age groups
due to deep pit and fissures, large size of crown [28]. Maternal
education, maternal age, location of residence and attitudes were positively associated with the caries and oral hygiene index [1].
Caries distribution was higher in maxillary jaw (62.4%) than in the
Mandibular jaw (37.6%) in this study molars are more commonly
affected ranging from (52.7% - 66.3%) which is due to deep occlusal
fissures on the first and second molars showed highest caries
rate [6]. Compared to the present study results, distal class-2
caries are predominant followed by mesial class-2 and MOD. It
was reported that distal surface of the posterior tooth commonly
shows high incidence to caries [31, 19].
Fast setting calcium hydroxide is used as pulp capping agents and
slow setting calcium hydroxide used as intra canal medicaments
should always be given after the completion of cleaning and shaping
[17]. A surgeon or a dental surgeon is always cautious in removing
all the cystic remnants of the linings of the pathological
lesion and remnants of caries or will be very careful in inspecting
its margins after removing it. Because any remnants such as dental
caries or periapical pathology that is left is going to cause further
future progression and regrowth or recurrence of the lesion [32].
The limitations of the study are due to insufficient data with less
sample size of 63 which can be expanded and diagnostic limitations.
Data mostly relies on the case sheets available in the DIAS.
Subject is not available for direct examination. In future the study
can be performed in larger populations for longer duration,better
management protocol with further scope of research.Thus the
study serves as an evidence and add to the consensus that can be
utilised for further studies at the larger population.
Table 1. Shows age and gender distribution of the sample population. 63.8% of the patients were males and 36.2% of the patients were females. 73.9% of the patients belonged to the age group between 61 to 70 years followed by 24.6% of the patients belonged to the age group between 71 to 80 years and 1.45% of the patients belonged to the age group between 20-30 years.
Graph 1. This graph represents the association of age and class II caries progression to root canal treatment. X axis represents the age and Y axis represents the incidence of class II caries and its progression to root canal treatment. Blue colour denotes distal class II caries, red colour denotes mesial class II caries, green colour denotes mesio occluso distal caries. Graph 1 shows that most number of class II caries treated with root canal treatment were in the age group between 61-70 years where distal class II caries is 37.68% followed by mesial class II caries - 31.88% and mesio occluso distal caries - 4.35%. In the age group between 71-80 years distal class II caries is 11.59% followed by mesial class II caries -13.4%. However age group between 20-30 years there is less incidence of class II caries that progressed to root canal treatment(1.45%). P value was found to be .679 which is >0.05, statistically not significant(chi square test).
Graph 2. This graph represents the association of gender and class II caries progression to root canal treatment. X axis represents gender and Y axis represents incidence of class II caries progression to root canal treatment. Blue colour denotes distal class II caries, red colour denotes mesial class II caries, green colour denotes mesio occluso distal caries. Graph 2 shows most number of class II caries progression to root canal treatment is observed to be higher in males compared to females. Males account for distal class II progression to root canal treatment is (27.54%) followed by mesial class -2 caries progression to root canal treatment (31.88%) and mesio occluso distal caries [MOD] is 4.35%. Whereas in females distal class II caries progression to root canal treatment is (23.19%) followed by mesial class II caries progression to root canal treatment (13.04%). P value was found to be .152 which is >0.05, statistically not significant(chi square test).
Graph 3. Pie chart represents frequency distribution of teeth that are commonly prone to class II caries. Light pink colour denotes lower left premolars, yellow colour denotes lower left molars,light green colour denotes lower right premolars and dark blue colour denotes lower right molars. From the derived results it is shown that lower left molars (30.43%) and lower right molar (24.09%) were more prone to class II caries when compared to lower left premolars (21.74%) and lower right premolars (21.74%).
Conclusion
Mandibular molars are likely to experience caries compared to
premolars, Furthermore Males have more class-2 caries teeth that
resulted in root canal treatment than females. The most commonly
affected age group is 60-70 years. On the other hand molars are
prone to distal caries.
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