The Scientific World Journal

The Scientific World Journal / 2019 / Article

Research Article | Open Access

Volume 2019 |Article ID 2357013 | 8 pages | https://doi.org/10.1155/2019/2357013

Epidemiological Profile of the Pathologies of the Oral Cavity in a Peruvian Population: A 9-Year Retrospective Study of 18,639 Patients

Academic Editor: Stefania Staibano
Received23 Oct 2018
Revised24 Dec 2018
Accepted03 Jan 2019
Published03 Feb 2019

Abstract

Aim. To determine the epidemiological profile of oral diseases in a marginal urban Peruvian population. Methods. A 9-year retrospective study was conducted, analysing 18,639 clinical records from the María Auxiliadora Hospital between 2006 and 2015 with diagnoses of oral lesions using ICD-10 criteria. Clinical records were analysed for sex, tumour, periapical abscess and sinus, cysts of the oral region, other lesions of the oral mucosa and cavity, gingivitis and periodontal disease, dentofacial anomalies, diseases of pulp, etc. Results. Of 18,639 cases, the prevalence was higher in women for the following pathologies: unspecified dental caries (30.6%); impacted tooth in the category of disorders of tooth development and eruption (2.0%); pulpitis (6.8%) in the category of diseases of pulp and periapical tissues; temporomandibular joint (TMJ) disorders (1.5%) in the category of dentofacial anomalies; acute gingivitis (7.5%); radicular cyst (0.3%) in the category of cysts of the oral region; and periapical abscess without sinus (2.0%). Conclusions. We found a significant association between sex and different types of dental caries, disturbances in tooth eruption, diseases of pulp and periapical tissues, and dentofacial anomalies. The study also shows a statistically significant association between sex and gingivitis, periodontal disease, and periodontal abscess and sinus.

1. Introduction

The jaws and maxillofacial region are affected by pathologies including lesions that vary in location, histopathogenesis, and aetiology involving bone and soft tissues, with manifestations requiring additional clinical examinations and where pharmacological treatments prevent or at least minimise extensive surgical procedures with mutilations [1]. Normal dentition develops from the dental lamina, which is sensitive to disturbances, and the enamel does not regenerate after injury. Multiple factors affect the development of teeth, resulting in different lesions with hypoplasia, dysplasia, hypomineralisation, etc. [2]. For instance, some lesions derive from the enamel organ, dental lamina or epithelial rests of Malassez, and remnants from odontogenic epithelium affecting teeth and periodontal tissues [35]. These lesions include dental caries, cysts, tumours, and infections, which are the diseases with the highest prevalence and the main reason for consultation in dentistry in the population. They are divided into lesions of odontogenic and nonodontogenic origin; these anomalies are genetically inherited while others are acquired such as tumours and cysts [68].

On the other hand, some lesions arise in the jaws, are not tooth-related, and have no aetiological or histopathogenetic relationship with the ectoderm, facial tissues, etc. These lesions appear as an inflammatory reaction or lesions of unknown aetiology, where lesions of the oral mucosa and cavity prevail; tumours and infections are also part of this group according to another study [9].

There are few studies that describe the most prevalent oral diseases in a Peruvian population, which has great genetic biodiversity in Latin America. Therefore, the objective of this research is important because this 9-year retrospective study examined the prevalence of oral lesions in a marginal urban Peruvian population.

2. Participants and Methods

2.1. Participants of the Study

A cross-sectional, retrospective, and observational study was conducted during the years 2006 to 2015. We identified 18,639 electronic clinical records which were evaluated from the Department of Dentistry of the María Auxiliadora Hospital in Lima (Peru), registering the patients examined and diagnosed with different types of oral lesions, to know what the regional prevalence was of these pathologies in the Peruvian inhabitants of scarce economic resources.

