Evaluation and Comparison of Salivary Nitric Oxide Levels Among the Smokers and Non Smokers With Gingivitis and Chronic Periodontitis and Its Correlation With Association of Diabetes Mellitus and With the Subject s Stress Levels A Cross Sectional Study

Abstract

Background and Objective: The past millennium has witnessed tremendous research regarding attempts to enhance our understanding of the etiopathogenesis of periodontal disease. Nitric oxide (NO), a free radical gas, is a noxious chemical in the atmosphere but in small controlled concentrations in the body, acts as a physiological and pathophysiological mediator and plays an important role in biological systems. Although the direct cause for periodontitis is oral bacterial infection, smoking is arguably the strongest behavioral risk factor for the incidence and progression of period ontitis. Diabetes mellitus (DM) is a disorder categorized by metabolic dysfunction. In India more than 33million people are suffering from this disorder with increasing prevalence rate of about 4.3%. The type 2 DM is seen in almost 70% in world population. It is known that stress mechanisms contribute to onset, exacerbation, and maintenance of oral inflammatory diseases and it is also known to generate a plethora of free radicals including NO. Hence, the aim of the study was done to evaluatethe involvement of Nitric oxide in periodontal disease, will enable us to understand one aspect of the complex process of periodontal disease progression and this is the reason for the present study which was performed to explore the comparison of the salivary NO levels among the smokers and non-smokers with the periodontal disease and correlate it withthe association of diabetes mellitus and patient s stress level. newline Methodology: The study was carried out in 216 outpatients who came as outpatients to the Department of Periodontics, SreeBalaji Dental College and Hospital, Chennai. A Cross-Sectional Study Design was undertaken which is divided into 3 groups:-The first group was the control group that comprised of 72 patients who were orally healthy individuals and with no systemic diseases,aged between of 25 75years. The second group was study group of 72 patients with evidence of gingivitis who are subdivided into two subgroups as smokers and non sm