2.2. Procedure

Oral lesions were identified using ICD-10 criteria (International Statistical Classification of Diseases and Related Health Problems). Variables such as sex, caries, disorders of tooth development and eruption, other diseases of hard tissues of teeth, and diseases of pulp and periapical tissues were collected for oral lesions of hard tissues. Similarly, variables such as gingivitis, and periodontal disease, other lesions of the oral mucosa and cavity, cysts of the oral region, periodontal abscess and sinus, and tumours were taken for odontogenic and nonodontogenic lesions of soft tissues.

The procedure for this research followed Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines. In addition, it was authorised by the Ethics Committee of Universidad Privada San Juan Bautista (approval code CEPB-FCS 0006).

2.3. Statistical Analysis

For the statistical analysis, we used frequency measurements and the chi-square test, establishing a level of significance of p <0.05. All statistical tests were performed with Stata software (version 12.0, USA)

3. Results

3.1. Study Population

Out of 18,639 electronic clinical records over 9 years, when evaluating the prevalence of oral lesions of hard tissues for the category of caries, 7,045 cases of unspecified dental caries (37.7%) were observed, followed by 1,221 cases of dentine caries (6.5%), being more common in females (30.6% and 3.8%, respectively). In addition, 125 cases of caries limited to enamel were found, among other pathologies, with a prevalence of <1% of the population. Regarding disorders of tooth development and eruption, there were 661 cases of impacted teeth (3.5%), being more common in females (2.0%); there were also 175 cases with disturbances in tooth eruption, 107 cases with disturbances in tooth formation, and other pathologies with a prevalence of <1% of the population. Regarding diseases of pulp and periapical tissues, there were 1,919 cases of pulpitis (10.2%), followed by 1,440 cases of retained dental root (7.7%) and 512 cases of pulp necrosis (2.7%), being more common in females (6.8%, 5.2%, and 1.4%, respectively), as well as other pathologies with a prevalence of <1% of the population. In relation to dentofacial anomalies, there were 341 cases of TMJ disorders (1.8%), being more common in females (1.5%); additionally, there were 113 cases of malocclusion, 47 cases of tooth position anomalies, and other pathologies with a prevalence of <1% of the population. There was a statistically significant association between sex and these evaluated categories (p <0.05). In the category of other diseases of hard tissues of teeth, there were 46 cases of other jaw diseases, 24 cases of deposits (accretions) on teeth, and other pathologies with a prevalence of <1% of the population. However, there was no statistically significant association between sex and this evaluated category (p >0.05) (Tables 1 and 2).


DiagnosisAbbrev.No.

CariesNot presentNP1023554.9
Dentine cariesCD12216.5
Caries limited to enamelCLE1250.6
Dental caries, unspecifiedDCU704537.7
Arrested dental cariesADC80.0
Other dental cariesODC30.0
Caries in pits and fissuresCPF20.0

Disorders of tooth development and eruptionNot presentNP1744493.5
Embedded toothEmbT820.4
Impacted toothImpT6613.5
Teething syndromeTS510.2
Disorders of tooth development, unspecifiedDTDU170.0
Hereditary disturbances in tooth structure, not elsewhere classifiedHDTSNEC90.0
Disturbances in tooth eruptionDTE1750.9
Supernumerary toothSpnT770.4
Disturbances in tooth formationDTF1070.5
Staining of teethST120.0
Atrophy of edentulous alveolar ridgeAEAR40.0

Other diseases of hard tissues of teethNot presentNP1847699.1
Excessive attrition of teethEAT1000
HypercementosisHpcmt1200
Deposits (accretions) on teethDAT240.1
Certain disorders of gingiva and edentulous alveolar ridgeCDGEAR180.0
Other diseases of jawsODJ460.2
Pathological resorption of teethPRT50.0
Complete tooth lossCLT150.0
Congenital absence of teethCAT80.0
Exfoliation of teeth due to systemic causesETDSC60.0
Other specified disorders of teeth and supporting structuresOSDTSS190.1

Diseases of pulp and periapical tissuesNot presentNP1463178.4
PulpitisPlpts191910.2
Necrosis of pulpNOP5122.7
Pulp degenerationPD170.0
Acute apical periodontitis of pulpal originAAPPlO320.1
Abnormal hard tissue formation in pulpAHTFP210.0
Chronic apical periodontitisCAP290.1
Retained dental rootRDR14407.7
Other and unspecified diseases of pulp and periapical tissuesOUDPPT380.2

Dentofacial anomaliesNot presentNP1807796.9
MalocclusionMlcs1130.0
TMJ disordersTMJD3411.8
Anomalies of tooth positionATP470.2
Anomalies of jaw-cranial base relationshipAJCBR150.0
Major anomalies of jaw sizeMAJS110.0
Abnormalities of size and form of teethASFT100.0
Dentofacial functional abnormalitiesDfclFA40.0
Anomalies of dental arch relationshipADAR140.0
Developmental disturbances of jawsDDJ10.0


SexTotalp
FemaleMale

N%n%N%
CariesNP686136.8337417.91023554.90.000
CD7223.84992.612216.5
CLE700.3550.21250.6
DCU571130.613347.1704537.7
ADC60.020.080.0
ODC20.000.020.0
CPF10.010.020.0

Disorders of tooth development and eruptionNP1270868.1473625.41744493.50.000
EmbT550.2270.1820.4
ImpT3912.02701.46613.5
TS290.1220.1510.2
DTDU80.090.0170.0
HDTSNEC50.040.090.0
DTE880.4870.41750.9
SpnT250.1520.2770.4
DTF550.2520.21070.5
ST80.040.0120.0
AEAR20.020.040.0

Other diseases of hard tissues of teethNP1326271.1521427.91847699.10.159
EAT80.020.01000
Hpcmt110.010.01200
DAT110.0130.0240.1
CDGEAR120.060.0180.0
ODJ310.1150.0460.2
PRT40.010.050.0
CLT100.050.0150.0
CAT70.010.080.0
ETDSC60.000.060.0
OSDTSS130060.0190.1

Diseases of pulp and periapical tissuesNP5957.7387220.71463178.40.000
Plpts12696.86503.4191910.2
NOP2791.42421.25122.7
PD150.020.0170.0
AAPPlO220.1100.0320.1
AHTFP150.060.0210.0
CAP190.1100.0290.1
RDR9815.24592.414407.7
OUDPPT240.1140.0380.2

Dentofacial anomaliesNP1295769.55122.71807796.90.000
Mlcs670.3460.21130.0
TMJD2841.5570.33411.8
ATP280.1190.1470.2
AJCBR80.070.0150.0
MAJS80.030.0110.0
ASFT70.030.0100.0
DfclFA20.020.040.0
ADAR100.040.0140.0
DDJ00.010.010.0
DfclAU30.030.0600

Pearson chi-square test; significance level p <0.05.
3.2. Prevalence

When evaluating the prevalence of different oral pathologies of soft tissues, in the category of gingivitis and periodontal disease, there were 1,648 cases of acute gingivitis (8.8%), followed by 677 cases of chronic periodontitis (3.6%) and 417 cases of chronic gingivitis (2.2%), being more common in females (7.5%, 2.3%, and 1.6%, respectively), as well as other pathologies with a prevalence of <1% of the population. Regarding cysts of the oral region, there were 93 cases of radicular cyst, 37 cases of developmental odontogenic cysts, and other pathologies with a prevalence <1% of the population, being more common in females. With regard to periodontal abscess and sinus, there were 712 cases of periapical abscess without sinus (3.8%), being more common in females (2.0%), followed by 153 cases of cellulitis and mouth abscess and other pathologies with a prevalence of <1% of the population. There was a statistically significant association between these evaluated categories and sex (p <0.05). In the category of other lesions of oral mucosa and cavity, there were 34 cases of other and unspecified lesions of the oral mucosa, in addition to other pathologies with a prevalence of <1% of the population. Similarly, in the category of tumours, there were only 3 cases of central giant cell granuloma, with a prevalence of <1% of the population. However, these two evaluated categories showed no statistically significant association with sex, p >0.05 (Tables 3 and 4).


DiagnosisAbbrev.No.
Gingivitis and periodontal diseaseNot presentNP1554983.4
Acute gingivitisAG16488.8
Chronic gingivitisCG4172.2
Acute periodontitisAP1510.8
Chronic periodontitisCP6773.6
Gingival enlargementGE730.3
Periodontal disease, unspecifiedPDU60.0
StomatitisStoma310.1
Mucocele of salivary glandMSG290.1
AlveolitisAlvlts520.2
PeriodontitisPerio60.0

Other lesions of oral mucosa and cavityNot presentNP1856499.5
Leukoplakia and other disturbances of oral epithelium, including tongueLODOEIT90.0
Other and unspecified lesions of oral mucosaOULOM340.1
SialadenitisSialo40.0
Oral submucous fibrosisOSF90.0
Other diseases of lip and oral mucosaODLOM40.0
Irritative hyperplasia of oral mucosaIHOM20.0
Hairy leukoplakiaHL20.0
Gingival and edentulous alveolar ridge lesions associated with traumaGEARLAT400
Granuloma and granuloma-like lesions of oral mucosaGGLLOM300
GlossitisGlos40.0

Cysts of the oral region Not presentNP1849199.2
Radicular cystRC930.4
Developmental odontogenic cystsDOC370.1
Other cysts of the oral region, not elsewhere classifiedOCORNEC30.0
Other cysts of the jawOCJ150.0

Periapical abscess and sinusNot presentNP1769494.9
Periapical abscess with sinusPAWS770.41
Periapical abscess without sinusPAWtS7123.8
Cellulitis and abscess of mouthCAM1530.8
Cellulitis of faceCF10.0
Abscess of salivary glandASG20.0

TumourNot presentNP1863699.9
Giant cell granuloma, centralGCGC30.0


FemaleMaleTotalp
NnN

Gingivitis and periodontal disease NP1100859.0454124.31554983.40.000
AG14017.52471.316488.8
CG3041.61130.64172.2
AP890.4620.31510.8
CP4382.32391.26773.6
GE500.2230.1730.3
PDU30.030.060.0
Stoma190.1120.0310.1
MSG120.0170.0290.1
Alvlts460.260.0520.2
Perio30.030.060.0

Other lesions of oral mucosa and cavityNP1332071.5523528.01856499.50.313
LODOEIT60.030.090.0
OULOM180.0160.0340.1
Sialo30.010.240.0
OSF50.040.290.0
ODLOM40.000.040.0
IHOM10.010.020.0
HL10.010.020.0
GEARLAT20.020.0400
GGLLOM20.010.0300
Glos20.020.040.0

Cysts of the oral region NP1328471.5520727.91849199.20.046
RC580.3350.0930.4
DOC210.1160.0370.1
OCORNEC20.010.030.0
OCJ90.060.0150.0

Periapical abscess and sinusNP1285568.9483925.91769494.90.000
PAWS310.1460.2770.41
PAWtS3892.03231.77123.8
CAM970.5560.31530.8
CF10.000.010.0
ASG10.010.020.0

TumourNP1337271.1526428.21863699.90.494
GCGC10.020.030.0

Pearson chi-square test; significance level p <0.05.

4. Discussion

Oral pathologies are reasons for consultation, and according to the WHO, biofilm is an ecosystem that causes odontogenic infections. Different authors consider these lesions the major and most common oral pathologies in all age groups, being a reason for professional intervention [68]. The available literature indicates that the misdiagnosis of these lesions results in various diseases such as periodontitis, osteitis, and other lesions; also, nonodontogenic lesions cause diseases such as mucosal and gland infections and tumours [6, 10, 11].

Out of a total of 18,639 electronic clinical records from a Peruvian hospital, this study showed 8,404 cases of caries (45.1%), of which 1,221 cases (37.7%) corresponded to unspecified dental caries, being more common in females (30.6%), which is in agreement with the empirical evidence from studies in Germany and the USA, where there was a greater prevalence in females [12]. In another study [13], the prevalence of caries was 93.19% greater in females, with a sex ratio of 0.77. Previously, a high prevalence of caries (69%) was observed in university students in Hong Kong using the DMFT index, where female prevalence was higher than that of males like other studies [14, 15].

Regarding disorders of tooth development and eruption, there were 661 (3.5%) cases of an impacted tooth, being more common in women (n=391; 2.0%), with a male-to-female ratio of 1:1.3. This is similar to the results of a study in Turkey, where there were 1,117 cases (9.2%) with one or more impacted teeth and a male-to-female ratio of 1:1.4. However, these results contradict what was found in Tanzania, where a male-to-female ratio of 1.2:1 was recorded [16].

With respect to diseases of pulp and periapical tissues, the most common lesion was pulpitis (10.2%), followed by retained dental root (7.7%), pulp necrosis (2.7%), and other pathologies, such as acute and chronic apical periodontitis, with a prevalence of <1% of the population, being more common in females for all conditions. This differs from a study of 4,209 emergency patients in a university hospital, where 2,058 suffered odontogenic infections: most (45.0%) had apical periodontitis, 20.8% had abscesses, 17.3% had marginal periodontitis, 16.3% had pulpitis, and 5.8% had pericoronitis, with men being more affected than women [17].

In relation to dentofacial anomalies, the most prevalent condition was a TMJ disorder (1.8%), being more common in females (1.5%), which was consistent with findings from Finland where 18.5% of 1,962 patients presented with a TMJ disorder, being more common in females [18]. Also, within this category, there was a higher prevalence of females with tooth position anomalies and abnormalities of the size and form of teeth, which is in agreement with a previous study where 1,172 radiographs of 581 men and 586 women were reviewed, finding abnormalities of form, position, and number with 213 teeth anomalies, being more common in women [8].

In the category of gingivitis and periodontal disease, there were 1,648 cases of acute gingivitis (8.8%), followed by chronic periodontitis (3.6%) and chronic gingivitis (2.2%), being more common in females, unlike what was found in Jordan, where 76% were cases of gingivitis, 5.5% were chronic periodontitis, and 2.2% were severe periodontitis, the latter being more common in men than in women, with a male-to-female ratio [19] of 1.6:1. Our results are also contrast with previous studies where there was a higher prevalence of gingivitis in men [20, 21]. They also contradict the higher prevalence of periodontitis found in the adult male population in the USA [22].

Regarding cysts of the oral region, there were 93 cases of radicular cyst, 37 cases of developmental odontogenic cysts, and other pathologies with a prevalence of <1% of the population, being more common in females. These results differ from a study on the prevalence of odontogenic cysts in Sicily, where the most common lesions were radicular cysts (84.5%), followed by dentigerous odontogenic cysts (11.4%), with radicular inflammatory cysts being more common in males [23].

There are limitations such as a lack of literature related to the subject to verify results in some categories (diseases of hard tissues of teeth and other lesions of oral mucosa). The study results provide data and establish the prevalence of a disease and the most affected population, resulting in the predominance of females for almost all conditions. This study is important for its contribution to the institution for monitoring and reporting, aiming to conduct prevention campaigns and thus compare the results with future studies.

5. Conclusions

In conclusion, according to this 9-year retrospective study in a Peruvian hospital, females predominated in almost all pathologies, and a statistically significant association was found between sex and types of caries, disorders of tooth development and eruption, diseases of pulp and periapical tissues, and dentofacial anomalies.

A statistically significant association was also found between sex and gingivitis and periodontal disease as well as periodontal abscess and sinus. This study is pioneering because it determined the most prevalent oral pathologies at one of the main national hospitals in Peru, and its results are useful for oral and maxillofacial surgeons and pathologists.

Data Availability

The data used in the statistical analysis of this study will be available upon authorization of the corresponding managers of the university.

Conflicts of Interest

The authors declare that they have no conflicts of interest.

Acknowledgments

The authors want to thank the Universidad Privada San Juan Bautista and Hospital Maria Auxiliadora for its constant and disinterested support for the execution of the present retrospective study. Finally, the authors wish to thank the research group “Hunaq" for their incessant motivation in the execution of the present investigation.

References

  1. W. H. Schreuder, A. W. Coumou, P. A. H. W. Kessler, and J. De Lange, “Alternative pharmacologic therapy for aggressive central giant cell granuloma: Denosumab,” Journal of Oral and Maxillofacial Surgery, vol. 72, no. 7, pp. 1301–1309, 2014. View at: Publisher Site | Google Scholar
  2. M. Atar and E. J. Körperich, “Systemic disorders and their influence on the development of dental hard tissues: a literature review,” Journal of Dentistry, vol. 38, no. 4, pp. 296–306, 2010. View at: Publisher Site | Google Scholar
  3. M. Mascitti, A. Santarelli, A. Zizzi, M. Procaccini, L. L. Muzio, and C. Rubini, “Expression of p73 and TRAIL in odontogenic cysts and tumors,” Journal of Oral Science, vol. 58, no. 4, pp. 459–464, 2016. View at: Publisher Site | Google Scholar
  4. A. V. Jones, G. T. Craig, and C. D. Franklin, “Range and demographics of odontogenic cysts diagnosed in a UK population over a 30-year period,” Journal of Oral Pathology & Medicine, vol. 35, no. 8, pp. 500–507, 2006. View at: Publisher Site | Google Scholar
  5. J. Philip, L. Eversole, and G. Wysocki, Patologia oral y maxilofacial contemporánea [Contemporary oral and maxillofacial pathology], Harcourt Brace, Spain, 1989.
  6. A. Bascones, J. Aguirre, A. Bermejo et al., “Consensus statement on antimicrobial treatment of odontogenic bacterial infections,” Revista Medicina Oral Patología Oral y Cirugía Bucal, vol. 9, pp. 363–376, 2014. View at: Google Scholar
  7. R. Lopez, L. Aguilar, and M. Gimenez, “Management of odontogenic infection of pulpal and periodontal origin,” Revista Medicina Oral Patología Oral y Cirugía Bucal, vol. 12, pp. 154–159, 2007. View at: Google Scholar
  8. E. A. Saberi and S. Ebrahimipour, “Evaluation of developmental dental anomalies in digital panoramic radiographs in Southeast Iranian Population,” Journal of International Society of Preventive and Community Dentistry, vol. 6, no. 4, pp. 291–295, 2016. View at: Publisher Site | Google Scholar
  9. A. Acikgoz, E. Uzun-Bulut, B. Ozden et al., “Prevalence and distribution of odontogenic and nonodontogenic cysts in a Turkish population,” Revista Medicina Oral Patología Oral y Cirugía Bucal, vol. 6, pp. 108–115, 2011. View at: Google Scholar
  10. R. Scott and J. Dillon, “Non-odontogenic Cyst of the jaws and treatment in the pediatric population,” Oral and Maxillofacial Surgery Clinics of North America, vol. 28, pp. 31–44, 2016. View at: Google Scholar
  11. D. J. Theodorou, S. J. Theodorou, and D. J. Sartoris, “Primary non-odontogenic tumors of the jawbones: An overview of essential radiographic findings,” Clinical Imaging, vol. 27, no. 1, pp. 59–70, 2003. View at: Publisher Site | Google Scholar
  12. C. Gleissner, “How does gender influence oral health?” Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz, vol. 57, no. 9, pp. 1099–1106, 2014. View at: Publisher Site | Google Scholar
  13. Y. Ouedraogo, W. A. D. Kabore, T. Konsem et al., “Tooth decay: epidemiological and therapeutic aspects in dental service of University Teaching Hospital Yalgado Ouedraogo and Municipal Centre of Oral Health,” Odonto-Stomatologie Tropicale, vol. 38, no. 152, pp. 49–55, 2015. View at: Google Scholar
  14. C. H. Chu, A. Ng, A. M. Chau et al., “Dental Erosion and Caries Status of Chinese University Students,” Oral Health & Preventive Dentistry, vol. 13, pp. 237–244, 2005. View at: Google Scholar
  15. K. Gündüz, A. Acikgöz, and E. Egrioglu, “Radiologic investigation of prevalence, associated pathologies and dental anomalies of non-third molar impacted teeth in Turkish oral patients,” Chinese Journal of Dental Research, vol. 13, no. 237-244, 2011. View at: Google Scholar
  16. F. Msagati, E. N. M. Simon, and S. Owibingire, “Pattern of occurrence and treatment of impacted teeth at the Muhimbili National Hospital, Dar es Salaam, Tanzania,” BMC Oral Health, vol. 13, no. 1, p. 37, 2013. View at: Google Scholar
  17. B. Mahmoodi, J. Weusmann, A. Azaripour et al., “Odontogenic Infections: A 1-year Retrospective Study,” The Journal of Contemporary Dental Practice, vol. 16, pp. 253–258, 2014. View at: Google Scholar
  18. P. Jussila, H. Kiviahde, R. Näpänkangas et al., “Prevalence of temporomandibular disorders in the northern Finland birth cohort 1966,” Journal of Oral and Facial Pain and Headache, vol. 31, no. 2, pp. 159–164, 2017. View at: Publisher Site | Google Scholar
  19. K. T. Ababneh, Z. M. F. Abu Hwaij, and Y. S. Khader, “Prevalence and risk indicators of gingivitis and periodontitis in a Multi-Centre study in North Jordan: A cross sectional study,” BMC Oral Health, vol. 12, no. 1, 2012. View at: Google Scholar
  20. Y. Li, S. Lee, P. Hujoel et al., “Prevalence and severity of gingivitis in American adults,” American Journal of Dentistry, vol. 23, pp. 9–13, 2010. View at: Google Scholar
  21. M. M. Idrees, S. N. Azzeghaiby, M. M. Hammad, and O. B. Kujan, “Prevalence and severity of plaque-induced gingivitis in a saudi adult population,” Saudi Medical Journal, vol. 35, no. 11, pp. 1373–1377, 2014. View at: Google Scholar
  22. P. I. Eke, B. A. Dye, L. Wei et al., “Update on prevalence of periodontitis in adults in the United States: NHANES 2009 to 2012,” Journal of Periodontology, vol. 86, no. 5, pp. 611–622, 2015. View at: Publisher Site | Google Scholar
  23. S. Tortorici, E. Amodio, M. F. Massenti, M. L. Buzzanca, F. Burruano, and F. Vitale, “Prevalence and distribution of odontogenic cysts in Sicily: 1986-2005,” Journal of Oral Science, vol. 50, no. 1, pp. 15–18, 2008. View at: Publisher Site | Google Scholar

Copyright © 2019 Ángelo Sabogal et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


More related articles

1349 Views | 287 Downloads | 0 Citations
 PDF  Download Citation  Citation
 Download other formatsMore
 Order printed copiesOrder

Related articles

We are committed to sharing findings related to COVID-19 as quickly and safely as possible. Any author submitting a COVID-19 paper should notify us at help@hindawi.com to ensure their research is fast-tracked and made available on a preprint server as soon as possible. We will be providing unlimited waivers of publication charges for accepted articles related to COVID-19. Sign up here as a reviewer to help fast-track new submissions.